ACOMS REVIEW
President’s Message
The American College of Oral and Maxillofacial Surgeons
Surgical Excellence Through Education
Volume VII, ISSUE V, 2015
Dear Colleagues and Friends, It gives me great pleasure to address you for the first me as President of the American College of Oral and Maxillofacial Surgeons. In the eight years during which I have served as a member of the ACOMS Board of Regents, I have seen the College grow considerably. We have never had more high‐quality, highly‐regarded, and mely educa onal offerings as we do today and the remarkable numbers of new Fellows, Members and Residents who have joined the College are a testament to the hard work and dedica on of my predecessors. Please join me in thanking the 2014‐2015 Officers, Regents, and We are happy to welcome three new regents to Commi ee Members who steered us through the Board: Tara Aghaloo, Brian Farrell, and another highly‐successful year. Antonia Kolokythas (see biosketches on pages 2‐ A special thank you and congratula ons is owed to 3), and two former Regents who return to the my immediate predecessor as President, Dr. Board as Officers: Bryan Bell and Marianela Robert Strauss. Dr. Strauss began his term with Gonzalez. To these new members of the Board, clearly‐defined, ambi ous goals for ACOMS. and those returning for another year of service: Remarkably, the majority of his goals were thank you. Thank you for your service, and thank achieved. As you all know, Dr. Strauss injected this you for filling me with such confidence in the newsle er with new life through his president’s upcoming year and the future of ACOMS. messages which captured his personality and wit and succeeded in being both informa ve and Best Regards, highly entertaining. He has set a high bar that I hope to match. We are going to have a great year. Not because I said so, but because our leadership team is energe c, smart, and intent on making it happen. Jon D. Perenack, DDS, MD
In This Issue:
Highlights from the Annual Conference
From the President
Stay Sharp—Resident Abstract
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New Regents
Prac ce Management Tips
Boot Camp
This Month in OOOO
Meet Your New Regents We are pleased to introduce three outstanding surgeons and educators as new members of the ACOMS Board of Regents for the 2015‐2017 Board term: Tara Aghaloo, DDS, MD, PhD is professor in OMFS at the UCLA School of Den stry. She completed her dental training at UMKC and OMFS residency and MD at UCLA. Subsequently, she completed a Ph.D. in oral biology at UCLA. She is a Diplomate of the ABOMS. Her clinical prac ce focuses on bone and so ssue regenera on and dental implants. Dr. Aghaloo is also ac ve in professional organiza ons where she is a board member of the AO, fellow of the ITI, AAOMS CRPTA commi ee member, past president of the OMS Sec on of the IADR, and sec on editor of IJOMI. She lectures na onally and interna onally on dental implant surgery and ssue regenera on, specifically including alveolar ridge augmenta on, sinus gra ing, growth factors, and periimplan s. Dr. Aghaloo will serve as the Regent for the Western Region of ACOMS. Brian Farrell, DDS, MD received his DDS from the University of Iowa College of Den stry and completed medical school in conjunc on with OMFS training at LSU in New Orleans at Charity Hospital. Dr. Farrell prac ces with Carolinas Center for Oral and Maxillofacial Surgery in Charlo e, NC and maintains a posi on as an Assistant Clinical Professor with LSU assis ng in resident training. Dr. Farrell serves as Director of the fellowship program offered through Carolinas Center for Oral and Facial Surgery covering the broad scope of oral and maxillofacial surgery. Dr. Farrell also serves as a board examiner for ABOMS and has authored mul ple ar cles, chapters and lectured na onally and interna onally covering dentofacial deformi es, virtual surgical planning and outpa ent orthognathic surgery. Dr. Farrell will serve as the Regent for the Southeastern Region of ACOMS.
Meet Your New Regents (ctd) Antonia Kolokythas, 2015‐2016 Officers and DDS, MSc graduated Regents of the College from the University of Officers: Thessaloniki Dental President: Jon Perenack, DDS, MD School in Greece and President Elect: Pedro Franco, DDS then completed her Vice President: R. Bryan Bell, DDS, MD, FACS OMFS residency at UIC. Treasurer: Jeffrey Benne , DMD Secretary: Marianela Gonzalez, DDS, MD, MS She then completed a two year Maxillofacial Past President: Robert Strauss, DDS, MD Oncology and Reconstruc ve Surgery Regents: Fellowship at UMD and UCSF. She is a tenured Associate Professor and the Program Director of Region I: Stephanie Drew, DMD the OMFS Residency program at UIC, as well as Region II: Allen Fielding, DMD, MD, MBA Region III: Brian Farrell, DDS, MD the Research Director for the Department of Region IV: Antonia Kolokythas, DDS, MSc OMFS. She is a Diplomate of the ABOMS, and a Region V: Kevin Rieck, DDS, MD, FACS Fellow of AAOMS, the AACMFS, and the IAOO. Region VI: Tara Aghaloo, DDS, MD, PhD Dr. Kolokythas has published over 45 peer reviewed ar cles, has contributed numerous book chapters, abstract presenta ons at na onal and interna onal mee ngs, has given invited lectures and has edited two textbooks. Her clinical and research interests are in Head and Neck Pathology, Oral Head and Neck Cancer and Reconstruc on. She is a member of the UIC Cancer Center and has several research collabora ons within her ins tu on as well at the interna onal level. She serves on several commi ees that include the UIC Cancer Center, the UIC College of Den stry, the University of Illinois Health and Sciences Center and AAOMS and is currently the President of the Chicago Society of OMFS. Dr. Kolokythas will serve as the Regent for the Great Lakes Region of ACOMS.
There is s ll me to register for this intensive, three‐day review! Kick Your Studies Into High‐Gear The third annual ACOMS Recer fica on Review Boot Camp is a comprehensive three‐day review of the en re scope of the oral maxillofacial surgical prac ce. With 10 hours of lecture and discussion each day, this intensive session is for oral and maxillofacial surgeons who are looking to get serious about their studies. Con nue Your Studies Through the Year A endees will receive PowerPoint slides and recordings of each session from the Boot Camp at no addi onal cost so you can con nue your studies throughout the year. The Convenience of Rosemont The DoubleTree O'Hare Rosemont is conveniently located just minutes from O'Hare Interna onal Airport, with frequent direct flights from most major airports. The DoubleTree is also located just steps from The Park at Rosemont, featuring dozens of dining and entertainment op ons for a endees.
Online Registra on is Now Open at www.acoms.org/bootcamp
Did you miss the ACOMS 36th Annual Scien fic Conference and Exhibi on? The Kurt H. Thoma Memorial Lecture, State of the College Address, and other lectures and highlights are now available in the ACOMS Learning Center.
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Congratula ons to the winners of the 2015 ACOMS Resident Abstract Compe on Presented on Monday, April 20, 2015 at the ACOMS 36th Annual Scien fic Conference and Exhibi on. 1st Place David Mar nez, DMD, MD ‐‐ Baylor College of Den stry/Texas A&M University Department of Oral Maxillofacial Surgery Addi onal Authors: Sterling R. Schow, DMD; David R. Kang, DDS, MD Cys c Fluid Component of Mandibular Ameloblastomas: A Poten al Source for Seeding or Recurrence? 2nd Place Ryan Richards, DDS and Pooja Gangwani, DDS, MPH ‐‐ St. Joseph's Regional Medical Center Oral & Maxillofacial Surgery Addi onal Authors: Michael Erlichman, DDS; Hillel Ephros, DMD, MD; Richard P. Szumita, DDS Airway Management and Control of Severe Hemorrhage By Transarterial Emboliza on through Interven onal Radiology and 3‐Staged Repair of Mul ple Facial Fractures in a Maxillofacial Trauma Pa ent. 3rd Place Zachary Kerr, BSc, DDS ‐‐ University of Western Ontario, London, Ontario, Canada Addi onal Authors: Thomas D. Daley, DDS, MSc, FRCDC; Zia A. Khan, PhD; Mark R. Darling, BChD, MSc (Dent), MSc (Med), MChD (Oral Path) Expression of Kallikrein‐Related Pep dases (Klks)iIn Adenoid Cys c Carcinoma.
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Save the Date Save the Date The ACOMS 37th Annual Scien fic Conference and Exhibi on on
Scien fic Co fic Co‐‐Chairs: Stephanie J. Drew, DMD and Pedro F. Franco, DDS Chairs: Stephanie J. Drew, DMD and Pedro F. Franco, DDS Carlton San Juan, Puerto Rico | www.acoms.org/2016 April 9 April 9‐‐11, 2016 | Ritz 11, 2016 | Ritz‐‐Carlton San Juan, Puerto Rico | www.acoms.org/2016
Stay Sharp This abstract was presented as a poster at the ACOMS 36th Annual Scien fic Conference and Exhibi on, April 18‐20, 2015.
ATTENTION RESIDENTS:
This new monthly segment in the ACOMS Review is your opportunity to share a case Expression of Kallikrein‐Related Pep dases (Klks)iIn Adenoid report or literature review with a Cys c Carcinoma na onwide audience. Ar cles must be Zachary Kerr, BSc, DDS; Thomas D. Daley, DDS, MSc, FRCDC; Zia A. Khan, PhD; Mark R. Darling, BChD, MSc (Dent), MSc (Med), 500 words or less and may not have been previously published. Residents whose MChD (Oral Path) ar cles are accepted in the newsle er will University of Western Ontario, London, Ontario, Canada receive a royalty payment of $100. PURPOSE: Kallikrein‐related pep dases (KLKs) are a group of
15 serine proteases implicated in a wide variety of biological Visit www.acoms.org/ar cles to learn processes. Overexpression of KLKs has been associated with more or submit your ar cle. the development of certain cancers, and epithelial‐ mesenchymal transi ons leading to metastasis. Furthermore, expression of specific KLKs is associated with unfavourable clinical outcomes in a number of different cancers. The clinical applica on of KLK 3, known as prostate specific an gen, as a biomarker highlights the poten al clinical u lity of KLKs in the diagnosis, prognosis and surveillance of tumors. However, the role of KLKs in salivary tumors has not been extensively studied. The purpose of this study was to determine whether dysregulated gene expression of KLKs occurs in adenoid cys c carcinomas (ACC). The consequence of altered expression will be inves gated to determine its usefulness in predic ng tumor behaviour and guiding the therapeu c management of cancer pa ents. METHOD: Formalin‐fixed, paraffin‐embedded (FFPE) ssue specimens were obtained from the Oral Pathology archives of Western University and London Health Sciences Centre. Total RNA was then extracted from a total 40 FFPE samples, which included 25 adenoid cys c carcinomas and 15 from normal salivary ssue. Complementary DNA, obtained by reverse transcrip on, was then combined with gene specific kallikrein primers (KLK1‐KLK15) to allow for quan ta ve real‐ me PCR. Data was normalized to a β‐ac n housekeeping gene. Con nue online to read the results and conclusions.
Ar cles submi ed to the ACOMS Review are not subject to scholarly peer‐review. Author(s) maintain responsibility for the contents of this ar cle.
Prac ce Management Life A er a Malprac ce Claim Jennifer Gibson, OMFS Specialist, Medical Protec ve It’s a seemingly pleasant workday, and your office manager places a stack of mail on your desk. You no ce an envelope from your malprac ce insurance company. As you review the le er, you recognize that you’re being non‐renewed and need to purchase tail coverage for your claims‐made policy. This tail coverage will cost you approximately two mes the base rate of your current premium and payment must be remi ed within 30 days. You panic. Failure to submit your payment within 30 days will leave you without malprac ce coverage for all your past work as an OMS. You ask yourself: why am I ge ng non‐renewed? Why is the company abandoning me; they have insured me since I completed my OMFS training program? What happens next? Although your confidence has been shaken and you’re le confused, these ques ons are normal in this circumstance. The good news is that you have malprac ce insurance op ons. The be er you understand those op ons, the more likely you are to make a wise decision. Malprac ce companies fall into one of two categories: admi ed or non‐admi ed. The primary differen ator is that admi ed companies are required to adhere to strict guidelines set forth by each state’s Department of Insurance (DOI). As for non‐admi ed companies, they are much less regulated, which allows them to provide coverage op ons not available through admi ed companies. Consider healthcare professionals, including oral and maxillofacial surgeons, that have experienced a malprac ce lawsuit, policy cancella on, license suspension, board complaint(s), prior gaps in coverage, or are prac cing in a ‘high risk’ area of the country. O en, they cannot find coverage with an admi ed company, and therefore, turn to a non‐admi ed company – typically an excess and surplus (E&S) lines carrier, the most common type of non‐admi ed company. When evalua ng non‐admi ed companies, it’s important to evaluate and consider the strength and benefits that each company can offer. Non‐admi ed companies generally have less stable premiums, when compared to the admi ed market. Thus, value – not price – needs to be at the forefront of a purchasing decision. What’s important to consider when making this choice? Considering the financial ra ngs of the company (A++ is the highest A.M. Best ra ng). Obtaining informa on on the company’s defense record; do they provide local claims professionals, expert witnesses and high customer sa sfac on scores? Asking about risk management support and tools to help reduce risk and improve pa ent safety. Determining how long the company has protected your specialty. A history of con nuous commitment to the OMS profession is reassuring. Malprac ce insurance is highly personal. You purchase it to protect your reputa on, financial assets, and license to prac ce. By truly understanding the different types of companies, you are posi oned to make a wise selec on – no ma er what the future holds. Medical Protective is proud to collaborate with ACOMS as an affinity partner to provide members with a solution for their dental liability insurance needs. MedPro’s120,000+ insureds have benefited from its unmatched financial strength, market commitment and claims expertise for over a century.
Prac ce Management Live Be er Longer By Cynthia L. Hutchins, Director of Financial Gerontology at Bank of America Merrill Lynch
Like many people, you’ve worked hard over the years to build your wealth for a more secure future. But have you taken me to consider your health in re rement and the financial implica ons? Health care expenses are people’s top financial concern in re rement however, less than one out of six pre‐re rees (15%) has ever a empted to es mate how much money they might need for health care and long‐term care in re rement. Beyond limi ng what you can do, health condi ons can be very costly. Preven ve care can help on both counts, and the good news is it's more affordable than ever. Medicare expanded its roster of free preven ve services in 2010, elimina ng co‐payments and deduc bles for many of them. Taking advantage of preven ve services that are available at no charge under tradi onal Medicare and most Medicare Advantage plans can help you have a healthy and fulfilling re rement. In your first year of enrollment, you're en tled to a free "Welcome to Medicare" exam from your doctor, and you can get annual wellness visits in subsequent years. Use the ini al exam to talk with your physician about your health, lifestyle, social support system and family medical history, and work with the doctor to develop a plan for the health screenings, immuniza ons and counseling you may need. The 2010 Affordable Care Act now covers many of those services. It’s important to incorporate regular exercise into your lifestyle. Numerous studies confirm the health benefits associated with it and many Medicare Advantage plans now cover fitness and yoga classes as a supplemental benefit — so long as your doctor prescribes them. Check with your plan about its rules. Medicare also now covers dozens of free screenings your physician can use to detect poten al health problems. There are a number of tests available which you may want to speak with your doctor about such as screenings pertaining to blood pressure, high cholesterol, breast cancer and diabetes. Proper financial planning is also impera ve. Not only can chronic health condi ons such as diabetes, asthma and heart disease ruin plans for an ac ve and rewarding re rement, such condi ons can cut deeply into your re rement funds…Con nued here. For more informa on, contact John Hasenberg, Merrill Lynch Financial Advisor, in the Washington, D.C. office at 202‐659‐7428 or
[email protected]. Merrill Lynch makes available products and services offered by Merrill Lynch, Pierce, Fenner & Smith Incorporated and other subsidiaries of Bank of America Corpora on. “Merrill Lynch” refers to any company in the Merrill Lynch & Co., Inc., group of companies, which are wholly owned by Bank of America Corpora on.
This Month In
OOOO is the official journal of ACOMS and a complimentary benefit for our members.
Featured in this month’s issue: Management of fractures of the atrophic mandible: a case series Andres Flores‐Hidalgo, DDS, Mehmet Ali Altay, DDS, PhD, Isabel C. Atencio, DDS, Ashley E. Manlove, DMD, MD, Keith M. Schneider, MS, DMD, Dale A. Baur, DDS, MD, Faisal A. Quereshy, MD, DDS, FACS
Objec ve: This study aims to report the outcome of pa ents with atrophic mandible fractures. Study Design: Atrophic mandible fractures in 11 pa ents (7 females and 4 males) were approached with a transcervical incision, and bone segments were stabilized with 2.7‐mm reconstruc on tanium plates and locking screws placed at the lateral border of the mandible. In 6 of the 11 cases, autogenous cancel‐ lous bone was used to repair a con nuity defect or to augment the ver cal height of the bone in the re‐ gion of the fracture(s). Results: No major intraopera ve or postopera ve complica ons were encountered in any pa ent. Two pa ents presented with postopera ve infec ons that resolved with incision–drainage and an bio cs, and removal or replacement of the reconstruc on plates or the bone gra s was not required. Conclusions: Treatment of atrophic mandible fractures can be performed safely and effec vely with re‐ construc on plates, with or without bone gra ing. The most conserva ve and predictable treatment in the long term is the defini ve reconstruc ve surgical procedure to restore form and immediate func on.
Also in this month’s issue:
Complica ons related to surgically assisted rapid palatal expansion Guhan Dergin, Sertac Aktop, Altan Varol, Faysal Ugurlu, Hasan Garip
Fracture of mandibular condyle—to open or not to open: an a empt to se le the controversy Sanjay Rastogi, Siddharth Sharma, Sanjeev Kumar, Mahendra P. Reddy, B. Niranjanaprasad Indra
Trea ng maxillofacial trauma for over half a century: how can we interpret the changing pa erns in e ology and management? George Rallis, Panagio s Stathopoulos, Dimosthenis Igoumenakis, Christos Krasadakis, Constan nos Mourouzis, Michalis Mezi s
Please visit www.OOOOJournal.net/Current to access the journal online. 11