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Background: Skin cancer in African countries results primarily from exposure to high ambient ultraviolet radiation. It is an emerging public health issue with limited improvement in management services. Mohs surgery, a renowned surgical procedure in the treatment of skin cancer, involves exact tumor excision along with horizontal frozen tissue examination. It is known to minimize the defect size and improve patient outcomes. Therefore, Mohs surgery is highly effective for almost all nonmelanoma skin cancers. Despite its proven potential, the implementation of Mohs surgery in Africa faces various limitations. This commentary seeks to provide insights into the current threats and opportunities surrounding the execution of Mohs surgery in African healthcare systems. The role of governments, healthcare professionals, and international organizations is also highlighted in this paper. Methods: A literature search was conducted by retrieving articles from PubMed and Google Scholar. Previous articles that discuss skin cancer, Mohs surgery, and cancer in Africa were analysed to understand the implementation aspects of Mohs surgery in Africa. Results: The implementation of Mohs surgery in Africa is very limited due to challenges such as inadequately trained healthcare professionals, costs associated with the surgery, and cultural beliefs and misconceptions. Nevertheless, telemedicine has been used in surgical consultations regarding the postoperative management of patients who undergo Mohs surgery. Conclusion: Despite advances in medicine, African dermatological health care remains underdeveloped. Therefore, increased investment in healthcare training, infrastructure development, and more African-based skin cancer studies are necessary and paramount factors for the expansion and accessibility of Mohs surgery in Africa. [ABSTRACT FROM AUTHOR]

Craniofacial anthropometry is important for identity, diagnosis of congenital anomalies etc. The incidence of craniofacial abnormalities is high in the Southeast Asian region. The population of Meghalaya differs in features from other states of Northeast India and the neighbouring East Asia. The objective was to study the craniofacial anthropometric features of the ethnic adults in the Meghalaya state of Northeast India. This cross-sectional study was conducted from 2022 to 2023 in the ENT OPD. OPD patients of Meghalayan ethnicity were included in the study. Head length (HL), head breadth (HB), Cephalic index (CI), intercanthal distance (ICD), lateral canthal distance (LCD) and ear length (EL) were measured. A total of 104 adults were included. The majority of the individuals belonged to the Khasi community 51 (49%) followed by the Garo community 27 (26%) and the Jaintia community 26 (25%). The mean ± S.D age of the total sample population was 29.5 ± 8.4 years. The mean CI of the total sample population was 79.13 (mesocephalic). No statistically significant difference was noted between male-female CI in the total and subpopulation groups. In our study, the common head types were dolichocephalic (29%), brachycephalic (29%), mesocephalic (21%), hyperbrachycephalic (16%) and ultrabrachycephalic (5%). A statistically significant difference was noted between Khasi and Jaintia in HL, HW, CI, LCD; between Khasi and Garo in HL, ICD, LCD and between Garo and Jaintia in HW, CI, ICD. We believe our conventional craniofacial anthropometry data could add to the pool of regional anthropometry data and be used for future scientific purposes like anthropology, maxillofacial surgeries, designing helmets, forensic analysis, and gender differentiation. [ABSTRACT FROM AUTHOR]

We know of few studies in the international scientific literature that specifically address the evaluation of surgical and clinical progress among physicians undergoing specialist training in maxillofacial surgery. Identifying a reliable tool to accurately assess both theoretical knowledge and surgical skills of trainees is essential. The primary aim of this study therefore was to design a comprehensive assessment tool that is capable of evaluating both the theoretical and practical skills of physicians undergoing specialist training in maxillofacial surgery. The methodology employed aims to ensure fairness and effectiveness in skills development, thereby optimising training activities. To meet this need, an evaluation and self-assessment test was developed for maxillofacial surgery trainees at the Ospedali Riuniti of Ancona. Data collection involved digitally administered evaluations and self-assessment tests focused on maxillofacial traumatology, based on AO trauma surgery references. Data were processed into graphs which revealed a progressive learning trend following an initial adjustment phase, leading to optimal outcomes in both clinical and surgical domains. The evaluation and self-assessment test proved to be a valuable learning tool with which to gauge advancements in clinical and surgical skills among maxillofacial surgery residents. [ABSTRACT FROM AUTHOR]

This study aimed to determine the accuracy of large language models (LLMs) in answering oral and maxillofacial surgery (OMS) multiple choice questions. A total of 259 questions from the university's question bank were answered by the LLMs (GPT-3.5, GPT-4, Llama 2, Gemini, and Copilot). The scores per category as well as the total score out of 259 were recorded and evaluated, with the passing score set at 50%. The mean overall score amongst all LLMs was 62.5%. GPT-4 performed the best (76.8%, 95% confidence interval (CI) 71.4–82.2%), followed by Copilot (72.6%, 95% CI 67.2–78.0%), GPT-3.5 (62.2%, 95% CI 56.4–68.0%), Gemini (58.7%, 95% CI 52.9–64.5%), and Llama 2 (42.5%, 95% CI 37.1–48.6%). There was a statistically significant difference between the scores of the five LLMs overall (χ2 = 79.9, df = 4, P < 0.001) and within all categories except 'basic sciences' (P = 0.129), 'dentoalveolar and implant surgery' (P = 0.052), and 'oral medicine/pathology/radiology' (P = 0.801). The LLMs performed best in 'basic sciences' (68.9%) and poorest in 'pharmacology' (45.9%). The LLMs can be used as adjuncts in teaching, but should not be used for clinical decision-making until the models are further developed and validated. [ABSTRACT FROM AUTHOR]

Hashtags on Instagram help users globally search for posts to their liking. This study aimed to determine who posts the most popular oral and maxillofacial surgery (OMS) hashtags on Instagram and to evaluate the impact of educational content. The posts were analyzed for the type of post and differences between content creators when posting OMS-related content. This cross-sectional study evaluated OMS content categorized by 36 hashtags. The top 9 posts with each hashtag were evaluated based on the type of content creator, if it was a video or picture, and if it was educational or for marketing purposes. 6 million posts existed among 36 hashtags. Regarding the categories of person/organization posting the content (US or non-US oral and maxillofacial surgeon, residency program, patient, and 'other'), the top posts (N = 295) were posted by 'other' and the least by 'residency program'. Among the posts by non-US oral and maxillofacial surgeons, there was 3.8-fold more marketing content, while among the posts by US oral and maxillofacial surgeons, there was 2-fold more educational content. Educational posts achieved the highest engagement in terms of 'likes'. This study highlights how oral and maxillofacial surgeons can educate the general population and expand their reach. [ABSTRACT FROM AUTHOR]

Background: Plastic surgeons use loupes or operative microscope to aid in tissue dissection and anastomosis of structures. These devices have their own limitations in areas of visualization and weight. Current uses of augmented and virtual reality in surgery have been limited to operative planning and simulation. We present a proof of concept that harnesses video passthrough AR technology to augment the capabilities of loupes. Methods: We first evaluated methods of gaze-based eye tracking to enable digital magnification. Using the Varjo XR-1 mixed reality headset, we compared discrete zoom through displayed pop-up menu vs continuous zoom through eye winking. Six participants were recruited to perform skin suturing simulation and completed a survey and interview. Next we assessed the performance and limitations of AR digital magnification. Varjo XR-3 was utilized to address the hardware limitations. Participants performed anastomotic suturing tasks with progressively finer suture, then completed a survey and interview. Findings: There was no strong preference between zoom methods, although participants felt the discrete zoom was easier to use. Participants had difficulty determining depth and visualizing the suture due to limitations of digital magnification. Using Wilcoxon rank sum test to examine differences in system usability scale, the Phase 2 user experience had significant difference in percentile distribution (P 0.0390). Conclusion: Virtual loupes may be a valuable tool for plastic surgeons, with potential for variable magnification and advanced visualization. Improvements in the hardware yielded higher ratings of system usability and user experience. Further development is needed to address the limitations of existing devices. [ABSTRACT FROM AUTHOR]

Background: Oral surgery involves the diagnosis and surgical treatment of diseases affecting the soft and hard tissues of the oral cavity and encompasses a wide range of surgical interventions. The aim of this investigation was to study the characteristics and age-related diagnoses of these oral surgeries, as well as to describe the surgical procedures performed in a pediatric oral and maxillofacial surgery service. Methods: A descriptive, retrospective, observational, and relational study was conducted on children and adolescents aged from 0 to 22 years who were treated in a pediatric oral and maxillofacial surgery service at a children's hospital. Results: We analyzed 1311 surgical interventions (51.4% were on boys and 48.6% on girls), consisting of 24.8% soft tissue surgeries, 65.9% bone and dental tissue surgeries, and 9.3% mixed tissue surgeries. The most common pathologies were tooth eruption disorders (65.9%), followed by ankyloglossia (20.5%). The most frequent treatment was wisdom teeth extraction (31.3%). A statistically significant association (p < 0.05) was found between surgical treatments and variables such as age, sex, tissue type, and biopsy. Conclusions: This study enhances our understanding of pediatric oral surgery, emphasizing that the most common pathology is altered tooth eruption, while the most frequent surgical intervention is the extraction of wisdom teeth at different stages of development. [ABSTRACT FROM AUTHOR]

Introduction: There are few publications concerning ankyloglossia in mixed-aged groups utilizing myofunctional therapy and frenuloplasty in patients undergoing orthodontic treatment and maxillofacial surgery. While it is well known that ankyloglossia is mainly diagnosed in babies, research on functional and structural disorders in different age groups is less common. Thus, there is a high need for specific information about the influence and effectiveness of frenuloplasty with myofunctional therapy on the stomatognathic function and final treatment outcome for a wider variety of patients, especially those with maxillofacial deformities. Aim: This paper aims to evaluate the impact of lingual frenuloplasty as an adjunct to myofunctional therapy for the treatment of ankyloglossia in children and adults with maxillofacial deformity. Methods: Prospective randomized control trial with 155 subjects. Methods were based on visual observation and examination of the oral cavity. There were two groups: myofunctional therapy vs. myofunctional therapy and lingual frenuloplasty. Patients were randomized based on order of entry into the study. χ2 test, Kruskal–Wallis, ANOVA, Student's t-test and others were used for statistical analyses. Results: The presented protocol with myofunctional therapy and surgical procedures proved to be significantly more effective in improving tongue mobility and stomatognathic functions such as swallowing, breathing, and oral resting postures as compared to the reference group who underwent myofunctional therapy only. Conclusions: Lingual frenuloplasty with myofunctional therapy is highly effective in restoring the equilibrium of the orofacial muscles and the skeleton, which is often disturbed and may lead to unstable functional effects among patients considering orthodontic and orthognathic treatments for maxillofacial deformities. [ABSTRACT FROM AUTHOR]

Background: This study aims to evaluate the efficacy of an oxygen scavenging mask device in reducing local oxygen concentrations from nasal cannula ventilation compared to a standard open facial surgical field. Methods: This is a controlled experiment using a custom-fabricated silicone midfacial oxygen scavenging device, SimMan airway management trainer manikin (Laerdal Medical, Stavanger, Norway), handheld oxygen detector (Forensics Detectors, Los Angeles, United States) and oxygen from a Datex Ohmeda Aisys Carestation anesthesia unit (GE HealthCare, Chicago, United States). Oxygen concentrations were measured at 18 facial landmarks (Fig. 1) with nasal cannula flow of 2, 4, and 6 L/min of 100% FiO2 in both masked and unmasked conditions (Fig. 2). Results: The mean oxygen concentration in the facial surgical field was 20.95% with the scavenger mask and 24.8% without (P < 0.001; two-tailed paired t-test). The unmasked condition was associated with suprathreshold oxygen concentration levels at 13 of 18 facial landmarks (Table 1). The device significantly reduced local oxygen concentration at 16 of 18 facial landmarks (Table 1). The device provided safe oxygen concentration levels at all three flow rates, and measured oxygen concentrations directly correlated with oxygen flow rate in the unmasked condition (Table 2). Conclusions: An oxygen scavenger mask device reduced local oxygen concentrations from nasal cannula ventilation to below the 23% fire threshold in the entire facial surgical field external to the mask in these experiments. The device may reduce intraoperative fire risk in patients that require supplementary oxygen during surgery. [ABSTRACT FROM AUTHOR]

Purpose. The aim of this study was to develop a competency framework based on entrustable professional activities (EPAs) in oral cancer management by postgraduate trainees in oral and maxillofacial surgery through expert consensus. Materials and Methods. The study design was based on a modified Delphi technique and involved iterative online surveys with two rounds of data collection and analysis. Initial development of the questionnaire identified five EPAs based on 42 competencies along with supervision level and assessment strategies. The first Delphi round involved administration of the survey questionnaire online to maxillofacial surgeons meeting the inclusion criteria for experts. Consensus was achieved on five EPAs and 36 competencies (≥80% response rate). Six competencies were rephrased and sent again in the Round 2 questionnaire to achieve a consensus. Results. A total of 45 experts participated in Round 1 followed by input from 27 experts in Round 2 of the Delphi panel. Following two iterative rounds of online surveys and feedback, expert consensus was achieved to develop an EPA framework in five EPA domains focused on the management of oral cancer by postgraduate trainees in maxillofacial surgery including 38 specific competencies, supervision level, and assessment strategies. High content validity of the study was established through a comprehensive literature search, and expert feedback was evidenced by an excellent response rate (93.34%, and 64.28%) and a stringent criteria of response agreement amongst experts (≥80%). Conclusion. In conclusion, this study employed expert consensus to identify five EPAs with 38 competencies along with the required supervision level of postgraduate maxillofacial trainees for the management of oral cancer. This EPA framework provides a roadmap for training supervisors to map the learning outcomes in oral oncology for postgraduate trainees in oral and maxillofacial surgery. [ABSTRACT FROM AUTHOR]

During maxillofacial surgery, the precise placement of surgical tools is crucial for accurate implant placement. Particularly if multiple implants are needed, e.g., after cancerous bone removal, visual landmarks might not be obtainable. To this end, we propose a vision-based tracking approach with deep learning. Our markerless tracking approach is based on video streams from two cameras for tracking a mandible phantom. We study, to what extent vision-based localization using deep learning is feasible. For real-time 6D pose estimation we propose a Siamese network with a ResNet-18 subnetwork. We acquire a large training dataset with a robot and evaluate the tracking accuracy on partially occluded images. Thereby, we mimic visual information that is accessible during clinical interventions. We report a mean position error of 1.33 ± 1.14mm and a rotation error of 0.86 ± 0.71 deg for partially occluded images. Overall we present a promising tracking approach that is marker-free and robust toward image artifacts. [ABSTRACT FROM AUTHOR]

Objective: Unusual clinical course Background: Submental intubation, a technique often considered a good alternative for managing the airway in challenging maxillofacial surgical scenarios, plays a pivotal role in providing accessibility to the surgical site and ensuring airway safety, particularly in cases involving facial fractures. This innovative approach not only grants surgeons adequate access to the operative field but also mitigates potential complications associated with traditional intubation methods, making it a valuable tool in dealing with complex facial trauma cases. Case Report: A 37-year-old man arrived at the Emergency Department (ED) with a severe facial injury caused from a traumatic incident involving a falling concrete wall, resulting in severe facial injuries that included multiple lacerations and abrasions on his face and body. The patient presented with multiple facial and body lacerations and abrasions, necessitating prompt medical intervention. The ED team swiftly treated the facial lacerations, controlled the bleeding, stabilized the patient, and proceeded to secure the airway through orotracheal intubation. Following stabilization, the patient was transferred to the operation theater (OT) for further management of his extensive pan-facial fractures under general anesthesia, utilizing the submental intubation technique for airway management. Conclusions: Despite its limited use, submental intubation is a good option for some maxillofacial surgeries, offering a less intrusive approach to airway management and presenting an alternative pathway to the conventional endotracheal intubation technique. Its ability to streamline procedures, enhance patient outcomes, and reduce complications underscores the importance of considering submental intubation as a valuable tool in dealing with complex maxillofacial cases. [ABSTRACT FROM AUTHOR]

Background: Venous malformations are congenital developmental abnormalities that consist of enlarged dysplastic blood vessels. The tongue is a common site of venous malformations in the head and neck region. The aim of the present study was to evaluate the therapeutic effect of using electrochemical therapy (ECT) combined with local injection of pingyangmycin (PYM) for venous malformations in the tongue. Methods: 60 patients (20 male and 40 female; age range, 8 to 68 yr) with venous malformations in the tongue were treated with a combination of ECT and PYM injection or with local injection of PYM alone in the department of oral and maxillofacial surgery of the stomatological hospital of China Medical University from January 2013 through June 2019. Among them, 30 patients (group A) were treated with ECT combined with PYM injection for tongue venous malformations and 30 patients (group B) were treated with local injection of PYM alone for tongue venous malformations. The size of the lesions in the two groups varied from 3.5 x 3 x 3 to 8 x 6 x 5 cm. There was no statistical difference in the volume of the lesions between group A and group B (p > 0.05). There was no statistical difference in the age between the two groups (p > 0.05). A repeated treatment of ECT combined with PYM injection or PYM injection alone was administered for venous malformations of tongue in the group A and group B. According to the size of the lesions, the amount of ECT was 5--10 C/cm² . The injection dose of PYM was 3 - 5 mL and the injection concentration of PYM was 1.6 mg/mL for adults and 1.0 mg/mL for children. Glucocorticoids were given to prevent postoperative swelling. The therapeutic interval was 3 months for ECT combined with PYM injection and 2 to 4 weeks for PYM injection alone. Hemisphere measurements were used to measure the size of the lesions. 4-scale score and feedback from the patients were used to evaluate the clinical efficacy. Results: During the follow-up period from 6 months to 3 years, 60 patients achieved different degree of improvement, with a total effective rate of 85%. 30 patients in the group A received ECT combined with local injection of PYM, with an effective rate of 97%. 30 patients in the group B received local injection of PYM alone, with an effective rate of 73%. The effectiveness of ECT combined with PYM injection in the group A was significantly higher than that of PYM injection alone in the group B (p < 0.05). Postoperative symptoms such as local pain, swelling and fever often occurred in the patients, and the symptoms generally disappeared after 5 to 7 days. No mucosa necrosis or nerve damage was found. Postoperative subjective sensation and function of the tongue were normal. Conclusion: Electrochemical therapy combined with local injection of pingyangmycin was a reliable, safe and minimally invasive method for the treatment of venous malformation in the tongue. The treatment modality has fewer complications and is worth of further promotion in clinic. [ABSTRACT FROM AUTHOR]

Background: The development of bone graft material to replace bone remains a formidable challenge in maxillofacial surgery. Although autogenous bone is the best material, however, the advantage of an autograft is offset by the limited supply of such bone and morbidity associated with surgery to harvest the graft. The thesis aims to study and compare the efficacy of two such bone substitutes in the healing of osseous defects of the maxillofacial surgery. Method: 20 patients reporting to DEPARTMENT OF ORAL AND MAXILLOFACIAL SURGERY, AL-AMEEN DENTAL COLLEGE AND HOSPITAL, BIJAPUR, requirin Treatment for osseous defects were selected for the study. They were categorized in two groups of 10 each. GROUP A were treated by DFDBA and GROUP B were using DFDBA and HYDROXYAPATITE in combination. Treatment outcome was evaluated using many parameters like pain, swelling clinically and bone density radiographically pre operative, 1st day,1st week, 4th week and 12th week post operative. Results: Analysis of the two groups did not reveal high statistically significant differences at any of the follow up periods except for radiological evidence at four weeks. All the patients had mild to moderate pain on GROUP A on first post-operative day. Pain was maximum on 2nd post-operative day and decreased gradually and almost nil by the end of 4th post-operative day. In case of GROUP B, all patients had moderate to severe pain on first post- operative day. Pain was maximum from 2nd to 4th post operative day and then gradually decreased but slight pain was there at the end of first post-operative week All the patients had mild to moderate swelling in GROUP A on first post-operative day. Swelling decreased gradually towards normal. By the end of first week post-operative, swelling was nil. In case of GROUP B, all patients had moderate to severe swelling on first postoperative day. Swelling was maximum from 1st post-operative week and then started decreasing towards normal. By the end of first week post-operative, slight swelling was still present. GROUP A No signs of infection (persistent post operative swelling, pain or pus discharge) were seen in any patient of GROUP A. No signs of implant (graft material) rejection (discharge, extrusion, tissue dehiscence) were seen in any patient of GROUP A. In GROUP B, however, all these three signs of implant (graft material) rejection were seen in one patient at fourth week. The graft material was surgically removed at fourth week. Radiological evidence of calcification, bone formation and bridging of the gap with new bone as evident by formation of irregular trabeculae of bone and appearance of radio-opaque areas in the defect was evident from fourth week onwards. It was seen 70 % cases of GROUP A, in 30% cases of GROUP B. The difference between GROUP A and GROUP B was statistically significant (P\0.01) at this point of time. Bone density was assessed by grey scale histogram. Conclusion: DFDBA when used for the obliteration of osseous defects bypasses the phase of obligatory resorption and shows early evidence of new bone formation. HA when used for Obliteration of osseous defects shows delayed first evidence of bone formation as compared to the decalcified freeze-dried bone matrix allograft and it undergoes resorption but takes a long period to resorbed completely and be replaced by bone. The radiograph assessment score over grey scale histogram indicates early bone formation with DFDB and the combination of DFDBA and HA [ABSTRACT FROM AUTHOR]

Necrotizing fasciitis (NF) is a life-threatening soft-tissue infection affecting the deep fascia and subcutaneous tissue. It is characterized by a fulminant course and high mortality rates. NF of the head and neck is very rare, with most cases being odontogenic in origin. The purpose of this study is to comprehensively review the most important features of cervical necrotizing fasciitis (CNF) in adults and add our experience in the management of this entity. The most common isolated organisms are Streptococcus spp. and Staphylococcus spp. If the infection progresses to descending mediastinitis, the prognosis becomes very poor. Since the initial clinical features can be similar to those of a non-necrotizing deep cervical infection, a high degree of suspicion is critical for an early diagnosis. A computed tomography scan is essential for the diagnosis and to define the extent of the infection/rule out descending mediastinitis. Early and aggressive surgical debridement of all compromised tissue and antibiotic therapy and fluid resuscitation are essential and should not wait for bacterial culture results. Despite prompt and adequate treatment, the mortality of CNF can be as high as 35%. [ABSTRACT FROM AUTHOR]

Background/Objectives: Surgical navigation has advanced maxillofacial surgery since the 1990s, bringing benefits for various indications. Traditional registration methods use fiducial markers that are either invasively bone-anchored or attached to a dental vacuum splint and offer high accuracy but necessitate additional imaging with increased radiation exposure. We propose a novel, non-invasive registration protocol using a CAD/CAM dental splint based on high-resolution intraoral scans. Methods: The effectiveness of this method was experimentally evaluated with an ex vivo 3D-printed skull measuring the target registration error (TRE). Surgical application is demonstrated in two clinical cases. Results: In the ex vivo model, the new CAD/CAM-splint-based method achieved a mean TRE across the whole facial skull of 0.97 ± 0.29 mm, which was comparable to traditional techniques like using bone-anchored screws (1.02 ± 0.23 mm) and dental vacuum splints (1.01 ± 0.33 mm), while dental anatomical landmarks showed a lower accuracy with a mean TRE of 1.84 ± 0.44 mm. Multifactorial ANOVA confirmed significant differences in TRE based on the registration method and the navigated level of the facial skull (p < 0.001). In clinical applications, the presented method demonstrated high accuracy for both midfacial and mandibular surgeries. Conclusions: Our results suggest that this non-invasive CAD/CAM-splint-based method is a viable alternative to traditional fiducial marker techniques, with the potential for broad application in maxillofacial surgery. This approach retains high accuracy while eliminating the need for supplementary imaging and reduces patient radiation exposure. Further clinical trials are necessary to confirm these findings and optimize splint design for enhanced navigational accuracy. [ABSTRACT FROM AUTHOR]

Objectives: This study aimed to determine the impact of standing electric scooters on maxillofacial on the Italian territory. Methods: The authors analyzed the epidemiology of the injuries to define electric mobility's impact on maxillofacial surgery practice. For this retrospective cohort study, data were collected by unifying the standing e-scooter-related fractures database from 10 Italian maxillofacial surgery departments. The reference period considered was from January 2020 to December 2023. The main data considered included age, gender, type of access, time slot of admission, type of admission, alcohol level, helmet use, dynamics of the accident, and area of the fracture. Results: A total of 79 patients were enrolled. The average age of the participants was approximately 31 years. The blood alcohol level was found to be above the Italian norm in 15 cases (19%). Only one patient wore a helmet. The most affected facial third was the middle one with 36 cases (45.5%), followed by the lower one (31, 39.3%). The most recurrent patterns were fractures of the orbito-malar-zygomatic complex (15, 19%), followed by multifocal (bifocal, trifocal) fractures of the mandible (14, 17.5%). Conclusions: This study demonstrated how maxillofacial fractures related to the use of electric scooters are associated with complex patterns, associated with a high rate of post-surgical aftermaths. [ABSTRACT FROM AUTHOR]

Purpose: This large retrospective, single-center, follow-up study investigated the endoscopic prelacrimal recess approach (PLRA) for treating maxillary sinus inverted papilloma (MSIP). Methods: Between January 2007 and November 2022, patients with MSIP treated with PLRA were enrolled. Data on clinical manifestations, imaging, and surgical procedures were collected. The visual analog scale (VAS) scores for maxillofacial numbness and nasal symptoms and the SNOT-22 nasal symptom scores were statistically analyzed. Result: Of 122 patients (68 males and 54 females) enrolled in the study, with a mean age of 50.75 ± 12.84 years (26–80 years), 111 patients underwent PLRA, nine underwent modified PLRA, one converted to an endoscopic medial maxillectomy (EMM), and one to an endoscopic modified Denker's approach. The average follow-up was 86.60 (13–192) months, the recurrence rate was 3.28%, and 29 patients (23.77%) complained of maxillofacial numbness one month postoperatively, which disappeared in most cases one year after surgery. Five patients (4.10%) experienced mild numbness at the end of the follow-up period. Maxillary sinus ostium contracture or atresia occurred in two cases (1.64%). After surgery, the VAS nasal symptom scores improved significantly (P < 0.001). SNOT-22 indicated that the most common postoperative symptom was thick nasal discharge. Conclusion: PLRA is a flexible first-choice surgical treatment for maxillary sinus inverted papilloma and can be modified according to the extent of the lesion, the surgeon's experience and technique, and surgical instruments. That can help achieve complete resection and reduce recurrence and surgical complications. Upper teeth numbness, the most common postoperative complication, tends to disappear after 1 year. [ABSTRACT FROM AUTHOR]

Background: The rise of value-based purchasing has led to decreased compensation for hospital-acquired conditions, including surgical site infections (SSI). This study aims to assess the risk factors for SSI in children and teenagers undergoing gastrointestinal surgery across US hospitals. Methods: The 2018-2020 Nationwide Readmissions Database was queried for patients undergoing gastrointestinal surgery under the age of 18. The primary outcome was SSI during index admission or readmission within a year. Comparison groups were elective, trauma, and emergent surgery based on anatomic location and urgency. Univariable comparison used chi-squared tests for relevant variables. Confounders were addressed through multivariable logistic regression with significant variables from univariable analysis. Results: 113 108 total patients met the study criteria. The SSI rate during admission or readmission was 2.9% (n = 3254). Infections during admission and readmission were 1.4% (n = 1560) and 1.5% (n = 1694), respectively. The most common site was organ space (48.6%, n = 1657). Increased infection risk was associated with trauma (OR 1.80 [1.51-2.16] P <.001), emergency surgery (OR 1.31 [1.17-1.47] P <.001), large bowel surgery (OR 2.78 [2.26-3.43] P <.001), and those with three or more comorbidities (OR 2.03 [1.69-2.45] P <.001). Investor-owned hospitals (OR.65 [.56-.76] P <.001) and highest quartile income (OR.80 [.73-.88] P <.001) were associated with decreased infection risk. Conclusions: Pediatric patients undergoing gastrointestinal surgery face an elevated risk of SSI, especially in trauma and emergency surgeries, particularly with multiple comorbidities. Meanwhile, a reduced risk is observed in high-income and investor-owned hospital settings. Hospitals and surgeons caring for high risk patients should advocate for risk adjustment in value-based payment systems. [ABSTRACT FROM AUTHOR]

Introduction The invasion of Ukraine by Russian troops on February 24, 2022, and the beginning of the full-scale war had huge humanitarian consequences. The major challenges facing the Ukrainian health care system included the disruption of medical infrastructure and logistics, the termination of the supply of expendable materials, significant migration, and a dramatic increase in high-velocity blast and gunshot injuries among combatants and civilians. The aim of the present study was to analyze the challenges and solutions in patient care faced by the Ukrainian system of maxillofacial surgery during the war in different regions of the country. Materials and Methods A cross-sectional study was designed and implemented as an online survey to collect national data concerning maxillofacial surgeons' experiences and professional activities. The study was initiated and supported by Bogomolets National Medical University (Kyiv, Ukraine), the Ukrainian representative of AO CMF (Arbeitsgemeinschaft für Osteosynthesefragen Craniomaxillofacial Surgery) and the University of Helsinki (Finland). The questionnaire was developed by specialists in maxillofacial surgery and sociologists and contained 65 close-ended questions. Surgeons who had not worked in this specialty in inpatient departments of hospitals since at least the beginning of the full-scale war were excluded from the study. We received and analyzed 97 responses that met the abovementioned criteria. The geography of respondents covered all the regions and the main cities of Ukraine, expect for the occupied territories. Results After a year of warfare, the percentage of surgeons who treated patients with blast and gunshot injuries increased from 43.4% to 86.6%. This percentage was higher in military hospitals and in regions located in the vicinity of the front line. We found that, during the war, 78.6% of respondents performed osteosynthesis in cases of high-velocity multifragmented facial bone fractures (in such cases, 58.3% of them strictly followed AO CMF recommendations, while 41.7% performed the fixation based on available hardware, existing technical possibilities and their own preferences). We found that 70.2% of respondents had the opportunity to apply Computer-Aided Design/Computer-Aided Manufacture technology and patient-specific implants for the treatment of gunshot injuries, 38.1% reported that their hospitals were able to perform microsurgical reconstructions for facial defects, 79.4% of respondents reported that their departments received humanitarian aid and support from volunteer organizations (either Ukrainian or international), which significantly facilitated the treatment process. Conclusions According to this nationwide survey of Ukrainian maxillofacial surgeons during a year of the full-scale war, 86.6% of respondents were involved in the treatment of gunshot and ballistic injuries in civilians and combatants. The main problems reported by the respondents were (1) a lack of experience and knowledge related to the treatment of severe wounds, especially by secondary reconstruction, and (2) a deficit of resources (equipment, materials, and medications) under conditions of disrupted logistics and changes in the numbers and nosological distribution of patients. There were the opportunity to transfer the patients to European clinics (29.9%), online consultations (45.4%), collaboration with foreign surgeons who come to Ukraine asvolunteers (32%). [ABSTRACT FROM AUTHOR]

Summary: Background: It is not certain whether the blade geometry of videolaryngoscopes, either a hyperangulated or Macintosh shape, affects glottic view, success rate and/or tracheal intubation time in patients with expected difficult airways. We hypothesised that using a hyperangulated videolaryngoscope blade would visualise a higher percentage of glottic opening compared with a Macintosh videolaryngoscope blade in patients with expected difficult airways. Methods: We conducted an open‐label, patient‐blinded, randomised controlled trial in adult patients scheduled to undergo elective ear, nose and throat or oral and maxillofacial surgery, who were anticipated to have a difficult airway. All airway operators were consultant anaesthetists. Patients were allocated randomly to tracheal intubation with either hyperangulated (C‐MAC D‐BLADE™) or Macintosh videolaryngoscope blades (C‐MAC™). The primary outcome was the percentage of glottic opening. First attempt success was designated a key secondary outcome. Results: We assessed 2540 adults scheduled for elective head and neck surgery for eligibility and included 182 patients with expected difficult airways undergoing orotracheal intubation. The percentage of glottic opening visualised, expressed as median (IQR [range]), was 89 (69–99 [0–100])% with hyperangulated videolaryngoscope blades and 54 (9–90 [0–100])% with Macintosh videolaryngoscope blades (p < 0.001). First‐line hyperangulated videolaryngoscopy failed in one patient and Macintosh videolaryngoscopy in 12 patients (13%, p = 0.002). First attempt success rate was 97% with hyperangulated videolaryngoscope blades and 67% with Macintosh videolaryngoscope blades (p < 0.001). Conclusions: Glottic view and first attempt success rate were superior with hyperangulated videolaryngoscope blades compared with Macintosh videolaryngoscope blades when used by experienced anaesthetists in patients with difficult airways. [ABSTRACT FROM AUTHOR]

Introduction: This study analyzed oncologic patient management from initial tumor diagnosis to tumor follow-up in oral and maxillofacial surgery (OMFS) in Germany. Material and methods: A dynamic online questionnaire with a total of 44 questions was used to generate general and specific data regarding oncologic patient management with head and neck malignancies, supportive care, and (pre-) rehabilitation from initial tumor diagnosis to tumor follow-up and head and neck cancer center (HNCC) structures in OMFS in Germany. The questionnaire was sent to 81 OMFS departments affiliated with the German-Austrian-Swiss Working Group for Tumors of the Jaw and Facial Region (DÖSAK) and the German Association of Oral and Maxillofacial Surgery (DGMKG). Data analysis was conducted descriptively. Results: Forty-eight OMFS departments participated (response rate 59.26%), of which 36/48 (75%) were certified HNCC. 28/34 (82.4%) reported subjective improvements in oncologic care, most often interdisciplinary collaboration (21/33, 63.64%) and clinic structure changes (21/34, 61.76%). Nearly all OMFS departments present patients in multidisciplinary tumor boards (45/46, 97.83%) and aim for osseous reconstruction post-tumor resection (43/44, 97.73%). Significant discrepancies regarding the frequency of masticatory-functional dental rehabilitation following osseous reconstruction were observed. Before oncologic therapy, patients are offered various supportive services, mostly psychotherapy and psycho-oncological support (24/26, 92.31%). Post-therapy, speech therapy (43/43, 100%), physiotherapy (40/43, 93.02%), lymphatic drainage, and follow-up rehabilitation (39/43, 90.7%, respectively) are most often offered. 17/43 (39.53%) have oncological nursing staff. 36/40 (90%) manage patients and side effects during adjuvant therapy, while 5/41 (12.2%) provide proprietary palliative care. 36/41 (87.8%) offer counseling to patients and families. Conclusion: Oncologic patient care in OMFS is highly standardized and potentially attributable to many certified HNCCs in Germany. Certain treatment aspects are handled differently, possibly due to institution-specific reasons. Clinical relevance: The high homogeneity in treatment protocols reflects the widespread high and comparable treatment quality of head and neck malignancies in OMFS in Germany. [ABSTRACT FROM AUTHOR]

The aim of this retrospective study was to analyze a series of patients who underwent full-arch rehabilitation of the atrophic maxilla using additively manufactured subperiosteal implants, between August 2018 and January 2023, at the Universities of Sassari and Poznan. In total, 36 patients and 72 implants were included, with no implants lost during follow-up, and a success rate of 90.3%. Seven (9.7%) of the implants showed class 1 exposure. Bleeding on probing was detected in 10.4% of the abutments at 6 months, 7.9% at 1 year, 10% at 2 years, 7% at 3 years, and 11.4% at 4 years. No significant bone resorption under the abutments was detected during the whole observation period. Based on the findings from this study, additively manufactured subperiosteal implants could represent a safe and reliable technique for full-arch rehabilitation in patients with severe maxillary atrophy. [ABSTRACT FROM AUTHOR]

Communication is an integral component of effective healthcare delivery to patients, and this includes breaking bad news (BBN). However, clinicians in dentistry are rarely exposed to diseases that can negatively and seriously affect an individual's view of their future and pose a mortality risk, except for oral cancer. The aim of this study was to assess clinician practices in BBN of oral cancer diagnosis in Malaysia. An exploratory sequential mixed-methods study design was used. A qualitative study was conducted among 12 clinicians to gather relevant information regarding their practices in BBN of oral cancer diagnosis using a descriptive–interpretive approach. The themes that emerged were preparation for BBN, BBN setting, communication, emotional aspects, and summarizing the session. These themes were used to develop a questionnaire with 34 items. In the quantitative study, this questionnaire was sent to 87 clinicians who had experienced BBN of oral cancer diagnosis in the past 5 years; the response rate was 100%. An arbitrary cut-off score between the third and fourth quartiles was set to distinguish 'good' and 'poor' practice in BBN among the clinicians. The data analysis was performed using IBM SPSS Statistics version 23.0. Overall, at least two-thirds of the clinicians had good practices in BBN of oral cancer diagnosis. The clinicians' designation (oral and maxillofacial surgery consultant/specialist vs dental officer) and BBN experiences were factors associated with their practices in BBN of oral cancer diagnosis. [ABSTRACT FROM AUTHOR]

Background: Unlike other amide local anesthetics (LAs), articaine has better lipid solubility and potency. Very few studies have been done on comparing articaine with other LAs as buccal infiltration among the participants requiring paired extraction of maxillary premolars but limitations of those studies include smaller sample size, lack of washout periods, and diversity in study designs. Aims and Objectives: This study compares the anesthetic efficacy of 4% articaine (1:100,000 epinephrine) with 2% lidocaine (1:100,000 epinephrine) as buccal infiltration. Materials and Methods: This is a randomized double-blinded crossover study conducted at the Department of Oral and Maxillofacial Surgery in collaboration with the Department of Pharmacology, SRIHER, Chennai. This study was done on 59 participants on an outpatient basis. The selected participants received 4% articaine or lignocaine with epinephrine (1:100000) in the mucobuccal fold at the maxillary area during their first visit and the same individual received the other local anesthetic drug on the other side in the same area during the second visit, i.e., 1 week from the date of the first visit. All the statistics were calculated using the software Statistical Package for the Social Sciences 16 version. For all primary and secondary outcomes in the study, the Mann--Whitney U-test was employed to compute the mean and standard deviation. Results: The total mean age of the participants included was 21.69. The volume of drug required was 1.578 ± 0.2760 mL for articaine and 2.2068 ± 0.0984 ml for lignocaine. The onset time was 30-45 s with articaine and 75-90 s with lignocaine. A decrease in pain scores was seen in the articaine group compared to the lignocaine group. Conclusion: This study showed better efficacy of articaine in comparison to lignocaine. Articaine may replace lignocaine in orthodontic corrections with its higher efficacy, faster action, and longer duration. [ABSTRACT FROM AUTHOR]

Odontogenic cysts are frequently encountered in clinical practice. However, residual cysts, a specific type of inflammatory odontogenic cyst, are relatively rare. These cysts may slowly expand over time, damaging surrounding soft tissues and bone, typically without posing a threat to life. We report the case of a 67-year-old man with liver failure and a cystic tumor in his right maxilla that had invaded his oral cavity and cheek, causing nasal obstruction and severe bleeding following an incisional biopsy. A computed tomography (CT) scan of the mass was nonspecific, and an initial histopathological analysis of the tissues was inconclusive due to chronic inflammation and hemorrhagic alterations, complicating the diagnostic pathway. The suspicion of a potentially aggressive malignant neoplasm and the need for immediate intervention due to bleeding necessitated a tracheotomy, tumor removal, percutaneous endoscopic gastrostomy, and transfusions of red blood cells. A subsequent histopathological examination revealed features indicative of a residual cyst. The entire lesion was excised through functional endoscopic sinus surgery. The surgical treatment was performed safely and effectively. Follow-up CT confirmed complete removal of the lesion. This case highlights a rare yet possible complication of odontogenic cysts and underscores the necessity of early diagnosis and comprehensive prophylaxis to prevent severe complications. [ABSTRACT FROM AUTHOR]

Study Design: Survey. Objective: Subcondylar fractures stand out as a particular challenge when treating maxillofacial trauma. The fracture site is often difficult to access and adjacent to critical structures like the facial nerve. Current treatment paradigms vary widely and we endeavored to elucidate these approaches from surgeons across the full breadth of Craniomaxillofacial Surgery. Methods: A survey was designed to gather general background training and experience information, perceived indications for ORIF of subcondylar fractures, options for treating subcondylar fractures, and reasoning for choosing or not choosing a given treatment approach. The survey was sent to members of AO CMF and the American Academy of Facial Plastic Surgery. Responses were collected for 4 weeks. Results: 514 total responses to the survey were obtained (response rate 17%). Of these, 43 (8.4%) identified as Otolaryngology trained, 417 (81.1%) as OMFS trained, and 54 (10.5%) as Plastic Surgery trained. While there was broad agreement in the indications for open repair, surgical approaches differed by specialty background as well as AO faculty member status. Those with less experience were less likely to perform open approaches due to lack of comfort with this skill set. Conclusions: There are some key differences in approaches to treatment of subcondylar fractures based upon specialty background and experience level. This provides an opportunity for further education to ensure optimal treatment for patients. [ABSTRACT FROM AUTHOR]

Study Design: The purpose of this study was to do a retrospective analysis about patients with mandibular fracture who were treated at the department of Maxillofacial Surgery, Regional University Hospital of Ancona, Italy, between 2011 and 2021. Objective: In this study we evaluated clinical and epidemiological findings of mandible fractures focusing on the association between surgical timing, type of surgical approach and mid- and long-term outcomes. Methods: Patients were evaluated based on various parameters including age, sex, etiology, symptoms, comorbidity, clinical findings, mandible fracture type, other facial fractures, treatment, waiting time before the operation, complications and sequelae. In the period described, we recorded 1023 mandibular fractures. 93% of patients underwent surgery under general anesthesia, almost exclusively patients undergoing an open approach to internal fixation. Results: Of the patients, 684 were male (66.86%) and 339 were female (33.13%). The average age of the patients was 42, 38 years (range, 7-94 years). The leading cause of these fractures was traffic accidents (27.3%) and mandibular parasymphysis fractures were the most frequent (34.1%). The most common clinical signs and symptoms were malocclusion, difficulty in chewing, limitation of the buccal opening, hypoesthesia extending through the territory of the inferior alveolar nerve, difficulty in protrusion movements and mandibular lateralization. Conclusions: The continuous research in epidemiology, etiology, materials, and techniques will further refine the treatments of mandible fractures, which are nowadays more and more customized according to the type of trauma. [ABSTRACT FROM AUTHOR]

The aim of this study was to perform a bibliometric analysis to discover what topics of dental YouTube videos have been investigated by the scientific literature, and evaluate how video characteristics were related to citation count. The Scopus electronic literature database was accessed to identify relevant papers. After screening, a total of 128 papers entered the analysis. The bibliographic data were provided by Scopus, whereas content evaluations were manually performed. Most papers evaluated videos recorded in English (85.9%). Each of the 128 papers analyzed a mean (±SD) of 79.2 ± 61.6 videos. Mean journal impact factor was 1.8 ± 1.4, and mean citation count was 13.0 ± 22.4. The preference for publication of papers was inclined towards dental journals (80.5%), with the majority (54.7%) being published without open access. Papers dealing with videos targeting patients/public had higher citations than those targeting dental professionals only (14.1 ± 23.4 vs. 4.0 ± 6.3, p < 0.001). The most represented as well as the most highly cited specialty of the dental YouTube publications was oral and maxillofacial surgery/oral medicine. Some twin or triplet studies published in the same year covering the same topic were identified, but they often covered a different number of videos. [ABSTRACT FROM AUTHOR]

Purpose: This study aims to conduct a thorough analysis, both quantitative and qualitative, of bibliometric parameters related to preemptive analgesia (PA) in oral surgical procedures (OSP). Methods: Research trends on PA in OSP using ibuprofen were reviewed through bibliometric analysis of 68 journal articles published from 1991 to 2022 in the Web of Science database. Bibliometric indicators were applied to analyze the journal article data, including the annual distribution of publications and literature growth, document types, citation indicators to measure qualitative research performance, and keyword mapping to identify research trends. The results were imported into RStudio, and the Bibliometrix package was used to prepare and analyze the metadata. Results: The 68 included articles received a total of 900 citations, ranging from 1 source to 72 citations with some fluctuations. The papers on PA in OSP using ibuprofen had an average of 16.85 citations per paper. These publications were originated from 25 countries, with the highest contributions from Brazil (n = 17), the USA (n = 13), and Turkey (n = 8). The top five major contributing journals were the International Journal of Oral and Maxillofacial Surgery, Journal of Oral and Maxillofacial Surgery, Journal of Cranio-Maxillo-Facial Surgery, Journal of Periodontology, and Acta Odontologica Scandinavica, representing more than half of all selected papers. Conclusion: Papers focused on PA in OSP received numerous citations. The citation per article correlated with the number of publications at the affiliation, author, country, and journal levels. However, there is still a scarcity of studies in this field. [ABSTRACT FROM AUTHOR]

Purpose: In the digital era, the internet is the go-to source of information, and patients often seek insights on medical conditions like TMJ ankylosis. YouTube, a popular platform, is widely used for this purpose. However, YouTube's lack of regulation means it can host unreliable content. Hence, the primary objective of this study is to assess the scientific quality of YouTube videos concerning TMJ ankylosis. Materials and methods: This study analyzed 59 TMJ ankylosis-related videos. Two Oral and Maxillofacial Surgery specialists assessed these videos. Data on the video source, duration, upload date, the time elapsed since upload, total views, likes, dislikes and comments, Interaction index, and viewing rate were collected and analyzed. Video quality was assessed using the Global Quality Scale (GQS) and the Quality Criteria for Consumer Health Information (DISCERN), comparing health professionals and non-health professionals. Results: Health professional's videos were better in terms of GQS 3.21 ± 0.94 and DISCERN score 3.03 ± 0.75 as compared to the non-health professional videos GQS 3.0 ± 1.04, and DISCERN 2.81 ± 1.13. Health professional group videos had more reliability and better quality than the non-health professional group (p < 0.01). Conclusion: YouTube should not be relied on as a trustworthy source for high-quality and reliable information regarding TMJ ankylosis videos. Healthcare professionals must be prepared to address any ambiguous or misleading information and to prioritize building trustworthy relationships with patients through accurate diagnostic and therapeutic processes. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study is to determine if supervised machine learning algorithms can accurately predict voided computerized physician order entry in oral and maxillofacial surgery inpatients. Methods: Data from Electronic Medical Record included patient demographics, comorbidities, procedures, vital signs, laboratory values, and medication orders were retrospectively collected. Predictor variables included patient demographics, comorbidities, procedures, vital signs, and laboratory values. Outcome of interest is if a medication order was voided or not. Data was cleaned and processed using Microsoft Excel and Python v3.12. Gradient Boosted Decision Trees, Random Forest, K-Nearest Neighbor, and Naïve Bayes were trained, validated, and tested for accuracy of the prediction of voided medication orders. Results: 37,493 medication orders from 1,204 patient admissions over 5 years were used for this study. 3,892 (10.4%) medication orders were voided. Gradient Boosted Decision Trees, Random Forest, K-Nearest Neighbor, and Naïve Bayes had an Area Under the Receiver Operating Curve of 0.802 with 95% CI [0.787, 0.825], 0.746 with 95% CI [0.722, 0.765], 0.685 with 95% CI [0.667, 0.699], and 0.505 with 95% CI [0.489, 0.539], respectively. Area Under the Precision Recall Curve was 0.684 with 95% CI [0.679, 0.702], 0.647 with 95% CI [0.638, 0.664], 0.429 with 95% CI [0.417, 0.434], and 0.551 with 95% CI [0.551, 0.552], respectively. Conclusion: Gradient Boosted Decision Trees was the best performing model of the supervised machine learning algorithms with satisfactory outcomes in the test cohort for predicting voided Computerized Physician Order Entry in Oral and Maxillofacial Surgery inpatients. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study was to (a) record and evaluate the epidemiological data relevant to the fractures of the atrophic mandible in the Greek population (b) present our experience in the management of these difficult injuries and (c) compare our results to the outcomes of other similar studies and discuss the postoperative complications. Methods: A prospective analysis of all the edentulous patients with fractures of the atrophic mandible treated at the Oral and Maxillofacial Surgery Department of K.A.T General Hospital of Athens in Greece was performed from November 2012 to December 2022. Age, gender and medical history of the patient, etiology and site of the fracture, classification of atrophy, type of surgical approach, type of osteosynthesis and postoperative complication. Results: 34 patients were included in the present study and 48 fractures of the atrophic edentulous mandible were managed surgically. 22 fractures were classified as class II of atrophy, 21 fractures as class III and 5 injuries as class I. In 32 patients we used an extraoral approach and only 2 patients were treated with an intraoral access. 44 fractures were treated with a 2.0 mm locking reconstruction plate and only 4 injuries of class I atrophy were treated with mini plates. Conclusions: Clinical practice has confirmed that for these cases an extraoral approach followed by stable fixation with a 2.0 mm reconstruction locking plate can deliver excellent results. Our findings show that the routine use of primary bone grafts is not necessary and can be reserved for more complex cases. [ABSTRACT FROM AUTHOR]

Purpose: To explore the ability of Dental Students (DS), Medical Students (MS), Trainee Interns (TI) and Pre-vocational Junior Doctors (JD) in identifying procedures performed by Oral and Maxillofacial Surgery (OMS), the scope of practice (SOP) of OMS and ability to differentiate OMS from similar specialities. Methods: The study included 282 complete responses to a survey consisting of: 9 demographic questions, 11 OMS awareness, professional ambition, teaching and exposure, confidence in identifying and referring questions and 70 procedural/scenario questions across four domains. Collected data was qualitatively and statistically analysed using SPSS V29. Results: OMS awareness was limited. 92.2% reported None to Small amount of OMS teaching and exposure during university, with 66.0% preferring to have had a Fair to Significant amount. DS experienced more than medical respondents (2.1 vs. 1.5, p < 0.001). Most respondents reported No to Low confidence in identifying the SOP and procedures performed by OMS (67.7%) and referring to OMS (62.4%) compared to similar specialities (32.4% and 33.2%, respectively). 52.9% of procedures performed by OMS were correctly identified as being performed by OMS. The ability to identify the OMS SOP (8.7%) and differentiate OMS from similar specialities (5.0%) was low, however better among DS than medical respondents (14.9% vs. 6.3%, p = 0.002 and 12.2% vs. 2.2%, p < 0.001). Conclusion: The study has highlighted a deficit in the understanding of OMS with potential implications in the public and private healthcare sector. Identification of procedures, OMS SOP and ability to differentiate OMS from similar specialities is limited however slightly better among DS. [ABSTRACT FROM AUTHOR]

Purpose: PEMF (pulsed electromagnetic fields) founds application in several medical fields to accelerate bone wounds healing and to reduce inflammation. The aim of our study was to evaluate the effectiveness of PEMF in reducing postoperative swelling and pain in patients undergoing orthognathic surgery. Methods: A prospective observational monocentric study was conducted on a sample of 30 patients undergone to orthognathic surgery in Maxillofacial Surgery Unit of University of Naples Federico II. The patients who followed these inclusion criteria were enrolled in the study: age ≥ 18 years, Class III malocclusion, Surgical procedure of Le Fort I osteotomy + Bilateral Sagittal Split Osteotomy (BSSO), Written informed consent. Patients were divided into two groups: Group SD) postoperative standard treatment with medical therapy and cryotherapy, Group SD + PEMF) postoperative standard therapy + PEMF. Each patient underwent a 3D facial scan, at one (1d) and four (4d) days after surgery to compare the swelling reduction. The pain score was assessed through VAS score and analgesics administration amount. Results: In SD + PEMF group, the facial volume reduction between 1d and 4d scan was on average 56.2 ml (6.23%), while in SD group, it was 23.6 ml (2.63%). The difference between the two groups was 3.6% (p = 0.0168). VAS pain values were significantly higher in SD group compared to SD + PEMF group in the second day after surgery (P = 0.021) and in the total 4 days (P = 0.008). Conclusions: Our data suggest that PEMF is valid tool to promote faster postoperative swelling and pain reduction in patients undergoing orthognathic surgery. [ABSTRACT FROM AUTHOR]

Purpose: The COVID-19 pandemic has affected the personal and social lives of millions of people and also impacted the etiological factors of midfacial trauma such as falls, interpersonal violence or traffic accidents. The aim of this study was to analyze the influence of the COVID-19 pandemic on maxillofacial trauma surgery in the German healthcare system. Methods: Nationwide data regarding the national diagnosis-related-group (DRG) inpatient billing system used in all German hospitals was received from the German Federal Statistical Office. Various trauma-associated procedures of the Operation and Procedure Classification System (OPS), a German modification of the International Classification of Medical Procedures (ICPM), were statistically associated with different epidemiological factors between 2012 and 2021. Results: A statistically significant decrease (p < 0.05) in surgeries regarding maxillofacial fractures was registered during the years 2020 and 2021. Young male patients had the largest decline in maxillofacial trauma surgeries during this period (p < 0.05). In contrast. elderly patients 80 years and older showed a dramatic increase in the frequency of fractures in both the midface and the mandible (p < 0.05). Conclusions: During the COVID 19 pandemic there has been a shift in the number, composition and etiology of maxillofacial fracture surgeries. Measures of social distancing and personal risk avoidance had a societal positive effect on the frequency of facial injuries. This stands in contrast to the drastic increase in fractures of elderly people who should be protected primarily by the measures taken. These results can help to understand these influences better in future pandemics. Trial registration: German Clinical Trials Register No: DRKS00032778. [ABSTRACT FROM AUTHOR]

Purpose: Orbital fractures are common injuries and represent an interesting chapter in maxillofacial surgery. This retrospective study analyses data collected from 528 patients surgically treated at the University Hospital "Magna Graecia", Catanzaro, Italy, from 1st January 2007 to 31st January 2021. Methods: The inclusion criteria were a diagnosis of orbital bone fracture, complete clinical and radiological records, and a minimum follow-up of 12 months. We analyzed gender, age, etiology, fracture type, treatment, timing of repair, and associated complications. Results: The most frequent cause of trauma was road accidents (37.88%), followed by domestic accidents (25.95%). The manifestation of diplopia (72.35%), infraorbital nerve hypoesthesia (53.41%), extrinsic eye movement limitation (51.70%), and enophthalmos (41.29%), determined the indication for surgery. Our trauma team preferred the sub-eyelid approach (79.36%). The study shows a statistical significance in the correlation between the severity of the herniation of the lower rectus muscle and the presence of preoperative diplopia (p-value = 0.00416); We found the same statistical significance for the post-postoperative diplopia (p-value = 0.00385). Patients treated two weeks after the trauma show a higher rate of diplopia and a greater limitation of long-term post-operative eye movements than those treated within two weeks (diplopia 23.08% vs. 15.56%; eye movements limitation 13.33% vs. 7.69%). Early surgical treatment (> 14 days) reduces the likelihood of functional and structural damage to the lower rectus muscle. Conclusion: Our data will support future maxillofacial traumatology studies, and the education and prevention measures taken will reduce the incidence of orbital trauma. [ABSTRACT FROM AUTHOR]

Adolescents and young adults' active lifestyles make dental trauma a significant medical concern. Aim: This study aims to assess the etiology, frequency, and localization of dental and periodontal trauma in adolescents and young adults, along with these individuals' predisposition based on age, gender, and residence. Materials and Methods This retrospective study included 109 adolescents and young adults from a database of the Emergency and Oral and Maxillofacial Surgery department at "Sf. Spiridon" Hospital, Iasi, Romania. The collected data included demographic details, mechanisms of dental and periodontal trauma, treatment approaches, and clinical outcomes. Statistical analysis was performed using SPSS 26.0, with comparisons based on age, gender, and residence. Results: Enamel fractures (23.9%) and enamel-dentin fractures without pulp exposure (20.2%) were the most frequent dental injuries. Concussion (58.7%), subluxation (21.1%), luxation, avulsion (7.3%), and extrusion (5.5%) were common periodontal injuries. The anterior region of the dental arch accounted for the majority (60.6%) of injuries. Adolescents under 17 years were more prone to enamel-dentin fractures without pulp exposure (23.8%), enamel-dentin fractures with pulp exposure (20.6%), and root fractures (20.6%), while young adults over 18 years had a higher incidence of enamel fractures (32.6%) and crown-root fractures (30.4%). Falls (66.7%) were the predominant cause of trauma for female patients, whereas male patients were more often injured during sports activities (49.3%). The younger age group was 0.29 times more likely to sustain enamel-dentin fractures without pulp exposure (p = 0.049, OR = 0.291) and root fractures (p = 0.047, OR = 0.241). Conclusions: Traumatic dental injuries are more prevalent in young adults compared to adolescents, with falls and sports activities being the most common causes, particularly among males. These findings emphasize the need for targeted preventive programs aimed at reducing the incidence of dento-periodontal trauma in these age groups. [ABSTRACT FROM AUTHOR]

In this paper, we investigate the effectiveness of shape completion neural networks as clinical aids in maxillofacial surgery planning. We present a pipeline to apply shape completion networks to automatically reconstruct complete eumorphic 3D meshes starting from a partial input mesh, easily obtained from CT data routinely acquired for surgery planning. Most of the existing works introduced solutions to aid the design of implants for cranioplasty, i.e. all the defects are located in the neurocranium. In this work, we focus on reconstructing defects localized on both neurocranium and splanchnocranium. To this end, we introduce a new dataset, specifically designed for this task, derived from publicly available CT scans and subjected to a comprehensive pre-processing procedure. All the scans in the dataset have been manually cleaned and aligned to a common reference system. In addition, we devised a pre-processing stage to automatically extract point clouds from the scans and enrich them with virtual defects. We experimentally compare several state-of-the-art point cloud completion networks and identify the two most promising models. Finally, expert surgeons evaluated the best-performing network on a clinical case. Our results show how casting the creation of personalized implants as a problem of shape completion is a promising approach for automatizing this complex task. [ABSTRACT FROM AUTHOR]

Background: Foam sclerotherapy is currently the first-line treatment for venous malformations (VMs). Hyaluronic acid-polidocanol (HA-POL) foam has been used in the treatment of head and neck VMs recently; however, its clinical efficacy and safety have yet to be further evaluated, and the impact of age and other related factors on its safety is still unclear. Objective: To assess the efficacy and safety of HA-POL foam in the treatment of head and neck VMs. Methods and materials: We performed a single-center retrospective review of all patients with VMs involving the head and neck region undergoing HAPOL foam sclerotherapy from February 2015 to February 2022 in the Oral and Maxillofacial Surgery Department of Qilu Hospital Shandong University. Patients’ medical records were collected and all patients enrolled were followed up for 1–6  months (group 1), part of them were followed up for 3–9  years (group 2). Results: A total of 223 patients with head and neck VMs were enrolled in the study, with 36 patients who were followed for 3–9  years. Total response rate in group 1 was 96.41% (n  =  215), of which 30.94% (n  =  69) of the patients met the criteria of “resolution,” and 65.47% (n  =  146) of the patients had “significant improvement.” In group 2, the total response rate was 72.22% (n  =  26), of which the rates of the patients met the criteria of “resolution” and patients had “significant improvement” were all 36.11% (n  =  13)0.144 (64.57%) patients experienced complications like localized swelling, pain and fever, and no serious complications occurred. The risk of developing complications after treatment was independent of age, and was weakly associated with the dose of HA-POL foam. Conclusion: The HA-POL foam sclerotherapy is safe and effective in the treatment of head and neck VMs. [ABSTRACT FROM AUTHOR]

Background: Diagnosis of an adnexal mass might be a sign of ovarian cancer, with an overall poor prognosis. This study aimed to explore women's experiences and perceptions of facing ovarian surgery due to an adnexal mass, and expectations on life after surgery. Methods: Individual in-depth interviews with 15 women facing ovarian surgery due to an adnexal mass. Interviews were analysed using qualitative content analysis. Results: An overarching theme, From symptoms to surgery–a pathway through uncertainty and hope, was identified. The theme was made up of three categories; I. The road to diagnosis, II. Striving for information and guidance, and III. Balancing emotions of hope and fear. The period between discovering the adnexal mass and surgery was often described as chaotic and difficult to manage. However, the diagnostic procedures were mostly described as timely and efficient, and participants felt safe and cared for. Person-centred care was considered crucial when being in this vulnerable situation, and the nurse navigator was described as a key person to approach for any queries. While participants expressed overall satisfaction with the information provided by health professionals, some reported a lack of information regarding the surgery's potential impact on hormonal production and sexuality. Restrictions during the COVID-19 pandemic forced participants to attend healthcare visits alone, and some wished that health professionals had taken more responsibility for informing their relatives. Many participants focused on the positive aspects of the information gained about the adnexal mass, and that the entire situation gave perspective of what was important in life. Conclusions: Waiting for surgery on a possibly malignant adnexal mass can be very stressful, however person-centred care and the guidance of a nurse navigator can make the process more manageable. To improve women's experience, health professionals may involve relatives more often and make sure to inform of potential hormonal loss and sexuality after ovarian surgery. [ABSTRACT FROM AUTHOR]

In orthopedic surgery and maxillofacial there is a growing use of augmented reality (AR) as a technology to increase the visual perception of the surgeon in the operating room. The objective of this review is to analyze the state of the art in the use of AR for osteotomies, highlighting the advantages and the most-known open issues to be addressed in the future research. Scopus, Web of Science, Pubmed and IEEE Xplore databases have been explored with a keyword search, setting the time limits from January 2017 to January 2023, inclusive. Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines has been used in this review, focusing on anatomical districts, real-virtual environment interaction, advantaged and limitations of existing AR-based applications. 49 articles met the inclusion criteria and have been selected in the final analysis. For the sake of clarity, works have been grouped according to the anatomical district, but also the real-virtual environment interaction methodology was reported, as well as information regarding accuracy assessment. A Quality Function Deployment (QFD) has been used to assess the AR-based solutions with regards to the more traditional freehand (FH) and Patient Specific Template (PST) approaches. Finally, some suggestions to foster the AR-based solution adoption in osteotomies treatment have been drawn, considering the highlighted advantages and limitations of this technology. The AR resulted to meet the surgeons' needs more than other traditional approaches. Among the emerged advantages, AR can lead to a better surgical field accessibility, more flexible solutions and lower the management effort. Nonetheless, future research should address some well-known issues, among which the calibration time, the robustness of the tracking, and the HMDs discomfort. [ABSTRACT FROM AUTHOR]

This study evaluates the accuracy and repeatability of craniofacial measurements with a 3D light scanner, specifically the EINSTAR scanner, in comparison to traditional caliper measurements for facial anthropometry. Eleven volunteers were assessed by two examiners, one experienced and one inexperienced, who performed direct caliper measurements and indirect measurements using the scanner. Results indicated minimal differences between caliper and scanner results, with overall high accuracy and reliability demonstrated by correlation coefficients. Despite the slightly longer scanning time, the benefits of 3D imaging, including detailed surface mapping and virtual modeling, justify its integration into clinical practice, particularly in maxillofacial surgery and craniofacial assessment. Craniofacial measurements obtained with the EINSTAR scanner showed excellent reliability and accuracy, which qualifies this method for clinical and scientific use. [ABSTRACT FROM AUTHOR]

Free flap reconstruction for postoperative tissue defects in oral and maxillofacial tumors is a critical component of reconstructive surgery. Identifying risk factors for flap necrosis is essential for improving surgical outcomes and patient quality of life. A retrospective study was conducted on patients who underwent free flap reconstruction between January 2020 and December 2023. Patients were included if they had comprehensive medical records and at least a six-month follow-up. We excluded those with a history of flap necrosis, uncontrolled systemic diseases, non-adherence to postoperative care, or concurrent malignancy treatments. Data on demographics, comorbidities, flap characteristics, and operative details were collected and analyzed using univariate analysis and logistic regression tests. Univariate analysis did not find a significant correlation between flap necrosis and factors such as hyperlipidemia, lymph node metastasis, or flap type. However, diabetes mellitus, oral infections, and albumin levels below 35 g/L were significantly associated with flap necrosis. Multivariate logistic regression showed diabetes mellitus increased the odds of flap necrosis by approximately ninefold, and oral infection increased it by over tenfold. Diabetes mellitus, oral infection, and low albumin levels are significant risk factors for flap necrosis in free flap reconstruction after oral and maxillofacial surgery. Prompt identification and management of these factors are crucial to mitigate the risk of flap necrosis. [ABSTRACT FROM AUTHOR]

The lip-splitting approach enables excellent access to all areas of the mouth and pharynx to remove tumors; however, traditional lower lip-splitting incisions produce an unsatisfactory scar. To achieve better functional and aesthetic results, we used a Z-shaped incision and compared the functional and aesthetic outcomes of the straight and Z-shaped incisions. Sixty patients who fulfilled the inclusion criteria were randomly divided into two groups and underwent lip-splitting between March 2021 and September 2023. Eventually, 77 patients were reviewed within 6 months and evaluated using the lip function assessment scale, patient and observer scar assessment scale, naïve observer scar assessment scale, and a clinical examination. The Z-shaped incision group performed better in terms of the lip pout movement at 3 months and in the subjective overall opinion, color, irregularity, and pigmentation at 6 months. The Z-shaped incision group had a lower incidence of notched vermilion. In conclusion, Z-shaped lower lip-splitting incisions have better functional and aesthetic outcomes than traditional straight incisions. Trial registration: Public title: Difference between the effect of Z-shaped and vertical incisions of labiobuccal flap on the recovery of lower lip scars. Registration date: 09/03/2021. Registration number: ChiCTR2100044084. Registry URL: http://www.chictr.org.cn. [ABSTRACT FROM AUTHOR]

Background: We developed a novel interlocking three-dimensional (3D) miniplate design with an adjustable configuration. As this device is new, surgeons must become familiar with its application. This study evaluated the usability and learning curves associated with the novel interlocking 3D miniplate for mandibular fracture fixation. Methods: The study participants, nine plastic surgeons, were asked to apply an interlocking 3D miniplate and a standard miniplate to polyurethane mandible models. The participants had completed the Basic Craniomaxillofacial Osteosynthesis course during residency and had operated on craniomaxillofacial fractures within the past 5 years. They were instructed to place the interlocking 3D miniplate three times and the standard miniplate once. We assessed the time required for implant placement, the comfort level of the surgeons, and the biomechanical stability of the plates. Biomechanical testing was conducted by subjecting the mandible to forces ranging from 10 to 90 N and the displacement was measured. Results: The results indicate increasing comfort with each attempt at placing the interlocking 3D miniplate, with a significant difference between the first and third attempts. Additionally, a reduction in application time was noted with repeated attempts, suggesting improved efficiency. Biomechanical tests showed comparable stability between the tested plates. Conclusion: Multiple attempts at applying the interlocking 3D miniplate resulted in increased comfort and reduced application time. These findings indicate that, despite its novelty, the interlocking 3D miniplate is relatively straightforward to apply and has a short learning curve. However, surgeons must have specific qualifications to ensure proper training and minimize errors during placement. [ABSTRACT FROM AUTHOR]

The purpose of this review is to assess the worldwide clinical utilisation of Glasgow Benefit Inventory (GBI) and New Five-factor Glasgow Benefit Inventory (GBI-5F) for various clinical and scientific objectives, as well as to validate its application in Latvia. Numerous articles indexed in the MedLine Library (Pubmed.gov) were examined, spanning from the initial GBI publication to the present. Various applications of these questionnaires have been investigated across multiple medical specialties, including otolaryngology, ophthalmology, urology, paediatric practice, neuro-surgery, gastroenterology, oncology, and maxillofacial surgery in different countries. The use of the questionnaire in Latvia, following examples from other countries, can aid in assessing factors such as General Health, Support, Quality of Life, Self-Confidence and Social Involvement post-intervention in chronic conditions. This could help compare treatment outcome data both in clinical practice within our country and within the scientific community on an international level. [ABSTRACT FROM AUTHOR]

Objective: To study the mandibular changes in the β-thalassemia major patient. Study Design: Cross sectional study. Setting: Husaini Blood Bank and Institute of Hematological Diseases Karachi, Department of Oral and Maxillofacial Surgery, and Department of Orthodontics, Baqai Dental College Baqai Medical University, Karachi. Period: January 2023-December 2023. Methods: 50 Orthopanthogram (OPG) radiographs of beta-thalassemia major patient were taken, analyzed and compared to check any variation from normal. Fifty diagnosed β-thalassemia major patients were voluntarily selected through convenience sampling. The study was carried out in collaboration of Husaini Institute of Blood Diseases Karachi, National institute of Oral Diseases Karachi Pakistan and, Department of Oral and Maxillofacial Surgery and department of orthodontics Baqai Dental College Baqai Medical University. Results: 18 (36%) patient's alteration of trabecular pattern are present and in 32 (64%) patient alteration of trabecular pattern absent. Similarly, in 16 (32%) patients have short spiky roots are present and 34 (68%) patients short spiky roots absent. Conclusion: Effect of anemia is not so profound in mandible of thalassemia patients from population of Karachi. [ABSTRACT FROM AUTHOR]

Background/Objectives: This study aims to assess the relationship between physical and psychosocial pre-surgical factors and post-surgical evolution in patients undergoing orthognathic surgery. Methods: A cohort study with 3 months of follow-up after maxillofacial surgery was conducted. Participants were recruited from the Maxillofacial Surgery Unit of Hospital Universitario La Paz in Madrid, Spain. Primary variables included the range of motion of mouth opening, protrusion tongue force, anxiety, depression and kinesiophobia. Assessments were realised on-site or via video call. Statistical analysis was conducted using mixed-effects models. Results: The initial recruitment yielded 22 patients, with 19 ultimately eligible for analysis. The study found significant impacts of pre-surgical factors on post-surgical evolution. Both ranges of motion and anxiety showed influences from baseline measures, with the range of motion affected by a pre-surgical range of motion (estimate: 3.89) and positive expectations (estimate: 4.83). Anxiety was influenced by both pre-surgical (estimate: 0.48) and baseline anxiety levels (estimate: 0.64). Kinesiophobia demonstrated a trend toward significance, with baseline levels affecting post-surgical evolution (estimate: 0.77). Conclusions: Our results highlight the relationship between pre-surgical factors and post-surgical outcomes in orthognathic surgery patients. Pre-surgical range of motion and positive expectations were found to influence post-surgical range of motion, while pre-surgical anxiety levels impacted post-surgical anxiety evolution. Pre-surgical kinesiophobia also showed potential as a post-surgical kinesiophobia predictor, but further investigation is needed to confirm this relationship. [ABSTRACT FROM AUTHOR]