Introduction to Amniotic Membranes in Maxillofacial Surgery-A Scoping Review.

Background: Amniotic membrane (AM) holds significant promise in various medical fields due to its unique properties and minimal ethical concerns. This study aims to explore the diverse applications of the human amniotic membrane (HAM) in maxillofacial surgery. Methodology: A comprehensive search was conducted on databases, namely Google Scholar, PubMed, and Scopus, from January 1985 to March 2024. Articles in English, Polish, and Spanish were included, focusing on keywords related to amniotic membrane and oral surgery. Results: Various preservation methods for HAM were identified, namely fresh, decellularized, cryopreserved, lyophilized, and air-dried formats. Clinical studies demonstrated the efficacy of HAM in repairing oral mucosal defects, vestibuloplasty, oronasal fistula closure, cleft palate treatment, bone defect repair, and medication-related osteonecrosis of the jaw (MRONJ). Surgeon evaluations highlighted the ease of handling but noted challenges in suturing and stability during application. Conclusions: Amniotic membranes offer a versatile and effective option in maxillofacial surgery, promoting wound healing, reducing inflammation, and providing a scaffold for tissue regeneration. Further research, including randomized trials and comparative studies, is warranted to validate the efficacy and optimize the utilization of HAM in clinical practice.

Prevalence and Variation of Medical Comorbidities in Oral Surgery Patients: A Retrospective Study at Jazan University.

BACKGROUND An aged population is susceptible to chronic diseases, which impacts oral surgery treatment procedures. This retrospective study aimed to evaluate the incidence of medical comorbidities in 640 oral surgery patients treated at the College of Dentistry, Jazan University. MATERIAL AND METHODS This single-center observational study investigated medical records of outpatients who visited Jazan University Dental College Hospital in a 1-year period (2018-2019). Patients’ clinical and radiographic archives were screened to obtain relevant data. Categorical and continuous variables were expressed in terms of frequency and mean values, respectively. Differences in variables were statistically analyzed using the chi-square goodness of fit and proportional test, with a probability value P≤0.05 considered significant. RESULTS Analysis of 640 patient records included records of 300 men and 340 women who underwent oral surgery, of whom 176 patients (27.5%), including 97 men and 79 women, had medical comorbidities. The most common comorbidities were endocrine disease (7.03%), cardiovascular disease (6.71%), respiratory disease (4.53%), and hematological disorders (3.43%). Individual diseases that showed higher prevalence were diabetes mellitus (4.68%), hypertension (3.43%), bronchial asthma (2.65%), and anemia (1.4%). Differences by sex were observed in many individual disorders. CONCLUSIONS Outpatients in oral surgery clinics presented a significant variance in the incidence of medical comorbidities, among which diabetes and hypertension were most common. A proper case history is the best preventive measure that helps a surgeon avert medical emergencies and post-surgical complications.

Evaluation of the efficacy of a simulation model used in oral and maxillofacial surgery education.

BACKGROUND: The traditional teaching methods of dental education are gradually being replaced with futuristic education methods based on the usage of educational tools such as mannequin-based simulation models and virtual reality. However, the effectiveness of mannequin-based simulation models as a learning method in the field of oral surgery remains unclear. This study aims to investigate the efficacy of training on a tooth extraction model (TEM) in view of undergraduate dental students' experience and perception of their education. METHODS: A quasi-experimental trial was implemented with two consecutive year classes, totaling 136 students at the Dentistry Faculty of Altinbas University, Turkiye. Two cohorts were created from dental students in the classes of 2023 and 2022 graduates. Cohort 1 (n = 71) received 14 h of theoretical education followed by 10 h of preclinical education on TEM. Cohort 2 (n = 65) received only 14 h of theoretical education. An anonymous questionnaire was prepared with four main sections including the preferences of learning style, participants' perceptions of the preclinical training methods, the students' competency and free text comments. Students' opinions were quantified with both 7-point Likert scales and thematic analysis. Anxiety levels were measured with the interval scale of anxiety response (ISAR). Descriptive statistics, inferential statistical and thematic analyses were conducted according to survey responses. Student characteristics were summarized and compared for two cohorts using a t-test. For all statistical analyses, the significance level was set atP ≤ 0.05. RESULT: Cohort 1 was more comfortable with sequential motions performed with the forceps (P = 0.033) and felt more ready for their first clinical tooth extraction experience (P = 0.028). Cohort 2 showed a significantly higher preference for textbooks among supplementary materials (P = 0.04); however, they tended to exhibit lower self-confidence and higher anxiety levels, though without any statistical significance (P > 0.05). CONCLUSION: It is clear that the students who have yet to start seeing patients benefit from increased practice with training models, which adequately reflect and represent real-life situations encountered in everyday practice.

Use of online educational resources before and during the COVID-19 era in oral and maxillofacial surgery.

Restrictions to traditional face-to-face meetings were mandated by many government authorities during the COVID-19 pandemic, impacting the delivery of educational training sessions for maxillofacial surgery trainees in the traditional group manner. An online survey was designed to review what effect the pandemic had on the use and uptake of online educational sources amongst a representative cohort of maxillofacial surgery trainees in higher specialist training. Their attitudes and satisfaction with online resources were considered. The use of live sources such as webinars and pre-recorded materials (e.g. YouTube videos) was investigated. Engagement with online sources was considered prior to, and then during the pandemic. Alterations in the behaviour of trainees were demonstrated, with increasing online resource use seen once the COVID-19 pandemic took hold. Online pre-recorded resource use increased by 26% during the pandemic, with the median number of hours watched per month increasing from 1-5 h to 5-10 h (p < 0.001). Engagement with live online sources (webinars) increased by 52% and median time watched increased from 15 h per month to 10-20 h per month (p < 0.001). Trainees expressed satisfaction with the quality and flexibility of the resources. There was a firmly positive response to live webinars with regard to teaching quality, audio and video quality, ease of access and relevance to training needs. Pre-recorded and live online resources may prove a useful alternative or adjunct to face-to-face teaching when regulations limit or restrict social interactions.

[Scoring early oral soft-tissue wound healing: A systematic review]. / Scoren van vroege wondgenezing van orale zachte weefsels: een systematisch literatuuronderzoek.

To date, there is no widely accepted system for evaluating soft tissue early healing events in oral surgery. This study aimed to identify variables used to assess early oral soft tissue wound healing. The PubMed-MEDLINE and Cochrane CENTRAL databases were searched up to and including March 1, 2022. Papers were included if they presented scores of wound healing after performing a mucoperiosteal flap operation with the intention of primary closure. The search yielded 2,286 unique titles and abstracts, of which 31 met the eligibility criteria. In general, the available definitions/indices were found to be imprecise. Based on the literature reviewed, six variables were considered relevant for scoring early oral soft tissue wound healing: primary closure, necrosis, redness, swelling, bleeding, and suppuration.

Post-graduation career pathways: a nationwide survey among dental students in Germany.

OBJECTIVES: Oral and maxillofacial surgery (OMFS) has to compete with other specialties for the best candidates. With the upcoming change of generations (Z and Alpha) and the movement toward gender parity of dentistry, understanding changing preferences and misconceptions is essential. MATERIAL AND METHODS: An online survey was conducted by the German-Association-of-Oral-and-Maxillofacial-Surgery (DGMKG) across German dental schools. The survey collected demographic data, academic background, and career aspirations, with a focus on OMFS. The dental student survey results were compared to a survey given to OMFS Specialists. RESULTS: 637 dental students, mainly female (70%), from 30 German universities participated. 27% had defined career aspirations post-graduation, with self-employment and academia being popular choices. 67% were unsure. Specializations leaned towards restorative dentistry (41%), orthodontics (36%), and prosthodontics (31%). While 73% showed interest in surgical practices, 20% were attracted in specializing in OMFS. Of those averse to OMFS, 78% cited long training duration as the deterrent, 12% were put off by perceived unattractive working hours. Other reasons included negative undergraduate experiences, scarcity of part-time positions, and perceived inadequate earnings. CONCLUSION: Accurate data is crucial for career decisions. OMFS societies must proactively share accurate information and guide students. OMFS offers family-friendly hours, and while its training might be longer than dental specialties, it is on par with other surgical professions. CLINICAL RELEVANCE: Dental students consistently regard OMFS as commendable career path. To guarantee sustained OMFS expertise, it is imperative to nurture this interest through dedicated academic mentorship and innovative education, thereby solidifying their professional direction.

Role of hydrocolloid dressing in preventing face pressure ulcers from non-invasive ventilation and facilitating postoperative wound healing in maxillofacial surgery: A meta-analysis.

Facial pressure ulcers from non-invasive ventilation (NIV) and challenges in wound healing post-maxillofacial surgery are significant concerns in clinical care. This meta-analysis aimed to evaluate the effectiveness of hydrocolloid dressings in these contexts. From a pool of 1135 articles, 8 studies met the inclusion criteria. Hydrocolloid dressings demonstrated a significant reduction in facial pressure ulcers for NIV patients, with lower REEDA scores 1-week postapplication (standardized mean difference [SMD] = -16.7, 95% confidence interval [CI]: -24.26 to -9.15, p < 0.01). In maxillofacial surgery, patients treated with hydrocolloid dressings exhibited improved wound healing and reduced scar formation, evidenced by lower Manchester Scar Scale scores 3 months post-surgery (SMD = -15.46, 95% CI: -20.28 to -10.64, p < 0.01). These findings suggest that hydrocolloid dressings are effective in both preventing NIV-related facial pressure ulcers and enhancing wound healing in maxillofacial surgery.

Risk Factors for Early Dental Implant Failure.

PURPOSE: To report the prevalence of early implant failure and evaluate factors that contribute to the early failure of dental implants placed at a teaching clinic. The study also aims to identify risk indicators for early implant loss to better predict and prevent early implant loss in the future. MATERIALS AND METHODS: This retrospective study included all patients with a dental implant placed by the Section of Oral Surgery and Oral Medicine, Department of Clinical Dentistry, University of Bergen, between January 2011 and December 2018. All information was collected from operation logbooks and from patient records. A failed implant in this study was defined as an implant lost before functional loading. RESULTS: A total of 1,005 dental implants were placed in the studied time period, of which 54 failed early, giving an early failure rate (EFR) of 5.4%, with functional loading obtained for the remaining 94.6%. Analysis showed an increased hazard for early implant failure among smokers, men, and younger patients. With an age increase of 10 years, the risk of implant failure was reduced by 14% (hazard ratio [HRR] = 0.86, P = .037). A higher failure rate was found in anterior maxillary implants than in posterior maxillary implants (7.79% vs 3.29%, respectively; HRR = 0.47; P = .041). The probability for early failure in the posterior mandible was significantly increased compared to the posterior maxilla (HRR = 3.68, P = .005). If the first implant failed, it was more likely that the consecutive implant would also fail (HRR = 1.82). In the study, 53.4% of the placed implants were Straumann (EFR = 5.2%), 30.3% were Nobel Biocare (EFR = 7.2%), and 16.3% were Astra Tech (EFR = 2.5%). CONCLUSIONS: This study found that younger, male, and smoker patients were associated with an increase in early failure of dental implants. Significantly increased failure rates were also seen for implants placed in the mandible, and there were differences with respect to implant system. Although differences were found in early failure both for patient- and implant-related factors, the overall early failure rate (5.4%) in this study was low.

Medical associate professionals in oral and maxillofacial surgery.

Recent discourse around the implementation of medical associate professions (MAPs) into medical specialties has proven divisive and controversial. These roles could benefit oral and maxillofacial surgery (OMFS) departments and grant trainees increased operating experience, but their implementation could prove detrimental to training. We discuss the potential impact in OMFS.

Survey of United Kingdom oral and maxillofacial surgery (OMFS) specialists and trainees about the reasons that they retain or drop their registration with the General Dental Council (GDC) including a summary of changes in the numbers registered with the GDC 2014-2023.

When dual degree OMFS training was mandated in the UK in 1995, OMFS specialists were required to be registered with both the General Dental Council (GDC) and General Medical Council (GMC). In 2005 this legal requirement for dual registration with both regulators was removed. During 2021 the authors surveyed UK OMFS specialists and trainees asking them why they chose to remain on or leave the Dental Register to give context to the changing numbers of OMFS specialists and trainees holding Dental Registration between 2014 and 2023. In 2014 of 539 OMFS specialists and trainees only 62 (12%) were solely GMC registered, that is, they had let their Dental Registration lapse. In 2023, of 709 OMFS specialists and trainees, 320 (45%) were solely GMC registered. Those whose first qualification was medicine were less likely to be dually registered. Of those who replied to the survey and remained dually registered, most (40%) based this decision on 'worries about the consequences' of dropping their dental registration. Some other reasons were not based on fact at that time. Cost was the most common reason (49%) given for dropping their GDC registration by respondents who were only registered with the GMC. On the positive side, the January 2023 GDC position statement about OMFS who are not on the Dental Register removed the GDC's previous restriction on location of practice and teaching dental students. However the statement does not unambiguously allow OMFS surgeons to practice across the full OMFS curriculum. Will the 2023 GDC position statement alter the trend of OMFS specialists and trainees towards single medical registration?