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Among healthcare workers, oral and maxillofacial surgeons are some of the most exposed to coronavirus disease (COVID-19). The aim of this retrospective study was to develop suggestions for continuing the work of oral and maxillofacial surgeons using a safe protocol for elective and urgent aerosol-generating procedures that could prevent the onset of new clusters. Based on the results obtained and a guidelines review of those Asian countries that had promptly managed the current pandemic, the following safety protocol was developed: [ABSTRACT FROM AUTHOR]

The aim of the current study was to review the use of fresh frozen bone (FFB) in oral and maxillofacial surgery. We performed a review of the articles published in the literature between 1976 and May 2014 analyzing three medical databases (PubMed, Cochrane Library, and Embase) and using specific search terms. Literature analysis on FFB applications in oral and maxillofacial surgery revealed 47 articles between 1976 and May 2014. There are 46 clinical articles and one review. Clinical articles are represented by 22 case reports and case series and 24 retrospective studies. Classifying the scientific production by year of publication, it is evident that especially during the last 6 years there was an increase of FFB graft use in oral and maxillofacial approaches. The literature analysis on FFB's use shows that its application in oral and maxillofacial surgery began slowly in 1992 with Perrott and since 2006 it had a real development. The recent significant increase emphasizes the importance of FFB for bone regeneration in oral and maxillofacial surgery. This review found consistent evidence of FFB's use increase in oral and maxillofacial surgery suggesting a valid instrument for bone regeneration. To date, risks connected to the infections' transmission and to the immunogenic potential are extremely low and could be considered practically absent. So, this is an important alternative in the preimplant reconstructive surgery. [ABSTRACT FROM AUTHOR]

Although the Le Fort I osteotomy is a safe surgical technique, many complications have been reported. We present a case of an extended cervico‑facial haematoma due to delayed bleeding from the terminal branches of the maxillary artery after orthognatic surgery. A 23‑year‑old man was referred to our observation for the surgical correction of a class III asymmetric malocclusion. The patient underwent a Le Fort I osteotomy, with impaction of the maxilla, associated with an Epker mandibular bilateral sagittal split osteotomy, with maxillary advancement and rigid internal fixation of the mandible with four miniplates and another four for the upper maxilla as well. The first post‑surgery day, the patient developed a gradual dispnea together with neck swelling. By second postoperative day, the patient’s general condition improved with a progressive normalization of laboratory tests values. The Computerised Axial Tomography (CAT) scan confirmed a decrease in the parapharyngeal thickening. Total recovery was achieved within two months, the final clinical check showed a healthy appearance with good occlusion. An increased knowledge of the basic biology of the Le Fort I osteotomy, the development of instruments specially designed for the Le Fort I procedure and the use of hypotensive anaesthesia could reduce the morbidity and duration of this procedure. [ABSTRACT FROM AUTHOR]

Among complications in orthognathic surgery, the insurgence of pneumothorax is very rare. Pneumothorax is the presence of air or gas in the pleural cavity and it is rare complications in the postoperative oral and maxillofacial surgery patient. The clinical results are dependent on the degree of collapse of the lung on the affected side. Pneumothorax can impair oxygenation and/or ventilation. If the pneumothorax is significant, it can cause a shift of the mediastinum and compromise haemodynamic stability. While 10% of pneumothoraces are asymptomatic, patients often complain of acute chest pain and difficulty breathing. There is a reduction in vital capacity, tachycardia, tachypnoea and a decrease in partial pressure of oxygen with an inability to maintain oxygen saturations. We observed this unusual surgical consequence in a 28‑year‑old female with negative clinical history and instrumental evaluation after Le Fort I osteotomy and bilateral sagittal split osteotomy (BSSO). No further consequences, no neurological sequelae, no infections and no other osteotomies sequelae were seen. Sudden post‑surgical dispnea associated to sub‑cutaneous emphysema of the neck and of the thorax must be adequately observed with the aim of monitoring further severe sequelae. The anaesthetic management of the emergency difficult airway in any post‑surgical orthognatic treatment can be extremely difficult requiring a multi‑disciplinary approach. [ABSTRACT FROM AUTHOR]