Reconstructive maxillofacial surgery refers to the wide range of
procedures designed to rebuild or enhance soft or hard tissue
structures of the maxillofacial region. Ablative tumor surgery
(benign or malignant) and traumatic injuries (especially avulsive)
commonly demand reconstructive procedures to restore the
functional and cosmetic deficit. Loss of soft or hard tissue
secondary to infectious processes (e.g. osteomyelitis), or tissue
injury due to radiation (e.g. osteoradionecrosis) may also require
reconstructive measures. In addition the decrease in quantity and
quality of maxillo-mandibular structures with age (that may be
accelerated by other processes such as early teeth loss), can be
addressed with reconstructive measures to augment the tissue for
restoration using dental implants.
In the past two
decades three developments have revolutionalized the
reconstruction of the maxillofacial structures. First, the
understanding of bone biology has allowed advanced bone grafting
procedures in a variety or circumstances (e.g. sinus lift
procedures, mandibular augmentation/reconstruction). Second, the
advent of microvascular free flap techniques allows the transfer
of tissue to reconstruct large soft and/or hard tissue defects
(e.g. radial forearm fasciocutaneous or fibula osteocutaneous free
flaps). Thirdly, the development and advances in dental implant
techniques allows for successful dental rehabilitation. More
recently, purification and identification of bone morphogenic
proteins (BMP) and other chemicals that induce new tissue (bone)
formation are becoming available, but remain to be fully
elucidated. Future research may reveal methods of regenerating
neural and muscle tissue. Future molecular biology techniques
using gene therapy may reveal further knowledge that can be
applied to maxillofacial reconstruction.
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