Battlesign

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Does anybody have solid numbers about surgical stats of various OMFS Programs?
Which Programs does the most orthognathic?
Most Implants?
Sedation Wizzies?
Program where residents run their own sedation cases?

Another question is why does everyone bag on Case? The program seems solid?
 
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Battlesign

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Where are all the OMFSers today?
 

tx oms

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Battlesign said:
Does anybody have solid numbers about surgical stats of various OMFS Programs?
Which Programs does the most orthognathic?
Most Implants?
Sedation Wizzies?
Program where residents run their own sedation cases?

Another question is why does everyone bag on Case? The program seems solid?
Honestly, who cares? To be accredited the program must meet minimum requirements. Implants aren't a big deal--probably more important to learn bone grafting techniques. Sedation also not a big deal, you'll learn all you need on anesthesia and in clinic.

No one is going to have the answer to your question b/c no one on this forum has access to that information. All I can say is my program does lots of orthognathic and I run my own sedations. However, we don't do too many implants. Can't be much to them, though, if periodontists do them...
 
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Battlesign

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tx oms said:
Honestly, who cares? To be accredited the program must meet minimum requirements. Implants aren't a big deal--probably more important to learn bone grafting techniques. Sedation also not a big deal, you'll learn all you need on anesthesia and in clinic.

No one is going to have the answer to your question b/c no one on this forum has access to that information. All I can say is my program does lots of orthognathic and I run my own sedations. However, we don't do too many implants. Can't be much to them, though, if periodontists do them...
Great point, thanks for the replies.
Where are you?
Do you think that any traing program will prepare a OMFS well, and if so why all the talk about the big names? LSU, Parkland, OSHU, Pitt, UAB
 

Drtrigeminal

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Tx OMS

Interesting comment about Implants and Periodontists. I am guessing your simplistic attitude reflects your overall quality of surgery!!!!!! There are many ways to skin a cat my friend, my grandmother could drill a hole and plug it with an implant but to carry out procedures properly with ST aesthetic considerations I would want a Periodontist placing an implant in my mouth over YOU any day!!!
 
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Battlesign

Battlesign

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Drtrigeminal said:
Tx OMS

Interesting comment about Implants and Periodontists. I am guessing your simplistic attitude reflects your overall quality of surgery!!!!!! There are many ways to skin a cat my friend, my grandmother could drill a hole and plug it with an implant but to carry out procedures properly with ST aesthetic considerations I would want a Periodontist placing an implant in my mouth over YOU any day!!!
This brings up a point that should be mentioned. Should perio be able to place implants in their office.
What if you were placing an implant, unintentionally bag the mandibular artery causing a slow but persistent bleeder? You think all is fine begin to close and stabilize your pt. when you notice that there is an uncontrolled bleeder causing elevation in the floor of the mouth, the tongue starts to raise, and the pt. starts to have problems with their air way. At this point the question is what are you going to do? It is not a matter of the simplistic act of the procedures that are done, but can you get out of a situation that can and will go wrong, you know the saying everything can and will go wrong.
What is the periodontists going to do in this situation? Reach for some bone in a bottle, is that not your solution to everything. Are you going to feel comfortable enough to do an endotracheal intubation of this pt.?
No you will get on the phone and call TX OMS you take care of you problem.
It is not matter of what you do, but are you trained to manage your pt.
No more simplistic talk. TX OMS can place my implant over a gum gardener any day.
 

rrc

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Battlesign said:
This brings up a point that should be mentioned. Should perio be able to place implants in their office.
What if you were placing an implant, unintentionally bag the mandibular artery causing a slow but persistent bleeder? You think all is fine begin to close and stabilize your pt. when you notice that there is an uncontrolled bleeder causing elevation in the floor of the mouth, the tongue starts to raise, and the pt. starts to have problems with their air way. At this point the question is what are you going to do? It is not a matter of the simplistic act of the procedures that are done, but can you get out of a situation that can and will go wrong, you know the saying everything can and will go wrong.
What is the periodontists going to do in this situation? Reach for some bone in a bottle, is that not your solution to everything. Are you going to feel comfortable enough to do an endotracheal intubation of this pt.?
No you will get on the phone and call TX OMS you take care of you problem.
It is not matter of what you do, but are you trained to manage your pt.
No more simplistic talk. TX OMS can place my implant over a gum gardener any day.
Hitting the mandibular artery (I assume you mean IA) would not cause floor of mouth elevation. However, there have been reported cases of implants in the anterior mandible which perforate the lingual cortex and cause bleeding which can do what you mentioned. (http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=9274086&dopt=Abstract). As for OMFS dealing with perio complications, that is perfectly fine. When an OMFS has a complication such as injuring the ossicles or middle ear during a TMJ then they would call an ENT surgeon to evaluate the situation. One of the things we must realize is that the dental/medical community often needs to work together to help with each other's issues and strive to give the patient the best overall care.
 
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Battlesign

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rrc said:
Hitting the mandibular artery (I assume you mean IA) would not cause floor of mouth elevation. However, there have been reported cases of implants in the anterior mandible which perforate the lingual cortex and cause bleeding which can do what you mentioned. (http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=9274086&dopt=Abstract). As for OMFS dealing with perio complications, that is perfectly fine. When an OMFS has a complication such as injuring the ossicles or middle ear during a TMJ then they would call an ENT surgeon to evaluate the situation. One of the things we must realize is that the dental/medical community often needs to work together to help with each other's issues and strive to give the patient the best overall care.
Great View. I should not have attacked so quickly. I agree that we should all work together. My main point was that we need to do that which is the best for the pt. Thanks for your view. Mandibular artery or IA are the same artery just a different name.
 

Drtrigeminal

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I also agree on doing what is best for the pt! an implant is there to replace a tooth which is aesthetically driven, perio's in general have a greater portion of there training dedicated to ST aesthetics. As for nicking the Ling A I would manage the best I could and refer to my trusty OMS if needed, that’s what you are there for, just like endo's are there to negotiate calcified canals and remove broken files. Don’t get me wrong, I know allot of OMS's that have taken CE above and beyond there programs and are amazing at placing implants but please don't dismiss Perio's to inflate your ego!
 

tx oms

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Haven't checked this thread in a few days, but, damn, that was easy! I knew they'd come out of the woodwork for that one.

battlesign said:
Great point, thanks for the replies. Where are you?
Do you think that any traing program will prepare a OMFS well, and if so why all the talk about the big names? LSU, Parkland, OSHU, Pitt, UAB
Any program will prepare an OMFS to do the core things: trauma, orthognathic, basic pathology, extractions, and dentoalveolar. Beyond that is more program specific. Sorry, I forgot to mention implants. Some specialists make them into a huge deal. I tend to forget them. I guess the overly complex view of implants indicates one's surgical training.

The talk about the big names occurs for various reasons. LSU and Parkland just have a reputation, mainly due to the research that has come from these institutions. Pitt has Dr. Fonseca (I think?) and UAB has a fairly wide scope of practice. Programs that don't publish much and only do traditional OMFS get labelled as "easy" or "country clubs". I'm guilty of using those names. In reality, so what if "all" you do is the regular stuff. Most guys in private practice only do the regular stuff.

I for one wanted to experience as much as I could as a resident so that I could have more to pick from in private practice. I chose my program b/c of the broad scope it has. Maybe I'll just pull teeth in private practice, or maybe I'll do neck dissections. We'll see.
 

tjb

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tx oms said:
Haven't checked this thread in a few days, but, damn, that was easy! I knew they'd come out of the woodwork for that one.


Any program will prepare an OMFS to do the core things: trauma, orthognathic, basic pathology, extractions, and dentoalveolar. Beyond that is more program specific. Sorry, I forgot to mention implants. Some specialists make them into a huge deal. I tend to forget them. I guess the overly complex view of implants indicates one's surgical training.

The talk about the big names occurs for various reasons. LSU and Parkland just have a reputation, mainly due to the research that has come from these institutions. Pitt has Dr. Fonseca (I think?) and UAB has a fairly wide scope of practice. Programs that don't publish much and only do traditional OMFS get labelled as "easy" or "country clubs". I'm guilty of using those names. In reality, so what if "all" you do is the regular stuff. Most guys in private practice only do the regular stuff.

I for one wanted to experience as much as I could as a resident so that I could have more to pick from in private practice. I chose my program b/c of the broad scope it has. Maybe I'll just pull teeth in private practice, or maybe I'll do neck dissections. We'll see.
Penn had Fonseca, now he's in private practice. Pitt has Ochs and Costello.

tjb
 

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Drtrigeminal said:
Don’t get me wrong, I know allot of OMS's that have taken CE above and beyond there programs and are amazing at placing implants but please don't dismiss Perio's to inflate your ego!
Are you suggesting that OMS have to take CE above and beyond Oral and Maxillofacial surgical residency training in order to place dental implants.. and Perio do not? :confused:

A general dentist can place implants if he wants! Dental implants are not specialty specific.
 

Drtrigeminal

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I should hope that anybody placing implants should take ce above and beyond there program whether it be perio, OMS or GD. IDEAL implant placement is not as easy as it looks and long term outcomes tend to disprove there simplicity. Implants are not rocket science, I was just defending a crack at the Perio specialty from an OMS perspective which is often disillusioned.
 

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Drtrigeminal said:
I should hope that anybody placing implants should take ce above and beyond there program whether it be perio, OMS or GD. IDEAL implant placement is not as easy as it looks and long term outcomes tend to disprove there simplicity. Implants are not rocket science, I was just defending a crack at the Perio specialty from an OMS perspective which is often disillusioned.

:thumbup: