Tag Archives | American Association of Oral and Maxillofacial Surgeons

AAOMS Issues New Position Paper on Medication-related Osteonecrosis of the Jaw

Earlier in 2014, the American Association of Oral and Maxillofacial Surgeons issued a new position paper on Medication related Osteonecrosis of the Jaw (MRONJ) see http://www.aaoms.org/docs/position_papers/mronj_position_paper.pdf?pdf=MRONJ-Position-Paper. The condition in the past has been called Bisphosphonate-related Osteonecrosis of the Jaw but both antiresorptive and antiangiogenic therapies are associated with it so the name has been updated. MRONJ appears as non-healing exposed bone in the mouth and may affect patients undergoing intravenous cancer-related therapy or those treated with oral or IV bisphosphonates for osteoporosis. The paper states that patients may be considered to have MRONJ if the following characteristics are present: Current or previous treatment with antiresorptive or antiangiogenic agents; Exposed bone or bone that can be probed through an intraoral or extraoral fistula(e) in the maxillofacial region that has persisted for more than eight weeks; No history of radiation therapy to the jaws or obvious metastatic disease to the jaws. Most patients on antiresorptive or antiangiogenic agents who develop MRONJ do so after a dental procedure, such as a tooth extraction. The position paper cites several studies which has shown that between 52% to 61% of patients report tooth extraction as the precipitating event who develop MRONJ. It is estimated that […]

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The Culture of Safety in Oral and Maxilofacial Surgery

Previously in a post over at http://blog.teethremoval.com/upcoming-changes-to-joms-and-aaoms-in-2014/, I discussed how the Journal of Oral and Maxillofacial Surgery is introducing a new perspectives section which “…will offer essays written on topics of interest to our specialty, including health policy, clinical controversies, and education and research matters, as examples.” On of the first perspectives section is written by Suzanne Morse Buhrow and titled “Promoting a Culture of Safety in Oral and Maxillofacial Surgery: The Time Is Now!” in the February 2014 Journal of Oral and Maxilofacial Surgery, pp. 239-240. The article opens by discussing the origins of the patient safety movement in the 1980s after the Institute of Medicine said 98,000 patients will die and 1.5 million will be injured every year from preventable medical errors in the United States. The article mentions how the National Practitioner Data Bank in the U.S. shows over 10% of all malpractice payments are from dental procedures. The article mentions a study from 2010 which said only 43% of oral and maxillofacial surgeons have reported a wrong site tooth extraction, mentioned as a leading preventable error. Further the article says only 60% of physicians share and report adverse events. The article applauds the American Association of […]

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Active Surveillance For Managing Retained Wisdom Teeth

An interesting expert opinion by Thomas B. Dodson appears in the Journal of Oral and Maxillofacial Surgery vol. 70, issue 9, supplement 1, pages 20-24, 2012, titled ” Surveillance as a Management Strategy for Retained Third Molars: Is It Desirable?”  The author opens by describing in the third paragraph that the treatment of symptomatic disease-free wisdom teeth can be challenging. The author states in the third paragraph “Absent good evidence, management decisions should incorporate the clinician’s experience and expertise, and after a careful, balanced review of the risks and benefits of both treatment options, weigh heavily the patient’s wishes and desires regarding extraction versus retention. The opinions in this chapter reflect the author’s personal decision-making process based on a careful literature review and clinical experience/expertise.” The author opens by describing his clinical classification of wisdom teeth rationale. He states that the clinician needs to determine if the wisdom teeth are causing symptoms or not. Patients can complain of pain near wisdom teeth but this may not mean the wisdom teeth are the source of the pain as other things could be going on such as normal teething pain. From this, the clinician can determine if the patient is symptomatic or […]

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Upcoming Changes to JOMS and AAOMS in 2014

I wanted to update readers on some of the upcoming changes which will be taking place in the world of oral and maxillofacial surgery in 2014. The first change has to deal with JOMS (Journal of Oral and Maxillofacial Surgery). These updates are addressed in the editorial in the September 2013, JOMS, by  James Hupp titled, “The Journal’s Performance and Upcoming New Features” (J Oral Maxillofac Surg., vol. 71, pp. 1481-1483, 2013). In brief, JOMS has managed to decrease the time it takes to get accepted in the journal from 12 to 18 months to just 3 to 6 months. This improves the time for new updates to permeate throughout the field. Furthermore, when articles are accepted they are available rapidly for viewing online (although editing still has to occur). Several interesting developments are occurring: A) Soon, AAOMS Press Releases will be developed for selected articles in JOMS. A press release will be written by AAOMS staff and allow for wider dissemination of ideas to the general public. B) A new perspectives section will be included “It will offer essays written on topics of interest to our specialty, including health policy, clinical controversies, and education and research matters, as examples.” […]

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Improving Patient Safety: Updates on Oral and Maxillofacial Surgery

In a recent blog post I discussed how a few new videos have appeared in recent months related to oral and maxillofacial surgery Videos Related to Oral and Maxillofacial Surgery. The American Association of Oral and Maxillofacial Surgeons (AAOMS) has also updated several sections of their website in the last year or so. They now have a section titled Orthodontics and Oral Surgery where they have videos related to showcasing various techniques that oral and maxillofacial surgeons and orthodontists perform. In addition they have updated and written a new page titled “Culture of Safety“. The page is a welcome addition and discusses how safety is the number one priority in the oral and maxillofacial surgery office. Now I wanted to take a moment to respond to this page and some other developments I have seen lately across the blogosphere. 1) The first point to address relates to the issue of safety versus appropriate treatment. Much of the of the motivation for my website was based on the fact that it was never discussed to me back in 2006 that no scientific evidence supported or refuted third molar extraction. In addition, many of the complications that can occur from wisdom teeth […]

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