Issue 49 / April 2017
Editor-in-Chief Javier González Lagunas
Assistant Editor Deepak Krishnan
Graphic Designer María Montesinos
Executive Committee 2016 - 2017 Board of Directors Julio Acero, President Piet Haers, Immediate Past President Alexis Olsson, Vice President Gabriele Millesi, Vice President-Elect Arthur Jee, Treasurer Larry Nissen, IAOMS Foundation Chairman Mitchell Dvorak, Executive Director
Members-at-Large Javier González Lagunas Sanjiv Nair David Wiesenfeld
Regional Representatives Abdellfattah Sadakah, Africa Kenichi Kurita, Asia Nick Kalavrezos, Europe Alejandro Martinez, Latin America Arthur Jee, North America Jocelyn Shand, Oceania Nabil Samman, Editor-in-Chief, IJOMS
Committee Chairmen Rui Fernandes, Education Committee Joseph Helman, Research Committee Deepak Krishnan, IAOMS NextGen Committee Steve Roser, COGS Committee Fred Rozema, IT Advisory Committee Mark Wong, IBCSOMS Representative Nabil Samman, 23rd ICOMS-2017, Hong Kong Luiz Marinho, 24th ICOMS-2019, Brazil David Koppel, 25th ICOMS-2021, Glasgow
CONTACT US IAOMS
8618 W. Catalpa Ave., Suite 1116, Chicago, IL U.S.A. 60656 1.773.867.6087 / communications@iaoms.org
Letter from the Editor HOW I SEE IT Javier Gonzรกlez Lagunas EDITOR-IN-CHIEF
We want to celebrate the outstanding ICOMS we held in Hong Kong. There is no better way to learn, share your knowledge and network with colleagues from all over the world. So, read Face to Face, and share it with your friends and contacts.
CONTENTS April 2017 10 SPECIAL REPORT
Backstage in Hong Kong PHOTO GALLERY... 16
22 WOMEN IN IAOMS
Dr. Suzanne Mc Cormick FROM PROUST TO PIVOT 24 Prof. Andrew Heggie
28 COPY ME
Coronal Split Corpus Osteotomy Technique to Enhance the Bone Volume of the Atrophic Mandible NOTE ON... 29 Hands-on Surgical Training Workshop in Nairobi
30 NEXT GEN
Mandible Maxillofacial Surgery in Kenya and the East African Region
34 WHERE ARE THEY NOW? Dr. Kishore Nayak
WORKING IN PARADISE 32 Brisbane BEYOND THE OR 36
You have to eat your cookies while they are being passed
GREAT TO MEET YOU….
T
he IAOMS Headquarters Team returned earlier this month from our first ICOMS. We enjoyed meeting (and learning from) so many IAOMS members and other Conference attendees from more than 70 countries. Thank you for taking time to attend this IAOMS signature event. Additionally, a big THANK YOU and congratulations to Prof. Nabil Samman and his team, along with Dr. Alfred Lau and the Hong Kong Association of Oral and Maxillofacial Surgeons, for their tireless work to plan and produce a terrific ICOMS. In the coming weeks, we will review your feedback and incorporate it as we plan ICOMS 2019. While each of us comes away from the Conference with increased knowledge, insights and new (or renewed) friendships, I would like to share some of my ICOMS highlights – and give you a glimpse of what’s upcoming in the second half of the year. Scientific – and Other -- Sessions The sheer number, variety and expert presentations lived up to its name: “From Innovation to Excellence.” In total, we had 135 sessions, including the Plenary Session and Presidential Lecture, Symposia, Free Paper Sessions, Master Classes and Workshops. Thank you to each and every presenter – along with everyone who submitted papers. I was particularly pleased to see the turnout at the NextGen Forum – geared to the next generation of OMF surgeons. Through the NextGen Council, we have representatives from each global region who will be our conduit to trainees and young surgeons. My thanks to IAOMS Vice President-elect Dr. Gabriele Millesi and Drs. Deepak Krishnan and Alfred Lau for planning such an informative session. I’m looking forward to updating you on the Next Gen Council’s progress. New this year at ICOMS: the DET session – a lively, entertaining and educational afternoon to help all of us think “outside of the box.” And while we know OMF Surgeons are highly skilled, we didn’t know that many also can carry a tune; we heard some great music from the Band of OMF surgeons, decked out in their IAOMS bow ties. Partnerships We were pleased to meet with leadership of several national associations to discuss closer collaboration and
ideas for how IAOMS could be of even greater service to their members. If you’re in a leadership position with your national organization and you’re interested in talking further about how the IAOMS can help your members, please contact Katie Cairns kcairns@iaoms.org. Social Events The Local Organizing Committee showcased “Asia’s World City” from the top of Hong Kong’s tallest building – the International Commerce Centre. The evening sky was crystal clear, allowing our 800 guests to see this skyscraper city and taste some of Hong Kong’s delicious local cuisine. The next night, our Gala was yet another unforgettable evening with approximately 400 guests who dined and danced the night away. And my thanks to those of you who attended the IAOMS Foundation Luncheon, the Laskin Legacy Society Reception and the Foundation Golf Tournament (read more about these events and the funds you raised in Dr. Nissen’s column on page XX). Certainly one of the real ICOMS 2017 highlights for me was seeing and talking with Dr. Daniel Laskin, one of the specialty’s pre-eminent surgeons. Up Next… We are moving ahead with strengthening our educational and digital capabilities. Late last year, we conducted an education study (consisting of qualitative and quantitative research) to understand the educational needs of members. Our Education consultant presented results and recommendations during the pre-ICOMS Board and Executive Committee meetings. I’m pleased to report that we will begin implementation of this educational programming later this spring/summer. And the Board and Executive Committee approved the re-development of the IAOMS website. We recognize the importance of digital communications and will develop a website that will become an IAOMS “hub” – for information, member-tomember communication, and education. Stay tuned for updates on both of these initiatives. Thank you for your membership and your commitment to IAOMS and the IAOMS Foundation. With your support, we continue to help you build your practice and our profession. Regards, Mitchell Dvorak EXECUTIVE DIRECTOR, IAOMS
Letter from the President IT WAS MAGICAL AND MEMORABLE... Dear colleagues and friends
I
was delighted to see and meet with so many of you dI was delighted to see and meet with so many of you during ICOMS 2017. The International Conference in Hong Kong provided an outstanding venue with an excellent scientific program and amazing social events. It was magical and memorable. Before the Conference began, the IAOMS Board of Directors, Executive Committee (EC) and Councilors held a series of very intense and fruitful meetings. I am pleased to report on highlights from those meetings as well as share with you some upcoming meetings which I will be attending as I represent the IAOMS until December during the second and last year of my presidency. I hope to see you at one of these regional meetings. Meeting Reports The Headquarters Staff updated the Board on activities to date as well as some programs that are underway. We continue to increase our membership and offer new programs, such as the live quarterly webinar series. Additionally, we will be enhancing our educational offerings and re-developing our website to make it a more effective tool for educating and engaging members. IAOMS Regional Representatives and Committee Chairs offered highlights and a look ahead for their particular areas. We took an important step forward and added to our leadership pipeline. At the Councilors Meeting, Alejandro Martinez from Mexico, was elected Vice President-elect. When Alexis Olsson assumes the Presidency following the conclusion of my term at the end of this year, Gabriele Millesi will become the Vice President and Alejandro will become the Vice President-elect. Additionally, the Board voted to hold ICOMS 2025 in Vancouver, British Columbia, Canada. I’ll provide additional details on these and other Board/EC actions in my quarterly
report to IAOMS members. Special thanks to the IAOMS staff for their tireless work during the official meetings as well as meetings including the Presidents of all Regional Associations, the organizers of the future ICOMS in Rio and Glasgow and others. Honoring Outstanding Practitioners and IAOMS Members My thanks to Dr. Rui Fernandes for delivering an exceptional Presidential Lecture. On behalf of the IAOMS Board of Directors, I was pleased to bestow the Distinguished Fellow Award on Jose Luis Ferreria, Piet Haers and Nabil Samman. The accolades continued at the Gala Dinner, where I was again
delighted to honor four IAOMS members with these awards: the IAOMS Distinguished Service Award to Dr. Miloro and Dr. Ademola Abayomi Olaitan; the Outstanding Committee Member Award to Dr. Javier Gonzalez Lagunas and the Presidential Citation Award to Dr. Kenichi Kurita. Strengthening our Foundation and Developing New Educational Projects Under Dr. Larry Nissen’s leadership, the IAOMS Foundation is making great strides towards reaching its 2017 goal of raising $500,000. Already this year, the Foundation has pledges totaling more than $200,000. I am grateful to everyone who has given to the Foundation to help us ensure that we will continue organizing educational programs, like the new project to be developed starting in 2017 in Myanmar, which will contribute to the specialty’s progress throughout the world and develop the next generation of OMF surgeons. And regarding the next generation – my thanks to Drs. Gabriele Millesi, Deepak Krishnan and Alfred Lau for developing the NextGen program (and my congratulations to newly-elected members of the NextGen Council, a wonderful group of young colleagues representing the different regions of the world). It is also our pleasure to announce a new project to create a
Visiting Scholars program facilitating short educational visits of young colleagues to reference departments of the specialty. Upcoming Lectures and Conferences Later this spring I will represent the IAOMS at the 6th World Oral Cancer Congress of the International Academy of Oral Oncology to be held in Bangalore, India, from May 17 to 20. From Bangalore I will travel to Beijing, China, where I will have the pleasure to visit our Oncology and Reconstruction Fellowship Training Center at the Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology and to lecture there. In June 2017 I will attend the National Congresses of the Spanish and the Italian Societies of Oral and Maxillofacial Surgery and later this summer will have the privilege of representing the International Association at the XX CIALACIBU (International Congress of the Latin American Association of Oral and Maxillofacial Surgery and Traumatology), to be held in Buenos Aires, Argentina. My participation in these and other events continues to position the Association as the global reference in OMFS and to express personally our support to all colleagues working to advance the specialty throughout the world. Finally, a special note of thanks to Prof. Nabil Samman, Dr. Alfred Lau, Louisa Chiu and the entire local organizing committee for developing and producing an outstanding ICOMS 2017 – and to all of you who attended and contributed to the scientific program, presented or submitted a paper for consideration. Thanks to all colleagues who participated in the amazing DET session and in the incredible social events. Thanks to all of you – for your commitment and for your membership in the IAOMS, the leading global association for OMF surgeons. Kind regards,
Julio Acero IAOMS PRESIDENT 2016-2017
This is ICOMS
Hong Kong
10 iaoms.org
April 2017
special report
01
From the Heart
Confessions of an ICOMS Chairman
By Dr. Nabil Samman Chairman of the 23rd ICOMS
S
o, you think you want to organize an ICOMS? Well, let me tell you……….. it’s crazy but great.
Crazy because it is so full of risk and the accompanying anxiety. It starts with worrying if there are enough sponsors. SPONSORSHIP IS ESSENTIAL and without enough of it, no ICOMS can go ahead. And sponsors are like prima donnas at the early stage, demanding and unreasonable. And you, the organizer, are insecure and accommodating, vulnerable to the whims of business. Anxiety has started! THEN THERE IS THE VENUE: expensive and often a monopoly so very rigid and inflexible. Mostly a bad deal but no choice -- so just accept the expense and try to get the income. Anxiety goes on! THE SPEAKERS ARE THE TRUE STARS OF THE SHOW, both literally as the performers and figuratively because they donate their efforts and pay their expenses. ICOMS does not sponsor speakers, so it is essential to have good speakers accept to participate, not just any speakers. And you have to vary their source. All countries and continents must be represented. You need contacts everywhere. This is where “Great” begins, when you have your speakers. THEN, THERE IS THE ENTERTAINMENT. This needs to be just right: a good mix of local culture and genuine interest to create a good experience for participants. You must strive to put up options that inform and educate as well as entertain. “Great” continues as the range of social events is successfully developed. IN THE MIDDLE OF ALL THAT WE HAVE THE FOUNDATION. Always looking for money to feed its habit of giving it away, to very good causes of course: education. Not easy in the ICOMS context because people have to pay registration and accommodations, and then be confronted with more requests for money. Anxiety reappearing, so you need a local dignitary to help you. April 2017
“You’re always hoping to achieve something worthy of IAOMS, our mother organization that we care so much about.” THE PCO IS DEFINITELY AN UNSUNG HERO. If you have a good one, you’re in with a chance. If not, pack it up early. You can tell within just a few months so don’t be late in deciding against the PCO if necessary and get another one. Don’t sign with a PCO too early. So how does it all work out? Well, it works out OK at the end. But not without stress and anxiety. You’re always hoping to achieve something worthy of IAOMS, our mother organization that we care so much about. But you don’t know until the end when your budget crosses from red to black. Hopefully Anxiety is gone but “Great” is here, even when slow in coming. ■ iaoms.org 11
special report
02 A further step for the trainee, the NextGen By Alfred LAU Specialist in Oral and Maxillofacial Surgery Hon. Clinical Associate Professor OMFS HKU President , HK Association of OMS
T
hree days after the 23rd ICOMS 2017 in Hong Kong, and I can still feel the adrenaline rush of it. I have to admit that I am missing it a lot. It is a mixture of many emotions - excitement, nervousness, exhaustion, fear and yet joy and love everywhere. It all came out to tell us that it is really worthwhile. We have incorporated different new ideas and components in this ICOMS, which we hope would make it a unique one. This has added in brand new colors to the already excellent scientific programme and social events. All of these are to encourage the younger generation to participate more. IT IS MY GREAT HONOR TO BE APPOINTED as a new Executive Committee member of the IAOMS, Chairing the NextGen. This is very intertwined to 12 iaoms.org
what I have started four years ago in Hong Kong. At that time, some very good friends and I took a leap and founded the Young Oral and Maxillofacial Surgeon (YOMS) Group of Hong Kong. Back in 2013, never would I have imagined to receive overwhelming response from students and trainees with over 400 members since. Organizing a young group takes a totally different perspective. It is a group of mixed generation where the mind of millenials has to be reached. Visualizing through their angle, getting them involved, to be the leader of their own, communicating to foster a bond amongst everyone are all what makes the glue that bonds a team together. That is why it is important to get different minds together, to think out-of-the-box, to progress forward and counter the ever changing environment. April 2017
The all on 4 mini soccer world cup competition of the ICOMS 2017 has set a very good example that will hopefully become a tradition. It is a good idea to have something different in an international conference that is ongoing for its 23rd time. A soccer tournament has never been seen in an international conference. The response was excellent, having 10 teams represent from all around the world, including Brazil, England, The Netherlands, Russia, Indonesia, Malaysia, India, China, Chile and the organizer, Hong Kong. With the help of a local soccer school (ANT football Academy) and blessed with the optimal weather, the event was marvelous. Trophies for the winners and runner-ups, awards for the best goal and MVP were taken home. Soccer is a perfect tool as it is a language that speaks on its own. I have to thank my Indonesian friends where I got this inspiration from. Further to this, another competition was launched before and during the conference, namely the “Design a future OMS instrument” competition. This has given out a perfect opportunity for people, especially young people to carve out their ideas. They were required to design an OMS instrument that could facilitate our daily practice on a piece of blank paper. The submission could be via email or through a drop box at the exhibition foyer. This was an easy and straight forward execution. The reward was irresistible: iPad! NEEDLESS TO SAY, THE NEXTGEN SYMPOSIUM is the highlight amongst trainee events as this session was tailored made for them. A series of lectures by renowned invited speakers in various topics on OMS started the gathering and was followed by the NextGen Forum. Dr Gabriele Millesi chaired the session among with newly appointed 12 young surgeons and trainees from 6 continents. The set up of this new NextGen council has set an important milestone for a further step to the entire trainee programme of the IAOMS. We had a session of great sharing, flow of ideas, exchange of information and experience from different countries. This is how we learn and progress, and we hope the connection and friendship will last. The session was very well attended and we witnessed the willingness to get involved from everyone in the hall. The NextGen round table ended with a cocktail reception where people can mingle and chat. The session ended with an exciting finale to spice up the crowd by having a lucky draw to give out ten ICOMS
“Young people are an important part of us; they are integral to the success of an organization.” April 2017
“Soccer is a perfect tool as it is a language that speaks on its own. I have to thank my Indonesian friends where I got this inspiration from.” polo shirt and two I-pads that were sponsored by two of our exhibitors. I think it takes a good cocktail mix: accessibility, convenience, platform for young people to voice, to interact, to question, break the tradition, get them involved and driven, style and fashion, everything on palm and fingertips for communications and information, reduce waiting time, digitalization, three and even four-dimensions, no borders and limits, opportunities, scientific, financially easy, rewards and recognitions – to get a young group to be responsive, enthusiastic and to sustain. Young people are an important part of us; they are integral to the success of an organization. If one wishes to run an association well, run the young group well. The IAOMS has a very good vision of this. ■ iaoms.org 13
special report
03 The back-office perspective By Louisa Chiu Advisor, LLInk Limited
I
t was my great honor and pride to have been appointed as the Professional Conference Organizer (PCO) for ICOMS 2009 – Shanghai. But when I was asked again to take the lead organizing ICOMS 2017 in Hong Kong I considered it a privilege and a blessing. I believe that this is probably the first time ever in ICOMS history where the same PCO has led two ICOMS. My heartfelt thanks to Dr Nabil Samman and the organizing committee as their faith was a strong vote of confidence to me in making this impossible task, possible. THE PREPARATION FOR ICOMS 2017 BEGAN IN LATE 2015. I have felt a very strong partnership with the Organising Committee as they were always clear on their expectations and they have shown trust in my judgement and leadership. My previous experience organizing ICOMS 2009 certainly helped me getting familiar with the ‘ICOMS style’ and protocols and definitely helped speed up preparation. However, we had several challenges to concede with. Land scarcity in Hong Kong limits our choice of venues suitable to host this group of thousands of participants, specially when it came to planning the social events. We had to get creative with decorating each venue, and re-cycling each of them for multiple purposes. Expensive rental and food costs also demanded fiscal diligence. 14 iaoms.org
IN COMPARISON, ORGANIZING ICOMS 2009 IN SHANGHAI WAS EASY! China is huge and hence we could find plenty of venues that could easily be set for a large group of meetings or for a exclusive service for a small group. Most of the delegates did not know much about China. For some of them, this was their first trip to China and they were curious about every experience they encountered. We receive positive feedback during and after the conference including but not limited to the remarkable Chinese cultural performances at the opening ceremony, the relaxing cruise along Huangpu River, not to forget the glamourous gala dinner. All of these remain an unforgettable experience to our overseas guests and helped us bolster our reputation. “Your work is going to fill a large part of your life, and the only way to be truly satisfied is to do what you believe is great work. And the only way to do great work is to love what you do.” I couldn’t agree more with this inspirational quote from Steve Jobs and I am grateful that I am in an industry that I am passionate about. The most exciting challenge was to make the Hong Kong ICOMS a unique and meaningful event to all delegates and not let the spectacular show we put on in Shanghai, overshadow it. We aimed to reach a balance between the attendees feeling our warm welcome and at the same time, this event becoming a springboard to a momentous leap to future ICOMSs. A great team of organizers have spent enormous time and effort to build an appealing and engaging program, both in the scientific and social aspects, hoping that this experience will be a fond memory for many years to come. It is always the team effort that counts and I am thankful for my team. Hong Kong is brimming with energy; the city truly is the crossroad of the customs and traditions of the East and West. I hope you found the worldclass scientific program and our top-notch social events memorable and rewarding. What do you think about our “Hong Kong Night” at ICC (the tallest building in Hong Kong) with the bird’s eye view of breath-taking harbor vistas and spectacular night scene. We are sure that view has left you a long lasting impression of this vibrant city! ■ April 2017
FOUNDATION CHAIRMAN REPORT
Th
A bi g
an
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yo u
D
Face-To-Face Post-ICOMS 2017
ear Friends, What a fantastic ICOMS we had in Hong Kong! As we came together to network, learn, and enjoy a beautiful city and country, it was a great time to reflect on the growth of the IAOMS Foundation.
During our time together, we shared exciting news with you, including: ✔ In 2016, we conducted a planning study, in which we spoke with IAOMS leaders, fellows, corporate partners, and other stakeholders about the Foundation’s unique value, direction, and potential. ✔ In January, we organized and launched the Foundation’s first-ever Annual Appeal. We are inviting all IAOMS members, corporate partners, and other stakeholders to help us meet this year’s historic goal of $500,000. ✔ Going into ICOMS, we had secured nearly $200,000 in pledges for 2017! Friends, I am thrilled to announce that at ICOMS, you collectively committed just over $40,000 to the Annual Appeal, bringing our growing total to over 240,000 at this early stage in the year. Thank you! We also held our first ever Laskin Legacy Society reception, where we acknowledged the 34 Charter Members who have contributed more than $300,000 in planned gifts to the Foundation! At the event, Dr. Daniel Laskin himself shared what the program means to him and for our specialty. We’re grateful for the 7 new members who joined at ICOMS as well, bringing our Charter membership over 40 members and more than $360,000 committed! The IAOMS Foundation has a grand vision: to elevate our impact through increased educational opportunities throughout the world. Education is at the core of what we do, and through expanded funding, we can make this vision a reality. The Foundation’s Fellowship program, Surgeon-to-Surgeon training, online learning, and regional symposia offer innovative learning for IAOMS constituents. The growth of these programs, together with new initiatives, will enhance our ability to teach and train the next generation of OMF surgeons. Additionally, creating member resources such as online resource libraries, leadership training, and scholarship opportunities can help us achieve our ultimate goal of improving patient care around the world. As we move forward in the 2017 Annual Appeal, I ask that you join us in this exciting initiative. We are recognizing our Annual Appeal donors on our website, in Foundation materials, and at IAOMS events when possible. While I urge you to consider joining our Leadership Circle with a $5,000 commitment, our goal is that each and every IAOMS member considers what the organization and specialty has meant for his/her life and career, and participates accordingly. On behalf of the Foundation, thank you for your support. We look forward to celebrating the success of the Annual Appeal with you at the end of the year! ■ 20 iaoms.org
April 2017
Larry W. Nissen IAOMS Foundation Chairman
By Arthur Jee, D.M.D. Treasurer & North American Representative, International Association of Oral Maxillofacial Surgeons (IAOMS)
The International Association of Oral and Maxillofacial Surgery (IAOMS) is a member-sponsored, member-driven, member-leadership organization. This is reflected in the dedicated volunteers who serve the association as well as in its financial pictures. The IAOMS Foundation is the critical ‘action’ arm of the IAOM mission. The Foundation funds research, fellowships, and educational programs. With leadership of its chairman, Dr. Larry Nissen, the Foundation is invigorated and flourishing. Dr Nissen has initiated matching funding with KLS Martin Endowment, and created the Daniel Laskin Legacy Society program. Both of these programs are restricted funds, that is only the investment value may be utilized. As the end of year 2016 Foundation financials are being finalized; there is showing of the completion of the $80,000 KLS matching funds, and an estimate of $30,000 pledges to the Daniel Laskin Legacy Society. Additionally, there is a contractual deposit of $20,000 as royalties from Elsevier. This is specific dedicated funding for fellowships thru IJOMS. The Foundation corpse is estimated to be $400,000. The administrative cost of the Foundation is less than 3%. The intent of the Foundation is to maintain and grow the corpse; and spending only from the investment income for programs. In order for the Foundation to fund all needed programs, the corpse must grow to minimal $5,000,000 or greater. ■
DONATIONS IAOMS FOUNDATION REVENUE DISPERSION TOTAL $210,000 $80.000
$80.000
$20.000 $15.000 $10.000 $5.000 $ INDIVIDUALS
AFFILIATE DONORS
REGIONAL ASSOCIATIONS
KLS MARTIN
ELSEVIER
FELLOWSHIP
The IAOMS Foundation is the critical ‘action’ arm of the IAOMS mission.
TOTAL FOUNDATION EXPENSES TOTAL $161.115
$60.000
$0
BRAZIL $6.200
SRI LANKA PANAMA $9.000 $8.500
$31.700
$31.423
$9.333 $4.459 BANK FEE
$3.000 SALARIES + ED
April 2017
AFRICA $8.000
CHAIRMAN
$11.700 $5.000
$1.459 PROF FEES/ FELLOWSHIP SITE LIBRARY SUBSCRIPTIONS MEMBERSHIP PROGRAMS VISITS
iaoms.org 21
IBCSOMS
EDUCATIONAL COURSES
Women in IAOMS
DATA DOES NOT HAVE FAVORITES By Dr. Suzanne Mc Cormick Oral and Maxillofacial Surgeon Private Practice in Encinitas. California UCLA instructor
I ALWAYS HAVE HAD A PASSION FOR SCIENTIFIC RESEARCH. The discovery of the unknown, confirmation of the known, the adventure of understanding the how. My first research project was a simple project on dirt. I investigated the effect of rain on the nutrient composition in the soil of
three hills around my house. I staked out the grid pattern, and measured five random samples from each grid after every rain over one winter. Results showed that the nutrients flowed down the hillside for the barren hill, less so for the hill covered with grass and not at all for the hillside with the trees and shrubs. I concluded that to preserve nutrients, 22 iaoms.org
one should terrace the hills. Not exactly earthshattering conclusions, especially as the Romans had concluded the same centuries before, yet I entered the California High School Science Fair and won First Place in my division, scholarship money, and a job at NASA! I was hooked. I loved research. During dental school and OMFS residency, I worked on making AAA bone (now called BMP) a project whereby I mixed AAA bone with HA. I submitted this work and it was accepted at my first AAOMS
meeting. Much to my surprise, the presentation was in the major symposium, in a room filled with hundreds of OMF surgeons looking at me, a firstyear resident. I was so nervous that I swayed in and out of the focal point of the microphone; my voice getting louder and softer as I swayed. The best part though, was the meeting’s social event, for it was April 2017
Face to Face newsletter By Dr. Gabriele A. Millesi M.D., D.M.D. Vice President Elect of the IAOMS Assistant Professor Medical University of Vienna University Hospital for Cranio Maxillofacial and Oral Surgery
“Dr. Mc Cormick is a well-known member of our association and Section Editor in IJOMS.”
there where I met the first of many life-long friends: time than necessary because I was a woman. For friends who would encourage me when I wanted data doesn’t have favorites, it just is. Data allows all to quit, saying, “if you quit, they win.” Friends with to have access with parity. Similarly with publication, whom I lectured and travelled together as “The for even the most famous of scholars, if the scientific Three Musketeers” and “Rolf’s Angels” to Boot Camp method is not followed, their data not gathered well, and faraway places. Friends who would say, “Susan the writing and conclusions poor, the paper is not your lectures are so boring, accepted for publication. too many pie charts and There is parity in science. “For data doesn’t have favorites, graphs. Tell me a story and I This I know, having the will listen.” Friends who are it just is. Data allows all to privilege of serving as still my friends today. have access with parity. Similarly Section Editor for IJOMS. As Dr. Paul Tessier always said, “Serendipity is the chance occurrence that falls on the prepared mind.” And so it was for me with Distraction Osteogenesis (DO). I joined the team at NYU, leading to an amazing opportunity. That is not to minimize the hard work and long hours, yet to me it was always an adventure.
with publication, for even the most famous of scholars, if the scientific method is not followed, their data not gathered well, the writing and conclusions poor, the paper is not accepted for publication. There is parity in science.”
Best of all, I gained the respect of colleagues and naysayers, who may be in the past, gave me a harder April 2017
I encourage you to be curious. Your scientific quest need not be laboratory based, for recently I published a book on Ethics and am currently working on “ERAS:” Early Recovery after Surgery Protocols. The joy of our profession is the recognition that through research there is parity and thus power for women, and that it can open a multitude of doors leading to opportunities I never could have imagined. You will be in a long line of female scientists who have changed the world. ■ iaoms.org 23
From Proust to Pivot
AN APPARENTLY INNOCENT QUESTIONNAIRE FOR ORAL AND MAXILLOFACIAL SURGEONS
Prof. Andrew
Heggie
Head, Oral & Maxillofacial Surgery. Department of Plastic & Maxillofacial Surgery Associate Professor, University of Melbourne. The Royal Children’s Hospital Melbourne
What is your favorite word? Excellent.
If you were reincarnated as some other plant or animal, what would it be? Peregrine falcon (soaring, independent, deadly).
What is your least favorite word? Closed. What is your favorite drug? Syrah grape juice (fermented).
If Heaven exists, what would you like to hear God say when you arrive at the Pearly Gates? “What took you so long?”
What sound or noise do you love? The crowd roar when my Aussie Rules football team (Demons) kicks a goal.
What is your idea of perfect happiness? Dinner after a sunny day of powder skiing.
What sound or noise do you hate? An incoming text message from my paging service after going to bed.
What is your greatest fear? A bad health event. What is the trait you most deplore in yourself? Trying to cram too much into one day.
What is your favorite curse word? Probably a word that rhymes with “Hit.” Who would you like to see on a new banknote? Nobel Laureate Scientists.
Andrew and daughter Caroline
What is the trait you most deplore in others? Pessimism. Which living person do you most admire? Ayaan Hirsi Ali - an intellectual with extraordinary courage.
What profession other than your own would you not like to attempt? Bomb Disposal Outfit. 24 iaoms.org
April 2017
What is your greatest extravagance? My coastal home on the Great Ocean Road. What is your current state of mind? Contemplative. What do you consider the most overrated virtue? “Social justice warrior” outrage. On what occassion do you lie? When asked how long a case will take when another patient is to follow in the OR.
Surgery with F ellows and Reg istrars What do you most value in your friends? Loyalty and reciprocal contactibility.
What do you most dislike about your appearance? My dwindling calvarial hair follicles. Which living person do you most despise? Nobody really, but am appalled by a number of political dictators. What is the quality you most like in a man? Integrity. What is the quality you most like in a woman? Determination. Which words or phrases do you most overuse? “Unbelievable.” What or who is the greatest love of your life? My family. When and where were you happiest? Having Xmas with my extended family tree this year at the coast. Which talent would you most like to have? Fluency in a second language (French). If you could change one thing about yourself, what would it be? Better time management.
Family at birthday
What do you consider your greatest achievement? Picking a great career yet able to enjoy being close to my children’s lives If you were to die and come back as a person or a thing, what would it be? A British blue short-hair cat (I have one, what a life!) Where would you most like to live? Where I am in the leafy eastern belt of urban Melbourne. What is your most treasured possession? My bagpipes (Hardy). What do you regard as the lowest depth of misery? Loss of a family member. What is your favorite occupation? Oral & Facial Surgery (time for a name change!) What is your most marked characteristic? Enthusiasm. April 2017
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Who are your favorite writers? Dostoyevsky, Rand, Zola, Orwell, Courtney, Dawkins, Blainey Who is your hero of fiction? Hank Rearden – “Atlas Shrugged” Which historical figure do you most identify with? None to identify with, but Charles Darwin surely formulated the biggest theory in human epistemology Who are your heroes in real life? Richard Dawkins, Steven Pinker, Stephen Hawking, James Watson, David Attenborough, Roger Federer What are your favorite names? Oliver, Winston, Katrina, Caroline (my children / grandchild of course) What is it that you most dislike? Traffic jams and delayed flights. What is your greatest regret? Being talked out of buying a stack of Apple Shares in the mid-1990’s. How would you like to die? On skis in an alpine avalanche in my late eighties. What is your motto Never give up. ■
Copy Me CORONAL SPLIT CORPUS OSTEOTOMY TECHNIQUE to Enhance the Bone Volume of the Atrophic Mandible
Adequate bone dimension is essential for the placement of osseointegrated dental implants for patients who have severely atrohic jaws. PROF. DR. MUSTAFA SANCAR ATAÇ, DMD, PhD Gazi University, Department of Oral and Maxillofacial Surgery, ANKARA, TURKEY
1a
The technique involves a mucosal and periosteal incision. A mucosal incision extending between retromolar regions is created at the cheek and labial sides of vestibular fornix.
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1b
Following the reflection of the mucosal flap an incision on the periosteum over the alveolar crest is performed and the periosteal flap is elevated.
April 2017
2a
2b
Crestal osteotomy
Horizontal lateral cortex osteotomy
Vertical osteotomy
After the mental nerves are identified, the crestal osteotomy, which is close to the lingual side, is performed at the premolar and molar region and begins from the alveolar crest to the mylohyoid ridge (Fig 2a and b). Subsequently 2 parallel vertical osteotomies mesial to the mental foramen are initiated at the lateral cortex. The lingual cortex is left intact. At the lateral cortex the vertical osteotomies are connected with a horizontal lateral cortex osteotomy above the inferior border without touching the lin gual cortex (Fig 2a and b).
3
Inferior border osteotomy The osteotomy continues with the inferior border osteotomy, which is carried out from the inferior border upward at the mental region.
4 After all osteotomies are made, the osteotomized segment is mobilized by using a thin spatula osteotome. After mobilization, the segment is slided coronally and fixed with miniplates and screws in the desired position. The corticocancellous bone that has been harvested from the anterior ilium simultaneously is used to augment the bony gaps.
†† April 2017
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Copy Me
5a
5b
5c
5d
Preprosthetic bony reconstructive surgery can be used for the rehabilitation of the atrophic mandible . Coronal split corpus osteotomy, which is a modification of Visor osteotomy, facilitates 3-dimensional reconstruction of the anterior mandible. The reverse L-shaped design of the osteotomy enables correction of intermaxillary relationship both vertically and horizontally (Fig 5a-d).
NEWS RECOGNITION TO DR. JULIO ACERO Dr. Leopoldo Meneses, President of ALACIBU and Dr. Alejandro MartĂnez-Garza, Latin-American representative to the IAOMS Executive Committee presented a Recognition Plaque to IAOMS President Prof. Julio Acero during the Gala Dinner. 28 iaoms.org
April 2017
Note on...
HANDS-ON SURGICAL TRAINING WORKSHOP IN NAIROBI By Dr. Fawzia Butt Consultant Oral & Maxillofacial Surgeon Lecturer Dept. Human Anatomy and Oral & Maxillofacial Surgery University Of Nairobi
T
he second Hands-on Surgical Training workshop was held in the Nairobi Surgical Skills Lab last November. The focus: local and regional flaps of the head and neck area. Thirty-one residents? from Oral and Maxillofacial Surgery and Plastic Surgery participated. Faculty from the School of Dentistry and the School of Medicine taught/led/participated.
as ed se wordinat r u o o he c nd c ✔ T nized a tt and u orga r. F. B thua. u D by S. G as . f p w Prof. Pro o h ks e by wor pened ting th nt e h e ✔ T ially o presen epartm c e i off engo, r the D and y f g J O rman o natom urrent nt i A e c Cha uman ambo, epartm i H D l h a d e of ci f th ofa W O Dr. rman o Maxill i Cha ral and O of ery. g Sur
ts ipan c i t r s t pa hat thi event s o ✔ M sted t annual able e u n sugg ld be a he inval d by t u e sho se of xchang u e beca iences ons. r expe t surge r expe
NextGen
Maxillofacial Surgery IN KENYA AND THE EAST AFRICAN REGION By Dr. James Kirimi Oral & Maxillofacial Surgeon Meru Teaching & Referral Hospital Meru, Kenya
The speciality of Oral and Maxillofacial Surgery is fairly young in East Africa. There were no training programmes in Maxillofacial Surgery until the early 2000s. The first indigenous African surgeons in Kenya received their training in the UK and USA, returning in the late 1980s and early 1990s to pioneer and lead the growth of the profession to what it is today. Kenya has the highest number of Maxillofacial Surgeons in the region with twenty-five (25) surgeons against a population of 45 million. Other East African countries have less than 10 surgeons (Tanzania, Uganda), or 2 (Rwanda), while there is none in Burundi. The numbers are no better in neighbouring countries like South Sudan, Ethiopia, Somalia and DR of Congo.
In East Africa, Oral and Maxillofacial Surgery is recognised as a speciality of dentistry. Kenya has had a training programme since 2001 while Tanzania and Uganda have began training OMFS recently. The programme in Kenya is a 5-year Master of Dental Surgery in Oral & Maxillofacial Surgery (MDS-OMFS) while Uganda and Tanzania have 3-year programmes in Master of Dentistry in Oral Surgery (MDent-Oral Surgery). Entry requirements into these programmes is a Bachelor’s degree in Dental Surgery, either BDS or DDS. On average only 2 or 3 trainees graduate every year from each of these programmes.
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The training programme in Kenya is undertaken at the University of Nairobi (UoN) and was the brainchild of Professor Symon Guthua, largely considered the Father of Maxillofacial Surgery in the region. From 2005 to date it has graduated twenty-five (25) surgeons from Kenya, Tanzania, Uganda, Zimbabwe, Swaziland and Cameroun. Admission to the program is extremely competitive with a rigorous admission process as only 2 or 3 candidates are selected per year. After an intensive 2-year preclinical programme trainees undertake their clinical training at Kenyatta National Hospital (KNH) and at the UoN Dental Hospital. These two hospitals are the main referral facilities in Kenya and the region. The clinical training has a wide coverage in relevant disciplines like Neurosurgery, Head and Neck/ENT Surgery, and Plastic and Reconstructive Surgery thus equipping the trainees with high level skills required in OMFS. The training in Kenya exposes trainees to a wide range of surgeries. Without a doubt trauma and tumours form the backbone of the surgical operations done in Kenya. It is not unusual to have patients with very large tumours that require complex surgery and reconstructive procedures. There is a multi disciplinary team composed of OMFS, ENT and Plastic Surgeons who meet once a week at KNH and are involved in the management of these complex cases for example with free flaps. The trainees in these disciplines are fully involved in the management of these patients as part of their training.
The East African Association Oral Maxillofacial Surgeons (EAAOMS) currently under the leadership of Dr Eric Kahugu is the umbrella association of surgeons in the region. It is a vibrant association which is involved in organising numerous training symposia in collaboration with UoN, IAOMS, AOCMF, and other partners.
On completion of training the Kenyan surgeons have gone on to work in rural/semi-urban government hospitals. The newly qualified surgeon usually finds him or herself as the only OMFS in the hospital and the entire region where they are sent to work.
The OMFS profession in this region is fairly young and would greatly benefit from increased collaborations from IAOMS especially in the areas of education and training. It is indeed an exciting time to be an OMFS in East Africa as the profession continues to grow. ■
VANCOUVER
2023
GLASGOW
2021
GUIDE TO NEXT
ICOMS
HONG KONG
2017
RIO
2019
WORKING IN PARADISE
By Prof. Martin D Batstone Director of the Royal Brisbane and Women’s Hospital Maxillofacial Unit
A
ustralia is a big country with wide open spaces and great distances between cities; tropical reefs and rainforests in the north to mountains with snow in the south offers geographic and climatic diversity. Because of its natural beauty and great climate, it’s a big attraction for visitors from all over the world. I live and work in Queensland, one of the most popular states to visit and live. Known as the sunshine state, the main tourist attractions are the Gold Coast and Sunshine Coast beaches and of course the Great Barrier reef further north. Brisbane is the capital city of Queensland and has a population of about 2.1 million people. Ideally situated with the Gold Coast to the South, and Sunshine Coast to the North, Brisbane (home to about 2.1 million people) is Queensland’s capital, ideally situated with the Gold Coast to the south and the Sunshine Coast to the north. 32 iaoms.org
There are hospitals on both Coasts; I work at the 929-bed Royal Brisbane Hospital, the state’s largest. I am the head of a department with seven other consultants, three trainees, one fellow and two resident medical staff. My special interests are head and neck surgery and microvascular reconstruction for which patients come from all over Queensland and other states. Together with my other colleagues, we provide the full scope of the speciality. Because all treatment in a public hospital is for Australian citizens and those countries with reciprocal agreements, we offer world-class treatment to patients free of charge. Trauma is a big part of our work. While gun-related facial injuries are very rare, fractures related to alcohol use are not rare (and because of Australia’s long distance drives, motor vehicle accidents still occur too commonly). We also have a very large burden of skin cancer in Australia because of our frequent sunshine. Brisbane has the unfortunate reputation as the melanoma capital of the world. April 2017
My special interests are head and neck surgery and microvascular reconstruction for which patients come from all over Queensland and other states
Like a lot of busy surgeons, I find it hard to strike the balance between patient care, professional responsibilities, teaching, research and leisure time. However, I am fortunate to live in Brisbane’s great climate where there’s only a month or two every year where it is a bit too hot. I ride my bicycle to work every day and that keeps me fit and happy. When I can escape work, like many Queenslanders, I try to make it to the beach where windsurfing and surfing are my passions. The Gold Coast is famous for its surfing beaches like Kirra and Burleigh heads but it’s easy to drive a little further to escape the crowds. Brisbane is not the Australian city most people think of when they come to Australia to sightsee. I feel very fortunate that the city’s population is large enough to support high end and complicated surgery in a teaching department. The cost of living is When reasonable and I can escape Brisbane is close work, like many to several nice Queenslanders, I try places where to make it to the beach I can enjoy my where windsurfing leisure activities and surfing are my and still have passions an interesting practice. We have many foreign doctors who come to work in Brisbane and Queensland and they all seem to want to stay -- so that says everything! ■ April 2017
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WHERE ARE YOU NOW? in lighter vein, somebody would ask me what I was doing and I would reply,” Nothing” and they would say. ‘But you then you were doing nothing all of yesterday” and my retort would be, “I wasn’t finished doing nothing yesterday.”
Today
Dr. Kishore Nayak By Deepak Krishnan Assistant professorof Surgery, UC Health. Cincinnati
D
ear Dr. Nayak
Where are you now and what do you do these days? I Currently live on the outskirts on Bangalore in India on an acreage where we have built a small farmhouse. My wife and I live there with our two dogs, grow some of our own vegetables and essentially have a lot of time to pursue things I always wanted to do… read, golf, long walks and help out kids at a community school nearby… it is very fulfilling indeed. 34 iaoms.org
What do you consider the single most meaningful contribution you made to the IAOMS? I think it will be tough to answer this. I served on the Executive for about 6 years and on the BoD for another 6, two of those as President as well. During that time a lot was achieved and I daresay most of this was due to collective decision and action. I have always had a flair for numbers, so if I had to pinpoint, I would say I liked to put in plans to make sure the bottom lines always mattered. I loved doing the ICOMS in Bangalore in 2007 and turning in a profit for the IAOMS. The experience of doing the ICOMS brought into focus several measures that made the running of subsequent meetings streamlined, predictable and a good source of revenue for the IAOMS. My term as President from 2011 to 2013 was challenging due to issues I faced on the health front as well as simultaneous problems that we encountered in the administration of our Head office. The handling of these and coming out on top was a satisfying experience for sure. While I like to think I have made a difference for the organization, I do think that it was always a team effort. Every President, every Bod and Executive has left the IAOMS better than when they found it... that has been the reason for its abiding success. What is your perception of how the specialty has changed from when you started to now? Certainly in Bangalore and in many parts of India we are now seen as a mainline surgical specialty. In the early 90s the perception of the specialty was that of a largely dental orientated one. The thrust many of us put in then, into management of trauma and orthognathic surgery and subsequently going into cancer and clefts and encompassing everything in the head and neck area have made us a force to reckon with. We are here to stay and grow... the Specialty cannot be wished away any more. We are the real deal and the competition now has to follow us. Of that I’m certain. I am a satisfied man on this front. April 2017
What do you miss the most about working in the IAOMS? Surprisingly, I don’t miss the work. I think my colleagues who now occupy my position(s) are doing a commendable job and even better that I did. The variety and scope of work has increased exponentially far beyond what I could have done singlehandedly. So patients and the specialty are better served by this. It’s a great thing to be able to let go and see things improve and know that you were never indispensable. The old making way for the new ...that is the way it has to be; only then do we move ahead. The only thing I do miss is the camaraderie with colleagues and interaction with hospital staff and the occasional adrenaline rush you had when you had your regular run ins with the hospital administration and fought turf and territorial battles…! Nothing can replace that! Do you keep in touch with former IAOMS colleagues? For sure yes, the friends I have made worldwide through the IAOMS and its network will stay with me forever. As long as I can, I will attend every ICOMS that I can…no longer for the science but certainly for the chance to renew old friendships and make many more new ones! What would you change about your career path if you could go back and do so? I always wanted to be a chef…so yes, if the clock could be turned back, I would have now been running my own restaurant with a microbrewery attached and been as contended as ever… I am well known in the neighborhood for my culinary skills and expertise around the grill…! Which technological advance in the specialty would have made a difference in your surgical activity? I cannot answer this precisely. When I see some of April 2017
“....Essentially have a lot of time to pursue things I always wanted to do…read, golf, long walks and help out kids at a community school nearby…it is very fulfilling indeed.” the 3D modelling, predictions, planning, navigation and robotics being bandied about nowadays I can’t help wondering how I would have adapted to these. However, all said and done, there will never be a replacement for good old surgical skill and common sense. Technology will come, move on and become obsolete. The basic science and art of surgery will and should always remain. What advice do you have for the OMS trainee starting training in 2016? It will be a long and challenging road ahead like it has been for all of us. Try to learn everything but remember that the specialty is too wide and encompassing now. Over time, work to your strengths and get the best out of those who train you and you work with, then build on it. Be at the cutting edge... always. What are you currently reading? Halfway through a book called “My Gita” by Dr. Devdutt Pattanaik. It spins out the essence and meaning of life based on his interpretation of the ancient Indian text. It goes on to say that those who shatter boundaries discover a lot. And in a world without boundaries, there will always be another chance…and another. Life goes on and always finds a way. ■ iaoms.org 35
Beyond OR
You have to eat your cookies while they are being passed By Javier González Lagunas (follow me on
@golagunas)
I
just have just read the book The Auctioneer: Adventures in the Art Trade by Simon de Pury, one of the art market’s global superstars. A piece of advice he received from Peter C. Wilson (one of his mentors and former head of Sotheby’s) is also this column’s title. Change can adopt many faces in our careers. Most of us have started our professional life as clinical surgeons. But with time, new opportunities may arise: from clinical surgeons to research, or to hospital or to department management. Or you can change from employee to employer or maybe change from a national health service to a univerisity setting or to private practice. Maybe you have to change the city or the country where you practice...
habits, ankylosed structures or inherited processes will open new doors in your professional careers. Vertigo against the unknown, fear to failure and economic concerns are only some of the obstacles you will face when contemplating such an important decision. So, answering the questions Where do I want to be in 10 years? And will my current job get me there? Is a good place to start. Being a smart maxillofacial surgeon as you are, you already have completed your homework, and you have a well thought and establised strategic plan for your career. Opportunities in such a competitive market as Maxillofacial Surgery do not not happen eveyday. So, you must be ready to eat your cookies in time... ■
Many health professionals feel captive in their workplace. Staying in the same place where you studied, where you trained, or where you started your career is comfortable; you don’t need to think too much, just let the tide lead your life. You stay in the comfort zone. You don’t take any risks – or maybe the only risk can be the doctor’s burn-out syndrome, after working for many years in the same environment, under the pressure of your institution and your patients and maybe the absence of a rewarding professional career. Abandoning the comfort zone is not compulsory. It’s certainly not for everyone. But in some situations, it can be the only way to succeed. Leaving behind old
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o t u o y k n a th ICOMS 2017
HONG KONG