BACKGROUND: The number of patients treated with coagulation disorders, and more specifically with anticoagulant therapy, has increased worldwide in recent years due to increased life expectancy in developed countries. The protocols for managing this type of patient in oral surgery has varied over recent years, especially after the appearance of new direct-acting oral anticoagulants (DOACs). The assessment of risk of bleeding in this type of patient when undergoing a surgical procedure continues to be a controversial issue for patients, dentists and general practitioners. The objective of this document is to offer recommendations, based on evidence, for decision making for patients with coagulopathies who require dental surgical intervention.
METHODS: Based on the indications of the \"Preparation of Clinical Practice guidelines in the National Health System. Methodological manual\", we gathered a group of experts who agreed on 15 PICO questions based on managing patients with coagulation disorders in dental surgical procedures, such as fitting of implants or dental extractions.
RESULTS: The 15 PICO questions were answered based on the available evidence, being limited in most cases due to the lack of a control group. Two of the PICO questions were answered by the experts with a grade C recommendation, while the rest were answered with grade D.
CONCLUSIONS: The results of this review highlight the need to undertake well designed clinical trials with control groups and with a representative sample size.

BACKGROUND: Oral cancer is the sixteenth most common malignant neoplasm worldwide, with a high mortality rate, greater than 50% at five years, and high morbidity. The effect of oncological treatment in the oral cavity is broad and has multiple levels, therefore knowing these effects and preventing them is essential for avoiding an increase in the oral pathology related with oncological therapy, maintaining the quality of life of the patient, and improving the efficacy of the treatment itself.
METHODS: A group of experts belonging to the fields of Dentistry, Maxillofacial Surgery and Oncology of the University of Seville and the Virgen del Rocío University Hospital of Seville in collaboration with the University of Valencia, University of Barcelona, and University of the Basque Country, developed this Clinical Practice Guideline for the proper clinical management of patients diagnosed with oral cancer. The clinical questions were formulated in PICO format. The databases consulted were Medline/PubMed and Embase/Elsevier. The systematic reviews published on the topic were identified on Tripdatabase, Cochrane Library and CRD (Centre for Reviews and Dissemination). The recommendations were prepared based on the GRADE methodology.
RESULTS: Various recommendations were defined, derived from the 21 PICO questions, referring to prevention, treatment and care for alterations arising from the pathology of oral cancer itself and its treatment.
CONCLUSIONS: The preparation of this clinical practice guideline allows recommendations to be generated based on the scientific evidence available, on dentistry actions in patients with oral cancer and undergoing oncological treatment, which may be of use to the multidisciplinary team treating this type of patient.

The coronavirus pandemic (COVID-19) has impacted essentially every country\'s healthcare system in extraordinary ways, fundamentally changing the way we deliver care. The practice of oral and maxillofacial surgery is no exception. In response to this global health crisis, the Saudi Society of Oral and Maxillofacial Surgery has prepared this consensus statement to inform our clinical and other medical colleagues and the public at large on proper procedures during this time. The statement is based on the best scientific evidence available and follows the guidelines put forth by the Saudi Ministry of Health on the COVID-19 response. It explains how to manage and triage oral and maxillofacial patients based on the level of care needed at the time of clinical presentation.

The emergence of coronavirus disease 2019 (COVID-19), caused by the SARS-CoV-2 (SC2) virus, in late December 2019 has placed an overwhelming strain on healthcare institutions nationwide. The modern healthcare system has never managed a pandemic of this magnitude, the ramifications of which will undoubtedly lead to lasting changes in policy and protocol development for viral testing guidelines, personal protective equipment (PPE), surgical scheduling, and residency education and training. The State of Washington had the first reported case and death related to COVID-19 in the United States. Oral and maxillofacial surgeons have a unique risk of exposure to SC2 and developing COVID-19 because of our proximity of working in and around the oropharynx and nasopharynx. The present report has summarized the evolution of COVID-19 guidelines in 4 key areas: 1) preoperative SC2 testing; 2) PPE stewardship; 3) surgical scheduling guidelines; and 4) resident education and training for oral and maxillofacial surgery at the University of Washington, Seattle, Washington.

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Medical as well as non-medical practitioners specialized in oral health are at high risk of infection with the Coronavirus-19 (Covid-19) because of the proximity with potentially infected biological fluids. This risk is permanent, especially during examination, care and transfer of patients. Regarding the pandemic progression of Covid-19, efficient protocols of prevention are urgently needed. Based on our experience and on the recently reported guidelines from the French National Agency for Public Health (ARS, March 5, 2020), the French Society of Hospital Hygiene (SFHH, March 4, 2020) and the Department of Infectious Risk Prevention of the Hospitals of Paris-Public Assistance (APHP, March 6, 2020), we provide several recommendations for practitioners specialized in oral health, to protect themselves from nosocomial infections, especially Covid-19.

Infective endocarditis (IE) is a devastating disease with high mortality. Most guidelines recommend routine use of antibiotic prophylaxis during oral surgery to prevent IE in patients with specific predisposing cardiac conditions, but this is not the case in the UK. The conflicting opinions and guidance are confusing and may affect IE prophylaxis implementation. We investigated how IE prophylaxis standards are defined in hospitals and outpatient clinics of oral and maxillofacial surgery. A survey was sent to 80 surgeons heading departments of oral and maxillofacial surgery in Germany. We observed significant heterogeneity in IE prophylaxis implementation among the clinics. This diversity was in relation to the definition of predisposing cardiac conditions, the type of dental and surgical procedures performed that require IE prophylaxis, the spectrum of compounds used, and the timing of antibiotic prophylaxis. We observed under-prescription of IE prophylaxis in high-risk patients, the overuse of antibiotic prophylaxis in patients not at high risk of IE, and the use of inappropriate drugs. These findings suggest that educational strategies and guideline implementation advice are needed to improve standards of IE prophylaxis in oral and maxillofacial surgery clinics.

An assessment of the quality of oral and maxillofacial surgery clinical practice guidelines is lacking. The aim of this investigation was to assess the quality of guidelines using the RIGHT (Reporting Items for practice Guidelines in HealThcare) checklist. The primary outcome was to assess the score (quality) of guidelines based on the RIGHT checklist and to identify predictors (region, type, single or multi-centre, and speciality/non-speciality) influencing the quality score. In this review, following a search of electronic databases and national society websites, a total of 25 guidelines were independently assessed by two assessors against the 22-item RIGHT checklist. Inter-assessor reliability was assessed. Deficiencies in the reporting of items relating to limitations, funding, declaration and management of interests, healthcare questions, and quality assurance were evident. The median overall score for the guidelines was 28 (range 14-66). Guidelines produced by multiple centres (β=57.15, 95% confidence interval -26.62 to 87.68, P= 0.001, multivariate analysis) and non-speciality societies (β=20, 95% confidence interval -0.03 to 40.03, P=0.05, univariate analysis) tended to have higher quality scores. Overall, the quality of clinical practice guidelines used in oral and maxillofacial surgery was deemed suboptimal. If clinical practice guidelines are to be used in making treatment decisions for patients, clinicians should be aware of their possible limitations.

The purpose of this study was to evaluate current state of authorship, financial disclosures, and conflicts of interest in position papers published by the American Association of Oral and Maxillofacial Surgeons (AAOMS).
This is a cross-sectional review of the position papers published by the AAOMS from 2013 to 2017. Primary outcome variables include position papers published by the AAOMS. Secondary outcome variables include declaration of authorship, financial disclosures, and financial payments. The Open Payments Database for financial disclosures was reviewed for the year the position paper was published and the immediate preceding year.
Ten position papers were published by the AAOMS from 2013 to 2017. Of the 10 papers, authorship was listed in 3, and none explicitly addressed the presence or absence of financial disclosures or conflicts of interest. Contributors to 3 of the 3 authored papers were found at review of the Open Payments Database to have received industry funding in the year the position paper was published and the immediate preceding year. The remuneration ranged from less than $1,000 to $554,006.02.
Position papers published by the AAOMS lack standardization for authorship and statements on potential financial disclosure. The authors suggest full disclosures of authorship and authors\' conflicts of interest should be stated on all position papers to provide transparency to the process.

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