A group of residents from the Dr. Gerald Niznick College of Dentistry showcased what can be accomplished when interdisciplinary oral health specialists work together.
The team presented a case study in April at the Prairie Lights Dental Convention, the Manitoba Dental Association’s (MDA) annual convention. This year, the MDA partnered with the Canadian Dental Association to host the national Oral Health Convention as part of its annual convention.
“This was a very complex case,” said Dr. Derek Oryniak, an oral and maxillofacial surgery resident. “The patient had a lot of challenges with her dentition. She had lost several teeth and she wanted to fix her bite in a way that would give her function.”
In November 2024, a team of graduate residents at the Dr. Gerald Niznick College of Dentistry was put together to develop a care plan for the patient. This team included Dr. Oryniak, Dr. Leslie Pesun, prosthodontics resident, Dr. Abdul Alsaad, orthodontics resident, and Dr. Daniel Su, periodontics resident. Su was not able to be part of the presentation, so his co-resident Dr. Madison Flamand stepped in to present the periodontal portion of the talk.
“We then went to the drawing board. We looked at her globally and saw that she had an underlying skeletal condition, and if we could treat that underlying skeletal condition, then we would be able to open up all the different prosthetic options for her to give her a definitive treatment that would give her a functional bite and the ability to maintain those teeth longer throughout her life,” Dr. L. Pesun said.
Dr. L. Pesun said the patient needed to have an appliance to stabilize her bite without damaging her teeth further while all her treatments were being done. And the patient needed jaw surgery to correct her deep bite and small lower jaw to even her bite and prevent further damage to her remaining teeth.
“To do this we needed to give her some back teeth to support the braces and help with the jaw surgery to make sure everything lined up properly,” she said. “This was a challenge because there was no room in the back to put anything in since her upper teeth were almost biting on her lower gums. Dr. Su built up the missing bone in her lower jaw and put in two implants.”
Dr. L. Pesun said the patient’s treatment will take another two years to complete. The patient will need another jaw surgery, and once she heals, they will finish her braces, put in a permanent bridge on the implants and fix the rest of her bite with crown and bridge work in the traditional way.
Learning opportunity
Dr. L. Pesun said the biggest takeaway from working on this case is that they couldn’t have done it without talking to each other.
“Communication is extremely important, because even if you think you’ve planned everything, questions will arise along the way,” she said. “So, you need to be bouncing those off of each other to be able to come up with the right solution.”
Oryniak said it was an excellent opportunity for the residents to showcase their work at the conference.
“I think that we do a lot of this behind the scenes that people don’t see,” Dr. Oryniak said. “We have a lot of expertise that people don’t get to recognize in the general dental community, even at the resident level. It’s awesome to get to show that off in front of our peers and hopefully give them a little bit of extra education along the way.”
Dr. Igor Pesun, founding director of the graduate prosthodontics program and professor at the Dr. Gerald Niznick College of Dentistry, said the residents had worked hard to put the presentation together to showcase how interdisciplinary they work within the college’s graduate programs.
“I think they did a wonderful job,” Dr. I. Pesun said. “They represented the University of Manitoba really well at the Canadian Dental Association meeting.”