North Texas Dentistry Volume 8 Issue 3 2018 ISSUE 3 DE | Page 28

SMILES
SPOTLIGHT
in the
Case Presentation
R. M. is a 55-year-old man with a shotgun wound to the face. This shot-
gun blast injury was suffered in New Mexico, and he was then trans-
ferred to Lubbock for care. He was stabilized in Lubbock and a
tracheostomy tube and gastrostomy tube was placed, however, there
was no surgeon available to tackle this difficult reconstructive case.
After several phone calls were made, he was transferred to Dallas in
order to be evaluated for reconstruction.
LEADERS IN NORTH TEXAS DENTISTRY
CREATING UNFORGETTABLE SMILES
OMS - Head & Neck Surgery
Oral & Maxillofacial Surgeons are often the go-to surgeon for facial
trauma in the world and have been integral in advancing facial recon-
struction during the Civil War and throughout the World Wars. In the
past decades, more OMSs have gone on to pursue additional training
in oncologic surgery and microvascular surgery in order to take care of
the complex oral, head and neck cancer patient. With the oncologic
training, we are now able to take on the more complex facial traumas
that in the past did not have desirable functional and aesthetic outcomes.
Dr. Kang is the only OMS-Head & Neck surgeon in Dallas who is double
board certified in both OMS and Head & Neck Surgery, and whose prac-
tice is solely devoted to oncologic surgery and reconstructive surgery.
Dr. David R. Kang earned a Masters
degree in Anatomy and Physiology in
Boston and a DDS at Columbia University
then moved to Dallas to begin medical
school and residency training. He com-
pleted a General Surgery internship at UT
Southwestern, and then his Oral and
Maxillofacial Surgery training at Parkland
Hospital. Dr. Kang pursued Fellowship
training in Head and Neck Oncologic
Surgery and Microvascular Reconstructive
Surgery at the Univ. of Michigan. After receiving a certificate in Head and
Neck Oncologic Surgery and certificate in Super Microsurgery, he became
an Asst. Professor in the Dept. of Surgery Texas A&M College of Medicine,
and Asst. Professor in the Dept.of Oral and Maxillofacial Surgery Texas
A&M College of Dentistry. He is one of the few in the country, and the only
surgeon in Dallas, who is board certified as an OMS-Head & Neck Surgeon.
Dr. Kang trains future oral and maxillofacial surgeons in oncologic surgery,
lectures nationally and internationally, and is a peer reviewer for the Journal
of Oral and Maxillofacial Surgery (JOMS) in the categories of oncology,
reconstructive surgery, and trauma.
28 NORTH TEXAS DENTISTRY | www.northtexasdentistry.com
INITIAL PRESENTATION
Treatment Plan
Reconstruction of this patient required consideration of his facial frac-
tures as well as the avulsive defects of his maxillary and mandibular
bones as well as the soft tissue avulsion of his chin, lower, and upper
lips. After evaluation of his imaging, it was decided to stage the surgery.
The first surgery would be limited to debridement of the necrotic soft
and hard tissues that had declared themselves during the interval time
period before his arrival to Dallas, and reduce and repair his maxillary,
malar, and orbital fractures. Once these fractures had been repaired,
he would be returned to the OR for reconstruction of his mandible, oral
cavity, his lip, and chin. Due to the extensive loss of tissues, microvas-
cular free tissue transfer would be required to repair these defects.