Practice Of Maxillofacial Surgery Research Articles

Application of lasers in oral and maxillofacial surgery: A literature review

Laser technology is an important addition to both therapeutic and diagnostic modalities. It is a rapidly growing field and the surgeon must have thorough knowledge of the current literature and also of the advancements so as to perform the laser surgical procedures efficiently and effectively. The surgeon must also be aware of the benefits, safety and hazards of the lasers and must follow the safety guidelines. Advances in the laser systems make the procedures easier to perform. Incorporating the lasers in the oral and maxillofacial surgery practice has led to improvement in the patient care. In this article, we have summarized the application of lasers in the field of oral and maxillofacial surgery by review of literatures.

Clinical considerations for oral and maxillofacial surgery practice during the COVID-19 pandemic

In order to strategically respond to COVID-19, the most important measure is to control COVID-19 by minimizing the spread of the coronavirus and preventing related diseases and morbidity. In dental and oral maxillofacial surgery treatment procedures, it is unavoidable that the patient's saliva and blood are generated in the form of droplets or aerosols. Recently, new variants of COVID-19 virus had been reported and cause more infection and faster spread. The risk of breakthrough infection, which occurs even after vaccination, is increasing. Therefore, this recommendation was prepared to help prevent infection of oral and maxillofacial surgeons exposed to such environments, and to maximize the safety of patients and medical staff.

An Update on Diagnosis and Pharmacologic Therapy for Headache in the Oral and Maxillofacial Surgery Practice.

Headaches are synonymous with neurovascular pain (cephalalgias), which comprise a heterogeneous group of pain disorders that share a common anatomic region (head and neck). Headaches are often a "universal" disease presentation that is evaluated by the oral and maxillofacial surgeon. Pharmacologic therapy of headaches is most often based on the severity of symptoms and the degree of disability experienced by the patient. This article describes the epidemiology of neurovascular headaches, their pathophysiologic mechanisms/presentation, the workup of patients, and an up-to-date overview of pharmacologic approaches that can be applied in the oral and maxillofacial surgical practice to treat this patient population.

Comparative study of analgesia of ketorolac, tramadol, and flupirtine in the management of third molar surgery.

Introduction:The most commonly performed surgical procedure in most oral and maxillofacial surgery practices is the removal of third molars. Postoperative pain is considered a form of acute pain due to surgical trauma with an inflammatory reaction.Materials and Methods:One hundred and fifty patients were included in the study which were divided into GROUP-A, B, and C-50 patients each; those who underwent third molar removal under local anesthesia. Local anesthesia was obtained by inferior alveolar, lingual, long buccal, posterior superior alveolar, and greater palatal nerve block injections after first complain of pain, all patients were prescribed analgesics (Ketorolac-10 mg), (Tramadol-50 mg), (Flupirtine-100 mg), and antibiotics co-amoxiclav-625 mg) T. D. S in all the three groups A, B, C, respectively, for 5 days and the timing noted in the patients assessment sheet. The statistical analysis was done using SPSS Version 15.0 statistical analysis software.Results:The flupirtine group has early onset and also had minimum side effects. All the groups showed similar trend in change in pain score from 3 h. P. O to different time intervals. It was observed the pain score increased significantly till 6 h. Post operative a decreased trend was found at 24 h, 48 h, 78 h, after 6 h. and this change was found to be statistically significant for all three groups.Conclusion:Flupirtine had faster onset and comparable pain management profile as compared to tramadol, it also had minimum side effects, hence the use of flupirtine might be recommended for postoperative pain management in cases undergoing third molar surgery.

First Bite Syndrome – An Underrecognized and Underdiagnosed Pain Complication After Temporomandibular Joint Surgery

First bite syndrome (FBS) can develop after head and neck surgical procedures. The aim of this study is to identify patients diagnosed with FSB after temporomandibular joint (TMJ) surgery, including their pain characteristics and risk factors for FBS. Using a retrospective study design, a cohort of 24 patients with confirmed diagnosis of FBS were identified from the oral and maxillofacial surgery and orofacial pain (OFP) practices at Massachusetts General Hospital and Research Patient Data Registry (RPDR) between 1975 and 2019. The inclusion criteria were facial pain that was triggered by taste stimulus only and followed by a refractory period until the next gustatory stimulus. Of the 24 patients identified, 19 had undergone TMJ surgery, 3 patients had idiopathic FBS, 1 had a parapharyngeal space tumor and 1 developed FBS after facial burns. In the surgical patients, the median duration of onset was 2.75 months post-surgery. Most patients reported pain in the parotid region. Pain was only triggered by a taste stimulus and subsided with subsequent bites of food. 2 patients underwent spontaneous resolution of their symptoms and 1 reported complete resolution with onabotulinum toxin A (BTX) injections. Anxiety and depression were the most common comorbid conditions. FBS is an underrecognized pain complication in TMJ surgery patients. A precise history and accurate description of the pain is necessary for correct diagnosis which is important for improved treatment outcomes.

Does the Use of a 'Wrap' in 3D Surgical Planning Influence the Bony Margin Status of Neoplasms of the Oral, Head and Neck Region?

PurposeThree-dimensional surgical planning (3-DSP) is becoming commonplace in the management of benign and malignant disease for oral and maxillofacial surgery practice within the last decade.1 Surgeons utilize a virtual “wrap” to preoperatively delineate and define maxillofacial tumor resection margins. The investigators hypothesized that the use of a wrap is a predictable method to obtain negative bony margins. MethodsThe investigators implemented a retrospective chart review. The sample was composed of patients over the age of 18 treated at John Peter Smith Health Network and Parkland/UT Southwestern Medical Center who obtained 3-DSP for pathology of the head and neck, involving bone, with a virtual wrap utilized for bony margins. The proportion of cases was calculated, descriptive statistics reported, and binomial exact calculation was performed for confidence intervals. The primary variable analyzed was bony margin status on final histopathology, involved or uninvolved, based on the pathology report. ResultsThe sample was composed of 39 cases, 1 of which was excluded due to aborting the preplanned 3-DSP. Of the 38 included cases, 1 had involved bony margin on final histopathology (2.6%; 95% confidence limits: 0.1%, 13.8%). There were 16 malignant cases (42%) and 22 benign cases (58%). When stratified by pathology, 1 out of the 16 malignant cases (6.3%; 95% confidence interval: 0.2%, 30%) and 0 out of the 22 benign cases (95% confidence interval: 0 %, 15.4%) had an involved bony margin on final histopathology. ConclusionThe results of this preliminary study suggest 3D surgical planning with wrap margins is a predictable method to obtain negative bony margins in benign and malignant disease of the maxillofacial complex. Further studies will focus on compiling prospective data to solidify the accuracy and predictability of using a wrap to obtain negative bony margins.

Share the Airway: An Interdisciplinary Course for Management of the Unexpected Difficult Airway

IntroductionWithin the scope of practice of oral and maxillofacial surgery, the unexpected difficult airway may occur in the trauma bay, operating theater, postoperative, or office-based setting. Oral and maxillofacial surgeons must be trained to diagnose and intervene in anatomically or anesthetically compromised airways. An interdisciplinary training course hosted by an anesthesiology airway expert and oral and maxillofacial surgeon is a novel resident training opportunity. Materials and methodsIn August 2019 and October 2020, the department of anesthesiology and the division of oral and maxillofacial surgery at Weill Cornell Medical College/NewYork-Presbyterian Hospital, New York, NY, co-hosted interdisciplinary educational sessions focused on management of the unexpected difficult airway, taught to residents and faculty. A SurveyMonkey (San Mateo, CA) questionnaire was taken 2 weeks before and after the course, with 10 questions assessing fund of knowledge in airway anatomy and physiology, etiology of difficult airway scenarios, difficult airway algorithm, and performance of emergency surgical airways. An interactive lecture on likely scenarios, airway algorithms, relevant surgical anatomy, routine and emergency airway management, airway devices, and emergency surgical airway techniques was conducted. A hands-on cricothyroidotomy tutorial using Crico-Trainer “Pig” (VBM, Sulz, DE) anatomic models with fresh porcine tracheas to simulate human airway anatomy were used. A post-course test consisted of a timed, filmed performance followed by a debriefing session. ResultsIncreased fund of knowledge and comfort with airway anatomy, difficult airway diagnosis and management, and emergency surgical airway techniques was evident between pre-and post-course surveys and was clearly demonstrated across multiple years. The sample size (n = 10, 2019; n = 7, 2020) was insufficient for statistical analysis. ConclusionInterdisciplinary didactic and clinical training in emergency airway management are of paramount importance to the oral and maxillofacial surgeon. Between years, a drop-off in knowledge base and technical skills occurred, even among senior staff, and all attendees agreed that periodic repetition is worthwhile. This course is now offered as part of the core curriculum on an annual basis and may be expanded to additional specialties for whom airway management is important.

Are Women Adequately Represented in Leadership Roles in Oral and Maxillofacial Surgery? A 10-year Retrospective Evaluation of Society Leadership and Journal Editorial Boards

Surgical specialties have traditionally been considered male-dominated fields within medicine. Oral and maxillofacial surgery (OMS) is also a surgical subspecialty whose practitioners largely comprise of men. While many factors contribute to the perpetuation of these trends, past studies have identified the significance of female role models in the decision to pursue a surgical field for female students. The authors thus sought to analyze female representation within key societies and journal editorial boards that play central roles in the academic advancement, organization, and clinical practice of oral and maxillofacial surgery in the United States (US).A retrospective review of 2 major OMS journals, the Journal of Oral and Maxillofacial Surgery (JOMS) and Oral Surgery Oral Medicine Oral Pathology Oral Radiology (OOOO), and six OMS professional and academic societies, including the American Association of Oral and Maxillofacial Surgeons (AAOMS), American College of Oral and Maxillofacial Surgeons (ACOMS), American Board of Oral and Maxillofacial Surgery (ABOMS), American Academy of Craniomaxillofacial Surgeons (AACMFS), OMS Foundation, Osteo Science Foundation, was conducted. The names and genders of the members of the editorial board and board of directors between 2011 and 2020 were acquired from their respective sources. Only verified OMSs were included, while non-OMS clinicians and administrative staff were excluded from the final count. OMSs from countries other than the US were also excluded. A line of best fit was determined using simple linear regression to demonstrate temporal trends in female representation in editorial boards and society leadership. The proportion of female OMS faculty and female OMS residents was obtained from AAOMS. Either the Chi-squared test or Fisher's exact test was used to compare the proportion of female representation in editorial boards and society leadership with the proportion of full-time female OMS faculty.During the study period of the past 10 years, female representation on the editorial boards of OMS journals grew from 4.5% in 2011 to 10.6% in 2020 (Figure 1). A growth from 3.0% in 2011 to 10.3% in 2020 was similarly observed for the proportion of women in society leadership (Figure 2). The proportion of women in editorial boards (8.9%) did not differ from that of full-time female OMS faculty (11.4%) in 2019 (P = .80). Similarly, female representation on society leadership (10.5%) was not different from that of full-time female OMS faculty in 2019 (P = .84).Although there are significantly fewer female surgeons on OMS journal editorial boards and the boards of OMS societies compared to that of male surgeons, the proportion of female representation in these organizations has been growing over the past decade. Currently, the authors found that women seem to be adequately represented in editorial boards and society leadership in the OMS field.

Shortening of bones using novel contraction osteogenesis device: An experimental study

Aim: Given the high complication rates associated with orthognathic surgery for the correction of maxillomandibular malformations, studies have focused on alternative methods of strengthening the jaw, such as distraction osteogenesis. However, methods of shortening of the jaw are not well-elucidated in oral and maxillofacial surgery practice. This study aims to investigate the efficacy of a new method of shortening osteotomized jaws.
 Methodology: A 2.5–3 cm skin incision was made on the left tibia of each of 15 New Zealand white rabbits aged 12–18 months, followed by fixation of 15 mm pre-opened distractor devices to the tibia after osteotomy. After a five-day latency period, the distractors were activated to a total of 8 mm, with closure of the device set at a rate of 0.25 mm/day in the test group. After a five-day latency period, the distractors closed at a rate of 0.125 mm/day, achieving a total contraction of 5 mm. The distractors were not activated in the control group. The bone at the contraction range was evaluated, and the resultant shortening was measured.
 Results: The tibia was shortened by an average of 4.32 mm. Exaggerated bone formation was identified around the osteotomized cortical bone in all rabbits in the control and study groups, and there were minimal complication rates.
 Conclusion: This study verified that the jaw can be shortened by performing slow, controlled contraction with a bone resorption pattern.
 
 How to cite this article: Ocak H, Kılıç E. Alkan A, Shortening of the bones using a novel contraction osteogenesis device: An experimental study. Int Dent Res 2021;11(Suppl.1):26-31. https://doi.org/10.5577/intdentres.2021.vol11.suppl1.5
 
 Linguistic Revision: The English in this manuscript has been checked by at least two professional editors, both native speakers of English.

Radiological examination of cranial, ear-nose-throat, and maxillofacial system findings of Dyke-Davidoff-Masson syndrome in 28 patients

ObjectivesIt was aimed to detail the intracranial and ear–nose–throat-maxillofacial (ENT-MF) system findings of Dyke–Davidoff–Masson Syndrome (DDMS), and to examine the association in a larger sample according to current literature. Patients and methodsThe study was designed retrospectively. Cranial magnetic resonance (MRI) and computed tomography (CT) Imaging records of patients were re-examined. Outcome parameters were identified as patients' demographics, the emergence of the central nervous system (CNS) pathologies, the asymmetric pneumatization of the skull bones, and ENT-MF system presentation. The correlation of the cranial and ENT-MF system findings was evaluated with Spearmen correlation analysis. ResultsRadiological images of 28 patients were examined. The number of men was 21 (75.0%) and the number of females was 7 (25.0%). The mean age of the patients was 23.6 ± 10.6 (min. 1, max. 44). DDMS involvement detected on the right side in 15 (53.6%) of the patients. Cerebral atrophy (n = 28, 100%), lateral ventricular dilatation (n = 26, 96.3%) and corpus callosum damage (n = 19, 67.9%) were most frequent findings respectively. Cerebellar atrophy (n = 4, 14.3) and venous sinus dominance (n = 4, 14.3) were the rarest pathologies. Facial asymmetry (n = 15, 53.6%) and frontal sinus hyperpneumatization (n = 15, 53.6%) were the most frequent findings in the ENT-MF system. Increased calvarial thickness showed a high positive correlation with facial asymmetry and frontal sinus hyperpneumatization (p = 0.002, r = 0.571 and 0.024, r = 0.424, respectively). ConclusionDDMS may occur with different radiological findings depending on the level of cerebral damage. Facial asymmetry often accompanies the disease and it should be considered in clinical practice of facial plastic and maxillofacial surgery.

Attitudes, stressors and work outcomes related to the COVID-19 pandemic among dental assistants in Germany: a cross-sectional study

ObjectivesThe COVID-19 pandemic has posed great challenges to medical professionals worldwide. Dental assistants (DAs) are at exceptionally high risk of infection with SARS-CoV-2 due to frequent and close patient contact...

Do Medical Insurance Companies Reimburse Telemedicine Office Visits the Same as In-Person Office Visits in an Academic Oral and Maxillofacial Surgeon Setting?

The use of telemedicine has grown exponentially over the last decade, but its widespread adoption has been hindered, at least in part, by uncertainty over reimbursement rate for services. The aim of this study is to compare reimbursement rates of telemedicine and in-person visits in an academic oral and maxillofacial surgery practice. The investigators implemented a retrospective cohort study. The sample was composed of patients who were treated by the oral-maxillofacial surgery service at the University of Pennsylvania Health System from March 17, 2020 to February 27, 2021. The primary predictor variable was the type of patient visit, either telemedicine or in-person. Patient status, either established or new, was a covariate. The outcome variable was the mean reimbursement-to-charge (RC) ratio. Descriptive and bivariate statistics were computed, and the P value was set at .05. This study included 6,082 submitted claims for 4,045 patients for in-person and telemedicine oral-maxillofacial surgery office visits. The mean reimbursement per insurance payor was $98.07 for a telemedicine visit (mean RC ratio = 0.48 with a standard deviation of ± 0.20) and $109.5 for an in-person visit (mean RC ratio = 0.50 with a standard deviation of ± 0.19). While there was a significant difference between the RC ratio for total telemedicine versus in-person visits (P = .001), the magnitude of the difference was only 2%. When stratifying the comparison by new (P = .73) and established patients (P = .20) for both telemedicine and in-person office visits, there was no significant difference in RC ratios. The results suggest that there are no major discrepancies in financial reimbursement rate between telemedicine and in-person office visits. Both methods of treatment may be financially effective for oral-maxillofacial surgery providers. Future studies can compare reimbursement rates among different insurance providers and among different institutions in the United States.

Antimicrobial green silver nanoparticles in bone grafts functionalization for biomedical applications

In maxillofacial surgery and implantology clinical practice, infection processes are common during the healing and graft osseointegration. Microorganisms’ resistance to various antimicrobials has increased steadily through the widespread use of topical antibiotics, and new substances with antimicrobial properties are urgently necessary to avoid the infection processes in bone grafts. In the present study, bovine bone grafts (BG) for dental application were functionalized with silver nanoparticles (NPs) synthesized by the bioreduction technique using extracted (EEO) and commercial orange essential oil (CEO). The majoritarian compound identified in EEO and CEO was d-limonene, with a concentration up to 95%. The UV–Vis spectroscopy of NPs demonstrated the maximum absorbance peak around 400 nm and the average diameter obtained by transmission electron microscopy was 50 and 80 nm, respectively for NPs-EEO and NPs-CEO. The physicochemical stability of the NPs was studied for 60 days, at refrigerated temperature (6 ± 2 °C), and NPs-EEO presented better results of zeta potential, polydispersity index, and particle size during storage. The antioxidant activity was determined by the inhibition of DPPH and ABTS free radicals and by the Fe3+ reducing power (FRAP assay). NPs showed better results of antioxidant activity by DPPH and FRAP methods when compared to individualized essential oils. NPs and functionalized bone grafts showed greater antagonistic actions than individualized essential oils against the seven studied microorganisms. Therefore, it is possible to affirm the biological importance of the biosynthesized NPs for use as an antimicrobial agent in dental biomaterials, being a promising alternative to avoid the infection processes in bone grafts.

Analyzing the Effect of the COVID-19 Pandemic on the Oral and Maxillofacial Surgery Literature

The COVID-19 pandemic has dramatically altered our world. Many of these changes directly impacted the clinical practice of oral and maxillofacial surgery. Somewhat less immediately apparent is the effect of COVID-19 on the oral-maxillofacial surgery literature. From new infection control protocols, to the aftermath of delays in care, to the sequela of prolonged prone positioning, oral and maxillofacial surgeons have been actively contributing to the literature throughout the pandemic.1 This study aims to discern the effects of COVID-19 on the oral-maxillofacial surgery literature and reflect on the implications on the specialty going forward.

Impact of COVID-19 on oral and maxillofacial surgery practice in India: A national survey.

Study Design:The Coronavirus disease-19 (COVID-19) pandemic has disrupted oral and maxillofacial (OMF) surgeons’ practice globally. We implemented a cross-sectional, questionnaire-based survey among the OMF surgeons of India.Objective:The objectives of the study were (1) gathering data among the maxillofacial surgeons in terms of their occupational exposure and access to adequate personal protective equipment (PPE) and (2) to estimate how the COVID-19 pandemic has affected the practice of OMF surgeons in India.Materials and Methods:Complete responses of 178 OMF surgeons were included in the study. Descriptive and analytic statistics were computed. The level of statistical significance was set at P < 0.05. Binary logistic regression models were created to assess the predictors of the impact of the COVID-19.Results:Out of the 178 respondents of the study, most (37.1%) were following their hospital's guidelines. Most had access to adequate PPE (89.9%), whereas 93.8% had COVID-19 testing available. One hundred and thirty-three (74.7%) surgeons were involved in teleconsultation. Ninety-two (51.7%) and 166 (93.3%) were involved in elective surgery and emergency surgeries, respectively. Median outpatient department cases and number of surgeries done per week reduced by 73.9% and 66.7% (P < 0.001), respectively. Most surgeons (86%) experienced that cost of treatment had increased during the COVID. Over 75% were afraid to get infected with COVID, whereas 44.9% were anxious to lose the income. More than 56% of the OMF surgeons reported a fall in income and 94% reported decreased productivity in academic research. Most surgeons (93.8%) believed that COVID had a positive impact on human behavior in terms of hand hygiene.Conclusion:The impact of COVID-19 among OMF surgeons has adversely affected clinical practice, personal lives, and academic productivity and has catalyzed an exponential increase of telemedicine. Future surveys should capture the long-term impact of COVID-19.

Evaluation on the Application Effect of Humanistic Teaching in Oral and Maxillofacial Surgery Practice Nursing Students' Guidance and Teaching

Evaluation on the Application Effect of Humanistic Teaching in Oral and Maxillofacial Surgery Practice Nursing Students' Guidance and Teaching

Does the Use of a Wrap in Three-Dimensional Surgical Planning Influence the Bony Margin Status of Benign and Malignant Neoplasms of the Oral, Head and Neck Region? An Initial Investigation

<h3>Purpose</h3> Three-dimensional surgical planning (3-DSP) is becoming commonplace in the management of benign and malignant disease for oral and maxillofacial surgery practice within the last decade.¹ In pathologic resections of the head and neck cysts and tumors in particular, a virtual wrap is used to delineate the tumor resection margin. However, there has yet to be a study in regard to the accuracy of this wrap and its effect on bony margin status. This study aims to discuss our experiences with the use of wraps created with 3-DSP and explore the accuracy of the wrap for margin status. We hypothesize that the use of a wrap is a predictable method to obtain negative bony margins. Furthermore, we explore the emerging challenges in the use of this technology specific to pathologic resection margins. <h3>Methods</h3> This is a retrospective chart review. The study included patients over the age of 18 (range, 18-99) treated at 2 centers, John Peter Smith Health Network Oral and Maxillofacial Surgery and Parkland/UTSW Oral and Maxillofacial Surgery. We included patients who obtained a 3-DSP for pathology of the head and neck involving the bone and who also obtained a virtual wrap for bony margins. There were no specific exclusion criteria. There were no exclusions due to racial, ethnic, or gender groups. Data accessed ranged from July 1, 2017, to May 1, 2020. Patient data were collected for processing via multilevel protected electronic health record system (Epic). Once the data were gathered, the identifiable link was destroyed and data were anonymized. Analysis was completed via Excel. <h3>Results</h3> There were 39 cases, but we excluded 1 that required intraoperative adjustment and thus did not follow preplanned case. One out of the 38 cases involved a bony margin (2.6%; 95% confidence interval, 0.1%, 13.8%). Table 1 defines the pathology. We classified SCC (squamous cell carcinoma) and low-grade osteosarcoma as malignant cases and the rest as benign. There were 16 malignant cases (42%) and 22 benign cases (58%). When stratified by pathology, 1 out of the 16 malignant cases (6.3%; 95% confidence interval, 0.2%, 30%) and 0 out of the 22 benign cases (95% confidence interval, 0%, 15.4%) had a positive margin. <h3>Conclusion</h3> Three-dimensional surgical planning with wrap margins is a predictable method to obtain negative bony margins in benign and malignant disease of the maxillofacial complex. The surgeon must be prudent to ensure accurate margin delineation by engineers before simulated wrap creation or resection.

Anatomical and Morphological Assessment of Nasopalatine Canal in Pediatric and Adolescent Population via Cone Beam Computed Tomography.

Anatomical and morphological structure of nasopalatine canal (NPC) is important for surgical techniques carried out on the maxilla. The aim of the present study was to analyze the anatomical and morphological characteristics of the NPC among pediatric and adolescent population using cone beam computed tomography (CBCT). A total of 437 cases were analyzed using CBCT images in this retrospective, cross-sectional study. Shape was analyzed as hourglass, cone, funnel, banana, cylindrical, and tree branch like. Number of foramina Stenson (FS) was evaluated through coronal, axial, and sagittal views. Landmark evaluation involved; diameter of FS, diameter of incisive foramen, diameter at the mid-canal length, NPC length, and narrowest buccal bone thickness. Pathology presence near NPC was evaluated to determine alterations on the landmark metrics. Nasopalatine canal shape distribution revealed 32% hourglass, 9.6% conic, 10.8% funnel, 11.9% banana, 29.5% cylindrical and 6.2% tree branch. Number of FS (P = 0.021; P < 0.05), diameter of FS (P = 0.041; p < 0.05), NPC length (P: 0.020; P < 0.05), and narrowest buccal bone thickness from the mid-canal length was significantly higher in males (P: 0.000; P < 0.05). Diameter of incisive foramen and diameter at the mid-canal length revealed no significance among genders (P1 = 0.318, P2 = 0.105; P > 0.05). Incidence of pathology near NPC is 20.8% and was not affected by gender (P = 0,192; P > 0.05). The current study demonstrates significant variations of NPC morphology among patients. Therefore, CBCT analysis is highly recommended for clinicians to reduce the complications in oral and maxillofacial surgery practices and to provide better surgical outcomes.

How has COVID-19 affected surgical practice in Oral and Maxillofacial Surgery in the East Midlands, UK?

The impact on the provision of care within the NHS due to COVID-19 can not be understated. It has created various challenges for Oral and Maxillofacial Surgeons due to the high-risk nature of working within this specialty. The aims of this study were to identify the ongoing clinical activities at the height of pandemic, the guidance issued to staff regarding the use of personal protective equipment and the changes to maxillofacial practice. A prospective analysis was commenced within six Oral and Maxillofacial Surgery units in the East Midlands, UK with data being collected by means of a 10-item questionnaire relating to changes in patient care during this time. The responses were analysed to identify compliance with the national guidance produced by the British Association of Oral and Maxillofacial Surgeons.An 87% response rate was obtained (26 respondents from 30 invitations). 73.1% of participants confirmed all surgical members of staff were offered fit tests for FFP3 masks. All units reported a continuation of Head and Neck cancer and emergency operations with a complete reduction in TMJ and orthognathic surgery. FFP3 masks were the most popular masks used for theatre activity whilst FFP2 and surgical masks were more widely used for examining patients and performing procedures in the emergency department. Changes in maxillofacial practice included the use of local flaps compared to free flaps, use of intermaxillary fixation (IMF) where appropriate for craniofacial trauma and routine COVID-19 testing for all inpatients.

Practice of Oral Surgery Post Pandemic (Covid-19) in the Oxford Dental College, Bangalore, India

COVID-19 is the currently challenging pandemic situation worldwide. This infection is caused by the severe acute respiratory syndrome corona virus 2.Its spread was rapid initially which has comparatively reduced as of now solely due to practice of guidelines given by WHO and CDC for its control and prevention. Especially practice of maintaining social distance, equipped with mouth mask, regular hand sanitisation, minimising travelling etc. Acceptance of vaccines by the community has improved in facing the present pandemic situation. Most of the population is vaccinated presently in India. This pandemic has impacted worldwide in each aspect and especially greatly in medical field which has led to few modifications in approaching patients and also treatment modifications like addressing emergency situations first. Because of 100% infection spread rate due to aerosol inducing procedures in dentistry there was a shut in dental treatment for a period of time during the initial times of pandemic except the emergencies. Later with strict precautions and Covid protocols dental treatment has been provided to the community. Tele and virtual consultation has gained a great importance during this pandemic, which most of the doctors and patients have accepted way of addressing the health issues. This paper mentions about change in attitude of patients and practice of oral and maxillofacial surgery in the oxford dental college, Bangalore, Karnataka, India and how in turn this has helped health care system in preventing spread of Covid-19.