ABAOMS2017Liverpool

ABAOMSAnnualConference

15th-17thNovember2017

CONFERENCEHANDBOOKWELCOMETOLIVERPOOLWELCOMETOABAOMS2017ABAOMSSPONSORSCONFERENCEINFORMATION&PROGRAMMESOCIALPROGRAMMEBOOKOFABSTRACTS&SPEAKERINFO

LIVERPOOL

WelcometoLiverpool

HELLOANDWELCOMETOLIVERPOOL-ACITYOFCULTURE,HERITAGE&

PEOPLE…

Liverpoolisacitywithuniqueattractions,excitingevents,worldclasssportofferings,unrivalledmusicalheritageandfamouslywarmwelcomes,Liverpool

istheidealdestinationtovisitandexplore.

WiththelargestcollectionofmuseumsandgalleriesanywhereoutsideoftheCapital,Liverpool’scultureandheritageareattheveryheartofthecity.

You’llalwaysfindafantasticselectionofthingstodo,placestoexploreandexcitingevents.

WelcometoABAOMS2017Awarmscousewelcometothe2017AssociationofBritishAcademicOralandMaxillofacialSurgeons(ABAOMS)scientificmeetinghostedbytheUniversityofLiverpool.Themajoraimofthescientificmeetingistofacilitatethedisseminationandapplicationofresearchfindingsrelatingtooralsurgery,educationandclinicalpractice.Wehopeyouhaveaproductiveandenjoyablemeeting.OnbehalfoftheLocalOrganisingCommittee

ABAOMSwasestablishedin2004tosupporttheDentalSchoolsandindividualsintheirdrivetoincreasetheinternationalcompetitivenessoftheresearch,educationandclinicalpracticeoforalandmaxillofacialsurgery.Itis

therepresentativebodyofacademicoralandmaxillofacialsurgeryintheUKandalltheUKandIrishDentalSchoolsarerepresentedinABAOMS.Membershipisopentoanyonewithaninterestinresearch,teachingandclinicalpracticeinanyaspectoforalandmaxillofacialsurgery.HistoryofABAOMSABAOMSarosefromanoriginalcommoninterestgroupcalledUTOMS;theUniversityTeachersofOralandMaxillofacialSurgery.UTOMSdevelopedinthe1980sasaspecialinterestgroupintheUKDentalSchools.ItwasUTOMSwhodevelopedtheoriginalAACOMSprogrammeinOMFS;theprototypicalUKschemecombiningacademicandclinicaltraining.ThisschemeisnowacknowledgedastheoriginoftheWalportschemeinclinicalacademicmedicineandsurgery.AsthedisciplinegrewitbecameclearthatthenamenolongerreflectedthemissionoftheorganisationandABAOMSwasestablishedin2004;recognisingthethreeinter-relatedkeyinterestsofitsmembership,i.e.teaching,researchandclinicalpractice.

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ABAOMS2017gratefullyacknowledgesthegeneroussupportofalloursponsors.

ConferenceProgramme

WEDNESDAY15th

ABAOMSMEETINGSESSION

Lunch12.45andRegistration14:00 EducationSubgroupCommittee(Suite9)15:30 ABAOMSCouncilMeeting(Suite8)16:00 Traineesmeeting(Suite5)18:00 Winetasting(CheshireMerseyWineSchool),JurysInn;1stfloorconference

centre)18:30 DinneratJurysInn,1stfloorSuite3/4

Thursday16th

EDUCATIONSESSION9:00–9:30 Registration9:30–9:40 ConferenceOpeningandWelcometoLiverpool

ProfessorCallumYoungson ChairFrancisO’Neill

9:40–10:30 MeasuringCompetenceinOralSurgery:RealityversusHopefulExpectationProfessorLukeDawsonDirectorofUndergraduateDentalEducation,LiverpoolDentalSchool

10:30–11:00 NationalRecruitmentinRelationtoAcademiaandNewCurriculum

DevelopmentUpdateDrColetteBalmerConsultantinOralSurgery/HonorarySeniorClinicalLecturer,LiverpoolDentalSchoolandChairoftheOralSurgerySpecialistAdvisoryCommittee&MissSarahMcKernonLecturer/StRinOralSurgery

11:00–11:30 Break

CLINICALSESSION11:30–12:15 NeverEventsinSecondaryCare

MrsAvrilMacphersonClinicalDirectorandConsultantinSpecialCareDentistry,LiverpoolDentalSchool

12:15–13:00 WrongSiteSurgeryinPrimaryCare

MrRupertHoppenbrouwersDDUSeniorDento-LegalAdviser13:00–14:00 Lunch

Thursday16th

EDUCATIONALPOLITICS/FREEPAPERSSESSION

Chair:LynneMillsopp/GillBarker14:00–14:40 UpdateonBrexit

ProfessorMichaelDouganProfessorofEuropeanLaw,UniversityofLiverpool

14:40–15:20 FreePapersSession1

a. 3-DimensionaltractographyoftheextracranialfacialnervecourseusingdiffusionweightedMagneticResonanceImaging(WEl-Kininy)

b. PreoperativeSubmucosalDiclofenacforAcutePostoperativePaininThirdMolarSurgery(PGorecki)

c. AnobservationalstudyofriskfactorsforheadandneckcancerinUKBiobank(MGormley)

d. Predictingtheoutcomeforpatientswithlow-stageoralcavitysquamouscellcarcinomausingavalidatedhistologicalriskmodel(NRahman)

15:20–15:40 Break15:40–16:30 FreePapersSession2

e. Improvingtheassessmentofpatientspresentingwithinferioralveolarnerveinjuries(ASavla)

f. Development of undergraduate IV sedation training experience in oral surgery through innovativetechnologyenhancedlearning(TShembesh)

g. Inter-examinerreliabilityingradinginvitrosurgicalexodontiavideos(HStancliffe)

h. Somatosensoryinvestigationoforofacialpain,unpleasantnessandpleasantness(PTaneja)

16:30–17:30 ABAOMSAGMDepart18:30forshortwalk/taxiridetoRacquetClub19:00:DrinksreceptionattheRacquetClub,accompaniedbytheUniversityChoir19:30:DinnerattheRacquetClub,HargreavesBuildings,5ChapelStreet,LiverpoolL39AG.

Friday17th

RESEARCHSESSION8:30–9:00 Registration9:00–9:10 Introduction Chair:KateTaylor9:10–10:00 ResearchintheRegionalHeadandNeckCancerCentreatAintree

ProfessorRichardShawSeniorLecturer/HonoraryConsultantinOralandMaxillofacial/HeadandNeckSurgeryRegionalMaxillofacialUnitatUniversityHospitalAintreeanddepartmentofMolecularandClinicalCancerMedicine

10:00–10:30 PositiveandNegativefactorsforSoftandHardTissueMaintenance

DrJosephChoukrounSpecialistinGeneralSurgery,AnaesthesiologyandPainManagement,Nice,France

10:30–11:00 Break11:00–11:40 ProstheticImplant-basedRehabilitationFollowingMaxillary&Mid-

faceMalignancyMrChrisButterworthConsultantinMaxillofacialProsthodonticsandOralRehabilitationandHonorarySeniorLecturerinMaxillofacialProsthodontics,RegionalMaxillofacialUnitatUniversityHospitalAintreeandLiverpoolUniversityDentalHospital,ClinicalLeadforDentalImplants,LiverpoolUniversityDentalHospital

11:40–12:20 MicroneurographyandTrigeminalPhysiology

DrFrancisMcGloneProfessorofNeuroscience,LiverpoolJohnMooresUniversity

12:20–12:30 CloseofMeetingandFeedback12:30–13:30 Lunch

SocialProgrammeWednesday15th

WelcomereceptionwithfantasticwinetastingbyCheshireMerseyWineSchoolfollowedbyeveningmealinJurysInn.Duringthisevening,wewillbeholdingacharityrafflewithprizesgenerouslyprovidedbysponsors.TheraffleisinaidofHaNC(HeadandNeckCancerSupportandResearch)whoprovidemuchneededhelpandassistancetothoseaffectedbyheadandneckcancer.Thursday16thBlacktiedinnerintheexclusiveRacquetClubHotel&ZibaRestaurant,withentertainmentprovidedbyUniversityofLiverpoolChoir.Thisislocatedashort7-minutewalkfromJurysInn.

ConferenceVenueTheABAOMSConference2017istakingplaceinJurysInn,locatedatAlbertDock.Alldelegatesarerequiredtoregisteronthe1stfloor.CarParkingJurysInnoffera25%discountonsecurecarparkingattheWaterfrontmulti-storeycarparknextdoortothehotelforguestsstayingover8hours.RegistrationLocatedinthefoyerofthe1stfloor,thiswillopenat1pmon15thWednesdayfor3daydelegatesandonThursday16that8:30am.FreeWi-FiWi-FiisavailablethroughoutJurysInnforFREE.Justclickandconnectyourdevice.PosterPresentationsGeneralposterswillbedisplayedthroughoutthewholeconferenceinthebreakoutarea.PosterboardswillbenumberedwithyourposterID.Pleaseseethelistavailableintheposterarea.OralPresentationsPleaseensureyouhaveacopyofyourpresentationonaUSB.ConferencerefreshmentsTeaandCoffeewillbeavailablethroughoutthewholeconferencefromself-servicedeskslocatedinthebreakoutarea.Atdesignatedbreaks,tea/coffeeandbiscuitswillbeprovided.PhotographyTherewillbetimeswhenorganisingstafffromUniversityofLiverpooltakeofficialphotographsforsocialmediaandfutureABAOMSpromotionalevents.Ifyoudonotwishtobeincluded,pleaseletamemberofstaffknow.LocalTransportLimeStStationisthemainhubintoLiverpool.ThisislocatedashorttaxirideawayfromJurysInnora25minutewalkforthoseenergeticamongus.UberisavailableandpopularwithinLiverpool.Otherlocaltaxifirmsareavailableandcanbeorderedbyaskingmainreception.

OralPresentations3-DimensionaltractographyoftheextracranialfacialnervecourseusingdiffusionweightedMagneticResonanceImaging.ElKininyW,RoddyD,DavyS,BarryD,OHanlonE&StassenLFTrinityCollegeDublin,DublinDentalSchoolandHospitalImagingofthefacialnerveinitsextracranialcourse,especiallyasitcoursesthroughtheparotidglandhashistoricallybeendifficulttoachieve.Therearemanypotentialadvantagesof3Dradiologicalvisualisationofthefacialnervetract.Diagnostically,thefacialnervecouldbeassessedforitsrelationtoparotidpathology,bothbenignandmalignant.Inthepreoperativesettingthisnewtechnologycouldallowsurgeonstoplansurgicalapproachesandtechniques,ofwhichtherearemany,inordertobestavoidinadvertentdamagetothefacialnerveand/oritsbranches.NewadvancesinDiffusionWeightedMagneticResonanceImaging(DW-MRI)scanning,processingandreconstructiontechniquesmayallowaccuratemappingofthefacialnerveonitsextracranialcourse.Aim:Ourfeasibilitystudyaimstoestablishanin-vivoreproducibleDW-MRIprotocoltoreplicatethecourseoftheextracranialfacialnerve:fromitsexitthroughthestylomastoidforamentoitsfiveterminalbranchdivisions.Methods:HighAngularResolutionDiffusionImaging(HARDI)DW-MRIscanswereundertakenat3Teslain4subjects(voxelsize2xmm3isotropicin61directionswithmultipleb-values=400/800/1500s/mm).Followingpre-processingandT1/T2imageregistration,constrainedsphericaldeconvolutiontractographywasundertakenwithmultiplestep-sizesandanglethresholds.Twocadavericscanswerealsoperformedusingthesamescanningandtractographyprotocolandrepeatedatareducedvoxelsize(1.2mm3isotropic)forincreasedresolution.Eachcadavericfacialnervewassubsequentlydissectedoutforanatomicallocalisationandcomparisontothescans.ResultsandConclusion:VariousscanningparameterswerecomparedtorevealtheDW-MRIprotocolyieldingthemostreliableextracranialcourseofthefacialnerveinvivo.Successfulanatomicalcorrelationswiththecadavericscanssuggestvalidityofourapproachinprinciple.Futuredirectionsincluderefinementofourscanningparameterswithgreaternumbersandfurthervalidationwithintra-operativeanatomy.

PreoperativeSubmucosalDiclofenacforAcutePostoperativePaininThirdMolarSurgery.

GoreckiP,RainsfordK,TanejaP,BulsaraY,SaundD,PearsonD,AhmedB,DietrichTSchoolofDentistry,UniversityofBirminghamDiclofenacsodiumisawidelyusednon-steroidalanti-inflammatorydrug(NSAID)forreliefofinflammatorypain.Recentformulationsusethecomplexingagenthydroxypropyl-β-cyclodextrin(HPβCD)asasolubilityenhancer,facilitatingsubcutaneousapplicationAim:Thisstudyaimedatassessingtheefficacy,safetyandlocaltolerabilityofdiclofenacHPβCDadministeredasalocalsubmucosalinjectionpriortolowerthirdmolarsurgery.Objectives:Weconductedaprospective,randomised,double-blind,placebo-controlled,parallel-groupphase-IIsingle-centrestudy,atTheSchoolofDentistry,UniversityofBirminghamandBirminghamDentalHospital,Birmingham,UK.Methods:Eligiblepatientswererandomisedintooneoffivegroups:diclofenacHPβCD50mg/1mL(D50),diclofenacHPβCD25mg/1mL(D25),diclofenacHPβCD12.5mg/1mL(D12.5),diclofenacHPβCD5mg/1mL(D5)orplacebo1mL.Therespectivedrugwasinjecteddirectlyintothemucosaltissuesurroundingthesurgicalsitepriortosurgeryandfollowingachievementoflocalanaesthesia.TheAreaundertheCurve(AUC)ofpainscoresfromendofsurgeryto6hourspost-surgerywastheprimaryendpoint.Secondaryendpointsincludedtimeuntilonsetofpain(TOP)andtimeuntilrescuemedication(TRM)wastaken.SafetyevaluationrecordedthenumberofAdverseDrugReactions(ADRs).Results:Seventy-fivepatientswererandomised(D5:n=15,D12.5:n=15,D25:n=15,D50:n=14,placebo:n=16).Theprimaryoutcomemeasuredemonstratedaglobaltreatmenteffect(p=0.0126)betweenactivegroupsandplacebo.Nostatisticallysignificantdifferencewasfoundbetweendiclofenacgroups.TOPandTRMwerestatisticallysignificantlylongerintheactivegroupscomparedtoplacebo(p<0.0161andp<0.0001,respectively).TRMrangedbetween7.8hrs(D25)and16hrs(D50).Interestingly,D5appearedtobesuperiortoD12.5andD25(TRM=12.44hrs).Eleven(14.6%)diclofenacpatientsrecordedADRs,mainlyinjectionsitepainandswelling.Twopatients(D25,D50)experiencedflapnecrosis.Discussion:Thisstudyoverallsuggestsefficacy,safetyandrelativetolerabilityofdiclofenacHPβCDusedasalocalsubmucosalinjectionpriortothirdmolarsurgery(ClinicalTrials.govregistrationNCT01706588).

AnobservationalstudyofriskfactorsforheadandneckcancerinUKBiobank.MarkGormley,RebeccaRichmondandSteveThomasUniversityofBristol,BristolMostheadandneckcancersaresquamouscellcarcinomas(HNSCC)affectingthelarynx,oropharynxandoralcavity.Establishedconventionalriskfactorsincludesmoking,alcoholintake,andinoropharyngealcases,exposuretothehumanpapillomavirus.Consequently,eachsubsiteispredicteddifferentlyandknownriskfactorsmaynotfullyexplainthesechanges.Aims:1.TodetermineifUKBiobankdataconcurswithotherheadandneckdatabiobanks2.Toestablishpotentialnovelriskfactors.Objectives:Usingdataanalysissoftwareandstatisticalmethodsdescribedbelow.LogisticregressionmodelsillustratedtheassociationbetweenHNSCCandconventionalriskfactors,usingStata®.Inaddition,aPHEnomeScanANalysisTool(PHESANT)wasusedwithinthestatisticalpackageR©totesttheassociationofHNSCCwithallphenotypicdatainUKBiobank.Allmodelswereadjustedforage,sex,ethnicityanddeprivation.Methods:UKBiobankisalargepopulation-basedcohortstudythatrecruitedover500,000menandwomenagedbetween40and69.Participantsweregivenaquestionnaireregardingsociodemographic,lifestyleandhealthfactors.Blood,urineandsalivasampleswerealsocollected.Currently1398incidentandprevalentcasesofHNSCChavebeenidentifiedwithinthedata.Results:Theresultssofarappeartobeinkeepingwithotherbiobanksintermsofconventionalrisks.WehopetohighlightpotentialnovelriskfactorsforHNSCCandbetterexplainthevarianceintheaetiologyofthisdiseaseacrossdifferentsubsites.Conclusion:Theresultswillbeofvalueinpreventionandpatientcounselling,providingevidencetoguidehealthcaredecisionswiththeaimofreducinghealthcarecostandtoenhancethequalityofpatientcare.ThisstudywillcomplementfurtherpredictiveresearchfollowingthegenotypingdatareleasefromUKBiobank.

Predictingtheoutcomeforpatientswithlow-stageoralcavitysquamouscellcarcinomausingavalidatedhistologicalriskmodel. NaomiRahmanandBrendanConnEdinburghDentalInstitute,EdinburghCurrentlypatientswithT1andT2OralSquamousCellCarcinomas(OSCCs)carcinomasareusuallytreatedwithsurgeryalone.Largestudieshavesuggestedthatdiseasespecificmortalityratesof12-25%and37%forT1andT2cancersrespectively.In2005,Brandwein-Gensler(MBG)thereforeproposedariskmodeltoaddprognosticvalueforlowstagecarcinomaswhichcouldofferradiotherapyto‘highrisk’cases.Aim:TheaimistoassesswhetherthevalidatedriskmodelbyMBGpredictsdiseaseprogressionanddiseasespecificmortality.Method:Retrospectivestudyof66earlyT1andT2OSCCswerescoredaccordingtothe3componentsofthevalidatedriskmodel:worstpatternofinvasion(WPOI),lymphocytichostresponse(LHR)andperineuralinvasion(PNI)andthencategorisedaccordingtorisklevel.Loco-regionalrecurrenceanddiseasespecificmortalitywerethestudyendpoints.Results:Fortypatients(61%)wereclassifiedwithloworintermediateriskand26(39%)patientswerehighrisk.Theinter-observeragreementwasinmoderatetostrongagreementwiththeconsensusscores(krange=0.45to0.82).Wefoundnosignificantassociationbetweenthehistopathologicalriskmodel,theRCPathdatasetprognosticfeaturesoranyoftheoutcomes.However,11tumoursarenowclassifiedasT3stageinthe8theditionofTNMstaging,73%wererecordedashighriskwithincreasedlikelihoodofPNI.Conclusion:ThisstudyhighlightsthelimitationsofusingtheriskscoreandthedifficultyinidentifyingaggressivefeaturesthatjustifytheuseofradiotherapyinlowstageOSCCs.However,majorityoftheT3tumours,wererecordedas‘highrisk’withaggressivefeatures(Overallscore:Mdn=3U=158p=0.011andPNI:Mdn=1U=161p=0.002),justifyingtheupgradeinthe8theditionTNMstaging,whichcouldincreasethepossibilityofreceivingadjuvantradiotherapy.FurtherstudiesshouldbeconductedtoidentifypredictiveprognostichistopathologicalfeaturesofOSCCs.

Improvingtheassessmentofpatientspresentingwithinferioralveolarnerveinjuries.AdeshSavla,JashmePatel,AneeshaShah.King’sCollegeDentalInstitute,LondonThemajorityofinferioralveolarnerveinjuries(IANI)areiatrogenicinnaturecausedbydentaltreatment.AssessmentofpatientspresentingwithIANIcanbecomplicated,requiringspecialistequipmentandtraining.Additionally,patientssufferingwithIANIarenotseenregularlyonroutineOralSurgeryclinics,resultinginconfusionforbothpatientsandclinicians.Aim:Todeterminehoweffectivecliniciansareinassessingandmanaging

distressedpatientspresentingwithIANI.Objectives: (1)ImplementationofaproformatoassessandmanagepatientspresentingwithIANI.

(2)Assessingwhethertheproformahelpsassess,manage,predictthedurationandoutcomesof,andrateofimprovementofIANI.

Method:AsimpleproformawasdevelopedforusewhenassessingpatientswhopresentedwithIANIinOralSurgeryandacutedentalcareclinicsinalargeteachinghospital.ThedocumentationofpatientswithIANIbeforeandaftertheintroductionoftheproformawascompared.Theassessmentinvolvedneurologicalexaminationandbasicassessmentofpatient’spsychologicalwellbeingfollowingIANI.Results:Priortointroductionoftheproforma25nerveinjuriesdocumentationswereassessed.Allhaddocumentedtheeventsprecedingthenerveinjuryandbasicdentalexaminationofthepatient.Only16%haddocumentationofthepsychologicalandfunctionalimpactfollowingIANI.Theneurosensorytestinganddocumentationaccuracywasvariable.Followingintroductionoftheproforma10documentedIANIswereassessedforcomparison.Therewasanimprovementintheneurosensory,psychologicalandfunctionalassessments.Conclusion:Theintroductionoftheproformahelpedcliniciansassessdistressedpatientsefficientlyandeffectively.Suchpatientscanbeupsetandtraumatisedandtimelypatientmanagementcanhelptomanagethemefficientlyandreducepatientcomplaints.Somepatientsmayneedtobereferredformorespecialisttreatmentandearlyidentificationofthesepatientscanbeeffectivelytriaged.TheresultsshowasignificantimprovementinthequalityofIANIassessmentandmanagementfollowingproformaimplementation.

DevelopmentofundergraduateIVsedationtrainingexperienceinoralsurgerythroughinnovativetechnologyenhancedlearning. ShembeshT,PatelJ,LowrinczA,SanDiegoJKhawajaNKing’sCollegeDentalInstitute,London

KCLDIhasdevelopedaninnovativetrainingprogramtointroduceundergraduatedentalstudentstointravenous(IV)sedationinoralsurgerybyblendingonlineandclinicaleducationusingavirtuallearningenvironment(VLE)platform.

Aim:Explorethestudentexperiencethroughfeedback&reflection.Objectives:DemonstratetheabilityoftheVLEMethods:1604thyearundergraduatedentistrystudentsintroducedtoIVsedationinoralsurgeryclinics.Studentswereinstructedtocompleteanonlinefeedbackquestionnaireattheendofthecourse.Results:DatawascollectedviaaMoodleoperatedVLE.LearningTypeanalysedbyLondonKnowledgeLab©-InstituteofEducation2013-2016:(54.17%)Acquisition,(18.75%)Practice,(10.42%)Inquiry,(8.33%)Discussion&(8.33%)Production.Conclusion:VLEscanbeusedtosupportclinicalcoursesbyassessingpriorlearning,accommodatingdifferentlearningstyles&allowingstudentstore-enforcelearningasneeded.

Inter-examinerreliabilityingradinginvitrosurgicalexodontiavideosHelenStancliffe,MichaelHicks,CharlotteCurrie,HannahDesai,StuartNelson,SarahBall,RachelGreen,LeeMercer,IanCorbett,JustinDurhamNewcastleDentalHospital,Newcastle

Standardisationinmarkingsurgicalexodontiaisdifficulttoachieveandteachersmayvaryevenwithcalibration.Trainingnewteachersisthereforefraughtwithpotentialdifficulty.Aim:Toexamineinter-examineragreementonstandardisedcasesusingformativegradingcriteria.Objectives:(a)Toexaminepercentageagreementbetweenexaminers

(b)Toexamineinter-examinerKappacoefficients(c)Onbasisof(a)&(b)toassessporcinemodels’viabilityastrainingaidfornewteachers.

Method:Eightteachingstaffwasaskedtowatch5differentporcinemodelsurgicalexodontiavideosonceandthenmarkthemusingstructuredclinicalobjectivetest(SCOT)criteria.Theobservationgroupsweredividedintotwoequalgroupsofparticipantsoflessthanormorethan5yearsteachingexperience.Anonlinesurveytoolwasusedtocollectdataanonymously,bycaseanddomain.Thegradingmethodwas:merit,satisfactory,borderlineunsatisfactoryandunsatisfactory(MSBU).Teacherswereinstructedtogradeasifmarkingafourthyearstudent.Thefollowinggradingdomainswereused:incision,flapraising,boneremoval,sectioning,useofelevators,safedeliveryoftooth,suturing,andanoverallglobalscore.DescriptivestatisticswereusedtoexaminepercentageagreementandKappacoefficientswerecalculatedtoexamineinter-examinerreliability.Results:Fivefemaleandthreemaleclinicalteachingstaffparticipated.Themodegradesandpercentageagreementwere:Case1U(63%),Case2MandS(38%),Case3U(75%),Case4B(63%),Case5BandU(38%).Examiningall5casesinapooledmannershowednosignificantagreementinglobalgrades(K=0.06,p>0.05).Conclusion:Thereisnosignificantagreementamongstexperiencedstaffonstandardizedcases,buttheremaybearoleforvideoexamplesofspecificproblemsinstagesofprocedure,thatcan’t,forobviousreasons,becreatedinvivoe.g.damagetoadjacentteeth.

Somatosensoryinvestigationoforofacialpain,unpleasantnessandpleasantness.PankajTaneja,HåkanOlausson,MatsTrulsson,LeneVaseToft,PeterSvensson,LeneBaad-HansenAarhusUniversity,AarhusInthepainfield,thescientificfocushasbeenprimarilyonthesensationofpainandunpleasantnessorproblemswithlackofnormalsensationsliketouchandtemperatureinthemouthandfaceasasignofforexamplenervedamage.However,lackofsensationofstimuli,whichwouldnormallybeconsideredaspleasant,israrelytakenintoaccount.Aim:Toapplyestablishedpsychophysicaltestsoftactileandpainsensitivityaswellasstandardisedpleasantstimuliandevaluatetheirpotentialcapacityforevocationofperceivedpleasantsensationsintheorofacialregion.Objectives:Toestablishifastandardisedbrushstimulus,knowntoactivatelowthresholdCafferentfibresleadingtoapleasantsensationontheforearm,inducessimilarpleasantsensationstotheface.Toevaluatethecapacityforevocationofperceivedsensationsofpleasantness,unpleasantnessandpainofdifferentstandardisedstimulusmodalities.Psychologicalquestionnaires:PainCatastrophizingScale,PositiveandNegativeAffectScaleandSocialTouchQuestionnaire.Methods:20healthyadultfemaleparticipantsunderwentstandardisedquantitativesensorytestingontherightinfraorbitalregion.Thisincludedtouch,pinprick,cold,warmth,thermalpain,vibration,pressure,softbrushstimuli.Foreachstimulusmodality,thelevelofevokedpleasantness,unpleasantnessandpainwasassessed.Results:

• Brushstimuliwassignificantlymorepleasantcomparedtootherstimuli(p<0.05)• SignificantpositivecorrelationswereseenbetweenNegativeEffectScoreandpainforpinprickstimuliof8,16and128mN(p<0.05).• Brushstimulationwasconsideredthemostpleasant.

• Thelevelofnegativeaffectisassociatedwiththepainintensityusingpinprickstimuliof8,16and128mN.• Noothersignificantcorrelations.

Conclusion:Theresultsfromthismethodologicalstudywillcontributetoalargerstudyinthemultisensoryintegrationandmodulationoffacialpain.

PosterPresentationsPoster1.Anaudittoassesspatientsatisfactionfollowingtreatmentwithintravenoussedationinasecondarycaresetting.AishaShabir,TinaHalai,MehriEghtessad,JosiahEyesonEastmanDentalHospital,LondonPatientsatisfactionauditsarevaluableinhelpingimprovepatientcare.Aim: (a) Assess satisfaction pre, peri and post sedation in patientsundergoingdentoalveolarsurgery.(b)QualityassureourserviceinlinewithIACSDGuidelines.Method: Consent formsand information leafletswereused to confirmpatient participation prior to delivery of sedation. A telephonequestionnairewasundertaken1weeklater.Objectives:Evaluatepatientexperiencewithintravenoussedation.Results:67patientswerecontacted.Ofthese,50patientsrespondedandformed our sample size 100% were very satisfied with preoperativesedationinformationprovided.98%statedtheywerecomfortableduringsedationandover80%reportedamnesiceffect. 93%expressedagoodoverallexperienceand100%wouldrecommendsedation.Conclusion: Changes to be implemented include regular departmentalsedationtrainingreviews.Ongoingre-auditwillbeessential toensureahighqualityserviceisdelivered.

Poster2.Tiering,TriagingandTraining.TinaHalai,ArwaSanalla,JosiahEyesonEastmanDentalInstitute,LondonCommissioningremainsatopicalissuewithintheNHSandthespecialty.Thisstudycomparesreasonsforreferralswithtreatmentoutcomes,determinestheproportiontreatedbydifferentoperatorgradesandtieringcomplexities.Aim:Assessoralsurgeryreferralpatternsandtreatmentcomplexities.Objectives: Highlight importance of considering triaging, tiering andtrainingforclinicians.Method: Casenoteswere reviewed for200patientswhohadattendedconsultationovera1monthperiodandcompletedtreatment.Datawascollated to determine reasons for referral,medical histories, treatmentand mode of anesthesia, operator grade and tiering using theCommissioningGuideResults: 94% were referred due to anticipated surgical extraction. Ofthese,59%weresimpleextractions.Overall,18%wereTier1,55%Tier2and26%Tier3complexity.ThemajorityofTier1(74%)andTier2cases(48%)wereperformedbySHOsandTier3(36%)bySTRs.Conclusion:Thisstudyhighlightstheneedforabalancebetweenfinancialconsiderationswithfutureworkforcetraining.

Poster3.Audittoassesstheuseofpatienteyeprotection.ChandniSoneji,HapriyaSuglani,NayeemAliBartsDentalHospital,LondonPatient eye protection (PEP) is essential during Oral and MaxillofacialSurgery (OMFS) procedures carriedout under general anaesthetic (GA).BreachesinPEPcarryriskofcornealabrasion,sharpsinjury,etc.Methodsof PEP include standard draping, eye shields: EyeGard©, OPSITE POSTOP©,eyemasks:Opti-Gard©andeyepads.Aim:ToimprovepatientsafetyforproceduresunderGA.Method:We audited patients undergoing OMFS procedures under GA,checkingbreachesinperiocularseal(PS)intraoperativelyandatproceduresignout.Goldstandard:NobreachesinPEP.Results: 1st cycle – 25 patients: 40%experienced a breach in PEP. 8/19Eyegard©onlypatientsexperiencedabreach.Re-audit-29patients:totalbreachesreducedto21%.4/6EyeGard©onlypatientsexperiencedabreach.Conclusion:Our1st cycle recommendation touse a combinationof PEPmethodsresultedina19%reductionintotalbreaches.OurresultssuggestusingEyeGard©aloneisinsufficient.

Poster 4. Enhancing the Situational Awareness of Dental Students; Amultifactorialapproachinoralsurgery.ClaireGraham,KathrynTaylor,LiverpoolUniversityDentalHospital,LiverpoolPatientsafetyisakeypriorityinhealthcareandthereisanincreasingneedto reduce adverse events and avoid patient harm. Analysis of criticalincidents has observed that many occur due to the absence ofnontechnicalskills(NOTECS)suchassituationalawareness(SA).Invaluableexperienceinhigh-riskenvironmentsforexample,aviation,hasprovidedinsight into theunderlyingcausesofadverseevents. Adverseevents indentistryarecommon.Thenumberofreportednevereventsisincreasing,andofthese,OSproceduresarethemostcommon.Aim:TodevelopfutureideasforthedevelopmentofSAinUGoralsurgery.Objectives: To review the literature for SA in undergraduate (UG) oralsurgeryMethod: A literature search using the followingwordswas performed:situation awareness and dentist undergraduate, oral surg, student,medicine.Results: UG dental students are inexperienced but have adequate datagatheringskills.Assituationschange,somewillanticipatechangesbetterthan others, e.g. a patient may faint. UG’s are also affected byenvironmentalfactors i.e.fatigueandstressthatmayleadtolossofSA.Novicesarelessabletofilteroutdistractionsandinterruptionsthanmoreexperienced clinicians and are more likely to be affected by patientsexhibitingextremebehaviourscausedbyanxiety.Conclusion:AdverseeventsinOSareunavoidablebutitisessentialthatthesearereduced.Novicesarepotentiallymorereadilyaffectedbyfactorsthat can lead to decreased SA and are more likely to be affected byenvironmentalfactorswhichcandistractthem,creatingsituationswhereerrorsmayoccur.Currently,ourUGcurriculumfocussesontheacquisitionoftechnicalskillsversusNOTECS.ToequipourUGswiththeskillsrequiredit is important that SA and HF training is introduced. Increased staffawareness and training will ensure optimal patient safety andminimalnumberofadverseevents.

Poster5.AprospectiveobservationalstudyinvestigatingtheIncidenceofdeepfascialspaceinfectionsfollowingalowerwisdomteethextraction.EleniBesi,MarialenaCresta,FionaWright,NicolasMaldenEdinburghDentalInstitute,EdinburghWisdomtoothextractionisthemostcommonlyperformedprocedurebyOralSurgeonsintheUnitedKingdom,andaswithanysurgicalprocedurecomplicationscanoccur.Thesecomplicationsincludedrysocket,trismus,traumatootherstructures,fracture,nervedamageandinfection,localorsystemic.Systemicinfectioncanprogresstoinvolvedeepfascialspacesoftheneck,whichcanpotentiallycauseseriousmorbidityandevenmortalityareassumedtoberare.Theactualincidenceisnotclearlyknownasfewstudiesaddressthedetailsofsevereinfectionfollowingmandibularthirdmolarremoval.Aimandobjectives:WepresentaprospectivestudyinEdinburghDentalInstitute(EDI),whichisaimingtoinvestigatetheincidenceofsystemicinfectioninthedeepfascialspacesoftheneckafterthirdmolarextraction.Method:ProspectiveobservationalstudyfromAugust2016toMay2017inpatientswhoattendedtheEDIforremovalofalowerwisdomtoothunderlocalanaesthetic,generalanaestheticorsedation.Patientsagreedtoafurthertelephoneconsultationafewweeksafterthesurgicalappointment.Results:500patientsfromwhom2,(incidenceof0.4%),acquiredadeepfascialspaceinfectionandrequiredhospitalisationandfurthertreatment.Nocorrelationwasseenbetweenthedevelopmentofadeepcervicalspaceinfectionandage,gender,smokingstatus,predisposingmedicalhistory,difficultyofextractionorexperienceofoperator.Conclusion:Patientsareinformedofthelowriskofpost-operativedeepfascialspaceinfectionfollowinglowerwisdomtoothremoval.Theincidencerateissimilartotheretrospectivestudy,whichwasconductedin2012-2013inEDIbyO’Connoretal(0.5%)andtotheJapanesestudybyYoshiietal2001(0.8%).Alargernumberofpatientsarerequiredintheprospectivestudy,whichwouldprovidemorereliableandaccurateinformationonthetrueincidenceofthissignificantpostoperativecomplication.

Oral surgery trainees include dental core trainees (DCT) and specialistregistrars (StR). They require exposure to cases different levels ofcomplexitytodevelopsurgicalskills.Aim: To evaluate the complexity of treatment provided by trainees inLondon dental teaching hospitals in order to understand their trainingneeds.Objectives: To understand the level complexity of care provided bytraineesToappreciatetheimpactthatcommissioningguidemayhaveontrainingMethod:InNovember2016,informationfromDCTsandStRsfromthreedental teachinghospitalswasprospectively collectedThedetailsoforalsurgery treatment provided under LA, IVS and GAwere included. Thegradeof the trainee, the levelofcomplexityand thepatientASAstatuswererecorded.Results:6StRsresponded.55%ofthetreatmentwas level3complexityand 40% was level 2 complexity. The 5% that was Level 1 treatmentcomplexityandthesehadpatientmodifyfactors.12DCTsrespondedandthemajorityofDCTsmanagedcasesof level1complexity(51%).43%ofcaseswerelevel2complexity.Conclusion: This study demonstrates the range of case complexity thatDCTsandStRsmanage.Asthecareoflevel1and2casesmaybeprovidedoutsideofhospitalstheremaybeanimpactonfuturetraining.

Poster 6. Complexity of oral surgery care provided by trainees- thepotentialimpactoftheCommissioningGuideontraining.JashmePatel,AneeshaShahandJudithJonesKing’sCollegeHospital,London

TheOralSurgeryCommissioningGuidewaspublishedin2015.ItoutlinedthefutureoforalsurgerycareacrossEngland.Thecarepathwayaimstoimprove access, quality of care and patient outcomes. It defines thecomplexity of a case by procedure and modifying patient factors.ComplexityisrankedasLevel1,2or3.Thisrelatestothecompetenceoftheclinicianrequiredtoprovidethatcasecomplexity.

Poster7.Factorsaffectingthedentalmanagementofhaemato-oncologypatients.MeeraSamani,JashmePatel,SukinaMoosajee,CathyBryant,King’sDentalInstitue,LondonHaemato-oncology patients often require dental treatment prior tochemotherapyorhaemopoeticstemcelltransplant(HSCT).Livingwithandhaving treatment for haematologicalmalignancy can result in poor oralhygiene,irregulardentalattendanceandaffectedpatientsareatincreasedriskoforaldiseasethemanagementofwhichmaydelaymedicaltreatmentandcompromisetheiroutcome.Wedescribeourexperienceofmanagingthe oral health needs of haemato-oncology patients in a dedicatedmultidisciplinary clinic and factors that can affect the timely delivery ofcare.Method: Retrospective analysis of themanagement of four patients atKingsCollegeHospitalwasundertaken.Rootcauseanalysiswasusedouttodeterminefactorsthataffecteddentalormedicalcareandthosewhichcould potentially be modified to minimise treatment delay or improveoutcome.Results:ThreeofthepatientswerereferredfordentalassessmentpriortoHSCTandoneforinvestigationofdentalsymptomspriortochemotherapy.Two patients had been diagnosed with Multiple Myeloma, one withHodgkin’sandonewithnon-Hodgkin’sLymphoma.TwoofthePre-HSCTpatients had their transplant delayed by at least a month because ofdelayedhealinganddelaysinmedicalworkuppriortodentalintervention.The patient who required chemotherapy had this delayed due to briskbleeding from the extraction site one week postoperatively despitepreoperativeplatelettransfusionwhichwasmanagedwithlocalmeasuresandfurthertransfusion.Conclusion:HSCTandchemotherapymaybedelayedbynecessarydentaltreatment.Earlyoralhealtheducationforhaemato-oncologypatientsandregulardentalassessmentbyGDPscouldhelptoreducedentaltreatmentneeds prior to HSCT or chemotherapy. GDPs, supported by specialists,shouldbeengaged inthemanagementof thispatientgroup inordertoensurethatcancertreatmentproceedswithoutdelayandisaseffectiveaspossible.

Poster8.Themanagementofmyofascialpaininchildren.JessicaBlanchard,LauraJohnston,SarahAli,EnamulAli,LeoCheng,HomertonUniversityHospital,London.Aimandobjectives:Myofascialpaininchildrenisbecominganincreasingoccurrence and its management is not well defined. At HomertonUniversity Hospital, a progressive increase in the number of childrenpresentingwithmyofascialpain toOral andMaxillofacial Surgery clinicswasnoted.Currentlydue to the lackof guidelines, clinicianshavebeenmanaging these patients like adult patients or based on previousexperience. In light of this, a retrospective study of the currentmanagement,variationintreatmentandoutcomeswerereviewed.Method: A retrospective study was carried out to identify all patientsundertheageof16whowerereferredtotheOMFSoutpatientclinicwithmyofascialpainoveratwo-yearperiod(2015-2016).Theclinicalnotesofeach of these patients were reviewed; identifying demographics,presentingcomplaints,clinicalfindings,themanagementandsubsequenttreatmentoutcomes.Results:30patientsundertheageof16werereferredoveratwo-yearperiodwithmyofascialpain.7weremaleand21werefemale.Theiragesranged between 8 and 15. 50% of patients had been experiencingsymptoms foroversixmonths.90%ofpatients identified ‘pain’as theirprimarycomplaint.37%ofpatientswereidentifiedtohavingcontributoryhabits, inadditiontoonepatienthavingapriortraumaticinjury.10%ofpatientshadclinicaltrismus.Allpatientsweregivenconservativeadviceasthe first line of treatment with great variation. 37% of patients wererecommendedasoftbiteraisingappliance.47%ofpatientswerereviewed,withonepatientreviewedfourtimes.Fivechildrenwerereferredtootherdepartments.Conclusion:Thisstudyidentifiestheneedforagreaterunderstandinginthemanagementofchildrenwithmyofascialpainandhighlightsavariationinmanagement of these patients at present. Taking amultidisciplinaryapproachshouldbeconsideredtoimprovethemanagementofthisuniquecohortofpatients.

Poster 9. The Experience and Effect of Never Events at a UK DentalSchool.FrenchK,DargueA,FyfeE.BristolDentalHospital,BristolWrong site surgery (includingwrong sitenerveblocks) aredefined as anevereventbytheNationalPatientSafetyAgency.Inthepastthreeyears,wehaverecordedthreenevereventsperformedbydentalstudents.Howdo we prevent them, whilst giving our students authentic experientiallearningopportunities?Aim:ToshowtherecentexperienceofnevereventsandtheirinvestigationandmanagementataUKdentalschool.Toexaminetheeffectofthisonoralsurgeryexperiencebystudents.Objectives: To examine preventative measures put in place and theirefficacy.Topresentthenumbersoforalsurgeryprocedurescarriedoutbyourstudentsoverthistimeperiod.Method: Our trust-wide never event and root cause analysis policy ispresentedalong-sidetheimpactofonoralsurgeryexperienceofstudents.Results: Student oral surgical experience has declined over time aspreventativemeasureshavecomeintoaction.Conclusion: It is difficult to balance safety and experience for bothstudents and patients. We hope to improve patient safety in theundergraduatesettingbyintegrationofpatientsafetyeducation(PSE)intotheir curriculum at the out-set, reinforcing this with experiential, spirallearningovertime.Wefeelthatpatientsafetyiscriticallyimportant,andthatthisshouldbeembeddedthroughoutthecurriculum,ratherthanasreactivemeasuresimplementedintheclinicwhereitisdrivenbyaqualityagendaratherthananeducationalone.

Poster 10. Attitudes and Barriers to Managing TemporomandibularDisordersinPrimaryCare.LaraZebic,DipaliAmin,MarianneHenien,ChrisSproatGuysHospital,London.

RCSengCommissioningGuidance2014attemptstoreduceinappropriatereferralsandstreamlinecarepathwaysforTMDpatientsasitisfeltthatless than 20% of cases require referral. Yet, a departmental serviceevaluation revealed 85% of TMD referrals received were suitable formanagementinprimarycare.Aim:ToconsiderthebarrierstomanagingtemporomandibulardisordersinprimarycareandassesstheneedforarelatedCPDevent.Objectives:Surveytheperceivedconfidenceof localNHSgeneraldentalpractitioners(GDPs)inthemanagementoftemporomandibulardisorders(TMD).IdentifychallengesinmanagingTMDpatientsinprimarycareandfactors leading to referral to secondary care. Identify self-perceivedlearningneedsofGDPsthroughtheuseofafocusgroup.Method: A telephone survey was developed, with three categories:Demographics, Diagnosis and Management. Dental practices providingNHS care in London were contacted in order of distance from Guy’sHospitalastheepicenter.Followingthis,afocusgroupmeetingwasheldtodiscussfindingswithGDPs,andexplorewhattheywouldlikefromaCPDevent.Results:GDPsreportedonaverage1-4patientspresentedwithTMDinthelastmonth.72%felt“fairlyconfident” indiagnosingTMD,althoughonly32% were aware of TMD subgroups. 92% reported routinely offeringconservative advice to patients, and 72% reported routine conservativemanagement. The most common reasons for referring patients tosecondary care include: lack of patient response to treatment, lack ofconfidenceindiagnosis/managementandpatientexpectations.Conclusion:Whilethissurveyindicatesreasonablelevelsofself-reportedconfidencewithregardtodiagnosisandmanagementofTMDinpractice,themajorityofTMDreferralsreceivedareforsimplemyalgicpain.GDPsexpressed interest in furthering their education. The focus grouphighlightedtopicsforinclusionandstylesofdeliveryinaCPDevent,andpossiblesolutionstoovercomingchallengesidentified.

Poster11.AnOesophagealDiverticulumPresentingasaNeckSwelling.LeeFeinberg,AlamNusrat,PaulNixon,LiverpoolUniversityDentalHospital

Dentists and Oral Surgeons are well versed with the diagnosis andmanagementof suprahyoidneck swellings.However,apatientwithaninfra-hyoid neck swelling may also present to an oral surgeon andthereforeitisimportanttobefamiliarwiththesepathologies.Thisisacaseofa60-year-oldmalethatwasinvestigatedforaswellingintheanteriortriangleoftheneck.ThiswasimagedwithultrasoundandMRIoftheneck.Thediagnosisofanoesophagealdiverticulumwasconfirmedbyabariumswallow.An oesophageal diverticulum is a sac or pouch arising fromtheoesophagus.Itisanunusualcauseofaneckswellingbutitremindsusthat pathology arising from the oesophagus must be considered whenevaluatingmidlineswellingsoftheinfrahyoidneck.

Theaimofthispresentationistodiscussthisinterestingcaseandhighlightthat oesophageal pathology can present as a neck swelling. Thispresentationwillalsoconsiderthedifferentialdiagnosisofinfrahyoidneckswellings and the importance of their location when considering thediagnosis.

Poster12.Theuseofdentalalertcardsforpatientsatriskofdevelopingosteoradionecrosis(ORN)–Apilotconceptstudy.Louise Ormondroyd, Jerry Kwok, Mary Burke, Damien Reilly, Mary Lei,TeresaGuerreroUrbano,VinodPatelGuy’sHospital,London

Alertingclinicianstomedicalconditionsviamedicalalertcardsorbookletsisbothpopularandsuccessful.Thisconceptcanbeappliedwheneveramedicalconcernispresentandtransferofthisinformationremainscriticaltootherhealthprofessionals.Forheadandneckradiotherapypatientsthisappliestotheriskofosteoradionecrosis(ORN)whichislife-longandhasserious sequelae. Prevention or early diagnosis is imperative tomanagement.Aim:Tofacilitatecommunicationbetweenthesecondarycaredentalteamand all primary care dental practitioners in the continued care of thepatientatriskofdevelopingORNthroughtheuseofadentalalertcard.Objectives: Toprovidepatientswitha simplealert system to relay toadentalprofessionalthepotentialriskofORN,aconsultantcontactandthereferralpathwaytosecondarycare.Method: Dental alert cardswere issued to patients following their pre-radiotherapydentalassessment.Cards includeddemographics,anamedoncologyconsultantandbriefdentaladvice.InadditionitprovidedawebaddressforareferraltothejawnecrosisclinicshoulddentalextractionberequiredorORNsuspected.Patientswereeducatedonthevalueof thecardandadvisedtoshowittoanydentalpractitionerupontreatment.Thecardwaspurposefullymadetoacreditcardsizeforeaseofcarryingandlaminatedtoprovidelongevity.Results:Atotalof23alertcardswereissuedovera2-monthperiodin2017attheweeklypre-dentalassessmentclinic.Conclusion:ThereisnoagreedmanagementstrategyforORNandafocuson prevention or early diagnosis is key, which requires effectivecommunication between primary and secondary care. The use of alertcardsmayfacilitatethislongafterthepatienthasbeendischargedfromtheheadandneckteam.Theinitialfeedbackhasbeenpositivefrombothpatientsandclinicians.

Poster 13. AnAudit assessing theUptake of Tier 1Oral Surgery casesreferredbytheAcuteDentalCareClinic(ADCClinic)totheOralSurgeryUndergraduateClinic(OSUClinic)atKingsCollegeLondon(KCL).MeenakshiKumar,DapoAkintolaKing’sCollegeHospital,London.Aim:ToensurethatallTier1OralSurgerycasesareseenontheOSUclinictofulfiltheundergraduatecurriculum.Objectives: 1. Investigate the percentage uptake of Tier 1 Oral surgerycasesontotheOSUclinic.2.ReviewthereferralguidanceforADCstaffonthis subject. 3. Investigate reasons for Tier 1 oral surgery cases beingreferredtotheStaffOralsurgeryclinic.Method:Wehavenowrunthe1st(December2016–March2017)and2nd(June2017-July2017)cyclesofthisaudit.Results: Uptake: 1st audit cycle: 93.3%, 2nd cycle: 99.4% Improvementshown.Conclusion: This audit addresses an important issue affecting the oralsurgerylearningexperienceofundergraduatedentalstudentsatKCL.

Poster 14. Evaluating postoperative bleeding complications inNOAC/DOACpatients.NaomiRahman,JulieBurkeEdinburghDentalInstitute,EdinburghInMay2016,ApixabanhadbeenapprovedforuseinNHSLothianbytheArea Drugs and Therapeutics Committee. The risk of postoperativebleeding from a dental extraction in patients who are prescribed ananticoagulanthasbeenreportedtobebetween4-9%.Aim:EvaluatingwhetherfollowingtheSDCEPguidelinesforNOACorDOACpatientsreducesthecomplicationofbleedingpostoperativelyfromMay2016.Method: Clinicians in our oral surgery department completed aquestionnaire for NOAC/DOAC patient undergoing dentoalveolarprocedures. The patients were phoned about postoperative bleedingcomplicationsuptoaweekaftertheprocedure.Results:11patients(7femalesand4males)onApixabanunderwent12surgical procedures. 81% of patients (n=9) with atrial fibrillation wereprescribedApixabanforstrokepreventionand18%(n=2)forpreventionofvenousthromboembolism.ThemorningdoseofApixabanwasomittedin11outof12surgicalprocedures (4simpleextractions,7surgicalsand1biopsy).Allpatientsreceivedlocalhaemostaticmeasures.2(18%)patientshadpostoperativebleedingcomplications,within24hoursand1weekofthe procedure, one of whom had not omitted their morning dose ofApixabanas itwas thought tobea simpleextractionof aperiodontallyinvolvedtooth,howeverithadproceededtobeasurgicalextraction.Conclusion:TheSDCEPguidelinesrecommendpatientswithahigherriskof bleeding i.e. surgical extractions, should omit their morning dose ofApixaban. It can be difficult to assess whether an extractionmay be asimpleextractionorasurgicalprocedure.Theseresultssuggestomittingthe morning dose of Apixaban on the day of the extraction isrecommendedforallpatients,topreventpostoperativebleeding.

Poster 15. Service evaluation of Temporomandibular Joint DisorderreferralstoOralSurgery.NazaninAhmadi-Lari,AneeshaShahKing’sCollegeDentalHospital,London.

The majority of patients presenting in General Dental Practice withtemporomandibular joint problems will be suffering from TMJPDS(temporomandibular joint pain dysfunction) or myofascial pain. Manypatientsimprovewithlimitedornointerventionandthiscanbemanagedeffectivelyinprimarycare.Aim: To evaluate Temporomandibular Joint disorder (TMD) referralsreceived from General Dental Practitioners to the department of OralSurgery, against the Guide for commissioning Oral Surgery and OralMedicine (2015). To implement changes where appropriate, includingdevelopmentofalocalacceptancecriteriaforTMDreferralsandprovideguidanceforreferringpractitioners.Objectives:Allreferralswillbecomparedagainstastandardandthedatawillbeanalysed.Method: 1000consecutiveOralSurgery referrals received in2016/2017wereanalysed.TMDreferralsweresingledouttoassessthequalityandinformationreceived.ThestandardwassetagainsttheguidancelaidoutbyNHSEngland1forTMDmanagementunderLevel1procedures,whichshould ideally bemanaged in a primary careNHSMandatory contract1.Referralswereanalysed to see ifadiagnosiswas stated, if conservativeadvicewasgivenandwhetherthiswasfollowedfor6months.Itwasalsonotediftheystatedwhetherabiteraisingappliancewasgiven.Results:14.5%ofalloralsurgeryreferralsreceivedwereregardingTMD.42.8%hadadiagnosiswritten.6.9%statedtheyadvisedasoftdiet,11.7%providedanalgesiaadvice,13.1%advisedjawexercises.Only2.1%followedconservativeadvicefor6months.25.5%weregivenabiteraisingappliance.6.9%hadunderlyingjointdiseaseand42.8%hadreducedfunctionandtrismus.Conclusion:AsignificantproportionofOralSurgeryreferralsreceivedareregardingTMD,ofwhichonlyasmallproportionmettheguidelinesoutlinedinthecommissioningguide.Localchangeshavebeenimplementedincludingthedevelopmentofanacceptancecriteria,informationforreferrerstouseinmanagingsimpleacuteTMDinprimary

carewithconservativemeasures,asoutlinedbythecommissioningguide,andinformationaboutwhattoreferandwhen.Thisevaluationshouldfreeupresourcesinsecondarycareforappropriatecases,improvepatientwaitingtimesandpatientexperience.

Poster 16. Dental anxiety – a cause of delayed presentation of oralcancer.OluwatoyinAiyegbusiandSukbirNandraQueenElizabethHospital,KingsLynnThe incidenceoforal cancer is increasingand thegreatest increasehasbeeninmiddleagedandyoungergroups.Thishasbeenattributedtowiderinfluences such as lifestyle factors including smoking and alcoholconsumption.Aim:Theaimofthisposterpresentationistohighlightdentalanxietyasareason forpatientsdelaying theprocessof seekinghelp fromdental ormedicalpractionersregardingsymptomsrelatingtooralcancer.

1. Objectives:Presentoralcancersignsandsymptoms2. Discussriskfactorsfororalcancer3. Explorereasonsfordelayedpresentationoforalcancer,including

dentalanxiety4. Discussimpactofdelayedpresentationoforalcanceronpatients5. Identifystrategiestoimproveearlydetectionoforalcancer

Method:Casepresentationoftwomalesundertheageof35,whowerebothdiagnosedwithadvancedstageoralcancers.Theoriginalpresentingsymptoms of ear pain and trismus were dismissed by the patients forseveralmonths.Thereasonfordelayedpresentationwasdentalanxiety,thiswillbeexploredindetail.Thestepstomanagethesepatientsandtheirsurvivalratefromthesecancerswillalsobediscussed.Results: Clinical photographs, CT/MRI imaging and histologicalinvestigations will be used to display the presentation of these oralcancers.Conclusion: Oral cancer has a good prognosis with early detection.Unfortunatelybypatientsfailingtopromptlyseekmedicalattention,dueto dental anxiety, oral cancers are detected late and the prognosisbecomessignificantlyreduced.

Poster 17. Case Report : AnUnusual Presentation of a Large EruptingComplexOdontome.OmeshModgill,DapoAkintolaKing’sCollegeDentalHospital,LondonOdontomes are benign odontogenic tumours that clinically present asintraosseous,peripheraloreruptedlesions.Intraosseousodontomesaremostcommonandfrequentlyobservedasincidentalradiographicfindings.Erupted odontomes are those that present coronal to an erupting orimpacted tooth are rarely observed.We present a case of an eruptingodontomeandthesurgicalmanagementofthislesion.Aim: To inform the readership of an unusual odontome variant that israrelyobservedandreportedupon.Method: A 21 year-old, fit and healthy male presented with painfulswellingandanextra-oraldrainingsinusattherightbodyofthemandible.Intra-orallyasoft tissueswellingextended linguallyandbuccallyaroundthe region of the lower right second molar tooth. A right sectionalorthopantomogram (OPG) revealed a unilocular radiopaque lesionsuperiortoadeeplyimpactedlowerrightthirdmolar.Asubsequent8x8cmsmall volume CBCT scan demonstrated a radiopacity approximately40mmx22mmx20mminsize in theregionof the lowerrightsecondandthirdmolarteeth.Theradiopaquelesionandlowerrightthirdmolarweresurgicallyremovedundergeneralanaesthesiaasadaycaseadmission.Thespecimen was sent for histopathological analysis and the patient keptunderclinicalandradiographicreviewatregularintervals.Results: Theextra-oraldraining sinusandoperative sitehealedwithoutcomplication.ThepatientdidnotexperienceanIDorLingualnerveinjury.Regularradiographicreviewdemonstratedbonyinfilloftheoperativesite.Thehistopathologyfindingswereconsistentwithacomplexodontome.Conclusion:Eruptedodontomesarerarelyobserved.Themechanismforeruption of odontomes is unclear but such large lesions can result inmarkeddetrimenttofunctionandappearanceandconsequentlysurgicalmanagementisnecessary.Whilstpotentiallycomplex,surgicallyexcisionofaneruptedodontomeisoftenassociatedwithasuccessfuloutcomeforbothfunctionandaesthetics.

Poster 18. What is being posted on Social Media about Oral &MaxillofacialSurgery?RebeccaKelly,TaranbirThind,ThomasHorgan,VictoriaDrummond-Hay,ThomasWalkerGreatWesternHospital,SwindonSocialmedia sites are amongst themost frequently visited sites on theinternettoday.Patientsusethesesitestoobtaininformationondiagnosisandtreatmentofdentalandmedicalconditions.Anyindividualcanpostinformationonlineregardlessofitsvalidity.Aim:Toidentifythetypeofmaterialbeingpostedonsocialmediaabout“#WisdomTooth”,“#OralCancer”and“#JawSurgery”.Explorethereasonswhypatientspostonsocialmediaaboutoralandmaxillofacialsurgery.Usethisinformationtohighlighttheextentofinformationavailableonsocialmedia, to help clinicians adapt how they discuss treatmentplanning/diagnosiswithpatientsandtheimportanceofdiscussingwherereliableinformationcanbefoundonline.Objectives:Improvethehealthcareprofessional-patientrelationship.Methods:Ananalysisofpostingsonsocialmediawascarriedoutoveratwoweek time frame. A search for selected “hashtags” on twitter andInstagram was conducted. The chosen ‘hashtags’ are: #WisdomTooth,#JawSurgeryand#OralCancerResults:#OralCanceronInstagramhadsignificantlyfewerpostscomparedto#WisdomTooth.Therewasalargedifferenceintheaveragenumberoflikesperhour.#WisdomToothhadthegreatestnumberof likesperhourat27.7,followed by #JawSurgery with 26.2 #OralCancer with 5.2. The motivesbehindthepostsvaried.#OralCancerpostsoftenaimedtoraiseawarenesswhereas posts relating to #JawSurgery saw authors seekacknowledgement for a change in their appearance. Videos associatedwith #wisdomtooth often showed patients still under the effects ofsedation.

Conclusion:Instagramprovedmoreinteractivethantwitter.Patientsusedsocialmedia for various reasons. There is aneed for clinicians todirectpatientstoappropriatesourcesofinformationonlineandencouragethemtodiscussanyquerieswiththehealthcareteam.Theneedtodiscusstheuse of socialmediawith patients undergoing sedation and escortswashighlighted.

Poster 19.Assessing theeffectivenessof CBCT inhigh riskmandibularthirdmolarremoval-aretrospectivestudy.SandeepJoshi,ClareSteel,TinaHalai,JosiahEyesonEastmanDentalHospital,London.

Inferior alveolar nerve (IAN) paraesthesia following lower third molarremoval is a well-documented postoperative complication. Robinsonreportedthattheriskofdamagetotheinferioralveolarnerveresultinginaltered sensation is around 4-5% for temporary and 1% for permanentalteredsensation.1Rentonfurtherreportedthatifthelowerthirdmolarisdeemedhighrisk{frommoredetailedassessmentonaconebeamCT(CBCT)}thenthisriskrisesto20%and2%respectively.2-4CBCT use in the assessment of IAN association to lower thirdmolars isincreasing at a rapid rate. However, Horner states that ‘there is noevidence for improvedoutcomes forpatientswhenCBCT information isavailable’inrelationtoIANdamage.5Thebenefitofmoredetailedimagingand reduced medico-legal concerns must be weighed up against theincreasedradiationdoseAim:ThisstudyaimstoassesswhetherCBCTsareusefulinpredictionofthosepatientswhoareathighriskofnerve injuryandwhethersurgicaloutcomesareaffectedMethod:Aretrospectiveanalysiswasundertakenof50patientswhohadCBCT due to concerning plain film features, such as deviation anddarkeningoftherootoftheIAN,ontheDPT.6ThepatientswereconfirmedashighriskfollowingtheCBCTduetofeaturesincludinglossofcortication,compressionandrootswrappedcloselyaroundthenerveitself.Results: All 50 patients declined coronectomy and subsequentlyunderwent extraction of the intimately associated lower third molarwithoutanyalteredsensation,temporaryorpermanent,noted.Conclusion: This study demonstrates that CBCT can be an effectiveinvestigationnotonlytohighlightpatientsatincreasedriskofIANinjurytherefore aiding thorough discussion regarding possible complications,whichinitselfmaymanagepatients’expectations,butcanalsobeusedtoguide the surgical procedure to help reduce the risk of neurosensorydeficit.

Poster20.Preparingfor2020:TeachingExcellenceFramework(TEF)forOralSurgery.TarikShembeshKing’sCollege,London

TEFisaimedatbetterinformingstudentchoice,raisingteachingesteem,recognizingexcellenceaswellasbettermeetingstakeholdersneeds.

Aim:UnderstandtheimplicationofaTEFontheteachingpracticeoforalsurgery.Method: Discourse and document analysis from Institutional level TEFreportsaswellasreflectionsfromattendingaHigherEducationAcademyTeachingExcellenceProgram.Results: Subject level TEF pilots over next two years. Practice has thepotentialtoinfluencesubjectlevelratingthroughmetricsandevaluatededucationalinitiatives.Currentpracticelacksaframeworkofexcellence.Conclusion:InstitutionalandsubjectlevelTEFssharecorevalueswithourprofessionalorganisations,commissionersandregulators.Earlyadoptionof framework-aligned practice affords to improve the education of oralsurgery and generate useful impact data on Teaching quality, LearningEnvironmentsaswellasstudentoutcomes.

Poster21.Dentaltourism–itsprevalenceandimplicationsintheUK.

AzzaAl-Mossallami,SandraGirgis,MonaHajatdoost,ChrisSproatGuy’sandStThomas’NHSFoundation,LondonDentaltourismcanbedefinedastravellingoutsidethepatient’scountryof residence to seek treatment in another country with the aim ofminimisingtreatmentcosts.ItspopularityhasgreatlyincreasedinrecentyearsamongstUKresidentswithseveralcompaniesprovidingall-inclusivepackagescoveringavarietyoftreatments.Aftercareisfrequentlylackingresulting inpatientsseekinganopinion fromcliniciansoncetheyreturnhomeiftheyexperiencepain,failureorrequirereparativeworktotheiroftenextensiveorcomplexdentaltreatment.Objectives:Giventhisnotablyincreasingtrend,aprospectivepilotstudyofpatientsattendingGuy’sHospitalAcuteDentalCaredepartmentwasconducted to gain an idea of prevalence and the impact on thedepartment.Method: Data was collected from self-referring patients over a threemonthperiod.Thiscomprisedof;countryoftreatment,typeoftreatmentcarriedout,reasonforattendanceandoutcome.Advicewasalsosoughtfrom themain indemnity providers in the UK regarding implications ofthesenon-UKtreatmentsandsubsequentmanagementofthesepatients.Results:Atotalof25patientsattendedduringtheperiodofdatacollectionwith the most common treatments carried out abroad being implants,endodonticsandbridgework.Thereasonsforattendancerangedfromarequestforsutureremoval,post-operativepainandfailingrestorations.Conclusions: For patients who have been treated abroad, it is oftendifficult tomanagecomplicationsorunfinishedtreatmentwithouta fullhistory or record of treatment detailswith financial impactions to bothpatientsandtheNHS.Indemnityprovidersadviseproceedingwithcautionand seeking specialist advice. The NHS and GDC offer patients adviceregardingseekingtreatmentabroadandpointsofconsideration.Theriseinpopularityofdentaltourismposesimportant,anddifficult,questionsforthe dental profession in the UK and can present challenges relating tofuturemanagementofthesepatients.

Poster22.HelpingpatientsunderstandPreMalignantLesionsoftheOralCavity:TheRailwayLineModel.ThomasJHorgan,VictoriaDrummond-Hay,TomWMWalkerGreatOrmondStreetHospital,LondonItcanbedifficultforpatientstograsptheclinico-pathologicalfeaturesandmanagementstrategiesforpre-malignantandearlyinvasivelesionsoftheoralcavity,particularlyassomepatientswillhavemultiplelesionsofdifferenttypessynchronouslyandmetachronously.Withlimitedevidenceontreatmentmodalitiesandrecallappointments,itcanbechallengingforclinicianstoexplaincomplexconditions.Aim:Todeviseaneasytoreadmodeltoaidcliniciansinexplainingandaidpatients’understandingof;thelevelofconcern,riskoftransformation,managementstrategiesandimportanceoffollowupappointments.Objectives:Toprovideavisualguidetoaidverbalcommunications.Tomakethevisualguidetopicaltothecohortofpatientsbeingtreated.Method:Afterliteraturereview,adiagrammaticmodelwasconstructedtodemonstratewhereoralpremalignantdiagnoses,definedbyWHOCollaboratingCentreforOralCancerandPrecancer,satonatrainlinefromBristoltoLondonwithanalogiesofsmallreturnjourneysversusaonewaytickettoLondon,inthiscaseLondonrepresentedcarcinomaandBristol,nosignofdisease.Results:Thedilemmainmanagingpatientswithpotentialmalignantoralconditionsishowtoexplainchangeandprogressiontocarcinomainaclearwaythatpatientsunderstand.Itwasclearthatwithoutsomeanalogyordiagramtorelateto,patientsmisconstruedinformationgivenandatfollowupappointmentscouldnotrecallsomebasicandvitalinformation.Withtheuseofaneasytofollowmodel,topicaltothatpatient(location)itwaseasiertoexplainriskfactormodification,treatments,importanceoffollowupappointments.Conclusion:Thisisnotapathwaysheetbutavisualaidwhendiscussingdiagnosisandmanagementstrategieswithpatientspresentingwithoralpremalignantconditions.Itwasfoundthatvisualaidscanbeofassistancewhendiscussingoralpremalignantconditions.

SpeakerBiographies

Presentation:MeasuringCompetenceinOralSurgery:RealityversusHopefulExpectation

ProfessorLukeDawsonDirectorofUndergraduateDentalEducation,LiverpoolUniversityDentalSchoolProfessorLukeDawsonhasbeenaclinicaleducatorsince1996,andhastaughtundergraduateoralsurgeryandoralmedicine.HewasmadeaNationalTeachingFellowin2012.Hisresearchinterestisinhowearlystagecliniciansdevelopexpertise,andhowthiscanbeenhanced

throughthedevelopmentofinnovativetechnology-supporteddesignsforcontinuousprofessionaldevelopment.Abi-productofthisinterestwasthedevelopmentofLIFTUPP,inconjunctionwithBenMason,ColetteBalmerandPhilJimmieson.LIFTUPPisatechnology-supportedlearningdesignthatoperationalisesthedevelopmentandmeasurementofprofessionalcompetence,andisnowusedbyseveraloftheUKdentalSchools.Outsideofeducation,hisresearchinterestsalsoincludethecausesofglandularhypofunctionthatunderlieSjögren’sSyndrome.LearningObjectives

• Explorethelimitationstocurrentapproachesofassessmentintermsoftheirabilitytopredictrealworldcapabilityandtheirimpactonmindsetdevelopment

• Understandthedifferencebetweencompetencyandcapability• gaininsightintotheroleoflearninganalyticsandhowtheycanbeusedtodevelop

andestablishcapability

Presentation:NationalRecruitmentinRelationtoAcademiaandNewCurriculumDevelopmentUpdate

MissColetteBalmerConsultantinOralSurgery/HonorarySeniorClinicalLecturer,LiverpoolUniversityDentalSchoolandChairoftheOralSurgerySpecialistAdvisoryCommitteeColettequalifiedinMicrobiologyandthenDentistryinLeeds.Shefolloweda

careerinoralsurgeryandiscurrentlyaConsultant/HonorarySeniorClinicalLecturerinOralsurgeryatLiverpoolUniversityDentalHospital.ShehasamajorinterestinteachingandtrainingandhasdevelopedanddeliveredlecturesandcoursesforDentalUndergraduates;DentalCareProfessionals;GDPsandDentalPostgraduatesincludingDCTsandStRs.Sheisoneofthefouroriginalinventorsof“LIFTUPP”.HerrecentnationalroleshaveincludedBritishAssociationofOralsurgeonsCouncil;AdvisoryBoardforFoundationTraininginDentistry;AdvisoryBoardforSpecialtyTraining;TheOralsurgerypathwaysdevelopmentgroup;TheOralsurgerypathwaysimplementationgroupandthecommissioningguidesproductiongroup.SheisanexaminerfortheMFDSandM.OralSurgeryRCSexaminationsandtheexternalexaminerfortheD.D.ScOralSurgeryprogrammeinDublin.ShesitsontheSABinEdinburgh;TheIrishspecialtyadvisoryBoardandiscurrentlytheChairoftheOralsurgerySAC.

MissSarahMcKernonClinicalLecturer/StRinOralSurgerySarahqualifiedfromtheUniversityofLiverpoolSchoolofDentistryin2011.FollowingseveralyearsasaSeniorHouseOfficerandawardofMembershiptotheRoyalCollegeofSurgeonsofEdinburgh,shereturned

totheUniversityin2014tocommencehercurrentroleasaClinicalLecturerandHonorarySpecialtyTraineeinOralSurgery.ShehassincereceivedFellowshipoftheHigherEducationAcademy.SarahisTraineeRepresentativefortheBritishAssociationofOralSurgeons(BAOS)andforNationalRecruitmentworkinggroup.ShewillpresentthefeedbackfrominterviewersandcandidatesfromthefirstroundofOralSurgeryNationalRecruitment.

LearningObjectives

• TounderstandtheproposedchangestotheOSCurriculumanditsimpactforfuturetrainees

• Tounderstandthenationalrecruitmentprocessandbenchmarking• TounderstandthenecessityforcarefultimingofacademicandNIHRrecruitment

processestoawardacademicNTNs

Presentation:NeverEventsinSecondaryCare

MrsAvrilMacpherson

ClinicalDirectorandConsultant in Special CareDentistry, LiverpoolUniversityDentalHospital

BDS (Edin), FDS RCSEd, MFDS RCSEd, MSND RCSEd, DipConSed(N’castle),PGCTLCP(Edgehill),FHEAAvrilwasappointedConsultant/HonorarySeniorClinicalLecturerinSpecialCareDentistry,LiverpoolUniversityDentalHospital&SchoolofDentistry,in2010andClinicalDirectorin2014.

She is Chair of theAssociationofDentalHospitals andPresident of theBritish Society ofDisability andOral Health. Avril represents BSDH on the Specialty Advisory Committee inSpecialCareDentistry(RCSEng),isaChairoftheSpecialtyAdvisoryBoardinOralMedicineandSpecialCareDentistry(RCSEd).Avrilteacheswidelyinconscioussedationandspecialcaredentistry and is a member of teaching faculty of the Society for the Advancement ofAnaesthesiainDentistry.SheisaRCSEdexaminerforMFDS,MSCD&DSCDexaminations.Her clinical and research interests include the dental management of medically complexpatients,theroleofpropofolindentalsedation,sedation/GAinthemanagementofadultswithspecialneeds&patientsafetyindentistry.LearningObjectives

• TounderstandthehistoricalcontextoftheNHSImprovementNeverEventsPolicy&Frameworkinthecontextofthewiderpatientsafetyagenda

• TounderstandthethemesandrootcausesassociatedwithNeverEventsinoralsurgicalpractice

• TobeawareoftherangeofNeverEventriskreductionstrategiesinplaceinUKDentalHospitals

• Tobeawareofpotentialcomplexitiesinclinicalteachingastheyrelatetopatientsafety

Presentation:WrongSiteSurgeryinPrimaryCare

MrRupertHoppenbrouwersBDSLDSRCSSeniorDDULegalAdviserRupertiscurrentlyapart-time(3daysperweek)SeniorDento-legalAdviser.HewasHeadoftheDentalDefenceUnionfrom1997to2015.Heisthemostexperienceddento-legaladviserintheUK,havingjoinedthethenDentalDivisionoftheMedicalDefenceUnioninJanuary1987.HeisaformergeneraldentalpractitionerandwasDirectoroftheSchoolofDentalHygieneatUniversityCollege

Hospital,Londonfrom1980to1986.Hehaslecturedandwrittenwidelyonriskmanagementanddento-legalmatters,andhasaparticularinterestincomplexethicalandlegalissuesaffectingdentalmembers.HeiscurrentlyChairmanoftheUKDentalLawandEthicsForum.LearningObjectives

• Thecommonsignificanteventsoccurringingeneraldentalpracticeandtheireffects.• Howtomanagetheriskofsignificantevents.• Whatactionthetreatingpractitionershouldtakewhenasignificanteventoccurs.

Presentation:UpdateonBrexit

ProfessorMichaelDouganProfessorofEuropeanLawandformerDeanoftheLiverpoolLawSchool,UniversityofLiverpoolMichaelspecialisesinEULaw,particularlyEUconstitutionallaw,theSingleMarketandEUwelfarelaw.HisworkontheEUconstitutionandinstitutionscoversprocessesofconstitutionalreformaswellastherelationshipbetweenUnionlaw

andthenationallegalsystems.HehaspublishedwidelyontheEU'sconstitutionalframeworkaftertheLisbonTreaty,ontheprincipleofdirecteffectofUnionlawinnationalcourts,andonthedomesticenforcementofUnionlaw.Morerecentresearchprojectshavecovered,e.g.theproblemofdefiningthe"scopeofEUlaw";andtherangeofpersonsprotectedbytheEUsystemofMemberStateliabilityindamages.Michaelhasalsowrittenextensivelyonsinglemarketlaw,especiallythefreemovementofgoods,personsandservices,andprocessesofharmonisationofMemberStatelaws.InthefieldofEUwelfarelaw,Michael'sresearchhasfocusedontheinteractionbetweenfreemovementrightsandsocialsecurityentitlementandtheimpactofEUcitizenshipinthisarea.HisworklookedinparticularattheroleplayedbytheCourtofJusticeinshapinganddelimitingcitizenshipandfundamentalrights.TogetherwithothermembersofEULaw@Liverpool,Michael'sresearchhascontributedtowiderpublicandpoliticaldebatesaboutEuropeanlaw.Forexample,MichaelhasprovidedwrittenevidencetovariousParliamentaryenquiries;appearedasanexpertwitnessbeforeHouseofCommonsandHouseofLordscommittees;andactedasanexternaladvisortoGovernmentdepartmentsonimportantdevelopmentssuchastheEuropeanUnionAct2011,theReviewoftheBalanceofCompetencesBetweentheUKandtheEU,andtheprocessofUKwithdrawalfromtheEuropeanUnion.Michael'spublicfacingactivities-bothbeforeandsincethe2016UKreferendumonEUmembership-includenotonlyinternetvideosanalysingrecentdevelopmentswhichhavebeenwatchedmanymillionsoftimesbutalsoanextensiveprogrammeofpubliclecturesanddebatesacrosstheUKandbeyond.Michael'scurrentworkfocusesonthelegalframeworkforandimplicationsoftheUK'swithdrawalfromtheEuropeanUnion.Herecentlyeditedalandmarkcollection,TheUKafterBrexit:LegalandPolicyChallenges(IntersentiaPublishing,2017).Heiscurrentlyworkingonamonograph-TheUKoutwiththeEUandtheEUwithouttheUK-tobepublishedbyOUPaspartoftheCollectedCoursesoftheAcademyofEuropeanLaw.MichaelteachesPublicLawandEULaw.LearningObjectives

• TounderstandtheoverallpositionreachedintheUK-EUwithdrawalnegotiationssofar,includingthekeyissuesandstumblingblocks

• TounderstandthelikelydirectionoftheUK-EUwithdrawalnegotiationsinthefuture,includingasregardstheframeworkforfuturerelations

• Tohavetheopportunitytoraisemorespecificpointsofparticularinterest

Presentation:ResearchintheRegionalHeadandNeckCancerCentreatAintree

ProfessorRichardShawProfessorofHead&NeckSurgery,HonoraryConsultantinOral&Maxillofacial,AssociateDirector&SurgicalOncologySpecialtyLead,NIHRClinicalResearchNetwork(Cancer)

ProfessorShaw,chairinHead&NeckSurgeryintheUniversityofLiverpool,hasbeenanHonoraryConsultantinOral&Maxillofacial/Head&NeckSurgerysince2007attheAintreeUnit.Hehasaninterestinclinicaltrials,hasledseveralandcurrentlyhastheroleofspecialtyleadforsurgicaloncologytrialsinalldisciplinesfortheUKNIHRCancerNetwork.HehaspreviouslychairedthesurgerysubgroupoftheNCRIHead&NeckClinicalStudiesGroup.Hislaboratoryresearchinterestsincludemolecularbiomarkers,cancerepigeneticsandHPVmediatedheadandneckcancer.Hisclinicalinterestsincludeallaspectsoforalcavitycancer,premalignancy,sentinelnodebiopsy,osteoradionecrosisandcomplexmicrovascularreconstruction.HeleadstheLiverpoolMastersDegreeinOral&MaxillofacialSurgeryandco-chairstheLiverpoolPracticalMicrovascularCourse.LearningObjectives

• TounderstandtheimportanceofcollaborativemulticentreclinicalstudiesandtrialsintheNHS,particularlywithregardtotheoralanddentalnetworkstudies

• Tounderstandhowtoaccessresearchsupport,researchgrantsandtrialsmethodology

• Abasicunderstandingofcancerbiology,particularlytheroleofepigenetics• Anunderstandingoftherapeuticapproachestooralepithelialdysplasia

Presentation:PositiveandNegativefactorsforSoftandHardTissueMaintenance

DrJosephChoukroun

SpecialistinGeneralSurgery,AnaesthesiologyandPainManagement,Nice,France

MD,UniversityofMontpellier,France1979

SpecialistinGeneralSurgery,Anesthesiology&Painmanagement

OwnerofPrivatePainClinic,NiceFrance.

PresidentofSYFAC,internationalsymposiumongrowthfactors,

InventorofthePRFtechniques:L-PRF,A-PRF&i-PRF

Authorofseveralscientificpublications.

InternationalspeakerLearningObjectives

• TounderstandhowthePRFimprovesthesofttissuehealing• TounderstandhowthePRFimprovestheboneformation.• Tounderstandallthefactorswhoinfluencethehealingcascade.(Positiveandnegative

factors)

Presentation:Prostheticimplant-basedrehabilitationfollowingmaxillary&mid-facemalignancy

MrChrisButterworthConsultantinMaxillofacialProsthodonticsandOralRehabilitationandHonorarySeniorLecturerinMaxillofacialProsthodontics,RegionalMaxillofacialUnitatUniversityHospitalAintreeandLiverpoolUniversityDentalHospital,ClinicalLeadforDentalImplants,LiverpoolUniversityDentalHospital

Chris Butterworth is a leading Maxillofacial Prosthodontist based at University HospitalAintree,oneofthelargestHead&NeckCancercentresinEurope.Sincehisappointmentbackin2003,hehasbuiltareputationforinnovativecareinthefieldoforal&facialrehabilitation.Chris has been in post since 2003 as the Consultant Maxillofacial Prosthodontist basedbetween the RegionalMaxillofacial Unit at University Hospital Aintree and the LiverpoolUniversityDentalHospital.HeistheleadclinicianfordentalimplanttreatmentattheDentalHospitalandalsoleadstheprostheticrehabilitationserviceinMerseysidefortheoral&facialrehabilitationofheadandneckcancerpatients.Hehasextensiveexperienceintheprostheticplanning, surgical placement and restoration of osseointegrated dental implants and haspioneeredtheplacementofzygomaticimplantsinMerseyside.Hehasanationalreputationin the prosthetic rehabilitation of oral cancer patients and was the youngest nationalpresidentoftheBritishSocietyofProsthodonticsin2011/12.Heisinterestedintheuseofcomputerizeddental implantplanningtechniquesforcomplexcases,theuseofzygomaticimplants,surgical tailoringof intra-oral freeflapsand inqualityof lifeoutcomesfollowingosseointegratedimplanttreatment.Heisactivelyinvolvedinhead&neckcancerresearchandisco-investigatorontheHOPONtriallookingattheefficacyofhyperbaricoxygenintheprevention of Osteoradionecrosis following surgery in the irradiated mandible. Chris hasauthoredover40scientificpapers,severaltextbookchaptersandistheleadauthorontherestorative guidelines forUK based head& neck cancer patients. Hiswork on the use ofzygomaticimplantsinhead&neckcancerpatientswasrecentlyrecognisedattheAcademyofOsseointegration2017meetinginOrlandowherehewasawardedtheBestOralClinicalResearchPresentationAwardforhispresentation“PrimaryvsSecondaryZygomaticImplantPlacementInHeadAndNeckCancerPatients–A10YearProspectiveStudy”.

LearningObjectives

• Todiscussthecomplexitiesofprovidingimplantrehabilitationforpatientswithmaxillaryandmid-facemalignancy.

• Toemphasisetheimportanceofmulti-disciplinarymanagementandteamworkinginordertotreatthesecases.

• Todiscussnewrapidrehabilitationapproachesforlowlevelmaxillectomypatientsusingzygomaticimplants

Presentation:MicroneurographyandTrigeminalPhysiology

ProfessorFrancisMcGlone

Professor of Neuroscience, Natural Sciences & Psychology, Liverpool JohnMooresUniversity,UKVisitingProfessor,InstituteofHealth&Psychology,UniversityofLiverpool,UK

BSc (Hons) inNeurobiology and PhDUniversity of Sussex. After postdoctoral positions atManchesterUniversity he tookup thepost of SeniorNeuroscientist at thePainResearchInstitute,DepartmentofMedicine,LiverpoolUniversity,investigatingmechanismsofchronicneuropathicpain.Thiswasthestartofarealisationthatresearchintothehumanbrain/mindhadtobemultidisciplinary,andafascinationwithallafferentclassesofc-fibres,whichhewassubsequentlyabletopursuewithamovetoindustry(UnileverR&D),butthenlookingattheirroleinpleasurebycharacterising,withhisSwedishcolleagues,thefunctionalpropertiesofarelativelyrecentlydiscoveredpopulationofmechanosensitivec-fibresinhumanskin,c-tactileafferents(CT).HeiscurrentlyProfessorinNeuroscienceatLiverpoolJohnMooresUniversityandpursingtheroleofc-tactileafferentsinallmannerofneurobiologicalandneuropsychologicalfunctions.LearningObjectives

• Recognitionofa3rdclassofafferentc-fibreintheVthnerve• Perceptionisnotsensation-anotesandchordsanalogy.

LIVERPOOL2017

S.L.McKernonandGBarker