Significant decrease of facial cellulitis admissions during COVID-19 lockdown in France: A multicentric comparative study.

During the 2020 coronavirus pandemic, a lockdown was imposed in France during the first wave. An apparent decrease in incidence of cellulitis of odontogenic origin was noticed then. This study aimed to compare the incidence of cellulitis during this extraordinary period with the same period in 2018 and 2019, based on retrospective multicentric data. All maxillofacial surgery departments in French public hospitals were contacted. Responders were asked to include all patients admitted for the surgical drainage of a head and neck abscess of odontogenic origin during the first 2020 lockdown period, and in a similar time frame in 2018 and 2019 (control group), based on screening the French diagnostic and therapeutic classification of medical acts. We report a 44% significant nationwide decrease in the incidence of admissions for cellulitis. There were 187 patients in 2020 for 334 and 333 patients in 2018/2019 respectively. The reasons to explain this finding are hypothetical (organizational reasons leading to earlier management, patients' fear to seek for medical management, usual excess in surgical indications or concomitant decrease of non-steroidal anti-inflammatory drugs delivery). Whatever the explanation, it would be of great interest to find it out in order to improve the prevention of cellulitis.

The significance of computer-assisted surgery in avoiding double-barrel fibula grafts in reconstruction of the horizontal mandibular ramus.

It is recognized that the mandibular reconstruction with free flap allows for both functional and aesthetic restoration. The flap must be used for reconstruction of a smooth lower mandibular contour and also the alveolar bone to allow dental rehabilitation. The double-barrel fibula free flap does respond well to these imperatives, but it increases risk of vascular complications. To overcome these risks, we propose a single-barrel fibula free flap, positioned at the alveolar level and a customized 3D implant, designed by computer-assisted surgery, at the basilar level. The interest of the single-barrel fibula associated with a customized 3D implant compared to the double-barrel fibula free flap is twofold: it decreases the vascular risks associated with the plication of the second pedicle and allows patients to have a pedicle of greater length. It also allows them to have a good cortical bone placed in the alveolar bone to rehabilitate the mastication function.

Management of patients with sickle cell disease in oral surgery. Literature review and update.

Sickle cell disease, the most common genetic disease in the world, is a chronic hemolytic disease that can be complicated by severe vaso-occlusive pain crises resulting in tissue necrosis and even death. Due to its increasing incidence, oral surgeons will inevitably be faced with the management of these patients. To limit the risk of crises, our goal is to share recommendations for the management of sickle cell patients in oral surgery. The vaso-occlusive crises (VOC), heart attacks and chronic anemia endured by these patients cause chronic lesions in various organs. Complications include retinal disease, avascular necrosis, priapism, neurological involvement (cerebrovascular accident), cardiomyopathy, lower limb ulceration, renal and hepatic dysfunction, and cardiopulmonary disease. These complications inevitably lead to an increase in mortality rate. Thorough knowledge of this pathology is essential for the management of these patients in oral surgery. Management strategies include prevention and diagnosis of oral lesions related to sickle cell disease and its treatment, as well as methods of preparation and execution of oral surgery procedures. We suggest guidelines for the management of these complications and implementation of preoperative, intraoperative and postoperative surgical protocols for both practitioners and patients.