Management of impacted third molars based on telemedicine: a pilot study.

PURPOSE: The incorporation of new technologies into clinical daily practice is nowadays a fact in the field of medicine. Within these new technologies, telemedicine is turning out to be a working tool that is used with increasing frequency in medical centers. The systems of telemedicine have still not reached the same development in oral and maxillofacial surgery that they have reached in other medical specialties. This study describes the preliminary results of a store-and-forward telemedicine system (SFTMS) aimed at the presurgical management of impacted third molar pathology. MATERIALS AND METHODS: A multicenter, longitudinal, descriptive, evaluative pilot study of an SFTMS aimed at the presurgical management of patients with impacted third molar pathology was conducted at the Oral and Maxillofacial Surgery Unit of Virgen Macarena University Hospital (Seville, Spain) and 4 primary care areas located between 15 and 95 km from the hospital. The study was carried out between January and December 2009. RESULTS: Over a period of 12 months, 97 patients were enrolled in the study, from 102 teleconsultations received and evaluated within the same period. Patients managed through telemedicine were included on the surgical wait list on within a mean interval of 3.33 days (95% confidence interval [CI], 2-4.65 days) since the visit to the primary care dentist, with only 1 visit to the hospital that was on the day of surgery. The mean waiting interval of patients managed through the conventional referral system was 28 days (95% CI, 24.51-29.6 days), with at least 2 visits to the hospital before the final intervention. The on-the-day surgery cancellation rate of the series was 7.8% (95% CI, 3.8%-10.5%) because 8 patients did not have surgery on the scheduled day. The cancellation rate in the sample of patients managed through the conventional system was 8.85% (95% CI, 5.62%-11.81%; P < .005). CONCLUSIONS: The SFTMS was effective and accurate as a preoperative tool for impacted third molar pathology. It avoids unnecessary visits to the hospital and shortens waiting intervals. Further randomized studies are needed, however, to establish real advantages, in clinical and economic terms, against the conventional presurgical management systems.

Quality of life in long-term oral cancer survivors: a comparison with Spanish general population norms.

PURPOSE: Health-related quality-of-life (HRQOL) data are becoming an important supplement to information pertaining to treatment outcomes for cancer patients. The purpose of this study was to evaluate the HRQOL of patients undergoing primary surgery for oral squamous cell carcinoma > or =5 years after treatment compared with the Spanish general population norms. MATERIALS AND METHODS: A total of 50 oral cancer patients (mean age 55.78 years, 80% male) with cancer-free survival of > or =5 years after surgery were enrolled. HRQOL was assessed with a standardized questionnaire: the Medical Outcomes Study Short Form 36-Item Health Survey. RESULTS: The Medical Outcomes Study Short Form 36-Item Health Survey scores of the oral cancer patients did not differ significantly from those of an age- and gender-matched sample from the Spanish normative population, except for the pain and social functioning domains. The patients had significantly better results compared with the population norms (Wilcoxon test, P < .05) in the physical function, general health, and vitality domains. CONCLUSIONS: These results provide patient-reported evidence that oral cancer survivors have a similar HRQOL compared with the general Spanish population. We also believe that it would be necessary to analyze the quality of life > or =5 years after treatment or from the moment the patient was discharged.