BACKGROUND An aged population is susceptible to chronic diseases, which impacts oral surgery treatment procedures. This retrospective study aimed to evaluate the incidence of medical comorbidities in 640 oral surgery patients treated at the College of Dentistry, Jazan University. MATERIAL AND METHODS This single-center observational study investigated medical records of outpatients who visited Jazan University Dental College Hospital in a 1-year period (2018-2019). Patients’ clinical and radiographic archives were screened to obtain relevant data. Categorical and continuous variables were expressed in terms of frequency and mean values, respectively. Differences in variables were statistically analyzed using the chi-square goodness of fit and proportional test, with a probability value P≤0.05 considered significant. RESULTS Analysis of 640 patient records included records of 300 men and 340 women who underwent oral surgery, of whom 176 patients (27.5%), including 97 men and 79 women, had medical comorbidities. The most common comorbidities were endocrine disease (7.03%), cardiovascular disease (6.71%), respiratory disease (4.53%), and hematological disorders (3.43%). Individual diseases that showed higher prevalence were diabetes mellitus (4.68%), hypertension (3.43%), bronchial asthma (2.65%), and anemia (1.4%). Differences by sex were observed in many individual disorders. CONCLUSIONS Outpatients in oral surgery clinics presented a significant variance in the incidence of medical comorbidities, among which diabetes and hypertension were most common. A proper case history is the best preventive measure that helps a surgeon avert medical emergencies and post-surgical complications.

BACKGROUND: Mandibular third molar (MTM) extraction is one of the most frequently performed surgeries in the oral cavity. Establishing the level of surgical difficulty pre-operatively is an essential step to ensure correct treatment planning. In Spain, MTM extraction - especially in cases presenting greater difficulty - is normally performed by doctors specializing in oral and maxillofacial surgery, or by dentists with postgraduate qualifications in oral surgery. The present work set out to analyze the extent to which perceptions of surgical difficulty of the said intervention vary in relation to professional training.
METHODS: This cross-sectional, descriptive, observational study took the form of a survey. Using a visual analog scale (VAS), participants evaluated both the perceived difficulty of 30 cases of MTM extraction described by means of digital panoramic radiographs and the perceived difficulty deriving from a series of factors conditioning MTM extraction. The results underwent statistical analysis with SPSS Statistics 28.0 software. Non-parametric tests (Mann Whitney test for independent samples and the Kruskal-Wallis test) were applied.
RESULTS: A total of 213 surveys were available for analysis. Both groups awarded the greatest importance to clinical experience, followed by anatomical and radiographic factors, root morphology obtaining the highest score among anatomical factors (9.01±1.42), while proximity of the MTM to the inferior alveolar nerve was regarded as the least important anatomical factor (8.11±2.54). Significant differences were only found for patient age, whereby maxillofacial surgeons awarded this factor more importance than dentists.
CONCLUSIONS: The different training received by dentists specialized in oral surgery and maxillofacial surgeons did not influence either perceptions of surgical difficulty of MTM extraction, or opinions as to the factors influencing surgical difficulty.

We analyzed the quality and quantity of systematic reviews (SRs) of orthognathic surgery, the most frequently published topic in maxillofacial surgery.
We searched the PubMed database for SRs of orthognathic surgery with no restriction on the language of publication date. We assessed the certainty of evidence presented according to the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocol and the Leiden Manifesto using the Grading of Recommendations Assessment, Development, and Evaluation approach. We analyzed the data using descriptive statistics, Pearson´s correlation test, and linear regression.
Of the 171 SRs evaluated, approximately one fifth presented evidence with a high level of certainty. The number of orthognathic surgery SRs has been increasing, and many SRs were published after very similar topics had already been published. There is no relationship between the impact factor and the certainty of evidence.
An excessive number of SRs of orthognathic surgery are published, and many SRs are superfluous, simply reporting previous findings. Clinicians should not base treatment decisions solely on the evidence presented in SRs, and journal editors and reviewers should evaluate these SRs more critically, particularly when they address topics that have already been covered in the literature.

The primary objective of this study was to validate an Urdu translation of Kleinknecht\'s Dental Fear Survey (DFS) for use in Pakistan and to explore which items contribute the most to the variance in dental fear scores based on patient perceptions and lived experiences during dental care.
This mixed-method study was conducted at Dow Dental Hospital from February 2022 to June 2022. For quantitative analysis, a total of 273 participants were enrolled through convenience sampling. After obtaining signed consent, participants were asked to self-report their dental fear. In-depth interviews with 25 patients displaying moderate to high dental fear were conducted to clarify the elements of dental fear scores through the lens of individual perceptions and experiences.
The prevalence of moderate dental fear was significantly higher among female participants than males. The mean dental fear score was higher among females (39.47 ± 14.23) as compared to males (30.83 ± 10.50). Most of the female participants reported an increase in breathing rate and heartbeat during dental treatment. The highest mean fear score was reported by participants who underwent oral surgical treatment (42.98 ± 14.21), followed by participants who received restorative care (36.20 ± 12.60). Approaching the dentist\'s office was the significant factor that contributed the most to the variance in dental fear scores. Four themes were generated through the content analysis of the interviews: physical reactions to dental procedures, perceptions and fears about surgical and restorative procedures, and gender and environmental factors in dental fear and interaction with dentists.
The Urdu translation of DFS is a reliable and valid instrument for assessing dental fears in Pakistan based on the findings of this study. Patients perceive surgical and restorative procedures as unpleasant and threatening. It was noted that \"the heart beats faster\" and \"the breathing rate increases.\" were the top two physiological responses.

OBJECTIVE: The aim of the study to study of physical, mechanical and biocompatible properties of the matrices manufactured by antisolvent 3D printing from the solutions of polylactide-co-glycolide in tetraglycol.
METHODS: Three-dimensional scaffolds were made from a solution of polylactide-co-glycolide mixed with tetraglycol using antisolvent 3D printing. The elastic properties and the structure of the obtained matrices were studied. MTT-test and staining with PKH-26, Calcein-AM, DAPI with subsequent fluorescence microscopy were used to study biological properties.
RESULTS: The three-dimensional scaffolds had good mechanical properties. Young\'s modulus value was 18±2 MPa, tensile strength was 0.43±0.05 MPa. The relative survival rate of cells after the first day was 99.58±2.28%, on the 14th day - 98.14±2.22%. The structure of the scaffold promoted cell adhesion and spreading on its surface.
CONCLUSIONS: The polylactide-co-glycolide matrices produced by antisolvent printing have high porosity, biocompatibility and good mechanical properties. It is allowed to use them in the future as a basis for personalized constructions for the replacement of extensive bone defects of the maxillofacial region.
UNASSIGNED: Изучение физико-механических и биосовместимых свойств матриксов, полученных с помощью антисольвентной 3D-печати из растворов полилактогликолида в тетрагликоле.
UNASSIGNED: Из раствора полилактогликолида, смешанного с тетрагликолем, с помощью 3D-принтинга изготавливали трехмерные скаффолды методом антисольвентной печати. Проводили исследования прочностных и упругих свойств, структуры полученных матриксов. Для изучения биологических свойств использовали MTT-тест и окрашивание витальными красителями PKH-26, кальцеин-АМ, DAPI с последующей флуоресцентной микроскопией.
UNASSIGNED: Трехмерные скаффолды обладали выраженными прочностными свойствами. Значение модуля Юнга 18±2 МПа, прочность на разрыв 0,43±0,05 МПа. Относительная выживаемость клеток после 1-х суток составила 99,58±2,28%, на 14-е сутки — 98,14±2,22%. Структура скаффолдов способствовала адгезии и распластыванию клеток на их поверхности.
UNASSIGNED: Изготовленные с помощью антисольвентной печати полилактогликолидные матриксы обладают высокой пористостью, биосовместимостью и выраженными прочностными свойствами. В перспективе это позволяет рассматривать их в качестве основы персонализированных конструкций для замещения обширных костных дефектов челюстно-лицевой области.

Unintentional intraoperative hypothermia is a common complication in patients who undergo open surgery, increasing the risk of adverse outcomes. However, few studies have focused on intraoperative hypothermia during oral and maxillofacial surgery. Our study aimed to analyze the prevalence and risk factors of hypothermia in patients who underwent oral and maxillofacial surgery.
A prospective cohort study was conducted on 128 patients who underwent oral and maxillofacial surgery.
This prospective study was conducted at West China Hospital of Stomatology between December 2020 and May 2021, and each patient was followed for at least 1-month postoperatively. Patients who underwent oral and maxillofacial surgery under general anesthesia, with at least 1-month follow-up were analyzed. The primary variable was intraoperative hypothermia, defined as core body temperature less than 36°C, measured using a tympanic thermometer during the surgery. We performed univariate and multivariate logistic regression analyses to identify the risk factors of unintentional intraoperative hypothermia.
The mean age of the 128 patients was 31.0 ± 20.9 years, and there was a male predominance (53.1%), with male to female ratio of 1.13:1. Thirty-one patients (24.2%) developed hypothermia intraoperatively. Older age (OR = 1.068, 95% CI: 1.028-1.110, P = .001), lower weight (OR = 0.878, 95% CI: 0.807-0.955, P = .002), greater blood loss (OR = 1.003, 95% CI: 1.000-1.006, P = .034), and undergoing cancer surgery (OR = 0.210, 95% CI: 0.067-0.656, P = .007) were associated with intraoperative hypothermia.
Unintentional intraoperative hypothermia is common in patients who undergo surgery for oral cancer. Warming interventions to prevent intraoperative hypothermia for high-risk patients (older, lower weight, or more intraoperative bleeding) should be considered. Meanwhile, with careful nursing and rehabilitation instructions, intraoperative hypothermia does not lead to serious perioperative complications.

OBJECTIVE: The aim of this study was to evaluate the current resistance situation concerning routinely used antibiotics for treatment in odontogenic abscesses.
METHODS: This retrospective study assessed patients with deep space head and neck infections who were treated by surgical intervention under general anesthesia at our department. The target parameter was the ascertainment of the resistance rates in order to identify the bacterial spectrum, sites in the body, length of inpatient stay, and the age and sex of the patients.
RESULTS: A total of 539 patients, 268 (49.7%) males and 271 (50.3%) females were included in the study. The mean age was 36.5 ± 22.1 years. There was no significant difference between the two sexes with regard to the mean duration of hospitalization (p = 0.574). The predominant bacteria in the aerobic spectrum were streptococci of the viridans group and staphylococci, in the anaerobic spectrum Prevotella and Propionibacteria spp. Rates of resistance to clindamycin were between 34 and 47% in both the facultative and obligate anaerobic spectrum. Increased resistance was likewise found in the facultative anaerobic spectrum, with 94% resistance to ampicillin and 45% to erythromycin.
CONCLUSIONS: Due to the increasing levels of resistance to clindamycin, their use in empiric antibiotic treatment for deep space head and neck infections should be viewed critically.
CONCLUSIONS: Resistance rates continue to increase compared to previous studies. The use of these antibiotic groups in patients with a penicillin allergy needs to be called into question and alternative medications sought.

Remimazolam is a recently approved, ultra-short-acting benzodiazepine. However, few studies have investigated remimazolam in relation to postoperative nausea and vomiting (PONV). This study aimed to compare the effects of remimazolam and propofol on PONV in patients undergoing oral and maxillofacial surgery.
Patients (n = 206) aged 19-65 years who were scheduled for oral and maxillofacial surgery were randomized into two groups, the remimazolam (R) and propofol group (P). In the R group (n = 94), remimazolam was used to induce anesthesia at 12 mg/kg/h and to maintain anesthesia at 1-2 mg/kg/h. In the P group (n = 95), anesthesia was induced and maintained with propofol (target effect-site concentration: 3-5 µg/ml). In both groups, remifentanil was administered at a target effect-site concentration of 2.5-4 ng/ml. The primary outcome was the overall incidence of PONV during the first 24 h after surgery. Secondary outcomes included the severity of nausea, use of rescue antiemetics, severity of postoperative pain, use of rescue analgesia, and quality of recovery.
The incidence of PONV during the first 24 h after surgery was 11.7% and 10.5% in the R group and P group, respectively, and there was no significant difference in the severity of nausea (P > 0.05). Ten patients in the R group and ten patients in the P group required rescue antiemetics during the first 24 h after surgery (P = 0.98). No inter-group differences were observed in terms of postoperative pain score, use of rescue analgesia, and quality of recovery (P > 0.05).
In this study, remimazolam did not increase the incidence and severity of PONV compared with propofol.
KCT0006965, Clinical Research Information Service (CRIS), Republic of Korea. Registration date: 26/01/2022.

This prospective study aimed to present, compare, and evaluate the suitability of five different magnetic resonance imaging (MRI) protocols (3D double-echo steady-state (DESS), 3D fast spin echo short-tau inversion recovery (SPACE-STIR), 3D fast spin echo spectral attenuated inversion recovery (SPACE-SPAIR), volumetric interpolated breath-hold examination (T1-VIBE-Dixon), and ultrashort echo time (UTE)) and for orthopantomogram (OPG)-like MRI reconstructions using a novel mandibular coil. Three readers assessed MR-OPGs of 21 volunteers regarding technical image quality (4, excellent; 0, severely reduced), susceptibility to artifacts (3, absence; 0, massive), and visualization of anatomical structures in the oral cavity and surrounding skeletal structures (4, fine details visible; 0, no structures visible). Average image quality was good (3.29 ± 0.83) for all MRI protocols, with UTE providing the best image quality (3.52 ± 0.62) and no to minor artifacts (2.56 ± 0.6). Full diagnostic interpretability of the osseous structures is best in VIBE-Dixon and UTE MR-OPGs. DESS provided excellent visualization of the finest details of the nervous tissue (3.95 ± 0.22). Intra-reader and inter-reader agreement between the readers was good to excellent for all protocols (ICCs 0.812-0.957). MR-OPGs provide indication-specific accurate imaging of the oral cavity and could contribute to the early detection of pathologies, staging, and radiological follow-up of oral and maxillofacial diseases.

OBJECTIVE: Three-dimensional framework theory classifies factors influencing career selection into intrinsic, extrinsic, and interpersonal dimensions. The objectives of this pilot research were to assess the psychometric properties of a scale encompassing factors affecting post-graduation specialty selection according to three-dimensional framework theory and identify motivational factors that affect dental students\' and interns\' choice of post-graduation specialty.
METHODS: A closed-ended self-structured research instrument consisting of a list of 19 factors was presented to dental students and dental interns at Margalla Dental College, Rawalpindi, Pakistan, and Islamic International Dental College, Islamabad, Pakistan (n = 235). Exploratory factor analysis and Cronbach-alpha (α) were used to assess the construct validity and reliability (internal consistency) of the scale respectively. Descriptive analysis and non-parametric tests were used for data analysis with a level of significance at ≤0.05.
RESULTS: A 3-factor solution with 11 items was stabilized. Cronbach-alpha of the pilot study turned out to be 0.72. With a response rate of 92.15%, the most common motivational factor affecting post-graduation specialty selection was the Intrinsic factor \"personnel joy and motivation to work hard.\" Dental interns and male participants were more likely to select the post-graduation specialty due to intrinsic motivational factors (p < 0.05). Inspiration from the family member and supporting the family also influenced male participants and interns respectively (p < 0.05). Female participants preferred to choose a less saturated field (p < 0.05). A medium positive statistically significant correlation was observed between the interpersonal motivational factor \"inspiration by a teacher\" and the choice of \"basic sciences\" as a post-graduation specialty (p < 0.01).
CONCLUSIONS: This pilot study resulted in the development of a scale with a 3-factor solution stabilized at 11 items. The internal consistency of the scale turned out to be 0.72. Oral and maxillofacial surgery was the first choice of post-graduation chosen by 35.5% of the respondents. Fellowship was chosen as the preferred type of post-graduation by 46% of the respondents. Irrespective of gender and designation, the top most influential factor, chosen by 88.5% of the respondents, was the intrinsic motivational factor \"personal joy and motivation to work hard.\"