The War in Europe: An Elsevier Academic Publishing Company Cordially Supports Oral and Maxillofacial Surgeons and Scientists in Ukraine

Infinite cornucopia: The future of education and training in oral and maxillofacial surgery

The International Association of oral and maxillofacial Surgeons (IAOMS) is committed to quality patient care. The education of oral and maxillofacial surgeons has, however, been in constant evolution ever since the inception of this speciality; and this state of flux reflects the dynamic expansion of its scope. Oral surgery has a unique relationship with medicine and dentistry as it straddles both professions. To understand this dynamic expansion, it is pertinent to review the present scope of oral and maxillofacial surgery. Today an oral and maxillofacial surgeon’s training includes management of trauma, surgical reconstruction of acquired and developmental deformities, temporomandibular joint surgery, dentoalveolar surgery, preprosthetic surgery including implants, management of odontogenic infections, management of oral pathology, and administration of general anaesthesia and sedation. The oral and maxillofacial surgeon routinely treats patients with systemic diseases such as acute and chronic alcoholism, diabetes mellitus, hypertension, cardiovascular and pulmonary disease, neurological problems, as well as drug abusers. The new requirement for oral and maxillofacial surgery training programmes is 48 months with rotations in anaesthesia, medicine and surgery, and a minimum of 30 months in the oral and maxillofacial surgery service. Eighteen months of off-service rotations, most or all of which are taken at an intern or resident level instead of medical student or clerk level, give oral and maxillofacial surgery (OMFS) residents high quality medical education. Their rotation in general surgery and surgical sub-specialties result in a broad exposure to the concepts and principles of surgery beyond that provided by the oral and maxillofacial surgery rotation. It is the dental education that differentiates oral and maxillofacial surgeons from other surgical specialties; therefore, formal dental education culminating in a D.D.S or D.M.D. degree is strongly encouraged. It is most desirable that this formal dental education be complemented by formal medical education culminating in a medical degree. [Jnl College of Medicine Vol.7(1) 2002: 27-29]

To determine the etiology and pattern of maxillofacial injuries in the Armed Forces of Pakistan in terms of anatomical distribution of injuries. A descriptive study. January 2001 to Jan 2004 at the Oral and Maxillofacial Surgery Department, AFID, Rawalpindi. Three hundred consecutive patients of Armed Forces of Pakistan with maxillofacial injuries reporting to AFID and admitted to the hospital or treated as out-patients in the oral surgery clinic, were included in this study. Isolated nasal bone and frontal sinus fractures were excluded from the study. Anatomical distribution, frequency and etiology of fractures, rank at job and occupational as well as personal hobbies were recorded. Descriptive analyses were used to determine mean, standard deviation, percentage and range values. The most frequent bone fractured was the mandible, which accounted for 159 cases (53%). The zygomatic complex was fractured in 51 cases (17%), the maxilla in 12 cases (4 %), and the alveolar process in 21 cases (7%). The most common cause was road traffic accident (168 cases; 56%), followed by accidental fall (69 cases; 23%), gunshot injuries (27 cases; 9%), sports related injuries (15 cases; 5%), and injury associated with a fight (12 cases; 4%); there were only 9 cases of animals related injuries (3%). In this series, mandible was the most commonly fractured facial bone, while road traffic accident was the most common etiological factor. Results could be influenced by the personal and working environment.

David Stanley Precious (1944-2015)

Trauma patients presenting to emergency rooms (ER) in rural or remote locations have significantly less access to oral and maxillo-facial surgery (OMFS) specialists. In this case, OMFS services at four hospitals were rearranged to concentrate expertise, inpatients, and 24/7 cover on a single site. A Federation (managed clinical network) model was used that improved the management of inpatients and made better use of a small team of junior medical staff. New government standards limiting the on-call burden for U.K. junior doctors (The New deal) were met under this service model. Despite the success of the Federation, the loss of on-site OMFS support to the three peripheral ER departments was problematic. Sites that do not have OMFS support used a simple telephone referral to transfer patients to the OMFS center. The degree to which referrals were considered inappropriate led to operational and patient satisfaction difficulties. The introduction of an OMFS telemedicine system linking the three peripheral/"spoke" ER departments to the OMFS center/"hub" succeeded in increasing the appropriateness of patient transfers, developed the skills of the ER medical staff, and was believed to have led to an overall improvement in the early-stage management of this group of patients. The telemedicine system augmented the overall success of the Federation model. New uses for telemedicine within the OMFS service soon developed.

The Importance of Being Walter

Objective To understand the current status of the discipline and work out the developmental tactics of oral and maxillofacial surgery in China. Methods A questionnaire on the status of oral and maxillofacial surgery was designed and dispatched to the departments of stomatology in general hospitals at the level of prefecture or higher, stomatological hospitals and schools of stomatology. The contents of the questionnaire included the scale, manpower, professional extent, amount of clinical work and professional training of oral and maxillofacial surgery. The current status was compared with the previous status 5 and 10 years ago. Results In the most institutions which were surveyed, the number of oral and maxillofacial surgeons, beds and out-patients increased, the professional extent enlarged, and the clinical level improved. However, the above-mentioned clinical parameters decreased in some basic level institutions. The number of graduate students and trainees of oral and maxillofacial surgery decreased in one-third of institutions. Conclusions The discipline of oral and maxillofacial surgery is continuously developing, but it is weakened in some basic level institutions. An effective developmental tactics should be carried on to improve the competition capability of the discipline. Key words: Questionnaires; Surgery, oral; Oral and maxillofacial surgery

Oral and Maxillofacial Surgery and Oral Surgery — what’s the difference? A Western Australian dental student survey

Oral and Maxillofacial Surgery Curriculum (2021) and Oral Surgery Curriculum (2023): A forensic comparison of two documents

Musings of Chairs

Dual-degree oral and maxillofacial surgery: evidence-based view of Chilean candidates

Background Ideally, an airway for a surgical procedure should be secured with the method that offers the greatest safety, the most efficiency, and the least morbidity. General anesthesia for oral and maxillofacial surgery is one of the most challenging tasks for an anesthetist. Nasotracheal intubation is usually required in these patients to allow an unrestricted surgical approach. It poses an interesting problem, particularly when associated with difficult airways. The GlideScope video-laryngoscopy (GVL) appears to provide better glottic visualization than direct laryngoscopy. However, the effectiveness of GlideScope for nasotracheal intubation in patients for oral or maxillofacial surgery with difficult airways requires more investigation. The aim of this study is to evaluate the usefulness of GVL versus a direct laryngoscope for nasotracheal intubation in adult patients with difficult airways presenting for oral or maxillofacial surgery. Patients and methods In this study, the Macintosh laryngscope and the Glidescope were compared for nasotracheal intubation in 40 patients ASA I–III with difficult airways undergoing oral or maxillofacial surgery. The patients were randomly assigned to a laryngoscopic group (DL group) or a Glidescope group (GV group). Before nasotracheal intubation, all patients were given a Cormack and Lehane (C&L) grade by a separate anesthetist using a Macintosh laryngoscope. The patients were then intubated using direct laryngoscopy or the GlideScope. Outcome measures included grading of view, the success or failure of intubation, numbers of intubation attempts, time to intubation, usage of Magill forceps, and complications. Results There were no differences between groups with respect to hemodynamic and oxygen saturation during the study period, P greater than 0.05. There was a significant difference in laryngoscopic views according to the C&L classification. The C&L I and II views obtained by the conventional laryngoscope increased from 70 to 95% of cases with the GlideScope ( P P less than 0.05. The intubation was successful in 95% of the patients in the GV group versus 85% in the DL group. The nasotracheal intubation performed with the direct laryngoscope (45.1±7.8 s) was significantly faster than that with the GlideScope (53.5±14.7 s), P less than 0.033. Magill forceps were used in 25% in the GV group, but were used 60% of the time in the DL group, P =0.02. The intubation failure rate was higher using the direct laryngoscope 15 versus 5% with the GlideScope, P =0.49. The incidence of a postoperative sore throat was significantly reduced in the GV group 15 versus 40% in the DL group, P =0.07. Conclusion Oral and maxillofacial surgery has a potentially difficult airway, but if managed properly, the morbidity and mortality can be reduced or avoided. The GVL can be used successfully for nasotracheal intubation in difficult airways in oral and maxillofacial surgery.

"Over my dead body": the future of oral (and maxillofacial) surgery.

Objective In order to provide evidence for the effective clinical prevention of postoperative delirium (POD) , this study analyzed the related risk factors of POD after oral and maxillofacial surgery. Methods Databases including Web of Science, PubMed, Cochrane Library and EMbase were included in the searching of literatures about delirium after oral and maxillofacial surgery. The searching period was from the establishment of the databases to July 1st, 2018. The literatures were screened strictly according to the included and excluded criteria, and their quality was evaluated afterwards. POD′s related factors were extracted as available data. Statistical analysis was carried out by using RevMan 5.3 and StataSE 12.0. Results In total, 11 original studies with 2429 patients were included, in which 415 patients (17.1%) suffered from POD. The results showed that age, gender, solitary life, mental status, history of hypertension, preoperative hemoglobin and total protein, intraoperative anesthesia time, operation time, blood loss, tracheotomy, postoperative pain were risk factors for delirium after oral and maxillofacial surgery (P 0.05) . Conclusions Patients′ age, gender, mental status, hypertension and related laboratory results (preoperative hemoglobin, total protein) should be paid close attention before oral and maxillofacial surgery. Factors including anesthesia time, operation time, bleeding and ventilation should be strictly controlled. Besides, postoperative analgesia should be well managed since it can effectively prevent POD. Key words: Oral and maxillofacial; Surgery, oral; Delirium, postoperative

With the vigorous development of navigation technology in various fields of medicine, craniomaxillofacial surgery has also entered a new eraofusing navigation surgery. It has a wide range of applications, which can be used in the treatment of complicated facial fractures, osteotomy, cleft lip and palate and other aspects. The aim of this review is to summarize the principles, developments, applications of the navigation technology in craniomaxillofacial surgery. Key words: Navigation technology; Craniomaxillofacial surgery; Application