Welcome back to Everyday Oral Surgery. In today’s episode, Dr. Stucki is joined by Dr. Andrew Jenzer for a dynamic session featuring mock board exam cases designed to help residents and practicing surgeons prepare for certification. Through realistic clinical scenarios that test both knowledge and composure, this episode offers valuable insight for trainees and a practical refresher for experienced OMS surgeons. Along the way, Drs. Jenzer, Frazier, and McMillan provide constructive feedback, share expert perspectives, and walk through strategies for navigating the complex situations commonly encountered in board examinations. This mini-series, based on Dr. Jenzer’s Weekend Warrior Course, aims to empower more surgeons to pursue board certification confidently and perform at their highest level, reflecting the excellence of the specialty. Thanks for listening.

Key Points From This Episode:

• An introduction to today’s episode: A series of mock board cases.
• Dr. Jenzer’s advice to those about to listen to this episode.
• Case 1: 17-year-old female presenting with a referral from her dentist stating, "Please extract wisdom teeth.”
• Feedback from Case 1 with Dr. Kyle Frazier, Dr. Jenzer, & Drs. Dane and Kale McMillan.
• Case 2: 56-year-old male with a referral from his general dentist saying, "Take all the teeth out. He's going to get complete dentures.”
• The examiner gives feedback on navigating two emergencies: the waiting room question.
• Feedback from Case 2 with Drs. Frazier, Jenzer, & McMillan.

Links Mentioned in Today’s Episode:

Dr. Andrew Jenzer — https://surgery.duke.edu/profile/andrew-clark-jenzer

Dr. Andrew Jenzer Email Address — andrew.jenzer@gmail.com

Dr. Kyle Frazier — https://providers.geisinger.org/provider/kyle-bryan-frazier/2610047

Dr. Dane and Kale McMillan — https://www.ottawaoms.com/drs-kale-dane-mcmillan-dental-surgeons-ottawa/

Weekend Warrior Course

ABOMS — https://www.aboms.org/

Everyday Oral Surgery Website — https://www.everydayoralsurgery.com/

Everyday Oral Surgery Blogpost — https://everydayoralsurgery.com/blog/

Everyday Oral Surgery on Instagram — https://www.instagram.com/everydayoralsurgery/

Everyday Oral Surgery on Facebook — https://www.facebook.com/EverydayOralSurgery/

Dr. Grant Stucki Email — grantstucki@gmail.com

Dr. Grant Stucki Phone — 720-441-6059

Managing mandible fractures requires more than textbook knowledge. It requires sound clinical judgment, careful evaluation, and an understanding of how treatment decisions impact outcomes. In this episode of the Everyday Oral Surgery Podcast, Dr. Grant Stucki welcomes back Dr. Andrew Jenzer, oral and maxillofacial surgeon, to continue their trauma series with an in-depth discussion on facial fractures. Dr. Jenzer breaks down the fundamentals that guide clinical decision-making, starting with how bone healing is influenced by fixation and mobility, and why minimizing movement is key to predictable outcomes. He walks through essential fracture terminology, zones of tension and compression, and the physical exam findings that should never be missed, including the importance of identifying a patient’s pre-injury occlusion. The conversation also explores imaging strategies, timing considerations, and how to approach treatment planning, from observation to closed reduction, or open reduction with internal fixation. Along the way, Dr. Jenzer shares practical insights, common pitfalls, and real-world considerations that go beyond textbook learning. This episode connects core principles to real-world surgical practice and offers a clear framework for approaching mandible fractures with confidence!

Key Points From This Episode:

• Primary and secondary bone healing and how fixation affects outcomes.
• Why minimizing mobility improves fracture healing success.
• Mandible fracture terms: simple, compound, comminuted, green stick, and pathologic.
• Muscle-related fracture terms: favorable, unfavorable, horizontal, and vertical.
• Zones of tension and compression and their clinical relevance.
• Physical exam findings: loss of function, malocclusion, and nerve changes.
• The importance of identifying the patient’s pre-injury occlusion.
• Imaging and clinical considerations for a thorough evaluation.
• When to escalate patients to the ER for full trauma evaluation.
• Three treatment paths: observe, closed reduction, or open reduction with internal fixation (ORIF).
• How patient factors and compliance shape treatment decisions.
• Closed reduction and Maxillomandibular fixation (MMF) options: arch bars, intermaxillary fixation (IMF) screws, Minne Ties, bridal wire, manual stabilization, and hybrid systems.
• Navigating trade-offs between efficiency, stability, and patient comfort.
• The advantages of ORIF for stability and faster recovery.
• Evaluation and management of condylar fractures, including surgical indications.
• Why coronoid fractures rarely require treatment.
• Ramus and angle fractures: approach and fixation options.
• Champy technique benefits, limitations, and the role of patient compliance.
• Ladder plates as a stronger, more reliable alternative to the Champy technique.
• How to approach decision-making for teeth in the line of fracture.
• Dr. Jenzer’s step-by-step approach to fracture exposure, reduction, and fixation.
• Navigating complications of healing mandible fractures, including malunion, nonunion, and infection.

Links Mentioned in Today’s Episode:

Dr. Andrew Jenzer — https://surgery.duke.edu/profile/andrew-clark-jenzer
Dr. Andrew Jenzer Email Address — andrew.jenzer@gmail.com

Everyday Oral Surgery Website — https://www.everydayoralsurgery.com/

Everyday Oral Surgery on Instagram — https://www.instagram.com/everydayoralsurgery/

Everyday Oral Surgery on Facebook — https://www.facebook.com/EverydayOralSurgery/

Dr. Grant Stucki

What are the most important steps to take after the primary survey to avoid missed injuries and set facial fractures up for a safer repair? In this episode of Everyday Oral Surgery, Dr. Andrew Jenzer returns to break down practical trauma fundamentals for oral and maxillofacial surgeons. He explores the steps for secondary surveys, core fracture repair principles, evaluating facial trauma, and making surgical decisions under pressure. He explains haemorrhagic shock staging, the Glasgow Coma Scale, cervical spine considerations, and a systematic approach for assessing trauma. He discusses the distinction between rigid and semi-rigid fixation, load-bearing versus load-sharing constructs, and how locking screws can help reduce complications. He unpacks the red flags to look out for, like orbital compartment syndrome, muscle entrapment with the oculocardiac reflex, and CSF leaks. Dr. Jenzer also shares planning guidance to help prevent missed injuries and unpacks why thin-slice CT scan reformats are vital. Tune in now!

Key Points From This Episode:

• The four classes of hemorrhagic shock and the vital signs associated with each stage.
• Learn about the Glasgow Coma Scale and why a low score is a cause for concern.
• Understand penetrating neck trauma zones and why the zone determines the approach.
• Discover the difference between rigid fixation and semi-rigid fixation for fractures.
• Unpack the ‘ideal lines of osteosynthesis’ concept and the biomechanical advantage it offers.
• Find out how load-bearing fixation differs from load-sharing fixation for plates and screws.
• Locking screws versus non-locking screws, and when is the best time to use each.
• Hear about the Advanced Trauma Life Support (ATLS) process and why it is important.
• How to confirm cervical spine safety using NEXUS criteria before proceeding.
• Dr. Jenzer shares his top-down, systematic approach to assessing trauma.
• Examples of when existing injuries have been overlooked and why.
• Ways to spot orbital compartment syndrome and why vision loss can be a bad sign.
• What muscle entrapment and the oculocardiac reflex indicate, and how to navigate it.
• Why thin-slice CT scans should be requested over standard thicker cuts.
• Explore why early airway and feeding strategies are vital to consider early on.

Links Mentioned in Today’s Episode:

Dr. Andrew Jenzer — https://surgery.duke.edu/profile/andrew-clark-jenzer
Dr. Andrew Jenzer Email Address — andrew.jenzer@gmail.com

ACOMS — https://www.acoms.org/

Everyday Oral Surgery Website — https://www.everydayoralsurgery.com/

Everyday Oral Surgery on Instagram — https://www.instagram.com/everydayoralsurgery/

Everyday Oral Surgery on Facebook — https://www.facebook.com/EverydayOralSurgery/

Dr. Grant Stucki Email — grantstucki@gmail.com

Dr. Grant Stucki Phone — 720-441-6059