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EDITORIAL

J Oral Maxillofac Surg63:1407-1408, 2005

The Elements of Surgical Stylejastyptrtjc

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Style is not a characteristic normally consideredhen discussing surgical science and practice. Styleay denote artistic flair, as with, “Now that’s a stylish

reatment plan!”; ease of execution, “The procedureas performed with style”; or pointless faddishness,

That surgeon is a slave to the latest style.” For Wil-iam Strunk, style was an essential component of allntellectual activity.1 When applied to English prose,tyle could be reduced to elements that revealed theuality and grace of our language. He defined thelements of style, and explained how style communi-ated ideas. Surgical science and surgical practice alsoely upon the communication of ideas, such as thoseresented in JOMS. The effective communication oflinical ideas depends upon style. The effective per-ormance of surgery depends upon style. For oururposes, Surgical Style is this fusion of surgicalhought, surgical practice, and surgical prose.

In The Elements of Style, William Strunk, Jr. (1869–946) defined how written thought should be orga-ized. Each paragraph discusses a single topic andegins with a sentence declaring its topic. He urgedhe expression of statements in the positive form, thevoidance of loose ideas, sticking to the point, andlearly stating conclusions. Each sentence should buildn the ideas of the previous one. To paraphrase Strunk,rose should be relevant, rational, resonant, and origi-al; exactly those qualities needed in Surgical Style.

he Three (Four) R’s of Style in Surgicalcience and Surgical Practice

Relevance: The topic at hand must be relevant tohe intended audience. The introduction of eachOMS paper establishes background information andtates its purpose. Reading this issue will give insightnto how relevance for a clinical oral and maxillofacialurgery journal is determined. The relevance of everyrticle to the practicing surgeon must be to improvehe health of our patients.

Formerly, articles were divided in JOMS betweenlinical Articles and Scientific Articles. In Clinical Ar-

icles, patients were the subject of research while incientific Articles, animals, molecules, and simulatedonstructs served as research subjects. As of August005, these categories have been combined into aew section: Basic and Patient-Oriented Research. Allf the articles in this category are selected for clinicalelevance that has the potential to improve the health

f our patients, without regard to the research sub- w

1407

ect. For example, in this month’s issue, Reinhardt etl examine whether we can accelerate extractionocket healing with Gelatinase.2 Rodgers evaluateshe safety of intravenous sedation in his first sevenears of practice.3 Wong and Rabie4 examine theotential role of Statins in accelerating bone forma-ion. One is a prospective study in humans, one inabbits, and one a retrospective patient review. Whilehese studies use different methods and research sub-ects, they share in common the relevance defined bylinical need.Rationality: A rational idea is usually the augmen-

ation of existing knowledge. Surgical rationalityuilds upon our contemporary understanding of dis-ase and effective therapy. The literature review inach paper should offer the rationale for the thesispurpose) offered. The Materials and Methods sectionresents a rational research design intended to an-wer the question posed. The most critical aspect ofny scientific paper is whether the methods appliedill answer the questions posed in the study. Theost critical aspect of any surgical care is whether theroposed treatment methods will successfully ad-ress the clinical problems presenting in the patient.n both cases, the key test of Surgical Style is rational-ty.

Resonance: The Discussion section of every papers where the author has an opportunity to have theirdeas resonate with the reader. A good discussion, like

good paragraph, seizes the main point that willesonate with the clinician. For example, in this JOMSssue, Gomes et al declare in their opening discussionentence “a significant increase in incidence of lingualerve deficit was found when a lingual flap retractoras used.”5 Little doubt remains regarding howomes hopes her findings will resonate with the

nquiring oral and maxillofacial surgeon. Resonance isstablished. The rest is commentary.Most of us have favorite articles, texts, handouts, or

ectures that resonate with us in daily practice. Wese them to support our clinical opinions and to formhe basis for rational clinical thought. Are we simplyollowing good science wherever it leads us or doeshat resonates with us simply reinforce precon-

eived notions regarding what is correct? To put itnother way: is what we find resonant simply a way toeinforce inertia? Not if we remember the fourth “R”.

‘Riginality: Originality is the only true way to-

ards Surgical Style. Strunk points out that truly

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1408 EDITORIAL

ifted writers often violate the rules of grammar.hen they do so however, “the reader will usually

nd in the sentence some compensating merit, at-ained at the cost of the violation.”6 For scientists andurgeons, originality implies a similar risk, albeit ofreater consequence. Scientists risk ridicule, ororse, loss of funding, if their ideas appear to be too

novel.” In surgical practice, though discouraged,riginality is often called for. After the “violation,” theurgeon often asks whether the “compensating merit”xceeded the “cost of the violation.” When the com-ensating merit does not exceed the cost, it is simplyrtful trial and error. When the merit exceeds theost, Originality is the singular expression of Surgicaltyle.

LEON A. ASSAEL, DMD©

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eferences. Strunk W: The Elements of Style, 1918. Available at http://

www.bartleby.com/141/strunk. Accessed August 2, 2005. Reinhardt R, His-Ming L, Schmid M, Payne J, Golub L: Relation-

ship between gelatinases and bone turn over in the healing bonedefect. J Oral Maxillofac Surg 63:1455, 2005

. Rodgers S: Safety of intravenous sedation administers by theoperating oral surgeon: Experience of the first 7 years of officepractice. J Oral Maxillofac Surg 63:1478, 2005

. Wong RWK, Rabie ABM: Histologic and ultrastructural study onstatin graft in rabbit skulls. J Oral Maxillofac Surg 63:1515, 2005

. Gomes, ACA, Vasconcelos BC, Silva ED, Silva LCF: Lingual nervedamage after mandibular third molar surgery: A randomizedclinical trial. J Oral Maxillofac Surg 63:1443, 2005

. Strunk W, White EB: The Elements of Style, p 1. Available athttp://www.bartleby.com/141/strunk1.html. Accessed Novem-ber 23, 2004

2005 American Association of Oral and Maxillofacial Surgeonsoi:10.1016/j.joms.2005.08.005