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DENTAL TRIBUNE The World’s Dental Newspaper · Africa Sub-Saharan E dition www.dental-tribune.com AFRICAN NEWS A Congolese Dental School - creating change six students at a time! CLINICAL Mechanically-retained facial pros- thesis for a large defect following Cancrum Oris: a clinical report ” Page 2 ” Page 4 Vol. 1, No. 1 CLINICAL Clinical significance of the anterior loop of the mental nerve: anatomical dissection of a cadaver population ” Page 6 Live surgery performed for the first time at a dental congress in South Africa - Nomads 2017 By DTI JOHANNESBURG - South Africa: The annual Nomads Congress is re- garded as one of the most antici- pated events on the South African dental calendar. Not only does it at- tract delegates from the whole of South Africa, but also from neigh- bouring states. This year saw partic- ipants from Uganda, Ethiopia, Zim- babwe, Namibia, Swaziland and Botswana. Presented by Nomads, the South African Society of Endodontics & Aesthetic Dentistry, the Congress has developed a solid reputation for its innovative programme, featuring top national and international speakers. Aimed at the entire Dental Team, a wide range of topics - includ- ing endodontics, aesthetics, restora- tive dentistry, implantology, anaes- thesia, CAD/CAM - are offered. Nomads 2017 saw the inclusion of live surgery for the first time at a South African dental congress. In two separate procedures, a root canal treatment and a single im- plant placement were performed. The logistics behind these presenta- tions were complicated - a fully- equipped 'surgery’ had to be built in the auditorium, complete with den- tal chair, imaging* and scanning equipment, cabinetry and com- pressor. To show the procedures in close-up on the big screen, audio-vi- sual requirements included a mi- croscope, video camera with opera- tor and a link to the main projector. The clinicians involved were spe- cialist Endodontist, Prof Peet van der Vyver and specialist Oral Sur- geon, Prof Andre van Zyl, and their teams, of whom most were dental specialists. Dental Tribune asked Prof Andre van Zyl, Head: Dept of Periodontics and Oral Medicine, University of Pretoria, to give a surgeon’s per- spective on being part of this novel event: “When I was first approached to do live surgery for the Nomads 2017 Congress, I immediately agreed and was excited. Only when I started playing the scenario through in my mind did the reality sink in and the magnitude of trying to present this dawned on me. The patient would be identified to the audience as he/she would be in the audience and this posed many ethical questions and would clearly be a very stressful situation for any patient. In fact, no-one had experi- enced such a scenario in South Africa before. What if the patient developed something as common as a vasova- gal syncope? We realized that a medical specialist would have to be on hand for any eventuality, from managing a nervous reaction to a potential life-threatening episode. The logistics to cover these situa- tions is daunting to say the least. I have done many live surgical procedures on camera through the last 20 years - but always from within the safety of a fully equipped practice, behind a cam- era, instead of more than 300 dele- gates watching. Delegates could never watch us perform in a cubi- cle, and it made me think of ani- mals in a cage. Not a happy picture for us. When doing surgery in the safety of a hospital environment, I can ask for anything and it will be fetched from sterilization, but in an au- ditroium, I would have no back-up. What if I that were 50km away in my department? A LASER to stop arte- rial bleeding? The mind boggles at all possible scenarios. Two days beforehand we found out that no proper suction could be installed in an auditorium, and a mobile suction would be used. This proved to be in strength, but thankfully our patient hardly bled during the operation. inadequate While performing the procedure,, we experienced two serious issues never thought of in the planning. The first being that the ‘surgery’ was exceptionally hot with all the sterile clothing, and no air-conditioning. Secondly, and even worse, was that the auditorium was dark and we could not see our instruments out- side the extremely bright LED oper- ating light! Assistants had to quickly use cell-phone torches to show the instruments. This made me think of a famous heart surgeon who was a patient and who told us how he and his team operated by cell-phone screen lights (not the current torches) many years ago with the first rolling black-outs and no generator kicking in! No newspa- per had that story! Other challenges were the two pa- tients who cancelled and we had to suddenly find a replacement just days before the congress and the planned CAD/CAM section could not take place as we had to close the bone-augmented implant as fast as possible. All part of the fun of trying something new. At the end I have to commend the Nomads organizing committee for such a courageous step to bring a new dimension to congresses in South Africa. I am not sure how many takers they will have next time. Perhaps younger clinicians will step up to the plate. With over- head lighting, a larger surgery- room and air-conditioning and les- sons learnt in 2017, it will be an eas- ier delivery.” Thank you, Prof van Zyl, for sharing your insight.