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The objective of this study is to compare virtual surgical planned (VSP) and postoperative condylar positioning outcomes in patients who underwent maxillomandibular advancement surgery with custom mandibular cutting guides and osteosynthesis plates to establish reliability and effectiveness using these forms of technology.An ambispective case series was performed by obtaining preoperative and postoperative computed tomography (CT) scans of obstructive sleep apnea patients who underwent maxillomandibular advancement surgery with VSP and custom printed mandibular cutting guides and plates at the San Francisco Veterans Affairs Healthcare System from February 2019 to October 2021. The primary predictor variables were the use of custom guides and plates compared to VSP over the course of a year. The outcome variable was the maintained condylar position, defined as the mean differences between the VSP and postoperative positioning. The comparison group was the preoperative VSP position. Covariates were planned surgical movements, age, and gender. Measurements were taken bilaterally in sagittal CT sections measuring the condylar positioning within the posterior space, superior space, and anterior space of the glenoid fossae. Similarly, coronal CT section measurements were taken to measure the condylar positioning within the coronal lateral space, coronal central space, and coronal medial space. A Wilcoxon signed rank test was used.This study included 6 male participants (n = 6) aged 32 to 57 years (mean 46.5). The median differences for the posterior space, superior space, and anterior space planned versus postoperative position were 0.25 (0.40), 0.40 (0.35), and 0.40 (0.55) mm, respectively. The median differences for the coronal lateral space, coronal central space, and coronal medial space planned versus postoperative position were 0.30 (0.30), 0.78 (0.70), and 0.40 (0.30) mm, respectively. There was no statistically significant difference in the planned and postoperative condylar position (Wilcoxon signed rank test, P .5). A qualitative analysis showed little to no displacement or rotation of the condyle in the virtually planned and postoperative condylar positions.Qualitative and quantitative comparisons of the preoperative virtual surgical planned and the postoperative condylar position with the use of custom-printed mandibular cutting guides and plates support the null hypothesis that there is no difference between planned and postoperative positioning.

Background Opioid misuse is a widespread public health problem, and opioids are often prescribed in the dental environment. These recommendations provide alternatives to opioids to reduce or eliminate dental procedure–related acute pain. Methods A multidisciplinary working group developed these clinical recommendations to specifically address procedure-related acute pain. These recommendations, which are based on published peer-reviewed research and guidelines, include therapies used before, during, and after dental procedures. When evidence is not definitive, the best practices, which are based on experts’ consensus, are included. The recommendations are not intended to be exhaustive. Results These recommendations are a summary of the evidence and best practices for opioid alternatives to treat acute pain related to dental procedures. Conclusions Dental providers should prioritize opioid stewardship when managing procedure-related pain with strategies such as thorough preprocedure pain assessment, minimally invasive techniques, preemptive analgesia, intraprocedure pain management, and appropriately selected postprocedure pharmacologic therapy. Practical Implications These recommendations are a concise resource for clinical providers. It is important to address patients’ procedure-related pain, using nonopioids whenever possible. Alternatives are outlined, allowing providers to make informed decisions.

Opioid misuse is a widespread public health problem, and opioids are often prescribed in the dental environment. These recommendations provide alternatives to opioids to reduce or eliminate dental procedure-related acute pain.A multidisciplinary working group developed these clinical recommendations to specifically address procedure-related acute pain. These recommendations, which are based on published peer-reviewed research and guidelines, include therapies used before, during, and after dental procedures. When evidence is not definitive, the best practices, which are based on experts' consensus, are included. The recommendations are not intended to be exhaustive.These recommendations are a summary of the evidence and best practices for opioid alternatives to treat acute pain related to dental procedures.Dental providers should prioritize opioid stewardship when managing procedure-related pain with strategies such as thorough preprocedure pain assessment, minimally invasive techniques, preemptive analgesia, intraprocedure pain management, and appropriately selected postprocedure pharmacologic therapy.These recommendations are a concise resource for clinical providers. It is important to address patients' procedure-related pain, using nonopioids whenever possible. Alternatives are outlined, allowing providers to make informed decisions.

Objective: To evaluate the impact on the quality of working life of Brazilian police officers with Temporomandibular Disorders (TMD). Materials and Methods: The sample consisted of 52 subjects and information was collected through the WHOQOL-BREF questionnaire and the Fonseca Anamnesis Index to evaluate the level of temporomandibular disorder (TMD), followed by clinical examination to determine the experience of dental caries, by means of the DMFT index. Descriptive and inferential statistical analysis (chi-square test) was performed through the Statistical Package for the Social Sciences software. The significance level was 5%. Results: The sample was predominantly composed of males (94.2%) with a mean age of 39.4 years (±9.4) and mean service length of 17.3 years (±11.0). The mean DMFT index value was 15.6 (±6.1), especially the "filled" component, whose mean was 12.1 (±5.4). The presence of TMD was found in 67.3% of the sample, of predominating mild degree (91.4%). Quality of working life (QWL) was classified as unsatisfactory/neutral by 57.7% of participants. There was a statistically significant association between QWL and presence of TMD (p0.05). Conclusion: Although military police officers presented a high mean DMFT index value, there was highest prevalence of the "filled" component, evidencing a past experience of caries and evidencing that this population has access to oral health services. The occurrence of TMD was high, predominating the mild degree, and there was an association with QWL.