Innovations in Oral Surgery

Podcast Transcript

Paul Bryson: Welcome to Head and Neck Innovations, a Cleveland Clinic podcast for medical professionals exploring the latest innovations, discoveries, and surgical advances in otolaryngology - head and neck surgery.

Thanks for joining us for another episode of Head and Neck Innovations. I'm your host, Paul Bryson, Director of the Cleveland Clinic Voice Center. You can follow me on X, formerly Twitter, @PaulCBryson, and you can get the latest updates from Cleveland Clinic Otolaryngology-Head and Neck Surgery by following @CleClinicHNI on X. That's @CleClinicHNI. You can also find us on LinkedIn at Cleveland Clinic Otolaryngology - Head and Neck Surgery, and Instagram at Cleveland Clinic Otolaryngology.

Today I'm looking forward to speaking with Dr. Alan Martinez, our new oral surgery colleague in the Section of Dentistry and Oral Surgery. Dr. Martinez, welcome to Head and Neck Innovations.

Alan Martinez: Thank you so much. I appreciate your invitation and I feel honored to be here.

Paul Bryson: Well, it's great to have you as part of the group, and looking forward to introducing you to our audience. So if you could, let's start by having you give some background on yourself for our listeners, where you're from, where you're trained, how you came to Cleveland Clinic.

Alan Martinez: Yeah, I have an interesting background. I was born in South America in Peru, and then I grew up in Honduras. I did my education initially there, and then in Peru my residency, and then I moved to upstate New York for further education. So spent a few years there, do my advanced education and dentistry there, then after that I matched here in Cleveland, the MetroHealth local hospital. From there, that was 2009, I stayed there and basically worked there until last year. That's when I came here in December.

Paul Bryson: That's great. I think it's always a strength I think when you have sort of a diverse training background. Just from where you're from to now, to be a Clevelander, it's great to have you. I'm sure the time spent at Metro, you've seen a pretty diverse array of pathology and patient care.

There may be a lot of listeners who don't know that Cleveland Clinic has a dentistry and oral surgery program. Can you talk about some of the conditions that you treat, maybe that your group looks after?

Alan Martinez: Yeah, of course. Cleveland Clinic has a very large dental department compared to other hospitals. They have several dentists there, do all kinds of general dental treatment. There's also periodontists, maxillofacial prosthodontist, there's a TMJ specialist doctor.

On my side, I specialize in the surgical part, and the oral cavity and the facial bones. So basically anything related to extraction, wisdom teeth, dental implants, I get to see those. We do also sedations for patients that require it, and if you have any problems with your TMJ and facial bones, benign tumors and cysts, all that, that's something that I do.

Paul Bryson: What about, we have a pretty large surgical sleep program, is surgical management of severe obstructive sleep apnea something that you're interested in?

Alan Martinez: Yes, of course. Within the jaws there is some osteotomies that can be done for some patients for sleep apnea, and that's something that is very rewarding to do and I am very interested in doing that too. Trauma is something that I've been doing too a lot, and actually yesterday we did a trauma case here. It was interesting and it was fun.

Paul Bryson: Yeah, I would think when I look back to my own training background, facial trauma and rehabilitation of injury and that is a pretty significant thing when we're on call and things like that, and I would imagine with your background you've seen quite a spectrum of facial injury.

Alan Martinez: Yeah, facial trauma is very rewarding area for specialty and it's something that we overlap a lot with ear, nose and throat and head and neck surgery and plastic surgery too. I was operating with the residents yesterday and it was very fun, I enjoy that a lot.

Paul Bryson: Well, it's a great opportunity to share your training background and teaching to the otolaryngology residents, and maybe the dental residents too. If they're coming in, they'd be lucky to have your expertise to learn those approaches.

Alan Martinez: Well, yeah, thank you. Appreciate that. Yeah, we're very happy to be here and I feel very welcome. It feels like a big family and I'm very happy and honored to be here right now.

Paul Bryson: Well, if you would too, what are some of the more recent and significant advancements in oral surgery technology? What's your opinion on how they've impacted patient outcomes?

Alan Martinez: Yeah, there's been so much development in the last few years with the use of virtual surgical planning and using our 3D models. That has reduced significantly the surgery time, and you can be more precise and improve the outcome of the patient, because you have less time in the OR, more precise patient-specific implants, and that's something that we basically do almost on every big case that we have now. Yeah, that's very interesting.

Paul Bryson: Yeah, I think the concept of personalized medicine, we hear about it with medical treatments and things like that. However, with imaging, I think it sounds like a really great opportunity, even just for pre-surgical counseling and to know what to expect. To have the patient feel that, all right, well, look, this is my facial and dental skeleton and this is the plan.

Alan Martinez: Yeah, I think it has made big impact. In those very challenging cases, it takes away a lot of the guesswork. Now that you have this virtual planning and 3D technology, you can just have a specific position of a shape of a plate that you have to use to fixate the bone, and it takes a lot of guesswork out I say, so that's very, very interesting and unique now.

Paul Bryson: As patients or as our listeners might want to refer patients to you, what can they expect if they're referred into or schedule an appointment with you and the dental team? Walk us through what that might look like.

Alan Martinez: There is a large pool of patients, and we have a good service of phone calls, and if there's an emergency, they do their best to accommodate patients as soon as they can. Then once they see me, usually I do a consultation first. Then it depends on the need of the patient, we decide where the care's going to be performed, either in the office on the local anesthesia or in the sedation room, or in the operating room too.

Paul Bryson: It sounds like you have some flexibility and options just depending on the problem.

Alan Martinez: Correct. Correct, yeah.

Paul Bryson: Yeah. Then anything on the horizon as far as research interests or new technology, or anything that you're excited about over the next few years? You mentioned high definition image guidance. Anything else that you're kind of interested in?

Alan Martinez: Yeah, I think I like to explore more the virtual side of doing the surgery virtually and see how that can be used to train future residents. That's something that I'm very interested in too. There's also a lot of new technology in dental implants that is interesting. You can do a lot of custom guides and you can now rehabilitate patients the same day of the reconstruction, something that they're doing right now here that is very impressive.

Paul Bryson: Yeah, to maybe decrease some wait times and things like that.

Alan Martinez: Correct.

Paul Bryson: Oh, that would be really nice for patients. I think we hear all the time where you're like, "Oh, I went and now I have to do this, and oh, it's going to take six months to get this implant done," and it feels like a long time.

Alan Martinez: Yeah, and a lot of times after they have the big major surgery, the patients are hesitant to do more.

Paul Bryson: Yeah.

Alan Martinez: Yeah, so if you can offer them something that is done in less surgeries and less time off, that's something that is priceless.

Paul Bryson: Yeah. Well, it's been great to have you on the podcast today. Any final take home messages for our listeners?

Alan Martinez: Just to remind everyone that we are here, we are happy to be here and see any patients with maxillofacial and oral surgery needs. I'm always available for a phone call, consult.

Paul Bryson: You’re welcome and it's been great to have you. For more information on oral surgery at Cleveland Clinic, please visit clevelandclinic.org/oralsurgery. That's clevelandclinic.org/oralsurgery. To connect directly with our Section of Dentistry and Oral Surgery or submit a referral, visit ClevelandClinic.org/Dentistry or call 216.444.6907. That's 216.444.6907.

Dr. Martinez, thanks for joining Head and Neck Innovations.

Alan Martinez: Thank you so much for the invitation.

Paul Bryson: Thanks for listening to Head and Neck Innovations. You can find additional podcast episodes on our website clevelandclinic.org/podcasts. Or you can subscribe to the podcast on iTunes, Google Play, Spotify, BuzzSprout, or wherever you listen to podcasts. Don't forget, you can access realtime updates from Cleveland Clinic experts in otolaryngology – head and neck surgery on our Consult QD website at consultqd.clevelandclinic.org/headandneck. Thank you for listening and join us again next time.