Surgical Margins in Oral and Maxillofacial Pathology
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Surgical margins play an important role in the surgical treatment of a wide range of head and neck pathologies, ranging from benign pathology to advanced malignancies. The importance of surgical margins is magnified with diseases that require surgical intervention. Surgical margins are strong predictors in eradicating pathology, achieving long-term surgical cure and survival. It is important for the treating surgeon to tailor surgical margins to the specific pathology being treated, especially with the surgical margin as the only variable the surgeon can try to control. The treating surgeon needs to balance the adverse effects from over-resection leading to morbidity against leaving residual disease that might necessitate further surgery and recurrent disease and might affect overall patient survival. This session will discuss proper surgical margins for a variety of head and neck diseases and how to achieve them, starting with planning of these cases and surgical technique while elaborating on the role of frozen section and their pitfalls. Finally, the session will address recurrent disease and strategies to address it.
Learning Objectives
At the conclusion of this program, participants should be able to:
- Review the importance of surgical margins and their impact on surgical management.
- Differentiate between surgical margins for benign surgical disease when compared to malignant/oncological disease.
- Explain the process of pathological surgical margins determination.
- Describe the management of close, positive margins and surgical management of recurrent benign and malignant diseases.
- Discuss the latest advancements in the world of surgical margins, such as adjunct tools to determine adequate surgical margins.
Thomas Schlieve, DDS, MD
Associate Professor/Program Director
Parkland/UTSouthwestern
San Francisco, California
Disclosure: Nothing to disclose.
Waleed Zaid, DDS, MSc, FRCDC, FACS
Associate Professor
Louisiana State University Health Scinece center
Baton Rouge, Louisiana
Disclosure: Nothing to disclose.
An Internet-based CDE/CME Activity
Original Release Date: October 1, 2021
Expiration Date: October 1, 2024
Estimated time to complete this educational activity: 1.0 hours
Method of participation: Self-Study
Thomas Schlieve, DDS, MD
Associate Professor/Program Director
Dr. Thomas Schlieve DDS, MD, FACS is the current program director of the oral and maxillofacial surgery training program at Parkland Memorial Hospital and UT Southwestern. He is an Associate professor of surgery and the medical director for oral and maxillofacial surgery at Parkland, UT Southwestern, and Dallas Presbyterian hospitals. HIs expertise includes diseases and pathology of the head, neck, and oral cavity including oral cancer, medication related osteonecrosis of the jaw (MRONJ), osteoradionecrosis, salivary gland disease and tumors, and odontogenic tumors and cysts such as the ameloblastoma and odontogenic keratocyst, along with reconstruction of the head, neck, and oral cavity.
Disclosure: Nothing to disclose
Waleed Zaid, DDS, MSc, FRCDC, FACS
Associate Professor
Dr. Zaid completed his undergraduate dental degree from Ajman University of science and technology and received his degree as a Doctor in Dental surgery. Dr. Zaid practiced as an Oral and Maxillofacial surgery trainee in multiple hospitals in the UAE until he moved to Montreal, Canada where he completed his oral and maxillofacial surgery residency program at McGill University.
Dr. Zaid composed his master’s thesis on a topic that is related to head and neck oncology titled “In Vitro Effects of bisphosphonates on Oral Squamous Cell Carcinoma” that awarded him an MSc degree from McGill University, during that time Dr. Zaid became a fellow of the Royal College in Oral and Maxillofacial Surgery after completing his Canadian Boards. Dr. Zaid went to Boston Medical center - Boston University Henry M. Goldman School of Dental Medicine to complete his clinical head and neck oncology and microvascular reconstruction fellowship.
Since completing his fellowship Dr. Zaid has been on Staff as an Associate professor at Louisiana State University Health Science Center New Orleans / School of Dentistry at the Department of Oral and Maxillofacial surgery where he spends most of the time in Baton Rouge where he provides full scope Oral and Maxillofacial surgery services with great interest to Head and Neck Oncology and microvascular reconstruction, his interest in research allowed him to be published in multiple peer-reviewed journals like JOMS, Triple OOO, Oral Maxillofacial Surgery Clinics of North America and multiple book chapters in the OMFS literature, this also allowed him to become a reviewer to many sections in multiple peer-reviewed journals, he is a Diplomate of the American Board of Oral and Maxillofacial surgery and finally he is an active member of multiple local, national and international Oral and maxillofacial surgery societies and associations and is one of the LSU-Oral and Maxillofacial review board faculty members.
Currently, he is the chief of Dentistry and Oral and Maxillofacial surgery at Our Lady of The Lake Regional Medical center in Baton Rouge, Louisiana.
Disclosure: Nothing to disclose
Continuing Education Provider Approval
The American Association of Oral and Maxillofacial Surgeons is an ADA CERP Recognized Provider.
ADA CERP is a service of the American Dental Association to assist dental professionals in identifying quality providers of continuing dental education.
ADA CERP does not approve or endorse individual courses or instructors, nor does it imply acceptance of credit hours by boards of dentistry.
The American Association of Oral and Maxillofacial Surgeons designates this activity for 1.0 continuing education credit(s).
AGD - Accepted Program Provider
FAGD/MAGD Credit
11/1/22-12/31/26
Provider ID# 214680
The American Association of Oral and Maxillofacial Surgeons (AAOMS) is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.
The American Association of Oral and Maxillofacial Surgeons designates this internet-based enduring material for a maximum of 1.0 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
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