A2 EVENTS Dental Tribune U.S. Edition | August 2018 From facial reconstruction to transplantation: Prosthodontist to discuss importance of teamwork When people working at the top of their professions make a concerted effort to know what their colleagues need, the whole represents the greater outcomes of the parts and exceptional things can be created. In other words, teamwork can accomplish so much more, especially in the field of prosthodontics and dentistry in general. That’s the idea Lawrence E. Brecht, DDS, hopes to convey in his lecture “Facial Re- construction to Facial Transplantation: Success Through a Team Approach” at CDA Presents The Art and Science of Dentistry in San Francisco in September. Brecht is the director of maxillofacial prosthetics at New York University Col- lege of Dentistry and has a joint appoint- ment in the Hansjörg Wyss Department of Plastic Surgery of New York Univer- sity Langone Medical Center, where he also serves on the cleft palate, craniofa- cial, ear anomalies and facial transplant teams. Brecht’s presentation will review and stress the importance of the surgical- prosthetic-industrial team approach in reconstruction, from the simplest ex- amples to the most complex, including facial transplantation. In his lecture, he will also discuss how the culmination of the team concept can be seen in the advances in composite tissue allograft surgery (facial transplantation) for the severest of facial deformities. “We’ll begin with how a team approach can benefit children with a cleft palate and the simplest of ‘reconstruction’ of a smile for a baby and move up through jaw reconstruction for cancer and trau- ma patients — utilizing the ‘Jaw in a Day’ procedure — and move outside the oral structures, to the orbit, nose and ear, and the technology that is used to create those prostheses,” he said. The lecture will end with a discussion of what Brecht calls the “worst-case scenario” — when facial transplantation becomes neces- sary. Brecht’s interest in prosthodontics and its subspecialty, maxillofacial prosth- odontics, began when he was a student at New York University, where he earned his DDS. “You’re dealing with reconsti- tuting portions of the face beyond the oral structures, and it seemed to me that it was not a difficult thing to reconstruct a tooth as a tooth,” he said. “I enjoy the challenge and the fact that you have to work with your colleagues to get the best possible result for a patient.” After completing a residency at Bos- ton’s Brigham and Women’s Hospital and a fellowship at the Harvard School of Dental Medicine, Brecht went on to earn certificates in both prosthodontics and maxillofacial prosthetics from the Department of Veterans Affairs Medical Center in New York, N.Y. He maintains a practice in New York City limited to prosthodontics and maxillofacial pros- thetics. Many previously unimaginable recon- structions are now possible and achieved following fewer and more efficient sur- gical procedures that also facilitate improved prosthetic restorations and functional outcomes. While facial trans- plantation may be an option in some cases, it should not be the “first thing you go to,” according to Brecht. He said many problems are associated with facial transplants, such as the need for lifelong anti-rejection medications that increase the potential for various cancers and the procedure’s extreme cost. Often, recon- structions are successful and make facial transplants unnecessary. Case in point: A successful reconstruction of one of his patients who was originally a facial- transplant candidate. “There’s a boy we’re taking care of who had a gunshot wound and was considered to have a face transplant but was able to be reconstructed” Brecht said. “Using leg bones, we made dental implants and were able to make dental prostheses to restore him to a fairly whole status.” When facial transplants do become necessary, Brecht and a team of profes- sionals plan out what structures to re- move from the donor to be accepted in the recipient. But the team also strives to maintain a level of dignity for the do- nor throughout the procedure, includ- ing making molds of the donor’s face, Brecht said. The molds are used to create a lifelike silicone replica of the face to be draped over the donor’s remains. “That keeps a sense of there being a humanity of the donor,” he said. Brecht credits a team approach and advances in digital technologies for the success of reconstructions and facial transplants. He enjoys the intellectual stimulation of being part of a team, which in his field may include computer engineers, microsurgeons and dental laboratory specialists. He says one per- son does not have all the answers to pro- vide the care that patients need. But with the team approach, everybody pulls to- gether, teaches each other and becomes amateur experts in their teammates’ specialties. “With the onset of some really new and creative technologies, we’re able to do things that we could not have done five years ago and it’s constantly evolving,” Brecht said. “Embracing technology and being part of a team that’s greater than just myself have led to great personal growth and satisfaction. And that gives me a different perspective on what I do.” “Facial Reconstruction to Facial Trans- plantation: Success Through a Team Ap- proach” takes place from 11:30 a.m. to 1 p.m., Thursday, Sept. 6, and is open to the entire dental team. (SourceD California Dental Association) “ CDA, page A1 Pharmacology Harold L. Crossley, DDS, PhD, professor emeritus at the Univer- sity of Maryland Dental School in Baltimore, will present four courses that explore the intersection of pharmacology and dentistry. One course will provide the “nuts and bolts” of phar- macology that are useful in the dental office. Recognizing the legalization of marijuana in a growing number of U.S. states, a second course will discuss some common concerns about the use and abuse of the drug. A third course teaches the dental team how to recognize the signs and symptoms of commonly abused prescription and illicit drugs in patients and adoles- cents, and, finally, “Avoid Liability: Know Your Patients’ Medica- tion History and Its Impact on Dental Treatment” will look at the indications, contraindications and side effects of the most common physician-prescribed medications. Restorative dentistry Thomas R. McDonald, DMD, Augusta University College of Den- tal Medicine faculty member, and Edward A. McLaren, DDS, MDC, professor at the University of Alabama at Birmingham School of Dentistry, will lead lectures and workshops on restor- ative dentistry. In McDonald’s hands-on workshop “Provisional Restorations for Today’s Restorative Practice,” participants will fabricate anterior and posterior provisional restorations for single and multiple units while learning about esthetic con- touring and how to troubleshoot and repair. McLaren’s work- shop will demonstrate the step-by-step processes of two types of etched ceramic restorations, after which attendees will com- plete their own preparations. All CDA Presents lectures, including those listed here, are non-ticketed courses available on a first-come, first-served ba- sis. While preregistration is not required, early arrival is recom- mended. CDA Presents workshops are ticketed courses. Tickets may be purchased during preregistration and on-site provided space is available. For more about the courses summarized here and other scheduled courses by these speakers, see the online pro- gram at www.cdapresents.com/SF2018. (SourceD California Dental Association) DENTAL TRIBUNE The World’s Dental Newspaper · US Edition PUBLISHER & CHAIRMAN Torsten Oemus t.oemus@dental-tribune.com PRESIDENT & CHIEF EXECUTIVE OFFICER Eric Seid e.seid@dental-tribune.com GROUP EDITOR Kristine Colker g.colger@dental-tribune.com EDITOR IN CHIEF DENTAL TRIBUNE Dr. David L. 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