1 President’s Message Volume VII, ISSUE VI, 2015 In This Issue: From the President Membership Residents MeeƟng Upcoming Events Stay Sharp—Resident Abstract PracƟce Management Tips This Month in OOOO The American College of Oral and Maxillofacial Surgeons Surgical Excellence Through Education REVIEW ACOMS Dear Colleagues and Friends, Summer has come, and as always, so too has the busiest season of the year for most oral and maxillofacial surgeons. At the same Ɵme, for those of you involved in the academic aspect of OMS, graduaƟon season is also upon us. More than 200 new OMS graduates should be entering our ranks in the U.S. someƟme around July 1. In fact, for the next few months, as new graduates of OMS programs join our private pracƟce colleagues, this Ɵme period is oŌen the point when the training acquired in an academic program suddenly has to be put into rapid‐fire pracƟce. While I think that we can always be proud of the educaƟon our new professionals have received, oŌen it is the senior partners at their new sites of employment that are relied upon to provide the “finishing school.” Even then, there remains a need for conƟnuing educaƟon for all to stay current, to stay sharp, and to stay safe. ACOMS is here to provide and support the surgeon in their conƟnuing educaƟon needs. Although summer is a comparaƟvely quiet period for the College, in deference to the aforemenƟoned busy season, we highly recommend that you look to the coming year to start planning your new educaƟonal experiences: In the fall, residents need look no further than our highly successful 4 th Annual ACOMS Residents MeeƟng November 14—15 in Philadelphia, PA. An excellent opportunity to present abstracts and case reports and for fellowship with other young doctors, this meeƟng has drawn excellent aƩendance and strong reviews year aŌer year. Under the directorship of ACOMS Immediate Past President Dr. Robert Strauss, this meeƟng promises to be another knock‐out, with dynamic guest speakers. Everyone is welcome—even prospecƟve employers. In February, we are proud to bring to our members, and their referring orthodonƟsts and prosthodonƟsts, the ACOMS/Faces 29 th Winter MeeƟng in Snowmass, Colorado. For years, Dr. Myron Tucker and Co. brought you the FACES course that spoke to both the OMS and their referring doctors. In that same spirit, directed by Drs. Bryan Bell, Brian Farrell, and Chuck Hasse, this course boasts an outstanding faculty speaking on cuƫng‐edge innovaƟons in contemporary OMS, which is pracƟcal for all dental professionals. The skiing and small group seƫng is ideal for renewing old friendships or making lifelong new ones. See you on the slopes! (ConƟnued on page 2)
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ACOMS The American College of Oral REVIEW and ......Scien fic Conference and Exhibi on, April 18‐20, 2015. Does Accutane (Isotre noin) Therapy Put Pa ents at Risk for Developing
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President’s Message Volume VII, ISSUE VI, 2015
In This Issue:
From the President
Membership
Residents Mee ng
Upcoming Events
Stay Sharp—Resident Abstract
Prac ce Management Tips
This Month in OOOO
The American College of Oral and Maxillofacial Surgeons Surgical Excellence Through Education REVIEW
ACOMS
Dear Colleagues and Friends,
Summer has come, and as always, so too has the busiest season of the year for most oral and maxillofacial surgeons. At the same me, for those of you involved in the academic aspect of OMS, gradua on season is also upon us. More than 200 new OMS graduates should be entering our ranks in the U.S. some me around July 1. In fact, for the next few months, as new graduates of OMS programs join our private prac ce colleagues, this me period is o en the point when the training
acquired in an academic program suddenly has to be put into rapid‐fire prac ce. While I think that we can always be proud of the educa on our new professionals have received, o en it is the senior partners at their new sites of employment that are relied upon to provide the “finishing school.” Even then, there remains a need for con nuing educa on for all to stay current, to stay sharp, and to stay safe. ACOMS is here to provide and support the surgeon in their con nuing educa on needs.
Although summer is a compara vely quiet period for the College, in deference to the aforemen oned busy season, we highly recommend that you look to the coming year to start planning your new educa onal experiences:
In the fall, residents need look no further than our highly successful 4th Annual ACOMS Residents Mee ng November 14—15 in Philadelphia, PA. An
excellent opportunity to present abstracts and case reports and for fellowship with other young doctors, this mee ng has drawn excellent a endance and strong reviews year a er year. Under the directorship of ACOMS Immediate Past President Dr. Robert Strauss, this mee ng promises to be another knock‐out, with dynamic guest speakers. Everyone is welcome—even prospec ve employers.
In February, we are proud to bring to our members, and their referring orthodon sts and prosthodon sts, the ACOMS/Faces 29th Winter Mee ng in Snowmass, Colorado. For years, Dr. Myron Tucker and Co. brought you the FACES course that spoke to both the OMS and their referring doctors.
In that same spirit, directed by Drs. Bryan Bell, Brian Farrell, and Chuck Hasse, this course boasts an outstanding faculty speaking on cu ng‐edge innova ons in contemporary OMS, which is prac cal for all dental professionals. The skiing and small group se ng is ideal for renewing old friendships or making lifelong new ones. See you on the slopes!
President’s Message (continued) March will bring a course that is near and dear to my heart, the ACOMS Hands‐on Profile‐plasty Course. Located in the heart of New Orleans, this course provides one day of didac c training focusing on rhinoplasty and genioplasty, with a second day available for interested par cipants to head to the cadaver lab for “hands‐on” instruc on. This is also a great course for residents, with reduced tui on available. The venue for this course is truly world‐class, and spots are limited. Registra on will open in July.
Although s ll far‐off in April of 2016, you will not want to miss out on bringing yourself and your family to sunny Puerto Rico for the ACOMS 37th Annual Scien fic Conference and Exhibi on. Mee ng me is generously spaced to provide free me for you and your family to explore and enjoy this unique island. Chaired by Drs. Stephanie Drew and ACOMS President‐elect Pedro Franco, this looks to be a truly world‐class scien fic and prac cal mee ng that our members will long remember.
As always, keep an eye on the ACOMS website. New in‐person and online educa onal content will be announced on a monthly basis, including the ques on of the week, member discussion forums, real‐ me and on‐demand webinars, and hands‐on courses in TMJ and Orthognathic Virtual Surgical Planning. Addi onally, ACOMS Fellows should be sure to download the ACOMS logo to proudly display on their own web page—addi onal informa on is available on the following page.
Sincerely,
Jon D. Perenack, DDS, MD
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Ar cles submi ed to the ACOMS Review are not subject to scholarly peer‐review. Author(s)
maintain responsibility for the contents of their ar cle.
This abstract was presented as a poster at the ACOMS 36th Annual
Scien fic Conference and Exhibi on, April 18‐20, 2015.
Does Accutane (Isotre noin) Therapy Put Pa ents at Risk for
Developing “Dry Socket” (Alveolar Ostei s) A er Dental Extrac on?
James B. Han, DDS, MD and Christopher F. Viozzi, DDS, MD
Division of Oral and Maxillofacial Surgery, Department of Surgery
Mayo Clinic, Rochester, MN
Purpose: To assess the incidence of alveolar ostei s in pa ents
undergoing dental extrac on while on ac ve and within 30 days of
comple ng isotre noin therapy.
Method: We retrospec vely reviewed all pa ents using the Mayo Clinic EMR from 01/01/2000 to
09/22/2014 and iden fied those who had “Accutane” or “isotre noin” men oned in their medical record
within 180 days prior to the surgical procedure.
Results: Twenty‐six pa ents (median age 17.5, range 13‐33) underwent dental extrac on while on ac ve
isotre noin therapy. The average cumula ve dose of isotre noin to date of surgery was 4424 mg (range
40‐10080 mg). Out of 96 teeth extracted (D7210 = 7; D7220 = 18; D7230 = 46; D7240 = 25), only one
pa ent (female, on OCP, 320 mg cumula ve dose of isotre noin at the me of surgery) developed alveolar
ostei s in one site (extrac on site no. 17, D7240). There were no known smokers in this group and 3 out of
the 4 total female pa ents were on OCP. In twelve pa ents (median age 16.5, range 16‐18) who
completed isotre noin therapy (average 10910 mg, range 6800‐15880 mg) within 30 days of surgery, none
developed alveolar ostei s. This group had three females (2 on
OCP), one known male smoker, and a total of 49 dental
extrac ons (D7220 = 3; D7230 = 26; D7240 = 20).
Conclusions: The incidence of alveolar ostei s in pa ents on
ac ve or recently completed isotre noin therapy is 3.8% or
2.6%, respec vely. These are within the range of previously
published reports and suggest that isotre noin does not confer
added risk of developing alveolar ostei s in pa ents undergoing
dental extrac on. The cumula ve dose of isotre noin therapy at
the me of surgery does not appear to be related to occurrence
of alveolar ostei s. View the full poster online.
ATTENTION RESIDENTS:
This new monthly segment in the ACOMS Review is your opportunity to share a case report or literature review with a nationwide audience. Articles must be 500 words or less and may not have been previously published. Residents whose articles are accepted in the newsletter will receive a royalty payment of $100.
Visit www.acoms.org/articles to learn more or submit your article.
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.
Congratula ons to the 2015 Class of New OMFS Jennifer Gibson, OMFS Specialist, Medical Protec ve
MedPro’s OMS Preferred Program extends congratulations to those oral and maxillofacial surgeons completing their residency. As you reflect on the completion of your residency, many of you will inevitably think about the responsibilities of entering private practice. One of many important decisions you will make is choosing your malpractice insurance coverage. It’s wise to make that choice based on the carrier’s financial strength ratings and the coverage details that best suit your needs including policy limits, consent clause and policy type. First, to assess a company’s financial strength, you should consult an independent rating agency such as A.M. Best. (www.ambest.com) A rating agency like A.M. Best offers an unbiased evaluation and labels companies ‘secure’ if they have a Superior (A++, A+), Excellent (A, A-) or Good (B++, B+) rating. This approach takes things into consideration such as balance sheet strength, long-term operating performance, and other factors that are critical to an insurance carrier’s longevity and ability to provide a strong defense if a claim is filed against you.
Once you know about a carrier’s financial strength, you should assess the coverage details. Policy limits reflect how much indemnity a company can pay on behalf of an insured. Limits for oral surgeons range between $1M /$3M and $5M/$7M. Many oral surgeons select limits of $2M/$4M or higher, given the history of claims in this specialty. The first number is the per claim limit, meaning the most an insurance company will pay for any single claim filed against you. The second number is the aggregate limit; this is the maximum an insurance company will pay for all claims filed against you in a given policy period. In addition to policy limits, each policy contains language regarding the handling of malpractice claims. Here you’ll find the policy’s consent clause, one of the most important provisions for you to fully understand. The strongest consent clause – often called ‘pure’ consent – gives you the authority to refuse to settle any claim. You must be careful, as many insurance companies have qualifiers in their provision allowing them to settle without your consent or providing other penalties if you choose to refuse consent. Another critical decision is choosing the best policy type given your specific needs. There are two options available to oral surgeons: occurrence and claims-made. With occurrence coverage, you need not worry about securing tail coverage for any change in your life or practice. Plus, in retirement, each occurrence policy provides a distinct set of limits for each year, potentially offering more protection if claims are filed against you over separate years. As you can see, there are significant choices to make about your malpractice coverage. Too often healthcare providers purchase a policy, make the annual payments, and don’t think about the details of coverage until they’ve been notified of a claim. We encourage you to make an informed purchasing decision upfront so you are best prepared in the unexpected even a malpractice claim is filed against you in the future.