Pursuing an OMFS Fellowship with Dr. Waleed Zaid

In this episode of Let’s Talk Teeth, we are joined by Dr. Waleed Zaid, the Fellowship Director of Head and Neck Oncology and Microvascular Surgery at Louisiana State University Health Sciences Center, to discuss his journey from dental school in the UAE to leading one of the top OMFS fellowship programs in the United States. Dr. Zaid delves into the nuances and challenges of oral and maxillofacial surgery, emphasizing the importance of passion in the field. He discusses advancements in digital dentistry, robotics, and AI, as well as LSU's unique oral surgery program. Additionally, Dr. Zaid offers invaluable advice for dental students and new graduates on how to stay motivated and absorb as much knowledge as possible. Don't miss this insightful conversation about the future of oral surgery and dental research.

00:00 Introduction and Guest Introduction

00:35 Dr. Zaid's Journey into Dentistry

01:41 Choosing Oral and Maxillofacial Surgery

03:15 Training and Experience in the UAE and USA

04:38 Joining LSU and Career Path

06:17 Pursuing a Fellowship in Head and Neck Oncology

10:55 Unique Aspects of LSU's Head and Neck Program

13:55 Challenges and Passion in Oral Surgery

15:38 Evolution of Full Arch Dentistry

17:46 The Role of Digital Dentistry in Modern Surgery

18:16 Nerve Grafting and Patient Expectations

20:24 Advancements in Oral Surgery

21:01 The Future of Robotics and AI in Dentistry

21:28 The Importance of Research in Dentistry

26:36 Innovative Techniques in Oral Surgery

29:33 Final Advice for Dental Students and New Grads

Transcript

Saad Alamgir 0:08

All right, everyone. Welcome back to another episode of Let's Talk Teeth. Today we have Dr. Waleed Zaid. Dr. Zaid, if you don't mind just taking a moment to introduce yourself, telling us a little about your background, where you're at, where you're practicing at now, and your journey into dentistry.

Waleed Zaid 0:24

Absolutely. Well, first of all, thank you so much for this kind invitation. Happy to be here and happy to be able to talk to the new generation of future dentists that's gonna be watching your podcast. As you said, my name is Willie Za. I'm a, so I'm a full professor at Louisiana State University Health Sciences Center here in Baton Rouge. I have started my journey internationally actually as an international dental student in the United Arab Emirates in a college there called Edgeman University. And then after that went to McGill University in Montreal, Canada, where I actually was very fortunate to get my residency training there. After finishing my residency, went to Boston University where I did my head and neck oncology and microvascular. Fellowship. And then after that I was heading south, got to Louisiana and has been there for the past almost 14 years. I'm I'm also happen to be the head and neck oncology and microvascular reconstruction fellowship director, so selfish plugin. If anyone is interested, please contact me.

Victor Razi 1:27

Awesome nice story to your story. And it's pretty unique too, that you got your training overseas, so you got to see like international work done and then come to the us. I feel like there's. A bit of nuances in between of like how different people practice. What do you think led you down the road to OMS?

Waleed Zaid 1:45

So, dentistry is a very unique career. But it's also, there tends to be a little bit of repetition in what you do day in and day out, and I wanted a little bit of challenge, a daily challenge every day you come in. Dentistry is challenging for sure, but I just wanted something

Victor Razi 2:05

Sure.

Waleed Zaid 2:05

And it always starts, if you ask, 90% of the oral surgeon will tell you, I was doing as a dental student doing a rotation with an oral surgery, and then I saw a procedure X, Y, Z and that procedure just made me, I wanna be a surgeon. And I'm not any different from all these stories. I vividly remember my first case was like a multi space infections that was approached through the neck. And to be honest with you, I fainted initially, and I'm like, wow,

Saad Alamgir 2:33

Yeah, I'll bet.

Waleed Zaid 2:34

this is this is cool. Okay. And then the next case was like a orthognatic surgery, and then now they're doing a down fracture of a LeFort and your eyes are going wide and you can, while you're driving back home from the hospital, you're still thinking about what happened in that or,

Victor Razi 2:49

sure.

Waleed Zaid 2:50

And you just make that decision. Something clicks in your brain and be like I always like to use this phrase, you found your passion. And once that clicks and you made an informed decision that's my passion, you just follow that passion for forever and that's why you still enjoy what you're, or at least I still enjoy what I'm doing right now.

Victor Razi 3:12

Yeah. That's awesome.

Saad Alamgir 3:14

I was I was interested. You mentioned your foreign trained dentist. How was your, I know again, you are working at LSU now, so I'm assuming you work with some dental students. How was the training that you received you say, compared to, you know, American based training?

Waleed Zaid 3:29

I think so. The training I got in the United Arab Emirates was a very excellent training. It was actually a five year program, so, it wasn't a four year program like the classic training here in the us which allowed this to be have a little bit more. In the curriculum, we had more subjects that we kinda covered. Like for example, as a undergrad dental student, we covered lasers. We covered, dental technologies. That was something

Victor Razi 4:00

that, that's cool.

Waleed Zaid 4:01

And talked about it in class. I really feel that there's also a lot of similarities. And I'll and I'm

Victor Razi 4:07

Sure.

Waleed Zaid 4:08

cause I'm gonna talk about LSU they're high reps, high volume very similar to Mississippi as well. There's just high reps, high volume, high cases that you need to go through. It prepares you to technically to do a procedure and be proficient and efficient in it as well. And that's something that I just was a very seamless transition for me from dental school in the United Arab Emirates where I moved to the us.

Victor Razi 4:37

awesome. So Dr. Ade, what kind of guided your direction towards LSU? Was that always on your radar or were you looking at different options for, kickstart your career? How did that turn out?

Waleed Zaid 4:49

Yeah, absolutely. So,

Victor Razi 4:51

i.

Waleed Zaid 4:52

to be completely honest with you, it was a coincidence and it's actually a very interesting story. I was sitting in the American Association of Oral Maxillofacial Surgery meeting in San Diego, California, and I'm attending one of the lectures. At that time, I was still, a at Boston University and it was a course. So the speaker asked every one of us to introduce himself, so I introduced myself. Well lead Zaid I'm a head and neck fellow from Boston, and next to me was a guy called Dan Spagnoli. He says, Dan Spagnoli, chairman of LSU, oral Maxillofacial Surgery. And I'm like. First of all, Dan Spanno is a very famous surgeon in our field, But he was very humble, very modest, sitting next to

Victor Razi 5:34

That's awesome.

Waleed Zaid 5:35

not a big deal.

Victor Razi 5:36

Right.

Waleed Zaid 5:37

And then I started looking for jobs. So I emailed him and I was like Dr. Spagnoli, I, you know, is there any opening? And he goes absolutely. He gives me a call like 20 minutes after my email. And he was

Saad Alamgir 5:50

Wow.

Waleed Zaid 5:50

wanna call? You wanna come to you wanna come to Louisiana? I'm like

Victor Razi 5:54

Have you ever been Louisiana at this point?

Waleed Zaid 5:57

I actually have never been to Louisiana at all, even more than that. I've never been to a city called Baton Rouge. I didn't know that city actually

Victor Razi 6:04

Yeah.

Waleed Zaid 6:05

So I

Saad Alamgir 6:05

Yeah.

Waleed Zaid 6:06

anything about Bat Baton Rouge. I was like, Baton

Victor Razi 6:07

Yeah,

Waleed Zaid 6:09

and the rest is history. Been in Baton Rouge for the past 14 years, and I'm proud to call it home.

Victor Razi 6:14

yeah. That's awesome.

Saad Alamgir 6:16

That's awesome. How's your transition been, you think from, well, first I had a question about your, at training at Boston University. You said you did microvascular and or.

Waleed Zaid 6:28

Head and

Saad Alamgir 6:28

was Head and neck oncology and microvascular, what kinda led you down to wanting to pursue a fellowship and kind of go further into that specific field? And then going off that, how has your day-to-day been at LSU since, like you said, for the past 14 years?

Waleed Zaid 6:46

Yeah, So, led me to pursue I had the neck fellowship was actually during my residency. So, the first day in my residency there's a gentleman setting by the name of Michelle El Hakim Michelle Hakim was actually just finished his head neck. Fellowship from University of Maryland and came to, became, or to become the program director at McGill. So here I am watching him doing the first free tissue transfer, borrowing someone's leg and reconstruction his jaw and suturing with sutures that are tinier than your hair under the microscope. And I'm like, whoa,

Saad Alamgir 7:23

Wow.

Waleed Zaid 7:24

I wanna do

Victor Razi 7:25

Yeah, that's.

Waleed Zaid 7:26

And for during my residency, I've been exposed to head and neck. And in order for you to pursue this as a career, all require to have a fellowship. We recommend having a fellowship. So I

Saad Alamgir 7:37

Mm-hmm.

Waleed Zaid 7:38

me go pursue a fellowship. And I told my wife, this is gonna be the last very labor intense thing that I will ever do. 14 years, she still reminds me, when is that day gonna come? But yeah, so that was the fellowship. And then when I came to L-S-U-L-S-U gave me a beautiful platform to exercise what I just learned in my fellowship. But I also was able to practice a full scope of oral surgery. So I do trauma. Head and neck oncology some endocrine surgery, SIV gland surgery, dental, alveolar implants, advanced implants. So I'm actually pretty happy in terms of the scope of practice. And I was very thankful. And this is actually that advice that one of my fellowship directors told me, never forget what you are like. Yeah, you're a head and neck surgeon. You're doing oncology. But you were a dentist first, and you were an oral surgery second,

Saad Alamgir 8:36

Mm-hmm.

Waleed Zaid 8:37

you should be able to always do

Victor Razi 8:39

Sure.

Saad Alamgir 8:39

Mm-hmm.

Victor Razi 8:40

That's an awesome story. And honestly, I can see your wi, see your wife sticking out with you all these years.

Waleed Zaid 8:47

Yeah, I keep telling her, honey, six months is gonna be great, and here we

Victor Razi 8:51

I promise, man. That's awesome.

Waleed Zaid 8:53

be early tomorrow and here we are.

Victor Razi 8:55

Yeah. So one thing that we actually haven't talked about much on our podcast yet, and I'm gonna ask you this, is we've asked on how you apply to like oral surgery residency or just residency in general, but we never really, explored much on how to, is the process of applying to fellowship relatively similar, you'd say? Is there any more nuances that dental students slash residents should know about?

Waleed Zaid 9:18

Yeah.

Victor Razi 9:19

or is it, would you say it's relatively similar to just applying to residency in general?

Waleed Zaid 9:24

Yeah. Excellent question actually. I think there's definitely a lot of similarities between applying from dental school to residency and from residency to fellowship, both of them. Share that you need to make up your mind a little bit early in the game because that helps you to prepare more, but also gives you an opportunity to go visit places and take a look at

Saad Alamgir 9:49

Right.

Waleed Zaid 9:50

what's going on in terms of their scope of practice. How's the dynamic between the teacher and the trainees? But I think it helps a lot to have that interest. But also the other thing that. Kinda a second gain when you have early interest in something is you can even start to become and prepare and kinda customize your CV to be more, to gear towards head and neck. For example, attending more head and neck conferences. Pursuing research that focuses on head and neck oncology, microvascular going to externships or visiting programs or even getting courses or advanced training courses as a resident head and neck during residency program of helps you a lot in preparing yourself for that. So the earlier you make that decision, the better it is for you. It gives you more time to prepare yourself

Saad Alamgir 10:51

You are right. Yeah.

Victor Razi 10:52

Yeah, that makes sense. Understandable. What, how would you say LSU Head and Neck program what would you say that makes it unique compared to like other head and neck programs in the country?

Waleed Zaid 11:03

Absolutely.

Victor Razi 11:04

obviously you have this great reputation, but you know, it'd be

Waleed Zaid 11:07

Oh,

Victor Razi 11:08

Nice to hear it in words of. Someone who's been there for 14 years about it.

Waleed Zaid 11:14

Yeah, absolutely. I think one of the biggest strengths about the LSU Head and Neck program is, one is we have a great team. So I am blessed that I have two partners that work with me Dr. Peter Park in Louisiana, new Orleans, and also a new partner that just joined us this year. Dr. Michael Malik, who's a graduate from, from Jacksonville, Florida. One of the interesting stories is Dr. Park actually used to be a resident at LSU and I think she had the pleasure to train him, and then he went to pursue fellowship and then came back and now he's a head and neck surgeon at LSU.

Saad Alamgir 11:51

Mm-hmm.

Waleed Zaid 11:51

have three surgeon team, and then also we have a mid-level provider. So we have Hannah and Jennifer. Both of them are nurse practitioners. They help us a lot. And then we have the fellows. So. Pretty much we have a very big team that can handle most of the surgical volume that we get. But more importantly the oncology practice requires a bigger team. So we also are very blessed by the medical oncologists that we work with, radiation oncologists that we work with. And at the end of the day, it's the hospitals that we perform these procedures in. There's a lot of team and there's a lot of. soldiers behind the scene that are actually allowing us to do what we do when we scrub in for a 10, 12 hour surgery. There's a lot of people behind the scene that are allowing us to do this, from scrub techs to circulating nurses, from anesthesia team, from PACU nurses, ICU nurses. Floor nurses and every individual that helps us take care of our patients. That I think what makes LSU Head and Neck program unique, but also power is at the numbers. I think we have a strong, robust number in terms of surgical volume and it's also spread out. So it's not like just one procedure that we do a lot

Victor Razi 13:10

Sure.

Waleed Zaid 13:11

We just have. From oncology to micro, to trachs to endocrine. I think it's a big practice, so I'm very happy to be working here. But also I think we are strategically, hopefully we're gonna be one of the biggest fellowships in the country.

Victor Razi 13:28

Sure. And that's awesome story. And I think that it sounds like y'all are very organized and I feel like with oral surgery kinda. Making its way or establishing itself through the dental school and also the hospital. I think that serves the specialty well, being very organized and having a good team that backs you up and supports you throughout your cases and follow ups and all that. So that is also that, that is definitely established at LSU. One question I have is, what would you say for your students. What would you say the most challenging part of what you're involved in they experience? What would you say that they.

Waleed Zaid 14:08

So, that's a very interesting question. What I would say is keeping the fire on and keeping the passion, and I think that's the, sometimes the passion gets diluted with, I'm tired, I'm hungry. I've been standing for, you know, eight hours. Once the passion is there, all these things become nuances and you don't

Victor Razi 14:31

Sure.

Waleed Zaid 14:31

them. Like I'll tell you, like my residents today, I don't think they actually had lunch. They just worked through lunch. We started like from eight o'clock in the morning and we just finished like 30 minutes ago. Four or five cases and they're just going at it and they enjoy it. So I'm very blessed to have a team that's actually very. Passionate about what they wanna do. and then after that we sit down together, we go eat together, and we just kinda have a good time, wash it out a little bit. But I think keeping the passion on and trying to think about the ultimate game and what are you gaining from this kind of makes the journey easier I guess.

Victor Razi 15:09

Sure.

Saad Alamgir 15:10

Yeah.

Victor Razi 15:10

Yeah. That's interesting because I always wondered, you know, you hear your challenges in dental school and you hear your challenges in residency, but then if you take it a step farther, you know, what are your next challenges? So, wanted to hear from you.

Waleed Zaid 15:21

That's life.

Victor Razi 15:22

Yeah.

Waleed Zaid 15:23

That's life. Life is full of challenges. I think if life was not, if life was there with no challenges. So it'll be a little bit meh, this is another day.

Victor Razi 15:34

sure.

Waleed Zaid 15:34

But it worth

Victor Razi 15:36

Yeah, for sure.

Saad Alamgir 15:37

Yeah.

Victor Razi 15:38

One question too, I had Dr. Za was so one thing that's really been picking up a lot of pace is like full arch dentistry. Like everyone wants to do all on x, all on for remote anchorage, yada, yada. So with your field with like reconstructive and, you know, oncology. Y'all are probably performing the most hardcore form of all on X. How has your field evolved with that over the years and has it, would you say it's evolved a lot or it's just gaining more recognition and then I don't know how, what are your thoughts on that area of

Waleed Zaid 16:11

Oh

Victor Razi 16:11

dentistry?

Waleed Zaid 16:12

Well, let me, maybe I'll take two minutes to tell you the journey.

Victor Razi 16:17

Sure.

Waleed Zaid 16:18

And I'm glad that I actually was part of this journey. So, when I was a a resident, we used to use wooden. sticks sterile, obviously to measure how we're gonna shape the fibula flap to become like a jaw.

Victor Razi 16:36

That's a God.

Saad Alamgir 16:37

Wow.

Waleed Zaid 16:38

And I'm serious, like we had a ruler, and then you'll measure the ruler and then we'll have the segments and you'll measure the angle with a, like a small proctor and you'll be like, all right, I think this is a 15 degrees. And we used to take that fibula from the legate on the back table, and the shaping of this fibula used to take between 45 minutes to an hour.

Victor Razi 17:00

Yeah.

Waleed Zaid 17:01

back

Victor Razi 17:01

Right.

Waleed Zaid 17:02

and then you start doing the micro. And I can tell you sometimes we are lucky and sometimes you look at that postoperative panoramic x-ray or CT and you're like, Ooh, that is. Ugly,

Victor Razi 17:14

Right.

Waleed Zaid 17:15

But that was the case. And then we moved into, okay, let's get a 3D printed model with the fibula on it, and we will prebend plates this way we can get plastic cutting guides to make that osteotomy kind closer to where it needs to be. And then after that, we evolved and now we started getting more accurate and customizable plates that are. Specific to the patient and they fit quicker and they save time in the

Victor Razi 17:45

Right.

Waleed Zaid 17:46

And digital dentistry and the workflow with the digital dentistry allows us to perform something called a John A. Day. And that topic basically is becoming a very topic in our specialty or in our niche because. Allows me to remove the patient's tumor, allows me to reconstruct him with a vascularized tissue, me to place dental implants, allows me to restore the dental implants at the same

Victor Razi 18:14

Sure.

Waleed Zaid 18:16

And

Saad Alamgir 18:16

Mm-hmm.

Waleed Zaid 18:16

on top of that, now you add another aspect or another dimension, which is the nerve grafting. So now these patients, we restore sensation back with nerve grafting. We restore their form and function in terms of jaw reconstruction, but now also they're restoring the teeth. And I always tell my fellows and residents this you could do the most beautiful surgical procedure. And very articulate, and you are preserving nerves and preserving vessels and beautiful. At the end of the day, the patient's gonna tell you, so when am I gonna get teeth?

Saad Alamgir 18:51

Right. Yeah,

Victor Razi 18:52

right.

Saad Alamgir 18:53

exactly.

Waleed Zaid 18:53

you remove the biggest tumor you've ever seen in your life, and the patient's gonna be thankful for you for a short period of

Victor Razi 19:00

Sure.

Saad Alamgir 19:00

Mm-hmm.

Waleed Zaid 19:01

then in six months you'll be like, so when am I gonna.

Victor Razi 19:04

Right.

Waleed Zaid 19:05

So that's where I think, you know, all these advantages that you talked about and all these advancements and the implant dentistry and restorative dentistry has been you know, taking a huge impact on what we do. And I think this is where we can serve our patients better and allow them to become you know, improve their quality of

Victor Razi 19:25

Yeah. That's awesome.

Waleed Zaid 19:26

placing dental implant at the same time allows them to restore form, function, occlusion, dentition, even if they're gonna go and have radiation later on or have chemotherapy, still, the teeth were restored and that's the most important thing for the patients at

Victor Razi 19:42

Yeah,

Saad Alamgir 19:42

Yeah,

Victor Razi 19:43

for sure. That's awesome.

Saad Alamgir 19:44

I really like how you brought up the fact that. Patients, you know, even if you do a big tumor resection, they're gonna ask when their teeth are coming in and that, that's reminiscent on dentistry as a whole. Our whole field is very results oriented and so. When the patient starts something even as serious as a tumor resection, the thing they're thinking about most is what the end result's gonna be when they're getting their T back, when they're getting, they're gonna be able to chew. And so I think that's just really I like the fact that you brought that up'cause it just ties You know what dentistry is into. One thing. And that being said, I did have a question. You know, we talked about, you talked about the jaw on the day, the, you know, all on four things like that. What advancements do you think that are coming into the field of oral surgery that you think that might have potential or that's not yet mainstream, but you think in the next five to 10 years could be very mainstream.

Waleed Zaid 20:43

right. That's an excellent question. I think we as dentistry as a specialty that is part of dentistry, we actually have to embrace and think about what's the next big thing that's gonna take place. Not today, not tomorrow, maybe in the next five. Years to 10 years. I really think robotics is gonna be a huge player in our field. Already I think there's two cases that has been performed in the us to do the microvascular anastomosis

Saad Alamgir 21:14

Oh, wow.

Waleed Zaid 21:16

with a performed procedure. But that's one aspect. So there's the technical. but where

Saad Alamgir 21:23

Mm-hmm.

Waleed Zaid 21:24

think we should be playing a role in is in the research part. So how can we prevent, how can we reduce the impact of oncology? I'll give you an example. One of my friends, and this is a a product that I use is called Prot site or a Protus site test, or a straighty. So basically what it does is in, rather than just thinking about how we're dealing with cancer, how can we customize the patient's experience? So, for example, someone comes with me with a orally or malignant, potentially malignant disease. Oral pathological, pre disease dysplasia. I give that patient a customized experience? And the answer is yes. By that test, I can predict what is the percentage that this dysplasia is gonna become cancer, so I can offer this patient maybe more aggressive surgical intervention, better follow up. what I mean?

Saad Alamgir 22:28

Mm-hmm.

Waleed Zaid 22:29

oh yeah, I read 10 papers and they. They cite that the chances of mild dysplasia becoming cancer is Go chill. You know,

Victor Razi 22:37

Right.

Waleed Zaid 22:38

it. No. Versus with that test, I can tell this patient your biopsy, despite it being mild dysplasia has a 60% chance of becoming a malign.

Saad Alamgir 22:49

Mm-hmm.

Waleed Zaid 22:50

Probably, I'm not gonna treat it like someone who has a chance of 3%. So what I'm trying to say is research allows us to better serve our patients and be experts in our field. And I think that's what benefit our patients better, is

Saad Alamgir 23:06

Yeah.

Waleed Zaid 23:06

we make life efficient, effective, less morbid, less surgery? And I think this is where the research comes in.

Saad Alamgir 23:15

Mm-hmm.

Waleed Zaid 23:16

research is important in our field, but I think from a technical perspective to the digital workflow, the ai, because now rather than me trying to combine data from your site and my site

Saad Alamgir 23:29

Mm-hmm.

Waleed Zaid 23:30

university, and take me three months to analyze your data, simply, I can analyze the data in a day.

Victor Razi 23:36

Yeah,

Saad Alamgir 23:37

Right.

Victor Razi 23:37

pretty sweet.

Waleed Zaid 23:39

So I can produce better evidence quicker, I think we're still there and we have to be the decision makers. But I think technology is beautiful and if you don't embrace it, you'll be forgotten.

Victor Razi 23:53

For sure. I feel like our generation at least is in a weird area of where we're like aware of the ai, but we don't fully trust the ai, so we're like stuck in between. But I definitely think, my opinion is at some point we're gonna be trusting it a lot more. Just the way technology unfolds. Like when you go to type A sentence, you don't second guess. If you hit T it's gonna put out w So I don't know, it'd be interesting to see, especially when you deal with more serious situations like tumor resections and tumor grading and things of that nature. How just how people rely on things like that and. If things get FDA approved and so, so on and so forth. Definitely interesting time to be alive.

Waleed Zaid 24:39

right, right. Well, I can, let me tell you this. I was attending a webinar recently and they were talking about the role of AI in predicting, survival, but also predicting. Neck disease. So rather than me doing a big neck dissection on patients, can the AI predict which patients will benefit from a neck dissection versus not?

Saad Alamgir 25:04

Mm-hmm.

Waleed Zaid 25:04

I think you can validate that premise, that's gonna be huge for our patients.

Victor Razi 25:10

For sure.

Saad Alamgir 25:10

Yeah, definitely. Dr. Zaid, I know you, you've mentioned a lot about research. I was wondering, do you personally have any research projects going on related to what we're talking or just in general?

Waleed Zaid 25:23

Yeah, absolutely. So, our chairman his name is Jeff James. He's a good friend of mine and a a colleague. He implemented that in our residency. In order for you to graduate, each resident has to a research project,

Saad Alamgir 25:38

Mm-hmm.

Waleed Zaid 25:39

number one. So, and again, being in an academic institution, research has been one of my interests.

Victor Razi 25:44

Sure.

Waleed Zaid 25:45

So we try to participate in national meetings, international meetings. One of the latest paper that we're working on, we finished the data collection is something called the Nodal. So basically what that means is when we do an enact dissection, we harvest nodes.

Saad Alamgir 26:05

Mm-hmm.

Waleed Zaid 26:06

trying to look at the yield and the ratios. So if I. Perform my neck dissection and I remove 12 lymph nodes. And I have zero lymph nodes positive for cancer. How is that versus have I harvested 56 nodes or 40 nodes?

Saad Alamgir 26:24

Mm-hmm.

Waleed Zaid 26:24

we're trying to see what is the relationship with that in terms of survival of the patients

Saad Alamgir 26:30

yeah.

Waleed Zaid 26:31

outcomes. The second interesting, and this is gonna be more dentistry geared,

Saad Alamgir 26:35

Mm-hmm.

Waleed Zaid 26:36

All of you guys in dental school have heard about a term called genic car OKCs,

Saad Alamgir 26:41

Oh, yeah. Mm-hmm.

Waleed Zaid 26:42

The basketball team. OKC.

Victor Razi 26:44

We have.

Waleed Zaid 26:45

So, so OKC has been one of the interesting thing that we face as surgeons, but also you guys as dentists. So, they tend to recur.

Saad Alamgir 26:55

Mm-hmm.

Waleed Zaid 26:55

They're very special, but also there's some genetic background to them. So, we are about to publish our case series where we started using a chemotherapy cream called five FU that is used for basal cell carcinoma actually,

Saad Alamgir 27:11

Mm-hmm.

Waleed Zaid 27:11

and it in the mouth to right, to reduce and decrease the chances of recurrence of this OKC.

Victor Razi 27:19

That's awesome.

Saad Alamgir 27:20

Wow.

Waleed Zaid 27:21

So,

Saad Alamgir 27:22

yeah, did it have promising results? Just curious from that.

Waleed Zaid 27:26

The first gentleman that the first surgeon that actually described that was Dr. Kati and his group from University of Toronto. And they published their case series and our case series were using a different method of delivery of the medication they used to use a gauze and they will. Basically soak this gauze with five FU, pack it in the socket or where the cyst was, and then the next morning they're gonna retrieve it.

Saad Alamgir 27:52

Mm-hmm.

Waleed Zaid 27:52

our technique, we're using something different. We're using gel foam

Saad Alamgir 27:56

Mm-hmm.

Waleed Zaid 27:56

applying five FU on gel foam. And then we're pushing it into the cyst, and then we're closing on top of it so we don't

Victor Razi 28:03

Yeah.

Waleed Zaid 28:03

a second procedure. kind of pretty much uncomfortable for the patients to do that. So we're publishing our case series. It's actually a multicenter, us and the University of Chicago, we're combining our data we're just drafting the manuscript.

Saad Alamgir 28:20

Wow. That's crazy. Yeah. How long of a, I'm sorry. I'm just curious as to how long of a follow up did y'all have for that specific, you know, report?

Waleed Zaid 28:29

Three, three years follow up.

Saad Alamgir 28:31

Okay. Yeah, so it's pretty, pretty dense, so yeah that's pretty interesting. I'm

Waleed Zaid 28:36

Yes.

Saad Alamgir 28:36

curious to see what the res, so the results were, I'm assuming, pretty good from

Waleed Zaid 28:41

So we did have promising results. Decreased. Decreased the rate of recurrence significantly

Saad Alamgir 28:47

mm-hmm.

Waleed Zaid 28:49

And more importantly, we use the five FU on both cohorts. So, you know, as you know, OKCs can happen in regular patients, but also in patients.

Saad Alamgir 29:01

Mm-hmm.

Waleed Zaid 29:01

the five FU technique in both patients and for both patients, the rate of

Victor Razi 29:06

Yeah.

Waleed Zaid 29:07

Or re recurrence decrease has been significant for both cohorts, which

Saad Alamgir 29:10

Yeah.

Victor Razi 29:11

interesting. If you think

Saad Alamgir 29:12

really

Victor Razi 29:12

of the genes and are they actually playing a role there or is that

Saad Alamgir 29:15

Yeah.

Victor Razi 29:16

Yeah.

Waleed Zaid 29:17

A hundred percent. A

Victor Razi 29:18

Yeah.

Waleed Zaid 29:18

hundred percent.

Victor Razi 29:19

Well, man we really appreciate you coming on and sharing your story and your contributions towards oral surgery and the field of research. That's awesome. And so I really appreciate you As we're wrapping up here, Dr. Zaid do you have any final advice for. Either dental students or new grads just in general of the field of dentistry or something you wish you would've heard when you were graduating school. Anything.

Waleed Zaid 29:41

Absolutely. Absolutely. What I would say, first of all, thank you for having me. This has actually been a lot of fun. So I appreciate you guys,

Saad Alamgir 29:50

Yeah.

Waleed Zaid 29:50

Inviting me

Victor Razi 29:51

Of course.

Waleed Zaid 29:52

I think sometimes we, and I was guilty at this as a dental student. I'll hear something and I'll be like, how is this relevant to me? This is like boring. This is not really something that I'm interested in. Someone talks about something, let's say about ortho or something about perio or, so I'm like I'm interested in surgery. This is not for me,

Saad Alamgir 30:13

Mm-hmm.

Waleed Zaid 30:13

what my advice is, try to absorb any. Knowledge that anyone offers you, even if you don't think this is relevant to you right now,

Saad Alamgir 30:24

Mm-hmm.

Waleed Zaid 30:25

because you never know when this might turn around and become relevant to you, maybe today, maybe in 10 years, maybe in five years. and once you close that door, there's no way to say, man, I wish I went back to dental school and listened to what my, you know. An anatomy doctor used to tell me, or I did not focus really in my ortho class, or I did not focus in area or pediatric

Saad Alamgir 30:51

Okay.

Waleed Zaid 30:52

class. So what I'm trying to say is use the opportunity that you have and try to make the best out of it because time doesn't go back and once you leave that era of your training. train moves forward. It doesn't go back. It doesn't go

Saad Alamgir 31:08

Right.

Waleed Zaid 31:10

It'll be like, man, I wish I paid attention to dental school in this or during residency. I wish I paid attention to that.

Saad Alamgir 31:16

Mm-hmm.

Waleed Zaid 31:17

Once things go, they go. So try to make the best out of it. Even if you don't see the benefit right across your eyes right now. Trust me, one day it's gonna become handy and you're gonna enjoy

Victor Razi 31:30

For sure Dr. Z. So I both could probably agree that's pretty exceptional advice, especially

Saad Alamgir 31:36

Yeah.

Victor Razi 31:37

reminiscent on some boring classes where I was like.

Saad Alamgir 31:41

Yeah. When you got a patient sitting in front of you, everything's fair game. You know, even the mundane things that you thought you'd never use in clinic, they end up. So,

Waleed Zaid 31:53

Or they ask you about it. You're like,

Victor Razi 31:55

That's the word.

Waleed Zaid 31:55

well, you know what? I skipped that class.

Victor Razi 31:58

We'll talk about it later.

Saad Alamgir 31:59

yeah, I gotta check my notes. You know, I'll get back to you on that,

Victor Razi 32:02

Alright, Dr.

Saad Alamgir 32:03

me.

Victor Razi 32:03

Za,

Saad Alamgir 32:03

we get it.

Victor Razi 32:04

we really appreciate your time and thank you for giving us a little bit of your day and I hope that our listeners and whoever. Gets involved with this podcast. Can enjoy your story and your contributions to the field.

Waleed Zaid 32:16

I really appreciate it. Thank you

Victor Razi 32:17

Of course. Have a good one.

Waleed Zaid 32:19

because You too. Thank you.

Saad Alamgir 32:21

So, yeah.