Everyday Oral Surgery

Pediatric Cleft and craniofacial surgery in kids is a needed, but very niche specialty. Talking to us today about his experience as professor and Chair of Oral & Maxillofacial Surgery, Neurosurgery, and Surgery at the University at Buffalo, as well as a surgeon in Western New York Craniofacial Center, is Dr. Michael Markiewicz. We cover everything from what the average day looks like for him, to the achievements he is most proud of as Department Chair. We hear about the structure of the program he runs, why it's not just a cancer residency, and the exposure he provides for his residents. He breaks down the three most common routes to becoming a cleft and craniofacial surgeon and gives some great advice for anyone looking to move into the field. Tune in to find out the pros and cons of working with children (and their parents), and why staying active and watching Seinfeld are so crucial to living a balanced life!Key Points From This Episode:Who Dr. Michael Markiewicz is, where and what he studied, and how he ended up as a Department Chair.What the average day looks like for Michael. How Michael decided to do a fellowship: following his interest in surgery. Tackling the position of Chair as a young surgeon and managing being in practice and his academic duties. What Michael is most proud of as chair, and his biggest challenges. The structure of the program and its main focus, from cancer to orthognathics and general practice. Leaving Chicago for Buffalo and creating a family atmosphere where everyone gets a say.The primary cases that Michael’s team does: cleft lip repair, craniostenosis, and more.Why it’s important to include other healthcare professionals in your practice. How Michael exposes residents to his specialty without offering a fellowship program. How to become a cleft and craniofacial surgeon: the three avenues (plastic surgery, otolaryngology, and maxillofacial surgery). Michael’s thoughts on whether an MD is necessary to get into craniofacial surgery. How Michael knows Mark Inglestad, and what makes him the ultimate educator. The pros and cons of working with children. Understanding the parents’ perspectives and managing them through the process. Why it’s so crucial to include the functional aspects of growth and development when working with kids. Michael’s advice for anyone interested in craniofacial surgery: take advantage of all that you can, and do a fellowship. What Michael feels the role of a craniofacial surgeon is, and the overlap between different specialties. Where you can contact Michael.Michael’s response to Grant’s rapid-fire questions: Being Mortal, taking time for yourself, and how to live the rest of your years being bald. Links Mentioned in Today’s Episode:Dr. Michael Markiewicz Email — mrm25@buffalo.eduDr. Michael Markiewicz Phone — 716-829-6230Being Mortal — https://www.amazon.com/Being-Mortal-Medicine-What-MattersDr. Grant Stucki Email — grantstucki@gmail.comDr. Grant Stucki Phone — 720-441-6059

Residency is one of the hardest parts of becoming an oromaxillofacial surgeon, made even harder when trying to juggle a work-life-family balance. Talking to us today about finding this balance, is Dr. Brent Ward, father, surgeon, man of God, and Chalmers J. Lyons Professor Section Head and Chairman of Oral and Maxillofacial Surgery at the University of Michigan. Through his extensive career in academia, Brent has had the opportunity to advise and learn from students, fellows, registrars, and surgeons alike, and he has taken it all in! We hear about the clinical research he is currently involved in, and why a group of people is always smarter than a single person. Brent also gives his perspective on the world of academia and the pros and cons of it, compared to private practice. We hear the advice he gives to young surgeons about chasing success and money, and why it's so important to collaborate with your fellows. For all this, and so much more, tune in today!Key Points From This Episode:Welcome to Dr. Brent Ward, Chalmers J. Lyons Professor Section Head and Chairman of Oral and Maxillofacial Surgery at the University of Michigan.How Brent found his passion for oromaxillofacial surgery via medical school. Managing a family during a residency and what Brent’s kids are doing now. Opioid vs non-opioid in third molar situations: Brent’s experience and why he is so interested in researching the dosage of opioids OMFS should use. Where the field is heading in terms of opioid use and prescription.The breakdown of the Opioid Analgesic Reduction Study.The importance of realizing that a group of people is always smarter than a single person. Why Grant started this podcast, and his goals of creating discourse, sharing, and humility, in the profession. Making careful choices whether you compete, avoid, accommodate, compromise or collaborate. Why you need to choose your first hundred cases wisely.Grant and Brent’s positive experiences of sharing cases and advice with other surgeons. Considering academia or private practice: Brent’s advice on weighing up the pros and cons. Brent’s advice on the financial disparity between private practice and academia, and what fellowship programs are doing to bridge the gap. Debunking the misconception that surgeons in academia work longer hours. Making a difference every day: what Brent’s favorite quote is, and why.The difference between happiness and joy. Links Mentioned in Today’s Episode:Dr. Brent Ward Email — bward@umich.eduDr. Brent Ward Phone — 734-936-5950The Opioid Analgesic Reduction Study — https://clinicaltrials.gov/ct2/show/NCT04452344Dr. Brent Ward’s Slide on Compete, Avoid, Accommodate, Compromise or Collaborate —https://www.negotiations.com/articles/negotiation-conflict-profiles/Oral/Head and Neck Oncologic and Reconstructive Surgery Fellowship Training Programs: Transformation of the Specialty From 2005 to 2015: Report from the AAOMS Committee on Maxillofacial Oncology and Reconstructive SurgeryThinking, Fast and SlowDr. Grant Stucki Email — grantstucki@gmail.comDr. Grant Stucki Phone — 720-441-6059

One of the hardest parts of doing implants is simulating the outcome accurately. Addressing this challenge is a new technology, InstaRisa! Using 3D facial scanning, InstaRisa is revolutionizing oral surgery and destroying the need for disclaimers around patient simulations. Tune in today to hear from co-founder and general dentist, Dr. Art Mirelez, and principal oromaxillofacial surgeon at InstaRisa, Dr. John Brokloff. Discover how Art and John met, and how heading down the wrong tracks inspired Art’s passion for dental implants. We find out how InstaRisa works, what you can use it for (everything!), and why it’s worth the investment (from patient satisfaction to improved productivity). Art talks about the importance of staging a Big Reveal for his patients, and why he does implants over two days. To hear all this and so much more, join us for this exciting episode.Key Points From This Episode:A brief history of Drs. John Brokloff and Art Mirelez, and how they met each other. How Art discovered his passion for the dental implant industry by being on the wrong track!What InstaRisa is, how it works, and why Art founded it. John’s comments on InstaRisa from the perspective of an oromaxillofacial surgeon. Why conversions are a stumbling block in restorations, and how InstaRisa overcomes these. The benefits of capturing the vertical before surgery.Understanding the advantages of doing extra-oral scanning, and integrating the imaging and the dental work. Why InstaRisa doesn’t have to use photogrammetry, and how it improves practice. What’s involved in the workup using InstaRisa, and the broad applications to oral surgeons. Minimizing in-office time: why next-day delivery of restorations is a benefit to your practice. How Art makes the reveal an impactful experience. What it takes to set this system up in your office: the basic control scanner and the facial scanner. The added benefits that you won’t expect from using InstaRisa. Where you can find out more about InstaRisa (www.instarisa.com).The origins of the name “InstaRisa”: combining “insta”, and “smile” in Spanish.Rapid-fire questions: book recommendations, non-oral surgery-related habits that hone dental skills, and favorite quotes!Links Mentioned in Today’s Episode:InstaRisaDr. Art MirelezDr. Art Mirelez Phone — 559-435-3113Dr. John Brokloff on LinkedInDr. John Brokloff Email — drbrokloff@instarisa.comDr. John Brokloff Phone — 330-668-1001TitanJohn AdamsThe Great BridgeDr. Grant Stucki Email — grantstucki@gmail.comDr. Grant Stucki Phone — 720-441-6059

Today’s guest, Dr. Frank Dolwick, has been a TMJ surgeon for over 50 years, since the days when focusing on TMJ patients would earn you the lowest ranking position in the US Air Force! In fact, Frank was one of the people who was instrumental in evolving this type of surgery and elevating it within the medical field, as you will hear today, and he is now considered a giant in the TMJ specialty. In this episode, you will also learn about the two categories of pain that TMJ patients fall into (myalgia and joint) and the differences between how each of these problems should be approached, the numerous benefits of doing arthrocentesis procedures rather than arthroscopies, and why oral surgeons need to change the way we think about pain!  Key Points From This Episode:Frank shares an overview of his educational background and the early days of his oral surgery career. Ray White; the surgeon who introduced Frank to TMJ surgery. How TMJ surgery has changed over the years that Frank has been working as an oral surgeon. Pros and cons of the technological advancements in TMJ surgery. Frank’s experience as a TMJ surgeon in the US air force. The disastrous period of the alloplastic implants.When and how arthroscopy was introduced in the United States. Frank’s first time doing a joint lavage and what the outcome was.The numerous reasons that Frank sees arthrocentesis as his most significant contribution to the oral surgery field.Advice for young surgeons regarding TMJ. How TMJ patients today differ from the TMJ patients Frank was treating in the early days of his career. Two categories that TMJ patients generally fall into. Frank’s advice on getting myalgia problems under control.How Frank treats TMJ patients who only have joint pain.Factors that determine whether Frank will use steroids of PRGF when doing an arthrocentesis procedure. Circumstances under which Frank will conduct an arthroscopy. Why the decision to do an open joint surgery should not be taken lightly.The benefits of botox in treating myalgia patients. Frank’s opinion on total joint replacement surgery, and the success rate that he sees with these procedures. Why you can’t eliminate chronic pain with total joint replacement surgery.Examples of places where you can go to learn about arthroscopy and arthrocentesis. The length of time Frank spends on his initial consultations with TMJ patients. How we, as oral surgeons, need to change our mindset with regard to pain.  Links Mentioned in Today’s Episode:Dr. Frank Dolwick Email — fdolwick@dental.uf.eduDr. Grant Stucki Email — grantstucki@gmail.comDr. Grant Stucki Phone — 720-441-6059

Today’s guest, Dr. George Kushner, has been working full-time in academia for the past 28 years, and he wouldn’t have it any other way. Every day he is making a difference in people’s lives, being mentally stimulated, and earning enough money to live a great life outside of work; what more could you ask for? George is the Chairman of the Department of OMS at the University of Louisville, and today he shares with us how he and his colleagues (in particular the late Dr. Brian Alpert) have created an environment which is defined by a caring attitude and a healthy work/life balance, or in George’s words; “the Louisville way.” In our discussion we also cover some of the technological advancements which are being driven forward by residents, George’s unusual site of choice for bone grafting, and what it means to “run your training program like a Greek tragedy” (and why you shouldn’t do that!). Key Points From This Episode: George shares what his educational and professional journey has consisted of to date. The influential role that Dr. Brian Alpert played in George’s life, and the lives of many others.What you can expect as a student attending dental school at the University of Louisville.How the University of Louisville tries to make it as easy as possible for dental students to go to medical school.The trauma heavy nature of the OMS department at the University of Louisville.A broad outline of the dental school schedule at the University of Louisville.Challenges and benefits of working in academia. How George’s department creates a healthy, balanced work environment. George’s approach to teaching oral surgeons. Why George is a big fan of AO North America. Examples of technological advancements in the oral surgery field that George and his team are embracing. George’s site of choice for bone grafting.Benefits of using ViviGen.  The importance of having “a lot of tricks in your bag” as an oral surgeon. Numerous reasons that George recommends a career in academia. Why George believes that playing team sport throughout his life has made him a better surgeon. What it means to “run your training program like a Greek tragedy,” and why you shouldn’t do this.George explains what “the Louisville way” is.   Links Mentioned in Today’s Episode:Dr. George Kushner Email — AO North America — https://aona.org/our-community/cmf Dr. Grant Stucki Email — grantstucki@gmail.comDr. Grant Stucki Phone — 720-441-6059

This episode is pure gold for any oral surgeons out there who are interested in setting up their own practice! In September 2020, Dr. Dustin Haupt opened the beautiful office that he built from scratch, and in today’s episode he lets us in on many of the tips and tricks which have resulted in its success. From deciding between what brand of chair to purchase, to the best way to set up your cassette, there are a wide variety of factors to take into consideration, each of which comes with a financial implication. Prior to opening his practice, Dustin spent a whole year visiting exhibition halls and getting a hands-on experience of the equipment available, so if you don’t have the time to do that yourself before opening your practice, this episode will provide you with all the information you need!  Key Points From This Episode: The process that Dustin went through before deciding on the office equipment he was going to use.Why Dustin didn’t choose the sterilization equipment for his office himself, and who he entrusted this job to. Dustin’s reasoning for choosing a true surgical chair as opposed to a traditional dental chair.A comparison between MTI and Boyd surgical chairs. Factors that led to Dustin choosing an EPM monitor.The software that Dustin uses in his practice. What Dustin’s anesthesia monitors cost, and why he has chosen to have one in each room of his practice.Pros and (very few) cons of the BN air drills that Dustin and I use. Why Dustin prefers corded to cordless equipment.Our shared appreciation for KLS products. The instruments that Dustin keeps in his cassette, and why a cassette is his preferred method of storage. Benefits of the auto drain and autofill system that Dustin has installed in his office.Dustin’s commitment to ensuring that his staff don’t get burnt out. Training that Dustin does for every assistant that he brings into his team. Burs that Dustin uses for different procedures. Implant kits and IV bags that Dustin uses in his office. Why Dustin always uses an IV bag during surgery. Advice from Dustin for anyone wanting to set up their own oral surgery practice.  Links Mentioned in Today’s Episode:Dr. Dustin Haupt on LinkedIn— https://www.linkedin.com/in/dustin-haupt-94605563/Avos Dental Specialists —https://www.avosds.com/meet-us/dr-dustin-haupt/ MTI — https://mti.net/ Boyd — https://www.boydindustries.com/products/oral-surgery/surgical-chairs-and-tables/ EPM — https://www.gegridsolutions.com/multilin/catalog/epm9900p.htm Mindray — https://www.mindray.com/en/ BN Air Drill — https://www.bnproducts.com/tools/aeropro-rp17101-38-reversible-air-drill/ KLS Martin — https://www.klsmartin.com/en/ Dr. Grant Stucki Email — grantstucki@gmail.comDr. Grant Stucki Phone — 720-441-6059

As Dr. Robert (Bob) McNeill knows all too well, being on the State Dental Board means that you have to put up with a lot of mistrust from fellow medical professionals who (wrongly) believe that you have ulterior motives. Through his many years of experience on both sides of the fence, Bob has come to understand that communication is one of the most valuable skills that an oral surgeon can learn. Examples of other valuable skills that Bob advocates for are stress-relieving techniques, such as meditation, and the ability to practice hypnosis, which is especially pertinent with the anesthesiology battle that oral surgeons are currently facing. Bob has so many fields of interest, and although he sometimes struggles to balance them all, it makes for a fascinating conversation which I hope you enjoy as much as I did!  Key Points From This Episode: Bob shares an overview of what his OMS journey has looked like to date. One of the main reasons that people get reported to the board. How people often respond when they find out that Bob is on the State Dental Board. The song which helps patients and surgeons relax (and the time that it didn’t work).Benefits of working in a multispecialty practice. Post-op complications that Bob commonly sees as a member of the State Dental Board.Examples of how Bob communicates effectively with his patients. Bob’s thoughts on hypnosis, and when he likes to use this technique. Opportunities that Bob has been afforded through being a Dental Board member.What an amygdala hijack is, and how to deal with it. Different communication strategies and how to know when to use which one. The importance of self-care for oral surgeons.I share the reasons that motivated me to start the Everyday Oral Surgery podcast.Relaxation techniques that have worked wonders for Bob and I.The approximate percentage of board complaints that are related to poor communication.Why you should tend towards the minimum with regard to anesthetic drugs. A rapid fire round with Bob.   Links Mentioned in Today’s Episode: The Surgical Dental Specialists — https://www.dfwdentalimplants.com/ Robert G. McNeill on LinkedIn — http://linkedin.com/in/robert-g-mcneill-dds-md-mba-facd-87012715Between Two Teeth — https://www.youtube.com/channel/UC4KXk4VI0STVSCM_7eDnBPw/videos?app=desktop Lifespan by Dr. David Sinclair — https://lifespanbook.com/ Headspace — https://www.headspace.com/ Calm — https://www.calm.com/ Dr. Grant Stucki Email — grantstucki@gmail.comDr. Grant Stucki Phone — 720-441-6059

Many oromaxillofacial surgeons take their right to anesthetize their patients for granted. Recently there has been a move to rescind this right, and talking to us today about why this is a disaster for patients and oromaxillofacial surgeons alike, is Dr. Chris Viozzi. Chris returns on this episode to remind us of the vital role of anesthesia in making dental procedures painless for patients, and what the field can expect in the way of updated safety and training procedures. Find out why the anesthetizing of a patient is so much more important than the procedure itself, and what you can do to support the fight for oromaxillofacial surgeons’ anesthetic qualification. We hear how disasters are like Swiss Cheese (all the holes have to be there), and what dentistry has learned from the aviation industry. For all this, and so much more, tune in today!Key Points From This Episode:Welcome back to Dr. Chris Viozzi, discussing the debate surrounding anesthesia (a reminder that his opinions are not reflective of official bodies). The double standards applied to medical procedures compared to dental procedures, and how the media portrays tragedies. Who is qualified and able to dissect the underlying cause of an anesthetic event, How oromaxillofacial surgeons can be safe when providing anesthesia to patients.Why Chris needs to reign in his residents' pre-surgery consult talking. How to prepare patients for surgery.The power of suggestion in reassuring your patients. How the board exams help early-career oromaxillofacial surgeons become competent in anesthetics. Why the questions in the board exams are structured the way they are. The benefits of being board certified regarding medical insurance and hospital employment requirements. How to avoid medico-legal issues: establish a good rapport with your patients, do quarterly reviews or training sessions, and evaluate your practice model.  The importance of resource management in preventing disasters!What private practice and academic surgeons can do to support the fight for oromaxillofacial surgeons’ anesthetic qualification. The questions you can ask to open critics' minds to other viewpoints. Why it’s important to focus on the anesthesia first, and then the surgery itself. Chris’s thoughts on anesthesia as a kindness to dental patients. A case study of Chris's, demonstrating the unique scenarios that oromaxillofacial surgeons are exposed to when administering anesthetic, compared to hospital cases. Why disasters are like Swiss Cheese: all the holes have to be present for a disaster to happen. The links between aviation and surgery. Links Mentioned in Today’s Episode:Dr. Chris Viozzi on LinkedIn — https://www.linkedin.com/in/christopher-viozzi-759605126/Dr. Chris Viozzi Phone — 507-284-2511Dr. Grant Stucki Email — grantstucki@gmail.comDr. Grant Stucki Phone — 720-441-6059

Today, you’ll hear from Dr. Ole Jensen, an Oral and Maxillofacial Surgeon and the Founder and Chairman of the Board of Ditron Dental Implants, who is known worldwide in the field of dental implants and reconstructive surgery. In this episode of Every Day Oral Surgery, Dr. Jenson shares his experience with zygomatic implants and reflects on the way we do them now and whether or not it is the best approach for our patients. He shares how his thinking about zygomatic implants has evolved over the years and, while he has no desire to reinvent the wheel, so to speak, he promotes the benefits of taking a more customized approach on a case-by-case basis. We also touch on why he suggests seeking mentorship, taking a more conservative and less invasive approach, and learning to do pterygoid implants first, as well as the benefits of constantly improving your diagnostic and technical skills. Dr. Jensen also shares a number of valuable resources, recommended organizations, and books, so make sure not to miss this detailed and highly informative episode!Key Points From This Episode:Dr. Jensen shares a brief overview of his experience with zygomatic implants.Direct vision and protection for a long-distance process like zygomatic implants.Insight into some of the main criteria that Dr. Jensen assesses to determine if a patient will benefit from zygomatic implants.How his thinking about zygomatics has evolved without ‘reinventing the wheel’.What he recommends for surgeons looking to gain more experience with these implants.The importance of learning by doing and seeking mentorship.Why Dr. Jensen promotes being more conservative and less invasive.His advice: learn to do pterygoid implants before you do zygomatic implants.Dr. Jensen shares some useful resources on pterygoid implants.The importance of working within the boundaries of your knowledge.The relationship between sinus infections or disease and zygomatic implants.Sinus grafting and zygomatics; learn more about the benefits of a ‘graftless’ technique.Dr. Jensen’s tip for younger surgeons: join the Academy of Osseointegration (AO)!Dr. Jensen shares a recommended read: Peri-implant Infection: Etiology, Diagnosis and Treatment by Frank Schwarz and Jürgen Becker.Some final words of advice from Dr. Jensen regarding overdenture implants.Links Mentioned in Today’s Episode:Dr. Ole Jensen on LinkedIn — https://www.linkedin.com/in/ole-jensen-6b871512a/Dr. Ole Jensen Email — olegjenson@icloud.comDitron Dental Implants — https://www.ditrondentalusa.com/‘Rescue implant concept: the expanded use of the zygoma implant in the graftless solutions’ — https://pubmed.ncbi.nlm.nih.gov/21492800/‘The Pterygoid Plate Implant: A Solution for Restoring the Posterior Maxilla’ — https://pubmed.ncbi.nlm.nih.gov/7751116/‘A ‘Graft Less’ Approach for Dental Implant Placement in Posterior Edentulous Sites’ — https://pubmed.ncbi.nlm.nih.gov/31613937/‘The use of BMP around zygomatic implants’ —Academy of Osseointegration 2022 Annual Meeting — https://ao2022.osseo.org/AAOMS Dental Implant Conference — https://www.aaoms.org/meetings-exhibitions/2021-dental-implant-conferenceDr. Grant Stucki Email — grantstucki@gmail.comDr. Grant Stucki Phone — 720-441-6059

Not everybody is going to have the desire or ability to run their own laboratory when they graduate from oral surgery, but it is Dr. Simon Young’s belief that every oral surgeon should graduate with an understanding of the scientific process. Simon’s own introduction to the field of clinical research happened completely by chance when he was volunteering at a local hospital looking to enhance his CV before applying to dental school. Now, as Director of Research at The University of Texas Health Science Centre at Houston, his working life consists of 75% protected research time, with the rest divided between clinical work at a county hospital, working with residents, and even a little bit of private practice. Tune in today for a deep dive into Simon’s fascinating world, which may leave you reconsidering your choice of specialty as an oral surgeon! Key Points From This Episode:Simon’s introduction to the field of research.What Simon’s career as a researcher has looked like.The process that Simon and his team went through in order to receive the prestigious R01 grant.Some stories which highlight the importance of networking as a researcher. What Simon’s working week consists of. Advice for getting involved in research as an oral surgeon. The mentoring program for residents that Simon has integrated into his program. Why Simon believes that every oral surgeon should have an understanding of the scientific process. Values that Simon’s department prioritizes. How Simon helps students identify the field of research they are interested in. Hear more about Simon’s passions and life philosophies during our rapid fire question round. Links Mentioned in Today’s Episode:Dr. Simon Young Email — Simon.Young@uth.tmc.edu Dr. Simon Young on LinkedIn — https://www.linkedin.com/in/simon-young-7a2875/ The University of Texas Health Science Centre at Houston — https://www.uth.edu/ Dr. Grant Stucki Email — grantstucki@gmail.comDr. Grant Stucki Phone — 720-441-6059