A survey regarding the organizational aspects and quality systems of in-house 3D printing in oral and maxillofacial surgery in Germany.

PURPOSE: The aim of the study was to get a cross-sectional overview of the current status of specific organizational procedures, quality control systems, and standard operating procedures for the use of three-dimensional (3D) printing to assist in-house workflow using additive manufacturing in oral and maxillofacial surgery (OMFS) in Germany. METHODS: An online questionnaire including dynamic components containing 16-29 questions regarding specific organizational aspects, process workflows, quality controls, documentation, and the respective backgrounds in 3D printing was sent to OMF surgeons in university and non-university hospitals as well as private practices with and without inpatient treatment facilities. Participants were recruited from a former study population regarding 3D printing; all participants owned a 3D printer and were registered with the German Association of Oral and Maxillofacial Surgery. RESULTS: Sixty-seven participants answered the questionnaires. Of those, 20 participants ran a 3D printer in-unit. Quality assurance measures were performed by 13 participants and underlying processes by 8 participants, respectively. Standard operating procedures regarding computer-aided design and manufacturing, post-processing, use, or storage of printed goods were non-existent in most printing units. Data segmentation as well as computer-aided design and manufacturing were conducted by a medical doctor in most cases (n = 19, n = 18, n = 8, respectively). Most participants (n = 8) stated that "medical device regulations did not have any influence yet, but an adaptation of the processes is planned for the future." CONCLUSION: The findings demonstrated significant differences in 3D printing management in OMFS, especially concerning process workflows, quality control, and documentation. Considering the ever-increasing regulations for medical devices, there might be a necessity for standardized 3D printing recommendations and regulations in OMFS.

An update on the current training situation of German interns in oral and maxillofacial surgery at special times in 2021.

The aim of this study was to evaluate the current state of training of German interns in oral and maxillofacial surgery (OMFS) under the influence of the COVID-19 pandemic in 2021. A previously tested questionnaire consisting of 53 questions was sent to interns in German OMFS (non-) university hospitals and private practices as an online survey. The questionnaire was adapted to current topics, such as the ongoing COVID-19 pandemic, aspects concerning nighttime and weekend services, overtime hours, surgical logbooks, benefits of academic degrees and support for scientific activities, part-time employment, parental leave and childcare. Next, results of questions from before the COVID-19 pandemic were re-evaluated. The COVID-19 pandemic influenced the clinical work (71.83%) and the current state of training (68.64%) in OMFS of most participants. Nighttime and weekend services are possible for employees in possession of only one degree (87.93% with a medical degree) in most hospitals. Not having one or both doctorate degrees was considered to be a disadvantage by 54.95%. In all, 42.11% of the participants attested to a positive influence of research on their training situation, and 50% reported financial or non-financial research support from the employer. Part-time employment was possible for 78.81% of the participants. The course of training was interrupted more often for women due to parental or maternity leave (10.53% of men and 30.95% of women). A total of 40.71% of the participants reported that childcare was available at the hospital, theoretically. The state of OMFS training in Germany can be referred to as positive. Current and future challenges are diverse, including aspects originating from the ongoing COVID-19 pandemic, gender aspects, reconciliation of family and work, and flexible working hours. Addressing these topics will ensure OMFS training at the highest surgical level and further increase interns' satisfaction, preserving the specialty's popularity and reception.

3D printing in oral and maxillofacial surgery: a nationwide survey among university and non-university hospitals and private practices in Germany.

OBJECTIVES: Oral and maxillofacial surgery (OMFS) has undergone pioneering progress through the development of three-dimensional (3D) printing technologies. The aim of this study was to evaluate the use of 3D printing at OMFS university and non-university hospitals and private practices in Germany. MATERIALS AND METHODS: For explorative assessment, a dynamic online questionnaire containing 10-22 questions about the current use of 3D printing and the reasons behind it was sent to OMFS university and non-university hospitals and private practices in Germany by the study group from the German Association of Oral and Maxillofacial Surgery (DGMKG). RESULTS: In total, 156 participants responded from university (23 [14.7%]) and non-university hospitals (19 [12.2%]) and private practices without (85 [50.5%]) and with 29 (18.6%) inpatient treatment facility. Highest applications of 3D printing were in implantology (57%), microvascular bone reconstructions (25.6%), and orthognathics (21.1%). Among the participants, 37.8% reportedly were not using 3D printing. Among the hospitals and private practices, 21.1% had their own 3D printer, and 2.5% shared it with other departments. The major reason for not having a 3D printer was poor cost efficiency (37.6%). Possessing a 3D printer was motivated by independence from external providers (91.3%) and rapid template production (82.6%). The preferred printing methods were stereolithography (69.4 %) and filament printing (44.4%). CONCLUSIONS: OMFS 3D printing is established in Germany with a wide range of applications. CLINICAL RELEVANCE: The prevalence of 3D printing in hospitals and private practices is moderate. This may be enhanced by future innovations including improved cost efficiency.

Managing mucormycosis in diabetic patients: A case report with critical review of the literature.

BACKGROUND AND PURPOSE: Rhino-orbito-cerebral mucormycosis (ROCM) is a rare and potentially fatal invasive fungal infection which usually occurs in diabetic and other immunocompromised patients. This infection is associated with high morbidity and mortality rates. Prompt diagnosis and rapid aggressive surgical debridement and antimycotic therapy are essential for the patient's survival. Herein, we reviewed the localization and treatment strategies in patients with ROCM and diabetes as an underlying condition. Furthermore, we report one case of ROCM in our department. MATERIALS AND METHODS: From 117 identified studies published in PubMed, 14 publications-containing data from 54 patients-were included. All patients were diagnosed clinically and by histopathological and/or bacteriological analysis for ROCM caused by the order Mucorales. CONCLUSION: Uncontrolled diabetes mellitus is one of the main risk factors for ROCM. A successful management of ROCM requires an early diagnosis, a prompt systemic antifungal therapy, and a rapid aggressive surgical debridement including exploration of the pterygopalatine fossa. An orbital exenteration may be necessary.

Training in oral and maxillofacial surgery in Germany - Residents' satisfaction and future challenges.

The aim of this study was to analyze the current situation of trainees in OMFS in a nationwide survey at German universities and teaching hospitals. A questionnaire about their training in OMFS and discrimination, gender (in-)equality, and reconcilability of work and family life was sent to many OMFS residents in Germany. Seventy-five questionnaires were included. The average age of the participants was 32.15 years (± 0.75 years); 47 participants were male, 22 female, and 3 "diverse". The participants' overall satisfaction rate was good. Training concepts existed in most of the teaching hospitals (54.67%). 8.11% of the participants stated discrimination existed against men while, 24.32% agreed that discrimination existed against women. Stating that discrimination against women exists, it was associated with female gender (p < 0.001), being married (p = 0.042), and not aiming for further academic degrees (p = 0.009). Overall, the training situation in Germany seems structured in most teaching hospitals. Apart from the residents' general satisfaction with the training concepts, there seems to be a matter of concern regarding discrimination especially against women and the reconcilability of work and family life in OMFS training. Furthering the establishment of structured training concepts might be useful to overcome these issues in the course of training in OMFS.