[MUSIC] Hi, my name is Helen Giannakopoulos. I'm an oral maxillofacial surgeon. Oral maxillofacial surgeons care for patients with problem wisdom teeth, facial pain, and misaligned jaws. They treat accident victims suffering facial injuries, place dental implants, care for patients with oral cancer, tumors, and cysts of the jaw, and perform facial cosmetic surgery. Their advanced training in anesthesia allows them to provide quality care with maximum patient comfort and safety in the office setting. The areas that we practice in are, administration of anesthesia, wisdom teeth management treatment of facial injury, corrective jaw surgery, facial cosmetic surgery, TMJ and facial pain, dental implant surgery, head, neck, and oral cancer, obstructive sleep apnea, cleft lip palate, and craniofacial surgery. Oral maxillofacial surgeons are the only dental specialists recognized by the American Dental Association, who are surgically trained in a hospital-based residency program for a minimum of four years. They train alongside medical residents in internal medicine, general surgery, and anesthesiology, and spend time in otolaryngology, ear, nose, and throat plastic surgery, emergency medicine and other specialty areas. This training focuses almost completely on the bone, skin, and muscle of the face, mouth and jaw. Oral and maxillofacial surgeons have knowledge and expertise that uniquely qualifies them to diagnose and treat a number of functional and aesthetic conditions in this anatomical area. I next want to show you some images of the types of procedures that oral maxillofacial surgeons do. This first image is of a young boy about seven years old, who has a large mass in his lower jaw and you can see the clinical photo of excession of the mass. This is an x-ray of the young boy, about a year later, you can see bone has filled in the area where the mass was removed and you can see the mass on the right hand side. This next image is of a young girl who fell while playing in the playground, and avulsed her two left front teeth. They were repositioned and a wire was placed to hold the teeth into position until they healed. This next image is of an older lady who came in and wanted dental implants, and on the left hand side of the screen, where the x-rays are, you can see that kind of darker structure, that's her sinus that has grown into the area where the bone used to be because she's been missing teeth for so long. So we had to do a bone graft and you can see that on the right hand side, and you can see the implants in place and this is with the case restored and you can see all her teeth have been placed on to the implants. This next case is a facial trauma case. This young man was in a motor vehicle accident and had an extensive laceration over his lower jaw as well as a broken jaw and you can see plates used to reposition the broken bones and at the bottom right-hand of the screen, you can see his lacerations have been re-approximated as well. This next image shows you a total joint replacement of the temporomandibular joint you can see the upper component is made of polyethylene and the lower component is made of chrome cobalt, with is a metal, and this can last in a patient for about 15 to 20 years, and then they would need to get it replaced. This next patient also had a total joint replacement, but the reason for his replacement was that he had ankylosis and you can see that on the top right screen. Where the bone has overgrown in that area. He had a history of trauma and he was a young boy and on the bottom left you can see he cane barely open his mouth, maybe to fit a finger through there. Well, we placed a total joint replacement on both the right and left temporomandibular joint and you can see we advanced his jaw forward, which is the middle part of the screen and now you can see he can open widely. This other patient also had a total temporomandibular joint replacement. You can see she has an open bite on the top right of the screen, where her teeth aren't coming together and then after she's had the replacement, which is in the bottom part of the screen, you can see her teeth now come together. And here's her x-ray showing that, you can see on the left side where she has the open bite where her teeth aren't matching up and then the total joint replacements and now her teeth line up. This is another trauma case. You can see small little fragments of the condolar head which is the top of the joint and those fragments were removed. Otherwise, you can get an ankylosis, like that other gentleman that I showed you. Here's another fracture of this area. And you can see plate repositioning that broken bone. This is another young lady who fell while giving a speech, and she actually displaced her jaw joint, or condyle, into the middle cranial fossa, or the brain cavity and you can see it kind of popping through where it shouldn't be on the x-ray images. And here's her after we repaired her broken jaw. This is another type of fracture that we encounter over the frontal sinus. That you can see the plates that we had to place over to reapproximate those, otherwise the patient will have a little depression in that area and in order to access this we have to make a little incision on the scalp and pull everything forward. Otherwise they have an unsightly incision over the over their forehead region. And lastly, this is a patient who had a jaw advancement surgery. The preoperative image is on the left. You can see the lower jaw is much bigger than the upper jaw so we had to advance the upper. Jaw forward, and slightly move the lower jaw back. So the primary problem was in the upper jaw, and you can see a much more normal profile now. These are some of the procedures that oral maxillofacial surgeons do. Hopefully, you have a better understanding of the specialty, and thank you for your time.
