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1.
J Oral Maxillofac Surg ; 82(3): 261-262, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-38432718
2.
Med Oral Patol Oral Cir Bucal ; 29(2): e263-e272, 2024 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-38288853

RESUMO

BACKGROUND: Mandibular third molar (MTM) extraction is one of the most frequently performed surgeries in the oral cavity. Establishing the level of surgical difficulty pre-operatively is an essential step to ensure correct treatment planning. In Spain, MTM extraction - especially in cases presenting greater difficulty - is normally performed by doctors specializing in oral and maxillofacial surgery, or by dentists with postgraduate qualifications in oral surgery. The present work set out to analyze the extent to which perceptions of surgical difficulty of the said intervention vary in relation to professional training. MATERIAL AND METHODS: This cross-sectional, descriptive, observational study took the form of a survey. Using a visual analog scale (VAS), participants evaluated both the perceived difficulty of 30 cases of MTM extraction described by means of digital panoramic radiographs and the perceived difficulty deriving from a series of factors conditioning MTM extraction. The results underwent statistical analysis with SPSS Statistics 28.0 software. Non-parametric tests (Mann Whitney test for independent samples and the Kruskal-Wallis test) were applied. RESULTS: A total of 213 surveys were available for analysis. Both groups awarded the greatest importance to clinical experience, followed by anatomical and radiographic factors, root morphology obtaining the highest score among anatomical factors (9.01±1.42), while proximity of the MTM to the inferior alveolar nerve was regarded as the least important anatomical factor (8.11±2.54). Significant differences were only found for patient age, whereby maxillofacial surgeons awarded this factor more importance than dentists. CONCLUSIONS: The different training received by dentists specialized in oral surgery and maxillofacial surgeons did not influence either perceptions of surgical difficulty of MTM extraction, or opinions as to the factors influencing surgical difficulty.


Assuntos
Cirurgiões Bucomaxilofaciais , Cirurgia Bucal , Humanos , Estudos Transversais , Dente Serotino/cirurgia , Extração Dentária
3.
Cancer Rep (Hoboken) ; 7(1): e1929, 2024 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-37884691

RESUMO

BACKGROUND: The burden of oral cancer in Nigeria is increasing. Different studies have shown how public education on oral cancer have increased knowledge of oral cancer across populations, however, it is not known if these practices are adopted by oral physicians, oral and maxillofacial surgeons, and oral pathologists in Nigeria. AIMS: To investigate the patient oral cancer education strategies adopted by oral physicians, oral and maxillofacial surgeons, and oral pathologists in Nigeria. METHODS: This study adopted an analytical cross-sectional study design. This study surveyed practicing oral physicians, oral and maxillofacial surgeons, and oral pathologists in Nigeria. An e-questionnaire was used for this study. The data were analyzed using the SPSS Version 20 software, and a p-value of <.05 was used to determine the level of statistical significance. RESULTS: The study's response rate was 46.6% (75/161). The 75 participants were from the six geopolitical zones in Nigeria responded to the survey questionnaire. Even though more than half (43/75, 57.3%) of the respondents have never received any training since their post-bachelor's degree qualification on the strategies that can be used in educating patients on oral cancer, majority (54/75, 72.0%) of them knew at least one education strategy; also, the most known (36/54, 66.7%) and utilized (33/54, 61.3%) strategy among those respondents who were aware of patient education strategy was health talk. Only 38.7% (29/75) of the respondents reported that health learning materials (posters, leaflets, fliers, and flipcharts) are available in their clinics, all of which were in insufficient quantities. Also, 93.3% (70/75) of the respondents opined that it is worthwhile that dental clinics/hospitals in Nigeria invest in the provision of oral cancer learning materials for patient use. Inferential statistical analysis did not reveal any significant relationship between the respondents' characteristics and their awareness and practice on patient oral cancer education strategies. CONCLUSION: This study identified that many oral physicians, oral and maxillofacial surgeons, and oral pathologists in Nigeria lack the needed capacity to educate their patients on oral cancer. There is a need to strengthen their capacity by giving them training on patient oral cancer education strategies, and by providing them with good quality and enough teaching aids.


Assuntos
Neoplasias Bucais , Médicos , Humanos , Cirurgiões Bucomaxilofaciais , Estudos Transversais , Patologistas , Educação de Pacientes como Assunto
4.
Br J Oral Maxillofac Surg ; 62(1): 97-100, 2024 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-37981521

RESUMO

The paper describes a modification of the surgical technique for temporomandibular joint arthroscopy, using an exchange guide to replace the 2.2 mm cannula with one of 2.9 mm to better facilitate osteoplasty of the medial wall. The procedure is a simple and safe manoeuvre that reduces complications such as fluid extravasation into soft tissues, damage to the articular eminence, and bleeding into the superior joint space. Every oral and maxillofacial surgeon could benefit from this novel method, which reduces the chances of failure when exchanging the working cannulas, the potential morbidity of re-entry, and the duration of surgery.


Assuntos
Artroscopia , Transtornos da Articulação Temporomandibular , Humanos , Artroscopia/métodos , Transtornos da Articulação Temporomandibular/cirurgia , Cânula , Articulação Temporomandibular/cirurgia , Cirurgiões Bucomaxilofaciais
5.
J Am Dent Assoc ; 155(1): 7-16.e7, 2024 01.
Artigo em Inglês | MEDLINE | ID: mdl-37988047

RESUMO

BACKGROUND: Despite decreases in opioid prescribing from 2016 through 2019, some dentists (general, specialists, oral and maxillofacial surgeons) in the United States continue to prescribe opioids at high rates. The authors' objective was to define dentists' trajectories of opioid prescribing. METHODS: The authors identified actively prescribing dentists from the IQVIA Longitudinal Prescription data set, from 2015 through 2019. Group-based trajectory modeling identified opioid prescribing trajectories on the basis of dentists' annual prescribing rates for the overall sample (model 1) and for high prescribers (model 2). The authors used χ2 or Mann-Whitney U tests to characterize the model 2 trajectory groups. RESULTS: In model 1 (n = 199,145 prescribers), group-based trajectory modeling identified 8 trajectories that were grouped into 5 categories. A total of 14.8% were nonprescribers who composed less than 1% of all prescriptions, low prescribers (3 groups; 46.0%) prescribed at low rates (2015: 5.5%-16.9%; 2019: 1.5%-11.9%), decliners (7.3%) decreased prescribing rapidly (2015: 29.4%; 2019: 5.1%), moderately high prescribers (2 groups; 28.5%) prescribed moderately (2015: 28.7% and 39.2%; 2019: 18.1% and 28.8%), and consistently high prescribers (3.4%) prescribed at high rates (2015: 54.6%; 2019: 44.7%). In model 2, from consistently high prescribers (n = 6,845), 4 trajectories were identified. Of these 4 groups, 1 group (7.5%) declined prescribing rapidly. The groups did not differ meaningfully; however, the rapid decliners included fewer oral and maxillofacial surgeons (13.0% vs 18.4%), saw more Medicaid patients (2.5% vs 1.0%), and had higher opioid prescribing rates in 2015 (95.5% vs 91.6%) (P < .001 for all). CONCLUSIONS: The authors identified variations in dentists' opioid prescribing rates. Although 60% of dentists decreased prescribing rates by 30% through 83%, 3.4% of dentists consistently prescribed at high rates. PRACTICAL IMPLICATIONS: Some dentists continue to prescribe opioids at high levels, indicating that additional information is needed to better inform policy and clinical decision making.


Assuntos
Analgésicos Opioides , Cirurgiões Bucomaxilofaciais , Humanos , Estados Unidos , Analgésicos Opioides/uso terapêutico , Padrões de Prática Odontológica , Padrões de Prática Médica
6.
Med Oral Patol Oral Cir Bucal ; 29(2): e227-231, 2024 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-37823296

RESUMO

BACKGROUND: There are still many doubts about anterior inferior crowding and indications of mandibular third molar extraction, although it is very studied subject in the literature. The aim of this study was to evaluate the perceptions of oral maxillofacial surgeons (OMFSs) and orthodontists about anterior inferior crowding and indications of mandibular third molar extraction. MATERIAL AND METHODS: A web-based survey was developed and sent to professionals in order to collect their opinion about the fact that third lower molars cause crowding and questions about the indication of third molars for orthodontic treatment. Descriptive analysis was performed and Chi-square or G tests were applied with a 95% confidence interval. RESULTS: The study included a total of 218 participants, of whom 115 were OMFSs and 103 were orthodontists. The results showed that 56.5% of OMFSs and 35.0% of orthodontists believe that the lower third molars cause anterior inferior crowding (p<0.001). A total of 91.3% of OMFSs and 70.9% of orthodontists indicate the extraction of lower third molars to aid orthodontic treatment (p<0.001). CONCLUSIONS: It can be concluded that in being an oral maxillofacial surgeon, a higher odds ratio is observed to consider that lower third molars cause dental crowding compared to those who are orthodontist. The indication of exodontia of lower third molars for orthodontic treatment was more frequent among OMFSs when compared to orthodontists.


Assuntos
Má Oclusão , Dente Serotino , Humanos , Dente Serotino/cirurgia , Ortodontistas , Cirurgiões Bucomaxilofaciais , Dente Molar , Má Oclusão/cirurgia
7.
Niger Postgrad Med J ; 30(4): 293-298, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-38037785

RESUMO

Background: Lingual nerve injury is a known complication of mandibular third molar (M3M) surgery, and retraction of the lingual flap is reported to reduce the incidence of this complication. However, there is no global consensus on the routine retraction of lingual flap. Aim: The aim of the study was to assess the perception and practice of lingual flap retraction amongst oral and maxillofacial surgeons in Nigeria. Materials and Methods: This cross-sectional national survey was conducted amongst 122 oral and maxillofacial surgeons in Nigeria from January 2023 to March 2023 using a validated, structured, self-administered questionnaire. The questionnaire had three sections and 14-item questions. Section A consists of the sociodemographic questions, Section B comprises questions on perception towards lingual flap retraction, whereas Section C consists of questions on the practice of lingual flap retraction. These questionnaires were deployed as an online survey and as hard copies. Both qualitative and quantitative data were analysed. A critical probability level (P < 0.05) was used as the cut-off level for statistical significance. Results: Most of the participants (47.6%) belong to the age group of 31-40 years. The male-to-female ratio was 6:1. Only 12 (9.8%) participants had a positive perception towards routine lingual flap retractions following M3M surgery. Perception of lingual flap retraction was found not to be associated with the demographic variables of the participants (P > 0.05). A total of 95 participants (77.9%) did not raise nor retract the lingual flap during lower third molar surgery. The rate of practice of lingual flap retraction during third molar surgery was not influenced by any of the factors studied (P > 0.05). Conclusion: The majority of oral and maxillofacial surgeons in Nigeria do not agree that routine retraction of the lingual flap is necessary to reduce lingual nerve injury and majority, too, do not practice this in their management of impacted lower third molar.


Assuntos
Traumatismos do Nervo Lingual , Dente Serotino , Humanos , Masculino , Feminino , Adulto , Dente Serotino/cirurgia , Traumatismos do Nervo Lingual/etiologia , Cirurgiões Bucomaxilofaciais , Estudos Transversais , Nigéria , Extração Dentária/efeitos adversos , Percepção
8.
Br Dent J ; 235(12): 977-982, 2023 12.
Artigo em Inglês | MEDLINE | ID: mdl-38102275

RESUMO

Terence Ward was a major maxillofacial surgeon in World War II, working with Sir Archibold McIndoe to treat badly injured forces personnel, especially air crew. He was important when the time came to establish his speciality in the post-war NHS. Sir Terence played an important role in the Royal College of Surgeons of England, where he was dean of its Faculty of Dental Surgery and raised a great deal of money for the Department of Dental Science.


Assuntos
Cirurgia Bucal , II Guerra Mundial , Humanos , Inglaterra , Cirurgia Bucal/história , Hospitais , Cirurgiões Bucomaxilofaciais
11.
J Oral Maxillofac Surg ; 81(11): 1330-1335, 2023 11.
Artigo em Inglês | MEDLINE | ID: mdl-37640236

RESUMO

The 3rd Anesthesia Patient Safety Conference of the American Association of Oral and Maxillofacial Surgeons was held at the Daniel M Laskin Institute for Oral and Maxillofacial Surgery Education and Innovation at American Association of Oral and Maxillofacial Surgeons headquarters in Rosemont, Illinois on June 6, 2022. The conference provided a platform to scrutinize collective errors, explore optimal practices, comprehend the concepts and principles of human complacency, assessing the system's capacity to handle deviations from the norm, and contemplate ideas and initiatives to enhance our practice model. These safety conferences are designed to foster collaborative, proactive conversations and understand best practices in safe delivery of anesthetic care to our patients.


Assuntos
Anestesia Dentária , Anestesiologia , Cirurgia Bucal , Humanos , Estados Unidos , Cirurgiões Bucomaxilofaciais , Segurança do Paciente
12.
J Contemp Dent Pract ; 24(3): 168-175, 2023 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-37272128

RESUMO

AIM: To assess the knowledge and practice of radiation stents for oral cancer patients among the Sudanese's maxillofacial surgeons, prosthodontists, oncologists, and radiotherapists in Khartoum state. MATERIALS AND METHODS: A self-administered questionnaire composed of three sections, including the participant's sociodemographic, knowledge, and practice data, was conducted and distributed among the specialists and Registrars of maxillofacial surgery, prosthodontics, oncology, and radiotherapy who were working at the Khartoum Teaching Dental Hospital, the Faculty of Dentistry (University of Khartoum), and the Khartoum Oncology Hospital, respectively, during the study's duration. A cluster sampling technique was used, and within the cluster group, simple randomization was used. The sample size was 137 participants. The participant's knowledge and practice scores were calculated as percentages achieved by dividing the numbers of the accurate answers of the participants by the total number of questions and categorized as good (66.6%-100%), average (33.3%-66.6%), and poor (less than 33.3%). RESULT: The response rate was 80%. Forty five (40.9%) of the respondents were males, and 65 (59.1%) were females. The high-frequency age-group was 30-40 years (59 subjects, 53.6%). Thirty-eight participants (75.5%) were unfamiliar with the radiation stent. The overall knowledge score was poor, with a significant difference between the different groups (p = 0.0001*). Only the prosthodontists reported a good level of knowledge about the radiation stent (73%), while the oncologists and the radiologists showed a zero level of knowledge. Despite this, the practice score of the radiation stent was poor among all groups. The level of knowledge regarding the complications of radiation and the different protective measures among the maxillofacial surgeons, oncologists, and radiotherapists was 55%, 60%, and 50%, respectively, while the prosthodontists reported 70%. Only 27 (24.5%) participants reported a multidisciplinary treatment approach. At the same time, the majority, 59.1%, declared that they do not follow a formal clinical guideline and/or protocol for dental treatment in oral cancer patients. The lack of knowledge and communication between the different health providers were the main barriers preventing the use of radiation stents. CONCLUSION: The knowledge and practice of the radiation stent were poor. A highlighted need was strengthened to improve the training and communication among the multidisciplinary oral cancer team members, and standard clinical guidelines and protocols need to be conducted and followed to improve patient treatment outcomes. CLINICAL SIGNIFICANCE: Radiation stents have a significant role in reducing the complications of radiation therapy. Improving the knowledge and practice of radiation stents will have a substantial influence on the quality of health services provided for the oral cancer patients and their quality of life.


Assuntos
Neoplasias Bucais , Oncologistas , Masculino , Feminino , Humanos , Adulto , Cirurgiões Bucomaxilofaciais , Qualidade de Vida , Neoplasias Bucais/radioterapia , Neoplasias Bucais/cirurgia , Odontólogos , Inquéritos e Questionários
13.
J Orthod ; 50(4): 410-422, 2023 12.
Artigo em Inglês | MEDLINE | ID: mdl-37357426

RESUMO

OBJECTIVE: To explore the decision-making patterns among expert and novice orthodontists and oral maxillofacial surgeons in the management of adults with Class III malocclusions and moderate skeletal discrepancies. DESIGN: Self-administered questionnaire survey. SETTING: Faculty of Dentistry, National University of Singapore and the University Dental Cluster, National University Hospital, Singapore. PARTICIPANTS: A total of 55 clinicians, comprising 13 expert orthodontists, 20 novice orthodontists, 10 expert oral maxillofacial surgeons and 12 novice oral maxillofacial surgeons. METHODS: Clinicians assessed six adults with a Class III malocclusion and moderate skeletal discrepancy. They were asked to decide who could be managed exclusively by orthodontic camouflage, who would require combined orthodontic-orthognathic surgery as the only viable treatment, or who could be offered both treatment options. RESULTS: The study found variable decision-making patterns among the clinicians in each case. Only 18.2%-40.0% of clinicians agreed that the cases selected were of moderate skeletal discrepancies and could be offered both treatment options whereas the rest were either more inclined to recommend orthodontic camouflage or orthognathic surgery. Intra-clinician agreement (n = 20) was only fair (Kappa value = 0.31). There was only slight inter-clinician agreement (n = 55) on their clinical decisions (Kappa value = 0.10). Clinical experience and dental specialty did not significantly influence clinicians' decisions. Oral and maxillofacial surgeons were 1.98 times more likely to indicate orthognathic surgery as the only viable treatment compared to the orthodontists (95% confidence interval = 1.15-3.42). CONCLUSION: Variability in the patterns of decision-making for adults with a Class III malocclusion and moderate skeletal discrepancy was observed among the clinicians with low repeatability and agreement.


Assuntos
Má Oclusão Classe III de Angle , Ortodontistas , Humanos , Adulto , Cirurgiões Bucomaxilofaciais , Má Oclusão Classe III de Angle/cirurgia , Inquéritos e Questionários
14.
PLoS One ; 18(6): e0286853, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37294785

RESUMO

Oral and maxillofacial surgeons are among the frontline healthcare workers and are classified as a high-risk group for COVID-19 infection; however, it has not yet been defined how these professionals were impacted. The aim of this study was to explore the conducts and perceptions of oral and maxillofacial surgeons during the COVID-19 pandemic in Brazil. Nine individuals, mean age 34.8 years, 66.6% men, were included in the study. A semi-structured interview with a qualitative approach was applied to professionals belonging to a messaging application group (WhatsApp). Content analysis was performed in the light of Hellerian theory in its daily theoretical framework for the interpretation of the memories reported by the participants. Four themes were identified. The lack of knowledge about COVID-19 and the fear of being contaminated during care were the main factors responsible for changes in the professionals' work routine. An important point was the collective reflection of the participants about the increase in biosafety barriers, which ensured a greater sense of security. The need for social isolation to contain the virus was also described. As a result, there was a great distance between professionals and their families, which generated high levels of anxiety in the former. Repetitive reports of slowness and reduced attendance directly related to financial loss and aggravated stress were also highlighted. The findings of this study reveal that oral and maxillofacial surgeons had their professional-personal axis affected in terms of daily habits, family life and financial strain, aspects that were responsible for impacting stress and anxiety levels.


Assuntos
COVID-19 , Masculino , Humanos , Adulto , Feminino , COVID-19/epidemiologia , Pandemias , Cirurgiões Bucomaxilofaciais , Pessoal de Saúde , Ansiedade/epidemiologia , Pesquisa Qualitativa
15.
J Oral Maxillofac Surg ; 81(8): 1042-1054, 2023 08.
Artigo em Inglês | MEDLINE | ID: mdl-37244288

RESUMO

Oral potentially malignant disorders (OPMDs) of the oral mucosa include leukoplakia, erythroplakia, erythroleukoplakia, lichen planus, and oral lichenoid lesions, each with varying incidences of dysplastic disease at the time of presentation and each with observed incidences of malignant transformation over time. The primary goal of the management of dysplasia, therefore, includes their early detection and treatment prior to malignant transformation. The recognition and management of these OPMDs and an understanding of their potential progression to oral squamous cell carcinoma will reduce the morbidity and mortality associated with these lesions with expedient and properly executed treatment strategies that will have a positive effect on patient survival. It is the purpose of this position paper to discuss oral mucosal dysplasia in terms of its nomenclature, epidemiology, types, natural history, and treatment to acquaint clinicians regarding the timing of biopsy, type of biopsy, and follow-up of patients with these lesions of the oral mucosa. This position paper represents a synthesis of existing literature on this topic with the intention of closing gaps in our understanding of oral mucosal dysplasia while also stimulating new thinking to guide clinicians in the proper diagnosis and management of OPMDs. The fifth edition of the World Health Organization classification of head and neck tumors published in 2022 represents new information regarding this topic and a construct for this position paper.


Assuntos
Carcinoma de Células Escamosas , Neoplasias de Cabeça e Pescoço , Líquen Plano Bucal , Doenças da Boca , Neoplasias Bucais , Lesões Pré-Cancerosas , Humanos , Estados Unidos , Mucosa Bucal/patologia , Neoplasias Bucais/diagnóstico , Neoplasias Bucais/cirurgia , Neoplasias Bucais/patologia , Carcinoma de Células Escamosas/cirurgia , Carcinoma de Células Escamosas/patologia , Cirurgiões Bucomaxilofaciais , Leucoplasia Oral , Lesões Pré-Cancerosas/diagnóstico , Lesões Pré-Cancerosas/patologia , Lesões Pré-Cancerosas/terapia , Doenças da Boca/diagnóstico , Doenças da Boca/patologia , Hiperplasia , Neoplasias de Cabeça e Pescoço/patologia , Líquen Plano Bucal/diagnóstico , Líquen Plano Bucal/patologia , Transformação Celular Neoplásica/patologia
16.
J Oral Maxillofac Surg ; 81(7): 831-837, 2023 07.
Artigo em Inglês | MEDLINE | ID: mdl-37004839

RESUMO

PURPOSE: Oral-maxillofacial surgeons (OMSs) are frequent prescribers of opioid analgesics. It remains unclear if prescription patterns differ for urban versus rural patients, given potential differences in access to and delivery of care. This study aimed to characterize urban-rural differences in opioid analgesic prescriptions to patients in Massachusetts by OMSs from 2011 to 2021. METHODS: This retrospective cohort study used the Massachusetts Prescription Monitoring Program database to identify Schedule II and III opioid prescriptions by providers with specialty of oral and maxillofacial surgery from 2011 to 2021. The primary predictor variable was patient geography (urban/rural) and secondary predictor was year (2011-2021). The primary outcome variable was milligram morphine equivalent (MME) per prescription. Secondary outcome variables were days' supply per prescription and number of prescriptions received per patient. Descriptive and linear regression statistics were performed to analyze differences in prescriptions to urban and rural patients each year and throughout the study period. RESULTS: The study data, which includes OMS opioid prescriptions (n = 1,057,412) in Massachusetts from 2011 to 2021, ranged annually between 63,678 and 116,000 prescriptions to between 58,000 and 100,000 unique patients. The cohorts each year ranged between 48 and 56% female with mean ages between 37 and 44 years. There were no differences in the mean number of patients per provider in urban and rural populations in any year. The study sample had a large majority of urban patients (>98%). MME per prescription, days' supply per prescription, and prescriptions received per patient were all generally similar between urban and rural patients each year, with the largest MME per prescription difference in 2019 (87.3 for rural to 73.9 for urban patients, P < .01). From 2011 to 2021, all patients had a steady decrease in MME per prescription (ß = -6.64, 95% confidence interval: -6.81, -6.48; R2 = 0.39) and day's supply per prescription (ß = -0.1, 95% confidence interval: -0.1, -0.09; R2 = 0.37). CONCLUSION: In Massachusetts, there were similar opioid prescribing patterns by oral and maxillofacial surgeons to urban and rural patients from 2011 to 2021. There has also been a steady decrease in the duration and total dosage of opioid prescriptions to all patients. These results are consistent with multiple statewide policies over the last several years aimed at curbing opioid overprescribing.


Assuntos
Analgésicos Opioides , Cirurgiões Bucomaxilofaciais , Humanos , Feminino , Adulto , Masculino , Analgésicos Opioides/uso terapêutico , População Rural , Estudos Retrospectivos , Padrões de Prática Odontológica , Massachusetts , Prescrições , Padrões de Prática Médica , Prescrições de Medicamentos
18.
Work ; 76(1): 243-249, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-36872817

RESUMO

BACKGROUND: Oral and maxillofacial surgeons (OMS) are continually required to adjust position and posture to access the limited surgical field in and around the head and neck, oral cavity, and oropharynx. Very limited data exists that quantifies the burden of musculoskeletal disorders (MSD) among OMS. OBJECTIVE: This exploratory study seeks to address these literature gaps by assessing the prevalence of MSD among OMS. METHOD: A 12-question survey was designed to investigate the prevalence of MSD for OMS, including residents in training, actively practicing surgeons, and retired surgeons. Seventy-six surveys were distributed and completed in person by surgeons attending professional conferences from September 2018-September 2019. Survey questions included the Baker-Wong Faces pain scale, years in practice, number of hours worked per week, job tenure, pain attributable to work, and age. The Nordic scale identified and delineated anatomic site of musculoskeletal complaints, duration and treatment sought. RESULTS: The most frequently cited sources and locations of pain attributable to occupation were shoulders, neck, and lower back. The risk of MSD symptoms was relatively two-fold [PR = 2.54, 95% CI = 0.90, 7.22] among OMS in practice for more than ten years compared to those in practice less than ten years. After adjusting for age and hours worked per week as potential confounders, the risk of MSD symptoms was higher among OMS in practice for more than ten years compared to those with less than ten years of experience, despite no statistically significant association. CONCLUSION: OMS are impacted by a high prevalence of MSD. The neck, shoulder, and lower back are the most frequently affected with discomfort and pain. This study found that practicing oral and maxillofacial surgery for more than 10 years is a potential risk factor for experiencing MSD.


Assuntos
Doenças Musculoesqueléticas , Doenças Profissionais , Cirurgiões , Humanos , Cirurgiões Bucomaxilofaciais , Doenças Profissionais/epidemiologia , Doenças Profissionais/prevenção & controle , Doenças Profissionais/etiologia , Doenças Musculoesqueléticas/epidemiologia , Doenças Musculoesqueléticas/etiologia , Doenças Musculoesqueléticas/prevenção & controle , Inquéritos e Questionários , Fatores de Risco , Dor , Prevalência
19.
Am J Orthod Dentofacial Orthop ; 164(3): 386-394, 2023 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-36967313

RESUMO

INTRODUCTION: Transverse occlusal plane (TOP) should be parallel to the true horizontal lines of the face (ie, the interpupillary line [IP] and commissural line [CL]). This study aimed to investigate the opinions of laypersons, orthodontists, and oral and maxillofacial surgeons about the impact of imbalanced IP and CL on facial attractiveness. METHODS: We used a symmetrical face image as the reference. Then, using Photoshop software, we constructed the following 6 photographs: TOP roll relative to CL and IP (3° and 6°) with parallelism of CL and IP, CL roll relative to TOP and IP (3° and 6°) with parallelism of TOP and IP, TOP and CL roll relative to IP (3° and 6°). Consequently, the participants rated the photographs on the basis of their attractiveness. Kruskal-Wallis and Mann-Whitney U tests were used to compare the ratings. RESULTS: One hundred thirty-one laypersons, 22 orthodontists, and 20 surgeons participated in this study. It was found that 51.1% of laypersons, 86.4% of orthodontists, and 70% of surgeons selected the reference photograph as the most beautiful, followed by the photograph with a 3° roll of CL relative to TOP, with parallelism of TOP and IP (29% of laypersons, 31.8% of orthodontists, and 35% of surgeons). CONCLUSIONS: Most participants selected the reference photograph as the most beautiful and realized a roll in the horizontal planes up to 3°. The parallelism of the esthetic line of dentition relative to interpupillary is preferred over its parallelism relative to CL.


Assuntos
Oclusão Dentária , Ortodontistas , Humanos , Cirurgiões Bucomaxilofaciais , Atitude do Pessoal de Saúde , Estética Dentária , Percepção , Sorriso
20.
J Craniomaxillofac Surg ; 51(2): 71-78, 2023 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-36858829

RESUMO

This study aimed to evaluate the use of microvascular free flaps (MFF) in oral and maxillofacial surgery (OMFS) in Germany, Austria, and Switzerland. A dynamic online questionnaire, using 42-46 questions, was sent to OMF surgeons based in hospitals in Germany, Austria, and Switzerland. The questionnaire was evaluated internally and externally. Aside from general information, data were collected on organizational aspects, approaches, MFF types and frequency, presurgical planning, intraoperative procedures, perioperative medications, flap monitoring, and patient management. Participants mostly performed 30-40 MFF each year (11/53). Most stated that the COVID-19 pandemic did influence MFF frequency (25/53) to varying extents. Radial forearm flap was most frequently used (37/53), followed by ALT (5/53), and fibula flap (5/53). Primary reconstruction was performed by most participants (35/48). Irradiated bony transplants were mostly used for implant placement after 12 months (23/48). Most participants (38/48) used reconstruction plates, followed by miniplates (36/48), PSI reconstruction (31/48), and PSI miniplates (10/48). Regarding the postoperative use of anticoagulants, low-molecular-weight (37/48) and unfractioned heparins (15/48) were widely used, most often for 3-7 days (26/48). Clinical evaluation was mostly preferred for flap monitoring (47/48), usually every 2 h (34/48), for at least 48 h (19/48). Strong heterogeneity in MFF reconstructions in OMFS was found, especially regarding the timepoints of reconstruction, types of osteosynthesis, and postoperative MFF management. These findings provide the chance to further compare the different treatment algorithms regarding relevant MFF aspects, such as postoperative management. This could create evidence-based treatment algorithms that will further improve the clinical outcomes in MFF reconstructions.


Assuntos
COVID-19 , Retalhos de Tecido Biológico , Cirurgia Bucal , Humanos , Cirurgiões Bucomaxilofaciais , Áustria , Suíça , Pandemias , Retalhos de Tecido Biológico/irrigação sanguínea , Alemanha , Inquéritos e Questionários
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