Oral Surgery as a Clinical Discipline
Oral surgery is a clinical discipline that studies diseases of the oral cavity and jaws, in which surgical intervention is the main method in outpatient complex treatment.
Oral surgery is closely related to other dental disciplines, such as maxillofacial surgery, orthodontics, therapeutic, prosthetic and pediatric dentistry. This connection is due to the anatomical, topographic and physiological unity of the oral cavity organs, the maxillofacial region and the pathological processes that develop in them. Complex treatment of dental diseases often requires participation of dentists of all specialties.
In addition to that, oral surgery is connected to other medical specialties. These include radiation diagnostics, therapy, surgery, otorhinolaryngology, ophthalmology, neurology, dermatology and others. One cannot ignore the fact that dentistry is also based on the achievements of many branches of the fundamental medicine, such as normal and topographic anatomy, normal and pathological physiology, microbiology, pathological anatomy, pharmacology, natural sciences, biophysics, biochemistry, etc.
Diseases the study of which is within the competence of oral surgery can be subdivided into a number of groups depending on their etiology, pathogenesis, pathological physiology and pathological anatomy, clinical picture and specifics of surgical treatment.
- Inflammatory diseases of the oral cavity and jaws. These include:
- odontogenic inflammatory diseases (acute and chronic periodontitis, alveolitis and post-extraction socket osteomyelitis, pericoronitis, acute periostitis of the jaw, osteomyelitis of the jaw, abscess, phlegmon, lymphadenitis, odontogenic maxillary sinusitis);
- infections:
- specific (actinomycosis, tuberculosis, syphilis);
- non-specific (furuncle, carbuncle, erysipelas, anthrax, noma);
- inflammatory diseases of the salivary glands, temporomandibular joint and facial nerves;
- injuries to the oral cavity organs, face, bones of the facial skull of non-firearm and gunshot origins; mixed injuries, as well as combined injuries during radiation exposure; thermal, chemical and other injuries; frostbite;
- diseases and lesions of the nerves of the face and jaws, and the temporomandibular joint;
- tumors and tumor-like lesions of the face, jaws and oral organs, modern methods of their diagnostics according to the International Classification of the World Health Organization;
- congenital and acquired defects and distortions of the face and jaws;
- diagnostic methods and referral of patients to specialized hospitals.
Dental diseases often require urgent surgical interventions (e.g. acute inflammatory and traumatic diseases including the resulting suffocation, bleeding, shock, etc.) and planned operations (e.g. precancerous conditions and neoplasms of the oral cavity; chronic inflammatory diseases; trauma; bone grafting; dental implant surgery; mucogingival surgery, etc.).
A dentist, regardless of his specialty, must be able to provide the first aid in emergency conditions such as fainting, collapse, shock, coma, heart and respiratory failure, myocardial infarction, hypertensive crisis, epileptic seizure, allergic reactions, traumas (including thermal ones), snake bites, poisoning, etc.
Among the operations that any dentist should be able to perform, a special place is occupied by tracheotomy.
History of the Development of Oral Surgery
The origins of oral surgery go back centuries, as evidenced by artifacts found during many excavations in Egypt and India. Attempts to replace the missing tooth with an artificial one have been made by mankind since ancient times. In ancient Egypt people tried to restore lost teeth with endosseous structures, as described by the found handwritten sources and skeletal remains. In one of the museums in Peru there is an Inca skull with 32 teeth that constitute implants made of quartz and amethyst. This operation was performed in the 800s AD.
Operations performed on the jaws were described in the writings of Hippocrates in the 5th century BC. From them it became known that the teeth were then removed with forceps made from lead. In his books, the ancient Greek doctor not only described dental diseases, but also tried to explain the reasons for their occurrence.
Despite the fact that the simplest surgical interventions were performed in ancient times, the development of this area of dentistry was rather slow. A significant leap took place in the 16th century, in France. At that time, the surgeon Ambrauz Paré began to remove teeth with the help of forceps that were modern at that time. He developed the algorithm for this procedure, described the indications and contraindications for it, and began to perform such a revolutionary procedure as replantation of a tooth after its complete dislocation or for the treatment of periodontitis.
Universities opened in Italy, France, Switzerland and Germany, in which surgeons were trained, were of great importance for the development of oral surgery. However, church prohibitions halted the development of oral surgery for nearly two centuries.
Important discoveries were made in the 18th century by one of the founders of dentistry - the Frenchman Pierre Fauchard, who described in his writings various aspects of oral surgery.
In Russia, the development of oral surgery occured even more slowly than in European countries. However, the need for such operations was especially pressing during the period of epidemics and wars. For these purposes, in the 14th century, hospital wards at churches have been created, in which monks were engaged in the extraction of teeth and treatment of facial wounds. At that time, there were 18 such monasteries in Moscow. Under Dmitry Donskoy, surgeons came from Europe. They not only treated privileged persons, but also shared their knowledge and experience with Russian doctors.