Facial aesthetics often dominate our social perceptions. For most Skeletal Class III patients, facial aesthetics is the chief complaint when seeking orthognathic surgery; therefore, the changes to appearance after surgery are of the utmost importance. This study aimed to investigate the level of facial aesthetic improvement following bimaxillary osteotomy as perceived by health professionals with different backgrounds and knowledge of orthodontics. Thirty evaluators were selected among specialist orthodontists ( n  = 10), general dentists ( n  = 10), and family medical practitioners ( n  = 10) and were requested to evaluate 16 skeletal class III patients (males; n  = 8, females; n  = 8) treated at a hospital-based orthodontic clinic. Customised questionnaires were prepared using visual analogue scales to score pre and post-surgery photographic (frontal and lateral) profiles. Questions surrounded perceptions of the overall facial attractiveness and the attractiveness of soft tissue neck, chin, lips, and nose. Improvements were detected overall and in all sub-domain scores between pre and post-surgery for all evaluator groups. Orthodontists found the greatest improvement, while family medical practitioners gave the least. All health professional evaluators perceived the benefits of bimaxillary osteotomy for facial attractiveness. The perceived benefit was most significant among specialist orthodontists, representing a need for restraint from overestimating surgical outcomes. Perceptions of improvement following combined orthognathic surgery depend on background knowledge of orthodontics; additionally, the involvement of family medical practitioners in the planning of orthognathic outcomes may be indicated.

PURPOSE:Osteo-odonto-keratoprosthesis (OOKP), or "tooth-in-eye" surgery, is a pivotal technique developed for the treatment of severe corneal blindness in patients unsuitable for traditional corneal transplantation. This review aims to highlight the evolution, current advancements, and global adoption of OOKP, particularly for individuals with end-stage ocular surface disease. METHODS:A comprehensive and systematic literature search was conducted across Embase, PubMed, Scopus, and Web of Science for articles published between 2014 and 2024, using the keyword search terms: "osteo-odontokeratoprosthesis" OR osteoodontokeratoprosthesis OR "osteo-odonto-keratoprosthesis" OR OOKP OR MOOKP. RESULTS:OOKP remains uniquely effective for cases of severe ocular surface damage, including Stevens-Johnson syndrome and chemical or thermal burns. Long-term data demonstrate consistent visual rehabilitation and prosthesis retention across diverse populations in Europe, Asia, and South America. Advancements have improved tissue integration and reduced complications like graft resorption and secondary glaucoma. Innovations in surgical precision have further minimized tissue trauma and improved postoperative stability. CONCLUSIONS:Despite its complexity, OOKP continues to evolve through surgical and material innovations, reflecting a sustained global commitment to improving visual outcomes in patients with otherwise untreatable corneal blindness. The continuous refinement of this technique holds promise for expanding its accessibility and success worldwide, paving the way for future advancements in keratoprosthesis surgery.

This research aimed to investigate the concordance between clinical impressions and histopathologic diagnoses made by clinicians and artificial intelligence tools for odontogenic keratocyst (OKC) and Odontogenic tumours (OT) in a New Zealand population from 2008 to 2023. Histopathological records from the Oral Pathology Centre, University of Otago (2008–2023) were examined to identify OKCs and OT. Specimen referral details, histopathologic reports, and clinician differential diagnoses, as well as those provided by ORAD and Chat-GPT4, were documented. Data were analyzed using SPSS, and concordance between provisional and histopathologic diagnoses was ascertained. Of the 34,225 biopsies, 302 and 321 samples were identified as OTs and OKCs. Concordance rates were 43.2

Background: Postoperative pain and swelling following third molar (M3) removal can be debilitating, and there is interest in using advanced platelet -rich fibrin (A-PRF) to reduce their severity. Purpose: This study compared postoperative pain and swelling between A-PRF and gelatin dressing in extraction sockets following mandibular M3 removal. Methods, Setting, Sample: This split -mouth, single -blinded, randomized controlled trial was completed at the Oral Surgery clinic of University of Otago between November 2020 and July 2021. Patients aged between 16 and 40 years with bilaterally impacted mandibular M3 of similar Pederson index difficulty and deemed to be American Society of Anesthesiologists (ASA) I or II comprised the study sample. Predictor/Exposure/Independent Variable: The exposure variable was M3 socket management. One socket received A-PRF and 1 gelatin dressing, while the other received 2 gelatin dressings. Main Outcome Variable(s): The outcome variables were postoperative pain and swelling over 7 days. Pain was measured using the visual analog scale (VAS), and swelling using stereophotogrammetry. Covariates: Demographic characteristics (gender, ethnicity, and age), dental anxiety, smoking status, Pederson index, and intraoperative surgical time were the covariates. Analyses: The two sides were compared using cross -tabulations and the McNemar test for categorical and paired t -tests for continuous variables. Statistical analysis used IBM SPSS Statistics for Windows (version 28).The Alpha level was 0.05. Results: 76 (87.3%) of 87 patients who met the eligibility criteria participated in the study, and 70 patients (65.7% female; age range 16-30 years) were included in the analysis. Mean visual analog scale scores showed no statistically significant difference between the A-PRF and control sides, being 29.6 (95% CI 23.9, 35.3) and 29.5 (95% CI 23.5, 35.5) on day 2, and falling to 12.6 (95% CI 8.7, 16.5) and 14.2 (95% CI 10.0, 18.4) by day 7. Likewise, mean peak facial swelling on day 2 was recorded as 6.3 cm(3) (95% CI 4.9, 7.7) and 6.6 cm(3) (95% CI 5.5, 7.7), and by day 7 they were 1.1 cm(3) (95% CI 0.5, 1.7) and 1.0 cm(3) (95% CI 0.3, 0.7) on the A-PRF and control sides, respectively. Conclusions: A-PRF placement in M3 sockets did not reduce postoperative pain and swelling over gelatin dressing alone. (c) 2024 American Association of Oral and Maxillofacial Surgeons J Oral Maxillofac Surg 82:581-589, 2024

Background: This research aimed to investigate the concordance between clinical impressions and histopathologic diagnoses made by clinicians and artificial intelligence tools for odontogenic keratocyst (OKC) and Odontogenic tumours (OT) in a New Zealand population from 2008-2023. Methods: Histopathological records from the Oral Pathology Centre, University of Otago (2008-2023) were examined to identify OKCs and OT. Specimen referral details, histopathologic reports, and clinician differential diagnoses, as well as those provided by ORAD and Chat PT-4, were documented. Data were analyzed using SPSS, and concordance between provisional and histopathologic diagnoses was ascertained. Results: Of the 34,225 biopsies, 302 and 321 samples were identified as OTs and OKCs. Concordance rates were 43.2% for clinicians, 45.6% for ORAD, and 41.4% for CHAT-GPT4. Surgeons achieved higher concordance rate (47.7%) compared to non-surgeons (29.82%). Odds ratio of having concordant diagnosis using CHAT-GPT and ORAD were between 1.4-2.8 (p<0.05). In differentiation between Ameloblastoma and OKC, CHAT-GPT4 had highest sensitivity at 75.9% and accuracy of 82.5%. For clinicians and ORAD the corresponding values were 66.7%/86.8% and 66.7%/84.9%, respectively. Conclusion: Clinicians with surgical training achieved higher concordance rate when it comes to OT and OKC. CHAT-GPT4 and Bayesian approach (ORAD) have shown potential in enhancing diagnostic capabilities.

Purpose To explore the ability of Dental Students (DS), Medical Students (MS), Trainee Interns (TI) and Pre-vocational Junior Doctors (JD) in identifying procedures performed by Oral and Maxillofacial Surgery (OMS), the scope of practice (SOP) of OMS and ability to differentiate OMS from similar specialities. Methods The study included 282 complete responses to a survey consisting of: 9 demographic questions, 11 OMS awareness, professional ambition, teaching and exposure, confidence in identifying and referring questions and 70 procedural/scenario questions across four domains. Collected data was qualitatively and statistically analysed using SPSS V29. Results OMS awareness was limited. 92.2% reported None to Small amount of OMS teaching and exposure during university, with 66.0% preferring to have had a Fair to Significant amount. DS experienced more than medical respondents (2.1 vs. 1.5, p < 0.001). Most respondents reported No to Low confidence in identifying the SOP and procedures performed by OMS (67.7%) and referring to OMS (62.4%) compared to similar specialities (32.4% and 33.2%, respectively). 52.9% of procedures performed by OMS were correctly identified as being performed by OMS. The ability to identify the OMS SOP (8.7%) and differentiate OMS from similar specialities (5.0%) was low, however better among DS than medical respondents (14.9% vs. 6.3%, p = 0.002 and 12.2% vs. 2.2%, p < 0.001). Conclusion The study has highlighted a deficit in the understanding of OMS with potential implications in the public and private healthcare sector. Identification of procedures, OMS SOP and ability to differentiate OMS from similar specialities is limited however slightly better among DS.

This research aimed to investigate the relative frequency of odontogenic tumours (OT) and selected odontogenic cysts in a single oral pathology center in New Zealand from 2008 to 2023. Histopathological records from the Oral Pathology Centre, University of Otago (2008–2023) were examined to identify OT. Odontogenic keratocyst (OKC) and calcifying odontogenic cyst (COC), previously classified as OT were also included. Patient demographics, clinical details and histopathologic diagnoses were recorded. Data were analyzed using SPSS. Of the 34,225 biopsies over the 15-year period, 1.8

Background: Oral squamous cell cancer (OSCC) is one of the commonest cancers in Sri Lanka. Objectives: This study aimed to determine the use of alcohol, its duration and consuming pattern in relation to the risk of developing OSCC in patients attending the National Cancer Institute of Sri Lanka. Methods: A case-control study was carried out on 105 patients with a histologically confirmed primary OSCC and 210 age-sex matched controls. Information on alcohol consumption was obtained via an interviewer-administered questionnaire. Results: Participants who had consumed alcohol at some point in their life had a 3.8-fold risk of developing OSCC (p=0.000). Current consumers had a higher risk compared to who have consumed previously. Former consumers had a lower risk of developing OSCC compared to current consumers. Individuals who had consumed alcohol for more than 20 years had a greater risk [Odds ratio (OR)=4.69] of developing OSCC compared to those who had consumed alcohol for less than ten years (OR=3.25). Those who consumed the locally-made illicit liquor (Kasippu) had the greatest risk (OR=8.45; p<0.05) of developing OSCC when considering the type of alcohol consumed. Conclusions: Alcohol consumption is a risk factor for OSCC. The OSCC risk increased with longer duration of alcohol use, the consumption of locally-made illicit liquor and current consumers of alcohol.

Rab GTPases function as essential regulators of vesicle transport between subcellular compartments of eukaryotic cells. Mss4, an evolutionarily conserved Rab accessory factor, facilitates nucleotide release and binds tightly to the nucleotide-free form of exocytic but not endocytic Rab GTPases. A structure-based mutational analysis of residues that are conserved only in exocytic Rab GTPases reveals three residues that are critical determinants of the broad specificity recognition of exocytic Rab GTPases by Mss4. One of these residues is located at the N-terminus of the switch I region near the nucleotide binding site whereas the other two flank an exposed hydrophobic triad previously implicated in effector recognition. The spatial disposition of these residues with respect to the structure of Rab3A correlates with the dimensions of the elongated Rab interaction epitope in Mss4 and supports a mode of interaction similar to that of other exchange factor-GTPase complexes. The complementarity of the corresponding interaction surfaces suggests a hypothetical structural model for the complex between Mss4 and Rab GTPases.

Odontogenic infections are a frequent presentation in hospital dental practice. The majority are trivial, stay localised with minimal systemic signs and symptoms, and are easily managed by identifying and eliminating the source of infection. Yet, some odontogenic infections may progress rapidly due to the virulence of the pathogens involved and/or impaired host immunity and resistance. The systemic effects of such infections may lead to generalised sepsis and rapid clinical deterioration. The local spread of infections into tissue spaces such as cellulitis or abscesses may interfere with eating, swallowing and could even cause airway compromise. Early identification and elimination of the source of infection are of paramount importance and should proceed alongside determining the setting of care. Prompt recognition of the severity of infection, initiation of appropriately aggressive surgical and medical management and constant evaluation of clinical progress are essential to avoid far-reaching, potentially fatal consequences.

Introduction: Routine methods of teaching gross anatomy including cadaver dissections have been a keystone of the anatomy curriculum and certain difficulties have led medical educationists to explore teaching using modern technology. This study aims to share the institutional experience of incorporating new methods into routine dissections at the Department of Anatomy, Faculty of Medical Sciences, University of Sri Jayewardenepura, Sri Lanka.Methodology: Prior to dissections, recommended anatomy 3D software and videos were shown in LED panels. Mock spots were conducted weekly. Applied anatomy sessions were conducted by clinicians. Ultra sound scan (USS) based teaching sessions were conducted by a consultant radiologist. Another study area with multiple illuminators with radiological films was present. Routine feedback was taken from students.Results: The use of LED panels for teaching was found to be helpful by most (82.6%) students. A majority (84%) also found that mock spots were helpful for their studies and 89.2% preferred the use of 3D software. Percentage 82.6% of students found USS guided teaching useful while 85.4% of students found X-ray & CT useful. Majority (91.5%) found the applied anatomy teaching sessions useful. The majority of students’ comments indicated recommendations for them to be continued for future batches.Conclusion: This initiative demonstrates that the combination of traditional and innovative methodologies in the teaching of gross anatomy is favored by students and the applied anatomy sessions can provide vertical integration of the subject.

Background: The global incidence of oral squamous cell carcinoma (OSCC) is on the rise with no improvement seen in survival rates. Tobacco consumption varies depending on geographic location, ethnicity and culture. The present case-controlled study aimed to determine the relative risk of OSCC for different tobacco consumption patterns in a selected Sri Lankan population. Methods: One hundred and five patients with histopathologically confirmed OSCC attending the National Cancer Institute (Apeksha Hospital) of Sri Lanka and 210 age and gender-matched controls from the community responded to an interviewer-administered questionnaire regarding their smoking and betel-quid chewing (with/ without smokeless tobacco) habits were included in the study. The odds ratios (OR) and 95% confidence intervals (CI) were calculated. p<0.05 was considered as statistically significant. Results: The overall risk of OSCC increased 2.93-fold for smokers. Those smoking two packets of cigarettes or more per day (OR=5.56; 95% CI-2.822- 10.984; p=0.000) had more than double the risk of OSCC than those smoking 1-2 packets per day. Smoking for more than 20 years had a 3.4-fold risk of OSCC. Consumption of betel quid containing tobacco (smokeless tobacco) had a 4.26-fold higher risk for OSCC (OR=4.26; 95% CI-2.21-8.21; p=0.000), and the risk increased when all four ingredients (betel leaf, slaked lime, areca nut, and tobacco) were consumed together (OR=4.26; 95% CI-2.34-7.74; p=0.000). The combined effect from concurrent smoking and betel chewing emerged as the highest risk for OSCC (OR=15.34) which significantly exceeded the risks evident for the two habits practised in isolation from each other. Conclusions: Use of smokeless tobacco, consumption of all four ingredients together, duration of smoking, the number of cigarettes smoked per day and combined consumption of betel quid and smoking are significant risk factors in the development of OSCC among Sri Lankans.

AbstractIntroductionOrbital floor fractures are a common injury managed by oral maxillofacial surgeons. They can result in significant bony defects that increase the orbital volume and necessitate surgical repair to avoid the development of enophthalmos. A variety of materials have been used in the reconstruction of orbits including alloplastic materials and autogenous bone grafts. The use of the anterior maxillary antral wall as a bone graft offers the advantage of being readily accessible, naturally thin and has less donor site morbidity than other bone graft sites. There is a paucity of literature in regards to how and when to use an anterior maxillary antral wall graft.Materials and MethodsWe performed a retrospective review of computerized tomography head scans for patients presenting with isolated orbital floor fractures over a 5‐year period. 25 patients were included in the study and manual measurements were recorded for the orbital floor defect and the dimensions of the ipsilateral and contralateral anterior maxillary wall.ResultsIt was found that 92% of fractures could have been repaired using a contralateral anterior maxillary wall bone graft (p < 0.05).ConclusionUse of the anterior wall of the maxillary antrum is a feasible alternative to traditional alloplastic materials. Further study using three‐dimensional bio‐modelling could help developing more accurate guidelines for using this technique in orbital fracture repair.