Reaching the top rung in dentistry

Lyna Mohammad

The Reconstructive Implant Unit was formed at the Maxillofacial, Facial Plastic and Reconstructive Surgery Centre (MFPRSC) in 2017, under the management of Pantai Jerudong Specialist Centre (PJSC), as part of the MFPRSC Surgical Team for oral rehabilitation of reconstructed jaw cases following oncologic head and neck surgery.

Head and Consultant at Reconstructive Implant Unit Dr Haji Muizzaddin bin Dato Seri Setia Haji Awang Abdul Mokti in a recent interview with the Bulletin said, “We treat patients who require fixed restorations; in this case it is in the form of dental implants to replace a missing tooth or teeth.”

Cases managed at the unit range from single tooth replacements, multiple teeth replacements, full upper and/or lower teeth replacements and the oral rehabilitation of patients who had their jaws reconstructed from the removal of tumour of the head and neck. “All of this are done locally – from initial appointment, investigations, diagnosis, planning, surgery and restoration.”

As a Harvard graduate, Dr Haji Muizzaddin was one of the few selected out of the many applicants to enrol into the Advanced Graduate Education in Implant Dentistry. He also received research grant from the International Team for Implantology (ITI), Joseph L Henry and American Academy of Implant Dentistry (AAID) Awards as well as publication in journals and a book chapter.

Dr Muizzaddin has been working in the dental field for more than 15 years where he and his colleague are responsible for dental implant treatment at the centre. The Reconstructive Implant Unit currently has two implant specialists who are a part of a surgical team in MFPRSC. The team, along with its auxiliary staff and a purpose-built building, offer the ideal environment for patients seeking dental implant treatment. Since its operation, the unit has expanded to take on more complex cases such as bone regenerative procedures.

Head and Consultant at Reconstructive Implant Unit Dr Haji Muizzaddin bin Dato Seri Setia Haji Awang Abdul Mokti. PHOTO: MUIZ MATDANI

They also successfully treated patients, who have lost most of their jaws as a result of tumours, after a year to 18 months, where they can chew again.

As with the survival rate for implants that remained in the patients mouth after insertion is high, a 94-97 per cent range, he added.

Dr Muizzaddin said it is important to know about the patient, understand the patient’s needs and expectations, establish existing medical and dental conditions to ascertain the risks for dental implant treatment.

“Risk factors exist, so it is crucial to take note of the medical and dental conditions.”
Risk factors such as patients having severe bone diseases for example osteoporosis, osteopenia and osteogenesis imperfecta; uncontrolled diabetes, blood or clotting disorders, heavy smokers, radiotherapy to the head and neck, mental and psychological disorders and medications that can alter bone metabolism such as bisphosphonates – all these can have a significant effect to patients requiring dental implant treatment.

“We can formulate ideal treatment plan or treatment options that we can propose to the patient once we get their medical information. This can lead to patients’ participation in the decision-making process as well as having a solution tailored to their oral health needs.”
Dr Muizzaddin said that he has special interest in oral rehabilitation of patients following head and neck reconstructive surgery as these surgeries affect patients’ appearance, chewing function and self-esteem.

He and his team’s role is to help these patients using implant retained prostheses so that their oral function and esthetics can be rehabilitated.

Asked what his biggest challenge in performing treatment or surgery, he said the challenges are on case to case basis.

“There are no specific areas or parameters that I could pinpoint. However, the most challenging cases would have to be the reconstructed jaw cases due to the fact that their bone anatomy and soft tissue coverage are dramatically altered. These cases require meticulous planning and extra precaution during surgeries.” Overall, Dr Muizzaddin said it is important to follow proper guidelines or guiding principles and hopes nothing unforeseen things would arise when performing the surgeries.

In regards to integrating the digital workflow, Dr Muiz said, “This is an area I’m really excited about and had the pleasure of being trained in the US.

“I was fortunate that I went for training, it was the period when the dental arena/field was transitioning from analog to digital.”

Initially switching from paper to electronic health records, these have made a significant impact in the day to day running of the clinic. Introducing digital technology can make the process faster, seamless, reproducible and accurate as compared to current conventional techniques. The guiding principles of implant surgery and its restoration is still the same, however, with digital technology it gives further aid in the accuracy and streamlining the process.

As for attending Harvard, Dr Muizzaddin said it was a dream come true for him. He never imagined the opportunity to do his training at one of the top universities in the world and working alongside accomplished professors and leaders in the field.

Dr Muizzaddin spent four years training in a combined and intensive clinical, research and leadership programme where the learning environment and resources provided, made studying at Harvard a fulfilling experience. He said the close friendship and networking gained from the collaborative work with the professors and colleagues are lifelong and is something he treasures the most.

Pressure at the post-graduate level no matter which institution you are in is always immense. “At the same time, we are serving the country, not only do we have to demonstrate our capabilities, we have to ensure that we come back fully qualified as well.

“I would not have been able to thrive there if it wasn’t for the intense training I received from my mentor at MFPRSC and the support from my family, friends and colleagues.”

Dr Muizzaddin noted that he still has a long career ahead and there is always room for improvement for him and the unit moving forward.

What he and the team hope is that with advancement in technology and its acquisition, MFPRSC will be on par with the region and become the referral centre and a center of excellence for dental implant treatment and the oral rehabilitation of reconstructed jaws.