Chapter 7 The Affiliated National Associations

Chapter 7

The Affiliated National Associations

This chapter contains the reports of the affiliated national associations, with an emphasis on their histories and origins. They also contain relevant information about the current situation, including membership, organization of training and education and the number of training institutions involved.

All councilors to IAOMS were asked during 2010–2011 to submit their abstracts and 63 of the 75 affiliated associations responded.

The common thread throughout the stories of the formation of national associations is the struggle to gain recognition from within the generality of surgery. The need for special dental skills became apparent and with this, progressive mobilization of interested dental surgeons to take care of these patients with oral and maxillofacial injuries and pathologies. The background of these individuals varied throughout the world. Some came from a single degree either in dentistry or medicine, while others held qualifications in both disciplines. Similarly, the need for further education and training, both to gain acceptance by the medical and dental professions as well as governments and regulatory bodies, was essential for the provision of support for the fledgling organizations. The guidelines on education and training, developed by IAOMS, greatly facilitated the accomplishment of these objectives.

Albania

Albanian Association of Oral and Maxillofacial Surgery

Oral and maxillofacial surgery is a rather young specialty in Albania. At the beginning, maxillofacial work was carried out by ENT surgeons in the 1930s, more precisely by Professor Besim Zyma, who was an obstetrician-gynecologist surgeon trained in Austria and Turkey, as well as an ENT surgeon. During World War II, Professor Zyma and Dr. Xhevdet Asllani covered all maxillofacial work in Tirana Civil Hospital.

In 1959, the University of Tirana opened for the first time and the dental school was created. In 1964, part of the ENT ward (10 beds) was used for maxillofacial patients and Albanian maxillofacial specialists, who were trained abroad, served there. Samedin Gjini and Dhori Pojani, who had their training in Sofia, Bulgaria, as well as Isuf Kasapi

and Ago Shametaj, who were both trained in Bucarest, Romania, all served there.

In 1971, the first maxillofacial postgraduate training course started. In the beginning this was a one-year course and the specialists were professionals who had dental degrees.

At present, maxillofacial training is a four-year course and the trainees come from medical schools and have medical degrees.

In 1976, the first maxillofacial ward opened within Tirana’s University Hospital Centre and was comprised of 15 beds and four consultants.

In 1998, the new dental school opened and part of the oral surgery work is carried out there.

In the Albanian territory with a population of nearly three million inhabitants, apart from our unit which is in the French hospital “Claude Barnard,” part of Tirana’s University Hospital Centre there are two other active hospital centers (one in Durres and the other in Vlora), where maxillofacial work is performed.

Recent years have been very positive for our unit as we have established very close relations with other maxillofacial centers in Europe, more precisely with the maxillofacial units of Dresden, Germany headed by Uwe Eckelt; the unit of University Hospital Centre of Gallway in Ireland, headed by Patrick McCann and Jack McCann of the plastic surgery department.

This cooperation has proved very positive as we have now expanded our knowledge and improved our work in important areas such as orthognathic, reconstructive and cleft surgery.

The Albanian Association of Oral and Maxillofacial Surgeons was established in 1993. It has some 70 members, 16 of whom cover the public sector throughout the country, the rest work only in the private sector. Andis Qendro

Argentina

Argentine Society of Oral and Maxillofacial Surgery and Traumatology

Sociedad Argentina de Cirugia y Traumatologia Bucomaxilofacial The Argentine Society of Oral and Maxillofacial Surgery found its roots in the establishment of a section of oral surgery and traumatology within the Argentine Dentistry Association in 1958. The founding fathers were Enrique Müller, Esteban Biolcati and Noberto Costoyas. The first years were characterized by attempting to increase the membership but in 1964, the first scientific meeting took place. In that year, the society was also one of the founding associations of ALACIBU. The society joined IAOMS in 1967.

During these early years, severe opposition was encountered, particularly from head and neck surgeons. Thanks to the steadfast attitude of Basilio Arienza and his colleagues Michael and Müller, who set up departments of oral surgery in three hospitals where they trained several new colleagues, the battle was won. These colleagues really can be considered the pioneers of OMF surgery in Argentina. Enrique Müller was also Vice President of IAOMS during the years 1989–1992.

In 1972, under the presidency of Hermes Becerra, the bylaws of the society were modified so as to incorporate the definition as used by the IAOS at that time. The society also improved their relationship with plastic and head and neck surgeons. The name change to Argentine Society of Oral and Maxillofacial Surgery and Traumatology came about in 1974.

A milestone in the history of the society, under the presidency of Pezza, was the recognition of the specialist certificate, as given by the society, by the Ministry of Public Health in 1978. This was followed by recognition of a voluntary recertification every five years, as suggested by

From left to right: Adrinian Bencini, President of the Argentine Society of Oral and Maxillofacial Surgery and Traumatology, Roberto Blanco, Mercelo Cerullo, Chairman of the 22nd Argentine National Conference. From left to right: Adrian Bencini, President of the Argentine Society of Oral and Maxillofacial Surgery and Traumatology, Carlos Alberto Bencinci, Mercelo Cerullo, Chairman of the 22nd Argentine National Conference.

the society. This was promoted by the then-president, Roberto Blanco.

A true highlight in the history of the society was the XIth ICOMS in Buenos Aires in 1992, so elegantly organized by José Ferreria and his committee. It drew a record participation and exposed Latin America to the international brotherhood of OMF surgery.

The society has steadily grown into a membership of approximately 500. They serve a population of about 40 million people. The training and education of OMF surgeons falls under the auspices of the society and includes a four-year full-time course. They are taught the full scope of the specialty along the guidelines of IAOMS. There are four accredited training institutions where currently 120 trainees are employed but several hospitals take part in the training of residents. Rotations in medicine, surgery and anesthesiology are common but not mandatory.

The society is optimistic about its future and counts on further development and growth. The biannual meetings are attended by about 900 participants, not only from Argentina but also from neighboring countries. Adrian Bencini

Austria

Austrian Association for Oral and Maxillofacial Surgery

Österreichische Gesellschaft für Mund-, Kiefer- und Gesichtschirurgie Austria, without any doubt, can be considered the cradle of modern oral and maxillofacial surgery on the continent of Europe. It all began with Hans Pichler, born in 1877 in Vienna as the son of a dentist. He studied medicine in Freiburg, Prague and Vienna, at that time the capital of the Austrian-Hungarian monarchy. He began a residency in general surgery, with Anton von Eiselsberg, at the famous department of general surgery of the University of Vienna, where Billroth had earned his reputation. Due to an allergic reaction to carbolic, he had to stop his training. Instead, he went to dental school in Vienna and later attended dental school in Chicago at Northwestern University. He became familiar with G.V. Black and translated his famous book on “Operative Dentistry” into German. He began a dental practice in Vienna in 1903 and became a consultant for the general surgery department, where his former teacher Anton von Eiselsberg was still in charge. The latter mentions in his memoirs the cooperation with Pichler that became effective as of 1903.

As in many countries throughout Europe, World War I became the “raison d’être” for the establishment of units to treat the wounded military, including maxillofacial trauma. Hans Pichler became the first chairman of such a unit in Vienna, in 1914, while still attached to the General Surgery department. Among his pupils was Richard Trauner, with whom he would later write a standard text on Oral and Maxillofacial Surgery. In 1923, he became the head of the dental clinic as well.

One has to realize that dentistry in Austria in those days was considered to be a specialty of medicine. Dentists went to medical school first and then specialized in dentistry. This only changed in 2000, when Austria had already joined the European Union, as a result of European regulations on the free movement of professionals. Since that time, dental schools have been established.

It is of special interest to mention Pichler’s intervention with the ailment of another famous Austrian; Sigmund Freud. He suffered from a squamous cell carcinoma of the hard palate and was treated by Pichler in 1923. He did a partial maxillectomy and marginal mandibulectomy along with a submandibular lymph node dissection. Freud survived but needed an obturator, which apparently caused some trouble because he had a total of 12 of these prostheses made, including eight made by Pichler, three by Kazanijan and one by Schröder.

Anton von Eiselsberg and Hans Pichler

Sigmund Freud

Siegfried Wunderer Richard Trauner Heinz Köle Rudi Fries

World War II caused another upheaval in the profession as again there was a need for the treatment of the wounded. Several military units to treat maxillofacial trauma were set up and many colleagues gained experience with these casualties, among them Rudolf Ullik, who became the successor of Hans Pichler in 1949. During his leadership the department became independent from the general surgery department in 1962. He ultimately became a full professor in maxillofacial surgery in 1967.

Ullik was followed by another well-known colleague, Siegfried Wunderer, particularly known for his approach to the anterior maxillary segmental osteotomy. The Vienna clinic trained several well-known colleagues who took on prestigious positions in other clinics throughout Austria, among them Rudi Fries, who went to Linz and Helene Matras in Salzburg.

In 1989, Rolf Ewers, who received his training from Wilfred Schilli in Freiburg and later from Franz Härle in Kiel, took the chair in Vienna until the present day. His energetic approach to the specialty resulted in several innovations, among which was the world’s first tongue transplantation in 2003; the procedure drew global attention.

Currently, the department covers the full scope of the profession and carries on the reputation which it had gained over more than one hundred years. A special mention, however, is warranted about the very successful organization of the XVII ICOMS in Vienna in 2005 in which all members of the department were involved.

In Vienna, three other small maxillofacial units are located in city hospitals. They are situated in the Danube Hospital (Ingeborg Watzke), in Hospital Hietzing (Werner Millesi) and in the Evangelic Hospital (Kurt Vinzenz).

Although Vienna was the nucleus of the specialty in Austria, over the years some eight departments were established in this country with a little over eight million inhabitants. During World War I. Franz Trauner became the chairman of the department in Graz and kept this position until 1937. Graz is the seat of the second medical school of Austria. He was followed by Hermann Mathis until 1947.

The next chairman was Richard Trauner, a son of Franz and a pupil of Pichler. He became a well-known cleft surgeon and above all the trainer of two well-known colleagues, Hugo Obwegeser and Heinz Köle. Köle eventually succeeded Trauner in 1971. He became known for his contributions to orthognathic surgery and was the inventor of the anterior mandibular segmental osteotomy to close an anterior open bite with interposed grafting, using chin bone. The current chairman in Graz is Hans Kärcher, who followed Köle in 1989 and who can be considered the pioneer in microvascular surgery in Austria.

Hugo Obwegeser went to Zürich, Switzerland in 1954, to become the chairman of the new department. He became full professor in 1964 and chaired his department until 1987, when he retired. His pioneering work on preprosthetic, orthognathic and craniofacial surgery is well known throughout the world. His name is attached to many innovative procedures of which many are still practiced. He is also one of the initiators of the establishment of the European Association for Cranio-Maxillofacial Surgery and a former president of the Swiss and German Associations of Oral and Maxillofacial Surgery.

At the third medical school in Innsbruck, a dental clinic was established in 1909 with a small department of oral and maxillofacial surgery. This clinic was chaired by Bernhard Mayerhofer. This department expanded during WWI for obvious reasons.

Mayerhofer was followed by Wilhelm Bauer in 1933 but he had to leave the country for political reasons in 1938. Georg Riha became the new chief but after WWII, Karl Häupl took over. He had an interesting career being involved with Andresen in Oslo, to co-author a book on functional orthodontics and also during WWII he was heavily involved in the treatment of war casualties in Berlin. While in Innsbruck, he reorganized the dental clinic and the department of oral and maxillofacial surgery.

Häupl left to become chairman in Düsseldorf, Germany and was succeeded by Otto Preissecker, who had trained with Pichler in Vienna. His chair was taken

by Hans Wunderer, a cousin of Siegfried Wunderer, after Preissecker passed away in 1964. The department of oral and maxillofacial surgery had no chairman at that time but Hans Mehnert and Otto Hofer were the surgeons. The latter became known for the anterior mandibular osteotomy that was widely practiced in the days before orthodontics became involved in orthognathic surgery.

In 1971, however, Ernst Waldhart became the chairman. He was trained in Innsbruck but had also done a fellowship in plastic surgery in Galveston, Texas, U.S.A. He managed to develop a full blown department as part of a “Head Clinic” and led this until 2003. His successor is Michael Rasse who trained in Klagenfurt and Vienna. He is known for his work on TMJ surgery but also has a reputation as an oncologic and reconstructive surgeon as well as a craniofacial and cleft surgeon. The department in Innsbruck is particularly recognized for its experience in trauma surgery, mostly related to accidents associated with skiing.

In Linz, an OMFS department was established in 1947 with Otto Hofer as its first chairman. He retired in 1964 and was briefly succeeded by Heinz Köle before he went to Graz again. In 1971, Rudi Fries became the chairman and would hold this position until 1989 when he retired. His special interest was tumor surgery and reconstructive surgery, the field to which he contributed a lot. His successor was Bernd Gattinger, who would also keep this position for 20 years. Gattinger made his name in craniofacial surgery and is considered the pioneer in Austria in that specialty. At present, Michael Malik has served as chairman since 2009.

In Wels, also in upper Austria, a department was established in 1977. The successive chairmen were Heinz-Peter Müller-Schenken, Michael Rasse, Günther Schultes and presently Gert Santler. The “Klinikum Wels-Griesskirchen” is a regional hospital in which this department is located.

In Salzburg, WW II also precipitated activities in oral and maxillofacial surgery but in a different way. An outpatient department was set up in 1940 within the department of ENT with Karl Czerwenka as a consultant dentist, who also treated maxillofacial trauma. A separate department of OMFS was finally established in 1947, headed by Franz Clementschitsch, known for his pioneering work in the field of pre-prosthetic surgery. He was also a disciple of Pichler and under his chairmanship the department flourished. He retired in 1977 and was briefly followed by Gerhard Zisser, who unfortunately passed away soon after.

Helene Matras, also trained in Vienna, became the successor and further developed this department. She was very active and a great team leader and made her name by the introduction of fibrin glue in reconstructive surgery. She also organized many international meetings, particularly about cleft lip and palate surgery. She was succeeded by Christian Krenkel, who was already a long- standing member of her staff. He became internationally known for his pioneering work in distraction osteogenesis and the application of osteosynthesis. In 2003, a private medical school was established in Salzburg and the city hospital with its department of OMFS became part of it. Krenkel retired in 2010 and was succeeded by Alexander Gaggl, who trained in Graz.

In three other hospitals departments of OMFS have been established: one in Klagenfurt since 1974, one in St. Pölten since 1976 and one in Feldkirch since 1985. All evolved over the years into complete units where the whole scope of the specialty is practiced. The current heads of the departments are Friedrich Chiari in Klagenfurt, Franz Watzinger in St. Pölten and Oliver Ploder in Feldkirch.

There are 11 departments of OMFS in Austria that are all involved in the training of residents. There is no national structured program and the training period, therefore, differs from place to place and also per individual. There is also no fixed number of trainees to be accepted per year but each year some 10 to 12 candidates apply for the final exit examination to achieve official specialist status.

The Austrian association was founded in 1967. Rudi Fries and Rudolf Ullik were the initiators with the idea in mind to structure the training programs and to promote interdisciplinary communication and relations with other disciplines. Ullik became its first president. The current president of the association is Ingeborg Watzke. Only in 1994 did the specialty receive an official status as a medical and dental specialty. There are currently 184 active members. The majority of them work in a hospital setting, often combined with part-time private practice. A few are private practitioners, combining oral and maxillofacial surgery with dentistry. Private practitioners can have a contract with the social insurance companies for dentistry but no contract exists for oral and maxillofacial surgery in Austria.

As a pioneer in our specialty, Rudi Fries needs to be credited for his outstanding contributions to the IAOMS. He not only was one of our founding fathers but also served as one of our former presidents as well as president of the German association, the European Association for Cranio-Maxillofacial Surgery and the IAOMS. On top of that he initiated the establishment of the GermanAustrian-Swiss working group on oral oncology (Doesak), which, until the present day, is a very active multinational scientific organization. Werner Millesi

Azerbaijan, Republic of

No report received.

Bangladesh

Bangladesh Association of Oral and Maxillofacial Surgeons

The first initiatives to develop oral surgery in Bangladesh took place in the early 1980s at Dhaka Dental College by Monjurul Haque. These initiatives mainly concerned dentoalveolar surgery.

The true development of oral and maxillofacial surgery, including the treatment of trauma, benign and malignant tumors and cleft lip and palate repair, was begun by Molla and his staff, including Rafique, Shaheed and Altaf, in 1987. Under the most difficult of circumstances, with a lack of sufficient and adequate instruments and materials and even with poor anesthetic equipment, these colleagues managed to provide Dhaka with some service in the field of oral and maxillofacial surgery. They were the true pioneers.

The year 1990 was the turning point for Bangladesh oral and maxillofacial surgery because of the foundation of the Joint Australian-Bangladesh Oral and Maxillofacial Surgery Project. The founding chairmen were Molla and Barry Fitzpatrick, later followed by John Arvier. This turned out to be the catalyst for the Bangladeshi colleagues since a fair number of Australian colleagues came over in the years 1991–2001 to instruct them and also to donate instruments. On top of that, OR nurses and young colleagues were trained in Australia for a short period of time. This project also initiated the establishment of post graduate training which resulted in an official master degree in OMF surgery in 1994.

Another important development was the initiative in 1996 of Omar F. Rahman who, along with the help of the Japanese Cleft Palate Foundation, began visiting Dhaka to provide treatment for cleft lip and palate patients with the assistance of Japanese colleagues.

In 1998, Molla was transferred to Shaheed Suhrawardy General Hospital where he managed to set up a new department with operating facilities and beds to admit his patients. By 2004, Bangabandhu Sheikh Mujib Medical University (BSMMU) was also able to provide an advanced OMF surgery service. Including Dhaka Dental College, where Rezaul Haque chaired the department of OMF surgery and Mohiudin is the current head. These three centers are now responsible for the education and training of students and they provide OMF surgical service for the 160 million people residing in Bangladesh.

The education and training of OMF surgeons in Bangladesh is currently based on a MS degree, which is a three-year, full-time course, followed by two years of advanced training in the above-mentioned hospitals.

At present, there is the beginning of a true OMF community with 35 qualified OMF surgeons and 90 trainees. Most of the colleagues work in Dhaka with the exception of a few who work in some other cities.

The Bangladesh Association of Oral and Maxillofacial Surgeons was established in 1993. The first successful international conference was held in 1995 with delegates from India, Japan, Nepal and some other countries. The association holds yearly conferences but also organizes free dental, cleft lip and palate and oral cancer screening clinics in the rural areas of the country. We are very interested in international exchange and treasure our association’s affiliation with the IAOMS.

Motiur Rahman Molla

Motiur Rahman Molla

Belarus

Jahn Arvier (Australia) is presented a plaque from the Bangladesh Association in 1994. No report received.

The oral and maxillofacial surgery team in Dhaka, 1990.

Belgium

Royal Belgium Society of Stomatology and Maxillofacial Surgery

Société Royale Belge de Stomatologie et Chirurgie Maxillofaciale Koninklijke Vereniging voor Stomatologie en Mond-Kaak-en Aangezichtschirurgie The evolution of oral and maxillofacial surgery in Belgium is rather unusual and, to a certain degree, comparable to that of France in that initially there were colleagues with a medical degree who practiced dentistry and who, in 1900, organized themselves and established the “Société Odontologique des docteurs en médecine de Belgique.” Some of these had some formal dental training abroad but all of them practiced dentistry, some along with general medical practice. These “pioneers” were, thus, not surgeons but medical doctors with some dental education. Four years later they renamed the society “Société Belge de Stomatologie.” As of 1903, they published a quarterly journal that was later called Acta Stomatologica Belgica.

The first chair in stomatology was established in Louvain, in 1905 and occupied by Auguste van Mosuenk. This was soon followed by similar appointments at the Universities of Gent, Brussels and Liege.

Dentistry became an academic study in 1929, but its scope was limited to the treatment of teeth and their supporting tissues. As of 1934, the practice of dentistry was reserved for people with a dental degree and for medical doctors with additional dental training. In 1956, stomatology became an official medical specialty based on a medical degree with four years of dentistry and stomatology training. Many of these stomatologists still mainly practiced dentistry but some sought further training in maxillofacial surgery, particularly in France and Germany.

A major supporter of the profession and a tireless fighter for the status of the stomatologists was Robert Peiffer. He was instrumental in the expansion of the scope of the specialty into maxillofacial surgery and in 1982 the “competence” of oral and maxillofacial surgery was officially recognized by the health authorities and the criteria for achieving this “competence” were precisely described. Some 37 stomatologists, almost equally divided among the French- and Dutch-speaking colleagues, received this competence, which could be achieved by an additional two years of training after the stomatology training.

The last step in this evolution is the formal recognition that candidates for training in oral and maxillofacial surgery needed to have a medical degree (six years) and a dental degree (three or four years, depending on the policy of the University involved), followed by a four-year training in one of the six medical schools, including Louvain (a Flemish and a French), Brussels, Gent and Antwerp. Part of the training is provided by some large training hospitals, where several consultants are practicing the full scope of OMFS. The content and quality of the training is supervised by special accreditation committees. The training includes the full scope of the specialty with a growing emphasis on esthetic surgery of the face. It also includes oncological surgery but colleagues interested in that part of the profession often follow a fellowship to gain expertise. In actual fact this scenario is rather similar to most European countries where dual degrees are required but in this country the origin of the profession stems from stomatology which is still reflected in the name of the society. The adjunct “Royal” was granted in 1973 by the King.

The society has currently some 250 members and some 10 trainees per year are accepted. Almost all members are also members of the European association and many of the IAOMS. The society holds two meetings a year and has a board with a president that alternates from the French and Dutch speaking regions. The doyen of OMFS in Flanders is Luc Neyt who was the first to really begin a full-scope practice in Bruges, in the early 1970s. The same is true for Hervé Reychler but for the Walloons, who chairs the University department in Brussels and who trained many colleagues from the French-speaking area. Another pioneer and specialist in head and neck surgery is Eric Fossion`, who is both nationally and internationally recognized as an expert oncological surgeon.

The highlights of the society were the jubilee congresses in 1975 and 2000, both in Brussels, where many guests

Robert Peiffer Luc Neyt

Herve Reychler Eric Fossion

from abroad were present and the two European meetings, in Brussels (1990) and in Bruges (2010), organized by the then presidents of the EACMFS, Robert Peiffer and Maurice Mommaerts. Constantinus Politis

Bolivia

Bolivian Society of Oral and Maxillofacial Surgery

Sociedad Boliviana de Cirugia The Bolivian Society of Oral Surgery was founded in 1944 by Luis Palza Veintenillas, a professor in oral surgery at the University Mayor of San Andrés. It happened at a meeting held at his home with Raúl Chavez Ayoroa, Jorge Rios Moscoso and Hugo Perez Salmon, all staff members at the same university.

In 1969, because of the development of the specialty and following the same tendency as adopted by Argentina, Brazil, Mexico, Chile and other Latin American countries, the society changed its name and became the Bolivian Society of Oral and Maxillofacial Surgery.

Thanks to the efforts of Eduardo Alandia Borda, in 1981, the Minister of Health created a section of oral and maxillofacial surgery at the department, directed by an oral and maxillofacial surgeon.

A training program was established in 1997 by Jorge Rios Jordan, who is still in charge of this three-year program. It is a program similar to other medical specialties and is spread over several hospitals. It is a full-time commitment and only one trainee a year is accepted. It is still the only program in the country recognized by the university, the Ministry of Health and the Medical and Dental associations.

The objectives of the society are: • To promote the development of the specialty. • To create centers or services of oral and maxillofacial surgery in hospitals or health centers where there is a need. • To stimulate the training and education of specialists in recognized centers. • To promote the exchange of knowledge and experience among national and international centers and specialists in OMFS. • To stimulate research related to OMFS and to assist in publishing these studies. • To improve the working conditions of the

OMF specialists. • To seek the cooperation of public and private, national and international institutions to help achieve our objectives. The society has 25 full members and 50 associate members. The latter group consists of dentists with a surgical interest. Bolivia has a population of almost 10 million inhabitants.

The society actively participates in the meetings of ALACIBU and of the group countries of the south part of Latin America. Jorge Rios Jórdan

Brazil

Brazilian College of Oral and Maxillofacial Surgeons

Colégio Brasileiro de Cirurgia e Traumatologia Buco-Maxilo-Facial As was the case in many countries, in Brazil the need for oral surgery was first recognized by the military. This happened at the end of the 19th century and it was especially the Navy that was in need of oral surgeons because they made long journeys in order to guard the long coast of the country. In 1931, this resulted in a federal act making the practice of oral surgery official in the military. It was not, however, until 1966 that the Federal Council of Odontology formalized oral and maxillofacial surgery as a specialty.

Four years later, in July 1970, a group of about 350 surgeons gathered in the capital Brasília for the 1st Brazilian Congress of Oral and Maxillofacial Surgery

The opening ceremony of the first Brazilian Congress in 1970. The tallest person in the photo is João Jorge de Barros, first president of the Colégio. The “founding members” during the 2nd Congress of the Colégio in 1971.

and decided to start an association. The meeting, which was the beginning of the Colégio Brasileiro de Cirurgia e Traumatologia Buco-Maxilo-Facial, was presided over by Gustavo Demerval da Fonseca and was attended by foreign colleagues including Harry Archer (U.S.A.), Norman Rowe (U.K.), Guillermo Ries Centeno (Argentina), Hirokichi Sato (Japan) and Chavez Jaramillo (Ecuador). The then- president of Brazil, Emílio Médici, participated in the opening ceremony. The event itself and the creation of the association were on the cover pages of some of the most important Brazilian newspapers in July, 1970.

In the following year, the “founding members” gathered again in Porto Alegre, for a second meeting. During its first three years, the association was presided over by João Jorge de Barros, a nationally renowned surgeon from São Paulo. Subsequently, the college members elected each new president for a period of two years during the “Congresso Brasileiro de Cirurgia Buco-Maxilo-Facial” (COBRAC).

During the last 40 years, the “Colégio” has undergone a dramatic evolution. The number of members has reached almost 1,400, which makes it the second largest association affiliated to the IAOMS and the largest in ALACIBU. The growing number of regional meetings and the current magnitude of the Brazilian congresses (1,800 participants are expected for the 22nd edition in 2013, in Rio de Janeiro), are reflections of the success of the association. Besides, even though this was not the original intention, the “Colégio” is now the formal consulting group of the Federal Council of Odontology with regard to the regulation and practice of OMFS. Being a member of the “Colégio” has become of significant value for Brazilian colleagues, both for their practices and for their patients.

There are currently 57 training programs in Brazil with approximately 334 residents in training (average of 5.8 residents per institution). The Federal Council of Odontology is the supervising body and sets the minimal requirements, such as the subjects to be taught and the training format. Basic disciplines of anatomy, physiology, pathology, pharmacology and medicine are taught during the first year. Programs have to offer at least 2,000 hours of training and the hospitals in which they take place must be fully equipped. Training in general takes a minimum of three years but each program has its specific priorities, such as trauma, orthognathic or reconstructive surgery.

The full scope of OMFS is practiced in Brazil, except for malignancies as they are treated by head and neck surgeons. Some colleagues participate in the head and neck team. In recent years, there has been an increase in the number of surgeons who have considered attending medical school after their residencies. As we still do not have an integrated residency program, including medical school, an MD degree takes at least six years to complete.

Considering the size of the Brazilian territory (8.5 million km2) and its population (184 million people in 5,560 cities), the “Colégio” currently has 14 regional chapters. One coordinator heads each of these branches with the goal of promoting the specialty, gathering more colleagues and organizing meetings. Partly due to the Brazilian dimensions, there are still many professionals registered as OMFS specialists in the Federal Council of Odontology who do not take part in the association.

The “Colégio” is very proud of its history and aware of its evolving role, not only of representing OMFS as a specialty in Brazil but also helping to establish training guidelines and standards of patient care. Paolo Rodrigues

Correio Braziliense caderno 2

Bulgaria

Society of Oral and Maxillofacial Surgeons in Bulgaria

The Society of Oral and Maxillofacial Surgeons in Bulgaria was founded in 2009. It officially became a national affiliate of IAOMS in 2011 during the 20th ICOMS in Santiago, Chile. At that time, the Society had 60 members while the total number of oral and maxillofacial surgeons in the country was 54. Nikolay Yanev

Canada

Canadian Association of Oral and Maxillofacial Surgeons

Oral surgery was the first specialty of dentistry, the “raison d’être” being necessity and public welfare.

Specialists in oral surgery were located in the larger population centers across Canada early in the 20th century, with the exception of Newfoundland and the central prairie region. It is fitting to recall the names of some of these self-reliant pioneers: Johnson and Cox of Vancouver; Henniger of Halifax; Roger McMahon in Montreal; E.W. Paul in Toronto; George Everett in Hamilton; Roy Beer in Winnipeg and Doug Coupland in Ottawa.

Those who nourished the flame of oral surgery in our teaching institutions during the early days merit grateful recognition. There were not many dental schools in Canada at that time and Dr. Henniger at Dalhousie, Beers and

Local organizing committee of the 1986 ICOMS in Vancouver. Seated from left to right: Kaye Lindsay, Al Swanson, Barbara Swanson and Bill Walter. Standing from left to right: Keith Lindsay, John Folkins, Brian Draper.

McMahon at McGill and Henderson and Paul at Toronto must be held in grateful and respected memory. The latter served his confreres in a teaching capacity for four decades.

The concept of the formation of a Canadian Society of Oral Surgeons started with discussion among some of the members of the Ontario Society of Oral Surgeons. The activating group decided that the most opportune time to organize would be at the time of the joint meeting of the CDA and the Montreal Fall Clinic in Montreal in the fall of 1953. Notice of such a meeting was publicized as widely as possible through personal letters and notices in the journals. Pro tem officers were elected and a committee to draft a constitution was set up.

For the previous few decades, Canadian colleagues had relied heavily on the American Society of Oral Surgeons (ASOS) for their continuing education. Many of them, of course, had taken their training in the U.S.A. and so there was a natural connection via their training centers, chiefs of service and fellow residents. The ASOS, a much older and larger organization, had also developed its meetings to a high degree of excellence, offering the very best in speakers and programs. Many Canadian colleagues were also members of the AAOMS and, indeed, in the 1960s and 1970s, the ASOS allowed for a Canadian delegate to sit in their legislative arm, the House of Delegates, as a voting member.

However, our American colleagues perceived that, with the passage of time, the CSOS should develop into a strong entity unto itself, independent of the ASOS. In 1969, with this constructive motive to foster this goal, the ASOS negotiated a gradual separation of the Canadian section of their House so that when the time came that the number of Canadian Active Members of the ASOS fell below 25, there would cease to be any delegates from Canada.

This was looked upon variably by our Canadian colleagues; some thought it was unfair and discriminatory, while others thought it might have a salutary effect by serving as a stimulus for growth and development of the fledgling CSOS. Influential leaders within the ASOS, such as Jim Hayward and Fred Henny, privately confided that this latter reason was the real basis for this decision, hoping that the move would stimulate the CSOS “to stand on its own two feet.” Indeed, this proved to be so and in retrospect, was one of the best things that could have happened to our national specialty association. Canadian oral and maxillofacial surgeons, formerly active members of the ASOS, were invited to remain as affiliate members under the new legislation.

As mentioned earlier, education and training of the early Canadian oral surgeons necessarily occurred offshore, principally in the United States. It was only natural, therefore, that standards of training of oral surgeons in Canada be modeled after those of our American confreres. With the achievement of section status within the specialties grouping of the CDA, the CSOS became a partner with the national dental association in nurturing its goals and objectives. To this end, the Council on Education of the CDA, at its 1971 annual meeting, was directed to seek the collaboration of the section in developing acceptable standards for the graduate and postgraduate educational programs in oral surgery. In response to this invitation, the CSOS produced a document entitled “Guidelines for Graduate and Postgraduate Programs in Oral Surgery.”

Canada currently supports six graduate training programs in oral and maxillofacial surgery: Dalhousie, Laval, McGill, Toronto, Manitoba and Western Ontario. Although these programs commenced as three-year requirements, consistent with accreditation demands of the day, expanded scope and elevated standards have necessitated an increase in the length of training to accommodate these changes. At present, there are 66 residents in training, of whom 53 are in Canada and 13 are in the U.S.A.

The history of the Canadian association would be incomplete if some mention were not made of the advent of the Royal College of Dentists of Canada and the interaction between that institution and the CSOS. This is particularly so in view of the significant contribution which our colleagues made and continue to make, to this esteemed establishment. Memorable surgeons of our past, such as Gerard De Montigny of Montreal, James Coupland of Ottawa, and Frank Smith of Vancouver, should be cited as major contributors to the genesis of the RCDC and its official launch on March 18, 1965.

The scope of practice of our specialty has undergone a metamorphosis over the years as well. Our European colleagues were quite influential in this regard and as their clinicians visited North America on speaking tours and our residents and fellows extended their training exposure

in Europe, the “oral” part of our designation as a specialty was seen as being patently inadequate to describe the full profile of our daily practice. Following the example of the U.S.A. colleagues, the CDA Board of Governors granted official approval of the name change to “Canadian Association of Oral and Maxillofacial Surgeons (CAOMS)” in 1977.

The steady growth and success of the association is due largely to the initiative, self-sacrifice and dedication of successive executive councils. The load has always been heavy but has progressively increased with the growth of the association. There are currently some 300 active members of whom 85 are life members. They serve a population of 34 million people.

Continued progress in oral and maxillofacial surgery depends upon constant renewal by younger oral and maxillofacial surgeons emanating from unassailable teaching programs. It also relies on the vigilance of the Canadian Association of Oral and Maxillofacial Surgeons in continually pressing for higher standards in the profession. Thus far, the success of the organization has more than fulfilled the dreams of its founders. Al Swanson

Chile

Chilean Society of Oral and Maxillofacial Surgery

Sociedad De Cirugia y Traumatologia Bucal y Maxilofacial de Chile As in many other countries, the practice of oral and maxillofacial surgery, as it is called today, was initially carried out by general surgeons. At first, in the colonial period (1540–1810), they were Spanish but in the years of the struggle for independence (1810–1818), there was a strong French and British influence. The first dentists arrived in 1828 but there is no evidence of their involvement in any oral and maxillofacial surgery.

With the foundation of the University of Chile in 1842, its faculty of medicine became the entity that regulated the practice and teaching of health sciences and the Dean authorized the entry of an increasing number of foreign dentists, especially from Europe. In 1889, the first dental school was established in Santiago. This new generation of dentists began to develop an interest in surgery and some worked together with general surgeons who had been in the practice of oral and maxillofacial surgery.

Two of these general surgeons in particular became the founders of the specialty in Chile. Italo Alessandrini and Alberto Rahaussen can be considered the pioneers. These strong characters had the vision to involve dentists in the surgery of the mouth and jaws and trained the first generation of oral surgeons, notably Manuel Ramírez, Mario Salcedo, Horacio Rivera, Juan Rojas, Leopoldo Panat, Luis Cobos, Rodolfo Villaseca, René Loubel and Antonio Kokic.

This generation became instrumental in the foundation of the Chilean Society of Stomatological Surgery in 1950. The evolution of the specialty into oral and maxillofacial surgery took place gradually and in 1991 this resulted in a name change “Sociedad de Cirugía y Traumatología Bucal y Maxilofacial de Chile”. The society has currently over 200 members spread over the whole country and is the official body that represents the specialty in Latin America and globally. The recognition of oral and maxillofacial surgery as a dental specialty was obtained in 1957 and from this time on, all public and private health institutions consider these specialists to be part of the surgical teams.

The society participates in the National Committee for Certification of Dental Specialties in collaboration with the universities and the College of Surgeon Dentists and has a say in the programs for education and training of oral and maxillofacial surgeons in Chile that are attached to the Universities. The aim of the society is to promote the development of oral and maxillofacial surgery in Chile.

There are five training programs in Chile, two in Santiago and one in Valparaíso, Concepción and Antofagasta. Each year there are 15 to 20 training positions available for which 150 candidates apply. The duration of the program is three years with full-time dedication to academic activities and hospital practice. At the end of the training program, the specialist is capable of dealing with the whole scope of the specialty, as described in the guidelines endorsed by IAOMS, with the exception of malignancies, that are dealt with by head and neck surgeons in cooperation with oral and maxillofacial surgeons. Hernan Ramirez, Edwin Valencia and Julio Cifuentes

2005 ICOMS. From right to left: Iris Ferreria (Argentina), Luis Quevedo (Chile), Edwin Valencia (Chile), Waldemar Polido (Brazil), Julio Cifeuntes (President of Chilean Society), José Luis Ferreria (past IAOMS President).

Colombia

Colombian Association of Oral and Maxillofacial Surgery

Asociacion Colombiana de Cirugia Oral y Maxilofacial The pioneers of Colombian oral and maxillofacial surgery can be traced back to the early 1940s with the names of Alfredo Barcenas and Vincente Plata. In those years the first dental school was established at the National University of Colombia in Bogota. The person who really made the difference was Waldemar Wilhelm, a German-trained oral and maxillofacial surgeon who served as a professor at the University for 20 years. He taught a whole generation of colleagues the art of oral and maxillofacial surgery, which had a tremendous impact on the level of practice in the country. He also served as president of ALACIBU for the years 1972–1976.

Another outstanding person who contributed to the Colombian OMFS community is Tomas Garcia. He trained in the U.S.A. from 1957 to 1959 and returned to Colombia in 1962 to become chairman of the department at the central military hospital. He would hold that position until 1971 after which he became Dean of the dental school at Pontificia University Javeriana in Bogota.

The Colombian Society of “Dentomaxillofacial Surgery” was established in 1958 through the initiative of four founding fathers in Medellin. The years to come would be characterized by rivalry between the two dental schools in Bogota and Medellin but in 1984 an agreement was achieved and from then on a uniform training program was established for both schools. Two individuals deserve credit for their tireless efforts to enhance the specialty:

Enrique Amador, who trained with Waldemar Wilhelm, became the chairman of the department at the University in Bogota. He developed international contacts by inviting several leading authorities from Europe and the U.S.A. to come and lecture. He also served as president of ALACIBU from 1994 to 1997.

Luis Campos, who did his postgraduate training in the U.S.A., worked with Thomas Garcia and became an outstanding clinician and academician.

In the late 1980s, Chirivi became the editor of the society’s journal Odontologica Maxillofacial, which was later renamed Revista Colombiana de Cirugia Oral y Maxilofacial.

During the 1990s, it became necessary to hold several meetings with representatives of neighboring specialties and health officials from the government to both defend the specialty and also to set up authorized training programs in the various hospitals. This battle ended with the establishment of recognized “oral health” departments in several hospitals, including entrée to the emergency rooms. During this period, the society changed its name to the Colombian Association of Oral and Maxillofacial Surgery.

The framework laid down in the 1990s has led to uniform training in seven university departments, along with the affiliated hospitals. There are five training programs in Bogota and two in Medellin, all of them recognized by the Ministry of Health. At this point, the training capacity appears to be somewhat redundant since the number of graduates is exceeding the demand. Nevertheless, several Latin American countries are benefiting from the excess of oral and maxillofacial surgeons in Colombia.

At present, Colombian oral and maxillofacial surgery meets the international standards and the association is very active in stimulating scientific work. The association currently has 223 full members and 83 trainee members. Daniel Alfonso Rey Vásquez

50th anniversary of ACCOMF in Cartegena 2008. From left to right: Robert Christensen (U.S.A.), Jaime Guerrero, Claudia Pena, Santiago Abello, Jaime Rodrigues, Danial Rey, Rodolfo Asensio, Robert Marx (U.S.A.), Jesus Gomez. From left to right: Luis Alberto Campos, James Quinn (U.S.A.), Enrique Amador after operating together in Cucuta in 1989.

Miso Virag, President of EACMFS 2010–2012 entertaining guests on the occasion of the 70th anniversary of his department in Zagreb in 2009. From left to right: Hans-Peter Howaldt, Julio Acero, Miso Virag, Henry Thuau, John Helfrick, Luigi Clauser, Guiseppe Consorti. Display of artists’ illustrations of patients with facial fractures and log books dating from the early days of the department in Zagreb.

Costa Rica

Costa Rican Academy of Oral & Maxillofacial Surgery

Asociación Costarricense de Cirurgia Oral y Maxilofacial (ACCOM) The idea of creating the Costa Rican Academy of Oral and Maxillofacial Surgery stems from 2003, when nine colleagues came together at the ALACIBU meeting in Panama. A draft of the bylaws was made there and the academy was officially established in the same year. Oscar Reiche Fischel was its first President and also became the first Costa Rican Councilor to the IAOMS. Today, the membership has grown to 16. It is likely that this number will grow since the population of the country is about 4.6 million.

Since there is no training institution in Costa Rica for OMFS surgery, trainees go abroad for their education. Most of them train in Latin American countries. After their training they are registered as OMF surgeons. Oral and maxillofacial surgery is a fully recognized specialty in the country by government authorities.

The ACCOM provides guidance and continuing education for its members to practice the full scope of the specialty. Oscar Reiche Fischel

Croatia

Croatian Society of Maxillofacial, Plastic and Reconstructive Head and Neck Surgery

Hrvatsko Društvo Za Maksilofacijalnu, Plastičnu I Rekonstrukcijsku Kirurgiju Glave I Vrata The Croatian Society of Maxillofacial, Plastic and Reconstructive Head and Neck Surgery was founded in 1954 as a branch of the Croatian Medical Association under the name “Croatian Society for Maxillofacial and Plastic Surgery.” The founder and first president of the society was Ivo Čupar. At that time, the society included also Croatian plastic surgeons.

In November 1954, the first scientific meeting of the society was held. During that meeting, it was decided to publish a journal, Chirugia Maxillofacialis & Plastica, and in 1955 the first issue was published. The second scientific meeting of the society was held in 1956, the third in 1959 and one every year after that.

The Croatian society members initiated the first Congress of the Yugoslavian Association of Maxillofacial and Plastic Surgeons, which was held in Opatija in 1960.

In 1968, during the third Congress of the Yugoslavian association, Celesnik mentioned the initiative of some European maxillofacial surgeons to establish the European association, which was founded in Zurich in 1970. The representative from Croatia on the founding assembly was Branka Pilar. Four members of the Croatian Society (Čupar, Barlović, Pilar and Korda) participated in the first Congress of the European Association for CranioMaxillofacial Surgery.

On the occasion of the 15th anniversary of the society in 1969, a scientific meeting was organized in Zagreb on “Head and Neck Traumatology.”

In 1973, Ivo Čupar retired and the next president of the society was Herbert Klemenčić, a plastic surgeon. At that time there were 33 members.

In 1981, Vladimir Mikolji became the president and under his leadership, with assistance from Mišo Virag, several meetings took place with renowned foreign speakers. The society also organized thematic symposia on current topics, such as: “Rigid fixation in maxillofacial surgery,” and “Oral cancer treatment.” In 1990, the society organized an international meeting in Zagreb with more than 100 participants and invited lecturers.

In 1993, the Croatian society, together with the American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS), organized and participated in the project: “Operation Second Chance – America Cares for Croatia.”

In 1997, after 42 years, the Croatian plastic surgeons withdrew from the society and established their own association. In 1988, during the general assembly of the society, the name changed to the Croatian Society of Maxillofacial, Plastic and Reconstructive Head and Neck Surgery. Mišo Virag was elected as president. The society presently has 45 active members and about 12 trainee members but also a large number of associate members, such as oral surgeons, otolaryngologists and other related specialists. The population of Croatia is approximately 4.5 million.

Education and training of maxillofacial surgeons is provided by four university clinics in Zagreb, Split, Rijeka, and Osijek. It takes at least five and a half years to complete maxillofacial training and a medical degree is required. In the training period, residents rotate through all dental disciplines for a total of one year. All residents of the four institutions will spend at least half a year at the University Hospital Dubrava in Zagreb.

Oral surgery can be done after achieving a dental degree and training takes three years. There are about 150 oral surgeons who often work together with the maxillofacial surgeons in the local clinics. They often join the society as associate members.

From 1999 until today, the society has organized meetings every year in different Croatian cities. The society also organized the 4th International Danubius Conference on Maxillofacial and Oral Surgery, in 2002 in Rovinj.

Since 2001, the Best Trainee Presentation, the “Dr. Vladimir Mikolji Award” has been given at the annual meeting.

In 2004, at the 50th anniversary of the Croatian Society, the society became affiliated to the IAOMS.

For the period 2010–2012, Professor Virag served as the president of EACMFS with Dubrovnik the venue of the 21st EACMFS Congress. Naranda Ratkovic and Mišo Virag

Cuba

No report received.

Czech Republic

No report received.

Denmark

Danish Association of Oral and Maxillofacial Surgeons

Maxillofacial surgery began in Denmark in 1943–1944 when the first Professor in “Jaw Surgery,” Erik Husted, was appointed at the Copenhagen University Hospital “Rigshospitalet” in Copenhagen. At the same time, the Royal Danish College of Dentistry was established in new buildings in Copenhagen.

The close neighbor, Rigshospitalet, had their first dentist employed in 1910. In 1917, Husted was succeeded by Otto Bjerrum, still known for his thesis on mandibular fractures written in 1934. Bjerrum was the chief of the Dental Clinic at Rigshospitalet until 1952, when he was succeeded by Jens Jorgen Pindborg. During the years 1960–1970, a number of dental clinics were opened at the various Danish county hospitals, and a close teaching and scientific collaboration between the Royal Dental College (later School of Dentistry) Painting by Jorn Beinkamp (1981) and Rigshospitalet proved of Jens Pindborg, first editor of the Journal, 1972–1976. fruitful over the years.

The establishment of the Danish Association of Oral & Maxillofacial Surgeons followed in 1953. Jørgen Rud, Herluf Baggesen and Jens Pindborg were the pioneers at the time, which moved the development forward from “dentists interested in surgery” towards the establishment of a formal specialist training based on a dental degree. It was accepted by the Danish Dental Association in 1964 and later (in 1976) authorized by the National Board of Health (Sundhedsstyrelsen). In the beginning, the dental consultants at the hospitals treated toothaches and jaw fractures, mainly non-surgically. The first two resident-intraining positions were created in 1964 at Rigshospitalet, comprising of a three-year training curriculum.

In those years (1965), the Scandinavian Association of Oral & Maxillofacial Surgeons was also founded with Erik Husted as the first president. In the following years, an extensive exchange took place between the Scandinavian countries regarding standardization, content of training and compliance with international trends. Another pioneer from the 1970s until recently was Erik Hjørting Hansen, who solidified the specialty in Denmark.

In 1972, the Danes became members of the European Union. It took until 1976 when the specialist training curriculum in “Hospital Dentistry” was officially authorized by the Danish National Board of Health. Denmark has two recognized dental specialties: oral and maxillofacial surgery and orthodontics. A five-year OMFS training curriculum including 1½ years of core medical training was formulated in 1986 under the auspices of the National Board of Health. However, it took another five years until the updated curriculum became formalized in 1991.

Departments of oral and maxillofacial surgery, mainly one-man units, appeared at almost every large county hospital in Denmark from 1980 on until recently but because of a major restructuring of the provincial governments in 2007, 15 counties were reduced to five and the hospital services also had to merge. As a result we have, at present, seven departments of OMFS surgery and four trauma centers, serving a population of 5.6 million, including Greenland. There are 45 active members of the association, with three trainees admitted per year.

The current specialist training in Denmark is based on a dental degree and takes five years to complete. Two years of general dentistry are obligatory before the beginning of training. The training includes general surgery and medicine, ENT, anesthesiology, plastic surgery, neurosurgery and oncology for 1½ years and 3½ years of oral and maxillofacial surgery. Danish specialists have appreciated international collaboration and after finishing training many have further developed their skills by working one or several years outside Denmark.

Many Danish OMFS have been pushing to open the option of double-degree based OMFS training (DDS + MD) in Denmark to comply with European and global trends. However, there is still a way to go before this wish may be implemented in Denmark.

The scope of oral and maxillofacial surgery has changed considerably over time in Denmark. From taking care of toothaches and wiring jaw fractures together, the specialty now covers orthognathic surgery, pre-implant and pre-prosthetic reconstructive surgery, secondary cleft surgery, maxillofacial traumatology and a fair share of maxillofacial and craniofacial reconstruction. This development has been conveyed by a growing understanding of the importance of collaboration with other medical specialties. The multidisciplinary collaboration involves a significant part of oral cancer diagnosis, treatment and rehabilitation, oral medicine, treatment of osteonecrosis and craniofacial anomalies and the units for treatment of rare diseases.

Major contributors to the international literature of OMF surgery were Jens Pindborg on oral medicine and oral pathology, Jens Andreasen on dental trauma and Erik Hjørting Hansen on bone biology and bone augmentation techniques.

We feel privileged to be a part of the international scene of OMF surgeons, which is essential in the global world of today. We are also proud of the role one of the Danish pioneers, Jørgen Rud, played in the early years of the IAOMS. The successful second ICOS, held in Copenhagen in 1965, was in fact the real start of the International association.(see chapter 2) Morten Schiodt

Dominican Republic

No report received.

East Africa

Eastern Africa Association of Oral and Maxillofacial Surgery

The Eastern Africa Association of Oral and Maxillofacial Surgery was established in February 2002 in the presence of the then President of IAOMS, Paul Stoelinga. The association was accepted as an affiliated association in 2003 at the ICOMS in Athens. For this affiliation, the IAOMS bent the rules a little bit as normally associations of single countries apply for affiliation and not regional associations. The situation in Eastern Africa, however, warranted this exceptional decision because despite the enormous size of this region, with an estimated population of over 220 million people, there were only a handful qualified OMF surgeons in this part of Africa. The countries involved in its establishment were Botswana, Burundi, Ethiopia, Kenya, Malawi, Mozambique, Rwanda, Somalia, Sudan, Tanzania, Uganda, Zambia and Zimbabwe.

Since its establishment, things have progressed nicely because the capacity for training has increased. In addition to Nairobi, Dar es Salaam also has become a training center for the region. The Eastern African association has agreed on a mutual training program that will be valid for the whole region, which is adapted to the needs of the countries involved. The IAOMS sponsored educational program, that ran from 2006 to 2011 and was held alternately in Nairobi and Dar es Salaam, has been instrumental in bringing expertise and the necessary means to spread the information needed.

Since its inception, several associations’ meetings have been held in Nairobi, which is the association’s headquarters. The association also joined the African association along

Founders of the East Africa Association with Paul Stoelinga, IAOMS president. Front row from left to right: M. Onguti, Paul Stoelinga, Simon Guthua, C. Luhanga, Mark Chindia. Back row from left to right: S. Mbuthia, Paresh Devani, Elison Simon, J. Kalyanyama, Eric Kahugu, J. Onyango, F. Shubi, J. Moshy.

with West and South Africa and the Egyptian association in 2003. With new maxillofacial surgeons qualifying every year from the two training centers, the number of members of the association is expected to slowly but steadily increase. The current numbers are 35 members (25 from Kenya and 10 from Tanzania) and 15 trainees; 10 in Nairobi and five in Dar es Salaam.

Further growth of the association is to be expected since many young trainees from several of the nations involved have enrolled in the two existing training programs. Since the inception of the joint IAOMS-sponsored courses in Dar es Salaam and Nairobi, young maxillofacial surgeons and trainees have benefited from knowledge offered by experienced local and international experts in the fields of biomedical sciences, oral maxillofacial surgery, surgical orthodontics, oral medicine and oral pathology.

With assistance from the IAOMS, the Dar es Salaam center renovated its operating rooms. When fully functional, they will increase the capacity for handling surgical cases and hence greatly reduce the waiting period of referred cases, while at the same time providing room for more exposure to practical maxillofacial surgery for trainees. Elison Simon

Ecuador

Ecuador Association of Oral and Maxillofacial Surgeons

Asociación Ecuatoriana de Cirugia Bucomaxilofacial Oral and maxillofacial surgery emerged in Ecuador in the mid-1950s through Pamina and Oswaldo who, after some training in Argentina, returned home to establish the first oral and maxillofacial surgery service in Quito. Pamina and Chavez subsequently taught at the Faculty of Dentistry of the Central University of Ecuador. Before this period, oral and maxillofacial surgery was performed by trauma surgeons, oncologists, otolaryngologists and plastic surgeons.

The first real specialist was Diaz, who acquired this status in 1970 in San Pablo, the Philippines. He worked in the Pasaje Military Hospital and later founded the Maxillofacial Surgery Service of the Armed Forces General Hospital, where he served for 30 years. It is fair to say that Chavez and Diaz were the real pioneers of the art of oral and maxillofacial surgery in Ecuador.

Another important person in our history is Cabezas, who completed his specialization at the University of Chile. For eight years, his work at the Hospital Eugenio Espejo was dedicated to people with limited financial resources. From 1988 until the present time, Chavez served as head of maxillofacial surgery at this hospital.

A pivotal role in the development of OMF surgery was played by Fernando Sandoval, who trained in Mexico and the United Kingdom and worked for 13 years in the Military Hospital. Later he joined the Quito Metropolitan Hospital where he was appointed head of the department of maxillofacial surgery, a position he has held until the present time. He strove to create the Institute of Postgraduate Studies at the “Universidad Central del Ecuador.” Through agreements with hospitals and with the help of foreign universities, the first graduate courses began in 1998. Currently, there are two universities that offer a specialized program in maxillofacial surgery: “Universidad San Francisco de Quito” and “Universidad Central del Ecuador.”

In the following years, many trainees finished their education and training and settled throughout the country. Many regional hospitals now have oral and maxillofacial surgery services.

The Ecuadorian Association of Oral & Maxillofacial Surgery and Traumatology is a founding member of ALACIBU and in 1986, hosted the ALACIBU Congress. Lyn Blanco Pérez and Fernando Sandoval Portilla

Egypt

Egyptian Association of Oral and Maxillofacial Surgeons

The Egyptian Association of Oral and Maxillofacial Surgeons (EAOMS) was established in 2000 and was accepted as a member of the International Association of Oral and Maxillofacial Surgeons in 2001. During the 3rd International Conference of EAOMS held in Cairo in 2004, the African Regional Association was established.

In 2005, EAOMS organized a scientific conference in Cairo, Egypt to celebrate the 500th anniversary of the Royal College of Surgeons of Edinburgh.

The mission of EAOMS is to improve the quality and safety of healthcare through the advancement of patient care, education and research in oral and maxillofacial surgery. Toward this aim, EAOMS organizes a biannual International Conference in which eminent international speakers participate. These conferences include training courses in recent advances and in technologies in the

The 3rd International Congress of the EAOMS. From left to right: Sherif El-Mofty, EAOMS president; Mohamed Awad Tag El Din, Minister of Health, Egypt; and José Luis “Pino” Ferreria, IAOMS president.

Participants and guests of the 10 Congress of EAOMS in Cairo, 2010.

field of oral and maxillofacial surgery, as well as a large commercial exhibit. EAOMS also organizes seminars in different cities in Egypt.

In 2004, EAOMS, in association with Ain Shams University, Al-Azhar University, Glasgow University and Cork University presented a research proposal entitled: “New curriculum for management of maxillofacial deformities” to the European Union and were granted a Tempus Joint European Project “2004–2009.”

In 2010, the Egyptian Association of Oral and Maxillofacial Surgeons is launching its scientific journal, The Egyptian Journal of Oral and Maxillofacial Surgery. Sherif El-Mofty

Estonia

Estonian Society of Oral and Maxillofacial Surgery

The development of the specialty in Estonia began before World War II. The teaching of oral and maxillofacial surgery, however, started in 1936 at the University of Tartu.

The pioneer of maxillofacial surgery in Estonia was Valter Hiie (1902–1963), who graduated from the Medical Faculty of the University of Tartu in 1927. He did his specialty training in Vienna, at that time one of the prime centers of Europe. He became a well-known and much respected maxillofacial surgeon, who developed reconstructive surgery in the maxillofacial region, cleft lip and palate treatment and orthognathic surgery. It was a major step forwards for the patients in Estonia who suffered from maxillofacial diseases, deformities and trauma.

In 1938, the Department of Oral and Dental Disease (as it was called in those days) was founded at the Faculty of Medicine, University of Tartu. Valter Hiie established the Department of Maxillofacial Surgery at Tartu University Hospital in 1945 and was appointed as a full professor and head of the department. His commitment was to teach both dental and medical students. Until 1944, training in dentistry could only begin after having obtained a six-year medical training (MD degree), followed by three years in dentistry.

In 1944, the department of stomatology was founded at the Medical Faculty, University of Tartu and in 1945, the departments of surgical stomatology, oral and dental diseases and prosthetic dentistry.

Valter Hiie established the Estonian Society of Stomatologists in 1938 and chaired the department of maxillofacial surgery until 1963, when he passed away. Maie Lövi-Kalnin became the head of the department of stomatology, Faculty of Medicine between 1982 and 1992. Edvitar Leibur was the head between 1992 and 2003 and from 2003 until the present time, Mare Saag.

Teaching has been based on the concept of training in both medicine and dentistry, being the essential prerequisites for the practice of maxillofacial surgery. The specialty evolved very much from a medical background on the basis of a mono-specialty of stomatology.

In Estonia, basic and professional education is 10 years: five years of undergraduate training in dentistry and five years of postgraduate specialty training in OMFS. Either a D.D.S., D.M.D. or M.D. degree is required for enrollment in the training program. The program has a different content for medical and dental graduates. For medical graduates, it is compulsory to study dental subjects, 40 credit points (1,600 hours), and dental graduates receive extensive training in general surgery and internal medicine.

Estonian delegation at the 19th ICOMS in Shanghai 2009. From left to right: Edvitar Leibur, Marianne Soots, Tiia Tamme.

It is realized that the dental skills to practice oral and maxillofacial surgery are necessary but that training in dentistry could be combined with training in surgery. The IAOMS International Guidelines for Specialty Training and Education in Oral and Maxillofacial Surgery have been taken into account and this document has provided guidance for the advanced training program.

A certificate of specialty is issued after the completion of training and the passing of a final examination.

Until 1992, the graduates of the department of stomatology at the Faculty of Medicine at the University of Tartu were awarded medical degrees. The accreditation process was created with an appropriate curriculum. Up until 1992, all oral and maxillofacial surgeons belonged to the Estonian Scientific Society of Stomatologists.

The Estonian Society of Oral and Maxillofacial Surgery has a written constitution and was established in 1992. At the same time, the Baltic Association of Maxillofacial and Plastic Surgery was founded and since then, regular congresses have been held biennially. The presidents of Estonian Society have been: • 1992–1995 — Siiri-Mai Hanstein • 1996–1999 — Edvitar Leibur • 2000–Present — Marianne Soots Membership of the society has grown to 23 registered members and four residents. The increasing number of young oral and maxillofacial surgeons in training is welcome and we hope that by the time they take over, our efforts will have started to yield fruit.

The Estonian Society of Oral and Maxillofacial Surgery was officially affiliated with the IAOMS in 1996, with Edvitar Leibur and Tiia Tamme serving as councilors of the Estonian Society of OMFS to the IAOMS from 1996 to 2004 and from 2005 to present respectively.

At present, 23 full members of the Estonian Society of Oral and Maxillofacial Surgery serve a population of 1.3 million. There is one university department for undergraduate and postgraduate training, including a five-year program for oral and maxillofacial surgery. Two hospitals, Tartu University Hospital and the NorthEstonian Regional Hospital in Tallinn, are involved in the training. A principal goal of the Estonian Society of Oral and Maxillofacial Surgery is to improve the specialty and the care provided to patients through the improvement of training programs. Tiia Tamme

Finland

Finnish Association of Oral and Maxillofacial Surgeons

Suomen Suu-ja Leukakirurgiyhdistys ry The early beginnings of the Finnish association can be traced back to 1951 when Juuso Kivimaki, a professor of oral surgery, formed a Club of Stomatology. He was a general surgeon but also a specialist in maxillofacial and oral surgery. The establishment of the association, however, occurred in 1966, initiated by Mikko Altonen, who was trained in Hamburg by Schuchardt. Of the founding members, two-thirds had a medical as well as dental degree, whereas one third had a single dental degree. The first president was Ingmar Virtanen, who was a professor of oral surgery at Helsinki University. The association was officially registered in 1968 and the logo for the new association was designed by Arvi Tasanen.

It was in 1892 that Matti Ayrapaa began a school of dentistry at the University of Helsinki. Before that time dentists received their education in Germany, Sweden or Russia. There were several reasons which led to the demand for a specialty that combined medical and dental knowledge, including the war circumstances, increase in

Meeting of the Finnish board in September 2010. From left to right: Tuiji Teerijoki-Oksavice, Ari Rajasuo, Jari Kellokoski, Juha Peltola, Irja Venta, Vesa Kainulainen.

At the 40th anniversary of the Finnish Association of Oral and Maxillofacial Surgeons, the induction of three honorary members with the Finnish president at the time. Left to right: Matti Lamberg, Pekka Laine (president, 2005–2009), Anna-Lisa Söderholm, Kaj Finne.

facial trauma and diseases together with the development of anesthesiology. Up until the 1960s, there were three different kinds of specialists with both dental and medical basic degrees, including specialists of oral diseases, specialists of oral surgery and specialists of maxillofacial surgery.

The next step was that medical and dental specialists received separate education and became single-qualified either oral surgeons or maxillofacial surgeons, although the latter usually also had a dental degree. In 1975, the first single-qualified dental specialists were approved. Since 1984, education and training of specialists has taken place at the universities.

From the beginning of 1999, the training program for oral and maxillofacial surgery was adapted to European and international recommendations. The two former specialties were united as one specialty of oral and maxillofacial surgery. Either a dental or medical basic degree is needed to start training in a specialty program. The official training period is six years and it is open for dentists and physicians.

Double qualification is not an official requirement for completion of the training. It appears, however, that all colleagues with a medical degree also have a dental degree. Dentists have to do complementary studies in medicine. The residents do their clinical service at several hospitals across Finland. Currently, three universities, including Helsinki, Turku and Oulu, are entitled to provide a specialist certificate. In 2009, seven new certificates were handed out.

The trainees keep a logbook, which indicates a minimum number of different kinds of treatment in which the candidate has shown proficiency and they must pass a national exit exam before graduating. The license to work as an OMFS specialist is granted by the National Supervisory Authority for Welfare and Health. The specialist training is supervised by the Ministry of Education and Culture which is the highest authority in Finland.

At present, the Finnish association has 164 members, for a population of 5.5 million. Colleagues with completed training for the specialty are eligible as full members. This is the biggest group comprising two-thirds of the members. One third of the members are trainees and are called associate members. Over the years, 10 honorary members have been added to the membership roster. In 1970, Norman L. Rowe from London, and in 1992, Hermann Sailer from Zürich were invited as corresponding members.

The membership of the Finnish association has been very active in the Scandinavian Association of Oral and Maxillofacial Surgeons (SFOMK) from the very beginning. Since the foundation of the Scandinavian association in 1965, there have been seven Finnish presidents.

The cooperation with the European Association for Cranio-Maxillofacial Surgery (EACMFS) brought the conference to Helsinki, Finland in 1998 with Christian Lindqvist acting as president. Since the year 1978, the Scandinavian councilor for EACMFS has been from Finland.

In the beginning, a councilor for the International Association of Oral and Maxillofacial Surgeons (IAOMS) was appointed through the Scandinavian association. Since 1995, the Finnish association has had its own representative. Irja Venta

France

French Society of Stomatology and Maxillofacial Surgery

Société Francaise de Stomatologie et Chirurgie Maxillo-Faciale French oral and maxillofacial surgery derived from a medical specialty called stomatology. Its origin goes back to the year 1883, when some colleagues with a medical degree but practicing oral medicine and dentistry, organized themselves in a “Society of Stomatology of Paris.”

In 1895, the first chair in stomatology was created in Lille, which was occupied by Redier, while during the previous year the Revue de Stomatologie was introduced. A person who was instrumental in introducing proper training was Paul Cires. He went to the U.S.A. to orient himself on the education and training of dentists and stayed for two years in Philadelphia where he acquired a formal degree in dentistry. On his return to France, he became the main promoter of the establishment of a School of Stomatology in Paris, which was eventually founded in 1910.

Board of the French Society of Stomatology and Maxillofacial Surgery, from left to right: Doctors Dujarric, F. Boutault (president-elect 2013), L. Ben Slama (president 2012), X. Pouyat, F. Cheynet, Joel Ferri (president 2011), P. Sabin, D. Pouit, J.P. Fusari, P. Blanchard and P. Breton (Secretary General).

It is of interest to note that the International Association of Stomatology was established in 1907 consisting of members from more than 20 nations, particularly from the south and east of Europe. As in other countries involved in World War I, the demand for treating the wounded created a need to organize their transport behind the front lines. For this reason special centers for the treatment of maxillofacial trauma were created, notably in Paris (Val de Grâce) but also in Lyon and Bordeaux.

In 1920, another important step in the development of stomatology occurred in that Chompret was appointed to chair the stomatology department at the medical faculty of the University of Paris. Over the years, several other schools of stomatology were established throughout France, notably in Bordeaux, Lille, Lyon, Nancy and Nantes. In 1943, the Society of Stomatology of Paris changed their name into the French Society of Stomatology.

In 1949, an official recognition of stomatology as a medical specialty was received. Subsequently the specialty gradually developed into a surgical specialty under the guidance of some key pioneers, such as, Pierre Cernea in Paris, Maurice Gosserez in Nancy, Freidel in Lyon and Georges Ginestet, who was a general in the military service. As of 1953, the society was called the “French Society of Stomatology and Maxillofacial Surgery.” However, it took another 20 years before the first congress was held in Paris in 1973. It was Pierre Cernea, the president at that time, who organized it and this congress marked the beginning of the true development of maxillofacial surgery in France.

Members of the society gradually lost their interest in dentistry and this went along with the establishment of national dental schools, which was made possible by law in 1965, in accordance with the practice in other European Community member states. The teaching of dentistry, at that time, however, remained the responsibility of the stomatologists in the medical schools. It was only after the “revolution” of 1968 that dentistry became completely separate from the medical schools.

Oral and maxillofacial surgery in France, despite its different background, has contributed substantially to the profession. The names of Dechaume, Delaire, Merville and Champy do not need any further explanation but there are many more that should be recognized. The work of Paul Tessier, although not a stomatologist, also does not need any reiteration. The specialty has also developed into a true regional specialty in that the whole face is included in the scope of the profession. This is exemplified by the world’s first facial transplant, carried out by Bernard Devauchelle and his team in Amiens.

At present, the training of stomatology and maxillofacial surgery takes a full five years and includes one and a half years of general surgery, two years of maxillofacial surgery and one and a half years minimum in plastic, neuro, or ENT surgery. One year, but often it will be two years, needs to be spent in a university department of stomatology and maxillofacial surgery. There are approximately 30 new trainees accepted each year, spread over the country, which implies that some 150 trainees are educated.

There are currently about 1,200 registered colleagues but some of them may be retired. The French Society organizes national meetings every year. Joël Ferri

At the 47th Congress of the French Society. From left to right: Paul Stoelinga, IAOMS past president; Joel Ferri, SFSCMF president and Francis Dujarric, SFSCMF past president. Jean Delaire

Georgia, Republic of

Republic of Georgian Association of Stomatology and Maxillofacial Surgery

The Georgian Association of Stomatology and Maxillofacial Surgery was established in 1991. Before that time, a Georgian society of dentists and maxillofacial surgeons existed. The first president of that association was Professor Omari Nemsadze. The association had about 300 members.

In 1997, Zurab Chichua attended the 4th Congress of Oral and Maxillofacial Surgery of the Mediterranean Sea countries, which was held in Antalya, Turkey. It was there that he met Rudi Fries, who was instrumental in the efforts of the association to join the international scene. Professor Fries was subsequently invited to attend a meeting of dentists and maxillofacial surgeons of the Black Sea countries and it was there that an application for membership of the IAOMS was agreed upon. The association eventually joined IAOMS at the Kyoto ICOMS in 1997.

Over the past several years, colleagues, particularly from Germany, have visited Georgia to hold workshops for trainees and young colleagues. In 1998, the association

Doctors from the Republic of Georgia. Seated, left to right: Prof. Gogiberidze, Dr. Dondua, Dr. Cchiqubava. Standing, left to right: Dekanosidze, Chichua, Bakuradze, Mgeladze.

also became involved with the European Association for Cranio-Maxillofacial Surgery and sent a councilor to the Helsinki Congress.

The Georgian association is responsible for the training of OMFS surgeons. It consists of four years of hands-on training in oral and maxillofacial surgery based on a degree in stomatology (dentistry). There are three training institutions that accept a total of six trainees per year. The specialty is officially recognized by the Ministry of Health.

There are currently approximately 30 OMFS surgeons in Georgia for a population of 4.6 million people. The association is keen to send some young colleagues to western countries to expand the scope of OMFS in Georgia. Zurab Chichua

Germany

The German Society of Oral and Maxillofacial Surgery

Deutsche Gesellschaft für Mund-, Kiefer- und Gesichts-chirurgie (DGMKG) The German profession has two organizations representing oral and maxillofacial surgery. Both organizations are affiliated with the IAOMS but are represented by one councilor.

The history of the German Society of Oral and Maxillofacial Surgery is tightly linked to the development of the specialty during the two World Wars. Hugo Ganzer and Christian Bruhn were the protagonists in the field at that time. They ran army hospitals for oral and maxillofacial surgery during World War I in Berlin and Düsseldorf. The department in Düsseldorf was later named West German Department of Oral and Maxillofacial Surgery and was the first department of this specialty at that time in Germany.

Already after World War I, a board certification for oral and maxillofacial surgery (“zahn-, mund- und kieferkrankheiten”) was established. From 1924 onwards, a three-year residency was mandatory to become a specialist.

In 1950, the professional “Union of German Oral and Maxillofacial Surgeons” (“Verband der Fachärzte für Zahn-, Mund- und Kieferkrankheiten”) was established. The members of this association founded the precursor of the German Society of Oral and Maxillofacial Surgery in 1951. Martin Waßmund was elected the first chairman of the society. The reason for the establishment of a new society was the need for a scientific representation of the specialty in the council of the German Medical Association.

The society started with 52 members and adopted the name “The German Society of Maxillofacial Surgery.” Karl Schuchardt became chairman of the society in 1953 and held this post until 1964. His successors included names of such well-known authorities as Rehrmann, Schröder, Steinhardt, Stellmach, Spiessl, Scheunemann, Pfeifer, Becker, Schilli, Schwenzer, Fries, Obwegeser, Machtens and Hausamen. The current chairman of the society is Henning Schliephake. In 1972, the term “oral” (“mund”) was included in the name of the society. From 1976 on, the specialty was officially called “oral and maxillofacial surgery.”

Between 1948 and 1990, oral and maxillofacial surgery took a separate course in East and West Germany. With the German reunification, the East German Society was integrated in the German Society.

The professional Union of German Oral and Maxillofacial Surgeons (“Bundesverband Deutscher Ärzte für Mund-, Kiefer- und Gesichtschirurgie”) represented the specialty and the professional interests of more than 1,000 oral and maxillofacial surgeons of 17 regional associations. In 2000, however, the professional Union of German Oral and Maxillofacial Surgeons and the German Society of Oral and Maxillofacial Surgery merged and formed the new German Society of Oral and Maxillofacial Surgery (Deutsche Gesellschaft für Mund-, Kiefer- und Gesichtschirurgie).

Today, the executive board consists of the president, vice president, treasurer and four additional board members, who represent the whole breadth of the specialty of oral and maxillofacial surgery, both with regard to patient care as well as research. The board is supported by

Karl Schuchardt, first president of the society, 1953–1964 Henning Schliephake, chairman of the society as of 2011

Board of the German Society of Oral and Maxillofacial Surgery. From left to right: Bernd Rehberg, Hans-Peter Howaldt, Stephan Wunderlich, Erich-Theo Mehrholz (president), Alexander Hemprich (vice president), Elmar Esser and Nils-Claudius Gellrich.

an executive’s office and special departments for quality assurance, scientific guidelines, esthetic surgery, pain therapy, implantology and continuing education. The current active membership is 1,600 for a population of 82 million.

The training and education for oral and maxillofacial surgery takes five years according to the current regulations for board certification. Board certification can only be achieved when the candidate has a medical as well as dental degree. Twelve months of the training can be done in general surgery, anesthesiology, otorhinolaryngology or neurosurgery. The sub-specialization “plastic operations” takes an additional two years.

The training in oral and maxillofacial surgery includes the acquisition of knowledge, experience and skills in the specialty as well as the performance of a defined number of operations (logbook) in traumatology, tumor surgery, surgery of malformations, orthognathic and TMJ surgery, dentoalveolar surgery, preprosthetic surgery and implantology, surgery of peripheral facial nerves, septic surgery and plastic and reconstructive and esthetic surgery. There are currently 79 hospital-based departments that are accredited to be a training institution. The number of trainees is not limited but at present, there are approximately 100 trainees in Germany.

In the bylaws of the German Society of Oral and Maxillofacial Surgery, it is written that it is the mission of the society to promote, protect and advance oral and maxillofacial surgery scientifically as well as on a professional level, to assure excellence in the field and to support its members in practicing their specialty through education, research and advocacy.

One of the major activities of the society was the patronage of the German-Swiss-Austrian Working Group on Maxillofacial Tumors (DOESAK, “DeutschÖsterreichisch-Schweizerischen Arbeitskreis für Tumoren im Kiefer- und Gesichtsbereich”) that was established in 1971 and was dedicated to a systematic documentation of all tumors in the oral and maxillofacial region. Along the same lines, the German Cleft Palate and Craniofacial Association (“Deutschen interdisziplinären Arbeitskreises für Lippen-Kiefer-Gaumenspalten/kraniofaziale Anomalien”) was founded in 1982. Both associations run annual congresses that are well established and attended by members of the DGMKG. The DOESAK has become an independent association since 2006.

A major activity of the German Society of Oral and Maxillofacial Surgery is the establishment of guidelines for diagnosis and treatment of diseases in the field of oral and maxillofacial surgery.

The Academy for Oral and Maxillofacial Surgery was founded in 2004 and aims at securing continuing education (e.g. in esthetic facial surgery and implantology). For this reason the Academy holds annual spring and fall meetings.

Publications of the German Society of Oral and Maxillofacial Surgery and the Federal Association of German Specialists in Oral and Maxillofacial Surgery were made in Fortschritte der Kiefer- und Gesichts-Chirurgie (Proceedings in Maxillofacial Surgery) from 1955 to 1996 and from 1977 to 1996 in the Deutsche Zeitschrift für Mund-, Kiefer- und Gesichtschirurgie (German Journal for Oral and Maxillofacial Surgery). After the merger of the two organizations the new journal Mund-, Kiefer- und Gesichtschirurgie was established and replaced its two predecessors. Mund-, Kiefer- und Gesichtschirurgie is also the official journal of the Austrian, Hungarian and Swiss Societies of Oral and Maxillofacial Surgery. In 2008, the journal changed its name to Oral and Maxillofacial Surgery and is now published online in English. The journal Der MKG-Chirurg was also launched in 2008 and is focused on continuing education. On top of this, the Journal of Cranio-Maxillofacial Surgery is also an official journal of the German Society of Oral and Maxillofacial Surgery.

The annual conference of the German Society of Oral and Maxillofacial Surgery is held each year in May at various places. From 1981 onwards, the conference has been run by an elected congress president. Joint congresses have been held in 1968 in Philadelphia and in 1993 in Orlando and in 1997 in Hamburg with the American partner societies and in 1993 with the Dutch association. The annual conference is always dedicated to one or two main and two minor topics. There is always a symposium on military medicine and the “Day of the Academy.” Since 1958, the Waßmund award is conferred annually on a member of the specialty for outstanding scientific achievements. The winner is chosen by a jury of five members of the society.

Oral and maxillofacial surgery is one of the surgical specialties of the head and neck region. As it requires

a dental and medical qualification, it will remain an irreplaceable link between medicine and dentistry. The engagement in the IAOMS is seen as an important activity in order to keep up with developments in the field and to represent the professional interests of the specialty on an international level. Emeka Nkenke

Germany

German Academy of Oral and Maxillofacial Surgery

Arbeitsgemeinschaft für Kieferchirurgie In the 1920s, a board certification for oral and maxillofacial surgery was established in Germany that required double qualification. From 1924 onwards, a three-year residency became mandatory. Detailed regulations for training in oral and maxillofacial surgery were established in 1935. Consequently, the predecessor of the Academy of Oral and Maxillofacial Surgery (Arbeitsgemeinschaft für Kieferchirurgie) had already been founded in 1932 by Georg Axhausen, who was the head of the department of oral and maxillofacial surgery in Berlin at that time, Wolfgang Rosenthal (1882–1972), who became the head of this department in 1950 and Christian Bruhn (1869–1942), who was the head of the West German Department of Oral and Maxillofacial Surgery (Westdeutsche Kieferklinik) in Düsseldorf. They named it “German Society for Stomatology.” In 1935, the name was changed to “Arbeitsgemeinschaft für Kieferchirurgie” (Academy of Oral and Maxillofacial Surgery).

The Academy of Oral and Maxillofacial Surgery aimed to bring together oral and maxillofacial surgeons with double qualifications and dentists interested in surgical aspects in their field, because Axhausen felt that there was need for establishing regulations for a board certification in oral surgery. The bylaws stated that it was the mission of the Academy of Oral and Maxillofacial Surgery “to give a clear definition of the specialty “oral and maxillofacial surgery” for doctors as well as dentists, who intended to practice in this field. Eligible members of the academy are surgeons as well as dentists who have proven their dedication to oral and maxillofacial surgery either “scientifically or on a professional basis.”

In the early years, the meetings of the Academy of Oral and Maxillofacial Surgery were included in the annual conventions of the German Society of Dental, Oral and Craniomandibular Sciences (Deutsche Gesellschaft für Zahn-, Mund- und Kieferheilkunde). The first separate conference of the academy was held in 1938 in Berlin with the main topic of “oral surgery.” From that time on, an annual conference was established.

In 1945, the short history of the Academy of Oral and Maxillofacial Surgery came to a temporary end. However, in 1951, it was re-established by Walter Sauvélet and 10 colleagues, as a reaction to the foundation of the Professional Union of Oral and Maxillofacial Surgeons (“Verband der Fachärzte für Zahn-, Mund- und Kieferkrankheiten”).

In 1950, Sauvelet and Axhausen, the honorary chairmen of the new Academy of Oral and Maxillofacial Surgery, feared that if oral and maxillofacial surgery was only represented by the Professional Union of Oral and Maxillofacial Surgeons of Germany, the aspect of dentistry in the field would lose its central role, although dentistry was supposed to be of utmost importance in oral and maxillofacial surgery. Again, it was the aim of the Academy of Oral and Maxillofacial Surgery to support the development of the specialty in a symbiosis of surgery and dentistry.

At the first conference of the new academy in 1952, it was emphasized again in the bylaws that “it is the mission of the academy to create a clear and consistent vision of the role of dentists practicing in the field of oral and maxillofacial surgery.”

In 1958, the Academy of Oral and Maxillofacial Surgery concluded an agreement with the Professional Union of Oral and Maxillofacial Surgeons of Germany in a way that the union would be responsible for the advocacy of professional interests of the specialty, while the academy would take care of the scientific progress in the field. From that time on, the different orientations of the two organizations were clearly defined. A comparable agreement was made with the Professional Association of German Oral Surgeons (“Berufsverband Deutscher Oralchirurgen”) in 1988.

One of the major activities of the Academy of Oral and Maxillofacial Surgery, together with the German Society of Oral and Maxillofacial Surgery, was the patronage for the foundation of the German-Swiss-Austrian Group on Maxillofacial Tumors (DOESAK, “Deutsch-

Georg Axhausen, 1877–1960, founding member of the Academy Walter Sauvelet, 1865–1965, re-established the Academy in 1951

Österreichisch-Schweizerischen Arbeitskreis für Tumoren im Kiefer- und Gesichtsbereich“) that was established in 1969 and was dedicated to a systematic documentation of all tumors in the field.

The annual conference of the Academy of Oral and Maxillofacial Surgery gives life to scientific, practice oriented and social activities of the members. From 1963 on, it has been held in Bad Homburg with only few interruptions until today. The conference traditionally takes place around Ascension Day. Today, the audience does have the opportunity to attend scientific lectures and practical hands-on workshops as well as a program dedicated to continuing education in oral surgery.

The Academy of Oral and Maxillofacial Surgery has been involved in joint conferences starting in 1962 when the German Society of Dental, Oral and Craniomandibular Sciences held the congress of the FDI. In 1971, the academy organized a joint conference together with the International Association for Dental and Maxillofacial Radiology. In 1977, the Academy affiliated with the IAOMS and held the 8th ICOMS in Berlin in 1983 in order to underline its interest in international relations.

Today, the Academy of Oral and Maxillofacial Surgery is one of the two major representatives of oral and maxillofacial surgery in Germany with the mission of securing the scientific and practice-oriented development of the specialty. In this context, it has achieved a central role in the development of scientific guidelines in the field and runs one of the most important annual conferences on oral and maxillofacial surgery. Emeka Nkenke

Ghana

Ghana Association of Oral and Maxillofacial Surgeons

The Ghana Association of Oral and Maxillofacial Surgeons (GAOMS) had its first meeting on 24th June 2005 but was inaugurated on 27th June 2008. Twelve members form the association, which currently has a president, secretary and treasurer as officers.

The aims of the association are: • To improve the healthcare of the population of

Ghana by improvement in the delivery of oral and maxillofacial surgery (OMFS). • To foster relations with other nations of West Africa. • To agree on common grounds of basic education, standards of delivering patient care and strategy of collaborative research • To forge links with other African countries. • To achieve international accreditation of the training programs and establish centers of excellence for education in Ghana. The association has an annual meeting in June but has not organized itself well enough to start scientific meetings on an annual basis. However, it joins the Ghana Dental Association for annual scientific meetings, where there are presentations on subjects relating to oral and maxillofacial surgery. One such presentation was by the president on the topic, “Common Oral Tumors in Ghana.”

The officers of the association are: president, Grace Parkins; general secretary, Emmanuel Kofi Amponsah and treasurer, Eric Ngyedu. The association sought affiliation with the International Association of Oral and Maxillofacial Surgeons in March 2009. This was agreed in Shanghai. Grace Parkins

First meeting of Ghana oral and maxillofacial surgeons in June 2005. From left to right: Danial Owusu Bankus, Ebenezer Nuako, Peter Donkor, Grace Parkins, Eric Asamoa, Maxwell Adjei, Francis Kwashie.

Greece

Hellenic Association of Oral and Maxillofacial Surgery

ΕΛΛΗΝΙΚΗ ΕΤΑΙΡΕΙΑ ΣΤΟΜΑΤΙΚΗΣ ΚΑΙ ΓΝΑΘΟΠΡΟΣΩΠΙΚΗΣ ΧΕΙΡΟΥΡΓΙΚΗΣ

The Hellenic Association of Oral and Maxillofacial Surgery was founded in March 1959 as “The Hellenic Association of Oral Surgery,” following the suggestion of Theo Mavrogordatos, professor of oral surgery in the dental school of the University of Athens. He was also the first president and remained president until 1972.

In 1960, the association began its activities organizing meetings with the participation of leading Greek and foreign specialists. In 1969, to mark the first decade of the HAOS, the first Assembly in Oral Surgery took place. It was followed by the second, third and fourth assemblies in 1979, 1983 and 1986 respectively.

In 1986, in accordance with the evolution of oral and maxillofacial surgery into a specialty with a broader

Cover of the Hellenic Association Journal George Panos, editor-in-chief of the Hellenic Journal

spectrum, the title of the association was changed to “The Hellenic Association of Oral and Maxillofacial Surgery.” The HAOMS became an affiliated association of the IAOMS and of the European Association for Cranio-Maxillofacial Surgery (EACMFS). The HAOMS has councilors in both associations. In the same year, in co-operation with the publishing company of LATTERE, The Greek Journal of Oral and Maxillofacial Surgery was launched. This journal appeared four times a year, until 2000.

In 1988, the 8th Congress of the EACMFS took place in Athens, while Professor Christos Martis was president of the EACMFS.

Beginning in 1989, the year of the 5th Assembly on Oral and Maxillofacial Surgery, it was decided that there be yearly congresses of the HAOMS instead of the assemblies that were held once in three years. In the same year, the specialty of oral and maxillofacial surgery was officially recognized in Greece. A change in the rules and regulations of the HAOMS was made, implying that only qualified oral and maxillofacial surgeons could become full members.

From 1989 until 2010, 25 Pan-Hellenic Conferences of the HAOMS have been organized. The number of members has risen to 300, 200 of whom are active members.

The HAOMS organizes courses for postgraduate education of medical doctors, dentists and OMS specialists. It also supports “The Residents’ Podium,” a series of meetings where the residents have the chance to present their views on various subjects of the specialty. One of the highlights of the HAOMS was the 16th ICOMS, held in Athens in May 2003, organized by a Greek organizing committee under the presidency of Angelo Angelopoulos and the president of HAOMS, George Panos. This meeting will be well remembered by those who participated.

From 2000, the HAOMS has published the bilingual Greek-English journal, “Hellenic Archives of Oral and Maxillofacial Surgery” and began a web site: www.haoms. org with George Panos being the present editor.

For the past 50 years, the Hellenic Association of Oral and Maxillofacial Surgery has contributed to the progress of the specialty in Greece and abroad. It has also helped educate medical doctors, dentists and oral and maxillofacial surgeons and is sure to play a significant role in the future.

The Greek requirements for entry into specialist training begin with examinations after the acquirement of both medical and dental degrees. Specialist training is a continuum lasting five years with an exit examination taken towards the completion of specialist training. It consists of six months General Surgery, 48 months Oral and Maxillofacial Surgery and 6 months of Plastic, ENT , or other relevant surgical specialty. George Panos Constantinos Alexadridis, current president of the association

Site visit Athens 2002 at the Parthenon, Acropolis. From left to right: Nikos Katsikeris, Dimitrois Karakasis, Paul Stoelinga, Victor Moncarz, George Panos, Nabil Samman and Angelo Angelopoulos.

Hong Kong

Hong Kong Association of Oral and Maxillofacial Surgeons

The development of the specialty started relatively late in Hong Kong, during the 1950s. The then colonial government ran a dental service mainly for its civil servants. The dentists in charge were educated overseas. Walter Allwright was the first dental specialist in charge of the service, who would also run an operating list in Queen Mary Hospital.

In the 1960s, dental officers with an interest and some experience in oral surgery were sent to centers overseas for further training. On their return they were deployed in various hospitals. The appointment of Eric Fung as the

first consultant oral surgeon was a milestone because it denoted the recognition of oral surgery as a specialty. This was gradually followed by appointments of other colleagues in some other hospitals.

An important event happened in 1980 with the establishment of a dental school at the University of Hong Kong. This also included a department of oral surgery and oral medicine. At the same time, some specialists, trained abroad, returned to Hong Kong and began practicing more advanced surgery, such as orthognathic surgery. Bill Yan and Nigel Clark are among these pioneers.

Things really changed with the arrival of Henk Tideman in 1988, who was appointed the new chairman of the department at the university. Under his leadership, the postgraduate training was structured and enhanced but above all, he was instrumental in advancing orthognathic and reconstructive surgery to meet international standards. The name of the department also changed to “oral and maxillofacial surgery.”

In 1990, Henk Tideman and some other surgeons from the department and private sector came together and founded the Hong Kong Association of Oral and Maxillofacial Surgeons. With the establishment of the Hong Kong College of Dental Surgeons as a constituent college of the Hong Kong Academy of Medicine in 1993, oral and maxillofacial surgery training programs were set up at the university and other major hospitals. The specialty was subsequently recognized as a specialty by the Hong Kong Academy of Medicine.

To qualify as a specialist, one has to undergo six years of postgraduate education and training divided into three years of basic and three years of higher surgical training. In the first part the emphasis is on pre- and post-operative patient assessment and management, including modern modes of imaging, sedation and pain treatment but also on oral diagnosis and surgery. An intermediate examination is conducted at the end of the first three years, which is held in conjunction with the Royal College of Surgeons of Edinburgh. In the following three years, the full scope of the specialty is taught with an emphasis on orthognathic and reconstructive surgery, including pre-implant and implant surgery. At the end of the sixth year, candidates have to sit for an exit examination. When passed, the candidates will receive a FCDSHK (OMS), after which one can be registered by the Hong Kong Dental Council as a specialist in oral and maxillofacial surgery.

In the first decade of this century, two special events took place. In 2006, the Hong Kong Association of OMFS was delighted to host the 7th Asian Congress on Oral and Maxillofacial Surgery. The 19th ICOMS, which was held in Shanghai in 2009, was organized in conjunction with the membership’s Chinese colleagues, with whom we maintain a cordial relationship. The membership is also proud of the positions held by two of their members. First, Nabil Samman served as the president of the Asian Association from 2004–2006, as president of the IAOMS from 2007–2009 and as chairman of the IAOMS Foundation from 2009–2011. He also participated in the editorial board for both associations’ journals and was selected as the editor-in-chief for the International Journal of Oral and Maxillofacial Surgery in 2012. Lim Cheung also served in various capacities in both aforementioned associations.

With the increasing number of qualified specialists, currently 48 for a population of 4.5 million, many of our members have entered private practice but still play an active role in the association. Despite the relatively short history of our association, it has grown into a robust and coherent group, which is friendly within and outside the association. We are proud to have a nationally recognized training program and accreditation and certification processes independent from other countries. This achievement could not have materialized without the pioneering vision of our forbearers and the continuing efforts of all our current members. Ben Chow and Jason Cheng

Meeting of the Hong Kong Association of Oral and Maxillofacial Surgeons in 1997. Front row from left to right: Margaret Comfort, Nabil Samman, Henk Tideman, John Helfrick, Bill Yan, Lim Cheung, John Pang, Lam Way Hay.

Sculpture of Jozsef Arkovy. From left to right: Jozsek Barabas, accompanied by the Dean and Vice Rector of the Faculty of Dentistry in Budapest.

Hungary

Hungarian Association of Oral and Maxillofacial Surgery

As in most continental European countries, oral and maxillofacial surgery began with general surgeons being faced with war victims. The first person to become known to have practiced oral and maxillofacial surgery is János Balassa, a general surgeon in charge of the treatment of gunshot wounds during the Austro-Hungarian War of 1848–1849. The St. Rokus Hospital, built in the 18th century in Pest, was the hospital where all wounded military were treated. Dr. Balassa’s claim to fame was also various types of labioplasties and the surgical treatment of cleft lip and palate. He became the physician of the court.

At the end of the 19th century, one of the most modern medical university complexes in Europe was built in Budapest. The University Stomatological Department was also planned at that time but it was completed only in 1908, with József Árkövy as the first director. After working as a surgeon in Hungary, Árkövy went to London to study dentistry. On returning home, he founded first a private and then the university dental school and in the early years of the 20th century, dentistry was officially included in the medical curriculum.

The Stomatological Clinic had one of the first inpatient wards. World War I led to further advances in the care of facial injuries. The Stomatological Clinic was rapidly filled and it was necessary to convert other treatment rooms into wards and operating theaters. As a result of the tremendous need for treatment of large numbers of patients with facial injuries, the importance of oral surgery became clear not only in Budapest but also in other hospitals throughout the country.

Árkövy retired in 1920 and died as a lonely and somewhat forgotten man in 1922. He was succeeded by József Szabó, who renewed the internal structure of the clinic and broadened the education in maxillofacial surgery. It was thanks to Szabó and his successors and colleagues (Károly Balogh, Ferenc Skaloud and Sándor Orsós) that a national network of units providing oral and maxillofacial surgical care, was built up. By the end of World War II, practically every large county hospital had a ward for oral surgical inpatients.

From the beginning of the 20th century there was an active exchange of science, as related to oral and maxillofacial surgery in Hungary. In recognition of this, the then International Society of Stomatology (L’Association Stomatologique Internationale) organized its congresses in 1908 and 1931 in Budapest.

Books in Hungarian on oral surgery were translated into English, German and Russian. In spite of the post-war hardships, a new lecture room was built at the oral and maxillofacial and stomatology department in Budapest in 1946. This gave a possibility for Károly Balogh, the head of the department, to hold scientific sessions on a regular basis, attended by colleagues from all over the country.

Dental education in the new Dental Faculty began in Budapest in the 1950s and later in the university cities of Szeged (1960), Pécs and Debrecen in the 1970s.

Forming the Hungarian association, Béla Berényi and Imre Vámos from Budapest and Károly Tóth from Szeged were the first professors from behind the Iron Curtain to take an active part in the congresses of the International Association of Oral and Maxillofacial Surgeons. Hungary became affiliated with the IAOMS in 1974.

In 1971, it became officially possible to specialize in oral and maxillofacial surgery in Hungary. At the beginning of the 21st century, the Hungarian specialization system was recognized by the UEMS, the board representing the medical professions in the European Union. The Hungarian association of Oral and Maxillofacial Surgeons, as an independent organization, had been established at the beginning of 1996, its first president being György Szabó. Before that time, it had functioned only as one of the sections of the Hungarian Association of Dentistry, under independent leadership but not with an independent budget. The next presidents of the association were: Adam Kovács, Jozsef Barabás and Lajos Olasz.

The Hungarian association has been very active internationally. Its national congress is held annually, attended by some 200 members. Since 1991, the Danubius Congress is held biannually, in conjunction with all countries through which the Danube flows. It has been held nine times in the subsequent 18 years. These events are recognized and co-sponsored both by the IAOMS and by the European Association for Cranio-Maxillofacial Surgery.

It was one of the great achievements of the Hungarian Association of Oral and Maxillofacial Surgeons to win the bid to organize the 12th ICOMS in Budapest in 1995. Together with the IAOMS, it succeeded in putting on a highly successful congress. It was a remarkable achievement so shortly after the lifting of the Iron Curtain and the organizing committee received many compliments afterwards.

At present, hospital units providing oral and maxillofacial surgery service are functioning in every region of Hungary. Their number is less than it was 15 years ago but they are headed by outstanding specialists with medical and dental qualifications. Both outpatient and inpatient care is available at the four medical universities in Hungary.

As a result of the present severe financial restrictions, only five to six maxillofacial residents receive training each year, though there are many more applicants. The duration of training is six years and the universities are responsible for the training programs.

The six-year maxillofacial training program begins with a compulsory two-year period of dental study; the trainees participate in this together with the undergraduate students. Many of them take advantage of the possibility of extending this two-year period with a further two years in order to also obtain a dental diploma. Unfortunately, these additional two years are no longer financed by the state. Double-qualified maxillofacial and single-qualified oral surgeons are members of the Hungarian association. Training in dentoalveolar surgery is also the responsibility of the universities. The training lasts three years after acquisition of the dental diploma, six months of which must be spent in a university inpatient unit. The ratio of maxillofacial to oral surgeons is 1:5 and at present, there are about 50 maxillofacial surgeons and 250 oral surgeons for a population of around 10 million.

The leadership of the association has so far succeeded in avoiding the separation of these professions.

Very significant roles have been played in the recent developments in oral and maxillofacial surgery in Hungary by the professors at the four university clinics: György Szabó and József Barabás in Budapest, Ádám Kovács and József Piffkó in Szeged, Pál Redl in Debrecen, and Lajos Olasz in Pécs. Joszek Barabas and György Szabó

India

Association of Oral and Maxillofacial Surgeons of India

Mino S. Ginwalla is generally considered as the father of Oral and Maxillofacial Surgery in India. He returned to India in the early 1950s after training as an oral surgeon at McGill University in Canada. Oral surgery was a late specialty in India as it did not have the advantage of war- trained oral surgeons as did Europe and America. Most surgery in the maxillofacial region before the 1950s was being done by general surgeons with an interest in oral surgery.

Ginwalla joined the Nair Hospital Dental College in Bombay (now Mumbai) as professor and head of the department. It was an exciting phase when plastic surgery was also in its infancy. Doyens such as Benjamin Rank (Melbourne) were establishing plastic surgery as a specialty in India under the Colombo Plan. Ginwalla, even in those days, had worked with the pioneer plastic surgeons and encouraged the participation of oral surgeons (as they were then called) in cleft rehabilitation. He started the first post graduate course in oral surgery in the early 1960s; the first generation of oral surgeons in India were mostly his students.

The early oral surgeons were united under a common banner with the formation of the Association of Oral Surgeons of India in 1969. The founding group included the late Mino Ginwalla, C. Dhanasekharan, C. Raju, K. Ramachandran, S. Khera and A. Chitre. Almost all of them had a dental background. Even today oral and maxillofacial surgery is a specialization of dentistry and 95 percent of all maxillofacial surgeons only have a dental qualification.

The association was formally affiliated to the IAOMS in 1977 at the Sydney ICOMS when a few of the members attended the International Congress. By the mid-1970s postgraduate programs were started in most of the main dental colleges including GDC Mumbai, Madras (Chennai), Bangalore, Trivandrum, Hyderabad, Calcutta (Kolkota), Manipal, etc. The AOSI was renamed “Association of Oral and Maxillofacial Surgery (AOMSI)” in 1985.

Today, the AOMSI is a registered organization and admits qualified oral and maxillofacial surgeons as life or annual members. It currently has 1,300 members,

19th ICOMS organizing committee. From left to right: Sanjiv Nair, Krishnamurthy Bonanthaya, Rhoopa and Ravi Hebballi.

most of whom are lifetime members. The association is committed to the promotion of the specialty through its scientific meetings and social causes. The journal is called The Journal of Maxillofacial and Oral Surgery and is the official publication of the association. It is published four times a year from its office in Chennai (changing with the residence of the editor).

The association has two major conventions every year. The annual conference is held in November/December in pre-determined venues around the country. The mid-term conference is focused on postgraduate students and trainees and is a two-day conference held in June/July every year. In addition, the AOMSI officially participates in continuing education programs held by its members in different parts of the country.

The executive committee meets three or four times every year and is the official decision-making body. The AOMSI is officially affiliated to the IAOMS and the AAOMS (Asian Association) and has cordial relationship with all national associations.

The AOMSI has recently promoted an Independent Board to further excellence in oral and maxillofacial surgery by conducting examinations and awarding board certification. The primary collegium of senior surgeons was selected through a point system and admission to the board is through an annually conducted examination.

The 19th ICOMS was held in Bangalore and was a huge success with almost 1,600 delegates from around the world. The AOMSI held a joint conference with the British association in November 2009 at Kochi.

Kishore Nayak is serving as the IAOMS president for the period of 2012–2014. He is the first Indian to be elected to this prestigious post.

The secretariat of the association is located at the place of residence of the Hon. General Secretary of the AOMSI and is presently situated in Madurai, Tamilnadu. George Paul

Indonesia

Indonesian Association of Oral and Maxillofacial Surgeons

Persatuan Ahli Bedah Mulut dan Maksilofacial Indonesia The Indonesian Association of Oral Surgeons was founded in 1973 after 11 oral surgeons came together in Jakarta. These pioneers were already established oral surgeons long before this date: Soedarmadi from Surabaya, Moerniyati from Jogyakarta, Soeriasoemantri, Tet Soeparwadi from Bandung, Pranoto, Subekti, Hendarmin, Eddy Aulia Fatah and Ilyas Darmawan from Jakarta and Geri Panjaitan and Lukito Handriyo from the military.

Education and training hardly existed and was based on an apprenticeship since 1971 in only one center in Bandung. Since 1975, the military had an established training center, which only served their needs. The first national congress took place in 1975 in Jakarta.

It took some years, until 1984, before the government began to see the need for an oral surgery service and formally opened four centers for training at four universities in Surabaya, Jakarta, Bandung and Yogyakarta. In the beginning, there was no uniform training pathway for these centers but currently there is. Training is based on a dental degree but the first two years of the total of five years in training are largely devoted to medicine. The following three years are solidly spent on oral and maxillofacial surgery. The programs are still localized in the four big centers and the total number of trainees is around 120.

The programs are recognized by the Indonesian Medical and Dental Council. The College of Oral and Maxillofacial Surgery keeps an eye on the programs and is responsible for the national examinations and standardization of the curricula in each center.

At the end of the training period, they all have to pass an exit examination that consists of two parts. First, they have to write a paper, which is assessed by two examiners from the College. Second, they have to do an oral examination at which a representative of another surgical specialty is present.

During the last three years, the demand for newly trained OMF surgeons has increased tremendously because of a change in government policy. Each of the 26 provinces is now responsible for its healthcare, which implies that they have to pay for the training of the young doctors in their own district hospitals. This policy is aimed at improving the spread of manpower over this huge country with 1,000 islands and a population of 250 million. The current number of 300 OMF surgeons is mainly concentrated in the large cities, whereas in the rural areas and remote islands, hardly any OMFS service is available.

Memorandum of Understanding signing. From left to right: President of the Indonesian Association, Kresna Adam; Nabil Samman, IAOMS president-elect; Sri Angky Sukanto, Dean of Faculty of Dentistry, University of Indonesia.

In order to raise professional standards, there is a need for international exchange and fellowships. Some but not enough colleagues did gain additional expertise in Japan, Germany, France, Scandinavia, China and several in the Netherlands but we need a lot more input from more advanced countries to raise the level of care in Indonesia. There is a large number of patients with untreated pathology and congenital deformities who badly need adequate care. There is also a need to begin to develop some research projects, as research is the basis for education. We hope to be able to do that with international collaboration. Benny Latief

Iran

No report received.

Ireland

Irish Association of Oral and Maxillofacial Surgeons

The development of oral and maxillofacial surgery in Ireland has had a hesitant start and a somewhat checkered history.

Prior to the establishment of “recognized” oral surgery units in Belfast and Dublin, dentoalveolar surgery was carried out by interested dentists, while facial trauma and head and neck oncology was managed by other specialties. The first oral surgery units on the island of Ireland were established in the Royal Victoria Hospital in Belfast, Altnagelvin Hospital, Derry, Dr. Steevens’ Hospital, Dublin and the Dublin Dental Hospital in the years following the second World War.

Notable figures in those days were Roy Whitlock, John Gorman and Robert Boyd in the north and Ian Findlay, Niall Hogan, Hugh Barry and Frank Allen in Dublin.

These units catered for injuries sustained during the “troubles” of the 1970s and 1980s and the Belfast unit established an international reputation in the management of severe gunshot and bomb blast injuries.

In 1979, Frank Brady was appointed to Dr. Steeven’s Hospital in Dublin as an oral and maxillofacial surgeon, following a period of training in the United States.

In 1984, a training program was established with David Ryan being the first trainer, although he completed his senior registrar training in the United Kingdom. Cliff Beirne and Kumara Ekanayke were subsequent trainees. Following Hugh Brady’s appointment, there were no further appointments at consultant level until 1989, when David Ryan replaced Professor Ian Findlay at the Dublin Dental Hospital and the Mater Hospital.

While the units in Belfast and Derry have thrived with consultant appointments and active training units in both cities, the situation in the Republic of Ireland has not been as fruitful due mostly to the lack of funding and leadership. The OMFS training program was withdrawn from the National Maxillofacial Unit in 2001. Currently, those interested in OMFS careers are required to train in the United Kingdom and United States.

A significant development in recent years, however, was the establishment of a chair in oral and maxillofacial surgery at Trinity College, Dublin in 2003. The current holder of that chair is Leo Stassen. He also heads up the National Maxillofacial Unit at St. James’s Hospital (formerly at Dr. Steeven’s Hospital) with fellow consultants Gerry Kearns, Padraig O’Callaigh, Kumara Ekanayeke and David Ryan. This is a developing unit, covering all aspects of maxillofacial practice, with a doubling of consultant numbers and the imminent re-establishment of a training program backed by the RCSI through its training committee.

Activity of the Irish Association of Oral and Maxillofacial Surgeons lapsed since the heady days of 1980 when the International Association visited Ireland but has resurrected itself with a new group of surgeons from both North and South, involving those who are interested in developing the specialty.

Currently there are eight oral and maxillofacial surgeons in the North of Ireland, four in Belfast and four in Derry. In the Republic of Ireland there are 10 health service appointments, five in Dublin, two in Cork, two in Limerick and one in Galway. The plan is to have 21 hospital appointed oral and maxillofacial surgeons in order to adequately cover the Irish population of 6.2 million, including Northern Ireland. David Ryan

Israel

Israeli Association of Oral and Maxillofacial Surgery

The development of the specialty in Israel began in the mid-1950s, carrying the name of “oral surgery” but as the specialty progressed, it turned into “oral and maxillofacial surgery.” The founding fathers were Jacob Lewin-Epstein, David Gutman and Yochanan Ramon.

Jacob Lewin-Epstein graduated from the Dental School at the University of Pennsylvania in 1944. He completed his postgraduate education in oral surgery at the University of Columbia in New York in 1953. At the establishment of the Faculty of Dental Medicine at the Hebrew UniversityHadassah in Jerusalem, he was appointed as the head of the department of oral surgery. He served in this capacity from 1955 to 1985. In the years 1969–1973, he served as Dean of the Faculty of Dental Medicine of the Hebrew University-Hadassah.

Jacob Lewin-Epstein David Gutman, member of the Executive Committee, 1980–1989, and vice president, 1986–1989 Yohanan Ramon Ofer Mardinger

During Lewin-Epstein’s tenure as head of the department, he had to compete with the disciplines of plastic surgery and ENT for the privileges of the overlapping surgical procedures. The head of surgery, Zaltz, made the “verdict” that all the overlapping surgical procedures with ENT, plastic surgery and general surgery should be performed by those who have skills and most experience. As a result, maxillofacial trauma, orthognathic surgery, salivary glands pathologies, benign and malignant maxillofacial tumors were performed by the staff of OMF surgery. Lewin-Epstein looked also into further training of the younger staff at different centers outside of Israel.

Azaz spent one year in 1963 as a Fellow at Queen Victoria Hospital-East Grinstead, U.K.; Shohat spent a year as fellow at Cleveland Hospital in 1963 and Arie Shteyer spent his last year of his residency program at the University of Kentucky in 1967. Badry Azaz followed Lewin-Epstein as head of the department for the period 1985–1995 and Arie Shteyer from 1995 to 2003. Both of them also served as deans of the Faculty of Dental Medicine at the Hebrew University.

David Gutman completed his residency in oral surgery in Pittsburgh, Pennsylvania, U.S.A. in 1953. In 1955, he founded the unit of OMFS at Rambam Medical Center in Haifa as part of the department of ENT. A few years later, his department became independent, performing all kinds of surgical procedures. Gutman served in the late 1980s as dean of the Faculty of Medicine at the Technion in Haifa. The following head of the department was Dov Laufer between the years 1980 to 2001. He spent two years as a fellow with Hugo Obwegeser in Zurich in the years 1967–1969. As of 2001, Micha Peled has acted as head of the department.

Yochanan Ramon, who was also a general surgeon, founded the department of OMFS at Sheba Medical Center in the late 1950s. He was followed by Shlomo Taicher as of 1986. He completed his residency at the Hadassah Medical Center in 1976 and continued for two years as fellow at NYU in New York.

The association was established in 1964 by the aforementioned pioneers but unfortunately, the exact date is not to be traced. However, it has to be before 1965 since the Israeli association was one of the six associations that affiliated with IAOMS at the 2nd ICOS in Copenhagen in 1965.

As the specialty developed, several other centers were established throughout the country. In 1969, Andre Edlan, who was able to leave Czechoslovakia and to immigrate to Israel, opened a new unit of OMFS within the department of ENT in Beilinson Medical Center in Petach-Tikva. He was followed by Shlomo Kalderon, who completed a fellowship in Miami, Florida.

Daniel Temkin opened a unit of OMFS at Poria Medical Center, near Tiberias, in 1972, within the department of ENT as a single staff member. Temkin had his training in OMFS at Queen Victoria Hospital, East Grinstead and U.K. and completed it at Rambam Medical Center in Haifa. He was head until 2001 and was followed by Zvi Laster, who also spent two years as a fellow at Queen Victoria Hospital, East Grinstead, U.K.

Amos Neder completed his residency program in 1966 at Rambam Medical Center in Haifa. Following that, he gained more experience by practicing in Africa for two years. Upon his return, he opened a unit of OMFS at the Barzilai Medical Center, Ashkelon, serving as head until 1996. He was followed by Oded Nahlieli, who has served as head from 1995 until the present time.

Itzhak Horowitz, completed his residency program at Hadassah Medical Center in Jerusalem in 1968 and did an ENT residency at Sheba Medical Center. He opened an OMFS Unit at Ichilow Medical Center in Tel Aviv, in the mid-1970s, within the department of ENT. He was followed as head of the unit by Gabriel Chausho and later by Benjamin Shlomi.

Now there are seven departments of OMFS in Israel that are accredited to provide training and education in the specialty, including, Poria Medical Center, Tiberias, Rambam Medical Center, Haifa, Beilonson Medical

Center, Petach-Tikva, Sheba Medical Center, Tel Hashomer, Ichilow Medical Center, Tel Aviv, Barzilai Medical Center, Ashkelon and Hadassah Medical Center, Jerusalem. On top of that, several small units have been established throughout the country in order to serve the whole population.

The training program of OMFS was the first in the field of dental medicine in Israel. Until the mid-1980s, the residency lasted three years. As the specialty grew, the program was extended to five years. In 1978, the Ministry of Health acknowledged specialties in other fields of dental medicine, which is controlled by the Scientific Council of the Israel Dental Association. All the residency programs are governed by this Council and controlled by the different boards, in our case the board of OMFS. The five-year program of OMFS consists of rotations in general surgery (six months), plastic surgery or otolaryngology (three months), general anesthesia (three months) and pathology (three months). The actual training in OMFS lasts 3½ years, whereas three months are reserved for research activities.

Upon completion of the program, the resident is entitled to take his final written and oral examination, controlled by the Board of Examiners in Oral & Maxillofacial Surgery. Those who pass the examinations are entitled to a specialty certificate in oral and maxillofacial surgery, which is provided by the Ministry of Health. The holders of the specialty certificate in oral and maxillofacial surgery, which is provided by the Ministry of Health. The holders of the specialty certificate may apply for membership of the Israeli Association of Oral and Maxillofacial Surgeons.

At present, the Israeli association has over 50 full members, for a population of seven million. There are 35 residents in the training programs and approximately seven residents graduate each year. Ofer Mardinger

Italy

Italian Society of Maxillofacial Surgery

Società Italiana di Chirurgia Maxillo-Facciale (SICMF) The first signs of Italian maxillofacial surgery can be traced back to the beginning of the 20th century, coinciding with World War I, when Arturo Beretta established a center for treating soldiers with facial injuries in Bologna (Beretta Institute). This task was entrusted to a general surgeon, Cesare Cavina, who gained considerable experience, using novel techniques that were particularly innovative for that time.

Among Cavina’s disciples, Giuseppe Maccaferri stood out but he left Bologna and moved to Parma University. In 1935, Natale Calabrò succeeded Cavina, continuing his work while expanding the scope of maxillofacial surgery. In 1966, Guido Stea took over the department of Calabrò, moving from the Beretta Institute to Rizzoli Hospital in 1977.

Bologna had been the center where many young surgeons, eager to enhance their experience and training in oral and maxillofacial surgery, were educated and trained and then they spread their work throughout the country. Some of them became chiefs of centers of maxillofacial surgery that gradually developed in northeastern and central Italy. Among them were Giuseppe Rossi in Venice and Camillo Curioni in Vicenza. Other schools in nonuniversity hospitals were those of Giuseppe Ferrari Parabita in Brescia, Franco Torrielli in Genua and Enrico Panzoni in Florence.

During these years, oral and maxillofacial surgery became part of the medical curriculum, mainly thanks to pioneers such as Giosué Giardino and Bernardo Roccia, from the Universities of Naples and Turin and stomatology also developed as a medical specialty in Italy.

Later on, a new generation of pioneers began to establish themselves in other Italian universities, such as Cesare Enrico Pini in Milan, and Giuseppe Maccaferri, followed by Luigi Rusconi in Parma. The next generation developed the specialty further, also thanks to experience gained in renowned foreign centers. As a result, other schools developed, such as that of Remo Modica in Turin, Paolo Gotte in Verona, Constantino Giardino in Naples, Roberto Brusati, who was first in Parma and later in Milan and, finally, Giorgio Iannetti in Rome.

Constantino Giardino created the first official training program in maxillofacial surgery at the University of Naples in 1977. His example was gradually followed by the Universities of Milan Turin, Parma, Verona and Rome. Many students of these universities would occupy new positions that were being gradually built throughout the country, following the evolution of maxillofacial surgery.

Cesare Cavina Natale Calabrò

At that time, many maxillofacial surgeons had a background in stomatology, a medical specialty before dentistry was introduced as an academic study in Italy in 1980.

The enthusiasm of that period led to the birth of two scientific associations; on the one hand there was the ASCMFOI (Association of Italian Hospital Stomatologists and Maxillo-Facial Surgeons), founded in 1965 and formed by surgeons working in non-university hospitals), while the other was the AICMF (Italian Association of MaxilloFacial Surgeons), founded in 1977 and formed by academic practitioners. Both societies organized scientific and cultural events separate from each other, even though their meetings addressed the same problems and developments of maxillofacial surgery. The members of both societies, however, began to feel the lack of mutual contacts and the need for a fruitful cooperation, which would be beneficial for all maxillofacial surgeons.

As a result, during the first congress of the AICMF, held in Naples in June 1978 and during the congress of the European Association for Cranio-Maxillofacial Surgery, held in Venice during the same year when Curioni was president of the European association, Giardino, Curioni and Arlotta began to negotiate the possibility of creating a single scientific society, bringing together all Italian maxillofacial surgeons, both academic and non-academic. In the end, Modica organized the first joint congress of AICMF and ASCMFOI in Saint Vincent in 1979.

Following the joint conferences of 1983 in Gardone Riviera and of 1985 in Ancona, between 1987 and 1989, Constantino Giardino and Pio Arlotta, presidents of the two separate scientific societies, decided to prepare the bylaws of what would later become the Italian Society of Maxillofacial Surgery (SICMF).

In 1989, the sixth National Congress of Maxillofacial Surgery was organized in Genua by Enrico Righi. This actually may be considered the first official Congress of SICMF where both Arlotta and Giardino were copresidents. Since then, the SICMF organizes its national congress every other year on topics of scientific and clinical interest but also dealing with the organizational evolution of specialist training in Italy and the European Union, in collaboration with the UEMS. The SICMF also organizes two thematic and practical training courses per year that are targeted at young colleagues and trainees. At present, SICMF has 307 active members serving a population of about 60 million people.

The SICMF also promotes the publication of its official journal, the Italian Journal of Maxillofacial Surgery, which is published in English. It also published a multiauthored handbook Patologia Chirurgica Maxillo Facciale (Maxillo-Facial Surgical Pathology) in 2007, written by Italy’s leading experts. This book is a reference manual for all those who want to study maxillofacial surgery, both at the medical schools and at the training programs.

During the past 70 years, maxillofacial surgery has grown both in scope as well as in the number of practicing surgeons. At present, there are departments of maxillofacial surgery in many general and academic hospitals throughout the country, while there are 10 post-doctoral training programs for a total of 33 to 35 new residents each year. The duration of the training is five years and includes 2,000 hours of dentistry, as agreed within the oral-maxillofacial surgery section of the UEMS. Only those who have earned a master’s degree in medicine and surgery, which takes six years, may apply.

Since the formation of the European Union in 1993 and because of the treaty of Rome, the recommendation is the promotion of freedom of movement for professionals among the European countries. Thus, there remains one hurdle for Italian OMF surgeons: in most European countries, a master’s degree in medicine and dentistry is a prerequisite for achieving a license to practice OMF surgery, of course after proper training. This precludes the free movement of Italian OMF surgeons to other European countries. The SICMF will continue to work to overcome these problems. Paolo Ronchi

Cover of Italian Journal of Maxillofacial Surgery

Japan

Japanese Society of Oral and Maxillofacial Surgeons (JSOMS)

Dentists gained legal independence from medical doctors in Japan in 1906 when the Physicians and Dentists Laws were published separately. Until then, diseases of the oral cavity had been treated by stomatologists for approximately 1,300 years since the dawn of medicine in ancient Japan. The establishment of the Faculty of Dental Science in Baltimore University in 1840 inspired Einosuke Obata to declare in 1875 that “dental science” should be independent from “medical science.” When the first qualified dentists came on the market, the old-fashioned stomatologists gradually disappeared. Soon, “oral surgery” emerged as a specialty of dentistry.

The Japanese Association of Oral Surgery was established in 1933. From the beginning, the specialty degree “oral surgery” could be achieved via either dentistry or

medicine but the great majority was via dentistry. The history of the JSOMS has been characterized by debate regarding licensing because of major changes in the education system before and after World War II. Before World War II, there was much debate about the scope of medical practice by dentists. But when military medical doctors became scarce during the war, dentists, who followed a condensed medical course, were sent to the battle fields. This was the origin of the double qualification in Japan.

After the war, under the rules of the government of the occupational forces, dentistry became an academic profession and the study was prolonged to six full years, the same as that of a medical university. Programs in oral surgery sprung up throughout the country in both faculties of dentistry and medicine. The JSOMS arose from its post-war dormancy in 1956 with its journal re-named as the Journal of the Society of Oral and Maxillofacial Surgery and has been vigorously active in society since then. Under the administration of the Occupational Forces, dentists were deprived of their right to write a certificate of death but five years later, that right was legally restored and continues to the present.

The specialist system of the JSOMS started in 1973. In the beginning, the JSOMS certified senior specialists and accredits training institutions. To become a senior specialist certified by the JSOMS, applicants must perform surgery as a chief surgeon in a total of at least 100 cases in the categories of dentoalveolar surgery, maxillofacial trauma surgery, orthognathic surgery, temporomandibular

joint related surgery, preprosthetic surgery, cleft lip and palate surgery, reconstructive surgery, implant surgery and surgery for cancer. The examination for the specialists has been carried out every year since 1980. The JSOS came to participate in the activities of the IAOMS in the early 1980s and its name was changed to the Japanese Society of Oral and Maxillofacial Surgeons in 1984. The JSOMS expanded its international activities by establishing the Asian Association of Oral and Maxillofacial Surgeons in cooperation with Korea and Taiwan in 1989. The Asian Association of OMFS came to include the Thai, Philippine, Malaysian and Chinese associations. One of the central concerns of the AAOMS was First issue of Japanese Journal, 1955 the issue of licensing. This issue was resolved in a new formulation in Durban in 2001, where the pre-training qualification was left to the agreement of the regional associations. During this period, the JSOMS had the proud honor to be the first Asian nation to host a conference of the IAOMS: the 13th ICOMS, held in Kyoto in 1997. More recently, there have been two significant developments in the history of the JSOMS. In 2003, the JSOMS was allowed by the government to officially provide certificates for “oral surgery,” the scope of which includes the treatment of malignancies and major reconstructive surgery. The Japanese Board of Cancer Therapy was established for high level treatment of malignant tumors in all fields of medicine in Japan and in 2009 dentally based oral and maxillofacial surgeons were officially permitted to treat malignant tumors. The current membership of the society is 9,266, including 1,755 registered specialists and 792 senior specialists who are responsible for the accredited training institutes and officially qualified to educate trainees. At present, the percentage of OMFS surgeons with both a dental and medical qualification is less than four percent. Both dentists and medical doctors, with at the least six Sixth Asian Congress on Oral and Maxillofacial Surgery. From left to right: José Luis “Pino” Ferreria, IAOMS president; Professor and Mrs. Kenichi Seto. 20th anniversary of sisterhood relationship between the Japanese and Korean associations, 2005.

years of postgraduate training, can take the surgical skill test in certain surgical cases as well as oral and written examinations. They have, however, to be trained in an accredited institution. This examination is rather difficult and includes a logbook of operations performed. There are currently 248 accredited training institutions and each year about 160 trainees pass the examination. Jinichi Fukuta

Kazakhstan, Republic of

No report received. Korea, Republic of

Korean Association of Oral and Maxillofacial Surgeons

The first evidence that patients were treated for diseases of the oral and maxillofacial area stems from the year 1915. Dr. Seok-Tae, along with some others, was responsible for this. The American evangelist and dentist JL Boots and another dentist, McAnlis, began to work in the dental department of Severance Hospital in Seoul in 1921 and they also carried out oral surgery.

The first dental school was established in Korea in 1922 but it was only after World War II that oral surgery was taught at Seoul National University by Professor ChunGeon Lee and his staff. They began a Master’s course in 1952 and the first students graduated in 1956. From 1959 onwards, the dental curriculum was extended to six years.

The Korean Association of Oral Surgeons was established in June 1959. Oral surgeons from the U.S. army, such as Alling, Shira and Cooksey and some Japanese colleagues participated in scientific meetings and contributed considerably to the advancement of the specialty in Korea.

In the early 1970s, the deans of the then three dental schools met several times and set the standards for education and training of oral surgeons. The association also published a journal from 1975, which is currently published bimonthly.

The association was renamed the “Korean Association of Oral and Maxillofacial Surgeons (KAOMS)” in 1984. A committee of chair professors of departments of OMF surgery of the then 10 dental schools once again formulated guidelines for training and education of OMF surgeons in 1987. They also published a translation of the “Textbook of Oral and Maxillofacial Surgery” from Kruger into the Korean language. This book became the standard text for residents in training.

At present, the training is based on a dental degree and takes four years. Residents in training receive additional medical education and training in the first year. The whole scope of the specialty, including the treatment of malignancies and their reconstruction, much along the lines of the Guidelines of the IAOMS, is covered during the training. There are currently 48 institutions involved with the training of 71 residents.

The association has about 750 active members, spread all over the country. They serve a population of 48.5 million people. The 50th anniversary of the KAOMS was celebrated in 2009 in Seoul with a scientific congress. The KAOMS is determined to further advance and promote the specialty in Korea but also in Asia and beyond. Thanks to the vision and inspiration of the pioneers of KAOMS, the specialty has gained the current status and position. Kyung-Wook Kim

Participants at the 12th Congress of the Korean Association, 1970.

Participants at the 50th Anniversary Congress, 2009.

Latvia

Latvian Association of Oral and Maxillofacial Surgery

The Latvian Association of Oral and Maxillofacial Surgery was established in 1995 by 19 stomatologists, who had different backgrounds. Most of them had acquired their training in surgical stomatology in either Moscow, St. Petersburg or Kiev. Since 2000, however, the specialization is based on a dual degree and five years of postgraduate training. This is in accordance with the recommendations of the EACMFS and implemented with the support of Rudi Fries, former president of the EACMFS and IAOMS. The first president was Andrejs Skagers.

Members of the staff of the department in Riga. Front row from left to right: Natalija Grasmane, Biruta Barkana, Addrejs Skagers, Ilze Akota, Marina Sevastjanova. Back row from left to right: Girts Salms, Egils Kornevs, Kaspars Stamers, Aldis Rozenblats.

Historically, Latvia and particularly Riga, have played an important role in the development of oral and maxillofacial surgery. Early pioneers in the 19th century were Alphonius von Szymanowski and Nikolay Pirogoff, the latter well known for his rhinoplasties.

The academic education in the specialty was introduced in 1920 when the University of Latvia was founded, including a medical school which also had an Institute of Stomatology. The department of surgical stomatology was established in 1944, with Ilja Leja as its first chairwoman. She was followed by successively Vladimir Aronson, Astra Linare, Indulis Bakulis and finally Andrejs Skagers, who has served in that position since 1978.

Currently, the Paul Stradins University in Riga provides the undergraduate and postgraduate training of OMF surgeons. The department of oral and maxillofacial surgery is responsible for this training. It also entails rotations at the Latvian Cleft Centre and the Latvian Oncology Centre. Residents also have the opportunity to rotate through centers outside Latvia such as Cardiff in Wales, Helsinki, Gothenburg, Rostock, Oslo and Lyon.

The Latvian Association has 35 active members serving a population of 2.2 million people. There are six residents in training. All members of the association are also members of the Baltic Association of Maxillofacial and Plastic surgery and some are members of the EACMFS and/or the IAOMS. The main activities of the association include certification and recertification of specialists, the latter every five years. There are regular meetings held and the association has an advisory voice both to the Latvian Medical Association and to the Ministry of Health. Andrejs Skagers

Lithuania

Lithuanian Association of Maxillofacial Surgery

The Lithuanian Association was established in 1995 and Pranas Tercijonas became its first president, a position he still holds. Many of the members are also members of the Baltic Association of Plastic and Maxillofacial Surgery and the European Association for Cranio-Maxillofacial Surgery, while LAMFS became affiliated with IAOMS in 1995.

LAMFS has honorary, associate and affiliate members and candidate members; the latter category is for trainees. Full members are those who are registered maxillofacial surgeons, while oral surgeons are associate members. They have voting rights and count for 50 percent of the total membership. Affiliate members can be physicians working in the same field but who are not registered maxillofacial or oral surgeons.

Lithuania, with a population of 3.6 million, has two training centers, one at Kaunas Medical University and one at Vilnius Medical University. A dual degree is necessary to become a maxillofacial surgeon. If dentistry has been done first, he or she has to do medicine first before the training can begin, which lasts three years. If medicine is the first diploma, dentistry is included in the training period, which will then take five years. Oral surgery can be done after achieving a dental diploma and requires three years of training. There are currently 29 maxillofacial surgeons and 20 oral surgeons. Each year, four to six oral surgery trainees are accepted and two to four maxillofacial trainees.

The association is quite active with the organization of three scientific meetings a year. The board of LAMFS is supported by a council that has executive power. Danius Razukevicius

Members of the staff and trainees of the department at Vilnius University.

Members of the staff and trainees of the department at University of Kaunas.

1st Asia Pacific Congress on Craniofacial Distraction Osteogenesis, 1998, Langkawi.

Malaysia

Malaysian Association of Oral and Maxillofacial Surgeons (MAOMS)

The idea of forming a Malaysian association of oral surgeons began with discussions among colleagues at the Ministry of Health and the University of Malaya, Kuala Lumpur. It was deemed necessary to establish such an association so as to have a forum for discussions related to the specialty, and to promote its development and progress. The formal meeting to approve the idea was held in December 1995, although the official registration did not take place until March, 1996.

The first general assembly and scientific meeting took place in December, 1996 in Kuala Lumpur. At this meeting the constitution was drafted and later approved. At that time, some 15 members were present.

Since that first meeting, scientific meetings were held each year along with general assemblies. Speakers from the region, Europe and the U.S.A. were invited to present the newest developments in the field of oral and maxillofacial surgery. Several courses and symposia were also organized with the intention of educating our membership. A highlight was the international symposium on craniofacial distraction osteogenesis, which was held in 1998 on the island of Langkawi. Several leading international clinicians were invited and it was a huge success.

The association has currently some 120 members, the vast majority having a dental degree only but there are 11 dually-degreed colleagues and their number will increase as some are in the process of acquiring a medical degree. Training of new specialists was traditionally based on sending them overseas, notably to the U.K. This has now largely been replaced by national training centers, one at the University of Malaya in Kuala Lumpur and one at the University Sains in Kelantan.

The training is organized along the lines of a master’s degree and takes four years. Each trainee has already worked for three years as a general practitioner, as required by the government. After that he or she can sit an entrance examination to the master’s program. This entails basic sciences, a research component and medical rotations in anesthesia, ENT and plastic surgery. The OMFS part covers the full scope of the specialty but after the master’s degree, additional training has to be done for at least six months, under supervision but can be prolonged as deemed necessary. At present, some three to four trainees finish the program each year but soon that number will increase to seven or eight.

An important event took place in 2001 when the Malaysian Journal of Oral and Maxillofacial Surgery was launched. It is the aim of the association to elevate the quality of patient care and to promote the advancement of practice and education by this publication.

Since its establishment, the association has seen a dramatic improvement in the scope of the specialty. This is well demonstrated by the microsurgery course that was presented in 2007 by Zhang Chen-Ping and his staff from Shanghai Jiao Tong University. It was particularly directed towards better reconstruction possibilities for patients with oral cancer.

The MAOMS hosted the 9th Asian Conference on Oral and Maxillofacial Surgery at the end of 2010. This was the second time that this honor was granted to the MAOMS.

As our membership gradually increased, some members became actively involved in charity work not only within the country but also overseas, notably in Cambodia, Sri Lanka and Bangladesh.

The growth and success of the association has largely been due to the initiatives, self-sacrifice and dedication of the successive executive committees headed by the presidents Sharifah Fauziah, Michael Ong, Wan Mahadzir, Kelvin Lim, Ong Siew Tin and Zainal Ariff. Wan Mahadzir

Inaugural issue of the Malaysian Journal of Oral and Maxillofacial Surgery Sharifah Fauziah, president of the Asian Association, 2008–2010

Mexico

Mexican Association of Oral and Maxillofacial Surgeons

Asociacion Mexicana de Cirugia Bucal y Maxilofacial In the 1940s, orthopaedic surgeon Zimbron was the first to perform surgery on patients with facial injuries. Learning from the experience of this surgeon, two dentists, Gomez and Lugo, assisted by Lavalle, began to teach these skills at the National School of Dentistry. Early beneficiaries of this training were doctors Miranda, Obregon and Oliva. From there, Obregon took charge of the dental and dentomaxillary service at the National Medical Centre. This led to the start of a residency program with two initial trainees. Other hospitals gradually developed training programs throughout the period of 1965–1975.

The first professor and departmental head appointed at the 20th of November Hospital was Soto. He subsequently moved on to the pediatric unit at the Centro Medico Naciaonal and later to be Chief of the Hospital Service de la Raza. He appointed Tavara to develop a residency program at the 20th of November Hospital ISSSTE, where from 1966–1986, he was Chief of OMFS and Professor of the Postgraduate Course in OMFS, a position he held until 1976, when he was succeeded by Mogel (1976–2003). Romero currently holds the chair and the program director is Pacheco.

Another important figure in the development of the specialty was Vidal, who, as well as being National Coordinator of Education in Dentistry, also served as the president of the Federal District Dental Association and president of the Mexican Dental Association.

This was a time of development of various training programs, notable amongst them being the one led by Torres in the Hospital Juarez. Here, despite only having a dental qualification, he was involved in teaching residents of orthopaedics and trauma about the management of facial injuries, as well as being responsible for the treatment of these cases.

Torres, without the advantage of modern means of communication, achieved a very significant advance in the management of maxillofacial injuries in Mexico. He created a renowned school both for his own trainees but also for all the programs in Mexico. He was a pioneer in the publication of modern techniques and wrote more than 50 articles. He was the pillar of union of all departments and responsible for the formation of the Council of the Mexican Association of OMFS.

Several new training programs were established at this time and in 1996, an agreement was signed between the three institutions to ensure that henceforth, these institutional programs would carry the recognition of the Universidad Nacional Autonoma de Mexico. This agreement was signed by the authorities of each of the Institutions and also by the government of the university. Rodriguez was appointed as the general coordinator of the training programs.

Orthognathic surgery was started at the National Medical Centre by Palomera and Fujikami. This was expanded to the creation of a cleft center with the appointment of Padilla.

Throughout this period of development of the specialty in Mexico, significant use was made of overseas speakers during annual national congresses, with many of the notable world authorities contributing. Most importantly, from 1989 onwards, a close integration with the Spanish society developed, which enabled teaching programs and workshops to be held; accomplishments which not only

Head panel at the 2008 Congress.

Attendees of the AMCBM Congress, 1978.

have greatly enhanced training, they also linked them with the outside world and all in the shared language of Spanish.

In 1994, an important change of status occurred when, after many years of the association being based within the capital of Mexico City, the association’s name and operating mode were changed to that of a national association under the presidency of Valenzuela. This meant that both the Chairman and Board members could come from anywhere in the country. In 2002, under the administration of Garcia, the name was changed from association to college and regulations were implemented which still stand.

A further link of importance was established when Garcia was president and Pino Ferreria president of the IAOMS. Garcia was also prominent within Mexico as head of department at the Medical Specialties Centre of the Government of Veracruz, which included the State cleft lip and palate service.

The association maintained partnerships for regulation and standards in compliance with the General Secretary Professions and consequently achieved the Federal Government’s recognition of the Mexican College of Oral and Maxillofacial Surgery, officially representing the entire professional guild. Additionally, there is a Mexican Council of OMFS, which is a civil partnership whose function is to improve the teaching practice in Mexico. Its main purpose for our specialty is to certify foreigners who wish to practice in Mexico. The association has, thus, gained recognition for the specialty at the highest possible level within Mexico. Cesar Villalpando

Moldova, Republic of

No report received.

Mongolia

Mongolian Association of Oral and Maxillofacial Surgeons

Oral and maxillofacial surgery was first recognized as a medical specialty and approved by the Minister of Health, on August 24th, 1971. The first oral and maxillofacial surgery department was officially opened in the Central Hospital in the capital, Ulaanbaatar. Since that time the specialty has evolved and great advances have been made in the last 28 years.

The pioneers of Mongolian OMF Surgery are doctors Selee, Tseren and Natsagdorj. They received great help from former USSR consultants doctors B. Pavlov 1962–1965, F. Saifullin 1964–1967, I. Fediyaw 1969–1971, A. Rukovishnikov 1982–1983, and K. Zamiyatin 1985–1989, who trained Mongolian colleagues.

At present, there are three major departments located in the Central Hospital, Maternal and Child research center and Central Oncology Hospital in Ulaanbaatar. In addition, there are several private practitioners. The new generation of Mongolian oral and maxillofacial surgeons is largely trained in Korea, Japan, Russia and the U.S.A.

In 1998, the Mongolian Association was established with a clear mission statement. The first president was Natsagdorj and first general secretary Dolgorsuren. Since 2009, Khentii is the president of MAOMS and Gantumur the general secretary.

Mongolia is a vast country that is sparsely populated (approximately 3 million). The majority of the people live in the capital and only about 1 million live in the rural areas. That is the reason why OMF surgery is concentrated in Ulaanbaatar.

Currently, the training and education is based on a dental degree. Candidates have to sit an entrance examination and must have two years of practical dental experience. There is only one training center located in Ulaanbaatar. The training period is one year but preparations are underway to expand this period.

In 2009, MAOMS was officially affiliated with IAOMS and sent delegates of MAOMS to international and regional congresses. MAOMS organized its first national congress in October 2009, discussing its future.

The MAOMS is determined to maintain the high standards of oral and maxillofacial surgery in Mongolia and to support the training of our members abroad. Gantumur Tsegmed

Attendees of the founding of the Mongolian Association of Oral and Maxillofacial Surgeons.

The Netherlands

Dutch Association of Oral and Maxillofacial Surgery

Nederlandse Vereniging voor Mondziekten, Kaak-en Aangezichtschirurgie (NVMKA) The development of the specialty began relatively late in the Netherlands. That had largely to do with the fact that the Netherlands was not involved in World War I and, thus, there was no need for the care of wounded soldiers as in most other European countries. World War I gave

an enormous impetus to the specialty, in that there was a great need for treatment of soldiers with facial gunshot wounds, including fractures of the maxillofacial skeleton.

In this context, it is of interest that the pioneer of Dutch oral and maxillofacial surgery was Johannes Esser, who had a medical degree from the University of Leiden and a degree in dentistry from Utrecht Dental School. He trained in general surgery in Utrecht and followed a course in “war surgery” in Paris in 1914. He offered his service to France and England but was turned down by both countries, which was reason for him to turn to the Austro-Hungarian monarchy, where he was accepted as an army surgeon.

Esser became a well-known and much respected maxillofacial surgeon, who developed pedicled flaps, based on feeding arteries, to cover defects in the face. This way he was able to treat large defects in the face with, for those days, exceptional good results. He deserved an honorary doctorate at the University of Berlin because of his groundbreaking work in the field of reconstructive surgery. After the war he established a surgical practice in Berlin but the economic downturn forced him to return to the Netherlands. Despite his widely known reputation, he did not succeed in finding a suitable job in the surgical world. He finally emigrated to the U.S.A. in 1940, where he lost all his money and died in 1946 as a poor and forgotten man.

The first head of a department of oral surgery and diseases as it was called in those days was H. de Groot, an ENT surgeon. He passed away at a relatively young age and was followed by Jeramiah Tjebbes, who was appointed an associate professor in 1932. He had training in general surgery and was educated in dentistry at the school in Utrecht. It was his responsibility to teach dental students at the only dental school in the Netherlands at that time.

The further development of the specialty was severely hampered by the German occupation. Tjebbes worked under the most difficult circumstances with a minimum of staff. Dental students were not allowed to study anymore and the university hospital was hardly operational during the last years of the war. Yet, Tjebbes had established himself very well and became an expert in cleft-lip and palate surgery. Immediately after the war, he was appointed full professor and became head of a department of oral and maxillofacial surgery. He would chair this department until 1973.

The person who would be instrumental in the establishment of the Dutch association was Martin Hut. He was a dentist with an affinity to oral surgery and worked in the general surgery department of the University of Groningen. During the war he and a group of influential dentists had prepared a memorandum for the post-war Dutch government that suggested giving dentistry an academic status. The recommendations of this group were accepted and in 1947, the law was changed so as to make dentistry an academic profession. This also had an enormous impact on the scope of dentistry, which from then on also included oral surgery in its broadest sense.

Hut began a department of oral surgery at the University of Groningen, which had also acquired a new school of dentistry, to combat the dramatic shortage of dentists that existed after the war. He also began a training program in oral surgery. From the beginning of his activities, there were frictions with stomatologists, who at that time were medical specialists. Their register had been closed, however, by the Dutch Medical Association, because of the new dental specialty. The Dutch Medical Association tried to bring together the two pioneers with a different background, Tjebbes and Hut, but that initiative failed for unknown reasons. Hut, frustrated by the battles he had to fight, established the Dutch Association of Oral Surgery in 1956 and became its first president.

From the beginning the association fared well, despite the fact that its members came from different schools. Its membership grew within a few years from a handful to more

Dutch association board. Front row from left to right: Erik Baas, Twoine Rosenberg and Theo Hoppenreijs. Back row from left to right: Steven Zijderveld, Fred Rosenberg, Egid Hannen and Rolf Bun.

Jeramiah Tjebbes after his valedictory lecture in 1973 in Utrecht. He has just received a decoration from the Queen. Martin Hut

than 50 full members. The training capacity was expanded along with the opening of three more dental schools in Nijmegen (1959) and two in Amsterdam (1960 and 1968). This caused an enormous increase in the number of dentists but also an increased demand for specialists. The Dutch population after the war also doubled in a matter of 40 years, which explains, in part, the growing needs. The increased motorized traffic and the demand for elective surgery, for instance preprosthetic and orthognathic surgery, also contributed to the fast growing demand for OMF surgeons.

In the early 1970s, some members of the association began to worry about the pressure from some medical, neighboring specialists, who tried to limit our activities to the oral cavity. At about the same time, the UEMS section on stomatology and oral and maxillofacial surgery began its meetings in Brussels to try to harmonize the education and training in the different European countries. It soon became clear that Dutch colleagues would become isolated if they would not adopt the mainstream European training pathway, which required a medical and a dental degree.

In the meantime several oral surgeons, as they were called until 1986, had begun their medical studies and indeed received medical degrees. With the arrival of Peter Egyedi and later Hans Peter Freihofer, the departments in Utrecht and Nijmegen pushed for a “double degree.” This course of events made the time ripe for a fundamental change in the education and training of oral and maxillofacial surgeons in the Netherlands. The “Guidelines,” as formulated by the IAOMS in 1992, were instrumental in receiving official permission from the Dutch government to require a medical and dental degree before one could be registered as a specialist oral and maxillofacial surgeon. Officially this became effective in 2000, but most trainees had already done their medical and dental studies before that time.

At present, the Dutch association has more than 200 full members, for a population of 16.6 million. There are eight university departments with training capacity, whereas eight general hospitals are also involved in the training of approximately 12 residents each year. The official training period is four years and follows a rather strict protocol. In general the programs follow a stepwise learning curve, covering all aspects of the profession. The trainees keep a logbook that needs to meet the minimum demands as laid down in a document produced by the association.

In the first year a surgical examination, organized by the Dutch College of Surgeons, needs to be taken, which is required for all surgical specialties. The training can only be continued when the trainee passes this examination. In the following three years they have to follow two-day courses, twice a year, which deal with special topics. These courses are organized nationwide and are followed by examinations that also need to be successfully completed. There is no exit examination but the European board examinations are highly recommended if one wants to make an academic career.

When the trainee wants to incorporate oncology in his or her armamentarium, another two years will be required. Oncology of the oro-facial area is limited to the eight university hospitals and some of the large regional hospitals. The surgeons who carry out the surgery need to be recognized as oncologic surgeons.

In general, the Dutch association is fairly active in that scientific meetings are held twice a year, while every five years this is done in conjunction with associations of neighboring countries. The universities are not only the principal institutions responsible for training but are also supposed to encourage research. This is often done either before training has begun but may also be done afterwards. The Dutch colleagues have contributed substantially to research in various areas of OMF surgery, particularly in the last 25 years.

The association became affiliated with the IAOMS from the early beginning and went “vertical” in 1998. There were two Dutch presidents of IAOMS; Bill van der Kwast (1977–1980) and Paul Stoelinga (2001–2003), whereas Geert Boering and Isaac van der Waal have been long-term councilors of the Dutch association to the IAOMS.

Membership in the European Association for CranioMaxillofacial Surgery is also encouraged. Paul Stoelinga

Nigeria

Nigerian Association of Oral and Maxillofacial Surgeons

In the period before independence there was hardly any specialization in medicine or dentistry. Things changed for the better with the founding of the University of Ibadan (UCH) in 1948. It started as an affiliated College of the University of London. With the establishment of UCH, many medical experts were deployed from the U.K. to Nigeria. One of the lecturers in surgery was Horatious Oritsejolomi Thomas, a Nigerian, who showed a keen interest in maxillofacial surgery and operated on cases coming from all parts of the country at UCH, between 1952 and 1962. Thomas moved to Lagos in 1962 and became the founding Dean of the College of Medicine of the University of Lagos, where he was largely responsible for maxillofacial surgery.

The first appointment of a trained maxillofacial surgeon was that of Akinosi, as a lecturer in surgery and a

consultant maxillofacial surgeon at the UCH in 1966. He established a maxillofacial unit in Ibadan, which became well known all over the country.

When the civil war broke out in 1968, the Federal Government of Nigeria, in response to the large numbers of casualties with hideous facial and jaw injuries, established an emergency maxillofacial surgery unit in the Military Hospital in Kaduna. This unit was set up by a tripartite arrangement of the Ministry of Overseas Development of Britain, the Royal Air Force and the Nigerian Armed Forces Medical Services. It was later ceded to Ahmadu Bello University. Experts were recruited from the U.K. and they came for short periods. Among the experts were: Terence Ward, Michael Awty and Peter Banks. Adekeye was the Nigerian counterpart for this program. By the end of the war, he continued to carry out maxillofacial surgery and trained many maxillofacial surgeons in this center.

Since 1962, several dental schools have been established and this has resulted in increased possibilities for the training of oral and maxillofacial surgeons. Today, training of OMF surgeons is available in nine teaching hospitals in the country. The training takes at least six years and begins with one-and-a-half years of basic medical science. This is followed by a primary examination by one of the two colleges. The candidate then has to rotate through departments of medicine, surgery, anesthesia, ENT and the emergency department for a period of one and half years. He or she then has to pass part one of the college examination, which consists of written, clinical and oral parts.

The actual OMF surgery training takes three years and covers the full scope of the specialty. This is concluded by part two of the college examination. There are two colleges involved, one is the West African College of Surgeons, and the other is the National Postgraduate Medical College of Nigeria. The candidate may choose the college he or she prefers. Both certificates are recognized by the health authorities. The number of trainees depends on the capacity of the training institution and is not consistent. At present, there are some 30 residents in various stages of training.

After a series of meetings and consultations, spearheaded by Arotiba, the Nigerian Association of Oral and Maxillofacial Surgeons (NAOMS) was formed in Lagos at the School of Dental Sciences, College of Medicine, University of Lagos on October 31, 1993. Election of the executive officers, amendment and ratification of the constitution were conducted in Ibadan on April 16, 1994. There were, at that time, about 40 members. Today, we have 75 members serving a population of approximately 100 million people. In 1995, the NAOMFS became affiliated with the IAOMS.

The activities of the association were curtailed by lack of funds in the turbulent political years of 1993–1998.The inaugural conference and the first scientific conference was held at the Lagos University Teaching Hospital in 2004. Since then, the scientific conference is held biannually. The association hosted the third conference of the African Association of Oral and Maxillofacial Surgeons in Abuja, in 2008. The immediate past president of the IAOMS, Nabil Samman, Paul Stoelinga and other international speakers were in attendance. Since becoming affiliated, the NAOMS has always been well represented at IAOMS conferences. Gwenba Ogunlewe

Norway

Norwegian Association of Oral and Maxillofacial Surgeons

The Norwegian situation is rather complicated since there is a medical and a dental specialty dealing with the same field. There are, of course, historical reasons for this that date back to the beginning of the 20th century. A pioneer of Norwegian OMF surgery is Sophus Lossius, who had an American dental degree and a Norwegian medical degree. He initiated a medical specialty called “dental and maxillofacial surgery,” later called “maxillofacial surgery and oral diseases.” The Norwegian Dental Association, in 1952, decided to recognize two dental specialties, including

Participants and guest speakers at the conference of the Nigerian Association in Abuja, 2008.

Sophus Lossius From left to right: Bjorn Bjercke, Eigil Aas, Gilhuus Moe, three pioneers of the Norweigan Association

dental surgery and orthodontics. Sophus Lossius opposed this move despite the fact that he was the first chairman of the department of maxillofacial surgery at Ullevål University Hospital until 1949 and professor at the dental school in Oslo until 1961.

A second dental school was opened in 1962 in Bergen and a third one in Tromsø in 2004. At these dental schools, departments of dental and oral surgery were also established.

Many Norwegian specialists, both single- and double-qualified, have had part of their training abroad, particularly in the U.S.A. and the U.K. There has also been a lot of interaction with the other Scandinavian countries, while the Scandinavian Association has had connections and combined meetings with the British, Dutch and German associations.

The teaching, training and supervision of dentally based specialists are confined to the three university departments but obligatory hospital experience of at least one year is required. This implies that the three university hospitals with OMFS departments (two in Oslo and one in Bergen) are responsible for this part of the training. These departments are often led by medical specialists. In the past, several chairmen of the OMFS departments at the university hospitals were also chair professors at the dental schools. That facilitated the rotations in the hospitals for the trainees with a dental degree.

In Bergen, formal arrangements were made in 1973 to secure these hospital rotations. The actual training consists of a five-year, full-time program, including medical education, which also entails rotations through departments of ENT, plastic surgery, general surgery and anesthesiology. Certification will be granted after final examination and a written paper.

Training and education for the medical specialty “maxillofacial surgery and oral diseases” is only available in Oslo at Ullevål Hospital. It includes a four-year program at a department of maxillofacial surgery and two years of rotations through ENT, plastic surgery and neurosurgery. A dental degree is no longer mandatory but will be recognized for a maximum of one year in each part of the training.

At present, some 10 departments of OMF surgery exist in so-called county hospitals. Cities like Ålesund, Arendal, Molde, Bodø and Stavanger now have this service.

The foundation of the current association is largely thanks to Olaf Grythe, who was a member of the committee that decided on the two dental specialties in 1952. He was the first president of the association that at that time only had four members. The name change from dental surgery to oral surgery took place in 1970 and to oral surgery and oral medicine in 1997. Presently, the association has 60 active members and 17 trainee members. The Norwegian Association of Maxillofacial Surgeons has 12 ordinary members; some of them are member of both associations. All together, they serve a population of 4.6 million

Like anywhere else, the scope of the specialty has expanded, which in part explains the need for more specialists. Single-qualified colleagues in hospitals often work together with colleagues from ENT, plastic surgery, neurosurgery and orthodontics in cases of cancer surgery, trauma, reconstructions or treatment of cleft lip and palate. A special topic in Norway is auto-transplantation of teeth, which has a long tradition Since the 1960s, about 1,500 tooth transplantations have been carried out in Oslo.

Despite its relative small size, the association is fairly active and holds yearly meetings. This comes on top of the yearly Scandinavian meeting that also attracts many Norwegian participants. Arne Groenningsaeter

Pakistan

Pakistan Association of Oral and Maxillofacial Surgeons

The Pakistan Association of Oral & Maxillofacial Surgeons (PAOMS) was founded in Karachi in 1994 by four OMF surgeons: Ajaz Aqeel, Mervyn Hosein, Mahmood Haider and Mansur Ahmed. Today, its membership is still limited to approximately 70 members. The association has been affiliated with the IAOMS since 2003.

Mervyn Hosein making his presidential address. Members of the Panamanian Society of Oral and Maxillofacial Surgeons.

The specialty of OMFS is typically dentally based in Pakistan. Specialist training consists of a structured four-year program followed by a fellowship examination. Some universities in the country also offer MDS and MSc courses in oral surgery.

With a population of 160 million, Pakistan is a large country with a dentist-to-population ratio of 1:26,000. There are plenty of patients with oral diseases, trauma, jaw pathologies, developmental defects and infections to be dealt with by the profession.

The specialty only took off in the early 1990s and most of the practicing surgeons are foreign trained, however, there is a new breed of specialists that are trained in Pakistan and their numbers are rapidly increasing. Overall, there are four training centers offering a residency in OMF surgery at various institutions. At present, the overall number of trainees may not have reached more than a couple of hundred but the quality of training is of a certain standard.

The PAOMS is entrusted to promote the cause of the specialty through its role in training, research and development of the profession and to protect the interests of its members. Seeking to broaden its membership base, PAOMS is also trying to promote itself on the international stage and affiliation with the IAOMS was our first step in that direction.

The first and second annual meetings were held in Karachi in 2003 and 2004. These were well organized and attended events but subsequent meetings have not been held apart from local meetings. The PAOMS, however, plans to develop a larger membership base, arrange regular annual events and regional meetings and to have a website. We would also like to have more representation in national, regional and international platforms.

We are happy to be part of the bigger picture and hope to learn and contribute to the development of the specialty on a global basis. Mahmood Haider

Panama, Republic of

Panamanian Society of Oral and Maxillofacial Surgeons

No report received.

Paraguay

Paraguayan Association of Oral and Maxillofacial Surgeons

Sociedad Paraguaya de Cirugia Buco Maxilofacial Oral surgery in Paraguay began earlier than 1958 but the first records regarding oral surgery are from this year, specifically from June 13, when the local Circle of Paraguay Dentists founded the Paraguayan Society of Oral Surgery, whose initials were SOPAC, as a subsidiary of the local Circle of Paraguay Dentists. The foundation charter was signed by doctors Guido Ciotti, Victor Boettner, Anthony Solomon, Norman Zavala, Fernando Gonzalez, Nicolas Pangrazio, Reinaldo Mayans, Miguel Barreiro, Juan Rios, Bittar Carin Ruben Ditore, Victor R. Vera V., Bianchi and Pierpont Insfran Homer.

Days later, the first board of directors was assembled with Pierpont Insfran (1958) installed as president and reelected in 1962. During his tenure, training sessions, institutional initiatives and scientific relations were all instituted with other countries. Insfran was succeeded as president of SOPAC by Artemio Salerno Netto in 1966.

In 1967, the society was partially renewed under the vice presidency of Reinaldo Mayans, when the association changed its name to the Paraguayan Society of Oral Surgery, SOPACIBU. In January 1968, a note from the Latin American Association of Oral Surgery mentions the draft of statutes by the society with the appointment of Caesar Franco and Antonio Nicolas Pangrazio as the authors. No further meetings took place until 1969.

In May 1968, Enrique Müller invited local oral surgeons to a five-day didactic and practical course. It was the first course of its kind in the area and it was duly recorded at the local Circle of Dentists in Paraguay along with the installation of the first dental team.

In 1969, Artemio Salerno Netto was again elected president.

From the aforementioned dates, a continued relationship with the Latin American Association of Oral Surgery was verified.

In 1973, Guido Ciotti, president of SOPACIBU, appointed Antonio Nicolas Pangrazio as the representative of the Paraguayan Society of Oral Surgery to ALACIBU. Months later, Pangrazio distinguished himself through his participation in the ALACIBU Congress. At that time, preparations were being made to integrate the words, “maxillofacial and traumatology” into the name of the specialty.

In 1975, President Guido Ciotti reported that ALACIBU appointed SOPACIBU as a member of the Arbitrator Tribunal, which included Venezuela and Mexico.

In 1976, Nicholas Pangrazio assumed the presidency. The minutes for this period reflect the significant scientific activities going on, including the number of oral and maxillofacial surgeons from Paraguay who completed their training abroad in countries like Argentina and France. During this time, Enrique Müller of Argentina, a former ALACIBU president, was appointed an honorary member of the society for his continued contributions and support of the specialty in Paraguay.

In 1979, Pierpont Infran is elected president at a time when many society members become more involved in both national and international scientific courses and congresses.

Victor Raul Vera Verci was elected president in 1981 of the now named Paraguayan Society of Oral & Maxillofacial Surgery. Vera Vierci, who had already distinguished himself in the area of surgery and traumatology at the Primeros Auxilios Hospital, laid down the foundation for what is now the surgical service of oral and maxillofacial traumatology in the Medical Emergency Center, under the Ministry of Public Health and Welfare.

From 1988 to 1998, Ezequiel Gomez Ocampo served as the society’s president, overseeing the very successful Cono Sur Americano Congress in Paraguay.

From 2006 until the present day, Carlos Mallorquín has served as president, focusing on drafting the statutes of the specialty, with daily practice parameters, as well as conforming to applicable national laws. The society also voted through the name of the Paraguayan Society of Oral Surgery and Oral and Maxillofacial Traumatology. Under Mallorquin’s direction, in 2009 and 2010, several very successful educational extension courses in oral and maxillofacial surgery, sponsored by the IAOMS and endorsed by ALACIBU took place, featuring educators from around the world.

Organizers of the 2nd Congress, 2004.

Organizers and speakers at the IAOMS Educational Course in Encarnación, 2009. Carlos Mallorquin Buey

People’s Republic of China

Chinese Society of Oral and Maxillofacial Surgery

The Chinese Society of Oral and Maxillofacial Surgery (CSOMFS) was established in December 1986 at the initiation of Qiu-Wei Liu. Before that time there was a professional group of oral and maxillofacial surgeons who were part of the stomatology branch of the Chinese Medical Association. The first Chinese national congress was held in 1981 in Hang-Zhou. From the beginnings of the association and, in fact, also before that time, the Chinese colleagues have maintained a cordial relationship. The structure of its organization evolved as its membership grew.

At present, the CSOMFS has approximately 1,000 members and has a permanent office in Shanghai, with one executive vice-president and two secretaries dealing with the daily affairs under the guidance of the board of the CSOMFS led by the president. There are also several regional societies of oral and maxillofacial surgery in this vast country. The society has six special interest groups including, oro-maxillofacial and head and neck oncology, orthognathic surgery, salivary gland diseases, traumatology, cleft lip and palate and vascular malformations. Each of these groups (divisions) has about 30 members with one chairman and four vice chairmen.

The society is responsible for the continuing education of its members and organizes, therefore, several hands-on training courses. It has published the official journal called China Journal of Oral and Maxillofacial Surgery since 2002. Each member of the society receives a copy of this journal.

The scope of oral and maxillofacial surgery has evolved over the years from mainly oral surgery to all branches of the specialty as described in the “Guidelines” of the IAOMS. It is particularly oncology and reconstructive surgery in all its facets that deserves a lot of attention not only from the specialty but also, among other topics, from orthognathic surgery, implants, cleft lip and palate, trauma, TMJ disorders, salivary gland diseases and the new developments such as distraction osteogenesis, minimally invasive and navigation surgery.

A prerequisite for training in OMF surgery is a stomatology degree. There are about 30 schools of stomatology in China. The curriculum includes two years of basic sciences, one year of pure medical science and two years of dentistry. After a successful final examination, the student will be a bachelor in stomatology. Some of the key schools have a combined bachelor/master program, which takes seven years to complete. At the School of Stomatology of Beijing University, an eight-year curriculum exists that includes a bachelor and a PhD degree. The postgraduate training in OMFS takes five years, including a half-year rotation through a general surgery department. It covers the full scope of OMF surgery, including oncology and cleft lip and palate. The resident has to keep a logbook with all procedures done in order to meet minimum requirements. A final written exit examination is required and also the candidate’s technical skills are assessed. When successfully passed, he or she will be a registered specialist. There are approximately 100 new residents accepted per year, divided among the 30 schools of stomatology.

The CSOMFS organizes a national congress every three years. It also has written training guidelines for the education and training of specialists, while consensus documents on diagnosis and treatment of various diseases and conditions were produced as well. Both documents were published in the Chinese Journal in 2006.

In 1999 the CSOMS joined IAOMS at the ICOMS in Washington DC. It had the privilege to organize the 19th ICOMS in Shanghai in association with the Hong Kong association, with Professor Qiu Wei-Liu as the honorary Chairman and Zhiyuan Zhang and Lim Cheung as the chairmen of the organizing committee. Steve Shen

Attendees at the 1st Congress of the Chinese Society, October 1981, Hang-Zhou. Approximately 200 participants attended this Congress.

The 6th Symposium on Oral and Maxillofacial surgery, organized by the School of Stomatology, Tongji University, People’s Republic of China. From left to right: Wang Zuolin, organizing committee chair; Lucas Bermudo, Spain; Piet Haers, IJOMS editor-in-chief; Tsugio Inokuchi, Japan; Gang Wan, president, Tongji University; José Luis “Pino” Ferreria, IAOMS president; Stephen Feinberg, IAOMS research committee chair; Qiu Wei-Liu, CSOMS president; Wangdaxhang, CSOMS vice president; Shaozhong Zhu, Tongji University vice president; and Jiliang Fu, president of the medical school, Tongji University. Preparatory meeting of oral and maxillofacial surgeons for the establishment of the Chinese Society. Far right: Qiu-Wei-Liu, first president of the Society.

Peru

Peruvian Association of Oral and Maxillofacial Surgeons

Asociación Peruana de Cirugia Bucal y Maxilofacial (ASPECIBUM) As in many other countries, it was the military which saw the need for oral surgery and they established the first service at the end of the 1940s in Peru. The department was headed by a dentist with a special interest in surgery and was located in the old San Bartolome Hospital in Lima.

It is, however, Felipe Plaza, who can be considered the pioneer of Peruvian oral and maxillofacial surgery. He was a dually qualified surgeon who was appointed in the 1960s, as a professor in oral surgery at San Marcos University. He was a very much respected colleague, who became president of the National Academy of Surgeons in the period 1994–1996.

A further boost to the development of the specialty came from some colleagues who trained abroad in Argentina, United States, Great Britain and Germany. Persons to mention include Yoel, who trained several colleagues at the Hospital Rawson in Argentina. After training overseas, doctors Guillermo Velezmoro, Adolfo Merino, Guillermo Cuadros, Segudo Hidalgo and Gilmer Rubio returned to Peru and began to develop the specialty of oral and maxillofacial surgery. It is of interest to note that the first bilateral sagittal split osteotomy in Peru was performed by Hidalgo in 1974.

In the 1960s, the specialty had difficulties in gaining access to the operating theaters as neighboring specialties tried to prevent them. Thanks to Apolinar Trevejo, the groundwork was done to change that. He was also a duallydegreed surgeon and could not be refused the right to operate upon his patients in a hospital. Another pivotal moment was the arrival of Carlos Abugattas Heredia in 1982, who had been trained in New York and who began to teach at Cayetano Heredia University in Lima. This evolved into the first formal training program in 1990, with doctors Delgado, Rojas and Trevejo in charge.

The second training program is located at San Marcos University, also in Lima and has been under the leadership of Hosting Barria since 1994. Both programs run a four-year residency program. The content differs somewhat between both centers as at Cayetano Heredia University, the medical rotations are limited to one year, whereas at San Marcos, they amount to almost two years. Both programs offer a broad scope of practice but are not involved in oncological surgery, although the residents do go through a rotation in head and neck oncology. The programs together graduate five to seven trainees per year. Since 2005, the specialty has earned official recognition from the national health authorities.

A tremendous jump in the development of the specialty resulted from the IAOMS supported educational course in Lima, as initiated by José Ferreria, who was president of IAOMS at that time. The program was run with the help of Eduardo Rey, as representative from ALACIBU and Samuel Allen as the local liaison. This three year course with several modules was a huge success and attended by many colleagues from the whole of Latin America. It definitely improved the level of the specialty in Peru but also elsewhere in South America.

The Peruvian association was established in 1976 with Oscar Lopez Zapata as its first president. Despite an enthusiastic beginning, this association was essentially dormant for several years. Only in 1997, when a group of colleagues formed a new association with Segundo Hidalgo as its president, did it become active again. In 1999 another group formed a second association with Freddy Gutierrez as president. The two associations, after many discussions, decided in 2010 to merge, recognizing that this would be in the interest of everybody involved. The new association has about 70 active members serving a population of 29.5 million people.

Both associations were affiliated with IAOMS in 2003 but the councilors rotated. This is no longer the case since the merger became effective. The current president of the association is Queneth del Aguila. Samuel Allen

Delighted Peruvian colleagues after the agreement has been signed to merge ASPECIME and ASPECOM into ASPECIBUM.

Queneth del Aguila

The Philippine College of Oral and Maxillofacial Surgeons celebrating the 50th anniversary at the Annual Convention in January 2010 at Quezon City.

The Philippines

College of Philippine Oral and Maxillofacial Surgeons

Doctors Ocampo Arenas de los Reyes and Nazareno were the pioneers who led the efforts to establish the Philippine College of Oral Surgeons, as it was called in the early days. Since no formal training existed in the Philippines, candidates for fellowship had to prove that they had followed postgraduate courses abroad. The constitution was finally approved in 1960 and the inaugural meeting was held in December 1960. There were 15 fellows accepted at that time.

In 1977, during its 17th anniversary, the presidential badge was introduced by then president Hilario. In the same year the PCOS was accepted as an affiliated association to the IAOMS. The association was honored by repeated visits from IAOMS presidents Bill van der Kwast and Geoffrey Howe in the following years.

In 1987, the name change into oral and maxillofacial surgery took place and a qualifying examination was introduced for those who wanted to be accepted as fellows, including a written examination and case presentations. An important event in the same year was the establishment of the Asian Association of Oral and Maxillofacial Surgeons. Its first meeting was held in Manila and not only attracted Asian participants but also surgeons from the U.S.A. and Europe. The revenues of this meeting were used to establish a Philippine Foundation, which would allow for assistance in the training of residents and rendering free service for underprivileged people, provided they were referred by members of the Philippine Dental Association. The close cooperation between the Asian associations opened pathways for the Philippine association to boost their expertise in that fellowships to renowned centers in neighboring countries became available. This resulted, for instance, in a sisterhood agreement with the Republic of China Association of Taiwan in 1990.

In 1997, Rudi Fries came to our national meeting as a guest speaker but also as president of the IAOMS.

The formal training in OMF surgery was established in 2004. There is presently only one center, located in Quezon City that takes one resident per year. Following the “Guidelines,” as formulated by the Asian association, the training consists of a four-year program, including rotations in the department of medicine. Senior residents spend six months at the Taichung Veterans Hospital in Taiwan thanks to the generosity of Daniel Wong and Chan Man Yee.

The PCOMS, with currently 40 full members, organizes yearly national meetings and seminars for continuing education of their members but also for general practitioners. It also plays an important role in the Philippine Dental Association as an affiliate association. Mario Esquillo

Poland

Polish Association for Oral and Maxillofacial Surgery

Polskie Towarzystwo Chirurgii Jamy Ustnej i Chirurgii Szczękowo-Twarzowej (PTCHjU) The Polish Association for Oral and Maxillofacial Surgery was founded in September 1997, independent from the Polish Dental Society.

The founders of the association were Leszek Kryst, from Warsaw Medical University, Stanislaw Bartkowski from Jagiellonian University, Krakow and Sylwester Kowalik, from Pomeranian Medical University in Szczecin. The Polish Association became affiliated to the IAOMS in 2005 and the EACMFS in 1997. Stefan Flieger was the first councilor for EACMFS, serving until 2002. He was followed by Leszek Kryst, serving until 2005 and Hubert Wanyura, until the present time.

Since 1997, every two years the Polish association organizes a congress and since then seven have been held, the majority of them had international input. Presidents are elected for a period of two years and the following persons have been in office: Leszek Kryst (Warsaw), Stanislaw Bartkowski (Krakow), Sylwester Kowalik (Szczecin), Zyta Grabowska (Bialystok), Tomasz Tomaszewski (Lublin), Jan

From left to right: Andrzej Wojtowciz, Hugo Obwegeser, Maciej Jagielak

Wnukiewicz (Wroclaw), Andrzej Wojtowicz (Warszawa), Maciej Jagielak (Warszawa).

All past presidents are affiliated with medical schools in Poland and were heads of the oral and maxillofacial surgery departments.

Andrzej Wojtowicz, past president, is an oral surgeon and president of the Polish Association of Dental Implantology.

The subjects of special interest are the application of piezosurgery in orthognathic surgery; implants in relation to orthognathic surgery and fixed epiphysis, application of stem cells, growth factors and bone augmentation. These topics are also the aim of many studies and international projects.

The number of maxillofacial surgeons is about 300 and the number of oral surgeons is about 800, while there are 1,000 implantologists.

The 7th Congress of the Polish association was held in 2010. The main topics were: “Transplants in oral and maxillofacial surgery,” “Congenital defects and disorders,” “Orthognathic surgery,” “Implantology,” “Oncology and reconstruction, including microsurgery.” This congress was a great success in which important scientific results were reported. Maciek Jakgielak and Andrzej Wojtowicz

Portugal

No report received.

Romania

Romanian Society of Oral and Maxillofacial Surgery

The development of oral and maxillofacial surgery in Romania is very much linked to the development of dentistry. The first professional dental association was established in 1923. The first dental school was founded in 1929 in Bucharest, at Coltea Hospital, with Mina Minovici as the first director. This institution played an important role in the evolution of oral and maxillofacial surgery. Minovici was succeeded by Iacob Iacobovici, who established the first department of oral and maxillofacial surgery, chaired by Dan Theodeorescu, in 1935. In 1938, the professional dental association changed its name to: “Romanian Society of Stomatology (RSS),” with Dan Theodeorescu as president, and Iacob Iacobovici as honorary president.

During World War II, the department of OMFS moved to a new building in the Colintina Hospital, where most of the wounded military were treated. After the war, academic education in dentistry was established at the universities, beginning in Bucharest in 1949, and the following years in Cluj-Napoca, Iasi, Timisura, Targu Mures and Craiova.

In Bucharest, Valerian Popescu had taken over from Theodeorescu and it was he who pushed for the proper teaching of oral surgery for dentists. Popescu became very actively involved in international affairs despite the problems associated with the Iron Curtain. He was a member of the committee of IAMFS that issued the regulations of that organization and a vice president of that association. He also organized its congress in 1967 in Bucharest.

Of particular interest is the fact that Popescu was also one of the founding members of the European Association for Cranio-Maxillofacial Surgery, in 1972. It was thanks to him and his successors that a national network of units providing oral and maxillofacial surgical care was built up.

The Romanian Association of Oral and Maxillofacial Surgery (RAOMFS) was established in 1991, just after the regime change, with Corneliu Burlibasa as its first president. This association became affiliated with the EACMFS and with the IAOMS.

The current president is Professor Alexandru Bucur. A national congress is held once every three years.

The members of the association are both medically and dentally qualified oral and maxillofacial surgeons as well as dentally qualified oral surgeons.

At present, OMFS departments are functioning in most county capitals of Romania. There are 260 members for a population of 22 million people, 140 of them are OMF surgeons, while 120 are oral surgeons mainly doing dentoalveolar surgery. Several of them work in hospitals that are not involved in training or private practice.

The training of specialists is provided by the departments at the nine universities and takes five years. This training includes three years of compulsory medical education for dental graduates and four years of dental education for medical graduates. This is not financed by the government.

The training of oral surgeons is also the responsibility of the universities. The training lasts three years after

Dan Theodeorescu Valerian Popescu, a pioneer of oral and maxillofacial surgery in Romania

7th Congress of the Romanian Association of Oral and Maxillofacial Surgery, 2004. From left to right: Viorel Ibric (Romania); Julio Acero (Spain); Adrian Creanga (Romania); Grigore Bacuit (Romania); Bernard Devauchelle (France); Emilia Ianes (Romania).

Speakers at the Romanian Congress, 1971.

acquisition of the dental diploma, three months of which must be spent in a university inpatient unit.

The EACMFS, particularly anxious to offer help to the impoverished Eastern European countries, were presented with a unique opportunity to assist with a program of courses in Iasi. Working with Dan Gogaluieceaniu, the Romanian councilor for the European association, EACMFS organized and funded a three-year rolling educational program, along the lines of the Thai IAOMS project.

Very significant roles have been played in the recent developments in oral and maxillofacial surgery in Romania by the chairmen at the university departments: Alexandru Bucur in Bucharest, Grigore Băciuţ in Cluj-Napoca, Mihai Surpăţeanu in Craiova, Carmen Vicol in Iaşi, Dezideriu Kovacs in Târgu Mureş, lecturer Marius Pop in Timişoara, and lecturer Adrian Creangă in Constanţa. Alexandru Bucur

Serbia

Serbian Association of Maxillofacial Surgeons

The Serbian Association of Maxillofacial Surgeons was founded in 1965 and it became a national affiliate of IAOMS in 2011 during the 20th ICOMS in Santiago, Chile. The Association has 80 members, which includes all oral and maxillofacial surgeons in Serbia. Saša Jović

Seychelles

Maxillofacial Surgeons Association of Seychelles

The Maxillofacial Surgeons Association of Seychelles was established in 2010 and it became affiliated with the IAOMS in 2011 during the 20th IOMS in Santiago, Chile. There are currently 11 members while there are a total of 16 oral maxillofacial surgeons in the country. Faiz Mohamed Tanveer

Singapore, Republic of

Association of Oral and Maxillofacial Surgeons Singapore (AOMSS)

The Association of Oral and Maxillofacial Surgeons Singapore was officially established in 1991 with only 16 members and held its inaugural general meeting on the 11th of January, 1992. The pioneers instrumental in accomplishing this were N. Ravindranathan (president), Loh Fun Chee (honorary secretary), Chew Swee Chiok (honorary treasurer), Teh Luan Yook, Myra Elliott and Lewis Lee, all of whom continue to be active members and still contribute significantly to the development of OMFS in Singapore.

There are currently some 57 members in the association, serving a population of approximately 4.5 million. Between two and three residents are accepted into training positions every year.

The dental faculty at the National University of Singapore and the National Dental Centre Singapore jointly carry out training in oral and maxillofacial surgery. Selected residents undergo a rigorous three-year basic specialty training program, with rotations to anesthesia, general surgery and plastic surgery. This cumulates in a Master’s degree. They then spend an additional three years in advanced specialty training at approved local or overseas hospitals to hone their surgical skills. A logbook of all their surgical cases is kept and exposure to the various sub-specialties is a requirement. An exit interview is then conducted to assess competency before entry into the specialist register is granted. To further develop their surgical skills, the Ministry of Health sponsors one young surgeon every year to take up a fellowship in his/her area of interest, at an overseas hospital of his/her choosing, under the Health Manpower Development Program. This has proved to be very effective in broadening the scope of practice of maxillofacial surgery in Singapore, with some even venturing into facial cosmetic surgery, once an exclusive domain of plastic surgeons.

The recognition of the specialty came relatively late in Singapore and the specialist dental register was only established by the Singapore Dental Council in 2008. With the Dental Specialist Accreditation Board and the

Dental Specialist Accreditation Committee (OMS) working in tandem, a proper and formalized training framework and pathway was quickly put in place and serves as a guide for the training of all future oral and maxillofacial surgeons in Singapore.

The association meets yearly for its annual general meeting where members discuss controversial issues, plans are drawn for the new year and the new executive committee for the incoming year is elected. It also organizes educational symposia, hands-on courses and journal clubs throughout the year to facilitate continuing dental education for both its members and the general dental population. Eminent local and overseas speakers are often invited to lecture at these events. Occasional social events provide interaction amongst the members.

The association is affiliated with both the International Association of Oral and Maxillofacial Surgeons as well as the Asian Association of Oral and Maxillofacial Surgeons and members are encouraged to attend their meetings. It also has close ties with the Hong Kong Association of Oral & Maxillofacial Surgeons. An inaugural joint symposium was held in Hong Kong on January 2011, with speakers from both countries sharing their research and experiences. Following its success, henceforth, it is to be held biennially.

The association celebrated its 20th Anniversary in 2011. With this milestone, it must continue to strive to reinvent itself to meet the challenges of the new millennium. Staying relevant in this ever-changing world is the only way to ensure the continued progress of the specialty in Singapore. Shyong Siak Goh

Slovakia

Slovak Association for Oral and Maxillofacial Surgery (SAOMFS)

The SAOMFS was established in 1998 as a branch of the Slovak Medical Association. Before that time, maxillofacial and oral surgery was a “sub-branch” of the Slovak Medical Association within the Slovak Stomatological Association, similar to that of prosthodontics, restorative dentistry, orthodontics, and oral medicine. The initiators were Ivan Satko, Eugen Kurill, Dusan Poruban, Jozef Mracna, Andrej Jenca and Peter Stanko. The current number of the SAOMFS members is 73 including 14 trainees. The president is Ivan Satko. Slovakia has a population of about five million. The education and training in Slovakia is concentrated in two universities; one in Bratislawa (Comenius University) and one in Koscice (Safarik University).

There are three pathways to becoming an officially recognized OMF surgeon. First, after acquiring a medical degree, one has to do two years dentistry followed by one year of medical rotations including, intensive care/ anesthesia (one month), general surgery/ trauma (six months), neurosurgery (two months), plastic surgery (three months), otolaryngology (two months) and oncology (one month). This is followed by three years of training in maxillofacial surgery.

Second, a person may do general surgery for three years and take a board examination and then go into training for maxillofacial surgery. He or she will still have to do two years of dentistry and three years of maxillofacial surgery.

Third, the most popular route starts from a dental degree. This person usually starts by doing two years of oral surgery and will receive a certificate that acknowledges his specialization. If they want to continue, they must do the same medical rotations and then the training of three years in maxillofacial surgery. One has to realize that dentists in Slovakia have, to a certain degree, a common curriculum with their medical colleagues. There is no special dental school, but dentistry is considered a branch of medicine.

All candidates have to sit an exit examination that includes a written paper on an assigned subject and an oral examination. They also have to keep a logbook and must have performed a given number of operations. On top of that they have to perform two operations, supervised by members of the board that is responsible for the whole exit examination.

The scope of OMFS in Slovakia covers the whole spectrum of the specialty. In summary, there are 14 residents in various stages of their training that varies from four to six years.

The SAOMFS has a close relationship and cooperation with the Czech and Polish associations. These three associations hold combined scientific symposia each year. Ivan Satko and Peter Stanko Ivan Satko

Participants at the annual meeting in 2010.

Slovenia

Slovenian Society for Maxillofacial and Oral Surgery

Združenje za maksilofacialno in oralno kirurgijo Slovenije The Slovenian Society for Maxillofacial and Oral Surgery in its present form was established in 1996 but the roots of the society go back to 1956. In that year, the Slovenian Section of Plastic and Maxillofacial Surgery was established as a part of the Slovenian Medical Association and it was Torol Skoog, a plastic surgeon from Uppsala, Sweden, who suggested the formation of this new section. The section was active as part of an Association of Plastic and Maxillofacial Surgery of Yugoslavia, which was also established in 1956. Bi-annual meetings were organized, each time in one of the republics of former Yugoslavia. The first president of the Yugoslavian Association of Plastic and Maxillofacial Surgery was Ivo Čupar from Zagreb.

In Slovenia, it was Jože Rant who began to perform maxillofacial surgery in 1933. After World War II, a Medical School was established as well as a Dental Clinic, which was later transferred into a Dental School. In 1949, Jože Rant passed the leadership of the division of oral and maxillofacial surgery to Franc Čelešnik. At that time, the division was part of the general surgery department, chaired by Božidar Lavrič. In 1958, a new department of oral and maxillofacial surgery was established and Franc Čelešnik became the director. He had close connections with surgeons from Graz, Prague, Zurich, Paris, Dusseldorf, Lyon and Stuttgart. In 1970, the European Association for Cranio-Maxillofacial Surgery was founded in Zurich and the first Congress of the association was held in Ljubljana, under the presidency of Franc Čelešnik in October 1972.

Slovenia became independent in 1991 and the Slovenian Society for Maxillofacial and Oral Surgery was founded in 1996, a few years after the Society for Plastic and Maxillofacial Surgery had stopped functioning. The first president was Borut Sotošek, who also initiated the formation of the new society.

The main goals of the society today are to set the standards and to promote and maintain the high quality of oral and maxillofacial surgery in Slovenia, as well as tending to the professional interests. The society, whose activities have been increasing over the years, prepares and holds seminars and courses for specialists and for general dentists. It has also prepared informative brochures for patients and guidelines on certain procedures for the

professionals. At least two meetings per year are organized for members of the society, at which scientific and professional issues are discussed. In Slovenia, it is possible to enter the specialty of maxillofacial surgery after obtaining a medical or dental diploma, while specialization in oral surgery can only be done by dentists. The specialist training takes six years to complete for maxillofacial surgery and four years for oral surgery. Trainees with a medical or dental degree have four years of the specialization in common, while two years are devoted to obtaining dental or medical knowledge respectively, depending on the degree with which one began. Maxillofacial surgeons cover the whole scope of the specialty, while oral surgeons deal mostly with dentoalveolar pathology. Currently, there is only one active maxillofacial surgeon in Slovenia with a medical and dental degree. There is only one training center for maxillofacial surgery and oral surgery at the University Medical Center in Ljubljana but part of the specialization can be completed in different departments in Slovenia. Slovenia has a population of 2 million and at present there are 17 active maxillofacial surgeons, 20 oral surgeons and 10 trainees (seven for maxillofacial surgery and three for oral surgery). The Slovenian Society for Maxillofacial and Oral Surgery has close connections with the department of oral and maxillofacial surgery at the University Medical Center in Ljubljana, with the faculty of medicine and with members of similar societies and associations in neighboring countries. Members often meet with Croatian colleagues to exchange knowledge and ideas and also to socialize. Colleagues Franc Celesnik from other countries are often invited to our seminars to present their work. In the future, the Slovenian Society will continue to spread knowledge by organizing seminars and courses and will also try to organize international courses on specific topics. It will try to connect with other associations in Europe and from other parts of the world. David Dovšak

South Africa

South African Society of Oral and Maxillofacial Surgery

Maxillofacial and oral surgery was one of various branches of surgery that evolved following the outbreak of World War I but it was World War II that introduced oral surgery to South Africa when Brenthurst, the residence of Sir Ernest Oppenheimer, was placed at the disposal of soldiers for the treatment of plastic and maxillofacial and oral surgery injuries. This unit was established by

Lester Brown, founder of oral and maxillofacial surgery in South Africa Major Jack Penn (a plastic surgeon) and Captain Lester Brown (a dentist).

The South African unit was based on the British pattern that recognized that a dental background was essential for the training and practice of maxillofacial and oral surgery. These units were all known as plastic maxillofacial and oral surgery units and included at least the following members:

•A plastic surgeon • A dentist/maxillofacial and oral surgeon • An anesthetist • A dental technician The South African unit performed a mammoth task that was on par with work done by similar units in the United Kingdom and U.S.A. When Penn and Brown found the Rodger Anderson extra-oral splint to be ineffective for the treatment of facial fractures, they developed an entirely different splint and called it the Brenthurst-splint (after the residence Brenthurst where the unit was accommodated). These splints were manufactured to exceptionally high engineering standards by the technical division of the South African Railways and Harbors and compared favorably with global standards at that time.

When the war came to an end, both maxillofacial and oral surgery and plastic surgery were well established and by 1948, recognized as separate specialties by the South African Medical and Dental Council. The institution of a maxillofacial and oral surgery register was announced in the Government Gazette on September 9th,1950. While the scope of maxillofacial and oral surgery was being designed, fierce disagreements arose between the plastic surgeons and the maxillofacial and oral surgeons. This continued for a number of years until a new generation of specialists saw the futility of these differences resulting in a better understanding and collegiate acceptance of the merit of each specialty.

The name “maxillofacial and oral surgery” was changed by the South African Medical and Dental Council in 1972 to “maxillofacial and oral surgery (dental)” because the former name could supposedly mislead the public! For the first decade after inception of a specialist register for maxillofacial and oral surgeons, only 10 individuals were registered, many of whom were not active.

Tribute is due to a number of people who were involved during the formation of the specialty. The brothers Lester and Jack Brown were pioneers and both worked in Johannesburg. Lester should be regarded as the founder of the profession, contributing greatly to both professional and technical aspects and who fought like a tiger to get a good dispensation for maxillofacial and oral surgery. He qualified in dentistry at Guys Hospital in London and then worked as a postgraduate with a number of British and continental European surgeons of note, before spending time in the U.S.A. and eventually, returning to South Africa in 1949, as chief of the Johannesburg group of hospitals. Honored by the Royal College of Surgeons of England, he was largely responsible for the development of maxillofacial and oral surgery in South Africa.

In Pretoria, Harry Goldin also contributed greatly to the specialty of maxillofacial and oral surgery. Chris Snijman started work as a miner on the Witwatersrand before he decided to study dentistry at the Witwatersrand University where he qualified in 1950. Two years later, he was appointed as lecturer in the department of pathology and histopathology of the oral cavity and oral surgery at the dental school of the University of Pretoria. Recognizing the need for qualified postgraduate teachers in maxillofacial and oral surgery, Chris Snijman resigned from his post and left for the United Kingdom in 1956 to attend postgraduate courses at this own expense.

After two years working in the major units in the U.K. and elsewhere in Europe, he returned to Pretoria, where the experience he had gained enabled him not only to master techniques that were up to then unknown in South Africa but also to demonstrate and introduce them to his home country. Chris Snijman was the first Afrikaans-speaking maxillofacial and oral surgeon to be registered with the South African Medical and Dental Council. When the South African Society of Maxillofacial and Oral Surgeons was established shortly thereafter, he deservedly became the first elected president.

A case with Brenthurst splints.

With the establishment of the first dental school for the Cape Province at the University of Stellenbosch, Manie Breytenbach was appointed as head of the maxillofacial and oral surgery department in 1973. A year later, he was promoted to dean of the newly established dental school at the University of the Western Cape and was succeeded by Frans Grotepass at Stellenbosch, who started the training program for specialist maxillofacial and oral surgeons at this institution in 1976.

Subsequent training units were established at the University of the Western Cape (1973) and the Medical University of South Africa (MEDUNSA) near Pretoria (1986), where the first maxillofacial and oral surgeons qualified shortly afterwards under the mentorship of Lionel Miles and Bernie Jordaan respectively.

Recognizing an international trend towards dual dental and medical qualifications in the late 1980s, various training models were introduced by individual departments at the universities of the Witwatersrand, Pretoria and Stellenbosch. Since the early 1990s, dual medical and dental courses have been offered for maxillofacial and oral surgery training in a two-tier system, which runs parallel to the single dental qualification courses. Lack of political support, economic as well as practical issues make a mandatory dual degree qualification unlikely in the near future.

Since 1973, the South African College of Medicine has contributed nationally to the development and setting of standards for examination and evaluation of specialists in dentistry. A faculty of dentistry within the parent college was established during 1973 and this allowed for assessment of postgraduate students parallel to but independent of South African universities.

In 1978, the first candidate entered the FFD Part I in maxillofacial and oral surgery with success and two years later, in 1980, the college conferred the first two fellowships in maxillofacial and oral surgery. By 1995, 20 FFD(SA)MFOS fellowships had been conferred and a further 10 FCD(SA)MFOS were conferred by the College of Dentistry before a separate constituent College of Maxillofacial and Oral Surgery was established within the greater College of Medicine on 23 April 1998. This was achieved largely as a result of the efforts and vision of John Lownie, who deservedly became the first president of the new College of Maxillofacial and Oral Surgery. To date, 22 FCMFOS(SA) fellowships have been conferred.

From humble beginnings in 1964, the South African Society of Maxillofacial and Oral Surgeons has grown to a membership of about 100. The society has been affiliated to the IAOMS from the early days. To date, two South Africans have served on the executive council of the IAOMS; Pat Uys as convener of the 15th ICOMS, from 1999–2001 and Conrad Masureik as member-at-large, from 2003–2005.

In conclusion, maxillofacial and oral surgery is recognized as a specialist discipline of dentistry in South Africa, with established training centers in Johannesburg, Pretoria and Cape Town. Albert van der Westhuizen

Patrick Uys addressing the attendees at the 15th ICOMS in Durban, 2001 Conrad Masureik

Spain

Spanish Association of Oral and Maxillofacial Surgery

Sociedad Española de Cirugía Oral y Maxilofacial (Secom) Dentistry was introduced in Spain in 1901. The need to expand the knowledge of undergraduate students meant that the specific studies in dentistry were modified and broadened in 1910. It was at this time that Bernardino Landete Aragó emerged as the founder of oral and maxillofacial surgery in Spain. It was he who created the stomatology concept and was responsible for this philosophy being incorporated within the dental curriculum. His tireless efforts to promote stomatology and oral and maxillofacial surgery were rewarded many years later when both were recognized as medical specialties.

During World War I, surgeons required the help of dentists to treat maxillofacial fractures. In fact, dentists with certain surgical skills were obliged, as pointed out by García Palao, “to take on more and more surgical tasks, as a result of which they developed surgical skills for treating the injured to such a point that these tasks were soon delegated to them.”

When the Civil War ended, the dental department at the University of Madrid suffered an enormous upheaval as Florestán Aguilar had fallen from grace and died in 1934, while Bernardino Landete had been politically ousted. During this time, the dental faculty was inaugurated in the University of Madrid in 1945, while stomatology was

Terry Ward receiving a plaque from his Spanish colleagues, 1974. Pictured far left: José Alonso del Hoyo. Pictured far right: Victor de Sada.

approved as a medical specialty, the medical-stomatology degree created and the dentistry degree eliminated.

From 1952 on, following the new Seguro Obligatorio de Enfermedades (Compulsory Health Insurance), health authorities were obliged to institutionalize the provision of a series of surgical specialties within the system. These slowly start appearing in the Instituto de Medicina, Higiene y Seguridad del Trabajador (Institute of Workers’ Medicine, Hygiene and Insurance) and gave rise to the National Centre of Surgical Specialties. The department of maxillofacial surgery was first created in 1954. Victor Sada Tejero was put in charge of the department and he was aided by José Alonso del Hoyo and Ramón Castillo Escandón y Sierra. Whereas Bernardino Landete had founded the specialty, it was Victor Sada who saw that the specialty was recognized and extended across the whole country. The transition of the existing departments of dentistry and stomatology began and maxillofacial surgery was incorporated into the surgical group. In 1956, José Alonso del Hoyo became section head and together they were able to change the name of the department to maxillofacial surgery.

Another important event in the history of the specialty took place in 1964 when the Hospital Complex La Paz, the flagship of the SOE insurance network, started operating but with two independent departments, stomatology and maxillofacial surgery. Victor Sada was named head of the maxillofacial department in La Paz and José Alonso del Hoyo moved to become head of the Gran Hospital de la Beneficencia del Estado, which today is known as Hospital de la Princesa. From this point on, departments were created in the specialty in all the important Spanish cities.

The residents in oral and maxillofacial surgery who trained from 1966 onwards were not recognized until a Royal Decree was passed in April 1977, when oral and maxillofacial surgery was recognized as a medical specialty.

Under a law passed in 1986, which created the degree in dentistry, the roles of these different specialties were defined. Dentists would carry out prevention, diagnosis and treatment related to anomalies and diseases of the teeth mouth jaws and adjacent tissues. They would be able to prescribe medicines, prostheses and health products corresponding to the area of their professional practice. This law in no way limited the professional scope of doctors and in particular, of specialists in stomatology and maxillofacial surgery, who would continue with their normal clinical responsibilities.

The Spanish association (SECOM) was established in 1965 thanks to a group of colleagues who worked in La Paz Hospital and the Gran Hospital de la Beneficencia del Estado in Madrid. There were 26 founder members. Victor Sada Tejero was elected president and he organized the first national congress, which was held in Madrid, in 1967.

From 1966 onwards, despite still not being recognized as a specialty, the training of residents in maxillofacial surgery commenced, in order to obtain the medical stomatology degree. The training period was three years in addition to the two previous years in stomatology. The new hospitals started training residents who were chosen through interviews, which was in the hands of the committees of the hospitals themselves. The public health service depended on the Ministerio de Trabajo but

Committee members of SECOM at the annual meeting, 2010.

more especially on the Instituto Nacional de Prevision, that gave the residents their certificates once their training periods were completed.

As previously mentioned, the oral and maxillofacial specialty was formed as a result of a Royal Decree in 1977. This official recognition of the specialty was the result of intense negotiations by the SECOM, in particular of its first three presidents, Victor Sada, García Palao and José Alonso del Hoyo. The latter was president of the SECOM when our specialty was recognized.

In 1978, a Royal Decree was issued that signified an important change in the regulations governing the training of medical specialists. Maxillofacial surgery and stomatology were then recognized as specialties. An important fact was the disappearance of the word “oral” from the name of the specialty and it will not be until many years later, in 2003, that the specialty regained its original name.

The Royal decree of January, 1984, which regulated specialized medical training and obtaining the degree of medical specialist, gave rise to a new list of medical specialties, which included maxillofacial surgery. There are currently 31 institutions involved in the training of oral and maxillofacial surgeons

According to the rules and regulations of SECOM, which were approved in May, 2004, the society is a scientific and professional organization. Its aim is to promote oral and maxillofacial surgery nationally as well as internationally and to offer services to its members as well as to defend their interests.

Spain, with a population of about 40 million, has 735 registered OMFS and 138 trainees who are members of SECOM.

In 1974, the first international scientific event took place regarding Spanish oral and maxillofacial surgery, organized by Victor Sada, which was the 5th ICOS.

In 1978, the fifth national congress of the specialty was held, which was presided over by Alvaro García Perla. It was the first Latin American congress. The transatlantic relationship of the society with ALACIBU is still maintained. During this congress, the first issue of the Revista Ibero-Americana de Cirugía Oral y Maxillofacial (Latin-American Journal of Oral and Maxillofacial Surgery) was presented, which years later would change its name to the Revista Española de Cirugía Oral y Maxilofacial (Spanish Journal of Oral and Maxillofacial Surgery).

In 1982, José Alonso del Hoyo was named presidentelect of the European Association for Cranio-Maxillofacial Surgery, which involved hosting the 1986 European Congress in Madrid. He was the first Spaniard to hold such a high position at an international level.

In 1980 in Palma de Mallorca, Guillermo Raspall organized the sixth national congress in conjunction with the American Association of Oral and Maxillofacial Surgeons. Guillermo Raspall was particularly keen to promote the society internationally. He was elected president of the European Association for Cranio-Maxillofacial Surgery for the period 2004 to 2006 and in 2006 he organized the 25th congress of the EACMFS in Barcelona.

Carlos Navarro Vila became chairman of the oral and maxillofacial surgery section of the UEMS between 1988 and 1994, subsequently becoming president of the European Board of Maxillofacial Surgery (EBOMFS) from 1994 to 1999. During these years, Clavero, who later took over as president of the SECOM, became president of the scientific committee of the board. Carlos Navarro was again made president of this prestigious body for the period of 2007 to 2011.

Julio Acero is currently one of the Spanish professionals with the most international influence. He is chairman of the educational committees of the EACMFS and the IAOMS.

At the 18th ICOMS held in Bangalore, Barcelona was chosen as the venue for the 21st ICOMS, to be held in 2013. Javier Lagunas-Gonzalez

Sri Lanka

Sri Lanka Association of Oral and Maxillofacial Surgeons (SLAOMFS)

The Sri Lanka Association of Oral and Maxillofacial Surgeons (SLAOMFS) was founded in 1998 with about six members joining and from that humble beginning it has grown into a substantial membership. Prior to the formation of SLAOMFS, all professional and academic activities related to oral and maxillofacial surgery were undertaken by an umbrella organization by the name of “College of Stomatology.” With the establishment of a Postgraduate Institute of Medicine and a diversification of training in several medical and dental specialties, the need for the foundation of SLAOMFS was felt.

A Japanese grant, to improve the training facilities in oral and maxillofacial surgery in Sri Lanka had been received around this time and this proved to be instrumental in the development of oral and maxillofacial surgery in Sri Lanka. Japanese oral and maxillofacial surgeons, who were involved in the training of local surgeons, drew our attention to the need to affiliate with the IAOMS and helped us to obtain this in 1998. Our founding president, N. A. de S. Amaratunge, attended the congress of the IAOMS that was held in Washington in 2000 and presented a paper on the prospects of our center, at the Faculty of Dental Science in Peradeniya, to develop as a training center for the region. Since then, SLAOMFS had been represented at every international congress of the IAOMS and also at regional

Opening ceremony at the SLAOMFS annual meeting, 2010. 2010 Executive Committee of SLAOMFS.

Asian meetings. Our members have presented papers at these meetings and participated at educational conferences.

Presently, SLAOMFS engages in training programs, scientific conferences and research activities. Sri Lanka has just entered a new era of peace, harmony and economic development. As the focus of economic development shifts towards Asia, our strategically placed country has the potential to grow into prosperity. As a result, quality of life and life expectancy should improve substantially. Oral and maxillofacial surgery likewise should expand both in scope as well as in the number of OMF surgeons needed to cope with the expected demand to improve the quality of life of the people. SLAOMFS will, thus, have a greater and more crucial role to play in the envisioned development of the health sector of Sri Lanka.

Postgraduate education and training in OMF surgery in Sri Lanka is organized along the lines of the fellowships as they exist in the U.K. Candidates with a dental degree follow a five-year course that will lead to a Master’s degree in OMF surgery. This course is being conducted by the Postgraduate institute of Medicine in Sri Lanka at the University of Colombo with the contribution of the staff of the faculty at Peradeniya and some other consultants.

The first three years of OMFS training in Sri Lanka includes about two years of training in pure medical science involving general medicine and surgery but also rotations through most other medical specialties. The OMF surgery part is mainly focused on oral diagnosis, dentoalveolar surgery, clefts and oral cancer including perioperative patient care. After the Master’s degree, two years of intensive training follows, which includes one year of training abroad. An official “Board Certification as a Specialist” is awarded after the successful completion of an exit examination. The Ministry of Health in Sri Lanka recognizes the Master’s degree qualification for the recruitment of consultants. Presently, only three to four candidates per year follow OMF surgery training.

There are five major hospitals where training facilities exist but the Dental Hospital in Peradeniya, the only dental school in the country, offers the main component of the training. At present, there are approximately 40 qualified OMF surgeons who are members of the association and about 20 trainees in various stages of their training for a population of around 20 million people.

The Dental Faculty at Peradeniya University also offers various postgraduate courses in OMF surgery. The MSc OMF surgery course is oriented towards researchers. The courses in minor oral surgery, basic orthognathic surgery, cleft surgery, oral cancer treatment, using pedicled flaps and microvascular free flaps are designed for the practicing OMF surgeons to improve their knowledge and skills. Members of SLAOMFS are the main instructors of these courses. Parakrama Wijekoorn

Sweden

Swedish Association of Oral and Maxillofacial Surgeons

Svensk Käkkirurgisk Förening The Swedish association was established in 1953 as a dentally based specialty. Its original name included the surgical treatment of the mouth and tooth-bearing region, which was changed in the mid-1980s to oral surgery. In the beginning of the 1990s the term “käkkirurgi,” which means “jaw surgery,” was introduced.” Pioneers of Swedish oral surgery were Åke Nordenram and Erik Jönsson. Although not an OMF surgeon, Per-Ingvar Brånemark is recognized worldwide as the “godfather” of modern implant dentistry.

During the first 23 years the association also included hospital dentists but in 1975 they separated and formed their own association. The name change came about in 1991 to “Oral and Maxillofacial Surgeons.” This name is not yet officially recognized by the Swedish National Board of Health and Welfare, in spite of diligent diplomacy by the association. If recognized by the health authorities, it would better reflect the content of the specialty.

The mission of the association is to promote education and science and the interaction of clinicians but also to

From left to right: Michael Awty, honorary member of the association has been instrumental creating possibilities for Swedish colleagues to spend time in U.K. units. Knut Swartz, consultant for many years in Boden.

officially represent the specialty when dealing with other organizations and the national authorities. To fulfill this mission, annual scientific meetings are organized and scholarships are given to young colleagues or trainees to broaden their scope in countries outside of Sweden.

The association has currently about 150 active members who are mainly hospital-based or work at the four dental schools. An increasing number are also active in private practice. About 50 percent of all colleagues have done research and received a doctorate (PhD). There are about 40 departments of oral and maxillofacial surgery, spread over the country, serving a population of approximately nine million people.

The training is provided by 16 departments that are all hospital based. Some five trainees are accepted per year. All trainees have to have two years of experience in general dentistry before they may apply. The program includes 18 months of rotations through medical departments, including anesthesia, internal medicine, ENT and surgery. There are various medical courses to be attended as well. This is followed by 30 months of training in OMF surgery. Recent discussions within the association have led to a planned change in the setup of the training program, so that it might be extended to six or seven years so as to include a medical degree but the specialty will remain a dental specialty. Björn Johansson

Switzerland

No report received.

Taipei — China

Republic of China Association of Oral and Maxillofacial Surgeons

The beginnings of the association can be traced back to about 50 years ago. During the years 1960 to 1980, “oral surgeons” were practicing mainly in four major health care institutions, including the National Taiwan University Hospital, National Defense Medical College Hospital, Taipei-Veterans General Hospital and Kaishiung Medical College Hospital. The leaders and senior staff of these departments were not only involved in the training of residents but also lectured in oral anatomy, radiology and oral and maxillofacial surgery at the seven dental schools in Taiwan. They held joint conferences in Taipei for almost a decade.

In the early 1980s, the pioneer oral surgeons began to work on founding the professional society, which resulted in an official recognition by the government in 1986. The association held its first annual meeting in 1987. While the members of the association continued to expand the scope and practice of oral and maxillofacial surgery in Taiwan, many well-trained pioneer members were trying to promote international collaboration.

In 1989, more than 30 members of the association participated in the first Asian Congress of Oral & Maxillofacial Surgeons (ACOMS) in Manila. In 1993, the ROCAOMS successfully hosted the 2nd ACOMS at the Grand Hotel in Taipei, with General Chao CF as the congress president and Charles A McCallum as the honorary president. Being highly appreciated by other medical and dental specialists, oral and maxillofacial surgery was subsequently recognized in 1998 as the first specialty in dental medicine by the Ministry of Health.

The mission of the ROCAOMS is to provide a service to the public, to be responsible for the education and training of their trainees and to promote research.

The training of a new generation of OMF surgeons is provided by 18 hospitals that are spread over the country and are approved Announcement of the 2nd Asian Congress in Taipei, 1993 by the association. The four-year training period consists of a minimum of six and a maximum of twelve months of medical rotations, including general medicine, surgery and intensive care. The remaining three years are devoted to OMF surgery, which covers the whole scope, including cleft lip and palate surgery and the treatment of malignancies.

Participants at the annual meeting of the association, 2010 in Cheng-Kung University Hospital in Taiwan.

After the completion of training, the candidate must pass an examination, which includes documentation of cases in all categories of the profession, a written test and a final oral examination. When successful, the candidate will receive a certificate accredited by the minister of health. This certificate is subject for renewal every six years, depending on proven postgraduate continued education.

The association has continued to grow for more than 20 years due to the lasting endeavor of all members and the contribution of previous outstanding board members led by the presidents: doctors Matthew C.F. Chao, Nien-The Yin, Liang-Jiunn Hahn, Richard C.S. Chang, Hong-Rong Chen, Duen-Jeng Wang, Chia-Ning Tu, Ying-Shiung Kuo, Steven Lai, Yong-Kie Wong, Shyun-Yen Liu, Chung-Ho Chen and Tung-Yiu Wong.

Currently, the ROCAOMS has 270 members spread over the country. We are confident to be in an excellent position to grow further and to support the growth and development of other OMFS societies in Asia. Shou-Yen Kao

Thailand

Thai Association of Oral and Maxillofacial Surgeons

Before 1940, oral and maxillofacial surgery was largely performed by general surgeons in Thailand. When the first faculty of dentistry was founded in 1940, a part of oral surgery came under the responsibility of dentists. The first postgraduate course in oral surgery was in 1963 but it was limited to dentoalveolar surgery and it took only one year to complete.

Chuachote Hansasuta can be considered the founder of oral and maxillofacial surgery in Thailand. He graduated in dentistry in 1957 and in medicine in 1962. He was trained in oral surgery at the University of Alabama at Birmingham, U.S.A., completing his training in 1969. He even took the American Board of Oral and Maxillofacial Surgery exam and by doing so he became the first foreigner to become a diplomate of the American Board of Oral and Maxillofacial Surgery. He set up the first training program in oral and maxillofacial surgery at the Faculty of Dentistry, Chulalongkorn University, Bangkok, in 1974. It was a two-year program until 1992, when it was extended to a three-year program.

In 1992, the second training center was established at the oral and maxillofacial surgery unit at Cholburi General Hospital, which is located in the east of Thailand.

In 1994, when the Dental Council was established, the training programs came under the supervision of the Dental Council’s training subcommittee. The examination for certification by the Thai Board of Oral and Maxillofacial surgery was launched and the first diplomas were handed out in January 1998. In December of the same year, the Office of the Civil Service Commissioners officially recognized the oral and maxillofacial surgery qualifications of the diplomates. Beginning in 2006, all dental training programs fell under the supervision of the Royal College of Dentistry.

New training centers in oral and maxillofacial surgery were established in 1996 at Mahidol University, in 1998 at Police General Hospital, and in 2000 at Prince of Songkhla University and Hat Yai General Hospital.

At present, postgraduate training in Thailand consists of a three-year program but it has been decided to extend the training to four years. The program includes one year devoted to medicine, which includes rotations in internal medicine, general surgery, ENT and others; and a three-month rotation in general anesthesia, which is mandatory. The training centers in Thailand take a total of 16 new residents each year. There are currently more than 200 trained oral and maxillofacial surgeons for a population of 62 million people. As of next year, there will be another three training centers: one in the north and two in the northeast. Each center will take at least two residents. The number of new residents will, therefore, increase to a total of 22 each year.

Since 1978, a society of oral surgeons existed but the Thai Association of Oral and Maxillofacial Surgeons was founded in 1990. In 1998, it earned the patronage of His Majesty the King. It is a professional and scientific organization which is also responsible for the quality of education and training of the residents.

The association has organized several symposia and scientific meetings since its foundation.

Committee members of the Thai Association at their annual meeting, October 2010.

The Thai association also hosted the first IAOMS sponsored, three-year modular course on oral and maxillofacial surgery, which began in 2001. This took place in Hat Yai, as this city was easily reachable for participants from neighboring countries, including Malaysia, Indonesia, Singapore, the Philippines, Vietnam, etc. The success of this course became legendary and the Thai hospitality will be remembered by all teachers and participants.

The association also organized the Asian Regional Seminar on Training Guidelines, which was held from December 13–14, 2003 at Chulaongkorn University, Bangkok. During the seminar it was agreed that the training should be extended to meet the international standards, as formulated in the document on education and training by the IAOMS. This implied that the training be extended to at least four years.

Recently, the Thai association had the honor to organize the 8th Asian Congress on Oral and Maxillofacial Surgery in November 2008, under the presidency of Vacharee Changsirivatanathamrong.

The Thai association organizes two scientific meetings a year and has grown substantially over the last 20 years, not only in numbers but also with regard to scope of practice. Vacharee Changsirivatanathamrong

Turkey

Turkish Association of Oral and Maxillofacial Surgery (TAOMFS)

Türk Oral ve Maksillofasiyal Cerrahi Dernegi The Turkish association was established in 1985 by 13 pioneers of Turkish oral and maxillofacial surgery, including Professors Türker and Akça and the doctors Borcbakan, Asri, Selahattin, Demiralp, Ergen, Yücetas, Güngör, Araz, Tasar, Colon and Güven. From its beginning, about 100 members have joined the association. Its first general assembly was held on June 21, 1986.

The TAOMFS has since organized 14 national and nine international conferences. Ferda Tasar

Ukraine

No report received.

Ferda Tasar presenting György Szabó with Honorary Membership.

United Kingdom

British Association of Oral and Maxillofacial Surgeons

Before 1948 and the establishment of the National Health Service (NHS), consultant appointments to hospitals were determined locally and there were very few dentally qualified surgeons who held hospital appointments. Among those who were engaged, a significant number were also medically qualified. It was from this group that the first organization to produce a coordinated professional body arose in the guise of the Oral Surgery Club of Great Britain. It was, and still is today, a club which individuals are invited to join, provided they were deemed suitable by the committee members. Its numbers were strictly limited to a ceiling of 50 active surgeons. Run along the lines of a gentleman’s club of the 1930s, it was strictly “men only” and no women were expected to be seen at any time during their clinical meetings. The leaders had all served military appointments; hence the behavior of the Club’s committee was very much along military lines, resembling an officer’s mess. Rupert Sutton Taylor, qualified in both medicine and dentistry and a consultant at the Westminster Hospital, was its leading light. Nothing occurred without his approval and as a body, the members of the club were those who led the profession; nothing occurred without their initiation, either officially or unofficially and collectively, they were a true “tour de force.”

As a group, these early surgeons had become progressively more disillusioned by their colleagues within the British Association of Plastic Surgeons who, while encouraging them to attend their meetings as guests, failed to incorporate them into an active role within that association. The rapid development of the specialty, combined with an increasing number of capable and ambitious surgeons who were not prepared to be treated in this way, provided a catalyst for change.

Other developments also contributed to the timing of these events: • The actions of successive governments, starting with the formation of the National Health Service (NHS) in 1948 and the establishment of “Consultant Dental

Surgeon” appointments which gave parity with all other medical specialties, a structured salary and a guaranteed superannuation, as well as admitting rights for dental consultants who were totally responsible for the care of their own inpatients. • The creation of the Faculty of Dental Surgery within the Royal College of Surgeons of England, who became responsible for inspection and accreditation of training posts and trainees within the NHS. Trainee standards were set and monitored through a process of regular inspections. The establishment of the Fellowship in

Dental Surgery in 1948 was an essential part of this process, since the two elements, satisfactory completion of a training program and the successful passing of an examination, became a necessity. Despite changes in training, accreditation and the examinations over the years to meet the changing nature of the specialty, this principle has remained. • Also in 1948, the British Dental Association was able to negotiate terms and conditions of service jointly with the British Medical Association, through their direct political link with government. It was through the hospital group of the BDA that the Royal College of Surgeons linked to form the initial Faculty of

Dental Surgery. A governmental committee was charged with determining the level of consultant cover per head of population for every specialty to service the new NHS. As far as consultant dental surgeons were concerned, this was 1 per 250,000 head of the population. There was, therefore, a tremendous need for recruitment and training to reach this figure.

Although these bodies were officially those involved, there is no doubt that it was the particular individuals concerned whose representation across the various committees provided the real driving force. They determined the need to combine together to ensure standards of conduct and ability; bring about further progress; keep pace with developments abroad both now and in the future and, even at that stage, bearing in mind the possibility that the U.K. could enter the Common Market, give an appropriate lead to young aspirants.

Two members of the Oral Surgery Club, John Hovell and Norman Rowe, decided to approach colleagues about the costs and feasibility of establishing a British Association of Oral Surgeons. They invited a small group to dinner at the Royal Society of Medicine on March 27, 1961 to form a working party. It was as a result of this that the decision was made to inaugurate a British Association of Oral Surgeons in 1962, some 25 years after the formation of the Oral Surgery Club. The steering group proposed Terence Ward CBE as the first president and he was elected unanimously.

In parallel with this and quite independently, another group had also determined that it would hold an International Conference on Oral Surgery in July 1962. The British felt it appropriate that the inaugural meeting of the British Association of Oral Surgeons should take place after the closing ceremony of this meeting on July 4, 1962 and that, at the closing ceremony, the presidential badge of office, which had been presented by the American association, should be conferred on the newly elected president of BAOS. They also elected four honorary fellows

BAOMS presidents at a luncheon on December 2, 2011. Back row from left to right: Peter Leopard, Brian Avery, Michael Wake, David Barnard, Peter Banks, Marie Morton, John Williams, Barrie Evans, David Patton, David James and John Langdon. Front row from left to right: Khursheed Moos, Ken Ray, Bob Woodwards, Harry Alty, Russell Hopkins and Michael Awty.

and conferred a special honorary fellowship on the president of the American association, ex officio. The first clinical meeting of the new association was held at East Grinstead October 5–6, 1962.

At that stage, it was clear that there was no international association but, rather, a group of individuals who were determined to hold an international meeting on a threeyear basis. However, the conference was such a resounding success that even during the week there was a clamor to establish an international association of oral surgeons. They moved rapidly, for within the same journal containing the write up on the conference, an advertisement appeared for the IAOS, along with an application form for membership! In March 1963, the newly fledged international association determined that their next conference would be in Copenhagen in 1965.

Within the U.K., training programs were organized around the District General Hospitals, rather than the teaching hospitals, since this was where accidents were seen predominantly and trauma constituted the principal element of work at that time.

Today, the U.K. has 125 trainees in 15 rotational programs under the control of a central committee on higher surgical training and its OMFS subcommittee. This is constituted from within the Surgical Royal Colleges and the specialist associations. Training lasts for five years in common with other surgical specialties, as agreed between EU member states. The rotations enhance experience and rotations are inspected regularly to ensure conformity with agreed standards.

It is of interest to note that within the minutes of BAOS, the desirability of medical training is mentioned as early as 1966. At the meeting of March 19, 1977, a formal proposal was made for the adoption of a dual degree for all future trainees. It was, however, not until 1981 that this proposal was put to the full membership and a vote taken to make it mandatory within a period of 10 years for anyone aspiring to a consultant position. The result was a vote in favor by 128 to 96, as recorded in 1982.

The alteration in the name of the association to BAOMS came about in May 1984, when members voted this a more appropriate reflection of their activities and to counter aspirational claims of other specialties, such as ENT, who had added “head and neck surgeons” to their title.

In 1984, the Royal College of Surgeons of Edinburgh inaugurated an FRCS examination in OMFS and the first examination was held in 1985. It was this departure that led ultimately to the Intercollegiate Final Fellowship Examinations in all surgical specialties as part of the restructuring of all surgical training and examinations.

Within the U.K. an increasing number of women have entered the profession. They have also entered leadership of BAOMS, with Moira Morten serving as the first female president.

Today, there are almost 500 consultant OMFS surgeons serving a population of over 60 million people through approximately 150 hospitals and there are 1,131 active members of the BAOMS. John Williams

United States of America

American Association of Oral and Maxillofacial Surgeons

Oral and maxillofacial surgery in the United States is defined by the American Dental Association as the specialty which includes “the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region.”1

The roots of the specialty can be traced back to the Civil War, when William A. Carrington, the medical director for the Confederacy, commented that dentists “plugged, cleaned, and extracted teeth,” in addition to “adjusting fractures of the jaw and operating on the mouth.” Dentists such as Thomas Gunning and J.B. Bean made revolutionary advancements in the treatment of facial fractures for the Union and Confederacy respectively. The first American textbook devoted to oral surgery, “A System of Oral Surgery”, was published in the late 19th century.

By the early part of the 20th century, oral and maxillofacial surgeons were already pioneering cleft palate and other facial reconstructive surgery. However, the majority of practitioners were known as exodontists, or extraction specialists and were not recognized as a cohesive specialty. As a result, there was a lack of a common interest among exodontists; no dental school offered a postgraduate course in exodontia and exodontists were not recognized as specialists either within or outside of the dental profession. An article in the Journal of Oral and Maxillofacial Surgery titled “The Building of a Specialty: Oral and Maxillofacial Surgery in the United States 1918–1998”2 notes that when the U.S.A. entered World War I, exodontists were inducted into the army as private soldiers. Even the Red Cross did not recognize the specialty. Clearly it was time to organize and unify the specialty to benefit both the exodontists and the public.

Led by the efforts of Menifee Howard, 125 prominent dentists who specialized in extraction gathered in Chicago

1Definition of oral and maxillofacial surgery, Approved by the Council on Dental Education and Licensure, adopted October 1990. 2The building of a specialty: oral and maxillofacial surgery in the United States, 1918–1998. J Oral Maxillofac Surg; 1989; 56(suppl 3):70–132.

AAOMS headquarters in Rosemont, Illinois. The atrium of the AAOMS headquarters building.

on August 9, 1918 for the charter meeting of the American Society of Exodontists (ASE). He was elected chairman. Early meetings of the new organization were characterized as “stormy,” as the members sought to establish policy and procedures for the fledgling group. In addition, there was opposition to the creation of the society from other dental organizations.

In 1919, the National Dental Association granted official recognition to the ASE and by the time the society met for its third annual meeting, the climate had improved to a point that it was possible to add educational programming to the meeting’s business sessions. The 1919 annual meeting was also significant for the House of Delegate’s decision to officially change the name of the association to the “American Society of Oral Surgeons and Exodontists (ASOSE).” This new name was reflected in the practice modalities addressed during the annual meetings. Topics presented during these meetings included: developments in anesthetics and advancements in anesthesia administration and monitoring; the treatment of complications resulting from extractions, facial fractures, oral surgery and plastic cases; impacted teeth and cleft lip and palate. These conditions and procedures continue to form the solid foundation of the specialty today.

In 1946, the word “exodontists,” which had been a point of contention for many members since the society’s earliest days, was eliminated. From 1946 until 1977, the organization was known as the American Society of Oral Surgeons (ASOS), however, beginning in 1961, it was evident this new, abbreviated name was not a comfortable fit.

The specialty was growing and its scope of practice was changing to the point that even the definition of “oral surgery” was a point of disagreement between the American Dental Association and the American Medical Association. At issue was the rise of orthognathic surgery as a major component of OMFS specialty practice and the increased involvement of oral surgeons in maxillofacial trauma care. The first suggestion that the word “maxillofacial” be added to the association’s name occurred in 1968, after oral surgeons from the United States attended international meetings and symposia that were designated “maxillofacial.”

As debate over incorporating the word “maxillofacial” into the association’s name began to heat up, similar discussions were taking place between plastic surgeons and otolaryngologists regarding the use of the term in the context of performing “facial plastic surgery.” In the end, a study session on maxillofacial surgery held by the AMA was co-opted by the plastic surgery section, which, over the objections of the otolaryngologists, was ultimately expanded to include maxillofacial surgery.

Following many discussions that included advice from legal counsel, a meeting between the ASOS and the ADA Board of Trustees in 1973 resulted in the approval of a resolution by the ADA House of Delegates permitting ASOS members to announce themselves as practicing oral and maxillofacial surgeons. Subsequent changes were also made to the ASOS Principles of Ethics and the definition of the specialty. In 1977, the ASOS House of Delegates changed the name of the organization to the American Association of Oral and Maxillofacial Surgeons and the name of the association’s journal to The Journal of Oral and Maxillofacial Surgery.

Throughout the 20th century, oral and maxillofacial surgeons were on the forefront in the development of oral and maxillofacial treatments and procedures that improved the outcomes and lives of their patients. Many current trauma techniques, for example, were developed by OMFS in combat hospitals in World War II, Korea, Vietnam, the Gulf Wars and the recent conflicts in Iraq and Afghanistan.

As we venture well into the second decade of the 21st century, the specialty of oral and maxillofacial surgery continues to be an exciting area of practice for the 9,500 oral and maxillofacial surgeons in the United States.

Oral and maxillofacial surgeons are respected and valued members of the U.S. healthcare team who maintain active staff privileges with local and regional hospitals in their communities and practice in a variety of settings, including private clinical practice, ambulatory surgical centers and hospitals. Other opportunities are available in academia, military service or in dental research and industry.

At present, there are 101 oral and maxillofacial surgery residency training programs in the United States providing the specialty with about 190 new surgeons each year. Following dental school, oral and maxillofacial surgery residents complete a hospital based surgical residency of at least four years. This includes a minimum of 30 months dedicated to oral and maxillofacial surgery, in addition to a core surgical year that includes rotations in medicine, general surgery, anesthesia and other services. All of our residents complete the same rotations with the same level of responsibility as medical residents.

Some oral and maxillofacial surgery residents earn medical degrees as an integrated component of their OMFS training but regardless of whether a resident decides to complete a residency with or without a medical degree, all training meets the accreditation standards and is, therefore, virtually identical. As a result, all oral and maxillofacial surgeons possess the knowledge and skills to perform the full scope of specialty practice.

Dentoalveolar procedures, including third molar and dental implant surgery, are a staple of the specialty but our surgeons also maintain a strong presence on the hospital staffs in their communities and routinely take trauma call. In fact, the American College of Surgeons’ guidelines for optimal care require Level I trauma centers to have oral and maxillofacial surgeons on call to perform complex reconstruction of the maxillofacial and craniofacial complex.

In recent years, their skill in facial reconstruction, the same skills that enable OMFS to excel at orthognathic and cleft procedures, has led many oral and maxillofacial surgeons to expand into the elective facial cosmetic surgical area and several AAOMS members have limited their practice to the cosmetic surgery field. Another growing area of practice is oral pathology. Regrettably, we are seeing more young people present with malignancies relating to their use of tobacco and exposure to Human Papilloma Viruses.

Five years ago, oral and maxillofacial surgeons in the U.S.A. were among the first to identify a correlation between bisphosphonate drug therapy and a condition presenting as exposed, necrotic bone in the maxillofacial region, which has since been termed Bisphosphonate Related Osteonecrosis of the Jaw (BRONJ). While the condition remains difficult to cure, AAOMS fellows and members have published a white paper, conducted a webinar, published a BRONJ focused supplement to the Journal of Oral and Maxillofacial Surgery and generally performed an outstanding service to the dental and medical communities by alerting them to the condition, its symptoms, and ways to screen potential patients before they undergo oral surgical procedures.

As exciting as the specialty’s future is, there are some areas of concern. The AAOMS is particularly troubled by shortage of faculty in the OMFS programs. As academicians leave their posts in growing numbers for private practice,

AAOMS 2011–2012 Board of Directors. Seated, left to right: Robert C. Rinaldi, Executive Director; Brett L. Ferguson, Treasurer; Miro A. Pavelka, President-Elect; Arthur C. Jee, President; Eric T. Geist, Vice President; Larry J. Moore, Immediate Past President and Steven R. Nelson, Speaker of the House of Delegates. Standing, left to right: J. David Johnson, Jr., District III Trustee; William J. Nelson, District IV Trustee; Lawrence J. Busino, District I Trustee; Douglas W. Fain, MD, District V Trustee; Henry C. Windell, District VI Trustee and Louis K. Rafetto, District II, Trustee.

there are not enough surgeons interested in filling their vacancies. In 2002, AAOMS established the Faculty Educator Development Award, which presents a three-year stipend to deserving young OMFS interested in working as an academician. Approximately four to five FEDAs are awarded each year and as of 2009, 33 individuals had been recognized.

Another concern is the effect of healthcare reform on our specialty. The bill signed into law in 2011 will not take effect until 2014 but there are a number of requirements that we must investigate further to determine how we may help our members comply. Further, we must determine what impact this bill will have on our abilities to continue to provide excellent oral and maxillofacial surgical care.

Overall, it is a privilege to be an oral and maxillofacial surgeon practicing in the United States today. OMFS enjoys a broad scope of practice that allows us to use the full range of our training and skill to save the faces and change the lives of our patients. It is truly an exciting time to be a member of this specialty. Mark Tucker and John F. Helfrick

Uruguay

Uruguayan Society of Oral and Maxillofacial Surgery

Sociedad Uruguaya de Cirugia Buco MaxiloFacial The development of the specialty in Uruguay began in 1946, when a section of surgery was established by the Uruguayan Dental Association but it was not until 1955 that the constitution of the society was written. In 1972, the silver jubilee was celebrated and Ries Centeno was appointed as an honorary fellow.

The first scientific meeting of the society was held in 1974. In 1976, under the chairmanship of Leon Römer, the need for official recognition of the specialty by the health authorities was recognized and a commission established to advance this issue.

In 1985, Mario Scarrone became president of ALACIBU and the headquarters moved to Montevideo. The scientific congress was subsequently held in Montevideo in 1988, attended by Wilfred Schilli, the president of IAOMS. That also was the year that the society affiliated with IAOMS. A seminal event in the history of teaching in the specialty was the organization of the first training seminar, organized by the Uruguayan Society in Punta del Este.

On the occasion of the 50th anniversary of the society, a scientific meeting was held in Punta del Este in conjunction with the countries of the Southern Cone. At a meeting, at which participants of the MERCOSUR countries were present, the issue of regulation of the specialty was discussed. During the period 1995–2002, when Andres Migliorisi was president, moves were made to have the specialty officially recognized by the health authorities, which was successfully accomplished.

In 2007, at the society’s national meeting, the dean of the dental school reported that the central board of the University of the Republic, had adopted the

Andres Migliorisi, president draft of “Specialization in Oral of the association, welcomes and Maxillofacial Surgery and attendees to the 50th Anniversary meeting in 1998.Oral and Maxillofacial Trauma,” a move which had been long delayed and was important for the training of specialists. This became official in November 2008, when the board of the faculty of dentistry, supported by the University of the Republic, awarded the title of “Specialist Surgeon in Oral and Maxillofacial Traumatology and Surgery” to six senior members of the society.

The current training is organized through the University of the Republic in which teachers of the dental and medical school participate. Mario Escarrone is responsible for the program, which lasts eight semesters. The clinical training is delegated to several hospitals that have formal agreements with the university.

The current membership of the society is 30, excluding five trainees. They serve a population of 3.6 million people.

Peter Banks (right), president of the IAOMS 1997–1999, receiving a plaque to commemorate the 5oth anniversary meeting of the association.

In summary, since 1946, when the section of surgery of the Uruguayan Dental Association was founded, numerous efforts had been made to achieve the establishment of the Uruguayan Society of Oral and Maxillofacial Surgery and Traumatology. Andres Migliorisi

Venezuela

Venezuelan Society of Oral and Maxillofacial Surgeons

Sociedad Venezolana de Cirugia Buco-Maxilofacial The pioneers in Venezuela were a group of surgeons who worked at the Red Cross Hospital, Dental Department, led by José Barros Saint-Pasteur. He was a dually qualified, self-trained maxillofacial surgeon, who performed a wide variety of surgical interventions, including oncologic surgery. Patients came from all corners of the country for dental extractions and treatment of oral-facial infections but also for reconstructive surgery and correction of facial deformities. For this purpose, hospital facilities were available. The members of the staff were mostly oral surgeons from Central University of Venezuela.

Raul Garcia Arocha, who trained at the University of Chicago, Illinois, was the initiator of the establishment of the Venezuelan Oral Surgery Society in 1957. He also became the first president, with José Barros Saint-Pasteur as his secretary. They organized seminars, wrote the bylaws and held a congress every two years. They also promoted strong ties with the AAOMS. The society grew and changed presidents every two years. The attendance at the meetings also increased steadily and international speakers were always invited to stimulate the new generation and to elevate the level of the specialty. The second Latin American meeting (ALACIBU) was held in Caracas in 1967 under the presidency of José Barros Saint-Pasteur. The relations with the national associations of other Latin American countries were strengthened at that meeting.

The first training program for oral surgery in Venezuela was established by Raul Garcia-Arocha in 1978 at the Central University of Venezuela in Caracas. It was a two-year program that provided little hospital exposure. The other dental schools in the country copied this two-year training program. The society changed its name to “Oral and Maxillofacial Surgery” in 1983, following the AAOMS. The society has grown ever since and currently has 265 members. Altogether, society members serve a population of around 27 million people. The society has several regional sections in order to stimulate local activities and to provide information to all registered colleagues.

The practice of oral and maxillofacial surgery improved dramatically with the input of Olaf Sandner, trained in Hamburg, Germany; Cesar A. Guerrero, trained in Dallas, Texas; Esteban Papp, trained in Minnesota and Raul Garcia-Arocha, trained in Boston, Massachusetts. They introduced modern techniques and concepts to the country and brought a new vision to the specialty. In 2002, this all led to the opening of a four-year oral and maxillofacial surgery program in Caracas, based on the guidelines as supported by the IAOMS. Since that time, this program has been directed by Alberto Lander-Hoffman. There are two full OMFS training programs in the country. The second program is in Valencia directed by Ruben Muñoz. Together they take six new trainees every year. The first graduates are already in teaching positions and

From left to right: Raul Garcia-Arocha, José Barros Sant-Pasteur, pioneers of Venezuelan oral and maxillofacial surgery. From left to right: Peter Waite, Esteban Papp, Mrs. Daniel Waite, Daniel Waite visiting and lecturing in Caracas.

are helping to further improve the level of training of OMFS throughout the country. These training programs comply with the IAOMS standards, including medical rotations, full-time dedication, emergency calls, etc. The society is also discussing the need for certification and re-certification every 10 years. ALACIBU is considering implementing an evaluation program and paying on-site visits to assess the state of the art in Latin American education and training and to set up a committee to permanently survey the different training programs and to offer recommendations in order to provide better standards of care.

Scientific meetings of the Venezuelan Society have been visited by many invited international speakers with great reputations. Among them have been: Hugo Obwegeser, Jens Pindborg, Roy Eversole, Robert Walker, William Bell, Philip Boyne, Per-Ingvar Brånemark and many others. They all have contributed to the improvement of the standards of our profession.

Venezuela also has contributed internationally with pioneering work. In 1967, José Barros Saint-Pasteur described interpositional bone grafting for the edentulous mandible, which was some five years before Schettler. In 1968, he also introduced the concept of the orbicularis oris muscle reconstruction for bilateral cleft lips and in 1970, maxillary advancement using a palatal approach. Cesar Guerrero initiated intraoral distraction osteogenesis for widening and lengthening as well as bone transport for mandibular reconstruction and alveolar clefts. He also did some pioneering work utilizing zygomatic implants and preimplant surgery for rehabilitation of oral function.

Venezuelan textbooks have contributed to Latin America OMFS. Olaf Sandner ’s books in Spanish on temporomandibular joint surgery and oral and maxillofacial surgery have served dental and postgraduate students in Latin America, and Cesar A. Guerrero ’s Distraction Osteogenesis of the Facial Skeleton was translated into Spanish and Portuguese after the original version was published in English. Zygoma Implants: an Atlas of Surgery and Prosthodontics also was published in English and Spanish.

Cesar Guerrero was president of ALACIBU from 2000 to 2003 and during that period the first index of surgeons in South America was introduced. An important contract was signed at that time between AAOMS, CAOMS (Canadian Association of Oral and Maxillofacial Surgeons) and ALACIBU to elevate the level of the specialty in this continent. AAOMS translated its journal into Spanish in Venezuela and a free issue was delivered to every surgeon of the ALACIBU membership roster. The project, unfortunately, did not continue because of the lack of interest from the Latin American surgeons to subscribe, even for a discounted fee. The Venezuelan society is indebted to the AAOMS for their help in training so many surgeons and for setting the example for the development of the specialty in Venezuela.

Medical and dental care in the country is currently based on government clinics and hospitals where the patients are treated for free. The National Health System evaluation, however, shows vastly deteriorated installations, poor assistance in technology and major deficiencies in available pharmaceuticals. Many medical specialties have ceased to exist in the hospitals and most of the elective surgery is not performed in the government system anymore. Elective surgery is performed in private hospitals or ambulatory centers, with minimal insurance coverage. Cesar Guerrero

Epilogue

The contributions of 63 of the 75 affiliated national oral and maxillofacial surgeon associations that submitted an abstract, contain a wealth of information in that for the first time in the history of the specialty and of IAOMS, a reasonably accurate impression is gained about the total number of oral and maxillofacial surgery who are operating worldwide.

Considering that not all colleagues are members of their national association and also that some countries have not submitted abstracts, while also some countries are not affiliated to the IAOMS, the total number of OMS should be around 30,000. These contributions also provide a good insight into how OMFS training is organized in the different parts of the world. Not only are there a number

global distribution of omfs

Region Africa

Asia

Europe Latin America North America

Oceania

Total Total Number of OMFS

522 6,454 8,322 2,863

9,971

200

28,332

of similarities, it also is striking to see how over the last two decades, the various pathways of education and training have seemed to converge to a common denominator. There are, however, still many differences that are largely defined by historical and socioeconomic factors. It is obvious, however, that the “IAOMS’ Guidelines on Education and Training,” as they exist today (see addendum), has had an enormous impact on the emerging specialty in the various countries. It seems likely that the training of the new generation will be universally based on a sound medical and dental base, albeit that this may be arranged in different ways in the specific regions.

Another lesson to be learned is that the specialty has made an enormous progress over these 50 years. This took place worldwide and probably continues to do so. It is heartwarming to see that many developing countries are catching up so quickly and are also participating in the academic setting by producing scientific articles in international literature. This is of great importance as Fred Henny pointed out in 1965; proper education and training is based on three pillars, education, patient care and research (see chapter 1). Let us hope that the content of this chapter will inspire even more educators to organize their education and training around these three fundamental aspects.