Melbourne, Australia has for the
The EIU’s Liveability Ranking measures living conditions in 140 countries across five overarching criteria of stability, healthcare, culture and environment, education and infrastructure. Melbourne achieved an overall score of 97.5%, with perfect scores in the areas of healthcare, education and infrastructure. The accolade recognises the enviable lifestyle Melbourne offers and highlights the city’s position as a leading destination for conferences and meetings. So we encourage you to mark 27-30 October 2015 in your diary now and plan to join colleagues and friends for the 22nd International Conference on Oral and Maxillofacial Surgery and experience first hand what makes Melbourne the world’s most liveable city.
MELBOURNE AUSTRALIA
HEADS TO THE WORLD’S MOST LIVEABLE CITY
ICOMS 2015
fourth year running, been voted the world’s most liveable city topping the Economist Intelligence Unit’s (EIU) Global Liveability Index.
CONFERENCE PROGRAM A strong program of invited speakers is currently being developed. Held over 4 days, the Scientific Program will consist of a combination of plenary sessions, symposia, panel discussions, workshops and poster sessions. A series of Pre Conference Workshops are also being planned for Saturday-Monday 24-26 October 2015, prior to the commencement of the Conference. Call for abstracts are now open and we encourage you to submit your abstract now for consideration.
SPONSORSHIP & EXHIBITION A vibrant and dynamic exhibition will be a valuable component of the Conference. Opportunities to participate are available. For further information please visit the website www.icoms2015.com
REGISTRATION To assist in your planning, online registration will open from 27 October 2014. You’ll be able to secure your place to attend the Conference, book accommodation, social events and consider an extensive range of optional Pre Conference Workshops, day tours to discover Melbourne, regional Victoria and other destinations within Australia and New Zealand. All information will be available on www.icoms2015.com
DISCOVER MELBOURNE Melbourne has a wide range of activities and experiences awaiting you. Whether you have an interest in art, architecture, food, wines, golf, shopping, discovering the spectacular wine regions or coastal areas or looking for activities for the entire family to enjoy, there are a multitude of options available to you. When registration opens, a range of optional tours will be on offer as well as ideas on the website for you to discover the city and its surroundings on your own if you prefer. Visit www.visitvictoria.com.au and www.thatsmelbourne.com.au to start planning your experience now!
Food & Wine Melbourne’s reputation for culinary excellence is expressed in the outstanding assortment of cafes, restaurants and bars that colour the city. From cheap eats to fine dining, rooftop bars to underground cellars, whether you are looking for a little taste of home or yearning for something exotic, you will be spoilt for choice when it comes to international cuisine. You’ll have the opportunity to experience the city’s diverse mix of cultures as you dine throughout the city. Arts & Culture In Melbourne, you’ll discover a city buzzing with dynamic and cutting-edge arts and culture. Head to the Southbank precinct – where The Arts Centre, MTC, Malthouse, Recital Centre and the National Gallery of Victoria form Melbourne’s beating cultural heart. Dozens of theatrical productions are staged each week in Melbourne, ranging from mainstream musicals to experimental works. At Federation Square, where art meets architecture, watch inspiring audio visual shows at ACMI, see the collection at the Ian Potter Centre, or catch a recital at The Edge theatre. Inside and out, you’ll discover the innovation and skill of local artists and designers at hole-in-the-wall galleries and theatres across the city. Or visit the Melbourne Museum showcase of Australian social history, Indigenous cultures, science and the environment. Located adjacent to the World Heritage listed Royal Exhibition Building and Carlton Gardens, and home to IMAX Theatre Melbourne. Shopping in Melbourne The city has a serious passion for fashion. Ever evolving shopping choices make it possible to create a different shopping spree every time you venture out, whether you’re after high fashion or fine art, jewelry or accessories, homewares or stationery. The city’s myriad laneways and arcades harbour untold gems, markets and inner city precincts spoil you for choice, while department stores and shopping centres continue to raise the bar.
We acknowledge the support of our valued Partners: ®
Platinum Partners M a k e
Gold Partners
Silver Partners
i t
S i m p l e
Issue 39 / September 2014
Editor-in-Chief Javier Gonzalez Lagunas
Managing Editor Lisa Markovic
Executive Committee 2014 – 2016 Board of Directors Piet Haers, President Kishore Nayak, Past President Julio Acero, Vice President Alexis Olsson, Vice President Elect Robert T.M. Woodwards, Treasurer Larry W. Nissen, Foundation Chairman Pierre Désy, Executive Director
Members-at-Large Gabriele A. Millesi Sanjiv Nair Javier Gonzalez Lagunas
Regional Representatives John Fisher, Africa Kenichi Kurita, Asia Henri Thuau, Europe Alejandro Martinez, Latin American Arthur Jee, North American David Wiesenfeld, Oceania
Committee Chairmen Rui Fernandes, Education Committee Joseph Helman, Research Committee Deepak Krishnan, IAOMST Committee Steve Roser, HADR Committee Fred Rozema, IT Advisory Committee Mark Wong, IBCSOMS Committee Juan Antonio Hueto Madrid, eLearning Sub-Committee
CONTACT US IAOMS
5550 Meadowbrook Industrial Court, Suite 210, Rolling Meadows, IL 60008 U.S.A. 1.224.232.8737 / communications@iaoms.org
Letter from the Editor How I see it
F
irst, a few words of gratitude to all of you who have enthusiastically supported the new version of F2F. We will try to be proactive, but your suggestions and proposals are (and will be) more than welcome. We want to have a succesful and popular newsletter that goes beyond your expectations.
This issue’s cover is devoted to one of the most exciting projects of IAOMS, one that has begun just a few weeks ago: eLearning. Our eLearning platform is an ambitious project with one basic objective: taking cutting-edge techniques and scientific updates to those oral and maxillofacial surgeons who have a need to learn and to improve their knowledge in all aspects of our speciality. We are especially proud of being able to offer presentations by leading surgeons to all those colleagues who by geographical reasons have serious difficulties to attend our meetings. Online education is an extraodinary tool to promote and spread knowledge all over the world. It is universal, convenient, cheap, and democratic, and it is a first step for one of the most sought dreams of people involved in international associations: One solid speciality with surgeons who share the same knowledge and the same scope of practice. We are on the way, and we are pushing hard!! ■ Javier González Lagunas Editor in Chief
We are on the way, and we are pushing hard!!
contents september 2014 IAOMS fellowship with Santosh rding The most rewa y life experience in m
OMS on a mission
Noma: the hidden disease
so you want to work...
? in brazil
From Proust to Pivot
An Apparently Innocent Questionnaire for Oral and Maxillofacial Surgeons
copy me
Transfacial clivus approach
24 hours
A day in The Life of an Aichigakuin University Dental Hospital Postgraduate Resident
interview
Dr. Andri Hardianto
beyond the or omers? r cust Patients o
Strengthening Connections Pierre Désy IAOMS Executive Director
S
ince the last issue of Face to Face, we had one of many firsts for our association. In midAugust, we launched the IAOMS eLearning Program to bring continuing education on key fellow-identified topics to you year-round. The first eLearning webinar was presented in Spanish by Julio Acero, IAOMS Vice President. eLearning webinars will be provided initially in English, Spanish and French and a schedule and list of topics , by language, will be available on the IAOMS web page (iaoms.org/ elearning). Another first for IAOMS, the IAOMS Foundation launched the $400,000 Challenge. The challenge is to encourage IAOMS Members to make a donation to the foundation and each dollar given will be matched by The KLS Martin Group, for up to $80,000 per year for the next five years. Let’s show them we are up for the challenge and demonstrate your support. Find more information on the $400,000 Challenge from The KLS Martin Group and the IAOMS Foundation’s mission and goals on our website- iaoms.org/foundation. Help us make this Challenge a success. Make your donation now! In late August, IAOMS was invited to attend the 11th Asian Congress of Oral and Maxillofacial Surgery. I traveled to Xi’an, China with IAOMS President, Piet Haers and other senior officers of the IAOMS Board of Directors. IAOMS actively recruited new members and shared the many benefits of membership including the upcoming International Conference on Oral and Maxillofacial Surgery (ICOMS) in Melbourne in 2015. During the Congress, IAOMS engaged in multiple productive and constructive conversations with leaders from multiple OMF surgery associations from
the Asia Pacific region and beyond. One of the many themes that emerged from those meetings is the need for assistance with recruitment and retention of IAOMS Fellows, Members and Trainees. This need had also been identified through Skype conversations with multiple IAOMS Councilors. To address this crucial need, IAOMS will introduce a Membership Campaign to strengthen the recruitment of new members and the retention of existing members. IAOMS will provide recruiting tools to help assist in this campaign along with honorable recognition for those who actively enlist new members. More information about the Membership Campaign will be posted on our social media pages and our website. At the beginning of September the IAOMS President Professor Haers, myself and other senior officers of the IAOMS Board of Directors attended the American Association of Oral and Maxillofacial Surgeons (AAOMS) Conference in Honolulu, Hawaii. We will also be attending the XXII Congress of the European Association for Cranio-Maxillo-Facial Surgery during which we will host multiple meetings with national and regional OMF surgery association leaders, exhibit, and promote the 2015 International Conference on Oral and Maxillofacial Surgery (ICOMS). One way, IAOMS is making a more active presence in the oms community. Finally, I would like to introduce you to Rupa Brosseau, Foundation Manager/Membership Coordinator. Rupa joined the IAOMS staff in late July and will be instrumental in operationalizing the IAOMS Foundation strategic plan. You can reach Rupa via email at rbrosseau@iaoms.org. Want to contact Pierre? Reach him at pdesy@iaoms.org. ■
A Historic Start Piet Haers IAOMS President
T
he first ever IAOMS eLearning live webinar took place on August 18th, with 180+ registered participants. This was the first IAOMS live webinar specifically geared towards Latin America, Spain and other Spanish speaking Fellows and Members around the world. Congratulations go to the Chairman of the IAOMS eLearning Committee, Juan Antonio Hueto Madrid, and the Spanish eLearning Committee, Alejandro Martínez, Leopoldo Meneses and Ricardo Vasconcelos for their instrumental role and help in launching this first webinar. I would also like to congratulate the inaugural presenter, IAOMS Vice President Julio Acero, for giving the webinar on Mandibular Reconstruction. This was a historic start and an important step for IAOMS to be more relevant in a digital world for our Fellows and for oral and maxillofacial surgeons worldwide. This is only the beginning of our IAOMS eLearning Program, with English and French speaking webinars soon to follow and only a fragment of our Continuing Education Program. Our goal is to bring you Continuing Education that will focus on making this a sustainable program for oms in the coming years. IAOMS is working hard to develop various programs that will target different audiences. The IAOMS Continuing Education Program will assist the young surgeon seeking additional resources of basic information, to the advanced surgeon seeking ongoing education in addition to the surgeon with special interests who wishes to communicate with other specialists. There will even be a special review program for those who wish to prepare for the IBCSOMS Fellowship Examination. IAOMS will be your go to for all your continuing education needs.
The IAOMS Continuing Education Program is one of the many initiatives IAOMS is implementing to strengthen and shape the future of oral and maxillofacial surgery. Become part of the movement and motivate your colleagues to join IAOMS. Let’s work together to grow our specialty. ■
“Our goal is to bring you Continuing Education that will focus on making this a sustainable program for oms in the coming years”.
The Future of the IAOMS Continuing Education Program
1. eLearning Webinars This program targets all IAOMS Fellows and will provide webinars that will aim to cover the complete scope of OMF Surgery. A digital Certificate of Completion will be issued by IAOMS and forwarded to participants who attend sessions in their entireties. Initially this program will run in English, Spanish and French.
2. Specialist Interest Group Networks
(SIGNs) SIGNs not only cover different clinical areas of our professional scope, but also include relevant special interest topics. SIGNs’ activities will involve hosting faceto-face educational programs and live webinars in specific specialty areas, for example trauma, reconstructive surgery, dental implants, etc. Participants of SIGNs will be eligible to receive Certificate of Completion.
3. IAOMS Trainee eLearning Yearly cycles of live webinars with Certificate of Completion and educational webinars on basic techniques available in our repository.
4. IAOMS eLibrary The IAOMS eLibrary will be your resource on the go. Available to you 24/7 for the live webinar you missed out on to the basic procedure you want to brush up on. This will be your authority on oral and maxillofacial surgery.
5. International Fellowship eReview
Course IAOMS will provide review courses accessible only to those who have registered to complete the Fellowship Examination organized by IBCSOMS. These review courses are not mandatory for FIBCSOMS candidates, but will provide well-structured review material.
In memoriam PROFESSOR GEOFFREY LESLEY HOWE: 1924-2014 By Peter Banks, IAOMS Past President
O
n July 17th, 2014 Professor Geoffrey Howe, a past president of IAOMS died peacefully at the age of 90 years. He became the IAOMS President at the 7th International Conference in Dublin in 1980 having been a founder member of the Councils of both the International and British associations of Oral Surgery. Born in 1924 and the passing of his father at the age of 10, Geoffrey’s main inspiration to become a dentist came from his uncle who had survived World War I to become a dental technician. He was a bright young man and won a scholarship for the then double degree course at the Royal Dental Hospital. Unfortunately the outbreak of hostilities in 1939 meant that the double degree course was abandoned. Geoffrey studied dentistry during the war years in London qualifying in 1945 and then joining the army for three years during which period he met and married his wife Heather. He obtained an academic post at Royal Dental Hospital during which he worked for John Hovell who encouraged a career in oral surgery. He entered medical school at the Middlesex Hospital in 1949 and worked his way through medical school with the help of his wife and part-time dental practice with his uncle. During his medical studies he joined the Territorial Army and thereafter had a long association with that organization. His higher training as senior registrar was at the Eastman Dental Hospital which was a rising star in the educational firmament under the influence of its then Dean Professor Frank Wilkinson and such distinguished oral surgeons as Sir William Kelsey Fry. During this period he published a number of papers and his first textbook. At this time the University of Durham advertised the first Chair in Oral Surgery in the UK. Geoffrey went to Newcastle where he met Professor (later Sir) Robert Bradlaw who encouraged him to apply. At the age of 34 he became the first and still the youngest professor of oral surgery in Britain. Geoffrey became increasingly involved in domestic dental politics, both with the British Dental Association,
and the emerging UK training committees involving both Universities and Royal Colleges. During the period in which he was a member of the Executive Committee of IAOMS he was also a member of the Board of the Faculty of Dental Surgery in the English Royal College of Surgeons, on numerous British Dental Association committees while still being involved with the Territorial Army and a trustee of the Royal Army Dental Corps Museum. He remained Professor of Oral Surgery in Newcastle for eight years and then returned to his alma mater in London to become Professor of Oral and Maxillofacial surgery of the University of London at the Royal Dental Hospital. Heavily involved in undergraduate teaching he produced a series of highly regarded textbooks on basic oral surgical techniques. In 1976 he was appointed chairman of the dental academic advisory committee of the University of Hong Kong where a new Dental School was proposed. In 1978 he became Dean of the Prince Philip Dental Hospital and school. He was an active member of the Executive Committee of IAOS and became President in 1978. He was the President of ICOS at the Berlin conference in 1983 where he passed the chain of office on to Professor Daniel Laskin. Geoffrey Howell had a somewhat sad ending to a distinguished academic career. He left his post in Hong Kong under a political cloud which was never satisfactorily resolved. He then almost started a new career when having retired he was asked to undertake some teaching of Oral Medicine at Yarmouk University in Jordan where there was a project to set up a new Dental School. He continued to work in Jordan in an advisory capacity until he was 72 years old when he finally retired. In the twilight of his life he tragically lost both his wife and only son and was rarely seen at OMFS meetings. His contribution to the specialty was considerable and he will be greatly remembered for it. Our thoughts and sympathies go out to his family and friends at this time. â–
lmarkovic@iaoms.org
The most rewarding experience y life
in m
Santosh Kumar Yadav shares his experience as an IAOMS Fellowship Recipient.
I
was born and brought up in a small village of Janakpur in Nepal. My parents managed to send me to a local school where I successfully completed my education. Ever since my school days, I had a deep interest in medical sciences and wanted to become a health professional so I could serve the suffering people of my community. With all these dreams and ambitions I joined Bachelor of Dental Surgery (BDS) at B. P. Koirala Institute of Health Sciences, Dharan, Nepal, well known for its quality medical education and training. During my BDS, I was very much attracted to the knowledge and clinical skills of my teachers and surgeons. I learned greatly from their compassion and caring approach in the hospital. All this reinforced my desire to become like one of them in future. Possibly because of my academic excellence, dedication, sincerity and appreciation of my teachers, I had the opportunity to join Master of Dental Surgery (MDS) in Oral and Maxillofacial Surgery at Manipal College of Dental Sciences, Mangalore, India, regarded as one of the best dental colleges in India. Soon after completion of my MDS which was mainly focused in oral and maxillofacial surgery, I was offered a faculty position in the Department of Oral and Maxillofacial Surgery at Chitwan Medical College (P) Ltd., Bharatpur-10, Chitwan, Nepal. By taking this position I became extensively involved in teaching and clinical practice. During my clinical practice I saw a lot of oral cancer cases, but was unable to give proper treatment to my underprivileged countrymen. This made me feel that I should work at gaining more knowledge. I was looking for a higher educational opportunity particularly in Oral Cancer, further clinical exposure and advanced learning under the tutorship of experienced surgeons outside my native academic grounds. Wishing to learn new schools of thought, expand the boundaries of my knowledge and see different technical skills, I wanted to travel overseas for a fellowship, and experience a foreign clinical perspective.
Googling fellowship programs, I looked for “oral and maxillofacial surgery fellowship” and suddenly it came to me-the International Association of Oral and Maxillofacial Surgeons (IAOMS) website. It took just few seconds to see the trainees tab and then I discovered the IAOMS Fellowship Programs. In that moment, I decided to apply for the Fellowship in Oral and Maxillofacial Oncology and Reconstructive Surgery. After a few months, I received an e-mail stating that I was awarded the IAOMS Fellowship with the great opportunity to visit the Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing, P. R. China, under the guidance of Professor Guang-yan Yu. Of course, the IAOMS Fellowship constitutes fantastic help for all the expenses encountered. At the end of August 2013, I finally flew from Nepal to China. My first time in China and the first moments of an incredible experience…
➠
1st September 2013 / 31st August 2014
Peking University School and Hospital of Stomatology, Beijing, China, Department of Oral and Maxillofacial Surgery, Maxillofacial Oncology and Reconstructive Surgery Unit. On my first day of duty, beginning my first day in the surgical room and ending my period in the same place, the team led by Professor Yu gave me a warm welcome. Within a very short period of time and in the most hospitable manner, I was introduced to all the activities of the department, such as the operative room, the out-patient clinic, the case-discussion meetings and rounds. It was really gratifying to attend surgeries that were underdeveloped in our institution and our country. In addition to participating in interdisciplinary meetings where the most prominent aim and interest was to provide the best treatment option in order to rehabilitate the patient. After a couple of days working with the maxillofacial team, we started to share a lot of time together in the hospital, both the consultants and the residents.
My Prof. Guang-yan Yu
I must say I was impressed with what hard workers they are and how friendly they are after work. They demonstrated their friendliness by inviting me to a Chinese dinner and gladly came along to taste a Nepalese one. Smiling and working is something that happened at the same time. I experienced a high level of surgery that has allowed me to acquire new knowledge, develop new skills, expand the boundaries and add a variety of treatments that can be performed with an interdisciplinary management in the interest of providing the best alternatives to our patients to regain their health and obtain a complete rehabilitation. The IAOMS role of Oral and Fellowship Maxillofacial Surgeon “I am very grateful in the interdisciplinary to IAOMS and treatment of tumors of the Fellowship the maxillofacial area is of Committee, who paramount importance, kindly awarded me and has as the main the Fellowship. treatment objective, Thank you for being reconstruction and supportive and rehabilitation of patients, helping me build thereby improving the confidence in this quality of life for them. clinical and surgical training, and making During my stay, I had the this wonderful opportunity to participate experience possible, in surgical procedures to which, I have no in all areas of Oral and words to express� Maxillofacial Oncology
Assisting case in operation theater
Observing case in operation theater
Welcome dinner at Prof. Yu
and Reconstructive Surgery, making the visit even more interesting. This type of training allowed me to evaluate treatment alternatives, compare and analyze in accordance to the developments reported in the scientific literature and consider the advantages and disadvantages to standardize the diagnosis, management and treatment in our patients. It was very gratifying to see the interdisciplinary medical management that exists in the hospital, the high degree of professionalism and commitment to patient-doctor to treat the disease. Likewise, the position and participation of the Department of Oral and Maxillofacial Surgery is of vital importance for the treatment of head and neck cancers.
“This experience has been one of the most rewarding experiences in my life...” Xin, Dr. Wang DC and to all physician members of the Department of Oral and Maxillofacial Surgery, at Peking University School and Hospital of Stomatology, Beijing, China who shared their experience and knowledge and that they made me feel at home from the first day until the last day of my visit.
Attending Ward Rounds
My stay in Beijing and my experience at Peking University School and Hospital of Stomatology motivated me deeply and positively influenced the path I have taken the last few years and keeping with my firm intention to take maxillofacial surgery to the highest level. This experience has been one of the most rewarding experiences in my life, not only for the reason that I could get rich in profound ways professionally and directly receive the benefits of the extensive experience at China, but that I can pass on this knowledge to new generations who are committed to the future development of oral and maxillofacial surgery. I am very grateful to IAOMS and the Fellowship Committee, who kindly awarded me the Fellowship. Thank you for being supportive and helping me build confidence in this clinical and surgical training, and making this wonderful experience possible, to which, I have no words to express. Today I can say: “I’m a better surgeon than I was before”. My heartfelt respect, my admiration, my gratitude go to Prof. Dr. Guang-Yan Yu, Prof. Dr. Mao C, Prof. Dr. Gu CB, Prof Dr. Peng
Finally, with a new horizon, better perspective and enriched knowledge, I will be returning to my country and I feel great that I will be able to share this knowledge with my professionals, plan and treat the cases with a better skill and thus, ultimately help the underprivileged countrymen by giving them a new smile on their faces. Last but not the least, wonderful visits to new and different places, great festivals, rich traditions and delicious food, moreover, all the people who walked me through the thick and thin of my life, in this country will always be cherished and treasured. ■
Santosh Yadav, Prof. Yu and Prof. Xin
OMS on a mission Noma: the hidden disease By Eloy García, Barcelona (Spain)
A
little time after my training as a maxillofacial surgeon, I heard about a family that was involved in bringing in children from Niger to Palma de Mallorca, Spain and were operated on by a maxillofacial team headed by Dr. José Iriarte. The children that were brought in had severe facial deformities caused by noma. Noma was an unknown disease to me as a maxillofacial surgeon, as it was to all my other colleagues. This disease had already been completely eradicated from Europe. The last cases happened during the Second World War in the Nazi camps.
“My need to help those inflected with noma led me to embark on a journey to Diffa, Niger”.
Noma is an oral infection caused presumably by a Fusobacterium necrophorum. In 70% to 90% of the cases, it produces septicaemia, which leads to the death of the patient. It is an infection that is almost exclusively found in children; habitually in patients with severe hypoproteinemia due to malnutrition (it is paradoxical that the best restaurant in the world has the same name - NOMA!!!!) Children who survive this infection (which is an easy disease to treat with one or two doses of penicillin and good nutrition) suffer the destruction, necrosis of the facial tissue according to the area of the face where the infection originates. It can destroy the cheek, mandible, maxilla, orbit and ear. My need to help those inflected with noma led me to embark on a journey to Diffa, Niger. Together with another maxillofacial surgeon, Carlos Marti and my wife Elena, (a hematologist) we arrived in Niamey, Niger our departure point for a 1500 kms trip. With a 4WD, we traveled for 2 days on terribly dusty roads through camels, sheep and giraffes. We felt like we were driving in the Paris-Dakar Rally, but with endless police patrols on our way. When arriving to our final destination of Diffa, the scenery turned from desert brown to a shade of green. Upon entering the facilities of our center we encountered a group of children shouting “Papa, papa”. Dozens of children with disfigured and mutilated faces were playing and shouting all around. As we progressed through the village, we came to the last well that had been constructed. The entire village came out to greet us. This would be where we would establish our medical practice. We would try to classify and organize all the children that needed our help. During our time in Diffa, we attended to noma patients as well as operating on some cleft cases. During the 3 weeks we were there, there was not a single moment of sadness. Children were playing and carrying on as if nothing had happened to them. Happiness was reigning in the village!! Our time spent in Diffa was wonderful, unforgettable and difficult to reproduce in words. Our journey was a success. ■
SOS, children Noma is an infection that is almost exclusively found in children; habitually in patients with severe hypoproteinemia due to malnutrition. It is an oral infection caused presumably by a Fusobacterium necrophorum. In 70% to 90% of the cases, it produces septicaemia, which leads to the death of the patient.
“Our time spent in Diffa was wonderful, unforgettable and difficult to reproduce in words. Our journey was a success�.
So you want to work... ...in Brazil? By Prof. Carlos Alberto Baraldi
A
s in many countries, it is not easy for a specialist to come to Brazil to work, even though recent projects have brought many foreign medical professionals. Most of these projects have focused their primary assistance to temporary programs, and are allocated to undeveloped regions. Language is an important issue, too. Speaking Portuguese is essential. Brazilian Portuguese is very different from Portuguese in Portugal and African/ Asian countries where Portuguese is spoken - although for legal purposes they are the same language. It is easier to come to Brazil for academic purposes – postgrad, postdoctoral or invited professor programs have the proper lines for financial support and easier regulation for visas and authorizations. In these kinds of activities, you will be able to exert your practice only in the institution where the program is developed. Brazilian OMS is Dentistry based, so to register as a specialist you should revalidate your dental degree at a Brazilian Dentistry school (click here for a relation).
“Language is an important issue, too. Speaking Portuguese is essential�
do not forget! For those who want to move to Brazil, do not forget that a working or student visa is required. Contact Brazilian consulate or embassy in your country for information in your language.
After this process, you may also revalidate your specialist title, always choosing a school which offers the OMS specialization program (click here for consultation). You should choose and contact the institution directly for revalidation details and timetables. Keep in mind that every institution may demand different activities for revalidation - theory and practice tests, as well as frequency on disciplines and learning activities may be a request. For those who also have a medical degree, here you will find information about revalidation. After revalidation it is possible to work in a public or private practice (office, clinics, hospitals, etc.).
Professionals must register in the state they intend to work. On the CFO site you can find more information about federal laws for legal practice. Most of the specialists are concentrating on Southeast and South states. North, Center-West and Northeast states have experienced improvement in the number of colleagues in recent years, but still have potential needs. For numbers of specialist by state, click here. Earnings are really variable in Brazil, not only for OMS surgery. Most of the professionals work in private and public practice, and in different contract manners. Initial earnings may start at US$1500-2500, and may grow as one invests in their career â–
Donate Now! iaoms.org/foundation
From Proust to Pivot An Apparently Innocent Questionnaire for Oral and Maxillofacial Surgeons
Y
ou’ve heard of the Proust Questionnaire? Adapted and made famous in the back pages of Vanity Fair Magazine, it was named not for the questions, but for the answers given by Marcel Proust to a set of questions asked by his friend Antoinette Faure.
Then, for many years, Bernard Pivot conducted a cultural program in French TV call “Apostrophes”. All of his guests received the same ten questions at the end of the interview. So, in Face to Face, we thought this questionnaire would be a great method to get to know the personalities of our interviewees, since oral and maxillofacial surgeons are human beings just like the rest of us! Turn the page, enjoy, and discover how Nabil Samman answers the IAOMS Proust Questionnaire. Enjoy, and compare their answers with those of celebrities!!!
The IAOMS Proust Questionnaire What is your favorite word? No problem What is your least favorite word? Sorry What is your favorite drug? Success What sound or noise do you love? The sound of the ball on the sweet spot of a 5 iron What sound or noise do you hate? Repetitive announcements during a flight What is your favorite curse word? Merde Who would you like to see on a new banknote? Clint Eastwood What profession other than your own would you not like to attempt? Deep Mining work If you were reincarnated as some other plant or animal, what would it be? A large migratory Bird If Heaven exists, what would you like to hear God say when you arrive at the Pearly Gates? Welcome anyway! What is your idea of perfect happiness? The shade of a big tree with the right book not far from a cold drink What is your greatest fear? Drowning What is the trait you most deplore in yourself? Oversensitivity What is the trait you most deplore in others? Selfishness Which living person do you most admire? The hardworking man without any apparent great hope What is your greatest extravagance? Working on it What is your current state of mind? Anticipating What do you consider the most overrated virtue? Hard work if disregarding other people’s rightful concerns On what occasion do you lie? To avoid excessive embarrassment
Which talent would you most like to have? Make people laugh If you could change one thing about yourself, what would it be? More patience and tolerance
Nabil Samman lives and works in Hong Kong, but only when is not lecturing and traveling around the world for IAOMS
What do you consider your greatest achievement? Our children If you were to die and come back as a person or a thing, what would it be? The Immortal Where would you most like to live? In South East Asia What is your most treasured possession? Some of my books What do you regard as the lowest depth of misery? Loneliness What is your favorite occupation? Chef Artisan What is your most marked characteristic? Adaptability What do you most value in your friends? Loyalty Who are your favorite writers? Amin Maalouf, Tom Clancy Who is your hero of fiction? Harry Hole
What do you most dislike about your appearance? Looking older and older Which living person do you most despise? The taxman
Which historical figure do you most identify with? Cicero Who are your heroes in real life? Those who risk their lives for others
What is the quality you most like in a man? Integrity What is the quality you most like in a woman? Promise
What are your favorite names? Houdini, Frankenstein, Dracula, Superman What is it that you most dislike? Housework
Which words or phrases do you most overuse? I know I know, but the point is‌ What or who is the greatest love of your life? My family of course When and where were you happiest? First travels in Europe
What is your greatest regret? Not pursuing major physical adventure How would you like to die? Quickly What is your motto? Do better and enjoy more. â–
Copy Me TRANSFACIAL CLIVUS APPROACH The facial splitting with technique of dismantling and reassembling of the facial skeleton,permits the approach of deeply located tumors. These permit the face to be opened like a book. The pedicled bone flaps available include: nasal-cheek flap, maxillo-cheek flap and naso-maxillo-cheek flap (bilateral association is possible).
2
1
Prof. Massimo Robiony Associate Professor of Maxillofacial surgery University of Udine FEBOMFS Board Director International Piezosurgery Academy Chordoma of the Clivus: Preoperative planning with navigation system. The incision lines.
3
Extraoral Incisions: Lateral rhinotomy, glabellar incision, bilateral subciliar incisions and labiotomy. Intraoral: Palatal midline incision.
4
Osteotomy line are performed using piezosurgery.
5
8
The osteotomy is performed immediately under orbital rim towards lateral nasal wall medially and malar bone laterally until pterigomaxillary junction.
On the right side of the face a maxillo-cheek flap on the left side naso-maxillocheek flap. Tha face is opened like a book. Lateral view during nasomaxillo-cheek flap repositioning with evidence of miniplate on the nasal bone
9 6
At this moment a preplating is carried out using titanium mini-plates
10 Lateral view during nasomaxillo-cheek flap repositioning with evidence of miniplate on the nasal bone.
7
12
11 Nasal osteotomy is completed and contro-lateral maxillary osteotomy is performed so the flaps can be rotated.
The two flaps are then medially rotated and the facial skeleton is finally reassembled using mini-plate. The Aesthetic suture is made with nylon 6-0
Final Aesthetic and functional result
Hours A day in The Life of an Aichigakuin University Dental Hospital Postgraduate Resident By Chiaki Tsuji (Nagoya, Japan)
N
ow I finished my residency in oral surgery, and then worked at a private clinic as a general dentist. This past April, I decided to turn over a new leaf. I have again started to study oral and maxillofacial surgery. For this year, we have four postgraduate students and five postgraduate residents as contemporaries. We are separated into two groups: one takes care of the ward and the other takes care of outpatients, switching roles every two weeks.
6:30 a.m.
8:45 a.m.
I get up and out of bed and have breakfast and get ready to start the day. I live in a room just five minutes away from the hospital.
Dr. Ch ia again t ki Tsuji has o starte maxillo study oral d and facial surger y.
. m . a 5 1 : 8
I arrive at the hospital, change clothes, and then order a lunch box. As part of the ward group, I go to see pre- and post-operative patients, keep track of their health, dietary intake, read the nursing record and prepare for the morning conference. If there are changes that require urgent attention, I report it to my supervisor and consult instructions.
We have a morning conference every day, starting at 8:45 (except on Tuesday at 8:30). First year fellows present about inpatients. Regarding the preoperative patients, we present the scheduled operation, the medical history, and physician and anesthesiologist’s preoperative examination results as necessary. Since we have many cleft lip and palate patients, mostly babies and toddlers, there’s a higher probability of them catching a cold right before hospitalization and needing to have their operations postponed according to the results. As for the post-operative patients, we report briefly about the operative methods, operative time, and patient condition during surgery, and their present state. We also present about outpatients who are scheduled for tooth extraction or other kinds of surgical treatment for the day.
LATEST ICOMS NEWS CALL FOR ABSTRACTS IS NOW OPEN! Abstracts for the 22nd International Conference on Oral & Maxillofacial Surgery ICOMS 2015 are now being accepted.
Click below for further information
CLICK HERE TO SUBMIT SUBMIT AN ABSTRACT
Hours 9:00 a.m. As the ward team, we do post-operative treatments and decide on formulas as needed. We also enter the operating room as assistants and continue to monitor patient postoperative condition over time. In the morning as the outpatient team, I see new patients and do medical examination interviews. Most of the patients are referrals from private dental offices or from other departments within the hospital. I also see some followup patients (usually post-extraction patients) and do extractions and treatments as well. At the appointed time, I call the patient into the chair and check the written informed consent, notify the instructor and start the treatment.
13:30 p.m. In the afternoon, we have special treatment consultations: Mondays are jaw deformities, Tuesdays are cleft lip and palate, Thursdays are temporomandibular disorders, and finally Friday is oncology. I check the medical records, take pictures and order the required x-rays. There are some interns and dental students coming to study the consultations and sometimes we do oral examinations. As in the morning, I do some treatments in the afternoon. Reservations in the morning are usually shorter than in the afternoon where we look at cases such as extraction of impacted wisdom teeth and treatment for hospitalized patients. About 16:00 we finish the outpatient work.
m. . p 0 3 : 16 On Thursdays, we have an evening conference, where we discuss the upcoming operations. For this time of the year, we hold study meetings for first-year residents, about the treatment plans and the usage of medicines such as antibiotics and intravenous drips. The medical specialists lecture on their field of specialties with certain cases as references. We also invite the manufacturers of the medicines and ask them to introduce their products.
18:00 p.m. Almost finished! I do the remaining tasks such as organizing photos, listing the first time patients, and preparing the medical records for the next day of hospitalization. After we finish most of the hospital duties, we work on the research paper. And we also concentrate on the scientific paper presentations.
20:00 p.m.
Night duty work starts. There are usually no emergency patients coming at night, so the main work is to observe the inpatients, especially the post-operative patients. Sometimes we have post-operative bleeding and nausea but for the most part we have calm and quiet nights.
“...The most pa rt we have calm and quiet nights”.
Professor Robyn Guymer will be the Guest Speaker for the Foundation Luncheon at the Melbourne 22nd ICOMS in Melbourne, Australia. Professor Guymer was one of the principal investigators on the successful Australia Research Council bid to develop an Australian “bionic eye” and is also a member of Bionic Vision Australia (BVA) consortium. She is the program leader of the clinical program in the consortium and is a member of the BVA research management committee overseeing the activities of over 150 researchers in 5 different lead organizations around Australia whose common quest is to develop a commercially viable “bionic eye”. This conference’s Foundation Luncheon promises to be exceptionally engaging as Professor Guymer will share her experience on the CERA Bionic Research Project. The IAOMS Foundation was established in 1996 with a core mission of enhancing and expanding OMS education and training worldwide by supporting surgeon to surgeon education. Your donations help oral and maxillofacial surgeons in developing countries who are striving to improve the health and quality of life for their patients. Mark Your Calendar and Support the IAOMS Foundation Tickets can be purchased with the Registration for Melbourne ICOMS For more information visit www.icoms2015.com To donate to the IAOMS Foundation visit www.iaoms.org/foundation/ www.iaoms.org/foundation/
Date and time: October 29th 2015 at 12.30pm Venue: Melbourne Convention Center
interview
Dr. Andri Hardianto “I still prefer going back to Indonesia because they (Indonesia) more need me than if i stay in China”.
Tell me about your background. any doctors or dentists in your family? I am now a staff educational of oral and maxillofacial surgery at Depatment of Oral and Maxillofacial Surgery of the University of Padjadjaran (Bandung-Indonesia). I obtained my DDS from Trisakti University (1998) and combined degree MD-Ph.D. at Shanghai Jiao Tong University School of Medicine. I had training in Oncologic and Reconstructive Surgery of the head and neck at Shanghai Ninth People Hospital, Shanghai P.R. China (1999-2000) Yes, I have several relatives directly involved in other medical and dental specialities, so dedicating myself to OMFS was a natural decision!!
Why did you choose to go to China Was it a deliberate decision or just a question of luck? China is one of the oldest civilzations in the world having a written history of more than 4,000 years, rich culture and a respected educational tradition, especially in the field of medicine or surgery. On completing the requirements of the program and passing the graduation examinations successfully, international medical will be granted a graduation certificate and conferred a medical degree by the university. Last reason, why did I choose to go to china? Living costs and tuition are considerably lower because of subsidized by the Chinese Goverment even I was a foreign student.
How did you become a maxillofacial surgery? Where did you do your basic training? After I graduated from dental school in 1998, my father always motivated me take a postgraduate program and clinical training in Oral & Maxillofacial Surgery. I made my decision to became resident in OMF Surgery. I was fortunate to be accepted in 1999, the Department of Oral and Maxillofacial Surgery was one of the many departments in the Chinese Stomatology School situated in the Shanghai Ninth Peoples Hospital of the Shanghai Jiao Tong University, China.
How were you received as a foreigner? Which were your basic difficulties there? I encountered a number of problems. I had certain problems in the beginning, that disappeared later. The Chinese language was the main problem, according to the Chinese Ministry of Education for foreigners wishing to study as a postgraduate student you must pass the National Chinese Examination (HSK) at the medium level. I prepared for one year full time in chinese language for take National Chinese Examination.
▲
Did you have the possibility of postgraduate training in your country? Absolutely yes, as long as you have a strong recommendation letter from outstanding Oral and Maxillofacial Surgeons.
RSHS, Bandung.
Why did you choose microvascular reconstruction?? Who were your teachers?How many cases a year were operated there? In my country Oral and Maxillofacial Surgery is still just developing in surgical skill techniques, especially in oncologic maxillofacial and reconstructive surgery need to developing, considered serve high amount of Indonesian Population (250 Million people). At Shanghai Jiaotong University affiliated Shanghai Ninth People Hospital: Doctorate Supervisor: Prof. Zhiyuan Zhang Clinical Teacher: Prof. Chenping Zhang Department of Oral and Maxillofacial Surgery Shanghai Ninth People Hospital, they served in-patient approximately: 4,600 case per year.
▲ Instructor of Microsurgery Training Course, Co-Sponsores by IAOMS 2007. ▼ Shanghai 9 Hospital
What was the role in IAOMS and how did we help you in all the process? Facilitating the establishment of training centers in developing countries and providing clinical teaching assistance as well especially in Oncologic and Maxillofacial Microvascular Reconstruction Surgery; also develop friendly methods of international electronic communication to improve each other. Did you have the opportunity to stay in China? Why did you decide to go back to Indonesia? I have opportunity to stay and work in Shanghai with my teacher Prof. Chenping Zhang. But, I still prefer going back to Indonesia because they (Indonesia) needs me more than if I were to stay in China.
jects What are your pro for the future? My special fields of interest are oncologic and reconstructive surgery of the large-scale oromaxillofacial defects with various composite free flaps. My research interests in serial studies of functional reconstruction of oromandibular defects.
What did you find when you arrived to your country? I felt very honored when I arrived in Indonesia, because an Indonesian Maxillofacial Institution Center asked me to become part of their staff. Finally, I accepted one institution in University of Padjadjaran – Dr. Hasan Sadikin General Hospital (Teaching Hospital) in Bandung as part of their Educational Staff. What are the difficulties now? Now my relationship with Indonesian Maxillofacial Surgeon don’t have any problem. But, for the relationship with some Department of Surgery such as Oncologic Surgeons; Plastic and Reconstructive Surgeons and ENT Surgeons still have some friction. I have confidence sooner or later surely we will solve our problems. ■
Beyond OR Patients or customers? By Javier González Lagunas
P
lease do not burn me at the stake before you read this comment…No word like customer in a medical environment delivers more discomfort. It is almost a sin to talk about customers inside a hospital or a medical practice. But think about it, you work in a busy practice, you have to pay the rent or mortgage, you have to pay your staff, you have to pay your providers... you have to make ends meet!!!! Just like any other business. On the other hand, how are you going to increase stability? Either you are a non-governmental organization (NGO) with a government subsidy or you need customers. Let´s define a customer: A party that receives or consumes goods or services and has the ability to choose between different products or suppliers. There is an ethical problem with medicine, but I am going to take it for granted and assume that we are all highly ethical professionals, and that we will never do anything that might hurt one of our patients. A good option: Who is this person that is entering the door of your practice? Well, the moment he is laying on the surgical table in the OR, he is definitely your
patient, and no other consideration should be taken. But before that, when they call your practice for the first time , when he is sitting in the waiting room for his first appointment, you should treat him like a customer of professional services. Why? Because you want him to stay with you, and not go to the practice next door do you? At this particular moment you are no different from a lawyer, an architect or a restaurant. If the situation is managed appropriately, the patient will stay, if not, he will go to the competition. Remember the definition of customer? They can choose… Do you know how customers evaluate our practices? Some of the main medical rankings in the U.S. (RateMD, Healthgrades…) talk about the quality of the staff, punctuality, waiting time, helpfulness or knowledge. So take care of your patients, treat them well. It is not only just healing them, but you want them to recommend you and reiterate their excellent experience with you. You want them to be your promoters; you need them to grow in number. The competition out there is fierce, so be better than the rest!! It does not matter how good you are. Your customer must feel you are the one, and that will not only depend on your technical qualities, but mainly on your capacity to go beyond their expectations as a consumer of professional services. ■
“So take care of your patients, treat them well”.
www.iaoms.org/foundation/fellowship/apply
YOUR AUDIENCE AWAITS...
Advertise in Face to Face Request a media packemail: lmarkovic@iaoms.org