In 2006, it was 50 years ago that the oral and maxillofacial surgery was officially recognized as a dental speciality in the Netherlands. During those five decades, oral and maxillofacial surgery significantly evolved, which is nicely reflected by the changes in the name of the scientific society supporting the speciality. Originally its name was the Netherlands Society for Oral Surgery and Surgical Prosthodontics, but in 1975 its name was changed into the Netherlands Society for Oral Medicine and Oral Surgery, and in 2006 into the Netherlands Society for Oral Medicine and Oral and Maxillofacial Surgery. Esser is considered to be the first oral and maxillofacial surgeon in the Netherlands. In the Netherlands, 2 schools of oral and maxillofacial surgery are recognized: the Utrecht School with Tjebbes as its founder and the Groningen School with Hut as its founder. Because of the 50th anniversary of the speciality, a thematic issue of the Dutch Journal of Dentistry offers a review of the current status of and expected future developments in oral medicine, head and neck oncology, maxillofacial traumatology, growth and development disorders of the maxillofacial skeleton, temporomandibular joint disorders and reconstructive surgery in the Netherlands.

The field of oral and maxillofacial surgery has greatly evolved during the last five decades. In the Netherlands, oral medicine is covered by the specialist inoral and maxillofacial surgery. Related to the increase in the ageing of the population, it is expected that both the dentist and the family dentist will more and more faced by patients with less usual oral disorders, either as a sign of a local disease or as a sign of a general (systemic) disease. Regarding research, there is a trend of a shift from therapeutic towards innovative research. Therapeutic research is mainly aimed at treating symptoms, whereas innovative research tries to increase insight in development of a disorder or to prevent the development of that disorder or to reduce its progression.

The incidence of head and neck tumors in the Netherlands is rising, mainly due to increasing numbers of oral and pharyngeal carcinomas. Notwithstanding good opportunities for early detection by inspection and palpation, there appears to be a tendency to detect cancer of the head and neck in its later stages. Dentists and physicians, therefore, need to become aware of the early signs of head and neck cancer, and to keep their knowledge up to date. The oral and maxillofacial oncolo-gist operates both as a gatekeeper specialist and as a participant in the multidisci-plinary head and neck oncology team, treating patients with referrals from other disciplines. His input in the team is substantial because of his specific knowledge of treatment of tumors, and also on account of his expertise in the possibilities for reconstruction and functional restoration of defects following ablative surgery.

During the last 50 years, significant developments have taken place in the treatment of cranio-maxillofacial fractures. The aim of treatment is to achieve the most complete possible restoration of facial functions Epidemiologic figures for these fractures are sparsely available in the literature, but traffic accidents, acts of violence and sports injuries appear to be the main causes. Currently, treatment of facial trauma is aimed at early and (nearly) complete restoration of function. To achieve this goal almost exclusive use is made of stable osteosynthesis methods in the Netherlands. An optimal fixation method exists for nearly every cranio-maxillofacial trauma due to the availability of a large variety of osteosynthesis materials, from micro-plates to reconstruction plates.

Due to many developments in oral and maxillofacial surgery, the contribution of oral and maxillofacial surgeons in the diagnostics and treatment of growth and development disorders of the craniomandibulo-maxillofacial skeleton has become more and more important. Many disorders are treated by multidisciplinary teams including orthodontists and prosthodontists. Arbitrarily, 3 categories of growth and developmental disorders can be distinguished: dentoalveolar, dento-maxillofacial, and dento-maxillo-craniofacial disorders. In addition to classic bony reconstruction methods, new methodologies have been developed, such as distraction osteogenesis and simultaneous skin and soft tissue corrections. For many decades, the treatment of growth and development disorders has been a frequent subject of doctoral dissertations in the Netherlands. Attention is currently being paid to developing methods for threedimensional planning and correction of these disorders, and methods which are minimally invasive.