OMF Surgeons Research Articles

Arthroscopic Assessment of Temporomandibular Joint Pathologies-Is It Possible for Non-Specialists in Arthroscopy? Analysis of Variability and Reliability of Dental Students' Ratings after a Comprehensive One-Semester Introduction.

Background: Arthroscopy of the temporomandibular joint (TMJ) plays a long-established role in the diagnostics and therapy of patients suffering from arthrogenic temporomandibular disorders (TMDs), which do not respond adequately to conservative/non-invasive therapy. However, the interpretation of arthroscopic findings remains challenging. This study investigates the reliability and variability of assessing arthroscopic views of pathologies in patients with TMDs by non-specialists in arthroscopy and whether a standardized assessment tool may improve correctness. Methods: Following a comprehensive one-semester lecture, dental students in the clinical stage of education were asked to rate 25 arthroscopic views (freeze images and corresponding video clips) regarding the severity of synovitis, adhesions, and degenerative changes on a scale of 0-10 (T1). The results were compared to ratings stated by two European-board-qualified academic OMF surgeons. In a second round (T2), the students were asked to repeat the ratings using a 10-point rating scheme. Results: With regard to all three subcategories, congruency with the surgeons' results at T1 was at a low level (p < 0.05 in 19/75 cases) and even decreased at T2 after the implementation of the TMDs-SevS (p < 0.05 in 38/75 cases). For both T1 and T2, therefore, the inter-rater agreement was at a low level, showing only a slight agreement for all three subcategories (Fleiss' Kappa (κ) between 0.014 and 0.099). Conclusions: The judgement of the arthroscopic pathologies of the TMJ remains an area of temporomandibular surgery that requires wide experience and training in TMDs to achieve expertise in TMJ arthroscopic assessments, which cannot be transferred by theoretical instruction alone.

Collaborative approach to paediatric chronic non-bacterial osteomyelitis of the mandible: Great Ormond Street Hospital case series

This paper outlines a 10-patient case series of chronic non-bacterial osteomyelitis (CNO) of the mandible at a tertiary paediatric hospital in the UK. Our findings highlight the homogeneous presenting signs and symptoms of an intermittently painful, swollen angle and ramus of the mandible. We present the typical laboratory investigative findings (normal inflammatory markers) and imaging appearances (sclerosis and periosteal oedema). Our paper outlines an investigation protocol, including recommendations for extraoral bone biopsies and systemic magnetic resonance imaging (MRI). We explain the importance of multidisciplinary care, with combined care by rheumatologists and infectious disease specialists. Finally we demonstrate the efficacy of our treatment algorithm for oral non-steroidal anti-inflammatory drugs (NSAIDs), and in those cases refractory to NSAIDS, intravenous pamidronate. This paper provides a useful addition to the literature by informing OMF surgeons of this rare condition and given the clinical equipoise in treatments, it can hopefully guide clinicians in an investigation pathway and management protocol.

Oral and maxillofacial surgeons’ views on the adoption of additive manufacturing: findings from a nationwide survey

ObjectivesHospitals in many European countries have implemented Additive Manufacturing (AM) technology for multiple Oral and Maxillofacial Surgery (OMFS) applications. Although the technology is widely implemented, surgeons also play a crucial role in whether a hospital will adopt the technology for surgical procedures. The study has two objectives: (1) to investigate how hospital type (university or non-university hospital) influences surgeons' views on AM, and (2) to explore how previous experience with AM (AM experience or not) influences surgeons' views on AM.Materials and methodsAn online questionnaire to capture surgeons’ views was designed, consisting of 11 Likert scale questions formulated according to the Consolidated Framework for Implementation Research (CFIR). The questionnaire was sent to OMF surgeons through the channel provided by the Association of Oral and Maxillofacial Surgery in Sweden. Data were analyzed using the Mann–Whitney U test to identify significant differences among OMF surgeons in terms of organizational form (i.e., university hospital or non-university hospital) and experience of AM (i.e., AM experience or no-experience).ResultsIn total, 31 OMF surgeons responded to the survey. Views of surgeons from universities and non-universities, as well as between surgeons with experience and no-experience, did not show significant differences in the 11 questions captured across five CFIR domains. However, the “individual characteristics” domain in CFIR, consisting of three questions, did show significant differences between surgeons’ experience with AM and no-experience (P-values: P = 0.01, P = 0.01, and P = 0.04).ConclusionsSurgeons, whether affiliated with university hospitals or non-university hospitals and regardless of their prior experience with AM, generally exhibit a favorable attitude towards AM. However, there were significant differences in terms of individual characteristics between those who had prior experience with AM and those who did not.Clinical relevanceThis investigation facilitates the implementation of AM in OMFS by reporting on the views of OMF surgeons on AM.

How can we raise awareness and educate medical undergraduate students about OMFS?

In recent years there has been a rise in medicine-first graduates pursuing a career within OMFS, yet many studies report that undergraduate medical students lack sufficient knowledge about the specialty. The COVID-19 pandemic has demonstrated that online methods of delivering undergraduate education are successful. We organised an online conference that comprised six lectures covering common clinical problems that OMF surgeons encounter, and the academic pathway. Delegates were asked to complete an optional pre/post-conference survey which aimed to assess students’ interest in the specialty and their attitudes to online conferences. Participants were invited to undertake a semi-structured interview about their attitudes towards the use of online conferences and their ideas about how to interest students further. The interview was thematically analysed. The pre-conference and post-conference questionnaires were answered by 21 and 22 participants, respectively. The demographic consisted largely of undergraduate medical students. Most participants reported increased interest in the specialty after the conference. The interest of delegates wanting to follow an academic pathway decreased. Fewer delegates after the conference believed that online conferences could replace in-person conferences. Five participants undertook a semi-structured interview. Key themes identified were: a lack of exposure drives a lack of interest in OMFS, a desire to learn more about the specialty, and in-person conferences provide more opportunities for delegates. Online conferences can be used to increase student interest in OMFS, but students value in-person conferences more. Students are keen to learn more about the specialty.

Adoption of additive manufacturing in oral and maxillofacial surgery among university and non-university hospitals in Sweden: findings from a nationwide survey

PurposeAdditive manufacturing (AM) is an innovative printing technology that can manufacture 3-dimensional solid objects by adding layers of material from model data. AM in oral and maxillofacial surgery (OMFS) provides several clinical applications such as surgical guides and implants. However, the adoption of AM in OMFS is not well covered. The purpose was to study the adoption of AM in OMFS in university and non-university hospitals in Sweden. Three research questions were addressed: What is the degree of using AM solutions in university and non-university hospitals?; What are AM solutions used?; How are the AM solutions accessed (production mode) in university hospitals and non-university hospitals?MethodsA survey was distributed to OMF surgeons in Sweden. The questionnaire consisted of 16 questions. Data were analyzed through descriptive and content analysis.ResultsA total of 14 university and non-university hospitals were captured. All 14 hospitals have adopted AM technology and 11 of the hospitals adopted AM in OMFS. Orthognathic and trauma surgery are two major types of surgery that involve AM technology where material extrusion and vat polymerization are the two most used AM technologies in OMFS. The primary application of AM was in medical models and guides.ConclusionMajority of Swedish university hospitals and non-university hospitals have adopted AM in OMFS. The type of hospital (university or non-university hospital) has no impact on AM adoption. AM in OMFS in Sweden can be perceived to be a mature clinical application.

Microvascular reconstructions in oral and maxillofacial surgery — Results of a survey among oral and maxillofacial surgeons in Germany, Austria, and Switzerland

This study aimed to evaluate the use of microvascular free flaps (MFF) in oral and maxillofacial surgery (OMFS) in Germany, Austria, and Switzerland.A dynamic online questionnaire, using 42–46 questions, was sent to OMF surgeons based in hospitals in Germany, Austria, and Switzerland. The questionnaire was evaluated internally and externally. Aside from general information, data were collected on organizational aspects, approaches, MFF types and frequency, presurgical planning, intraoperative procedures, perioperative medications, flap monitoring, and patient management.Participants mostly performed 30–40 MFF each year (11/53). Most stated that the COVID-19 pandemic did influence MFF frequency (25/53) to varying extents. Radial forearm flap was most frequently used (37/53), followed by ALT (5/53), and fibula flap (5/53). Primary reconstruction was performed by most participants (35/48). Irradiated bony transplants were mostly used for implant placement after 12 months (23/48). Most participants (38/48) used reconstruction plates, followed by miniplates (36/48), PSI reconstruction (31/48), and PSI miniplates (10/48). Regarding the postoperative use of anticoagulants, low-molecular-weight (37/48) and unfractioned heparins (15/48) were widely used, most often for 3–7 days (26/48). Clinical evaluation was mostly preferred for flap monitoring (47/48), usually every 2 h (34/48), for at least 48 h (19/48).Strong heterogeneity in MFF reconstructions in OMFS was found, especially regarding the timepoints of reconstruction, types of osteosynthesis, and postoperative MFF management. These findings provide the chance to further compare the different treatment algorithms regarding relevant MFF aspects, such as postoperative management. This could create evidence-based treatment algorithms that will further improve the clinical outcomes in MFF reconstructions.

49. Is it time for OMFS to bring non-surgical aesthetics into the training syllabus?

The number of non-surgical aesthetic treatments being carried out in the UK and globally continues to rise. Despite reports from both Government (The ‘Keogh’ Report 2013) and Parliament (The APPG BAW 2021), such treatments can legally still be performed by anyone, regardless of qualifications or experience. OMF Surgeons are frequently tasked with managing the complications of non-surgical aesthetics treatment.

139. The JTG and Facebook: Progression & Potential

The Junior Trainee Group (JTG) of the British Association of Oral and Maxillofacial Surgeons (BAOMS) represents everyone interested in OMFS from first day of university until entering specialty training. The JTG engages, supports and inspires the next generation of OMFS surgeons.

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

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. 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. 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." 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.

Comparison of clinical and photographic assessment of facial scars by three different professionals using SCAR scale- An Observational study

Scars can have functional, cosmetic and psychological consequences. The impact becomes even more profound when these scars occur on the face. Assessment of scars forms the basis for understanding them. Scars can be assessed both clinically and photographically. Though such assessments are common after burns, they are least studied in the maxillofacial region. Results obtained through an interdisciplinary approach are more effective; this study intends to combine a plastic surgeon, a dermatologist, and two maxillofacial surgeons. This study aims to evaluate the facial scars through the SCAR scale. Subjects and Methods: After obtaining their consent, thirty patients with facial scars were included in this study. Clinically, two OMFS surgeons independently used the SCAR scale to evaluate the rating scale. Scars were photographed in a standardized manner and were evaluated by a plastic surgeon and dermatologist independently using the same scale. Results: The results were tabulated, and interobserver and intraobserver differences were statistically analyzed using an independent t-test, ANOVA test and Turkey B post Hoc test. Conclusion: Clinical assessment of scars is superior to photographs. Assessment of scars by different specialists helps achieve evidence-based research and promotes more sophisticated treatment. Besides that, we must educate the patients about scar revision, as many are unaware of such procedures. Key-words: Facial Scars, Clinical assessment, Photographic assessment, SCAR scale

Reconstructie na aangezichtstrauma met dentoalveolair letsel

While abroad, a healthy 36-year-old woman slammed head-on into a rock wall at high speed, resulting in significant facial trauma. The initial trauma care and first aid took place abroad. In the Netherlands, the woman was referred to the Department of Oral and Maxillofacial Surgery (OMFS) for reconstruction of her face and alveolar processes, gingiva and dentition. In view of the seriousness of the injuries, a 3D treatment plan was drawn up in a multidisciplinary collaboration with an OMF surgeon, an implantologist, dentist and dental technician. By making a digital setup of both the top and bottom front in advance, it was possible to work predictably. The first step consisted of bone augmentation by means of an iliac crest graft to reconstruct the major bone defects of the superior and inferior alveolar processes. Implants were then placed in the upper and lower jaws in the ideal position for the suprastructure by means of drill jigs. Within 10 months after the trauma, the implant bridges could be placed on individual zirconia frameworks to optimally restore oral function and aesthetics, completing the reconstruction.

Importance of early identification of a deep neck abscess

Treatment of odontogenic infections, such as drainage of submucosal abscesses, should be carried out by the dental practitioner. However, when an odontogenic infection deteriorates into a deep neck abscess, treatment should be carried out by the oral maxillofacial surgeon. Based on two cases, this article describes the clinical presentation, course, and necessary treatment of a deep neck abscess. It also points out that timely recognition of the disease is key in treatment. In any case of delay, there is a possibility for fast deterioration by complications, such as airway obstruction, development of descending necrotizing mediastinitis, or sepsis. Oral health practitioners play an important role in early identification of a deep neck abscess. This article proposes recommendations for dentists when to suspect a deep neck infection, which could be useful in quick and adequate referral to an OMF surgeon.

A better way to ….structure training in non-surgical aesthetics: An OMFS-led training scheme

Introduction: The recent All Party Parliamentary Group made 17 key recommendations regarding the non-surgical aesthetics (NSA) industry, including mandatory regulated training. Most training currently consists in unregulated, non-academically accredited one- or two-day courses. Lack of information around training has been highlighted as a key concern by doctors and dentists. Methods: We surveyed 90 medical and dental students regarding NSA, with questions about relevance to practice, understanding of training pathways, and regulation. We used these findings to create a non-profit mentorship scheme for soon-to-graduate and newly graduated medics and dentists, consisting in theoretical and practical components. The scheme leads mentees towards the OFQUAL-regulated, academically accredited Level 7 PG Diploma in Injectables. Results: Of 60 respondents, 85% were interested in practising NSA, and 92% thought it relevant to medical/dental practice, however only 15% had a good or very good idea of how to train. After one year of the scheme, we surveyed our mentees; 88% had a good or very good understanding of regulation, 90% for training pathways. The scheme now boasts 50 mentees, with teaching designed and delivered by a team of dual-qualified OMFS trainees. Conclusions: Complications from NSA treatments are widely reported. OMF Surgeons are uniquely placed to both manage complications, and to provide training in NSA. Robust training pathways are needed to address significant undergraduate and postgraduate interest in the area. Such pathways should lead to regulated and accredited courses, while ensuring doctors and dentists are given balanced and valid information in what is still a largely unregulated education sector. Introduction: The recent All Party Parliamentary Group made 17 key recommendations regarding the non-surgical aesthetics (NSA) industry, including mandatory regulated training. Most training currently consists in unregulated, non-academically accredited one- or two-day courses. Lack of information around training has been highlighted as a key concern by doctors and dentists. Methods: We surveyed 90 medical and dental students regarding NSA, with questions about relevance to practice, understanding of training pathways, and regulation. We used these findings to create a non-profit mentorship scheme for soon-to-graduate and newly graduated medics and dentists, consisting in theoretical and practical components. The scheme leads mentees towards the OFQUAL-regulated, academically accredited Level 7 PG Diploma in Injectables. Results: Of 60 respondents, 85% were interested in practising NSA, and 92% thought it relevant to medical/dental practice, however only 15% had a good or very good idea of how to train. After one year of the scheme, we surveyed our mentees; 88% had a good or very good understanding of regulation, 90% for training pathways. The scheme now boasts 50 mentees, with teaching designed and delivered by a team of dual-qualified OMFS trainees. Conclusions: Complications from NSA treatments are widely reported. OMF Surgeons are uniquely placed to both manage complications, and to provide training in NSA. Robust training pathways are needed to address significant undergraduate and postgraduate interest in the area. Such pathways should lead to regulated and accredited courses, while ensuring doctors and dentists are given balanced and valid information in what is still a largely unregulated education sector.

A Better Way to Manage Paediatric Maxillofacial Trauma; A Retrospective Study Examining the Presentation of Maxillofacial Soft Tissue Injuries and Management over 3-year period at a Regional Children’s Hospital

Introduction: Maxillofacial treatment is evolving with changing paediatric lifestyles and clinical limitations, including COVID-19. The aim of this study is to assess trends in the presentation of maxillofacial soft tissue injuries and subsequent management within a regional paediatric hospital. Methods: Retrospective study over a 3-year period (from 2019-2021 between January and April). Inclusion of all paediatric patients seen on the emergency department by OMFS team. Results: Between 2019 and 2021, the total number of patients dropped by over half. The average age dropped from 5.9 in 2019 to 3.8 in 2021. Males were more commonly seen. Extraoral injuries increased by 21%. Intraoral injuries reduced by 8%. Less complicated communicating injuries and associated dental trauma were seen in 2021. Lip lacerations accounted for most injuries. In 2020, there was 21% reduction in conservative management of injuries. Wound closure under LA increased by 12% in 2020. There has been an overall increase in wound closure under GA by 5% between 2019 and 2020. Falls accounted for most injuries, however, there has been an increase in dog bite injuries by 5% in 2021. Conclusions: The average age has dropped between 2019-2021 and hence treatment options remain limited. Age, cooperation, and severity of injury are important factors. The number of overall lacerations has decreased but a greater proportion required formal closure under general anaesthesia. It is vital OMFS surgeons are aware of the changes in presentation and current trends in management. This will help to better equip surgical teams for the changing landscape of paediatric maxillofacial trauma. Introduction: Maxillofacial treatment is evolving with changing paediatric lifestyles and clinical limitations, including COVID-19. The aim of this study is to assess trends in the presentation of maxillofacial soft tissue injuries and subsequent management within a regional paediatric hospital. Methods: Retrospective study over a 3-year period (from 2019-2021 between January and April). Inclusion of all paediatric patients seen on the emergency department by OMFS team. Results: Between 2019 and 2021, the total number of patients dropped by over half. The average age dropped from 5.9 in 2019 to 3.8 in 2021. Males were more commonly seen. Extraoral injuries increased by 21%. Intraoral injuries reduced by 8%. Less complicated communicating injuries and associated dental trauma were seen in 2021. Lip lacerations accounted for most injuries. In 2020, there was 21% reduction in conservative management of injuries. Wound closure under LA increased by 12% in 2020. There has been an overall increase in wound closure under GA by 5% between 2019 and 2020. Falls accounted for most injuries, however, there has been an increase in dog bite injuries by 5% in 2021. Conclusions: The average age has dropped between 2019-2021 and hence treatment options remain limited. Age, cooperation, and severity of injury are important factors. The number of overall lacerations has decreased but a greater proportion required formal closure under general anaesthesia. It is vital OMFS surgeons are aware of the changes in presentation and current trends in management. This will help to better equip surgical teams for the changing landscape of paediatric maxillofacial trauma.

Does the Geographical Distribution of Facial Trauma Surgeons Correspond to Facial Trauma Burden? A Nationwide Population-Level Analysis.

It is unknown if craniofacial trauma services are inequitably distributed throughout the US. The authors aimed to describe the geographical distribution of craniofacial trauma, surgeons, and training positions nationwide. State-level data were obtained on craniofacial trauma admissions, surgeons, training positions, population, and income for 2016 to 2017. Normalized densities (per million population [PMP]) were ascertained. State/ regional-level densities were compared between highest/lowest. Risk-adjusted generalized linear models were used to determine independent associations. There were 790,415 craniofacial trauma admissions (x? = 2330.6 PMP), 28,004 surgeons (x? = 83.5 PMP), and 746 training positions (x? = 1.9 PMP) nationwide. There was significant state-level variation in the density PMP of trauma (median 1999.5 versus 2983.5, P < 0.01), surgeon (70.8 versus 98.8, P < 0.01), training positions (0 versus 3.4, P < 0.01) between lowest/highest quartiles. Surgeon distribution was positively associated with income and training positions density ( P < 0.01). Subanalysis revealed that there was an increase of 6.7 plastic and reconstructive surgeons/PMP for every increase of 1000 trauma admissions/PMP ( P < 0.01). There is an uneven state-level distribution of facial trauma surgeons across the US associated with income. Plastic surgeon distribution corresponded closer to craniofacial trauma care need than that of ENT and OMF surgeons. Further work to close the gap between workforce availability and clinical need is necessary.

1492 The Age of Trainees When Joining the Specialist List – What Are the Differences Across Specialties?

Abstract Introduction Those wishing to pursue a career in surgery will be aware of stereotypes that exist within each specialty, including how long it takes to attain a certificate of completion of training (CCT). These perceptions are often historic, and whilst may be based on elements of truth, are rarely backed by robust data. Oral &amp; maxillofacial surgery (OMFS) for example is plagued by the stigma of necessitating a second degree which gives the assumption the age of being appointed a consultant is somewhat above average. We aim to dispel (or prove, depending on one’s predisposition) such myths by analysing the age of surgeons when appointed to the General Medical Council’s specialist list. Method Information on the age of entry onto the surgical specialist lists between 1997 and 2018 was obtained from the General Medical Council (GMC). Data was suitably statistically analysed. Results 19,135 surgeons joined surgical specialist lists during the study period. General and trauma and orthopaedic surgery accounted for 60% of all surgeons (n = 11,444). The age on joining surgical specialist lists ranged from 27–83 years, with a mean of 41.4 years. Neurosurgeons most frequently joined the specialist list in the youngest age bracket. OMF surgeons, along with their cardiothoracic and vascular colleagues, are joint eldest by 1.3 years. Conclusions Since the creation of the specialist list, training has seen several upheavals. This data shows that despite each specialty’s specific requirements and individuals’ varying paths, there is little difference in the age when the consultant destination is reached.

1395 The Influence of Shortened Antimicrobial Courses in Surgical Management of Mid 1/3rd Facial Fractures

Abstract Aim Antimicrobial resistance (AMR) is an increasing issue posing a grave threat to global public health. A prospective pilot study within our OMFS unit investigated the effects a shortened course of perioperative antimicrobial cover had on infective post-operative complications in patients who had surgical management of mid 1/3rd facial fractures. Method As per the World Health Organisation (WHO) global action plan on antimicrobial resistance, with our microbiology team we developed and implemented a shortened antimicrobial protocol for use in the surgical management of mid 1/3rd facial fractures. Following protocol implementation, the records of 55 patients who underwent surgery for their mid 1/3 facial fractures between May 2019 and May 2020 were reviewed. Results Of 55 patients who underwent surgical management of mid 1/3rd facial fractures 28/55 (50.9%) were prescribed a shortened course of perioperative antimicrobials depending on whether an intra or extra oral surgical approach was used, whilst 27/55 (49.1%) were prescribed a longer course of antimicrobials. Of those given a shortened course of antimicrobials 1/28 (3.6%) experienced infective post-operative complications. Conversely 4/27 (14.8%) of those given a longer course of antibiotics experienced infective post-operative complications. Conclusions This data supports growing evidence that shorter courses of antimicrobials are appropriate in the surgical management of facial fractures. As OMFS surgeons we can utilise evidence-based medicine to provide optimal surgical care whilst simultaneously contributing to healthcare professionals’ obligations to tackle the increasing challenge of antimicrobial resistance.

Radiographic imaging in relation to the mandibular third molar: a survey among oral surgeons in Sweden

ObjectivesTo query the experience of oral surgeons concerning referral routines and preferences for radiographic imaging modality before surgical removal of mandibular third molars and investigate factors that influence imaging modality preferences.Materials and methodsMembers of the Swedish Association of Oral and Maxillofacial Surgeons (n = 280) were invited to participate in a web-based digital survey concerning their experiences and use of three imaging modalities in pre-surgical assessment of mandibular third molar removal. The survey comprised multiple-choice questions and four cases depicted in images; respondents reported whether they would supplement the cases with other images and, if so, from which modality.ResultsThe response rate was 64%. Panoramic radiographs were most commonly used in pre-surgical planning (response options: always or often), significant difference between professions (p = 0.039), and considered to facilitate treatment planning (87%), as was CBCT (82%); for 51%, CBCT reduced post-operative complications. Preferred modality for localizing the mandibular canal was fairly evenly distributed and for non-complex case, significant difference between subgroups of OMFS surgeons was found (p = 0.003) as to preference for intraoral radiographs.ConclusionsA majority of respondents received a report within 2 weeks of their referral for CBCT and would read the report and view the images before surgery. Image modality preference differed depending on case complexity, with a greater perceived need for CBCT. Profession and practical experience affected choice.Clinical relevanceChoice of imaging modality in mandibular third molar assessment is also important from dose delivery and social economy standpoints.

BAOMS – Inspiring and Supporting OMFS Surgeons of the Future

BAOMS – Inspiring and Supporting OMFS Surgeons of the Future

First degree hotspots for OMFS recruitment 1967-2010: dental and medical schools where OMFS specialists and trainees were more likely to start their careers.

Evidence around careers shows that many surgeons were inspired early in their career and this was often based on their undergraduate experience. In this context we have reviewed the location of the first degrees of oral and maxillofacial surgery (OMFS) consultants and specialty trainees to look for any patterns or trends. It has been shown that there is variation across medical schools when core surgical trainee recruitment is analysed. To our knowledge no previous paper has undertaken a similar analysis of medical and dental schools in the context of OMFS. The first-degree universities of OMFS specialists and trainees were compiled from the Medical and Dental Register, tabulated and analysed. There were 680 entries in total with dates of graduation ranging from 1967 - 2010. The relative frequency of first-degree locations based on the number of current places for medical and dental students was calculated to aid comparison. There are 'hot-spots' from where many OMFS specialists originate and also universities that rarely or never produce OMF surgeons. Reviewing these figures in the context of the number of places available to students and against time, points to areas where OMFS appears to be promoted, and others were the specialty has a low impact. The University of London leads the way for both medicine and dentistry-first trainees by a considerable margin. Glasgow is the next most productive for dentistry and Nottingham for medicine. The 13 current medical schools from which no OMFS specialists or trainees have originated are Brighton, Cambridge, Anglia Ruskin, Exeter, Hull, Keele, Lancaster, Norwich, Plymouth, Swansea, University of Central Lancashire (UCLan), and Warwick. Other new medical schools are opening this year. There are opportunities for all OMFS units and training rotations to look at 'best practice' for OMFS recruitment and apply as many inspiring interventions as they can in their local medical and dental schools, and in foundation and core training programmes.