Purpose: This study aimed to evaluate the effect of recurrent injectable-platelet-rich-fibrin (I-PRF) in conjunction with autogenous bone on gingival thickness (GT), alveolar width, and volumetric bone changes during maxillary alveolar augmentation using cone-beam computer tomograms (CBCT). Materials and Methods: Twenty-eight patients with alveolar defects require bone augmentation. Two patient groups were chosen at random. Group I consisted of 14 patients who received only cortical ramus autogenous bone harvest (control group). Fourteen patients in Group II received autogenous bone grafting in addition to repeated I-PRF. To examine the alveolar ridge width, CBCT was performed before, immediately following, and at 6 and 9 months. Three-dimensional volumetric changes in bone were carried out using the sequence of CBCT image segmentation and 3D superimposition analysis. Results: At 9 months of follow-up, Group II showed significant improvements in GT compared to Group I. Radiographic evaluation of ridge width at 9 months revealed a significant mean increase in ridge width in Group II. There is a notable variation in bone volume between the two groups. Group II’s volumetric measurements increased significantly when compared to preoperative readings at 9 months ( P = .02). Conclusions: Repeated injections of I-PRF improve GT and bone growth. Additionally, it maintains the autogenous bone graft’s integrity throughout the early healing phase.
Introduction: Tobacco smoking is listed as one of the top ten health indicators in the objectives outlined by the “World Health Organization’s Healthy People 2020” initiative. Hookah tobacco presents a significant health risk due to the widespread misconception among college students that this product is harmless and non-addictive. Evaluating practices is a crucial initial step to mitigate the spread of shisha use. Additionally, comprehending its usage patterns and addiction is vital for formulating effective prevention and cessation strategies. Aim and Objectives: The aim of the study was to assess shisha smoking-related knowledge, attitudes and practices among students of dental institutions of Lucknow city (U.P.) India. Materials and Methods: A descriptive cross-sectional study utilizing a self-designed, close-ended questionnaire was conducted. The study received approval from the Institutional Ethical Committee, and written informed consent was obtained from all participants. Categorical data were presented as frequencies ( n ) and percentages (%). Comparisons between categorical groups were made using the Chi-square (χ2) test. Data analysis was carried out using SPSS software (Windows version 22.0). Results: Among the 1050 dental students surveyed, the prevalence of shisha smoking was 59.1%. The prevalence was significantly higher in males (69.1%) compared to females (39.7%), with a statistically significant difference (χ2 = 83.75, P < 0.001). Categorical data were reported as frequencies ( n ) and percentages (%). Conclusion: This study provides essential data to authorities and health policymakers, facilitating a deeper comprehension of the adverse health effects and misconceptions related to shisha use.
Introduction: Achieving good nasolabial esthetics and symmetry in unilateral cleft lip repair is often challenging. Although techniques of cleft lip repair have evolved over the years, each has different implications and its own setbacks. The aim of the current paper is to describe a double unilimb Z-plasty with upper rotation advancement for the management of complete unilateral cleft lip. Materials and Methods: A prospective cohort study was conducted at our center, including all patients who reported to us for the correction of unilateral cleft lip. Preoperative frontal and submental photogrammetric evaluation facilitated the planning of rotation-advancement flaps with double unilimb Z-plasties. Nasolabial esthetics were assessed using the Asher–McDade scale and a modified photographic evaluation by three independent reviewers to evaluate the efficacy of the technique in enhancing nasolabial esthetics. Results: Thirty-three patients with unilateral cleft lip within the age group of 4 to 10 months were enrolled in the study. Twenty-five patients were included based on the inclusion and exclusion criteria. The average width of the cleft ranged between 14 and 18 mm, the mean discrepancy in the height of the philtral column was 6–12 mm, and the mean discrepancy in the thickness of the vermilion was 3 mm. The immediate postoperative period did not reveal any significant surgical-site complications, while late postoperative evaluation revealed satisfactory nasolabial esthetics, with none of the patients requiring revision cheiloplasty. Conclusion: Upper rotation advancement with double unilimb Z-plasty appears to be an effective method of achieving good nasolabial esthetics in patients with wide unilateral cleft lip without NAM.
Introduction: Maxillofacial fractures pose a significant health challenge in military settings due to high-risk combat and training activities, impacting facial aesthetics, function and overall well-being. This 7-year retrospective observational study at a tertiary care army centre analyses prevalence, patterns, etiology and outcomes of the injuries among military personnel and dependents from 2017 to 2023. Patients and Methods: This single-institution retrospective study reviewed 431 maxillofacial trauma cases at a tertiary-level military teaching hospital, including serving personnel, ex-servicemen, paramilitary, emergency civilians, and dependents. Inclusion criteria covered direct and referred cases with maxillofacial injuries; exclusions were non-maxillofacial trauma, incomplete records, and conservative management cases. Data from medical records on demographics, injury details, mechanisms, and outcomes were analysed using Microsoft Excel for descriptive statistics, frequencies, and cross-tabulations, with institutional review board approval. Results: Males predominated (381/431, 88.4%), with most cases in the 19-44 age group (62.41% males, 4.64% females); children under 12 were least affected (1.39% males, 0.70% females). Road traffic accidents were the leading cause, followed by falls and sports injuries; maxillary fractures (380) slightly exceeded mandibular (368), with zygomatico-maxillary complex fractures most common (52.89%). Fractures showed no significant right-left side preference (similar bilateral rates ~10%). Conclusion: Maxillofacial fractures predominantly affect young adult males via road traffic accidents in this military cohort, with midface (zygomatico-maxillary) injuries most prevalent. The incidence of fractures resulting from RTAs can be effectively reduced through stricter implementation of preventive measures, including the mandatory use of helmets and seat belts, as well as more stringent enforcement of laws against driving under the influence of alcohol.
Introduction: Securing a difficult airway is pivotal during anesthesia, with the risk of severe complications driving the need for effective intervention. Awake fiberoptic intubation (AFOI) often necessitates sedatives, which can cause airway obstruction. This clinical trial compared the use of nebulized dexmedetomidine with ketamine, combined with lignocaine, to improve patient comfort and procedural effectiveness for AFOI while minimizing side effects. Materials and Methods: In this prospective randomized controlled trial, 60 patients with difficult airways were assigned to one of two groups. Group 1 received nebulized dexmedetomidine (1 μcg/kg) with 2% lignocaine, and Group 2 received nebulized ketamine via nebulizer (3 mg/kg) with 2% lignocaine. The primary outcome measure was the ease of intubation, and secondary outcomes included cough severity and glottic conditions during the procedure. Results: The dexmedetomidine cohort saw a marked improvement in intubation ease and reduced coughing severity, showing a significant contrast to the ketamine group. Specifically, 70% in the dexmedetomidine group reported easy intubation versus 33.3% in the ketamine group, with reduced instances of moderate to severe coughing (20% vs. 50%). Both groups maintained hemodynamic stability. The favorable outcomes observed with nebulized dexmedetomidine can be attributed to its unique pharmacological properties, including anxiolysis, analgesia, and antisialagogue effects, all of which are desirable for AFOI. Conclusion: Nebulized dexmedetomidine with lignocaine proved to be a more effective regimen than ketamine with lignocaine for AFOI, improving patient comfort and ease of procedure without compromising safety. This study highlights the advantageous pharmacological profile of dexmedetomidine, underscoring its potential for airway management in anesthesia. Further research is needed to validate these results and explore wider clinical applications.
Background: Smooth preoperative separation, hemodynamic steadiness, and rapid, calm recovery are central goals in pediatric anesthesia. Dexmedetomidine (D) may complement ketamine (K) by attenuating sympathetic tone without respiratory depression. We compared ketamine alone, dexmedetomidine alone, and their combination (KD) in children. Materials and Methods: In this single-center randomized, three-arm trial, 96 children (32 per group) undergoing elective ophthalmology procedures under general anesthesia were allocated to K, D, or KD. Preoperative hemodynamics were recorded at 0, 15, and 30 minutes; sedation and separation were assessed at 30 minutes using the Five-Point Sedation Scale (FPSS) and the Parental Separation Anxiety Scale (PSAS). Intraoperative vitals (0/15/30 minutes) and recovery outcomes—Emergence Agitation Score (EAS) and time to an awake, easily arousable state FPSS—were collected. Group differences used Welch ANOVA or Kruskal–Wallis as appropriate, with prespecified change-from-baseline and area-under-the-curve (AUC) summaries. Results: Groups were balanced for age/sex and baseline vitals, except for a modestly higher baseline heart rate in K. Preoperatively, FPSS medians were similar across arms (all 3 [3–4], but PSAS favored D and KD over K (K 3 [3–4], D 2 [2–3], KD 2 [2–3]; omnibus P < 0.001). Intraoperatively, D and KD maintained lower heart rate and mean arterial pressure than K at 15 and 30 minutes (all omnibus P < 0.001), while respiratory rate and SpO₂ were stable and comparable between groups. Recovery outcomes aligned with these patterns: EAS was lowest with KD, intermediate with D, and highest with K; time to FPSS (mean ± SD) was 1.562 ± 0.669 min (K), 1.468 ± 0.567 min (D), and 1.375 ± 0.491 min (KD) (omnibus P < 0.001). AUC and Δ-from-baseline analyses corroborated lower cumulative cardiovascular load with D/KD. No desaturation events were observed; adverse events were not systematically captured. Conclusions: Compared with ketamine alone, dexmedetomidine—alone or combined with ketamine—facilitated easier parental separation, steadier intraoperative hemodynamics without respiratory compromise, and faster, calmer recovery. When smooth separation and efficient early recovery are priorities, D or KD appears advantageous. Confirmation with standardized adverse-event reporting and multicenter designs is warranted.
Introduction: Precise anchorage control is critical for predictable orthodontic tooth movement. Extra-alveolar mini-implants in the infrazygomatic crest (IZC) region benefit from robust cortical bone; however, the distribution of stress—and thus long-term stability—is heavily influenced by implant design, insertion angle, and force orientation. Finite element analysis (FEA) offers the robust method for simulating these biomechanical interactions. Objective: The study aims to evaluate von Mises stress distribution patterns in mini-implants and surrounding bone at various placement angles and force directions in the IZC region using finite element method (FEM), with the goal of determining the configuration that minimizes peak stress and optimizes load transfer. Material and Methods: Two 3D FEM models were generated to simulate orthodontic force applications on mini-implants with different geometric parameters and insertion angles. A static load of 3 N was applied to the implant head from three directions (horizontal, oblique, vertical) over four defined insertion angles. FE simulations were performed using Ansys Workbench v24 (a software developed and manufactured by ANSYS, Inc., Pennsylvania, USA & distributed in India by INNOVENT Eng. solutions Pvt. Ltd, Bangalore-560038) to analyses stress and strain distributions. Results: Simulations revealed that the highest von Mises stress localizes at the implant neck and adjacent cortical bone. Lower insertion angles (40°–50°) produced a more uniform stress distribution and reduced peak values compared to higher angles (60°–70°). Maximum von Mises stress was observed in the mini-implant of 20.05 MPa, in cortical bone of 10.94 MPa, and in cancellous bone of 0.79 MPa. Conclusion: The data indicate that mini-implant insertion angle between 40° and 50° in the IZC region minimizes critical stress concentrations, likely enhancing implant stability. Furthermore, the VectorTAS system generally exhibits lower screw stress than the Osstem model; however, both designs operate within the safe fatigue limits of titanium. These findings underscore the utility of FEA in optimizing implant design and surgical protocols for clinical success.
Background: The maxillary sinus is an important anatomical structure in many fields, particularly dentistry and maxillofacial areas, due to its proximity to the working region. Objective: To assess the correlation between maxillary sinus volume (MSV) and gender, age, and the condition of the maxillary molars. Materials and Methods: The study involved 130 patients from the Can Tho University of Medicine and Pharmacy Hospital. CBCT imaging was done with precise positioning and settings using a Sirona Orthophos SL 3D device. Radiographs were processed with Mimics Research software. Results: There was no statistically significant difference in MSV between sides. Volume peaked at 18–24 years and decreased with age, consistently being higher in males than in females. Individuals missing maxillary molars had smaller sinuses, but the difference was not significant. Regression analysis identified age and gender as key factors, with age being primary. These findings support understanding the effects of age and gender on sinus volume in anatomical and clinical research. Conclusion: The study demonstrates that MSV varies according to gender and age, underscoring the importance of understanding demographic characteristics and utilizing advanced imaging technologies in dental treatment planning. This provides an overview of the anatomical features of the maxillary sinus in the Vietnamese population, in particular, and the Asian population in general. These findings play a crucial role in clinical planning, especially in dental implant placement and sinus augmentation procedures that are closely and directly related to the maxillary sinus.
Temporomandibular joint disorders (TMDs) represent a heterogeneous group of conditions affecting the joint and associated structures, often leading to pain, restricted mandibular movement, and functional impairment. In recent years, regenerative approaches such as prolotherapy have gained attention as minimally invasive treatment options aimed at enhancing tissue repair and improving clinical outcomes. Commonly used agents include dextrose solutions and platelet-rich plasma (PRP), both of which are proposed to modulate inflammation and stimulate healing within the joint complex. A systematic review and meta-analysis was conducted to evaluate the efficacy of prolotherapy in improving functional outcomes in TMDs. The protocol was registered in the PROSPERO database (CRD42024537525). A comprehensive search of PubMed, Embase, and the Cochrane Library, supplemented by manual screening of Google Scholar, was performed. Study selection was carried out independently by three reviewers, with disagreements resolved by a fourth reviewer. From an initial pool of 1150 articles, 19 studies met the inclusion criteria and were included in the meta-analysis, contributing data from 347 patients. Among these, 335 patients received dextrose prolotherapy, while 436 were treated with PRP. The mean patient age was 37.7 years, with an average follow-up duration of 22.8 weeks. Overall, prolotherapy demonstrated potential benefits in improving functional outcomes; however, treatment efficacy varied depending on the agent used and patient-specific factors. These findings highlight the need for individualized treatment planning and further high-quality studies.
Introduction: Oral submucous fibrosis (OSMF) is among the most common potentially malignant disorders of the oral cavity, closely linked to the habitual chewing of areca nut and tobacco. Management options range from habit cessation counseling and physiotherapy to pharmacological and surgical interventions. This study aimed to assess and compare the effects of turmeric—given orally, applied topically, or in combination—with those of a positive control (antioxidants) in patients with OSMF. Material and Methods: Ninety six clinically diagnosed OSMF patients, aged 18–50 years, were randomly assigned to four equal groups. Group A received turmeric capsules; Group B applied turmeric topically; Group C received both oral and topical turmeric; and Group D was given antioxidant tablets. Active treatment lasted three months, followed by monitoring up to six months. Monthly assessments included burning sensation, interincisal mouth opening, tongue protrusion (TP), and cheek flexibility (CF). Results: Burning sensation was reduced notably in all groups within the first three months. Group A achieved the greatest gain in mouth opening (mean: 33.13 ± 3.56 mm, P < 0.001). Group B showed the highest TP improvement by the sixth month. CF increased steadily in Groups C and D over six months, with statistically significant results. The combined turmeric approach (Group C) demonstrated the most balanced improvement across all measured outcomes. Conclusion: Turmeric, whether oral, topical, or both, is a safe, inexpensive, and effective adjunct for managing OSMF. Combined therapy appears to offer the most comprehensive benefit. Larger, longer term studies are recommended to strengthen the evidence base and guide clinical protocols.
Introduction: Secretory carcinoma (SC) of salivary gland, a recently described entity resembling secretory carcinoma of breast. It harbors a t(12;15) (p13;q25) translocation resulting in a genetic fusion product ETV6-NTRK3, alternative fusion partners like ETV6-RET, ETV6-MAML3, and ETV6-MET also been described in SC cases lacking classic transcript which aids in targeted therapy. It is characterised by strong immunopositivity for S100, mammaglobin and vimentin. Aim: As the clinicopathological and treatment outcome data of SC of head and neck sites is limited, we aimed to address the same in this study. Methodology: After ethical approval of the institutional ethics committee, a through a retrospective search of all salivary gland tumors were made from our electronic medical record. Five cases of SC of head and neck were found, out of which 03 cases involved salivary glands, and 02 cases involved buccal mucosa. Result: The demographic, clinical, histopathological, radiological, treatment and follow up data were aggregated for all patients. Patients age varies from 12- 70 years, with majority occurred in females. All the patients underwent surgical excision and neck was addressed based on clinico-radiological finding, adjuvant therapy in the form of radiotherapy were received in 02 patients in view of higher stage. On average follow up of 06 months, no evidence of disease recurrence noted. Conclusion: SC is a low grade tumor with favorable outcome and prognosis, histomorphological features with IHC is mandatory for diagnosis. Standard of treatment is surgery, adjuvant treatment based on high risk features, with long term observation is needed.
Introduction: Dentistry is a profession with significant occupational hazards, including physical strain, mental stress, microbial threats, and notably, Work-Related Musculoskeletal Disorders (WMSDs). These disorders affect the musculoskeletal system, including bones, muscles, ligaments, and nerves, and are exacerbated by occupational tasks and environmental factors. The prevalence of WMSDs among dental practitioners ranges from 10.8% to 97.9%, with common areas affected including the lower back, shoulders, neck, and hands. This study aims to assess the impact of professional ergonomic training on the posture of third and fourth-year dental students using the Rapid Entire Body Assessment (REBA) method. Material and Methods: This interventional, randomized, double-blind study was conducted, involving 70 third and fourth-year dental students. Participants received didactic theory lectures and clinical demonstrations on ergonomic principles, followed by supervised clinical practice for 30 days. Posture assessments were conducted using digital photography, and REBA scores were calculated at baseline, one-day post-lecture, and after 30 days. Scores were categorized into risk levels, and statistical analysis was performed using the Microsoft SPSS statistical package 2.0. Results: At baseline, 60% of participants were in the medium-risk category and 40% in the high-risk category according to REBA scores. One day post-lecture, there was a substantial decrease in high-risk participants to 7.1%, with an increase in the medium-risk group. By Day 30, 84.3% of participants were in the low-risk category, with significant improvements in posture noted ( P < .001). Discussion: The study revealed a significant reduction in WMSD risk levels among dental students following professional ergonomic training. The notable shift from high and medium-risk categories to a predominantly low-risk category underscores the efficacy of the ergonomic intervention. These findings are consistent with some prior studies and highlight the importance of integrating ergonomic principles into dental education to promote long-term practitioner well-being. Conclusion: Professional ergonomic training has a significant positive impact on reducing the risk of WMSDs among dental students. Incorporating ergonomic education into dental curricula can enhance practitioner health, improve patient care quality, and extend professional longevity. Future research should include larger sample sizes, long-term follow-up, and a broader range of participants to further validate these findings.
Adenoid cystic carcinoma (ACC) is an infrequent epithelial tumor primarily affecting the minor salivary glands. It rarely affects the major salivary glands, especially the parotid gland. Isolated involvement of the deep lobe of the parotid, without affecting the superficial lobe, is even more uncommon. Deep lobe tumors typically present at a later stage due to their concealment on the medial aspect of the mandibular ramus. External swelling becomes evident only when the tumor reaches a considerable size. In the case of a slow-growing tumor, prolonged pressure effects can distort surrounding anatomical structures over time. This report describes a case of ACC involving the deep lobe of the parotid in a 35-year-old female, emphasizing the uniqueness of the case, including the elongation of the facial nerve trunk, and its implications for surgery, as the altered anatomy often leads to misleading established surgical landmarks.
Context: The intricate etiopathogenesis of the temporomandibular disorders (TMDs), presenting varied signs and symptoms, makes it difficult to propose a standardized treatment protocol. Recent literature suggests an effective role of platelet-rich plasma (PRP) injections in both inflammatory and degenerative TMDs. Also, arthrocentesis has gained popularity as a minimally invasive surgical procedure. Aim: This study was conducted with the aim to compare the effectiveness of arthrocentesis v/s arthrocentesis followed by PRP in TMD patients. Materials and Methods: The study has been conducted in the institution. Priori power analysis was performed using G*Power software version 3.1.9 for estimating the sample size. The study is a randomized controlled trial in which 20 participants were randomly divided into two groups following the inclusion and exclusion criteria. The first group consisted of 10 patients who underwent arthrocentesis. The second group consisted of another 10 patients who were administered PRP followed by arthrocentesis. The patients were evaluated on the basis of maximum mouth opening, pain scores (VAS), laterotrusive movements, and joint sounds at weeks 1, 3 and months 1, 3, 6. Statistical Analysis Used: The data for the present study was entered in Microsoft Excel 2007 and analyzed using the SPSS statistical software 23.0 Version. The descriptive statistics included mean, standard deviation, frequency, and percentage. The intergroup comparison was done using the independent t tests, and the intragroup comparison was performed by the repeated-measure ANOVA. The Shapiro–Wilk test was used to investigate the distribution of the data. Levene’s test is used to explore the homogeneity of the variables. To understand the comparative analysis for both procedures, post hoc Turkey test was used. The level of significance for these tests has been denoted by the “ P value.” The P value was set as < 0.05 for significant results. Results: Participants in both groups showed statistically significant improvements with respect to maximum mouth opening and VAS in the six months postoperative period ( P < 0.05). However, there were no significant improvements with regard to joint sounds and laterotrusive movements ( P > 0.05). The outcomes of maximum mouth opening and pain scores were better in the second group after six months of follow-up ( P < 0.05). Conclusion: Within the limitations of this study, it can be concluded that arthrocentesis followed by platelet-rich plasma injection is a better treatment protocol for the management of TMDs.
Objective: To evaluate different shapes of lingula and anti-lingula and their relative positions with respect to different fixed landmarks of the mandible. Materials and Methods: A total of forty cone-beam computed tomography (CBCT) scan images of the mandible were included in this cross-sectional study. The shape of the lingula was analyzed and classified into four types. The locations of the lingula and anti-lingula were evaluated from various fixed landmarks by measuring the distance from the mandibular foramen to the anterior and posterior border of the ramus, mandibular notch, and angle of the mandible. The vertical distance from the lingula to the center of the mandibular foramen was measured as the height of the lingula. Descriptive statistics were used. The side- and gender-wise differences in the position of lingula and anti-ligula were evaluated by using the t -test. The P value of 0.05 was considered as the level of significance. Results: The nodular shape was the commonest shape of the lingula. The height of the lingula was 6.94 ± 2.42 mm. The position of the lingula was 16.20 ± 2.21 mm posterior to the anterior border of the mandibular ramus, 13.35 ± 2.76 mm anterior to the posterior border of the ramus, 20.32 ± 3.78 mm inferior to the mandibular notch and 20.52 ± 3.77 mm anterosuperior to mandibular angle. The anti-lingula was located 2.8 ± 1.2 mm posterior and 1.80 ± 0.30 mm superior to the lingula, and 1.60 ± 0.20 mm posterior and 4.80 ± 1.30 mm superior to the mandibular foramen. Conclusion: The nodular type of lingula was the most common shape. The position of the anti-lingula was posterior and superior to the lingula.
The purpose of this case report is to highlight the understated regenerative potential of the pediatric mandible, which favors early aggressive management and delayed secondary reconstruction of the mandible in the management of ameloblastoma, a well-known pathology. This is a case of an otherwise healthy 12-year-old girl presented with complaints of loose teeth and right facial swelling. An orthopantogram was obtained, which revealed a unilocular radiolucent lesion of the right mandible. The lesion was biopsied to be plexiform ameloblastoma, and the patient underwent segmental mandibulectomy and temporary reconstruction with custom reconstruction mandibular plate with future plans for microvascular reconstruction. The patient was followed postoperatively with serial orthopantograms and 3-dimensional computed tomography at 17 months that revealed progressive mandibular regeneration avoiding the need for further reconstruction. Delayed reconstruction of the mandible in the pediatric population can be minimized with early aggressive management of a solid ameloblastoma. The ideal environment for regeneration of the mandible should be taken into consideration during treatment planning: the absence of infection, rigid fixation, patient age, and an intact periosteum.
Temporomandibular disorders (TMDs) are musculoskeletal conditions affecting the jaw, face, and temporal regions, significantly impacting quality of life and well-being. While extensively studied in high-income countries, limited data exist on their prevalence and associated factors in low- and middle-income countries (LMICs). This systematic review and meta-analysis has been conducted as per Preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines to determine the prevalence and incidence of TMDs in LMICs and explore their association with demographic factors (age, gender) and psychological factors (depression, anxiety, and stress). A comprehensive search of multiple databases and gray literature identified 444 articles, of which seven studies met the inclusion criteria. Data synthesis included meta-analysis to estimate pooled prevalence rates and assess demographic and psychosocial associations. The seven studies included a total of 21,761 participants. The pooled prevalence of TMDs was 6% (95% CI: 5.5–6.5%). TMD prevalence was higher among females and young adults, with a decline in older populations. One study identified significant associations between TMDs and psychological factors such as stress, depression, and anxiety, highlighting the multifactorial nature of the condition. Our findings concluded that TMDs are a significant health concern in LMICs, with prevalence rates comparable to global averages and underscore the influence of demographic and psychological factors on TMDs, emphasizing the need for further research to elucidate these relationships. Enhanced understanding of TMD epidemiology in LMICs can inform targeted interventions, improve diagnostic and treatment approaches, and support the development of prevention strategies.
Introduction: Efficient patient management is a key quality indicator in healthcare services. Delays in hospital processes, from admission to discharge, can adversely affect patient satisfaction, resource utilization, and overall hospital efficiency. Materials and Methods: This observational study explores the challenges at different steps in patient management within the Department of Oral and Maxillofacial Surgery. Through time-motion based study and self-audit measures, potential areas for improvement in various hospital processes were evaluated and baseline-generated data were studied for quality improvement and efficiency optimization. Results: The audit study revealed high variability in pre-anesthetic check-ups and surgical delays. Opportunities for improved coordination among the medical, nursing, and administrative teams were identified, which impacted the efficiency of the discharge process. Additionally, the average waiting time for the surgeries was 47 h, and the length of hospital stay was 11 days, which included all types of patients like trauma, pathology, and cancer. Conclusion: A comprehensive assessment of the patient’s profile and identification of potential obstacles is crucial for enhancing the patient experience and making efficient use of hospital resources. Conducting regular self-audits allows for ongoing monitoring and improvement of hospital operations, ensuring timely care delivery and better patient outcomes.
Background and Purpose: Facial paralysis has devastating consequences. Different surgical techniques have been proposed for the treatment of lagophtalmos, but lid loading is the preferred technique. Its simplicity, reversibility, and effectiveness are well established. In this study, we aim to discuss which implant shows better results (gold or platinum implants) and which approach (supratarsal or retrograde approach) can lead to lower complication rates. Material and Methods: We performed a retrospective study of patients with facial paralysis that had been treated with lid loading techniques using gold or platinum implants, either through a supratarsal or retrograde approach at our department. Demographic data, type of implant and approach were recorded. Complications and outcomes were analyzed. Results: In this study, 79 patients met the inclusion criteria. The use of a platinum implant and a retrograde approach demonstrated 0% migration and the lowest rates of implant removal. The retrograde approach showed lower migration rates (6.6%) than the supratarsal approach (8.3%). Also, platinum implants demonstrated better cosmetic results and most patients reported good and excellent results (52.64% and 26.31%, respectively). The retrograde approach was also superior in terms of cosmesis compared to the supratarsal approach. Conclusions: In our study, the lowest migration rates were found with the retrograde approach. Furthermore, we found that the combination of a platinum implant and a retrograde approach offered the best results, showing the lowest rates of implant removal and migration and better cosmesis.
