Evaluation of the (clinical) relevance of gross anatomical teaching for dental students and practicing oral surgeons in Berlin.

Knowledge of human anatomy is an important scientific basis for every dentist, and the adequacy of its provision by anatomy faculties is therefore constantly being adapted. Students' motivation to comprehend knowledge is a fundamental prerequisite and has been shown to increase when the relevance of the subject is clear. This study examines dental students' perceptions of the relevance of the anatomy curriculum, with particular reference to clinical practice and the dissection course, in conjunction with the perceptions of surgically specialized dentists. The distinctions between the participating groups concerning their perceived relevance are being discussed particularly regarding their applicability to improve the anatomical education of dental students. The overall aim is to find and highlight aspects of the clinical use of anatomical knowledge towards students, which they are unable to apprehend yet. A questionnaire consisting of information on demographics and professional competence as well as a Likert-style section was administered to dental students at Charité Universitätsmedizin in 2019/2020 (n = 322, 84.96%) and a modified version with congruent questions was administered retrospectively to oral surgeons practicing in Berlin in 2020 (n = 81, 63.3%). A Wilcoxon rank-sum test was used to examine differences in responses between the cohorts. Demographic data and professional competence were correlated with the participants' ratings of the given statements using Spearman's rank correlation coefficient. Both groups of respondents expressed a high level of appreciation of the overall relevance of anatomical knowledge, valued the teaching of all human anatomy for dental education, and recognized the relevance of anatomical knowledge for clinical practice. The importance of the dissection course was also rated relatively high by both groups of respondents. The overall appreciation of anatomical knowledge was more prevalent among oral surgeons. There were few correlations between demographics in our findings, showing slightly higher motivation in female students and a growing appreciation of anatomical knowledge as students qualification progressed. The demographics and post-qualification experience of the participating oral surgeons did not influence their perceptions. The results of this survey suggest that there is potential to increase the motivation of dental students to learn anatomy by emphasizing clinical relevance, as perceived by experienced practitioners, during the anatomy curriculum.

Oral and maxillofacial surgeons' views on the adoption of additive manufacturing: findings from a nationwide survey.

OBJECTIVES: Hospitals in many European countries have implemented Additive Manufacturing (AM) technology for multiple Oral and Maxillofacial Surgery (OMFS) applications. Although the technology is widely implemented, surgeons also play a crucial role in whether a hospital will adopt the technology for surgical procedures. The study has two objectives: (1) to investigate how hospital type (university or non-university hospital) influences surgeons' views on AM, and (2) to explore how previous experience with AM (AM experience or not) influences surgeons' views on AM. MATERIALS AND METHODS: An online questionnaire to capture surgeons' views was designed, consisting of 11 Likert scale questions formulated according to the Consolidated Framework for Implementation Research (CFIR). The questionnaire was sent to OMF surgeons through the channel provided by the Association of Oral and Maxillofacial Surgery in Sweden. Data were analyzed using the Mann-Whitney U test to identify significant differences among OMF surgeons in terms of organizational form (i.e., university hospital or non-university hospital) and experience of AM (i.e., AM experience or no-experience). RESULTS: In total, 31 OMF surgeons responded to the survey. Views of surgeons from universities and non-universities, as well as between surgeons with experience and no-experience, did not show significant differences in the 11 questions captured across five CFIR domains. However, the "individual characteristics" domain in CFIR, consisting of three questions, did show significant differences between surgeons' experience with AM and no-experience (P-values: P = 0.01, P = 0.01, and P = 0.04). CONCLUSIONS: Surgeons, whether affiliated with university hospitals or non-university hospitals and regardless of their prior experience with AM, generally exhibit a favorable attitude towards AM. However, there were significant differences in terms of individual characteristics between those who had prior experience with AM and those who did not. CLINICAL RELEVANCE: This investigation facilitates the implementation of AM in OMFS by reporting on the views of OMF surgeons on AM.

Knowledge of novel coronavirus disease (COVID-19) among dental surgeons of Nepal: a nationwide study.

BACKGROUND: COVID-19 is an emerging respiratory disease caused by a novel coronavirus. There is not much evidence assessing the knowledge of dental surgeons regarding COVID-19. This study was conducted to assess the knowledge of COVID-19 among dental surgeons of Nepal. METHODS: A web-based cross-sectional study was conducted among registered dental surgeons of Nepal. Ethical approval was obtained. Consent was taken, and knowledge on COVID-19 was assessed via a pre-tested structured questionnaire using Google form. The form was emailed to the participants. Descriptive analysis was performed using frequency, percentage, median and inter-quartile range. Man-Whitney test and Kruskal-Wallis tests were carried out to see the difference in knowledge score. P-value < 0.05 was considered statistically significant. RESULTS: Total 227 dental surgeons responded to the questionnaire (male: 46.4%; female: 53.7%). Almost two-third ( 65.2% ) of the respondents were B.D.S. (Bachelor of Dental Surgery) graduates. Only 29.1% worked in the government hospitals. 17.6% were currently involved in COVID-19 management. Of the participants, 87.7% knew about the condition of the requirement of Personal Protective Equipment (PPE) but only 29.1% could correctly answer the framed question for PPE. The median knowledge score calculated was 14.0 (8.0-18.0). The bivariate analysis showed a statistically significant difference in knowledge score among the age group ≥30 years and < 30 years (p = 0.013); M.D.S. (Master of Dental Surgery) graduate and B.D.S. graduate (0.041); dental surgeons of government healthcare facilities and other healthcare facilities (p <  0.001); dental surgeons of COVID-19 centers and non-COVID-19 centers (0.002). CONCLUSION: The dental surgeons of Nepal have a good knowledge of COVID-19, and they can be utilized for assisting in the management of COVID-19 cases in Nepal.

Pre-implantological treatment routines for alveolar ridge atrophy - an investigation among maxillofacial and oral surgeons in southern Germany.

BACKGROUND: It is not well-known which pre-implantological procedures are preferred by maxillofacial (MFS) and oral surgeons (OS) for the narrow atrophic alveolar ridge under practice based conditions and, if different training paths in surgery lead to other pre-implantological techniques being preferred. This study aims to identify which procedures are preferred by the respective specialists in which indication. METHODS: A questionnaire was sent to a total of 300 MFS and OS in southern Germany. The questionnaire examined pre-implantological procedures (bone block, bone grafting material and/or particulate autogenous bone, titanium mesh, bone split, resection) in the edentulous severely atrophic mandible and in the severely atrophic single-tooth gap. Kendall's Tau-b test was used for statistical analyses. RESULTS: One hundred seventeen participants returned the questionnaire. 68 (58%) were OS and 49 (42%) were MFS. In the edentulous mandible, bone substitute material and resection were most preferred by both specialists. Bone blocks were statistically significantly more frequently associated with MFS and bone substitute materials with OS. Bone split was more frequently used in the atrophic single tooth gap than in the edentulous mandible. OS preferred bone blocks in the single tooth gap more often than in the edentulous mandible. MFS and OS preferred resection in the edentulous mandible significantly more frequently than in the single tooth gap. CONCLUSIONS: MFS in general prefer more invasive pre-implantological therapies with the same initial diagnosis than OS, which seems to be attributed to different training paths.

The alteration of stress-related physiological parameters after probiotics administration in oral surgeons with different degrees of surgical experience.

PURPOSE: Stress is a multifactorial and complex pathway, gaining growing attention from the healthcare community. Surgeons are subjected to higher levels of stress, due to surgical procedures that are demanding and repetitive; unfortunately, high-stress levels may also cause side-effects, as surgical mistakes. This study aimed to evaluate the efficacy of specific probiotics strains formula on stress levels in oral and maxillofacial surgeons, to improve their quality of life. METHODS: We have investigated the hormonal (salivary Cortisol; sC), immune (salivary Immunoglobulin A; sIgA) and cardiovascular (Heart rate, HR, and systolic blood pressure, SBP) responses induced by stress conditions in 40 oral surgeons, randomly selected and allocated, according to their experience level, in three categories: senior, expert, and junior. RESULTS: The results described how the number of heartbeats/ minute and SBP are slightly raised in all surgeons at different timepoints. Such data allow us to assess that work-related stress can induce an increase in cardiovascular parameters, even if they are not significantly modified by the use of probiotics. On the other hand, our data indicate that 10 weeks of probiotic integration may induce the improvement of other stress-related physiological parameters in oral surgeons with different degrees of surgical experience, such as the salivary cortisol levels, even under stress conditions. Moreover, in the test group (probiotics administration), the immunoglobulin levels were higher than the control (placebo administration) group: this happens as a consequence of the regular use of probiotics, which may induce an increased number of IgA producing cells. DISCUSSION: Our data indicated that 10 weeks of probiotics-enriched diet modify some stress-related physiological parameters in oral surgeons with different degrees of surgical experience, but it does not impact on the overall cardiovascular risk.

Knowledge, Attitude and Practice of Oral Biopsy Procedures among Dental Surgeons Registered with Nepal Dental Association.

BACKGROUND: Oral biopsy procedures are rarely practiced by dental surgeons around the world though they should be able to perform the biopsies for the diagnosis of oral lesions. Our objective was to access the knowledge, attitude and practice of oral biopsy procedures among the dental surgeons who are members of Nepal Dental Association. METHODS: A cross sectional study was conducted from December 2018 to March 2019, among the dental surgeons who were registered in Nepal Dental Association till September 2018. A standard pretested questionnaire was prepared using Google forms, was emailed to 374 dental surgeons. Two reminder emails were sent at an interval of 1 month. The non-responding dental surgeons who were reachable through mobile number (N=274) were contacted after the third 3rd email. Out of 274, 10 dental surgeons had completed postgraduation, so 264 of them were included in the study. A reminder call was made after one week. The data was entered in SPSS version 20 software and analyzed using descriptive statistics. RESULTS: There were 160 responses to the emails after the conversation through mobile phone. The response rate was 60.6% with the predominance of female responders (66.9%). Though the majority of dental surgeons (96.2%) had encountered one or the other lesions requiring biopsy, only few of them (7.5%) had performed the biopsy which was mainly due to lack experience and skill (75.6%). CONCLUSIONS: Most of the dental surgeon are not comfortable performing biopsy with majority seem to lack expereice and skill. There is need to organize training to Dental Surgeons to enhance their practical skills.

Odontogenic chronic rhinosinusitis patients undergoing tooth extraction: oral surgeon and otolaryngologist viewpoints and appropriate management.

OBJECTIVE: This study aimed to propose appropriate management for odontogenic chronic rhinosinusitis. METHOD: Thirty-one adult patients with odontogenic chronic rhinosinusitis undergoing maxillary extraction were retrospectively analysed. Patients with (n = 21) and without (n = 10) oroantral fistula on computed tomography were classified. Functional endoscopic sinus surgery was performed when sinusitis did not improve after extraction. The critical indicators for surgical requirement in the management of odontogenic chronic rhinosinusitis were analysed. RESULTS: Sinusitis significantly improved after extraction in both groups. Patients without oroantral fistula had significantly more severe remnant sinusitis than those with oroantral fistula after extraction on computed tomography (p = 0.0037). The requirement for functional endoscopic sinus surgery was statistically significant for patients without orofacial fistula over those with orofacial fistula (p < 0.0001). The surgical improvement ratio was 93 per cent. CONCLUSION: The absence of oroantral fistula and severe sinusitis can be critical indicators for the requirement of functional endoscopic sinus surgery after extraction in the management of odontogenic chronic rhinosinusitis.

Practice Management in Oral and Maxillofacial Surgery.

Managing an oral and maxillofacial surgery (OMS) practice has undergone dramatic changes. Electronic health records, privacy laws, revenue cycle management, online marketing, and the rise of dental service organizations (DSOs) present increased daily complexity for oral and maxillofacial surgeons in private practice, hospital-based employees, and academic surgeons. This article is structured to discuss the role of DSOs, private equity in OMS, online practice marketing, accounting and tax considerations, and modern essentials of practice management.

Pneumatic tourniquets in maxillofacial surgery: do we need to change practice? A national study.

The use of pneumatic tourniquets during the harvest of free flaps is an established practice in oral and maxillofacial surgery. Their use can be associated with severe but preventable complications, for which operating surgeons are ultimately responsible. The aim of this study was to find any pitfalls concerning the safe use of tourniquets by maxillofacial surgeons. An electronic questionnaire based on the Association of Perioperative Registered Nurses (AORN) guidelines was distributed to maxillofacial surgeons nationally. A total of 37 questionnaires were completed and analysed. The mean (range) score for the knowledge-based questions for all respondents was 72.8% (47.3%-94.7%). The number of clinicians who answered correctly on topics relating to cuff position, reperfusion time and contraindications for the use of tourniquets were 15, 10 and 6, respectively. A total of 35 clinicians had had no formal training on the application of a tourniquet. Our study shows that knowledge about their use by maxillofacial surgeons is poor, and it highlights the importance of formal education during basic and higher surgical training.

See-Through Type 3D Head-Mounted Display-Based Surgical Microscope System for Microsurgery: A Feasibility Study.

BACKGROUND: The surgical microscope is used primarily for microsurgeries, which are more complicated than other surgical procedures and require delicate tasks for a long time. Therefore, during these surgical procedures, surgeons experience back and neck pain. To solve this problem, new technology, such as wearable displays, is required to help surgeons maintain comfortable postures and enjoy advanced functionality during microsurgery. OBJECTIVE: The objective of this study was to develop a surgical microscope system that would work with wearable devices. It would include a head-mounted display (HMD) that can offer 3D surgical images and allow a flexible and comfortable posture instead of fixed eyepieces of surgical microscope and can also provide peripheral visual field with its optical see-through function. METHODS: We designed and fabricated a surgical microscope system that incorporates a see-through type 3D HMD, and we developed an image processing software to provide better image quality. The usability of the proposed system was confirmed with preclinical examination. Seven ENT (ear, nose, and throat) surgical specialists and 8 residents performed a mock surgery-axillary lymph node dissection on a rat. They alternated between looking through the eyepieces of the surgical microscope and viewing a 3D HMD screen connected to the surgical microscope. We examined the success of the surgery and asked the specialists and residents to grade eye fatigue on a scale of 0 (none) to 6 (severe) and posture discomfort on a scale of 1 (none) to 5 (severe). Furthermore, a statistical comparison was performed using 2-tailed paired t test, and P=.00083 was considered significant. RESULTS: Although 3D HMD case showed a slightly better result regarding visual discomfort (P=.097), the average eye fatigue was not significantly different between eyepiece and 3D HMD cases (P=.79). However, the average posture discomfort, especially in neck and shoulder, was lower with 3D HMD display use than with eyepiece use (P=.00083). CONCLUSIONS: We developed a see-through type 3D HMD-based surgical microscope system and showed through preclinical testing that the system could help reduce posture discomfort. The proposed system, with its advanced functions, could be a promising new technique for microsurgery.

Health-related impediments to learning among dental and oral surgery students.

Dental education is a challenging experience that places significant demands on students' intellectual, financial, and psychosocial well-being. Dental students who simultaneously experience physical illness, emotional upset, or interpersonal difficulty may be at greater risk of experiencing negative academic consequences. It is well documented that stress affects student learning, however, the impact of other health concerns on academic success is less understood. The purpose of this manuscript is to document the prevalence and perceived academic impact of 24 health concerns on the academic performance of a sample of 130 undergraduate dental students as measured by the National College Health Assessment (NCHA). Health concerns that were most prevalent among dental students were generally also perceived to be most detrimental to their learning. These included upper respiratory infections (cold, flu, sore throat), interpersonal concerns (concerns about a troubled friend or family member, and relationship difficulty), and mental health issues (depression/anxiety/seasonal affective disorder, and stress).

Esthetic preferences of orthodontists, oral surgeons, and laypersons for Persian facial profiles.

INTRODUCTION: The patient's perception of facial esthetics is not necessarily consistent with that of the practitioner. The aim of this study was to compare the perceptions of Persian orthodontists, oral surgeons, and laypersons with regard to facial profile attractiveness and the most favorable mandibular position. METHODS: Software (Dolphin Imaging and Management Systems, Chatsworth, Calif) was used to alter the mandibular position depicted on profile photographs of a young man and a young woman. Nine construction profile photos were produced with incremental changes of the G'-Sn-Pg' angle at 2° intervals (6° to 22°). Thirty-two orthodontists, 32 maxillofacial surgeons, and 32 laypersons were asked to score all 18 profiles on a 1-to-10 visual analog scale. They also evaluated whether each profile needed orthognathic surgery for improvement of facial esthetics. Actual agreement and intraclass correlation coefficient tests were used to assess reliability. The data were analyzed using 2-way repeated measures analysis of variance and Wilcoxon signed-rank tests. RESULTS: The intraparticipant reliability was acceptable (intraclass correlation coefficient >72%; actual agreement, >79%). The sex of the participants was not a significant factor influencing the scores, although the sex of the models was a discriminating factor for the most acceptable mandibular horizontal position. The scores given by the 3 groups were different, especially for the female model. The orthodontists had similar opinions and preferred a slightly more protrusive mandible (G'-Sn-Pg', 12°-14°). Laypersons' scores were the most inconsistent, and they generally preferred a retrusive profile (G'-Sn-Pg', 14°-18°). There was no significant correlation with regard to the necessity of orthognathic surgery for G'-Sn-Pg' angles over 20° in men and below 8° in women. CONCLUSIONS: Although the laypersons' perceptions were slightly different from those of the clinicians, most participants preferred a more protrusive mandible for male models compared with female models.

African Americans in Oral and Maxillofacial Surgery: Factors Affecting Career Choice, Satisfaction, and Practice Patterns.

PURPOSE: There are few data available on the experience of minority surgeons in the field of oral and maxillofacial surgery (OMS). Therefore, the purpose of this study was to 1) explore factors that contribute to African Americans choosing OMS as a career, 2) examine satisfaction among minority oral and maxillofacial surgeons with the residency application and training process, 3) report on practice patterns among minority oral and maxillofacial surgeons, and 4) identify perceived bias for or against minority oral and maxillofacial surgeons in an attempt to aid the efforts of OMS residency organizations to foster diversity. MATERIALS AND METHODS: A 19-item survey was sent to 80 OMS practitioners by use of information from the mailing list of the National Society of Oral and Maxillofacial Surgeons, an American Association of Oral and Maxillofacial Surgeons-affiliated organization. All surveys were sent by mail and were followed by a reminder mailing after 8 weeks. Responses returned within 16 weeks were accepted for analysis. RESULTS: Of the 80 mailed surveys, 41 were returned within the 16-week parameter, representing a return rate of 51%. Most of the minority surgeon respondents were married men with a mean age of 60 years who worked as private practitioners. Most respondents practiced on the eastern and western coasts of the United States. Exposure in dental school was the most important factor in selecting OMS as a specialty. Location and prestige were the most important factors in selecting a residency program. Most respondents reported that race did not affect the success of their application to a residency program and did not currently affect the success of their practice. However, 25 to 46% of participants experienced race-related harassment, and 48 to 55% of participants believed there was a bias against African Americans in OMS. CONCLUSIONS: Our data suggest that a substantial number of minority oral and maxillofacial surgeons subjectively perceive race-based bias in their career, although it does not appear to affect professional success.

The influence of sagittal position of the mandible in facial attractiveness and social perception.

OBJECTIVE:: This study aims at comparing the perception of orthodontists, maxillofacial surgeons, visual artists and laypersons when evaluating the influence of sagittal position of the mandible - in lateral view - in facial attractiveness; at a job hiring; and in the perception of socioeconomic profile. METHODS:: A black male, a white male, a black female and a white female with harmonic faces served as models to obtain a facial profile photograph. Each photograph was digitally manipulated to obtain seven facial profiles: an ideal, three simulating mandibular advancement and three simulating mandibular retrusion, producing 28 photographs. These photographs were evaluated through a questionnaire by orthodontists, maxillofacial surgeons, visual artists and laypersons. RESULTS:: The anteroposterior positioning of the mandible exerted strong influence on the level of facial attractiveness, but few significant differences between the different groups of evaluators were observed (p < 0.05). CONCLUSIONS:: The profiles pointed as the most attractive were also pointed as more favorable to be hired to a job position and pointed also as having the best socioeconomic condition.

The influence of sagittal position of the mandible in facial attractiveness and social perception

ABSTRACT OBJECTIVE: This study aims at comparing the perception of orthodontists, maxillofacial surgeons, visual artists and laypersons when evaluating the influence of sagittal position of the mandible - in lateral view - in facial attractiveness; at a job hiring; and in the perception of socioeconomic profile. METHODS: A black male, a white male, a black female and a white female with harmonic faces served as models to obtain a facial profile photograph. Each photograph was digitally manipulated to obtain seven facial profiles: an ideal, three simulating mandibular advancement and three simulating mandibular retrusion, producing 28 photographs. These photographs were evaluated through a questionnaire by orthodontists, maxillofacial surgeons, visual artists and laypersons. RESULTS: The anteroposterior positioning of the mandible exerted strong influence on the level of facial attractiveness, but few significant differences between the different groups of evaluators were observed (p < 0.05). CONCLUSIONS: The profiles pointed as the most attractive were also pointed as more favorable to be hired to a job position and pointed also as having the best socioeconomic condition.

RESUMO OBJETIVO: a presente pesquisa teve por objetivo comparar a percepção de ortodontistas, cirurgiões bucomaxilofaciais, artistas visuais e leigos ao avaliar a influência do posicionamento sagital da mandíbula, em vista lateral, na atratividade facial; na contratação para um emprego; e na percepção do perfil socioeconômico. MÉTODOS: um homem negro, um homem branco, uma mulher negra e uma mulher branca com faces harmoniosas serviram como modelos para obtenção de fotografias do perfil facial. Cada fotografia obtida foi digitalmente manipulada para a obtenção de sete perfis faciais: um ideal, três simulando avanço mandibular e três simulando retrusão mandibular, originando 28 fotografias. Essas fotografias foram avaliadas, por meio de um questionário, por quatro grupos de avaliadores: ortodontistas, cirurgiões bucomaxilofaciais, artistas visuais e leigos. RESULTADOS: o posicionamento anteroposterior da mandíbula exerceu forte influência sobre o grau de atratividade facial, porém foram observadas poucas diferenças significativas entre os diferentes grupos de avaliadores (p < 0,05). CONCLUSÕES: os perfis apontados como mais atraentes foram, também, os mais apontados como favoráveis à contratação para um emprego e os mais apontados como aqueles que aparentavam melhor condição socioeconômica.