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Good afternoon. Good evening. Good morning from wherever you are joining. Uh welcome to the Zoom Academic Meeting of the Department of Pediatric Surgery on Tuesday 13th of May 2025. And we have Doctor Martin Douglas Jones who is going to talk to us about intra oral and maxillofacial pathologies. What do pediatric surgeons need to know? So, Doctor Jones is um he is a maxillofacial and oral surgeon at and Red Cross War Children's Hospital in Cape Town. He did his undergraduate dental degree at the University of Stellenbosch. He did his medical degree at the Wits University in Johannesburg. He did his registered training at University of Western Cape in Cape Town and an a fellowship in Basel Switzerland. He has worked in the Eastern Cape as a medical officer and as a Maxillo Fisher and oral surgeon consultant. He graduated from the surgical leadership program, Harvard University class of 2022 2023. And I know Martin is a very family man and he is friend with many of us uh in East London. We miss him here, but we understand uh and, and we support his career choices. So, Martin, I will stop sharing, you can share your screen and you can start your talk. Thank you. Thank you very much prof uh It's um always nice to, to chat to you and, and, and thank you for a very kind introduction. II sort of appreciate that. As, as you mentioned, I've got a very soft spot for the Eastern Cape. Um and, and it's great to, to be with you today. So, and sort of in preparation for this talk. I didn't really want to come across as um sort of punting maxillofacial surgery. Um, but it may come across that way and, and, and, uh, I sort of the, the hope is that this talk would be quite informal and if you do want to stop me as we're going along, please, please do. Um, yeah, so, so the thought is I just want to give you sort of AAA brief idea of maxillofacial surgery and, and, and then we can sort of, um, sort of unpack it as, as we sort of move along. So, so the title I II try to be clever and sort of get a few t together here. So, teeth Trauma and Tiny face pathology, um, maxillofacial surgery for the pediatric surgeon. So, just, just briefly a sort of a roadmap um to this presentation, um I'm just going to give you sort of an introduction to maxillofacial and oral surgery. I think it, it, it is a really small um speciality and, and often sort of not really well understood. Um, I'm also going to sort of look at some key aspects of maxillofacial and oral surgery and I'm going to add dentistry to that as well because I think, um, often sort of within sort of medical training. Um, I know when I was at med school there was almost sort of no dental training, um, in, in the undergraduate medical program. I'm hoping that we're going to be able to sort of put, put everything together and, and see how maxillofacial surgery fits into. So the hospital and, and definitely into pediatric surgery and then sort of just sort of briefly do deal with maxillofacial and oral pathologies. And I think um one of the things to, to bear in mind is that any one of these um pathologies could sort of have a lecture on its own and, and we're going to try and just keep it quite informal, um and very superficial. Um But I am willing and happy to take questions as we go along. So the objective of, of this talk would be to highlight the relevance of maxillofacial and oral surgery in, in pediatric surgical practice. And then hopefully for everyone to understand maxillofacial pathology and maxillofacial surgery scope a little bit better and then sort of sort of putting it all together is that sort of to try and highlight the importance of interdisciplinary sort of understanding and, and multidisciplinary teams um in patient management So, so what is maxillofacial surgery? And I think, often sort of when sort of, we, we, we think of maxillofacial surgery, we sort of see this picture on the right hand side of the screen, we sort of think of sort of wisdom teeth. Um, and, and, and I think that's sort of generally, sort of the perception sort of out in the public and possibly sort of within the sort of medical fraternity as well. But generally, it's sort of the way, the best way to explain it would be that it's a surgical speciality focusing on sort of the mouth and teeth, the jaws and the face and the neck and sort of putting together sort of pathology of both the heart and the soft tissues in this region. Sort of, we often sort of joke and say that we sort of the orthopedic surgeons of the face plates and screws that we would, we would use. Um quite often sort of in, in a lot of the procedures we perform. This is, this is um the TSI Karma bridge. So it's, it's, it's the bridge between sort of often if I'm sort of heading down to East London, um, from Cape Town, I crossed this bridge. Um, but I think sort of maxillofacial surgery is sort of the bridge between medicine and dentistry. And uh yeah, I think sort of that it's a good sort of way of describing maxillofacial surgery. So the key aspects of maxillofacial surgery would be dental alveolar surgery, which would include things like um, surgical removal of teeth. Um, dental implants, obviously sort of dental implants in the pediatric population would be very limited. Maxillofacial trauma T MJ T MJ is sort of very sort of um different within the sort of the adult and the pediatric population, facial pain. We don't often deal with facial pain in the pediatric um population, but it is, is most certainly present and what we're finding is more and more sort of um that it is becoming an issue, particularly within sort of um adolescents. Then also then sort of looking at sort of maxillofacial um pathology and these would include obviously sort of benign and malignant pathologies of both the bone and the soft tissue as well as the salivary glands. I am going to deal briefly with orthognathic surgery and then sort of craniofacial um and cleft um pathologies generally sort of maxillofacial surgery, sort of sort of operates sort of in interdisciplinary teams and, and sort of from the dental side, we often work with the dentist which are sort of omitted from this, ii, apologize to the dentist here, but sort of working closely with the dentist who work quite closely with prosthodont prosthodontists, which are sort of people who build prostheses for the mouse. So often sort of um dentures or sort of implant um retained um prostheses to help with function. They also sort of help and often do things like crowns and veneers and, and do quite a lot of aesthetic work. Then there's periodontics and oral medicine and they often sort of are involved with sort of the structures that support the teeth. So the bone and the ligaments that hold the teeth in the mouth and then sort of um the oral medicine side would be sort of the systemic sort of involvement of the oral oral environment um in systemic disease, orthodontics is something that I think most of us sort of are aware of and that would be um sort of dealing with sort of the, the misalignment and malalignment of teeth and sort of putting on braces and straightening the teeth and sort of getting a good smile. There are maxillofacial and oral surgical pathologists who are quite similar to anatomical pathologists, but their, their sole sort of focus is obviously sort of head and neck, pediatric dentistry. We work closely with them. Um I put them in brackets because they aren't actually a sort of a specialty at, at, at this point, but they are sort of striving to become one and are in the process of getting that ball rolling. And then we sort of work with other allied health sort of professionals within sort of the dental realm. And that would be sort of the, the oral hygienist, generally sort of on, on the medical front. We sort of generally work quite closely with the plastic and reconstructive surgeons Um here in the Western Cape, we actually share the, the, the um trauma core rosal core roster with, with the plastic and reconstructive surgeons. We, we work quite closely with neurosurgery and ent and ophthalmology and, and that would sort of make sense just because we sort of in that sort of area, we sort of all sort of standing on each other's toes. Um We work quite closely with the pediatric surgeons down here, obviously with medical genetics, particularly in the in, in the pediatric population and then sort of with the allied health um uh professionals. So things like the audiologists, um the speech therapists, the dieticians, um so, so interface areas where we sort of work with the pediatric surgeons. And I think sort of we all have sort of this ideal um sort of outlook um to the patient where we sort of looking at the biopsychosocial model and we are trying to sort of give the patient the most comprehensive care. I think sort of we obviously sort of need to be looking for from a maxillofacial point of view, pediatric surgical conditions and from a pediatric surgical point of view, looking for maxillofacial surgical conditions, I think sort of what we're finding is that the pediatric surgical um discipline is obviously sort of the first to sort of identify maxillofacial and oral surgical pathology and, and refer on. And sort of, I think we're all looking for the best patients outcomes and to work in sort of multidisciplinary teams where we can all learn off of each other. So sort of key considerations from a dental perspective. Um and I'm just going to go through these quickly cause I'm going to try and sort of make it a little bit more interesting with pictures and describe them with pictures. But I think sort of it's important to, to, to know sort of normal tooth development um as well as stages and, and the normal oral anatomy, I think sort of tooth decay and is something.