Maxillofacial Research Articles

The Composition of England’s Single Qualification OMFS Posts: A Descriptive Analysis of Foundation Year and Dental Core Training Posts

Post-graduate Oral and Maxillofacial Surgery (OMFS) exposure for medical and dental graduates differs significantly. The availability and opportunities provided by these single qualification posts have not previously been explored. We investigated the number of OMFS posts available for Foundation Year (FY) doctors and Dental Core Trainees (DCTs) using information from UK Foundation Schools and by analysing data from Health Education England (HEE) and the UK Foundation Programme (UKFPO). In 2023-24, there were over 11 times as many OMFS posts for DCTs compared to FY doctors. The implications are explored in this paper, including the impact on interprofessional working and team development. OMFS as a specialty, with teams consisting of dental and medical graduates, is distinctive for fostering interprofessional education (IPE) and collaboration (IPC). IPE/IPC has been shown to increase knowledge of practitioners and can lead to benefits for both clinicians and patients. By understanding the national composition of single qualification posts, we hope to establish the foundations for further research into this unique interdisciplinary learning environment.

How clinical exposure improves dental students' understanding of oral and maxillofacial surgery: A cross-sectional study.

To assess dental students' understanding of oral and maxillofacial surgery (OMFS) practice areas and examine changes in referral preferences across their educational progression in Israel. A cross-sectional survey was conducted among 349 dental students from two Israeli universities (46.5% response rate). The primary independent variable was the year of study (pre-clinical vs. clinical years). The main outcome variables included perceptions of OMFS scope and referral preferences for various procedures. Covariates included demographics and prior OMFS exposure. Chi-square tests, linear trend analysis, and mediation analysis were performed. Students in clinical years exhibited a broader understanding of OMFS scope compared to pre-clinical years. Referral preferences to OMFS increased significantly for complex procedures like facial skeletal deformities (46.2% to 61.3%, p=0.004) and oral cancer (66.2% to 78.9%, p=0.008). The perception of extractions as the primary OMFS procedure increased from 63.6% in the first year to 77.6% in the sixth year (p=0.033). Personal and family experiences with OMFS significantly mediated the relationship between year of study and referral tendencies (16.2% of total effect mediated, p<0.001). Clinical exposure improves understanding of OMFS capabilities, leading to increased referrals for complex procedures. However, several practice areas remain underrecognized, highlighting the need for improved educational interventions.

Measuring Patient-Reported Outcomes Following Traumatic Craniomaxillofacial Injuries: Development of the AO CMF Injury Symptom Battery

Background/Objectives: Traumatic craniomaxillofacial (CMF) injuries are associated with various symptoms/concerns that affect patients’ quality of life. The assessment of outcomes from the patient perspective has been limited by the absence of patient-reported outcome (PRO) measures tailored to this patient population. To address this need, we employed a mixed methods, multi-step process to first identify the most important symptoms/concerns and then use this information to construct a PRO symptom battery. Methods: CMF clinicians and patients who had sustained traumatic CMF injuries participated in semi-structured interviews to elicit the symptoms/concerns considered the most important. The data were analyzed using an iterative coding procedure and symptom/concern frequency was tabulated. The findings were used to develop a conceptual model of the most important symptoms to include in a PRO battery. Existing items were modified as needed and new items were drafted to ensure adequate coverage of the symptoms. Results: The resulting AO CMF Injury Symptom Battery includes four modules specific to the injury site (oral, ocular, nasopharyngeal, ear) and five universal modules (pain/sensation, cognitive, cosmetic, psychosocial, and injury impact). Conclusions: The AO CMF Injury Symptom Battery offers promise for assessing symptoms only patients can report on in clinical research and practice. Ongoing research will examine the battery’s psychometric properties.

Understanding the Impact of Ergonomic Practices on Musculoskeletal-Related Symptoms and Emotional Wellness in Craniofacial Surgeons.

A systematic review conducted in 2017 found that Musculoskeletal (MSK) injuries were prevalent among surgeons. Few studies have assessed the role that poor surgical ergonomic practices have had in the development of MSK injuries in plastic and reconstructive surgery (PRS), and fewer specifically in craniofacial surgeons. The impact that MSK injuries have on the emotional well-being of craniofacial surgeons is also not well understood. A branched logic survey with a maximum of 35 questions pertaining to surgical practices, MSK injuries, and emotional well-being was distributed to all active attending physicians who were members of the American Society of Maxillofacial Surgeons (ASMS). The responses were divided into 2 groups, surgeons who reported developing MSK injuries or physical discomfort and those who denied developing MSK injuries or physical discomfort. Data analysis was performed to determine which factors contributed to the incidence of MSK injury and the emotional impact that these injuries had on craniofacial surgeons. A total of 82 active craniofacial surgeons completed responses to the survey for an overall response rate of 16.6%. Of these respondents, 65.9% (n=54) suffered MSK injuries or physical discomfort, and 53.7% (29/54) reported difficulty with either falling asleep or staying asleep because of these symptoms within the last year. Both male and female respondents reported experiencing some level of anxiety or depression because of their MSK injuries. The impact of a MSK injury may impact both physical and emotional wellness of craniofacial surgeons. This study found that a high percentage of craniofacial surgeons have MSK-injuries whereas some have reported a negative impact on their sleep and emotional well-being.

Attitude of general dental practitioners, oral surgeons, and dentistry students towards oral lesions and oral biopsy.

Oral biopsy is a fundamental surgical procedure used to obtain a histopathological result that assists clinicians in establishing a definitive diagnosis of oral mucosal lesions. The aim of this study was to asses the knowledge and attitudes of dental students, general dentists, and oral surgery experts regarding the detection of oral lesions and the use of biopsy as a diagnostic tool. a self-administered questionnaire consisting of 26 questions and 3 clinical cases on oral lesions was distributed to general dentists, oral surgery specialists and final-year dentistry students at the University of Barcelona. A descriptive analysis of all variables included was performed. The chi-square test was used to compare categorical variables, and a multivariate logistic regression model was performed. A total of 281 questionnaires were included in the study. In terms of diagnosing of oral lesions, 44.7% of students and 32.1% of general dentists were unable to make an accurate diagnosis, compared to 81.7% of specialists. Twelve students (15.8%) and twenty general dentists (14.9%) reported lacking the skills to perform a biopsy. Ninety general dentists (67.2%) reported feeling uncomfortable performing biopsies due to a lack of experience. Oral surgeons are 84.4 times more likely to identify lesions of the oral mucosa compared to students. General dentists experience 9.6 times more difficulty diagnosing oral lesions compared to students. General dentists are 0.43 times less likely to perform sample analysis compared to students. Oral biopsy is a procedure primarily performed by specialists in oral surgery, with its use among general dentists being limited, likely due to a lack of training in the field. To encourage the use of biopsy among general dentists, clinical training should be a fundamental component of the education of oral healthcare providers.

SPECTRUM OF ORAL AND MAXILLOFACIAL SURGERY PATIENTS SEEN AT TRIAGE WITH SUBSEQUENT EMERGENCY TREATMENT PROVIDED – A CLINICAL STUDY AT SMBBIT

Oral and maxillofacial injuries constitute a significant portion of trauma cases in emergency departments, often resulting in life-threatening complications and sometimes death. Effective triage is crucial for prioritizing care, especially in resource-limited settings. Despite the importance of standard protocols, many institutions lack uniform guidelines for managing these complex injuries, which can lead to adverse patient outcomes. Objectives: To explore the clinical presentation patterns of oral and maxillofacial trauma patients at triage, focusing on injury types and patient demographics while documenting initial emergency interventions administered. Methods: This descriptive cross-sectional study was conducted at SMBBIT over six months, involving patients presenting with OMFS Trauma sustained at Emergency Room. Data were collected using a pre-designed pro forma and analyzed using SPSS software for descriptive statistics. Results: A total of 73 patients were included, predominantly male (84.94%), with a mean age of 35.2 years. Road traffic accidents were the leading cause of injury (68.5%). Most patients were self-referred (37%), and 82.2% had no significant co-morbidities. Imaging revealed comminuted pan-facial fractures (37.5%) as the most common diagnosis. Following triage assessment, 80.8% required hospitalization, with 32.2% undergoing immediate surgical interventions, including open reduction internal fixation, closed reduction and soft tissue closure. Conclusion: This study underscores the importance of effective triage in managing oral and maxillofacial surgical patients, particularly in polytrauma cases, with a focus on a multidisciplinary team (MDT) approach. Our findings suggest that incorporating oral and maxillofacial surgical emergency care into triage protocols and resource allocation can improve care quality and reduce patients’ complications. Inclusion of oral and maxillofacial surgeons in Emergency Trauma teams in Pakistan is essential for enhancing collaboration and improving patient survival outcomes.

Bone Tumors of the Jaw - the "Blind Spot" for Radiologists Experienced with Tumors? - Part II.

Primary bone tumours of the jaw are rare tumoral entities and do substantially differ from other bone tumours of the human body with respect of their frequently encountered unusual radiological appearances. The reason for that may be confined to the co-existence of two closely neighbored but different anatomical structures (i.e., tooth-forming apparatus and jaw bones with adjacent gingiva) and some tumour pathologies which are nearly excusively encountered in the jaw bones only (e.g., ameloblastoma, ossifying fibroma, ghost cell carcinoma).This paper would like to highlight some basic principles of the diagnostic approach and possibilities of radiological differentiation of such tumour-suspicious changes within the gnathic system are elucidated and discussed.The paper presented here is substantially based on the most recent classification of odontogenic and maxillofacial tumours (5th edition, 2022) which serves as a scaffold for the selection of typical tumour entities. Due to the educational character of this paper, only important jaw tumours worth mentioning and their characteristics are subject to be extracted from the literature and further discussed.The main focus was put onto both the description of radiological tumoral appearance and the rational selection of a radiological diagnostic work-up. In order to better visualize this difficult field of tumour entities, much attention has been paid on a comprehensive pictorial essay.For radiologists, it is their foremast task to detect, describe, and to classify bone tumours of the jaw when they are found intentionally or accidentally, resp. A close co-operation with their clinical partners is of upmost importance to gain information about patient´s history and clinical presentation. It is readily reasonable that radiologists are mostly able to provide only a suggestion of the presented tumour entity but this expert opinion would be very helpful to further narrow down the list of potential differential diagnoses (e.g., differentiation of a cyst vs. solid tumour osteolysis, identification of jaw osteomyelitis vs. tumoral infiltration, recognizing of secondary tumour involvement of the jaw). · primary bone tumours of the jaw are very rare, moreover difficult to differentiate radiologically, and do need therefore histological proof;. · profound knowledge about tumour characteristics (location within the jaw, relationship to the tooth, bony destructive pattern) may allow a rough orientation and classification;. · matrix-forming tumours and dysplasias of the jaw facilitates their radiological differentiation and classification;. · in contrary, osteolyses should be thoroughly scrutinized for the more frequent gnathic cysts in differentiation of rather rare solid primary tumours;. · an interdisciplinary round-table discussion amongst well-experienced maxillofacial surgeons and specialized radiologists may be appropriate to avoid severe misinterpretations.. · Grieser T, Hirsch E, Tödtmann N. Tumours of the jaw bones - Part II. Fortschr Röntgenstr 2024; DOI 10.1055/a-2416-1282.

Bone Tumors of the Jaw - the "Blind Spot" for Radiologists Experienced with Tumors? - Part I.

Primary bone tumours of the jaw are rare tumoral entities and do substantially differ from other bone tumours of the human body with respect of their frequently encountered unusual radiological appearances. The reason for that may be confined to the co-existence of two closely neighbored but different anatomical structures (i.e., tooth-forming apparatus and jaw bones with adjacent gingiva) and some tumour pathologies which are nearly excusively encountered in the jaw bones only (e.g., ameloblastoma, ossifying fibroma, ghost cell carcinoma).This paper would like to highlight some basic principles of the diagnostic approach and possibilities of radiological differentiation of such tumour-suspicious changes within the gnathic system are elucidated and discussed.The paper presented here is substantially based on the most recent classification of odontogenic and maxillofacial tumours (5th edition, 2022) which serves as a scaffold for the selection of typical tumour entities. Due to the educational character of this paper, only important jaw tumours worth mentioning and their characteristics are subject to be extracted from the literature and further discussed.The main focus was put onto both the description of radiological tumoral appearance and the rational selection of a radiological diagnostic work-up. In order to better visualize this difficult field of tumour entities, much attention has been paid on a comprehensive pictorial essay.For radiologists, it is their foremast task to detect, describe, and to classify bone tumours of the jaw when they are found intentionally or accidentally, resp. A close co-operation with their clinical partners is of upmost importance to gain information about patient's history and clinical presentation. It is readily reasonable that radiologists are mostly able to provide only a suggestion of the presented tumour entity but this expert opinion would be very helpful to further narrow down the list of potential differential diagnoses (e.g., differentiation of a cyst vs. solid tumour osteolysis, identification of jaw osteomyelitis vs. tumoral infiltration, recognizing of secondary tumour involvement of the jaw). · primary bone tumours of the jaw are very rare, moreover difficult to differentiate radiologically, and do need therefore histological proof;. · profound knowledge about tumour characteristics (location within the jaw, relationship to the tooth, bony destructive pattern) may allow a rough orientation and classification;. · matrix-forming tumours and dysplasias of the jaw facilitates their radiological differentiation and classification;. · in contrary, osteolyses should be thoroughly scrutinized for the more frequent gnathic cysts in differentiation of rather rare solid primary tumours;. · an interdisciplinary round-table discussion amongst well-experienced maxillofacial surgeons and specialized radiologists may be appropriate to avoid severe misinterpretations.. · Grieser T, Hirsch E, Tödtmann N. Bone Tumors of the Jaw - the "Blind Spot" for Radiologists Experienced with Tumors? - Part I. Fortschr Röntgenstr 2024; DOI 10.1055/a-2415-8880.

New strategies to prevent and control nerve dysfunction after dental extraction

Nerve dysfunction is a common postoperative complication of dental extractions. In dental extraction, the nerves involved mainly include the inferior alveolar nerve, lingual nerve, buccal nerve, chin nerve and nasopalatine nerve. Nerve dysfunction will seriously affect the patient's quality of life and may lead to medical disputes. This review firstly summarizes the clinical manifestations and pathological mechanisms of post-dental extraction nerve dysfunction, then summarizes its clinical risk factors and preventive strategies, then analyzes the clinical characteristics and physiological mechanisms of natural sensory recovery after dental extraction nerve dysfunction, and finally summarizes the cutting-edge therapeutic tools and research directions in the treatment of post-dental extraction nerve dysfunction in recent years. The aim of this article is to comprehensively review the cutting-edge advances in post-dental extraction nerve dysfunction from clinical to molecular mechanisms, and from pathogenesis to prevention and treatment strategies, and seeks to provide reference for oral surgeons in preventing and responding to the treatment of nerve dysfunction after dental extraction.

Long-Term Stability in Temporomandibular Joint Replacement: A Review of Related Variables.

Background: The temporomandibular joint (TMJ) is a key component of the stomatognathic system, playing a major role in maintaining mandibular stability and function. Temporomandibular disorders (TMDs) are a prevalent disease in the world, with surgical treatment being reserved for complex cases or end-stage TMJ disease. A narrative review was conducted to describe the quantitative and qualitative factors that affect TMJ prosthesis stability. Methods: Studies with a sample size equal to or greater than 10 subjects who underwent surgical procedures for joint replacement using stock or customized ATM prostheses were included. This narrative review examined some variables that may influence in terms of the longevity of the TMJ prosthesis, highlighting issues to be considered in future research. Results: The current development of TMJ prostheses is benefiting from technological advances, offering a suitable adaptation to the patient's anatomy and superior results in functionality and patient satisfaction. However, the biomechanical complexity of the TMJ shows unique challenges compared to other joints in the body, where anatomical, biomechanical, and functional requirements are high. The stability of the TMJ prosthesis is affected by multiple variables, including the selection of biocompatible materials that resist corrosion and wear, the design of the prosthesis, the diagnosis and indication for its use, and the surgeon's experience. The success of TMJ replacement can be measured by improving the patient's quality of life, reducing pain, restoring mandibular functionality, and recovering suitable facial morphology for the patient's conditions. Conclusion: There is a need for training of maxillofacial surgeons in TMJ surgery and replacement, as well as a greater focus on the research and development of systems to simplify surgical design and procedures and to optimize the results of TMJ replacement.

Development, Implementation and Evaluation of the Fellowship Course Regenerative Medicine in Dentistry

Introduction: Scientists have developed solutions, for oral health by leveraging advancements in medicine. These solutions, known as “ reconstructive dentistry “ aim to address the limitations and short lifespan of restorative methods. Unlike restorative treatments, reconstructive dentistry focuses on not only restoring the structure of tissues but also their physiological functions. To achieve this, it requires an effort among dentists, biologists, stem cell researchers, material scientists, tissue engineers and other experts. Consequently, this study was carried out to create and evaluate a fellowship program called “Reconstructive Medicine in Dentistry.” The program aims to foster an approach towards reconstruction, in dentistry. Materials and Methods: This research involved three stages. Utilized a mixed method approach. In the first stage, we developed a design based on the Kern model, which involved conducting a review of relevant studies to extract and determine the goals and topics related to medical reconstruction, in dentistry. Expert panel meetings were held to finalize these goals and topics. For each target group, we identified the learners, learning environment and educational strategies. We also made arrangements for implementing the program. Established evaluation methods for both students and the program itself. Subsequently, we implemented the designed curriculum for two groups of students. Finally, we evaluated the program’s effectiveness through questionnaires and semi structured interviews, with students, professors and organizers. The collected data was analyzed using statistics. Results: In 2020 and 2021, two groups of students were meticulously selected from disciplines such as maxillofacial surgeons, oral medicine specialists, periodontists, endodontists, and more, after passing the entrance exam. The primary objective of this program is to educate graduates with the skills to restore missing tissues in the mouth, jaw and facial regions using cutting edge regenerative medicine techniques. The curriculum was developed in collaboration with experts from areas like tissue engineering, dental specialization (including maxillofacial surgeons) biomaterials and developmental biology. Both students and professors expressed satisfaction, with the program. Conclusion: A group of professors, from specialties came together to implement a fellowship program in reconstructive dentistry. The main goal of this program was to train specialists in tissue reconstruction for patients who have suffered jaw and facial injuries; by using advanced methods in medicine. Additionally, this initiative can also be a step towards strengthening the university’s movement towards third and fourth-generation universities. The findings from this study can provide insights, for those involved in planning and implementing interdisciplinary fellowship programs.

Dental Treatment Needs Among 16-Year-Old Patients with Cleft Lip and Palate: An Observational Study in Western Norway

Objectives This study aimed to a) assess intermaxillary sagittal relations, dental alignment, and occlusion among patients with Cleft Lip and/or Palate (CL/P) and b) evaluate the need for future dental treatment. Material/methods Clinical assessment, lateral cephalogram, orthopantomogram, and study models from 1019 patients with CL/P collected at age 16 from the Bergen national CLP team in Norway. Records included the number of dental agenesis or hypoplasia, ANB angulation, dental alignment, occlusion, oronasal fistula, and indications for future dental treatment needs. Results One-third required further treatment by an orthodontist, prosthodontist, or oral surgeon in adulthood, and complete bilateral or unilateral CLP had a significantly higher need than patients with isolated cleft of the lip or the palate. Missing teeth increased the risk for retrognathic maxilla (OR = 3,62), need for orthodontic and prosthodontic treatment (OR = 5.20), and a negative overjet and need for orthognathic surgery (OR = 4.86) (p &lt; 0.001). Oronasal fistula was present in 4.7% of the participants, significantly worsening all clinical indicators (p &lt; 0.001). Boys exhibited more adverse findings than girls, except regarding the need for dental porcelain bridges. A noticeable trend indicated increased dental treatment needs among 16-year-old patients with clefts born between 1990–2001, compared to patients born between 1980–1990. Conclusions/Implications The findings underscore the need for comprehensive, individualized treatment plans and interdisciplinary dental services for adult patients with CL/P. The original cleft pattern, male gender, presence of oronasal fistula, and a high number of missing teeth negatively influenced the dental status and treatment outcomes measured at the 16-year-old assessment.

Management of Smith-Lemli-Opitz Syndrome Type II associated with Cleft Palate

Rationale: This case report presents the management of a patient with the rare occurrence of SmithLemli-Opitz Syndrome (SLOS) and complete cleft palate Patient Concerns: The patient's cleft palate repair was not done in infancy, and she reported to the dental institution complaining of difficulty with proper food intake and speech. A clinical examination revealed muscle deformity, limited neck mobility, scoliosis, malocclusion, and inadequate oral health. The patient exhibited facial and limb anomalies characteristic of SLOS, in tandem with substantial challenges in speech and nutrition due to the cleft palate. Diagnosis: The patient was referred to the dental wing to manage the cleft palate defect. On dental examination a complete cleft of the hard and soft palate, which had not been surgically corrected during infancy, was confirmed through clinical and radiological investigation. Additional musculoskeletal complications, including scoliosis and muscle deformity, were also identified. Interventions: The treatment plan addressed both SLOS and cleft palate. A prosthodontic appliance was prepared to assist with palatal function and speech therapy. Comprehensive care for SLOS included genetic counselling, nutrition management, and targeted physical therapy. The patient was also referred to an orthodontist, oral surgeon and a speech-language therapist further intervention. Conclusion: This case emphasizes the importance of early diagnosis and intervention in congenital disorders. It advocates for proactive, multidisciplinary care from infancy to enhance the quality of life for individuals with complex syndromes, underscoring the need for ongoing support and resources

Retro and prospective analysis of complex treatment of a patient with a polyostotic form of osteoclastoma of the maxillofacial region: clinical observation

In global literature there is not sufficient information on the course of the polyostotic form of osteoclastoma and methods of its treatment. For this reason, the analysis of this clinical case may be interesting for oncologists, maxillofacial surgeons and dentists of various specialties, who can reveal both the onset and recurrence of the disease. A characteristic feature of the course of this disease is the relapse of neoplasms with localization of foci in various parts of the upper and lower jaw. A clinical case of polyostotic form of jaw osteoclastoma and patient`s management tactics from 2006 to 2024 are described in the article. The disease was first diagnosed in 2006, when a neoplasm was revealed in the right part of the lower jaw. The neoplasm was removed by resection and mandibular defect was replaced by a carbon implant with further prosthesis. In 2011 a new neoplasm was detected on the left side in the frontal part of the upper jaw. At the same time a relapse of the disease was diagnosed with a new tumor focus in the lower jaw on the right. Surgical treatment was performed. Firstly, the neoplasm in the frontal area of the upper jaw was removed with replacement of the defect with a resection prosthesis. And secondly, a removal of the tumor on the lower jaw with resection of the chin within healthy tissues and replacement of the defect with an implant made of carbon-carbon material "Uglecon M" were performed. In 2023 the patient was invited to the dental hospital of the Clinical Multidisciplinary Medical Center of E.A. Vagner Perm State Medical University for dispensary observation and evaluation of the results of the treatment. The obtained results indicate the need for medical follow-up of patients after surgery for osteoblastoclastoma. The effectiveness of jaw implants made of carbon-carbon composite material " Uglecon M" was proved as well.

Orthodontic-orthognathic combined case management in postgraduate orthodontic and oral maxillofacial surgery programs.

With the development of three-dimensional (3D) image, the 3D virtual surgical planning (VSP) system has been broadly used in the treatment planning of orthodontic-orthognathic cases. This study aimed to understand the current education status regarding the use of orthodontic-orthognathic surgical planning tools in the postgraduate orthodontic and oral and maxillofacial surgery (OMFS) programs in North America. An electronic multiple-choice survey was sent via email with 2-week and 1-month follow-ups, requesting anonymous participation of program directors/department chairs from all postgraduate orthodontic and OMFS programs in North America. Responses were collected directly on Qualtrics for analysis. The response rate was 25.68% for orthodontic and 34.34% for OMFS programs. Two-dimensional traditional surgical planning (TSP) at initial treatment planning and 3D VSP right before surgery were most commonly utilized in both specialty programs. All responded postgraduate OMFS programs utilized VSP, yet 26.32% of responded orthodontic programs did not utilize VSP. For the surgical outcomes, fewer orthodontic programs were highly satisfied than OMFS programs. More orthodontic programs warranted secondary surgery at a higher rate due to the unsatisfied outcome. Additionally, the orthodontic programs that did not use VSP showed higher unsatisfied surgical outcomes than the programs that used VSP. Moreover, there were discrepancies between orthodontic and OMFS programs regarding the perceived level of collaboration of each other on the surgical planning for the patients. There were discrepancies between orthodontic and OMFS programs regarding the utilization of VSP, treatment outcomes satisfaction, and perceived level of collaboration on surgical planning for the patients.

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

IntroductionIn the UK Oral and Maxillofacial Surgery (OMFS) and Oral Surgery (OS) are distinct specialties governed respectively by the General Medical Council (GMC) and General Dental Council (GDC). There has always been overlap of training and care between both specialties. The OMFS curriculum was updated in 2021 and the Oral Surgery Curriculum in 2023. This paper quantitatively compares the two documents. ResultsThe generic professional elements of both curricula are extensive and similar in content. The specialty specific elements of the OS and OMFS curricula with focus on knowledge domains and competencies including index procedures and critical conditions were compared with the level of coincidence colour coded: green (matching), amber (substantial overlap) and red (not present).OMFS curriculum contains all components of the new UK OS curriculum with the exception of formal documented competence in conscious sedation for dentistry. This overlap between OMFS and OS has been recognised by the General Dental Council who give OMFS specialists direct access to the Oral Surgery specialist list by Route 4.In contrast, the OS overlap with OMFS is limited, particularly in the important critical/emergency conditions where ‘competence’ has been replaced by “experience of” in the 2023 OS curriculum in the domains of trauma and acute infections. This change will preclude OS specialists trained on the new curriculum being able to share on-call with OMFS specialists without significant additional training. ConclusionWe hope this comparison will be useful to those commissioning services and also for young dentists/doctors considering their future careers

Evaluating Artificial Intelligence Chatbots in Oral and Maxillofacial Surgery Board Exams: Performance and Potential

BackgroundWhile artificial intelligence (AI) has significantly impacted medicine, the application of large language models (LLMs) in oral and maxillofacial surgery (OMS) remains underexplored. PurposeThis study aimed to measure and compare the accuracy of four leading LLMs on OMS board examination questions and to identify specific areas for improvement. Study design, setting, and sampleAn in-silico cross-sectional study was conducted to evaluate four AI chatbots on 714 OMS board examination questions. Predictor variableThe predictor variable was the LLM used — LLM 1 (Generative Pre-trained Transformer 4o [GPT-4o], OpenAI, San Francisco, CA), LLM 2 (Generative Pre-trained Transformer 3.5 [GPT-3.5], OpenAI, San Francisco, CA), LLM 3 (Gemini, Google, Mountain View, CA), and LLM 4 (Copilot, Microsoft, Redmond, WA). Outcome variablesThe primary outcome variable was accuracy, defined as the percentage of correct answers provided by each LLM. Secondary outcomes included the LLMs’ ability to correct errors on subsequent attempts, and their performance across 11 specific OMS subject domains: Medicine and Anesthesia, Dentoalveolar and Implant Surgery, Maxillofacial Trauma, Maxillofacial Infections, Maxillofacial Pathology, Salivary Glands, Oncology, Maxillofacial Reconstruction, Temporomandibular Joint Anatomy and Pathology, Craniofacial and Clefts, and Orthognathic Surgery. CovariatesNo additional covariates were considered. AnalysesStatistical analysis included one-way ANOVA and post-hoc Tukey HSD to compare performance across chatbots. Chi-square tests were used to assess response consistency and error correction, with statistical significance set at p < 0.05. ResultsLLM 1 achieved the highest accuracy with an average score of 83.69%, statistically significantly outperforming LLM 3 (66.85%, p=0.002), LLM 2 (64.83%, p=0.001), and LLM 4 (62.18%, p<0.001). Across the 11 OMS subject domains, LLM 1 consistently had the highest accuracy rates. LLM 1 also corrected 98.2% of errors, while LLM 2 corrected 93.44%, both statistically significantly higher than LLM 4 (29.26%) and LLM 3 (70.71%) (p<0.001). Conclusions and relevanceLLM 1 (GPT-4o) significantly outperformed other models in both accuracy and error correction, indicating its strong potential as a tool for enhancing OMS education. However, the variability in performance across different domains highlights the need for ongoing refinement and continued evaluation to integrate these LLMs more effectively into the OMS field.

A review of the ‘second degree’ universities of Oral and Maxillofacial Surgery (OMFS) Specialists and Trainees in the UK. Locations of their graduate entry medicine and graduate entry dentistry degrees, graduating between 1979-2019

IntroductionBy spending 3-5 years in a single location studying for their second degree, OMFS trainees often put down domestic roots which they are reluctant to pull up to train elsewhere. MethodThe universities at which OMFS specialists/trainees obtained their second degrees were assembled using the General Medical Council’s OMFS specialist list, the General Dental Council’s Dental Register and a database of OMFS trainees and consultants. ResultsThe second degrees of 818 past and current OMFS specialists/trainees were analysed. The most common location for second degrees of either type was London 287 (35%) followed by Birmingham 67 (8%), then Cardiff 51 (6%) and Manchester 45 (6%). There is a trend, with time, to more OMFS trainees obtaining their second degree in London.For those 689 whose second degree was medicine, London was the top location with 206 (30%) followed by Birmingham 67 (10%) and Cardiff 50 (7%). For those 129 whose second degree was dentistry, London was the top location with 81 (63%) followed by Europe 11 (9%) and Ireland 7 (5%). DiscussionThe predominance of London as a source of their second-degree for both dentistry and medicine first OMFS trainees impacts on recruitment. Many who study in London want to train/work in or near London.Understanding where OMFS trainees obtain their second degrees, may help those planning for the future workforce for example creating opportunities outside London.

Training and Learning Resources Available for Singly Qualified Dental Graduates Entering into Junior Oral and Maxillofacial Surgery Roles

For dental graduates transitioning into junior Oral and Maxillofacial Surgery (OMFS) roles, the shift from general dental practice to the hospital environment presents unique challenges. This article reviews the key resources and training tools that are available and commonly used by these graduates to prepare for their roles. The findings are based on a survey of 61 junior OMFS practitioners, highlighting the most helpful resources and identifying gaps that could be addressed to better support new entrants into the field and enhance training satisfaction.

Gender Changes in Oral and Maxillofacial Surgery (OMFS) in the UK 1996 to 2030. Current trends suggest gender parity of those joining the OMFS specialist list may be achieved by 2048

Gender Changes in Oral and Maxillofacial Surgery (OMFS) in the UK 1996 to 2030. Current trends suggest gender parity of those joining the OMFS specialist list may be achieved by 2048