Unusual case of extramammary Paget disease of the oral mucosa: A case report and literature review.

Paget disease is an intraepithelial neoplastic proliferation, commonly occurring in the breast and apocrine-rich areas, often associated with an underlying internal malignancy. Extramammary Paget disease (EMPD) of the oral cavity is exceedingly rare, with only eight reported cases, four of which were associated with an underlying internal malignancy. Here, we report a case of oral EMPD involving the buccal mucosa and gingiva of an 81-year-old male with no known underlying internal malignancy. The Paget cells were positive for CK7, CK20, CAM5.2, and androgen receptor, but negative for SOX10 and p63. The immunophenotype, association with internal malignancies, and treatment approaches for oral EMPD are reviewed.

Efficacy of adjunctive modalities during tooth extraction for the prevention of osteoradionecrosis: A systematic review and meta-analysis.

BACKGROUND: Jaw osteoradionecrosis (ORN) is a complication in patients with previous head and neck radiotherapy. Its incidence increases with dental extractions. Hence, this review aimed to evaluate the efficacy of adjunctive treatment modalities undertaken at the time of extraction in previous head and neck radiotherapy patients in preventing ORN. METHODS: A systematic review was conducted, where studies with data on ORN incidence after extraction with or without adjunctive interventions were included. Meta-analyses were conducted to estimate the pooled prevalence of ORN per intervention and the pooled odds ratio for incidence of ORN between interventions. RESULTS: In total, 1520 patients in 29 studies were included. Interventions identified were hyperbaric oxygen (HBO), pentoxifylline-tocopherol (PENTO), antibiotics (ABX), platelet-rich fibrin and photobiomodulation. The pooled prevalence of ORN for HBO (4.6%), PENTO (3.4%) and ABX (3.8%) was significantly lower than the Control (17.6%). For studies with direct comparisons between groups, HBO had lower but not significant odds of developing ORN than the Control (OR 0.27) and ABX (OR 0.57). CONCLUSIONS: HBO, PENTO and ABX may reduce the incidence of ORN compared to no intervention. Given that all three have similar incidences of ORN, ABX may be the most cost-effective and accessible adjunctive modality.

Insights into Predicting Tooth Extraction from Panoramic Dental Images: Artificial Intelligence vs. Dentists.

OBJECTIVES: Tooth extraction is one of the most frequently performed medical procedures. The indication is based on the combination of clinical and radiological examination and individual patient parameters and should be made with great care. However, determining whether a tooth should be extracted is not always a straightforward decision. Moreover, visual and cognitive pitfalls in the analysis of radiographs may lead to incorrect decisions. Artificial intelligence (AI) could be used as a decision support tool to provide a score of tooth extractability. MATERIAL AND METHODS: Using 26,956 single teeth images from 1,184 panoramic radiographs (PANs), we trained a ResNet50 network to classify teeth as either extraction-worthy or preservable. For this purpose, teeth were cropped with different margins from PANs and annotated. The usefulness of the AI-based classification as well that of dentists was evaluated on a test dataset. In addition, the explainability of the best AI model was visualized via a class activation mapping using CAMERAS. RESULTS: The ROC-AUC for the best AI model to discriminate teeth worthy of preservation was 0.901 with 2% margin on dental images. In contrast, the average ROC-AUC for dentists was only 0.797. With a 19.1% tooth extractions prevalence, the AI model's PR-AUC was 0.749, while the dentist evaluation only reached 0.589. CONCLUSION: AI models outperform dentists/specialists in predicting tooth extraction based solely on X-ray images, while the AI performance improves with increasing contextual information. CLINICAL RELEVANCE: AI could help monitor at-risk teeth and reduce errors in indications for extractions.

Clinical experience improves academic outcomes in dental Oral surgery education.

INTRODUCTION: This paper aimed to determine if the level of a dental student's clinical experience in oral surgery influences the student's oral surgery academic outcomes. MATERIALS AND METHODS: The oral surgery clinical activity and academic outcomes for all students who completed their dental training in 2017, 2018, 2019 and 2020 from the University of Sydney were analysed for correlation. RESULTS: The clinical activity performed by 313 students was recorded. There was a weak, but statistically significant, Pearson correlation between total dental extractions and academic outcomes (r = .243, p = <.001). The total number of dental extractions performed was the only statistically significant variable on academic outcomes with linear regression analysis (ß = .227, p = .005; model R2  = .077). The increase of a student's clinical experience from less than 45 to more than 65 dental extractions raised their oral surgery academic results by an average of 6.4%. There were no academic benefits to earlier clinical experience. CONCLUSION: An increase in experience with dental extractions resulted in an increase in oral surgery academic outcomes, plateauing at 65 dental extractions. There was no academic advantage to dental student's having earlier clinical experience.

Expectations, Experiences and Perceptions of Oral and Maxillofacial Surgery Residents to Training in Nigeria.

PURPOSE: How surgical residents fare during their training could enhance job satisfaction and fulfilment post-training. But there is paucity of literature on the experiences of oral and maxillofacial surgery (OMS) trainees during residency training. The aim of this study was to report the expectations, experiences and perceptions of OMS residents towards training in Nigeria. METHODS: Cross-sectional study of OMS residents in accredited Nigerian training institutions was conducted between September and December, 2017. Study tool was adapted from that used for general surgery residents in the United States. Results were analysed using Microsoft Excel for Windows 10. RESULTS: Sixty-eight of seventy-three questionnaires were returned (response rate was 93%). More respondents were males (86.8%) than females (13.2%). 44.1% of all respondents were aged 35-39 years. Senior residents (n=31, 45.6%) were more than those in the junior cadre. The most important reason for choosing OMS residency training was for knowledge (72.1%) followed by the prospect of better pay (8.8%). Most residents believed their opinions were important (66.7%) and looked forward to their daily work (72.1%) but were dissatisfied with the didactic teaching aspect by consultants (57.3%) and felt the hours and stress of working were straining their family life, respectively (91.0% and 76.7%). CONCLUSION: Most OMS residents were happy and expected to gain knowledge from the training. However, some were dissatisfied with the training duration and level of didactic teaching by consultants and the impact of residency training on family life. There is need to improve didactic teaching and ensure adequate work/family balance for better OMS residency training in Nigeria.

Criterion for trismus in head and neck cancer patients: a verification study.

PURPOSE: Several cut-off points for trismus in head and neck cancer patients have been used. A mouth opening of 35 mm or less is most frequently used as cut-off point. Due to the variation in cut-off points, prevalence, risk factors and treatment outcomes of trismus cannot be studied in a uniform manner. To provide uniformity, we aimed to verify the cut-off point of 35 mm or less. Additionally, we aimed to determine associated covariates with reported difficulties when opening the mouth. METHODS: In a cross-sectional design, we measured the mouth opening in 671 head and neck cancer patients at the Department of Oral and Maxillofacial Surgery, at the University Medical Center Groningen. The cut-off point was determined using the receiver operating characteristic curve and Youden index, with reported difficulties when opening the mouth as criterion for trismus. Cut-off points for significant covariates were also determined. RESULTS: The Youden index was highest at 35 mm, with a sensitivity of 0.71 and a specificity of 0.86. Of the covariates analysed, type of treatment modality was significantly associated with reported difficulties when opening the mouth. The highest Youden index for patients treated with surgery alone was 37 mm and for patients treated with radiotherapy alone 33 mm. CONCLUSIONS: The cut-off point of 35 mm or less for trismus was confirmed in a head and neck cancer population and is recommended to be used in future studies. Patients receiving different treatment modalities experience difficulty when opening the mouth differently.

Tranexamic acid as a local hemostasis method after dental extraction in patients on warfarin: a randomized controlled clinical study.

OBJECTIVES: The present work is a controlled, blinded, and randomized clinical trial comparing hemostatic measures for the control of post-tooth extraction hemorrhage in patients on anticoagulation therapy with warfarin. MATERIALS AND METHODS: The sample consisted of 37 patients (37.8% male and 62.2% female) with a mean age of 45.5 years. After randomization, 20 patients were allocated to the control group (conventional hemostasis measures) and 17 to the study group (addition of local tranexamic acid). All variables that could influence the outcome were similar between the groups and no significant difference was seen (p > 0.05). RESULTS: In the assessment of immediate hemostasis, for the control group, the time to achieve cessation of bleeding was 9.1 (± 3.6) minutes. For the study group this was much lower, and this difference (6.018 / confidence interval of 95%, 4.677 to 7.359) was statistically significant (p < 0.001). In evaluating the control of intermediate hemorrhage, the use of tranexamic acid was more significantly associated with the absence of bleeding, especially in the first 24 h. CONCLUSIONS AND CLINICAL RELEVANCE: Thus, this measure of local hemostasis in topical form with gauze compression and irrigation was shown to be more effective in reducing the time to attain immediate hemostasis, and in preventing intermediate hemorrhage.

Preemptive Effect of Dexamethasone in Third-Molar Surgery: A Meta-Analysis.

The aim of the present study was to assess the effectiveness of preemptive dexamethasone in surgery of the lower third molars and to compare it with other oral anti-inflammatories. An electronic search was conducted for preemptive effects related to lower third-molar surgery in 3 separate databases. The variables pain, swelling, and trismus were assessed. Meta-analysis was used to calculate the pooled effect measures for mean and standard deviation values (95% confidence interval [CI]). Seven split-mouth clinical trials were selected. Two studies were included in the meta-analysis. Three studies showed a low risk of bias; 2 studies exhibited a moderate risk and 2 a high risk of bias. Dexamethasone was better than nonsteroidal anti-inflammatories for preemptive effectiveness. Meta-analysis for swelling confirmed better results for dexamethasone than for methylprednisolone after 2 days (95% CI = -1.28 to -0.38), 4 days (95% CI = -1.65 to -0.71), 7 days (95% CI = -1.42 to -0.71), and overall (95% CI = -1.25 to -0.72). Dexamethasone was better than methylprednisolone for mouth opening after 4 days (95% CI = 0.18 to 1.07). There is insufficient evidence through meta-analysis to conclude that dexamethasone is better than other nonsteroidal anti-inflammatories or methylprednisolone as a preemptive analgesic. The results of this meta-analysis suggest that dexamethasone is more effective than methylprednisolone for swelling and trismus.

[Low power laser as an adjuvant to paresthesia. report of two cases]. / Láser de baja potencia como coadyuvante a la parestesia. reporte de dos casos.

Tooth extraction or extraction is a common procedure in dental practice, although it is a common practice, it is not exempt from complications. Paraesthesia is defined as a neuropathy with altered sensations and permanent anesthesia. The case of two patients who attended the Department of Pathology at the Faculty of Dentistry with paresthesia is reported. Both were treated with low-power laser therapy, showing a significant improvement in their clinical condition. The application of low-power laser presents ideal benefits in various areas of the stomatological field. As it is a non-invasive, painless treatment and short sessions, the patient is encouraged to continue with the treatment until they are almost completely rehabilitated.

Magnetic resonance imaging for jawbone assessment: a systematic review.

PURPOSE: To evaluate the accuracy of magnetic resonance imaging (MRI) for jawbone assessment compared to reference-standard measurements in the literature. MATERIALS AND METHODS: An electronic database search was conducted in PubMed, EMBASE, Scopus, Web of Science, and the Cochrane Library in June 2022, and updated in August 2023. Studies evaluating the accuracy of MRI for jawbone assessment compared with reference-standard measurements (histology, physical measurements, or computed tomography) were included. The outcome measures included bone histomorphometry and linear measurements. The risk of bias was assessed by the Quality Assessment Tool for Diagnostic Accuracy Studies (QUADAS-2). The review was registered in the PROSPERO database (CRD42022342697). RESULTS: From 63 studies selected for full-text analysis, nine manuscripts were considered eligible for this review. The studies included assessments of 54 participants, 35 cadavers, and one phantom. A linear measurement error ranging from 0.03 to 3.11 mm was shown. The accuracy of bone histomorphometry varies among studies. Limitations of the evidence included heterogeneity of MRI protocols and the methodology of the included studies. CONCLUSION: Few studies have suggested the feasibility of MRI for jawbone assessment, as MRI provides comparable results to those of standard reference tests. However, further advancements and optimizations are needed to increase the applicability, validate the efficacy, and establish clinical utility of these methods.

Risk factors and longitudinal regenerative outcomes of sinus membrane perforation during lateral window sinus floor elevation: A retrospective analysis up to 9 years.

BACKGROUND: Lateral-window sinus floor elevation (LSFE) is a reliable procedure to reconstruct the posterior maxilla for implant therapy. This retrospective study aimed to investigate risk factors associated with Schneiderian membrane perforation (SMP) occurrence during LSFE and longitudinal regenerative outcomes following LSFE up to 9 years. METHODS: Patients who had LSFE between 2010 and 2019 were included. All demographic and surgical-related data were retrieved from existing electronic health records. Radiographs were used to evaluate the vertical dimensional changes of ridge and graft materials and the potential anatomic factors of SMP. RESULTS: A total of 122 LSFE procedures in 99 patients were included in the study. Mean ridge height gain and graft shrinkages were 9.5 ± 3.47 and 1.57 ± 2.85 mm. The influence of the healing period on graft shrinkage showed a positive trend; the longer the healing period, the greater the graft shrinkage (p = 0.09). The pathology in the sinus showed a positive correlation with SMP (p = 0.07). However, other anatomical factors did not negatively impact SMP and subsequent ridge height gain (p > 0.05). CONCLUSIONS: With inherent limitation, the findings with up to 9 years of follow-up indicate a consistent ridge remodeling lasting for about 3 years after LSFE procedures. SMP or membrane thickening may not significantly affect the ridge gain following LSFE. The healing period had the most significant influence on graft shrinkage, showing that the longer the healing time between LSFE and implant placement, the greater the graft shrinkage.

Oral and maxillofacial literature from Middle East: a bibliometric analysis and list of top-100 most cited articles.

OBJECTIVES: The aim of this work is to perform a bibliometric analysis on Middle Eastern oral and maxillofacial surgery through years and to compare the data with previous studies. A list of the top 100 most cited articles was generated. METHODS: A Pubmed bibliographic search for literature journals specialized in oral and maxillofacial surgery in the Middle East was performed. A graphic representation of authorship and keywords was created with VOSviewer. Mendeley and Microsoft Excel were used for tabulation and data visualization. A list of the top 100 most cited articles was created using Web of Science. Some statistical tests were performed with a 95% confidence interval, which was considered significant. RESULTS: A total of 6,536 articles were retrieved in fifteen selected oral and maxillofacial journals. A moderate correlation between number of publications and total population (R = 0.6052), low correlation with area (R = 0.302291), and a negligible correlation with the Human Development Index (HDI) were found (R = 0.1747). A disparity can be seen in the number of publications by country, leaded by Turkey (46.30%), Israel and Iran (13.68% each). The more common studied topic was oral surgery (25.77%), maxillofacial trauma (16.13%) and oral pathology (10.25%). CONCLUSIONS: A useful list of the top 100 most cited articles on oral and maxillofacial surgery from Middle East has been created. Middle East publications on oral and maxillofacial surgery can be considered high quality (IF = 1.879). Some issues on performing an adequate selecting of MeSH keywords were discussed.

Bilateral supernumerary maxillary fourth and fifth molars: A clinical case report and literature review.

Supernumerary teeth that are present in the molar region may be evident based on crowding and impaction, but most cases are asymptomatic and discovered as incidental findings during routine radiological examinations. This article reports the case of a 29-year-old woman who presented with a severe feeling of pressure in the region of the maxillary third molars that had been increasing in intensity for weeks. A clinical examination revealed crowding of the maxillary anterior teeth despite the completion of orthodontic treatment and an erupted third molar with localized gingivitis in the second quadrant. A radiographic examination revealed bilateral supernumerary maxillary fourth and fifth molars, so cone-beam computed tomography was performed to locate the supernumerary teeth precisely for a preoperative diagnosis and comprehensive treatment planning. This report presents the radiological and surgical case management of a rare case of bilateral supernumerary molars and reviews the literature regarding epidemiology and treatment options.

Prediction of post-traumatic neuropathy following impacted mandibular third molar removal.

OBJECTIVES: The extraction of impacted mandibular third molars is a common surgical procedure often associated with complications including post-traumatic neuropathy. Previous work has focused on identifying confounding factors, but a robust preoperative risk prediction model remains elusive. METHODS: Using a dataset of 648 patients and 812 impacted mandibular third molars, we used least absolute shrinkage and selection operator (LASSO) to fit prediction models based on risk factors assessed at both the tooth and patient levels. In addition, we fitted multivariable logistic regression models with the Firth correction for generalized estimating equations (GEE). RESULTS: The LASSO model for post-traumatic neuropathy identified distoangular impaction of ≥ 45° (odds ratio [OR] = 2.9), proximity to the inferior alveolar nerve of ≤ 3 mm (OR = 1.9), disadvantageous curving (OR = 1.4), and psychiatric conditions (OR = 2.1) as predictors [area under the receiving operator characteristic curve (AUC) = 0.75]. Among other complications analyzed, the LASSO model for bleeding identified deep embedding or full impaction (OR = 1.8), psychiatric conditions (OR = 1.3), and age (OR = 0.9) as predictors (AUC = 0.64). These associations between predictors and postoperative complications were fundamentally reinforced by the corresponding GEE models. CONCLUSIONS: Our findings point to the predictability of post-traumatic neuropathy and bleeding based on tooth anatomy and patient characteristics, overall suggesting that preoperatively identifiable factors can predict the risk of adverse outcomes in the extraction of impacted mandibular third molars. CLINICAL SIGNIFICANCE: Mandibular third molar extraction is both a routine procedure and a leading cause of trigeminal neuropathy. Prevention of post-traumatic neuropathy, aided by individualized preoperative risk prediction, is of high clinical relevance.

Dental students' OMFS-related experiences and interest in OMFS careers: An exploration.

PURPOSE: While the numbers of oral maxillofacial surgery (OMFS) residents increased over time, women and residents from underrepresented minority backgrounds are still underrepresented. The objectives were to assess dental students' OMFS-related personal and educational experiences and attitudes and explore which factors correlate with their interest in future OMFS careers. METHODS: Data were collected from 493 dental students in 1 dental school and 206 students from 15 other US and Canadian dental schools. RESULTS: The students in the national sample were more likely to have experienced an OMFS procedure themselves (64.6% vs. 50.7%; P = 0.001), have shadowed an OMFS in an operating room (23.2% vs. 14.9%; P = 0.009) prior to coming to dental school and to be much/very much interested in an OMFS career (36.4% vs. 12%; P < 0.001) than the students at the home school. While the majority of both groups rated their experiences with rotations in the OMFS department in the dental school (68% vs. 62.5%) and in the hospital (80.3% vs. 85.7%) as very interesting, the students in the national sample were more likely to agree/strongly agree that they were satisfied with their OMFS experiences (68.1% vs. 36.3%; P < 0.001) and had learned a lot from the OMFS faculty (57.9% vs. 30.8%) than the students in the home school. For both groups, the degree of interest in an OMFS career correlated with having had more personal OMFS experiences (home: r = 0.28; P < 0.001/other: r = 0.39; P < 0.001), more interesting OMFS experiences in the dental school (r = 0.23; P < 0.05/r = 0.40; P < 0.001) and the hospital (0.33; P < 0.05/r = 0.50; P < 0.001) and more positive attitudes toward OMFS faculty (r = 0.26; P < 0.001/r = 0.37; P < 0.001). CONCLUSIONS: Positive personal and educational OMFS experiences and positive attitudes toward OMFS faculty were associated with an interest in OMFS careers. These findings provide a basis for developing educational interventions aimed at increasing the percentage of women and residents from URM backgrounds in OMFS programs.

[Clinical observation of three-dimensional printing donor tooth model in peri-operative period of autotransplantation of tooth].

Objective: To prepare a three-dimensional (3D) printing donor tooth model and to observe its application in the peri-operative period. Methods: In part one, 192 cases (2017.9-2019.8) from Department of Oral & Maxillofacial Surgery, School of Stomatology, The Fourth Military Medical University ï¼»107 males and 85 females, age (34.2±10.7) yearsï¼½ which need autotransplantation of teeth (ATT) were collected. Whether the donor teeth can be completely extracted was predicted through clinical and imaging examination (first prediction). The second prediction was supplemented by the three-dimensional printing model of the donor teeth. Each of the prediction was compared with the actual results and the coincidence rate was calculated. In part two, 64 cases (2017.9-2019.8) from Department of Oral & Maxillofacial Surgery, School of Stomatology, The Fourth Military Medical University ï¼»28 males, 36 females, age (30.2±8.3) yearsï¼½ which need ATT were randomly divided into the model group and the donor group. The time of alveolar fossa preparation, time of donor tooth in vitro, times of trial implantation and time of pulptomy and root canal location were recorded respectively. Results: In part one, the coincidence rate between the second prediction and the actual results ï¼»97.4%(187/192)ï¼½ was significantly higher than that of the first prediction ï¼»93.2%(179/192)ï¼½ (P<0.05). In part two, the preparation time of the alveolar fossa in the maxillary and mandibular were (18.8±4.6) and (22.7±3.4) min, the time of the teeth in vitro were (3.0±0.6) and (2.1±0.6) min, the times of trial implantation were (1.3±0.8) and (1.0±0.9), and the time of pulpotomy and root canal location were (4.3±0.6) and (4.0±0.5) min. All values in the model groups were better than those in the donor group (P<0.05). Conclusions: The 3D printing model is accurate. It can be used in autogenous tooth transplantation to shorten the preparation time of alveolar fossa and time of donor tooth in vitro, and reduce the times of trial implantation of donor teeth, and to help to improve the prediction accuracy of complete extraction of donor teeth and the time of pulpotomy and root canal location.

[Common characteristics of temporomandibular joint surgery and orthognathic surgery].

Orthognathic surgery and temporomandibular joint (TMJ) surgery are two relatively independent disciplines in oral and maxillofacial surgery. Dentofacial deformities and TMJ diseases commonly coexist. The diagnosis and treatment of the diseases with coexisting dentofacial deformities and TMJ disorders is complex. Thus it is very important to comprehensively understand the common characteristics of orthognathic and TMJ surgery, which places a greater demand on oral and maxillofacial surgeons. The present work focuses on our thinking on common characteristics of TMJ and orthognathic surgery based on the managements of these diseases.

Does the Angulation of an Impacted Mandibular third Molar Affect the Prevalence of Preoperative Pathoses?

STATEMENT OF THE PROBLEM: The removal of a third molar tooth associated with a pathological condition is usually an easy decision. However, it is necessary for clinicians to know about the prevalence of preoperative pathologies associated with impacted mandibular third molars to the identification of the prophylactic approach to be applied to symptom-free impacted third molars. PURPOSE: The objective was to investigate the effect of the angulation of impacted mandibular third molars on the prevalence of associated pathologies. MATERIALS AND METHOD: In this retrospective study, we examined the panoramic radiographs of 954 patients referred for impacted third molar surgery. A total of 1598 impacted mandibular third molar teeth were included in the study. Pathological conditions included the caries on distal surface of the adjacent second molar, caries on impacted mandibular third molars, bone loss distal to the adjacent second molar, the radiolucent area distal to the impacted mandibular third molar were determined. RESULTS: Caries were observed more in the impacted third molar (18.9%) compared to the adjacent second molar (15.8%). The radiolucent area on distal surface of the impacted mandibular molar was 11%, while the periodontal bone loss distal to the adjacent second molar was 4.9%. Mesioangular-impacted mandibular third molars had high risk of caries development on second and third molar. The prevalence of periodontal tissue damage to the adjacent second molar was higher in horizontal and mesioangular angulation. Vertical and distoangular-impacted mandibular third molars had high risk for bone loss at distal aspect. CONCLUSION: The prevalence rate of pathological conditions in mesioangular impacted teeth was higher.

Anxiety and dental treatments in a hospital in Lima, Peru / Ansiedad y tratamientos dentales en un hospital de Lima, Perú

Background: The dental treatment anxiety affects patient care consultation, regardless of the dental specialty, each with own treatment acts. Objective: To determine the anxiety level of dental treatment of operative dentistry and oral surgery in a hospital of Lima. Methods: The study was conducted in the specialties of operative dentistry and oral surgery, with 72 patients from each specialty, chosen at random over a period of five months, through their answers at Beck Anxiety Inventory. Results: The level of anxiety of patients was similar in the two specialties (p = 0.402). No statistical significant difference was found between anxiety and the patient's sex (p = 0.06), nor with the age of the patient (p = 0.08), nor with the sex of the operator (p = 0.521). The higher frequency of anxiety was the minimum level, 86.1% in operative dentistry and 79.2% in oral surgery. A difference was found between anxiety levels of patients from each specialty (p < 0.001). Conclusions: The frequency of anxiety before entering the specialty was similar, minimum level. Other research is required to determine whether the degree of anxiety is related to the patient's care to dental specialties services.

Introducción: la ansiedad ante un tratamiento odontológico repercute en la asistencia de los pacientes a consulta, independientemente de la especialidad odontológica, cada una con actos propios de tratamiento. Objetivo: determinar el nivel de ansiedad ante el tratamiento de operatoria dental y de cirugía bucal en un hospital de Lima, Perú. Métodos: el estudio fue realizado en las especialidades de operatoria dental y cirugía bucal, con 72 pacientes de cada especialidad, elegidos de manera aleatoria durante un periodo de cinco meses, quienes respondieron el Inventario de Ansiedad de Beck. Resultados: el nivel de ansiedad de los pacientes fue similar en las dos especialidades (p = 0.402). No hubo diferencias entre ansiedad y sexo del paciente (p = 0.06), entre ansiedad y la edad del paciente (p = 0.08), y tampoco con el sexo del operador (p = 0.521). El nivel de ansiedad predominante en todos los pacientes, fue mínimo, 86.1% en operatoria dental y 79.2% en cirugía bucal. Al comparar por separado los niveles de ansiedad de los pacientes de cada especialidad, hubo diferencias en cada caso (p < 0.001). Conclusiones: el nivel de ansiedad antes de entrar a la especialidad de operatoria dental y cirugía bucal fue similar, mínimo. Se deben realizar otras investigaciones para establecer si el grado de ansiedad se relaciona con la asistencia del paciente a los servicios de especialidades odontológicas.

Epidemiología de padecimientos frecuentes en cirugía maxilofacial: Hospital General Regional No. 1, Tijuana / Epidemiology of frequent conditions in maxillofacial surgery: Hospital General Regional No. 1, Tijuana

Introducción: uno de los servicios que el IMSS ofrece a sus derechohabientes es la cirugía maxilofacial; sin embargo, existen pocos estudios en esta área, que nos puedan proporcionar información acerca de la epidemiología de los tratamientos realizados. Objetivo: conocer la epidemiología de las intervenciones quirúrgicas en Cirugía Maxilofacial remitidas de diferentes Unidades de Medicina Familiar (UMF) al Hospital General Regional No.1 (HGR No.1) del turno vespertino en Tijuana, Baja California, México. Material y métodos: estudio descriptivo retrospectivo basado en revisión de «expedientes clínicos electrónicos¼. Se revisaron 2,945 expedientes, de los que se obtuvieron datos generales, UMF y diagnóstico, registrados bajo la plataforma Expediente Clínico Electrónico y Sistema de Información de Medicina Familiar. Se confeccionó un documento con los expedientes analizados. Fueron excluidos pacientes que no cumplieron con un diagnóstico definido por el cirujano maxilofacial o presentaron inasistencia. Debido a la pandemia por SARS-CoV-2 se excluyeron algunos meses. La muestra final la integraron 2,452 pacientes. Resultados: el 2019 fue el año con el mayor número de registros. Predomina el género femenino. La mediana de edad en el estado es 30 años, relacionando el diagnóstico más común «dientes incluidos¼ coincide con la edad predominante entre 20 y 44 años. La UMF 27 remitió más pacientes a hospital. Conclusión: estomatología y médicos familiares pueden hacer envíos a hospitales. El HGR No.1 no cuenta con el instrumental adecuado, el servicio se satura constantemente, es demasiada la demanda, continuamos con poco instrumental y falta de personal (AU)

Introduction: one of the services that the IMSS offers to its beneficiaries it is maxillofacial surgery; however, there are few studies in this area that can provide us with information about the epidemiology of the treatments carried out. Objective: to know the epidemiology of surgical interventions in Maxillofacial Surgery referred from different Family Medicine Units (UMF) to the Hospital General Regional No.1 (HGR No.1) of the evening shift in Tijuana, Baja California, México. Material and methods: retrospective descriptive study based on the review of «Electronic Clinical Files¼. 2,945 records were reviewed, obtaining general data, UMF and diagnosis, registered under the platform Electronic Clinical Record (ECE) and Family Medicine Information System (SIMF). Prepared a document with the files analyzed. Patients who did not meet a diagnosis defined by the Maxillofacial Surgeon or who were absent were excluded. Due to the SARS-CoV-2 pandemic, some months were excluded. The final sample was 2,452 patients. Results: 2019 was the year with the highest number of records. The female gender predominates. The median age in the state is 30 years, relating the most common diagnosis «included teeth¼ coincides with the predominant age between 20 and 44 years. UMF 27 referred more patients to hospital. Conclusion: stomatology and family doctors can make referrals to hospitals. HGR No.1 does not have adequate instruments, the service is constantly saturated, the demand is too high, we continue with few instruments and lack of personnel (AU)