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Abstract: Oral dysplastic lesions may have an increased chance of becoming oral squamous cell carcinoma, but to date their management remains controversial. The aim of this survey was to explore the current practical aspects of the management of patients with dysplasia by oral and maxillofacial consultants in the UK. In the survey we asked consultants about the numbers of patients they see with oral premalignant lesions, the frequency and specialty of designated hospital clinics, their use of photographs and biopsy, factors that influence their decision whether to biopsy a lesion at the first appointment, the procedure for treatment and follow-up and their use (if any) of chemopreventive agents. We found a wide variation in the practical aspects of managing patients with dysplasia, and the lack of consistency among clinicians supports the idea of an initiative to establish more robust national guidelines to use as a gold standard in the future. [Copyright &y& Elsevier]

Abstract: Patient reported outcomes (PRO) have an established role when reporting treatment outcomes. This data is usually collected using patient self-completed questionnaires. There are numerous questionnaires available and selecting the most appropriate one can be difficult. Aim: The aim of this article was to carry out a systematic review of the literature to identify publications using patient self-completed questionnaires suitable for oral and maxillofacial surgery. The questionnaires were collated and grouped according to sub-speciality interests. Method: The ISI search engine with cross-reference using Pub Med and Ovid was searched for publications between 1981 and March 2009. Abstracts written in English were reviewed by two of the authors independently. Results: A total of 511 abstracts were reviewed and the paper cites 56 studies with self-administered instruments. The number of subsite specific questionnaires identified were; cleft lip and palate (1), craniofacial surgery (2), dentoalveolar surgery (6), distraction osteogenesis (1), facial aesthetic surgery (4), facial pain (1), head and neck cancer (14), maxillofacial injury (3), oral medicine and oral mucosal disorders (2), orthognathic surgery (1), pre-prosthetic surgery and dental implants (15), skull base surgery (7), temporomandibular joint (2). Conclusion: There is a tremendous variety of validated questionnaires available that are suitable for oral and maxillofacial surgery. This summary serves as a useful reference point when selecting a questionnaire for an audit or research projects. It also describes publications, which have used the various questionnaires, thus readily identifying papers that might be useful for comparison. [ABSTRACT FROM AUTHOR]

Objectives: To analyse the antibiotic prescribing trends for exodontia and minor oral surgery in patients with a history of radiotherapy. Also, to evaluate the use of hyperbaric oxygen as a separate modality in the prevention of osteoradionecrosis.Design: A survey of antibiotic prescribing involving the analysis of a questionnaire which included the management of three patients with a history of head and neck malignancy.Method: The heads of the departments in each unit in the UK were sent a closed-response questionnaire. Antibiotic prescribing was assessed in three case scenarios. Case one referred to a patient that had surgery alone as part of the management of head and neck cancer, who needed the surgical removal of second molar roots. Case two referred to a patient that had surgery and adjuvant radiotherapy as part of the management of head and neck cancer, and needed the same procedure as in case one. Case three included a patient with a history of surgery and adjuvant radiotherapy, who required the extraction of three mobile and periodontally-involved lower incisors. Consultants were also asked about the use of hyperbaric oxygen in the patients who had radiotherapy as part of their treatment strategy.Results: A total of 109 questionnaires were sent to all the Maxillofacial Units in the UK. The response rate was 73%. In patients with a history of radical surgery alone for the management of head and neck cancer, 20% of the surgeons advocated pre-operative antibiotics for the surgical removal of lower posterior teeth. In contrast, in the patient with a history of adjuvant radiotherapy 86% supported pre-operative antimicrobial use for the surgical removal of the same teeth. In the extraction of mobile and periodontally involved lower incisors in the previously irradiated patient, 63% of the clinicians supported pre-extraction antibiotics. Postoperative antibiotics were advocated in 52% in the first case, 89% in the second case and 71% in the third case. 34% of the clinicians advocated hyperbaric oxygen for surgical removal of posterior teeth and 15% for the extraction of mobile anterior teeth.Conclusions: The use of peri-extraction antibiotics was favoured among oral and maxillofacial surgeons. There was little enthusiasm towards the use of hyperbaric oxygen as a prophylactic measure, alone or in conjunction with an antimicrobial regime. Control randomised trials that will measure the effectiveness of hyperbaric oxygen and the appropriate use of antibiotics for prophylaxis in pre- and post-operative regimes are necessary to evaluate the use of these modalities. [ABSTRACT FROM AUTHOR]