Facial dog bites in children: A public health problem highlighted by COVID-19 lockdown.

BACKGROUND: Stay-at-home injunction during COVID-19 pandemic led to new dynamics in households and increased the risk of domestic accidents involving pets. The aim of the study was to demonstrate an increase of facial dog bites in children during first lockdown period in France, compared to the same period in 2018 and 2019. Secondary objective was to investigate the demographics and circumstances in which dog bites occurred. METHODS: A retrospective multicentric study was conducted nationwide. Patients under 18 years old managed in fifteen oral and maxillofacial surgery departments for a dog bite were included. RESULTS: Eighty-seven patients were included. A significant increase of the number of children managed for facial dog bite was noticed in 2020 (p=0.0005). The male-to-female ratio was significantly reversed in 2020 with more bites in girls than boys (p=0.02). In 2020, children were mostly bitten to cheeks (28.6 %), lips-and-chin region (26.2 %), and eyelids (23.8 %). Severe bites increased in 2020, in comparison with 2018 and 2019. Dog bites occurring while petting or playing significantly increased in 2020 (31 %) (p=0.03). CONCLUSION: The process leading to bites is highly dependent on the balance of dog-owner relationship. This was strongly disrupted during COVID-19 pandemic, resulting in the increase of dog bites in households. Regarding dog bites, face is the most vulnerable area in children. Its injury has lots of esthetic and functional consequences and maxillofacial surgeons have a key role to play in their prevention. Reminders of some of these management and prevention strategies are presented in this article.

Does 3D stereoscopy support anatomical education?

PURPOSE: The teaching of anatomy in medical education has historically been based on lectures, cadaveric dissections, and illustrated books for students. Stereoscopic 3D videos are now easily accessible via smartphone and affordable for students. This study aimed to investigate whether a 3D stereoscopic instruction video could improve learning over 2D video. METHODS: A prospective controlled study on a single-site was conducted at the University of Angers. Content knowledge was assessed, followed by the presentation of an instructional neuroanatomy video. Participants watched the video in either 3D or 2D format, then they completed an anatomy written test. Pre-video and post-video performances were analyzed with independent t tests on total score, fundamental anatomical knowledge, anatomical relationships and reasoning. RESULTS: 175 subjects completed the study. At baseline, the 3D (n = 91) and 2D (n = 86) groups were similar, in age and class level. 3D and 2D scores were similar in the pre-test session and in the fundamental knowledge post-test (mean 73.2% vs 74.4%, p = 0.37). Average scores for the 3D group were better for the post-test regarding anatomical relationships (mean 86.4% vs. 63.5%, p = 0.004), clinical inference/reasoning (mean 76.8% vs. 67.6%, p = 0.023) and total note (mean 76.8% vs. 67.6%, p = 0.07). Regarding the 3D student's satisfaction questionnaire (n = 91), 70 students (77%) agreed that the stereoscopic video allowed good 3D visualization of anatomical structures. The student enjoyed using the stereoscopic video (n = 75, 82.5%). Most students supported the use of this kind of stereoscopic 3D video in their normal teaching as a complementary tool (n = 78, 85%). CONCLUSIONS: The incorporation of 3D videos as ancillary teaching into curricula could be of interest to improve the knowledge of anatomical relationships and reasoning among students.

Mandibular bone effects of botulinum toxin injections in masticatory muscles in adult.

OBJECTIVE: Botulinum toxin (BTX) is injected into masticatory muscles to treat various conditions. Animal studies have demonstrated bone loss at the condylar and alveolar regions of the mandible after BTX injection into masticatory muscles. The aim of the present study was to investigate mandibular bone changes in patients who received BTX injections in masticatory muscles. STUDY DESIGN: Twelve adult patients who received BTX injections into masticatory muscles were included in this study. Cone beam computed tomography (CBCT) was performed before and 12 months after the injection. The condylar and alveolar regions of the mandible were analyzed by using texture analysis of the CBCT images with the run length method. Condylar cortical thickness was measured, and 3-dimensional analysis of the mandible was also performed. Six patients who did not receive BTX injections were used as controls. RESULTS: A run length parameter (gray level nonuniformity) was found to be increased in condylar and alveolar bones. A significant cortical thinning was found at the anterior portion of the right condyle. Three-dimensional analysis showed significant changes in the condylar bone and at the digastric fossa. No changes in mandibular angles were found. CONCLUSIONS: This study identified mandibular bone changes in adult patients who received BTX injection into masticatory muscles.