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Oral And Maxillofacial Surgery Specialty

Definition of specialization
Oral and maxillofacial surgery one of the specialties of dentistry, which includes diagnosis, surgical and non-surgical treatments of disease, and malformation of soft and bones tissues in the oral and maxillofacial area functionally and aesthetically.
Specialization fields
The specialization of oral and maxillofacial surgery according to the specialization guide of the international society of oral and maxillofacial surgery includes the following fields:
a) Oral pathology/oral medicine, including diagnosis and management of diseases of oral and maxillofacial regions.
b) Dentolaveolar surgery and management of pain and anxiety.
c) Preprosthetic surgery including implantology.
d) Surgical and nonsurgical management of TMJ diseases and disorders.
e) Management of maxillofacial trauma (soft and hard tissues).
f) Management of benign and malignant tumours surgically.
g) Regional reconstructive surgery, including harvesting of hard and soft tissue grafts and microsurgery.
h) Orthognathic/orthopaedic facial surgery.
i) Aesthetic facial surgery.
j) Surgical treatment of congenital abnormalities, including cleft lip and cleft palate surgery.
k) Craniofacial surgery.
Saientific council of oral and maxillofacial surgery
The  scientific council consists of specialists in oral and maxillofacial surgery who have experience and practice in this field (review supplement number 1) and includes the following:
1. Council president.
2. Council vice-president.
3. Committee of decision, characterization, training and exchange of experience. It consists of seven members, including the committee rapporteur.
4. The examinations committee is composed of seven member, including the committee rapporteur.
5. The committee of continuing medical education cinsists of seven members, including the presiding judge.
6. The executive committee shall consist of the council president, the council vice-president, and the three committee rapporteur.
Scientific Council Duties:
1. Putting the public policy and work plans to achieve the objectives of the program.
2. Setting work-route strategy and supervising the specialization of oral and maxillofacial surgery throughout the specialization certificate.
3. Describing supervision and training, and creating committees stemming from the scientific board to undertake the task per se.
4. Setting the regulating instructions for examinations and recommending certificates issuing.
5. Organizing courses for training the current doctors in the specialization field, who aspire to or previously register in the program to prepare the properly. This is met in cooperation with academic medical institutions related to dental medicine in the Arab World, providing the existence of meetings and courses on the Arab states level.
6. Publishing pamphlets and other publications which contribute to instigating the scientific board objectives.
7. Contributing to publishing references in the focal specialization, and cooperating with Arab and international information and documentation centers.
8. Issuing the instructions which organize the application of the training program.

The study period to obtain the Arab Board certificate extends to five years including one year for basic sciences, and four years for surgical clinical sciences, in addition to scientific clinical research as an essential stipulation for their graduation.
First Year:Basic Sciences: the study period spans for one year within which the following subjects are covered:
1. General Physiology and Oral Physiology.
2. Microbiology and Immunology.
3. General Embryology, General tissues and oral and dental tissues.
4. General Descriptive Anatomy and Head-Neck Descriptive Anatomy.
5. General pathology and oral and maxillofacial pathology
6. Biochemistry.
7. Training in specialization department subject.
Second Year: It includes the following courses:
1. Pharmacology.
2. Training in medical diagnosticimaging.
3. Training in the department of internal medicine on cases as important for oral and maxillofacial surgery.
4. Training in the department of general surgery on cases as important for oral and maxillofacial surgery.
5.Training in specialization department subject.
Third Year: It includes the following courses:
1. Biostatistics and research.
2. Training in department of plastic surgery.
3. Training in department of emergency.
4. Training in department of orthopedic osseous surgery (for one month).
5. Training in department of general anesthesia and intensive care treatment (one to three months).
6. Training in specialization department  subject.
Fourth Year: It includes the following courses:
1. Training in the department of otorhinolaryngological training.
2. Training in the department of brain-neurosurgery.
3. Research Thesis in the Specialization at the end of fourth year.
4. Training in specialization department  subject.
Fifth Year: It includes the following courses:
Training in specialization department  subject.

Courses Description
General Physiology and Oral Physiology:
a. Mastication and Swallowing Physiology.
b. Occlusion Physiology.
c. Saliva Physiology and Functions, and Taste.
d. Phonation and Speaking Physiology.
e. Endocrine Glands, Liver and Kidneys General Physiology.
f. Calcium and other Minerals Regulation.
g. Cardio-Vascular General Physiology.
h. Respiration General Physiology.
i. Neuro-Muscular General Physiology.
j. Acid and -base balance physiology.
k. Hormones
l. Reaction of traumatic injuries.
m. physiology of human body fluids.
Microbiology  andImmunology:
a. Immunology General Principles and Applications.
b. Germ Cell Cytology.
c. Oral Cavity.
d. Dental Plaque, related to oral and maxillofacial surgery.
e. Germinal Genetics.
f. Antibiotics.
General Pathology and Oral and maxillofacial pathology Pathology of mouth, face and jaws:
a. Principles of pathology.
b. The science of oral diseases.
c. Viruses.
d. Mycology.
e. Immunology.
f. Inherited and Acquired diseases.
General Histology and Oral Biology Oro-dental Histology:
a. General Histology and Cytology.
b. Oral and Maxillofacial Development.
c. Oral soft Mucous Membrane and hard Osseous Tissues.
d. Salivary Glands.
e. Paranasal sinuses.
f. Temporomandibular Joint.
Descriptive Anatomy:
a.Branchialarches
b. Mastication, speech and tongue Muscles.
c. Temporomandibular Joint.
d. Oral and Maxillofacial Sensory and Motor Innervation.
e. Head and Neck Bones Descriptive Anatomy.
f. Head and Neck Blood and Lymph Vessels.
g. Thorax Descriptive Anatomy.
h. Teeth development and growth
i. Salivary glands.
Biochemistry:
a. Introduction to current methods used in biochemistry.
b. Biochemistry:    - Metabolism and Anabolism.
            - Respiration.
            - Basic Substance and Proteins.
            - Calcium and Phosphorus Metabolism and Mineralization.
            - Glucose and Lipids Metabolism.
c. Biochemistry of Saliva and Oral Cavity.
Biostatistics and Research:
a. Probability and Calculation.
b. Normal Distribution Curve.
c. Converting to Standard Distribution.
d. Bio-Averages.
e. Applied Statistics Methods.
f. Research General Classification.
g. Academic Reading.
Pharmacology:
a. Pain killers and Sedatives.
b. Local and General Anesthetics.
c. Circulatory System Drugs.
d. Respiratory System Drugs
e. Antibiotics.
f. Drug Interaction and complications Contraindication.
Medical Diagnostic imaging radiographic:
a. Definition of medicaldiagnostic imaging.
b. The role of imaging radiation in diagnosis and treatment.
c. The principle of magnetic resonance imaging radiographic and its diagnostic role diagnosis of MRI.
d. Computedtomography and its uses.
e. Cone-beam computed tomography and its uses.
f. Interventional radiology and its uses in oral and maxillofacial surgery.
General Anesthesia:
a. Respiratory System Anatomy.
b. Respiratory System and Gas Exchanges Physiology.
c. General Anesthesia-Based Systems Disorders.
d. General Anesthesia Patient Preparation.
e. General and Partial Anesthesia Methods.
f. General Anesthesia Contraindications.
g. Cardiopulmonary Resuscitation.
h. Post General Anesthesia Patient Care.
i. Blood and Fluid Liquids Transfusion.
j. Shock.
Practical Training: assistance in anesthetizing patients (general anesthesia and deep sedation) under the supervision of a specialist.
Specialization subject: It generally includes the following topics:
a. Surgical extraction for Teeth and buried  impacted Teeth.
b. Surgical Treatment for Apical infections.
c. Local and regional Anesthesia.
d. Oral and Maxillofacial Inborn and Acquired Deformities and Treatment.
e. Oral and Maxillofacial Traumata Diagnosis and Treatment.
f. Paranasal Sinuses Diagnosis and Treatment.
g. Benign and Malignant Oral-Cavity Tumors Diagnosis and Treatment.
h. Pre-Prostheses  Prosthetic Oral Surgery.
i. Mouth and Jaws Cysts Diagnosis and Treatment.
j. Mouth and Jaws Infections Diagnosis and Treatment.
k. Salivary Glands Disorders Diagnosis and Treatment.
l. Temporomandibular joint diseases Surgical Diseases Diagnosis and surgical treatment.
m. Mouth-Head-Neck malignant Tumors Diagnosis and Treatment.
n. Simple and Advanced oral and cranio-maxillofacial implants Teeth Implantation.
o. Orthognathic Surgical Cases Diagnosis and Treatment.
p. Reconstructive Soft and Osseous oral and cranio-maxillofacial Facial Tissues.
q. Treatment of oral and cranio-maxillofacial Facial and Maxillofacial pain.
r. Training in ways to improve facial aesthetics in moderns ways.
Training In Departments:
1.Medical Diagnostic lmaging Department:
It aims at enabling the trainee to recognize and use of conventional x ray, CT scanner, and other imaging methods such as, ultra sonography and magnetic resonance (MRI) equipment in oral and maxillofacial surgery.
2. Generalmedicine:
It aims at enabling the trainee to manage the admitted patient, to perform a standard clinical check-up, and to both read and analyze analyses reports. Includes training in internal medicine, blood disease, endocrinology, oncology, liver disease, and gastrointestinal tract.
3. General Surgery:
It aims at enabling the trainee to manage the admitted patient, to prepare for surgical operations, and to be informed and involved of the general surgery principles. This process encloses a systematized training in the departments of: Emergency and Aids and Cosmetic Surgery with attention to the cases of oral and maxillofacial surgery.
4. Training in plastic cosmetic surgery department:
It aims at training in the principles of plastic surgery, grafts, flaps, stomatology, and treatment of facial malformations including lip and palatine clefts, microscopic surgery principles and training in the use of modern techniques in this field to facial beautification such as, facial injections, laser use, and face lift treatment.
 5. Training in the emergency department:
It includes training in receiving and providing emergency care for polytrauma patients and working within the team for the treatment of traumatic injuries.
6. Training in the Department of Orthopedic Surgery:
It aims at enabling the trainee to care for osseous disease  patients and to introduce the principles of surgical treatment for this type of diseases and to identify the modern methods of treatment in this field.
7. Training in general anesthesia department and intensive caretreatment:
The training includes the principles of anesthesia, deep relaxation training, the use of various local and general anesthesia methods and the principles of treatment of intensive care patients.
8. Training in Ear, Nose and Throat Department:
It aims at enabling the trainee to perform the required clinical examination and to introduce the surgical principles in specialization and training in the treatment of diseases which related to oral and maxillofacial surgery.
9. Training in theBrain and Neurosurgery Department:
It aims at enabling the trainee to perform the required clinical examination and to introduce the surgical principles in specialization and training in the treatment of diseases which related to oral and maxillofacial surgery.
Curriculum for the Specialized Practical Study during the Training Period
1. Minor surgery:
a. 50 cases of surgical extraction of buried teeth.
b. 70 cases of Minor surgical  (tumor, cyst, apicoectomy, aleveolar bone fracture, etc).
c. 30 cases of dental implants.
2. Trauma surgery:
a. Trauma surgery: 20 different cases of traumata treated as an assistant surgeon, and 20 cases as first surgeon including: 5 cases of closed fracture and the rest are divided between splintered and open fractures of the mandible, floating fractures, Le Fort I/II/III zygomatic fractures, and zygomatic arch).
3. OIrthognathic surgery:
As the first surgeon,the trainee participates in preparing and performing 10 cases in the mandible and maxilla. In addition, they perform one case of partial surgical cut for one of the jaws (segmental). 5 cases in which the student participates in the case study in terms of the preparation and cutting of examples and the study of cephalometricradiography and analysis of dimensions of face, jaw and teeth.
4. Surgical treatment for different diseases:
Participation in the study of 25 cases in terms of pathological story and diagnostic media then diagnosing the case. It involves Large cysts; arthro-injuries; benign tumors; malignant tumors; salivary glands disorders; infections of the jaws, face and neck. As first surgeon treats 25 cases from this type.
5. Prosthetic cosmetic surgery:
The trainee assists in 15 cases after full examination of each one. It includes grafts of soft and hard tissue, restoration of cleft lip and palate, correction of various deformities stemming from increased or decreased facial bone growth.As a first surgeon 5 cases of cleft lip and palate and 5 cases of bones grafts.
6. Experience in emergency cases:
The trainee is given the opportunity to obtain sufficient experience in the field of emergency treatments taking full responsibility for treating and managing cases associated with maxillofacial injuries or urgent pathological cases.
On the basis of this, every student must be attending at the training center during the third and fourth years.

1. The enroller student should be a holder of BSc in dental medicine and surgery from one of the universities recognized by the states participating in this program, or from one of the dental medicine schools in foreign countries providing that the university itself be recognized by its own origin country.
2. The enroller must be registered in the Ministry of Health or its representative, for initiating the right of professional practice in the country where they are trainees.
3. The acceptance of the student shall be based on the basis established by the local training centers.
4. Other stipulations essentially improvised by the board.
5. Payment of the annual fees to the Arab council.

  • First-Part Exam:

1. The trainee has to proceed to the first exam after being initialized for one year in the training program.
2. The exam follows the written pattern where the items are multiple choices, and the pass mark is 60%. Further, the exam comprises one paper including (150) items taken for three hours.
3. The exam includes basic sciences related to the field of oral and maxillofacial surgery.
4. The trainee has the opportunity of three successive repetitions for the first exam, after which they are to be given an additional opportunity provided that they have scored 50% or more in the last try.
5. An examination center is held upon having ten examinees; once this number reaches lower than ten, the exam should be administered in the nearest center where the results are conditioned to be immediate sent via mail.
6. If the student does not pass the first part exam. He will continue the training program for the first six months of the second year and submit the second test if he does not pass the exam, the training program will be stopped until he successfully passes the first part exam and begins with the completion of his training program.
7. Those who passed the first-part exam of the local medical centers or those who are holders of the Membership of Faculty of Dentistry, Royal College of Surgeons, or of equivalent are to be exempted from taking the first-part exam.
8. Offer applications to other certificate holders in the relevant jurisdiction to the training committee.

  • Second-Part Exam:

• The following is required to enter the written final exam:
1. The trainee must have completed the five years of training in centers recognized by the scientific council. They have also to complete five years of gradual training with responsibility being allowed a month’s leave each year, where the actual training period is no less than 55 months.
2. The trainee is evaluated by the training supervisor satisfactorily and confidentially and has to pass the local annual evaluation.
3. They have to submit a report of twenty participations in the scientific activities in the department.
4. To have passed the first-part exam.
5. To have conducted or participated actively in at least one scientific research.
6. That their scientific and practical Log Book conforms to the council's previously mentioned requirements.
7. To submit the exam application on the special form for this purpose three months before the exam date and to pay the required subscription fee.
8. Four images 4x4 should be attached to the application.
9. If the trainee withdraws his application for a period of at least two months before the exam date, they reclaim 50% of the exam fee; after which time, they lose the right for refunding.
10. The passing grade is 60 marks out of 100.
11. The exam is standardized in the first and final year, while the exams in the other years are left to be organized by the training centers.
• Form of final written examination:
- The exam is in the form of multiple-choice questions and consists of a single sheet of 120 questions for 3 hours.
- The trainee has the right to apply for the second-part exam four consecutive times in addition to an exceptional fifth opportunity.

  • Clinical and Oral Exam:

- The clinical exam takes place in December each year.
- It is not allowed to take the clinical and oral exam if one did not pass the written one.
- The trainee has the right to apply for the clinical and oral exam four consecutive times in addition to an exceptional fifth opportunity , and if he does not succeed in the four exams he is given an exceptional opportunity.
• Form of clinical exam:
- One long case lasts for 30 minutes.
- 2 short cases for 10 minutes each and/or one substantive clinical examination.
- The examination committee consists of three examiners per trainee, with only one of them being from the same training center of the trainee.
• Oral exam:
The examinee is asked about all the scope axes of specialization. There are at least two committees, and the duration of each examination is 15-20 minutes.

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