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1.
Zhonghua Kou Qiang Yi Xue Za Zhi ; 56(9): 939-944, 2021 Sep 09.
Artigo em Chinês | MEDLINE | ID: mdl-34496546

RESUMO

At present, robotic system has been applied in many aspects of the field of prosthetic dentistry, such as tooth preparation, oral implant surgery, full denture arrangement, prosthodontic material testing and robotic education of prosthodontics. The advantages of prosthodontic robotics lie in their ability to perform quantitative and precise operations whilerepeating the work flow indefinitely, which assist dentists to complete heavy and complicated daily treatment. In the research and development of prosthodontic robotics, the limitation of oral operation space should be fully considered, and robotics should have high safety and flexibility. The review briefly summarizes the application and existing problems of robotics in prosthodontics, and provides references for further development and design.


Assuntos
Prostodontia , Cirurgia Bucal , Odontólogos , Humanos , Preparo do Dente
2.
Oral Maxillofac Surg Clin North Am ; 33(4): 491-503, 2021 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-34565512

RESUMO

Medical training in the United States has undergone multiple evolutions and maturations. The Flexner Report and its effects, written in 1910, still has significant impact on modern professional education in the medical and dental arenas. The National Academy of Medicine (Institute of Medicine) in 2003 documented the need for diversity in the health care workforce, and the Association of American Medical Colleges additionally looked at Medical Education and health care through the lens of Academic Medicine. Both these reports reflected that health care institutions, providers, educators, students, and surgical residents are mandated to improve the health of the nation.


Assuntos
Especialidades Cirúrgicas , Cirurgia Bucal , Humanos , Estados Unidos
3.
J Oral Maxillofac Surg ; 79(8): 1587-1590, 2021 08.
Artigo em Inglês | MEDLINE | ID: mdl-34334169
4.
Rev. Odontol. Araçatuba (Impr.) ; 42(2): 52-55, maio-ago. 2021. ilus
Artigo em Português | LILACS, BBO - Odontologia | ID: biblio-1283891

RESUMO

Pacientes com históricos de defeitos ósseos provocados por infecções, malformação congênita, neoplasias, deformação por iatrogenia, radioterapia e trauma buscam contornos faciais mais harmônicos através da reabilitação cirúrgica. Para facilitar a reconstrução maxilofacial dois grupos de materiais podem ser utilizados, os enxertos ósseos e os materiais aloplásticos. O objetivo é relatar um caso incomum de infecção e exposição de material utilizado para enxertia a base de polimetilmetacrilato, bem como a sua posterior reabordagem cirúrgica. Embora o Polimetilmetacrilato aparente ser seguro, ele exibe complicações diversas em função da imunologia do hospedeiro, que poderá reagir de diferentes formas. Desse modo, faz-se necessário ressaltar a importância da prevenção e proservação de cada caso de forma individualizada(AU)


Patients with a history of bone defects caused by infections, congenital malformation, neoplasms, iatrogenic deformation, radiotherapy and trauma seek more harmonious facial contours through surgical rehabilitation. To facilitate maxillofacial reconstruction, two groups of materials can be used, bone grafts and alloplastic materials. The objective is to report an unusual case of infection and exposure of material used for grafting with polymethylmethacrylate, as well as its subsequent surgical approach. Although Polymethylmethacrylate appears to be safe, it exhibits different complications depending on the host's immunology, which may react in different ways. Thus, it is necessary to emphasize the importance of preventing and preserving each case individually(AU)


Assuntos
Humanos , Feminino , Pessoa de Meia-Idade , Transplante Ósseo , Polimetil Metacrilato , Traumatismos Maxilofaciais , Órbita , Cirurgia Bucal , Zigoma , Materiais Biocompatíveis , Doença Iatrogênica , Maxila
5.
Oral Maxillofac Surg Clin North Am ; 33(4): 475-480, 2021 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-34389228

RESUMO

The COVID-19 pandemic altered all facets of society on a fundamental level, impacting work, mental health, and family life. Female surgeons experienced gender inequity and bias before COVID; therefore, women in oral and maxillofacial surgery (OMS) were affected disproportionately by the repercussions of the pandemic. Well-established inequalities are intensified during times of crisis. This article enlightens readers regarding the preexisting inequalities in the OMS specialty, how the COVID-19 pandemic exacerbated these ubiquitous issues, and how the specialty should accommodate these inequities moving forward.


Assuntos
COVID-19 , Cirurgia Bucal , Feminino , Humanos , Cirurgiões Bucomaxilofaciais , Pandemias , SARS-CoV-2 , Inquéritos e Questionários
6.
Oral Maxillofac Surg Clin North Am ; 33(4): 467-473, 2021 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-34364748

RESUMO

Oral and maxillofacial surgeons experience high levels of stress and work-home conflict, which predispose them to burnout. There is emerging evidence in support of work-life integration to prevent burnout; interventional strategies exist on an individual and organizational level. This article explores the current evidence on promoting work-life integration for improved surgeon satisfaction, performance, and efficiency. Work-life integration initiatives can help promote the recruitment and retention of a diverse surgical workforce in oral and maxillofacial surgery.


Assuntos
Esgotamento Profissional , Cirurgia Bucal , Esgotamento Profissional/prevenção & controle , Humanos , Satisfação no Emprego , Cirurgiões Bucomaxilofaciais , Equilíbrio Trabalho-Vida
7.
Oral Maxillofac Surg Clin North Am ; 33(4): 505-513, 2021 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-34364749

RESUMO

The diversity bonus theorem developed by Scott Page postulates that in specific environments, diversity is an absolute necessity to creating the most successful team. The theorem dispels the myth that institutions must choose between diversity and excellence. Within oral and maxillofacial surgery, this bonus is captured through expanded access to care, more equitable and relevant research, and attracting the best and brightest to the specialty. To capture the bonus, oral and maxillofacial surgery must invest in policy changes to admissions and hiring practices, and offer training in communication, cultural competency, and implicit bias.


Assuntos
Diversidade Cultural , Cirurgia Bucal , Humanos
8.
Oral Maxillofac Surg Clin North Am ; 33(4): 429-433, 2021 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-34389229

RESUMO

The author explores gender issues related to oral and maxillofacial training programs and the role that accreditation should have to ensure gender equity, antidiscrimination, and support of women in the profession of oral and maxillofacial surgery.


Assuntos
Internato e Residência , Cirurgia Bucal , Acreditação , Feminino , Humanos , Relações Interpessoais , Inquéritos e Questionários , Estados Unidos
10.
Br Dent J ; 230(12): 823-830, 2021 06.
Artigo em Inglês | MEDLINE | ID: mdl-34172869

RESUMO

Introduction Dentistry is progressing into person-centred care and away from a paternal approach. Effective verbal and written communication are crucial to allow this collaboration; however, misunderstanding of terminology can lead to confusion, poor decision-making and poor health outcomes.Methods A voluntary questionnaire with multiple-choice and short-answer questions was given to patients attending the NHS Lothian Oral Surgery and Oral Medicine Department over two weeks; 137 were completed. Eighteen terms were assessed, including: ulcer, local anaesthetic, impacted tooth, radiograph, sedation, biopsy, mucosa and benign. Exclusion criteria were non-English speakers who required a translator.Results The multiple-choice questions revealed that terms such as 'blister' and 'local anaesthetic' are relatively well understood. Other terms, such as mucosa, were poorly understood. Over a third of patients confused 'sedation' with general anaesthetic. Short-answer questions revealed a wide range of answers. 'Biopsy' and 'radiograph' were generally better understood compared to other terms. Demographics, educational background and English as a first language appeared to have an influence on understanding.Conclusion Patients had a varied understanding of terminology. Incorrect interpretation of words may lead to ill-informed decision-making or unnecessary concern. It is essential that challenging terminology is identified and explained at an understandable level.


Assuntos
Medicina Bucal , Procedimentos Cirúrgicos Bucais , Cirurgia Bucal , Humanos , Idioma , Inquéritos e Questionários
11.
Anesth Prog ; 68(2): 94-97, 2021 06 01.
Artigo em Inglês | MEDLINE | ID: mdl-34185856

RESUMO

Laryngeal granuloma development can be a postoperative complication of laryngeal trauma or irritation resulting from general anesthesia and endotracheal intubation. These rare benign lesions are located primarily over the cartilaginous portions of the larynx, particularly the vocal processes of the arytenoids. Airway manipulation during the intubation process and prolonged intubation periods can be contributing factors to intubation-related laryngeal granulomas, which may manifest 1 to 4 months after intubation. The patient in this case was a female who returned with complaints of throat pain without hoarseness or sensations of a "lump in her throat" 3 months following surgery, during which she was intubated with a 7.0-mm nasotracheal tube for 30 hours, likely contributing to her bilateral laryngeal granulomas. The patient underwent successful conservative medical management consisting of a proton pump inhibitor and an inhaled corticosteroid.


Assuntos
Granuloma Laríngeo , Laringe , Cirurgia Bucal , Feminino , Granuloma Laríngeo/diagnóstico , Granuloma Laríngeo/etiologia , Rouquidão/etiologia , Humanos , Intubação Intratraqueal/efeitos adversos
12.
Anesth Prog ; 68(2): 114-116, 2021 06 01.
Artigo em Inglês | MEDLINE | ID: mdl-34185860

RESUMO

The incidence of childhood-onset Basedow's (Graves') disease is approximately 5% of all cases. Herein, we report a teenage female patient diagnosed with childhood-onset Graves' disease immediately following general anesthesia. Her signs and symptoms included tachycardia immediately prior to general anesthesia, delirium upon emerging from anesthesia, persistent postoperative tachycardia and anxiety, and prolonged nausea and vomiting.


Assuntos
Doença de Graves , Cirurgia Bucal , Adolescente , Anestesia Geral/efeitos adversos , Feminino , Humanos
13.
J Pak Med Assoc ; 71(4): 1197-1199, 2021 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-34125771

RESUMO

OBJECTIVE: To evaluate the existing practices of obtaining and documenting informed consent in cases of oral and maxillofacial surgery. METHODS: The cross-sectional study was conducted from April to June 2017 at the Oral and Maxillofacial Surgery departments of five teaching hospitals of Rawalpindi and Islamabad, Pakistan, and comprised patients who underwent surgery under general anaesthesia. Data was collected using questionnaire-based interviews a day after the surgery in each case regarding multiple aspects of the informed consent practices. Data was analysed using SPSS 21. RESULTS: Of the 100 patients, 58(58%) were males and 42(42%) were females, while 81(81%) were adults aged >18 years. In 42(42%) cases, the consent document was signed by the patient, and by a relative in 38(38%) cases. In the remaining 20(20%) cases, only verbal consent was taken. In 54(54%) cases nursing staff and in 46(46%) cases residents took the consent. Most patients were informed about nature of their disease 87(87%), proposed treatment 86(86%) and type of anaesthesia 100(100%). Fewer patients were informed about any alternative treatments 38(38%), and possible complications of the surgery 51(51%) or anaesthesia 26(26%). Overall, 44(44%) patients did not fully understand the written information, and 23(23%) said they were encouraged to ask questions. CONCLUSIONS: The quality of informed consent practices was found to be sub-optimal in oral and maxillofacial surgery setups.


Assuntos
Anestesiologia , Cirurgia Bucal , Adulto , Estudos Transversais , Feminino , Humanos , Consentimento Livre e Esclarecido , Masculino , Paquistão/epidemiologia , Inquéritos e Questionários
14.
Shanghai Kou Qiang Yi Xue ; 30(2): 206-209, 2021 Apr.
Artigo em Chinês | MEDLINE | ID: mdl-34109364

RESUMO

PURPOSE: To evaluate the sedative effect of dexmedetomidine in awake intubation and its influence on swallowing function. METHODS: Fifty patients with awake intubation in oral and maxillofacial surgery were randomly divided into two groups: dexmedetomidine(DEX) group and midazolam+fentanyl(MF) group. 15 min before intubation, patients in DEX group were intravenously given 50 mL dexmedetomidine(1.0 µg/kg), and others in MF group were intravenously given 50 mL normal saline respectively. 5 min before intubation, 10 mL normal saline was given to DEX group, 0.02 mg/kg midazolam and 2.0 µg/kg fentanyl were given to MF group. HR, MAP, RR, SpO2, Ramsay sedation score and swallowing time were measured at different time points (before induction-T0, before intubation-T1 and after intubation-T2). SPSS 20.0 software package was used for data analysis. RESULTS: There was no significant difference in HR, RR, MAP, SpO2 and swallowing time between the two groups at T0 time point(P>0.05). Compared with MF group, HR significantly decreased and swallowing time significantly shortened(P<0.05). RR, MAP, SpO2 and Ramsay sedation score had no significant difference (P>0.05) in DEX group at T1 time point. Compared with MF group, HR significantly decreased and Ramsay sedation score significantly increased(P<0.05); RR, MAP and SpO2 had no significant difference (P>0.05) in DEX group at T2 time point. Compared with T0 time, HR significantly decreased and swallowing time significantly prolonged (P<0.05); RR, MAP and SpO2 had no significant difference(P>0.05) in DEX group at T1 time point. Compared with T1 time, Ramsay sedation score decreased with significant difference(P<0.05) at T2 time point. CONCLUSIONS: Dexmedetomidine can provide good sedative effect for patients with awaking intubation without obvious inhibitory effect on swallowing reflex of patients, improving the safety of intubation.


Assuntos
Dexmedetomidina , Cirurgia Bucal , Deglutição , Humanos , Hipnóticos e Sedativos , Intubação Intratraqueal
15.
Evid Based Dent ; 22(2): 74-75, 2021 01.
Artigo em Inglês | MEDLINE | ID: mdl-34172914

RESUMO

Design Cross-sectional study/special report.Study population This paper presents the early experience of the oral and maxillofacial surgery department at Hadassah University Medical Centre in Jerusalem during the first wave of the COVID-19 pandemic in 2020. The study involved both medical staff and patients.Data analysis A retrospective analysis of an eight-week period (February-April 2020) collated 1,471 patient records and examined diagnoses, procedures performed and COVID-19 status of patients and staff. Any attempts made to access routine dental care before presentation in secondary care were recorded.Results In the study period, one member of staff was confirmed as COVID-19-positive. Sixty-three patients had formal COVID-19 tests; all were negative. Forty-three patients were admitted for drainage of odontogenic fascial space infections; 53% reported delayed or failed attempts to access dental care before their infection. Additionally, the authors describe a screening process, personal protective equipment (PPE) allocation and staff/patient testing protocols employed in their surgical unit throughout this period.Conclusions The authors suggest a series of triage and screening measures to limit the risk of unknowingly exposing clinical staff to the COVID-19 virus and offer advice on safely delaying non-emergency treatment where necessary. Recommendations for use of PPE for aerosol and non-aerosol generating procedures are made, but it is important to recognise that the efficacy of these measures cannot be determined by the methodology employed. This paper demonstrates an early example of complications developing from absent or delayed routine dental services resulting from lockdowns. This 'excess morbidity' is likely to have an impact on healthcare services as the pandemic recovery unfolds and services begin to return to normal.


Assuntos
COVID-19 , Procedimentos Cirúrgicos Bucais , Cirurgia Bucal , Controle de Doenças Transmissíveis , Estudos Transversais , Humanos , Pandemias , Estudos Retrospectivos , SARS-CoV-2
17.
J Oral Maxillofac Surg ; 79(10): 2123.e1-2123.e6, 2021 10.
Artigo em Inglês | MEDLINE | ID: mdl-34171221

RESUMO

PURPOSE: To examine possible changes in the emergency patient volume and reasons for presentation to an oral and maxillofacial surgery department during the coronavirus disease 2019 (COVID-19) pandemic and the resulting contact prohibitions. We hypothesized that the pandemic would lead to fewer patients presenting with emergent conditions. METHODS: A total of 939 patients, who presented to the Department for Oral and Maxillofacial Surgery of Hannover Medical School during the first 4 weeks of contact prohibitions in Germany, starting from March 23, 2020 until April 19, 2020, and in comparable periods were examined. The number of patients, reason for presentation, and required treatments were documented and compared to the years 2018 and 2019. Special attention was paid to the changes in trauma cases. RESULTS: We found that the number of patients in 2020 was significantly lower (P(2019) < .001, P(2018) < .01), but sex and age distributions were comparable to those in the previous years. Both the absolute and relative frequencies of dental diagnoses were significantly lower in 2020 (P(2019) < .001, P(2018) < .001), while the proportion of patients who presented with trauma was significantly higher (P(2019) < .001, P(2018) < .001). A significant decrease in patient number to the hospital, despite private practices being closed, was presumably due to patients' infection-related concerns. Trauma cases were more frequent in private settings, and traumatic events under the influence of alcohol were frequent. The circumstances and not the absolute number of trauma events had changed. CONCLUSIONS: The results of this study suggest that the COVID-19 pandemic has important effects on the use of emergency services concerning oral and maxillofacial surgery in Germany.


Assuntos
COVID-19 , Cirurgia Bucal , Serviço Hospitalar de Emergência , Humanos , Pandemias , SARS-CoV-2
18.
J Oral Maxillofac Surg ; 79(9): 1821-1827, 2021 09.
Artigo em Inglês | MEDLINE | ID: mdl-34062131

RESUMO

PURPOSE: To evaluate recent trends in Medicare reimbursement rates for common hospital-based oral-maxillofacial surgery procedures. METHODS: Physician Fee Schedule Look-Up Tool by the Centers for Medicare and Medicaid Services was searched for reimbursement rates for the 20 most performed oral-maxillofacial surgery procedures between 2003 and 2020. Total percent change, annual percent change, and compound annual growth rate (CAGR) were calculated using the adjusted reimbursement rates over the study period. Annual changes in reimbursement rates before and after 2016 were compared. RESULTS: After adjusting for inflation, average reimbursement rates for procedures decreased by 13.4%. Annual percent change and CAGR were -0.79 and -0.88%, respectively. Annual reimbursements decreased more between 2016 to 2020 (-1.83%,) than from 2003 to 2016 (-0.49%; P value = .003). CONCLUSION: Inflation-adjusted Medicare reimbursement rates for oral-maxillofacial surgery procedures have decreased from 2003 to 2020. The rate of reimbursement decreases has accelerated in recent years.


Assuntos
Medicare , Cirurgia Bucal , Idoso , Centers for Medicare and Medicaid Services, U.S. , Hospitais , Humanos , Reembolso de Seguro de Saúde , Estados Unidos
19.
Clin Oral Investig ; 25(10): 5755-5764, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-33956216

RESUMO

OBJECTIVES: Oromandibular dystonia is a focal dystonia characterized by sustained or intermittent contractions of the masticatory and/or tongue muscles. This epidemiological study aimed to estimate the prevalence and incidence of oromandibular dystonia in Kyoto (population: 1,465,701). MATERIALS AND METHODS: The population sample was citizens of Kyoto who visited our department between 2015 and 2019 and were differentially diagnosed by an oromandibular dystonia specialist having idiopathic (primary) and acquired (secondary) oromandibular dystonia. A total of 144 patients (100 women and 44 men; mean age, 57.5 years) were analyzed for clinical features, and the prevalence (prevalence date, January 1, 2020) and annual incidence were estimated. RESULTS: The male-to-female ratio was 1:2.3 (p<0.001). Age at onset was significantly (p<0.01) earlier in men (47.5 years) than that in women (56.9 years). The crude prevalence of oromandibular dystonia was estimated at 9.8 per 100,000 persons (95% confidence interval: 8.3-11.6) (idiopathic dystonia, 5.7 [4.6-7.1]; tardive dystonia, 3.4 [2.5-4.5]) and incidence at 2.0 (1.3-2.8) per 100,000 person-years (idiopathic dystonia, 1.2 [0.68-1.9], tardive dystonia, 0.68 [0.32-1.3]). The prevalence was 13.0 (10.5-15.8) in women and 6.3 (4.6-8.5) in men. All age groups showed female predominance. The highest prevalence was 23.6 (14.4-36.5) in women aged 60-69 years. CONCLUSIONS: As this is an oral and maxillofacial surgery service-based study, the actual prevalence of oromandibular dystonia may be even higher. CLINICAL RELEVANCE: It was suggested that oromandibular dystonia might be more common than cervical dystonia or blepharospasm.


Assuntos
Distonia , Distúrbios Distônicos , Cirurgia Bucal , Distonia/epidemiologia , Distúrbios Distônicos/epidemiologia , Feminino , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Prevalência
20.
Br J Oral Maxillofac Surg ; 59(7): 763-770, 2021 09.
Artigo em Inglês | MEDLINE | ID: mdl-33972140

RESUMO

The on-call component of a dental core training (DCT) post in oral and maxillofacial surgery (OMFS) is considered to be the most daunting and challenging aspect of the job. The average trainee is a singly-qualified dentist with limited knowledge and experience of managing OMFS presentations. Given the short duration of DCT posts, there is a continual rotation of junior staff through OMFS departments with a varying skillset and knowledge mix. As such, the consistent recording of appropriate information remains a constant challenge. The coronavirus pandemic has presented a unique situation in which the majority of dental foundation trainees (DFTs) entering OMFS DCT posts will only have around six months experience of independent practice. This lack of experience and onerous on-call workload could be a potentially dangerous combination, especially during nightshift patterns of on-call. We demonstrate that implementation of an on-call bleep-sheet proforma provides a validated, standardised, systematic, and chronological method of record keeping that exceeds the minimum required standard of clinical governance, in an era where junior trainees entering OMFS will have had even more limited experience than normal.


Assuntos
Cirurgia Bucal , Assistência Odontológica , Humanos , Encaminhamento e Consulta , Inquéritos e Questionários , Reino Unido , Carga de Trabalho
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