Odontogenic Infections: Disease Burden During COVID-19 at a Single Institution.

PURPOSE: The purpose of this study was to document the effect of coronavirus disease 2019 (COVID-19) on patients presenting to the University of Washington Oral and Maxillofacial Surgery (UW OMS) with an odontogenic infection. MATERIALS AND METHODS: The investigators designed a retrospective cohort study and enrolled a sample of 889 subjects who presented for an odontogenic infection from March 19 to June 18 in the years 2017, 2018, 2019, and 2020. The primary predictor variable was OMS consultation for an odontogenic infection during a non-COVID-19 (2017, 2018, and 2019) year (control) or during the COVID-19 pandemic in 2020 (experimental). The primary outcome variable was treatment rendered. Appropriate univariate and bivariate statistics were computed, and the level of significance was set at .05 for all tests. RESULTS: There was no significant difference in the incidence of OMS consults in the 2 cohorts (P > .05). The number of patients presenting to the UW emergency department (ED) for an odontogenic infection decreased from an average of 246 in non-COVID years to 151 in 2020. Patients in the experimental cohort were more likely (55 vs 30.0%; P = .04) to present primarily to UW than a dentist and were less likely to undergo an incision and drainage (70.0 vs 88.8%; P = .04), aerosol-generating procedure (70.0 vs 88.8%; P = .04), and incision and drainage in the ED (15.0 vs 41.3%; P = .03). CONCLUSIONS: The investigators did not find evidence of increased hospital or ED burden by odontogenic infections during the COVID-19 pandemic.

Oral adverse outcomes associated with the buccal mucosa graft for urethroplasty.

OBJECTIVE: The buccal mucosa graft (BMG) is the standard graft for reconstructive urology, but management of the donor site remains under debate. The authors compared postoperative oral adverse outcomes between management methods (closure, nonclosure, or xenograft-assisted closure). STUDY DESIGN: A retrospective cohort study was conducted, enrolling patients treated at Harborview Medical Center, Seattle, Washington. The patients had a history of urethroplasty using a unilateral BMG, and the primary outcome variables were postoperative oral adverse outcomes, defined as subjective changes in mouth opening, smile, chewing, speech, intraoral bleeding, paresthesia, trismus, and infection. Multivariate and regression analyses were performed. RESULTS: The sample was composed of 137 patients (95% male; mean age, 48 years). The mean surface areas of the BMG for closure, nonclosure, and xenograft were 1059, 1178, and 1228 mm2, respectively. Thirty-four patients completed the survey (7 closure, 17 nonclosure, and 10 xenograft). Multiple linear regression showed a significant difference between the 3 groups with respect to patient-reported chewing ability and trismus favoring xenograft at larger graft sizes (P < .01). CONCLUSIONS: Xenograft-assisted closure may reduce long-term oral adverse outcomes associated with trismus and subjective changes in chewing, mouth opening, speaking, and smiling with larger grafts. In addition, limited postoperative patient education for oral rehabilitation exercises was noted.