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GUEST EDITORIAL
Year : 2017  |  Volume : 7  |  Issue : 2  |  Page : 163-164

To infinity…. and beyond!!


Department of Maxillofacial and Oral Surgery, School of Oral Health Sciences, University of Witwatersrand, Johannesburg, South Africa

Date of Web Publication22-Nov-2017

Correspondence Address:
Wynand Van Der Linden
Department of Maxillofacial and Oral Surgery, School of Oral Health Sciences, University of Witwatersrand, Johannesburg
South Africa
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DOI: 10.4103/ams.ams_92_17

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How to cite this article:
Linden WV. To infinity…. and beyond!!. Ann Maxillofac Surg 2017;7:163-4

How to cite this URL:
Linden WV. To infinity…. and beyond!!. Ann Maxillofac Surg [serial online] 2017 [cited 2017 Dec 14];7:163-4. Available from: http://www.amsjournal.com/text.asp?2017/7/2/163/218982





Current oral and maxillofacial surgery is benefiting greatly from technological advances. Having had the privilege of experiencing the inception and refinement of a number of them, I often feel like the author HG Wells who wrote “I must confess my imagination refuses to see any submarine doing anything but suffocating its crew and floundering at sea”! Thank goodness for innovators who dream and before long, change our lives!

In a developing country that often lacks resources taken for granted in developed countries, the cornerstone of clinical experience is usually trauma management. Registrars would wet their fingers wiring fractured mandibles, performing a Gillies Lift and occasionally performing “an open reduction with wire fixation “of severely displaced fractures. Zygomatic and maxillary fractures required suspension wires from the Frontozygomatic suture area or Zygomatic arch, while orbital fractures required much guesswork and crude biomaterials skilfully utilized!

How satisfying to be able to plan a complex trauma case from a computed tomography scan with three-dimensional images from which a stereolithographic model, prebent fixation plates, meshes, and developed custom-made implants planned on the volumetric analysis of an orbit! Pharmaceutical advances have assisted in reducing the complications encountered and improving patient recovery periods.

The advent of cone beam computerized tomography has greatly enhanced treatment outcomes in dental implantology and even wisdom teeth removal. Where additional information about the exact location of the inferior alveolar nerve is advantageous, treatment outcomes can be improved and risks diminished. Additional planning software can allow for guided implant placement in technically challenging sites and thereby improve the prosthodontic results. The patient expectations can also be met by delivering same day prostheses where indicated.

Perhaps it is in the field of ablative surgery for pathological lesions, cleft lip and palate repair and craniofacial anomalies that technology has assisted modern day surgeons the most. The ability to detect and then plan treatment with advanced imaging has greatly assisted the surgeon in enabling a relatively rapid rehabilitation, reconstruction, and return to a reasonably normal appearance and lifestyle. Customized reconstruction plates, templates, and implants mimic the “normal” as closely as possible, limiting the potential for complications and providing much improved esthetic and functional outcomes. Surgical skill utilizing vascularized tissue transfer combined with dental and craniofacial implants have greatly increased the predictability of these once challenging and often morbid procedures. Recovery times for the patient are now much shorter, and quality of life can be much improved.

We are now in the realm of biochemical reconstruction manipulating stem cells and providing necessary growth factors to allow tissue regeneration. Recognizing the tissue markers and proteins necessary for repair will soon further promote superior treatment outcomes. Devices harnessing these elements such as in Distraction Osteogenesis within the body are already well developed in reconstructive surgery.

How privileged we are to practice in the field of oral and maxillofacial surgery at this time. “We continue to fine tune not only the technology but also how the technology is implemented” (Craig Littlepage). Marc Andreessen said “You are cruising along, then technology changes you. You have to adapt!”

However, learned people have warned against becoming over dependent on technology. Christian Louis Lange wrote “Technology is a useful servant, but a dangerous master.” Billy Cox said “Technology should improve your life, not become your life.” We are healers often dealing with frightened, stressed and sensitive individuals and their families. A physician, John Doolittle wrote “Developments in medical technology have long been confined to procedural or pharmaceutical advances, while neglecting a most basic and essential component of medicine: Patient information management.” Let us also heed the warning of Albert Einstein who wrote “I fear for the day when technology will surpass human interaction. The world will have a generation of idiots!”

The role of the physician is to minister to his fellow beings utilizing technology to optimize the patients recovery. Let our focus on technology enhance rather than detract from our patient care!






 

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