A Bow to Daniel Laskin

PURPOSE: Virtual surgical planning (VSP) is the gold standard for preoperative treatment planning for orthognathic surgery.1 Prior to the implementation of VSP, traditional orthognathic preoperative preparation required hours of labor and utilization of a dental laboratory. This often limited orthognathic surgery to providers with dental training. The combination of VSP and 3-dimensional printing has allowed orthognathic surgeons the ability to more accurately and efficiently create treatment plans for these cases.2 This technology has also allowed practitioners such as plastic surgeons to begin to perform orthognathic procedures. This review serves to illustrate how plastic surgeons use VSP and highlight its impact on surgical outcomes and research output within orthognathic surgery. METHODS: A literature search was conducted in the PubMed database to identify all articles published before January 2020 that report perioperative use of VSP technology in orthognathic surgeries. Only articles that were written in English, involved operations on live human patients, and used VSP to plan or assist with orthognathic surgery were included in the analysis. All articles that fit inclusion criteria were reviewed to determine the year of publication, type of orthognathic surgery performed, how VSP was used, and the primary outcomes measured. RESULTS: A total of 419 publications regarding VSP in orthognathic surgery resulted from initial search. Of them, 244 publications were authored by oral and maxillofacial surgeons, 28 publications by plastic surgeons, and 34 by surgeons with training in both fields. TEMPORAL TREND OF PUBLICATIONS: Prior to the late 1990s, VSP in orthognathic surgery publications was primarily authored by oral and maxillofacial surgeons. Plastic surgeons first began publishing on VSP technology for orthognathic surgery in 1998. Since then, there has been a rising trend in plastic surgery usage of VSP paralleled by increasing VSP publications in the field, with 2 publications before the year 2010 (7.2%), 9 from 2010 to 2015 (32%), and 18 between 2015 and 2019 (64%). CATEGORIES OF PUBLICATIONS: Most publications from oral and maxillofacial trained surgeons highlight optimal positioning of craniofacial bones, anticipated stability and functionality of occlusion, and the interplay between orthodontic treatments and orthognathic surgery. In contrast, plastic surgeon authored papers often discuss postoperative facial aesthetics by ensuring facial symmetry and treatment especially in the cases of congenital craniofacial abnormalities like cleft lip/palate, Treacher-Collins, and hemifacial microsomia. CONCLUSIONS: VSP is an increasingly utilized tool that reduces the workflow without compromising accuracy and outcomes in orthognathic surgery. This is the first paper to create a temporal relationship between a new technology and the emergence of plastic surgeons into a field typically predominated by oral and maxillofacial surgeons. As plastic surgeons become more familiar with this technology, they have produced literature that provides alternative perspectives on orthognathic surgery that will push the field forward. REFERENCES: 1. Langdon J, Patel M, Brennan P. Operative Oral and Maxillofacial Surgery. 2nd ed. CRC Press; 2010. 2. Baker SB, Goldstein JA, Seruya M. Outcomes in computer-assisted surgical simulation for orthognathic surgery. J Craniofac Surg. 2012;23:509–513.

To What Extent is Each Area of Oral-Maxillofacial Surgery Practiced in the United States Today?

Introduction: Oral and maxillofacial surgery (OMFS) is a comparatively new surgical specialty that primarily emphasizes identifying and managing disorders of the head and neck, bridging dentistry and medicines. Objectives: The basic aim of the study is to assess the knowledge of the patients about the scope of oral and maxillofacial surgery. Material and methods: This cross-sectional survey was done in Peshawar, Pakistan, between April 1, 2020, to May 30, 2020, with a total of two hundred and sixty-five participants (n = 265). Individuals from the general population, licensed dentists, and medical experts from the private and public healthcare sectors participated in this study. Results: We surveyed 256 participants, of whom 39% were illiterate. 94% of those individuals were unaware of a department called maxillofacial surgery that specializes in treating head, neck, and face illnesses. 19% of the population was in elementary school, of which only 2% were aware of a "special doctor" for their requirements since their parents were concerned about their illness and were finally referred by another doctor (80%) or a relative (20%). 15% of students with secondary/intermediate education and 5% of those recognized maxillofacial surgeons as acceptable physicians for their treatment, primarily for dental extractions and/or palatal cleft patients who had been receiving therapy from infancy or post-operative TMJ ankyloses patients. Conclusion: Much of the common public was not aware of the scope of Oral and Maxillofacial surgery. While the majority of medical graduates surveyed knew that maxillofacial surgeons treat facial injuries, the vast majority did not know that these specialists treat a wide variety of certain other disorders affecting the head and neck. The need for spreading awareness among the population regarding the domains of Oral and Maxillofacial surgery is evident.

The Most Influential Publications in Oral and Maxillofacial Surgery Over the Past Decade

Collective Wisdom and Multidisciplinary Tumor Boards

S234: Evaluation and Rejuvenation of the Upper Facial Third

Training Satisfaction Versus Dissatisfaction Among Chief Residents in Oral and Maxillofacial Surgery—A Pilot Survey

The authors recently documented a significant decrease in orthognathic surgical cases performed by both plastic and oral surgeons in Ohio over a recent 5-year period. The main reason noted was related to third-party reimbursement. This is a potentially serious issue that may affect the quality of health care for patients with dentofacial deformities. Therefore, an expanded survey was conducted to determine whether this was indicative of a national trend. A three-page questionnaire was sent nationally to plastic surgeons and oral surgeons who were members of the American Society of Maxillofacial Surgery and the American Association of Oral and Maxillofacial Surgeons, respectively. Surveys requested information regarding changes in the number of orthognathic operations over a 5-year period (1999-2003) and reasons for these changes. Of the 3273 surveys sent, 883 were returned, representing an overall response rate of 27 percent. Of the 883 returned, 771 (87.3 percent) were completed by oral surgeons and 112 (12.7 percent) were completed by plastic surgeons. The majority surveyed (70.0 percent) noted a decrease in the number of orthognathic procedures performed over a 5-year period, and 443 (77.3 percent) stated that the decrease was attributable to problems with insurance. Professional reimbursement per hour was calculated based on data collected from consecutive operations performed at the authors' institution. These data demonstrated that reimbursement per hour is significantly lower when orthognathic surgery procedures were compared with other standard plastic surgery operations. Orthognathic surgery may rapidly be becoming a cosmetic procedure. This has the potential of creating a two-tier system whereby only those who can afford it will undergo orthognathic correction.

Why Do Women Choose to Enter Academic Oral and Maxillofacial Surgery?

Little is known on career factors and expectations for female oral and maxillofacial surgeons (OMFS) in developing countries. The study aimed to explore career perceptions of females in 2 related surgical specialties: oral and maxillofacial surgery and otolaryngology (ENT) with a focus on career obstacles and success factors. A structured questionnaire was distributed to female surgeons working in Jordan in the 2 surgical specialties. Questions addressed socio-professional characteristics and career-promoting and hindering factors. All surgeons registered in both specialties were invited. A total of 56 surgeons participated in the survey. Age range was 29 to 55 years (mean = 38.55 ± 5.799). Significantly more OMFS surgeons were single (P = 0.000) younger (P = 0.003), and had fewer years of experience (P = 0.01) than ENT surgeons. Significantly more ENT surgeons perceived the "hard working" attribute and "better communication skills" as career-promoting factors (P = 0.04, P = 0.015, respectively). Further, significantly more ENT surgeons believed that females in the surgical profession help in changing the traditional surgical stereotype linked with the male gender (93.8% ENT in contrast to 75% OMFS, P = 0.047), and expressed a preference for female mentors (48% ENT in contrast to 0% OMFS, P = 0.000). The results of this study indicate that female OMFS surgeons have different socio-professional characteristics and perceptions to their peers in ENT surgery, and this mainly manifested in professional experience, marital status, and important career perceptions. They seem to lack confidence in female participation and promotion of the surgical career, and they show preference for having exclusively male mentors.

This narrative review aims to explore the current applications and future prospects of AI within the subfields of oral and maxillofacial surgery (OMS), emphasizing its potential benefits and anticipated challenges. A detailed review of the literature was conducted to evaluate the role of AI in oral and maxillofacial surgery. All domains within OMS were reviewed with a focus on diagnostic, therapeutic and prognostic interventions. AI has been successfully integrated into surgical specialties to enhance clinical outcomes. In OMS, AI demonstrates potential to improve clinical and administrative workflows in both ambulatory and hospital-based settings. Notable applications include more accurate risk prediction, minimally invasive surgical techniques, and optimized postoperative management. OMS stands to benefit enormously from the integration of AI. However, significant roadblocks, such as ethical concerns, data security, and integration challenges, must be addressed to ensure effective adoption. Further research and innovation are needed to fully realize the potential of AI in this specialty.

Publication bias in oral and maxillofacial surgery journals: An observation on published controlled trials

Objective: This study aimed to determine if dental students, interns, and newly graduated dentists' perception of the oral and maxillofacial surgeon's (OMS) surgical scope would change when OMS was used instead of an oral surgeon (OS). Methods: This cross-sectional study surveyed dental students, interns, and newly graduated dentists' choice of specialist to treat 20 different conditions. The independent variable was the term of the specialty (OMS vs.OS). The dependent variables were specialists chosen for the procedure (ENT surgeon; plastic surgeon; OMS or OS; periodontist; other). Results: Dental students' perception of the OMS's surgical scope increased significantly from 35.7% to 49.8% when OMS was used instead of OS. Interns' perception of the OMS's surgical scope increased significantly from 36.4% to 52.4% when OMS was used as an option instead of OS. Dentists' perception of the OMS's surgical scope increased but was not significant from 39.1% to 45.1% when OMS was used instead of OS. Conclusion: The use of OMS increased students, intern, and newly graduated dentists' perception of the OMS's surgical scope.

Objective To explore the role of disposable drainage bag as an attachment of postoperative drainage device in oral and maxillofacial tumor surgery. Methods Using convenient sampling method, a total of 200 patients with wound drainage requiring postoperative maxillofacial tumor observation from December 2017 to March 2018 in the PACU of Peking University Hospital of Stomatology were selected as subjects. According to the enrollment time, they were divided into two groups. The first 100 cases were the control group, the negative pressure drainage device was used alone, and the latter 100 cases were the experimental group, the negative pressure drainage device was used to connect the disposable drainage bag. The working time of nurses with drainage device, contamination of drainage fluid and wound infection rate related to drainage device were compared between the two groups. Results The nursing operation time of the control group was (73.57±42.17) s; there were16 cases of drainage fluid contamination; the infection rate of drainage tube was 0. The nursing operation time of the experimental group was (49.20±22.35) s; the drainage fluid was contaminated in 2 cases; the drainage infection rate was 0. The working time of nurses with drainage device and contamination of drainage fluid in the experimental group were significantly lower than those in the control group (P<0.05) . Wound infection related to drainage device did not occur in either groups. Conclusions Disposable drainage bag as an attachment of postoperative drainage device can significantly decrease the time of nursing work, reduce contamination of drainage fluid and does not increase the incidence of drainage-related infections. It can be promoted to use in clinical work. Key words: Perioperative nursing; Drainage; Infection control; Oral and maxillofacial surgery; Negative pressure drainage device

The global distribution of oral and maxillofacial surgeons: a mixed-methods study