Application of digital 3D printed model combined with case-based learning in practice teaching of oral and maxillofacial surgery / 中华医学教育探索杂志

Objective:To investigate the application effect of the combined teaching model of digital 3D printed model and Tencent conference in case-based learning (CBL) teaching of oral and maxillofacial surgery.Methods:A total of 80 undergraduates in the classes of 2015 and 2016 were selected from School of Stomatology, Qingdao University. The students in the class of 2015 received traditional teaching, and those in the class of 2016 received the combined CBL teaching model of 3D printed model and Tencent conference. A questionnaire survey was used to evaluate the teaching effect, and theoretical examination was used to assess comprehensive abilities of the two groups. SPSS 24.0 was used to perform the chi-square test and the t-test. Results:There was no significant difference in the degree of satisfaction with teaching between the combined CBL teaching model of 3D printed model and Tencent conference and the traditional teaching model ( P>0.05), and both models were generally recognized and accepted by students. The experimental group had a significantly higher score than the control group (94.05±4.16 vs. 86.10±3.37, P<0.05). Conclusion:The combined teaching model of digital 3D printed model and Tencent conference integrates the advantages of the Internet and digital information and thus provides a certain reference for the teaching methods for other majors in stomatology.

Effect of a care bundle on prevention of nasal pressure injury in patients with nasotracheal intubation undergoing oral and maxillofacial surgery under general anesthesia / 中国实用护理杂志

Objective:To investigate the effect of care bundles on prevention of nasal medical device-related pressure injury in patients with nasotracheal intubation undergoing oral and maxillofacial surgery under general anesthesia.Methods:This was a retrospective study. Using the convenient sampling method, patients with a surgical time more than 4 hours and a surgical grade of 3 or 4, with nasotracheal intubation undergoing oral and maxillofacial surgery under general anesthesia from Hospital of Stomatology, Sun Yat-sen University were selected. A total of 96 patients from July to December 2019 were in the control group, and 99 patients from July to December 2020 were selected as the observation group. The control group was treated with routine nursing measures, the observation group was subjected to a nursing care bundle. The incidence of nasal pressure injury was observed after the operation, 24, 48, 72 hours after the nasotracheal intubation was removed, and patients′ satisfaction score was compared.Results:The incidence of nasal pressure injury in the control group was 6.25% (6/96). None of the patients in the observation group had any pressure injury, which was significantly lower than the control group (Fisher exact probability method, P=0.013). The satisfaction scores in the observation group was significantly higher than that in the control group (26.88 ± 1.94 vs 24.71 ± 3.33), the difference was statistically significant ( t=-5.54, P<0.01). Conclusions:The care bundle can effectively prevent the occurrence of nasal pressure injury in patients undergoing oral and maxillofacial surgery with nasotracheal intubation and improve patient satisfaction.

Comparison of application of three dimensional microscope and optical microscope in oral and maxillofacial vascular anastomosis / 口腔疾病防治

Objective@#To investigate the application value of 3D microscope in vascular anastomosis in oral and maxillofacial surgery, to provide a reference for clinicians. @*Methods @#Eighty-seven cases of free flap reconstruction in oral and maxillofacial surgery were retrospectively included, including 30 cases in the 3D microscope group and 57 cases in the optical microscope group. The differences in intraoperative vascular anastomosis time, postoperative flap survival rate and doctor evaluation scores between the 3D microscope group and the optical microscope group were compared and statistically analyzed, and the feasibility of using three-dimensional microscope in surgery was evaluated. @*Results @#The arterial anastomosis time was (26.53±3.83) min/root in the 3D microscope group and (24.88 ± 2.97) min/root in the optical microscope group, and the difference was statistically significant (P<0.05). The venous anastomosis time was (30.68 ± 3.51) min/root in the three-dimensional microscope group and (28.70 ± 2.91) min/root in the optical microscope group, and the difference was statistically significant (P<0.05). There was no significant difference in the survival rate of flaps between the 3D microscope group (n = 28, 93.33%) and the optical microscope group (n = 53, 92.98%) (P>0.05). The doctor's evaluation scores of visual fatigue, training and learning, operative difficulty index, image sharing in the three-dimensional microscope group were higher than those in the optical microscope group, and the differences were statistically significant (P<0.05). @* Conclusion @# 3D microscope has good reliability and safety in surgery, a strong sense of three-dimensionality, and the convenience of teaching and training. It can be well applied to vascular anastomosis in oral and maxillofacial surgery.

Impact of COVID-19 on maxillofacial surgery practice: a systematic review / Impacto da Covid-19 na prática da cirurgia bucomaxilofacial: uma revisão sistemática

Abstract Objectives: The aim of this systematic review was to evaluate the possible impacts of COVID-19 on oral and maxillofacial surgery practice, as well as the protocols employed by oral and maxillofacial surgeons to minimize the risks of contamination. Methods: Searches were performed in different databases up to 15 March 2021. Articles related to oral surgery dynamics within the context of the COVID-19 pandemic were included. The articles were considered eligible if they met the following inclusion criteria: observational studies that provided recommendations regarding maxillofacial surgery measures during the COVID-19 pandemic and that analyzed the risk of contamination of patients/professionals with SARS-CoV-2. Results: Seven studies met the inclusion criteria and were selected for the present systematic review. Demands for personal protective equipment increased significantly, with studies reporting the scarcity of fundamental equipment such as FFP2/N95 masks. Significant changes in the infrastructure of outpatient, surgical and inpatient units and in the care protocols themselves were observed. Conclusion: The COVID-19 pandemic particularly affected the routine of oral and maxillofacial surgery residents. Several additional recommendations for surgical practice or for the surgical team were evaluated and discussed, such as performing primarily urgent and emergency surgeries, remote patient care and screening, postponing elective surgeries, and new teaching methods in oral and maxillofacial surgery residency programs. In addition, screening of patients and of the surgery team for COVID-19 is strongly recommended.

Resumo Objetivos: Avaliar os possíveis impactos da Covid-19 na prática da cirurgia bucomaxilofacial, bem como os protocolos empregados pelos cirurgiões bucomaxilofaciais para minimizar os riscos de contaminação. Método: Foram feitas buscas em diferentes bases de dados até 15 de março de 2021. Foram incluídos artigos relacionados à dinâmica da cirurgia oral no contexto da pandemia de Covid-19. Os artigos foram considerados elegíveis se atendessem aos seguintes critérios de inclusão: estudos observacionais que fornecessem recomendações sobre medidas de cirurgia bucomaxilofacial durante a pandemia de Covid-19 e que analisassem o risco de contaminação de pacientes/profissionais com SARS-CoV-2. Resultados: Sete estudos preencheram os critérios de inclusão e foram selecionados para a presente revisão sistemática. As demandas por equipamentos de proteção individual aumentaram significativamente, estudos relataram a escassez de equipamentos fundamentais, como máscaras FFP2/N95. Foram observadas mudanças significativas na infraestrutura das unidades ambulatoriais, cirúrgicas e de internação e nos próprios protocolos assistenciais. Conclusão: A pandemia de Covid-19 afetou particularmente a rotina dos residentes de cirurgia bucomaxilofacial. Diversas recomendações adicionais para a prática cirúrgica ou para a equipe cirúrgica foram avaliadas e discutidas, como a feitura de cirurgias prioritariamente de urgência e emergência, atendimento e triagem remota de pacientes, adiamento de cirurgias eletivas e novos métodos de ensino em programas de residência em cirurgia bucomaxilofacial. Além disso, a triagem de pacientes e da equipe cirúrgica para Covid-19 é fortemente recomendada.

Abordagem multidisciplinar no tratamento de incisivo lateral com fratura oblíqua e lesão periapical: relato de caso clínico / Multidisciplinary approach in the treatment of lateral incisor with oblique fracture and periapical injury: clinical case report

Casos de fraturas dentárias oblíquas muitas vezes possuem um prognóstico desfavorável, geralmente com indicação da extração do elemento dental. O presente artigo visou relatar o tratamento do caso clínico de um paciente do sexo masculino, 12 anos, que compareceu à Unidade de Saúde Bucal do Hospital Universitário de Brasília com encaminhamento de extração do dente 12, apresentando fratura oblíqua que se estendia subgengivalmente na face vestibular. O trauma havia ocorrido há três anos e o paciente havia sido submetido a diversas intervenções endodônticas, apresentando no momento da consulta inicial por nossa equipe uma lesão periapical extensa. Após a realização da anamnese, exame clínico e radiográfico, foi adotada uma abordagem multidisciplinar conservadora com a manutenção do dente e a realização da enucleação da lesão periapical por meio de intervenção cirúrgica e posterior reabilitação. Em uma mesma sessão, foi realizada a obturação do conduto com cone de guta percha e cimento sealer 26 e a cirurgia parendodôntica juntamente com a apicoplastia. Uma semana após a intervenção cirúrgica foi realizada restauração classe IV com resina composta baseada no enceramento dos modelos de diagnóstico montados em articulador. Com base em uma avaliação criteriosa e multidisciplinar, foi possível adotar uma abordagem conservadora no caso em questão, com a manutenção e reabilitação de um dente permanente em um paciente jovem, evitando a indicação de exodontia(AU)

Cases of oblique dental fractures often have an unfavorable prognosis, usually with the indication of extraction of the dental element. The present article aimed to report the treatment of the clinical case of a 12-year-old male patient, who attended the Oral Health Unit of the Hospital Universitário de Brasília with a referral for extraction of tooth 7, presenting an oblique fracture that extended subgingivally on the labial surface. The trauma had occurred three years ago and the patient had undergone several endodontic interventions, presenting an extensive periapical lesion at the time of the initial consultation by our team. After anamnesis, clinical and radiographic examination, a conservative multidisciplinar approach was adopted with the maintenance of the tooth and the enucleation of the periapical lesion through surgical intervention and subsequente rehabilitation. In the same session, the conduit was filled with gutta-percha cone and sealer cement 26 and parendodontic surgery was performed together with apicoplasty. One week after the surgical intervention, class IV restoration was performed with composite resin based on the waxing of the diagnostic models mounted on an articulator. Based on a careful and multidisciplinary evaluation, it was possible to adopt a conservative approach in the case in question, with the maintenance and rehabilitation of a permanent tooth in a young patient, avoiding the indication of extraction(AU)

Estudio Descriptivo de las Cirugías y Hospitalizaciones en Cirugía Maxilofacial Durante la Pandemia en Chile. Experiencia del Hospital Barros Luco Trudeau

RESUMEN: Desde la aparición del SARS-CoV-2 se ha establecido, en la mayoría de los países afectados por esta pandemia, la suspensión de toda cirugía electiva, centrando la atención solo a urgencias. Son varios los estudios que mencionan las recomendaciones necesarias, sin embargo, hasta el minuto existe poca evidencia de la cantidad y tipo de cirugías realizadas por los servicios de Cirugía Maxilofacial. El objetivo del presente trabajo es dar a conocer la epidemiología de los pacientes tratados por el equipo de cirugía maxilofacial en el Hospital Barros Luco Trudeau de Santiago, Chile. Se realizó un estudio de corte transversal entre Marzo y Agosto del 2020, de todos los paciente atendidos por la unidad de Cirugía Maxilofacial del Hospital. Se analizó datos epidemiológicos como también el tipo de patología, la etiología, días de estadía hospitalaria y días de espera para cirugía. La muestra estuvo constituida por 41 pacientes, 20 % mujeres y 80 % hombres. El rango etario fue de 17 a 92 años, con un promedio de 40,39 años (DE 17,67). En al diagnóstico, el 61 % correspondió a patología traumática y el 39 % a patología infecciosa. El trauma más frecuente fue la fractura mandibular parasinfisiaria (23 %) y la infección más frecuente, la infección secundaria a quistes y tumores (25 %). A pesar del periodo de pandemia con las restricciones asociadas a la cuarentena, la muestra se comporta similar a estudios previamente reportados tanto en la distribución por sexo y edad, así como en el tipo el trauma.

ABSTRACT: Since the appearance of SARS-CoV-2, the suspension of all elective surgery has been established in most of the countries affected by this pandemic, focusing only on emergency. There are several studies that mention the necessary recommendations, however, until now there is little evidence of the amount and type of surgeries performed by the different Maxillofacial Surgery services. The objective of this study is to present the epidemiology of the patients treated by the maxillofacial surgery team at the Barros Luco Trudeau Hospital of Santiago, Chile. Material and method: A cross-sectional study was carried out between April and August 2020, of all the patients treated by the Maxillofacial Surgery unit of the Hospital. Epidemiological data were analyzed as well as the type of pathology, the etiology, days of hospital stay and days of waiting for surgery. Results: The sample consisted of 41 patients, 20 % women and 80 % men. The age range was from 17 to 92 years, with an average of 40.39 years (SD 17.67). At diagnosis, 61 % corresponded to traumatic pathology and 39 % to infectious pathology. The most frequent trauma was the parasymphyseal mandibular fracture (23 %) and the most frequent infection, infection secondary to cysts and tumors (25 %). Despite the pandemic period with the restrictions associated with quarantine, the sample behaves similar to previously reported studies, both in the distribution by sex and age, as well as in the type of trauma.

Pattern of Oral and Maxillofacial New Referrals During COVID-19 Lockdown

ABSTRACT@#The study aimed to quantify the impact of lockdown during the COVID-19 pandemic on new case referrals to the Oral and Maxillofacial Surgery (OMS) service. The researchers retrospectively reviewed all new referrals received during a government-imposed 47-day lockdown period and a similar period pre-lockdown as a control group. The main outcome was the differences in the number of new case referrals between the two periods. The contributing clinical and demographic factors were also explored. Appropriate bivariate statistics were computed and the level of significance was set at 0.05 for all tests. A total of 309 referrals were received during the study period. There was a reduction of new referrals due to the lockdown from five to two cases per day. There was a statistically significant reduction of cases referred from outpatient and emergency departments. There was also a statistically significant difference with regard to home address distance to the centre. Medically compromised and orofacial infection referrals were not affected by lockdown. The lockdown imposed due to the pandemic has significantly impacted the pattern of new OMS referrals. Referrals for orofacial infections, the medically compromised and inpatients were minimally affected by lockdown.

Prevention and control strategies of coronavirus disease 2019 in oral and maxillofacial surgery wards / 第二军医大学学报

Coronavirus disease 2019 (COVID-19) has been confirmed to transmit by contact and respiratory droplets, and possibly by aerosols. Medical staff of oral and maxillofacial surgery departments need close contact with head and face of patients during the diagnosis and treatment, and aerosols may be generated during the operation. The risk of infection exposure is high, and the ward management is facing severe challenges. During the COVID-19 epidemic, the diagnosis and treatment in oral and maxillofacial surgery wards should be carried out reasonably after comprehensive assessment of patient condition. We put forward relevant prevention and control measures during the epidemic from the aspects of patient treatment, ward infection prevention and control, supply management, emergency plan, and training of medical staff, so as to provide references for prevention and control of the epidemic in oral and maxillofacial surgery wards.

Antimicrobial modulator of inflammatory response in third molar surgery compared with conventional medication

Surgeries performed in retained third molars occur in the contaminated field, bringing post-operative problems such as pain, bleeding, discomfort, swelling, infection, trismus, and inactive days. This study evaluated the differences between conventional medication and topical doxycycline in third molar surgery. Twenty-eight patients were selected requiring removal of four third molar. Half of the mouth was randomly selected to undergo surgery with the use of conventional medication (analgesic, anti-inflammatory and antimicrobial) and after 25-30 days, the other half of the mouth was subjected to surgery using doxycycline delivered through gel nanotubes. The results showed that in both treatments there was no clinical infection. The other evaluations were significantly lower in relation to pain, bleeding, edema, inactive days, trismus, and discomfort when compared with conventional therapy.

Dental consultation requests to oral and maxillofacial surgery in a hospital in Brazil

Introduction: This study analyzed dental consultation requests to the division of oral and maxillofacial surgery in a Brazilian tertiary hospital. Methods: A cross-sectional study with data collected retrospectively from inpatients' electronic medical records containing dental consultation requests made between January 2013 and December 2017. Results: 327 consultation requests were analyzed. Mean (SD) patient age was 38.71 (24.4) years; 164 (50.2%) were male and 267 (81.7%) were Caucasian. Regarding systemic conditions, 34 (10.4%) were classified as ASA I, 86 (26.3%) as ASA II, 182 (55.7%) as ASA III, and 25 (7.6%) as ASA IV. Dental consultations were mostly requested by the internal medicine team (n = 42, 12.8%). The most common reason for consultation was septic teeth (n = 131, 40.1%). Complementary tests were required in 188 (57.5%) cases. Surgical intervention was required in 82 (25.0%), with tooth extraction as the most prevalent procedure (20.2%). The most demanding service was inpatient care, with 276 (84.4%) requests. Cases were resolved in 249 (76.1%). Conclusions: The division of oral and maxillofacial surgery in our hospital deals with a great amount of consultations, contributing with surgical procedures to the adequacy of patients' oral health with a high effectiveness rate. Our data illustrate the contribution of dentists in a hospital setting, assisting the medical team in providing comprehensive care for inpatients. (AU)

The application of minimally invasive surgery in oral and maxillofacial surgery / 口腔疾病防治

@#Oral and maxillofacial area constitute an important part of the human appearances, the means of treatment, the size of surgical incision become the concern of patients. With the continuous improvement of minimally invasive surgical instruments and imaging technology, minimal invasive surgery has been rapidly developed in various surgical fields that including oral and maxillofacial surgery. The purpose of minimally invasive surgery is to seek the smallest surgical incision path and the minimal tissue damage to complete the diagnosis and treatment for the patients. In recent years, with broader development and application of minimal invasive surgical techniques in the field of oral and maxillofacial surgery, such as dento-alveolar surgery, maxillofacial tumor, maxillofacial trauma, the operative approach and surgical procedures of these diseases have been changed greatly. This article intends to synthesize the literatures and the author's clinical experiences, describing the application and development of minimally invasive surgery in oral and maxillofacial surgery.

The application of minimally invasive surgery in oral and maxillofacial surgery / 口腔疾病防治

@#Oral and maxillofacial area constitute an important part of the human appearances, the means of treatment, the size of surgical incision become the concern of patients. With the continuous improvement of minimally invasive surgical instruments and imaging technology, minimal invasive surgery has been rapidly developed in various surgical fields that including oral and maxillofacial surgery. The purpose of minimally invasive surgery is to seek the smallest surgical incision path and the minimal tissue damage to complete the diagnosis and treatment for the patients. In recent years, with broader development and application of minimal invasive surgical techniques in the field of oral and maxillofacial surgery, such as dento-alveolar surgery, maxillofacial tumor, maxillofacial trauma, the operative approach and surgical procedures of these diseases have been changed greatly. This article intends to synthesize the literatures and the author's clinical experiences, describing the application and development of minimally invasive surgery in oral and maxillofacial surgery.

Cirugía y traumatología bucomáxilofacial en la red hospitalaria chilena / Maxilofacial surgery in the Chilean healthcare network

RESUMEN: Argumentando la existencia de listas de espera de cirugía bucal y máxilofacial, los Ministerios de Salud y Educación chilenos deciden crear un profesional de menores competencias que el cirujano bucal y máxilofacial existente, cuya formación dure un año y se desempeñe en la atención primaria de salud. Decretan la especialidad de Cirugía Bucal, comprometiendo la calidad y seguridad de la atención, exponiendo a los enfermos a eventos adversos de impredecibles desenlaces, afectando la calidad de vida de éstos o provocando eventualmente un desenlace fatal. El objetivo del presente estudio es establecer el número de cirujanos bucales y máxilofaciales formados en el país, conocer cuantos se desempeñan en hospitales públicos y su distribución en los servicios de salud, así como también evaluar si se cumplen las condiciones de infraestructura necesarias para desarrollar la especialidad según la normativa vigente. Consideramos que éstos son datos fundamentales al momento de modificar políticas públicas. La metodología propuesta es un estudio descriptivo de corte transversal, realizando una encuesta dirigida a los jefes de los servicios odontológicos de la red hospitalaria pública del país, destinada a obtener información del prestador individual e institucional en cada centro de la red. Se concluye que existe una cantidad suficiente de especialistas formados y en vías de formación para atender las necesidades de la población. La evidencia muestra que faltan cargos e infraestructura, por lo que la medida adoptada por el MINSAL respecto a la creación de la especialidad de Cirugía Bucal obedece a un error diagnóstico desde el punto de vista del prestador individual e institucional, originado por la ausencia de un estudio técnico que evalúe la red hospitalaria del país.

ABSTRACT: Arguing the existence of waiting lists in oral and maxillofacial surgery, the chilean Ministries of Health and Education decided to create a professional less skilled than the existing oral and maxilofacial surgeon, whose training lasts one year and works in primary care health. They established the specialty of Oral Surgery, compromising the quality and safety of care, exposing patients to adverse events with unpredictable outcomes, affecting their quality of life or eventually causing a fatal outcome. At the time of this study there is no record of the number of oral and maxillofacial surgeons trained in our country, it is unknown how many are working in public hospitals and their distribution in health services, as well as whether there is the necessary infrastructure to develop the specialty under current regulations. We made a descriptive transversal study, conducting an interview aimed to obtain information from individual and institutional providers to know the reality of the specialty in the public health network. It is concluded that there is a sufficient number of specialists trained and in training to meet the needs of the population. The evidence shows missing possitions and infrastructure, so that the action taken by the Health Ministry regarding the creation of the specialty of Oral Surgery is due to a misdiagnosis from the point of view of an individual and institutional provider, caused by the absence of a technical study to assess the country’s hospital network.

Influences of the cognitive behavior therapy on anxiety for postoperative patients with oral and maxillofacial malignant cancer in surgery intensive care unit / 中国实用护理杂志

Objective To investigate the effects of the cognitive behavior therapy on anxiety for postoperative patients with oral and maxillofacial malignant cancer in surgery intensive care unit. Methods A total of 82 patients with oral and maxillofacial malignant tumor who accept surgery from January 2014 to September 2016 were chosen and averagely divided into intervention group with cognitive behavior therapy based on control group and control group taking routine nursing and general psychological care by random number table in SICU. The application of self-evaluation of anxiety scale (SAS) evaluation of anxiety level before and after the intervention in patients with and without improvement, and compare the two groups of stay in SICU patients satisfaction evaluation intervention is effective. Results Compared with control group, the cognitive behavioral therapy, after intervention group patients with SAS scoring[(50.56 ± 6.52) ]points SAS scores than the control group [(57.51 ± 6.11)] points decrease, the difference was statistically significant (P<0. 01);intervention group check in SICU satisfaction (97.6％,40/41) also better than the control group (90.2％, 37/41), the difference was statistically significant (χ2=7.527, P < 0.05). Conclusion cognitive behavioral therapy can effectively reduce the anxiety of postoperative patients with oral and maxillofacial malignant cancer in SICU, and effectively improve the comfort level and satisfaction in SICU.

Flexible laser endotracheal intubation optical device used for oral and maxillofacial intubation operations in 42 patients / 天津医药

Objective To explore the effect of flexible laser endotracheal intubation optical device (patent number 201520785723.7) on oral and maxillofacial intubation operations. Methods Forty-two patients with the oral and maxillofacial intubation optical device for general anesthesia were included in this study. The patients were from 16 to 73 years old and ASAⅠ-Ⅱ. Surface anesthesia was prepared for airway and nasal cavity. There were 27 patients whose mouth opening were smaller than 3 cm. After intravenous injection of midazolam 0.05 mg/kg and sufentanil 0.2μg/kg, reinforced endotracheal tube was inserted into throat 13-15 cm, then the probe shape to 120° and optical device were placed into the tube respectively, guided the tube according to the light spot in front of neck. There were 15 patients whose mouth opening were not smaller than 3 cm. The quick guidance optical device and larygoscope were adopted to help the intubation. After intravenous injection of midazolam 0.05 mg/kg, sufentanil 0.5 μg/kg, propofol 2 mg/kg, cisatracurium 0.2 mg/kg, the reinforced endotracheal tube was inserted into the oral cavity nasally, and completed intubation with laryngoscope. The success rate of intubation, time of intubation, the real-time blood pressure before and after intubation, heart rate and related complications were recorded before intubation and after intubation. Results In the 42 patients, 41 patients were successful for guidance intubation, and the success rate of intubation was about 97.6%. The average intubation time was(124.5±38.2) seconds. The shortest intubation time was 12 seconds and the longest was 276 seconds. During intubation, the increases of blood pressure and heart rate were in the normal range (<30%). Levels of SpO2 were maintained at 0.92-1.00. All the patients were without agitation. There were no serious complications such as hoarseness and pharyngalgia after operation.Conclusion The flexible laser endotracheal intubation optical device can be used quickly for oral and maxillofacial intubation, and the 45° bevel design for optical device can form two kinds of zones with bright light upward and downward. It is a new tool for nasal intubation that is more convenient for location of light guidance, and has high success rate and small stimulation.

The application effect of different doses of dexmedetomidine combined with remifentanil anesthesia in oral and maxillofacial surgery / 中国基层医药

Objective To explore the clinical effect of different doses of dexmedetomidine combined with remifentanil anesthesia in oral and maxillofacial surgery.Methods 135 patients with oral and maxillofacial surgery were randomly divided into three groups according to the random number table method,45 cases in each group.All patients received dexmedetomidine and remifentanil anesthesia,the dexmedetomidine doses of A,B and C group were 0.4,0.6,0.8μg· kg-1 · h-1.MAP,HR,SpO2 and Rasmay score in the three groups were observed before administration(T0),after administration of 5min (T1),10min (T2),20min (T3),30min (T4),and the analgesic effects of patients were observed.Results Comparison within the group,the MAP,HR at T0-T4 showed a significant downward trend in all groups,the differences were statistically significant (F =3.651,3.985,4.212,all P ＜ 0.05).The Ramsay score significantly increased at T0-T4,the differences were statistically significant (F =3.156,3.827,4.546,all P ＜ 0.05).The SpO2 in each group showed a downward trend,but there were statistically significant differences in C group(F =3.737,P ＜ 0.05).Comparison among groups,at T2-T4,the MAP[(66.3 ± 6.1) mmHg,(64.6 ± 6.5) mmHg,(63.8 ± 7.5) mmHg],HR [(61.9 ± 6.8) times/min,(59.1 ± 5.9) times/min,(57.6 ±5.6) times/min] and SpO2 [(96.6 ± 0.2) ％,(94.7 ± 0.4) ％,(96.8 ± 0.4) ％] were significantly lower in C group than in A group,B group(t =3.245,2.986,3.875,4.103,all P ＜ 0.05),the Ramsay scores [(3.1 ± 0.5) points,(4.2 ± 0.8) points,(4.6 ± 0.7) points] were significantly higher than those in A group,B group (t =1.465,2.011,1.664,1.034,all P ＞ 0.05).The analgesic effect of C group was significantly better than B group and A group (93.3 ％,82.3 ％) (x2 =3.998,4.234,all P ＜ 0.05).In C group,the incidence rates of hypoxemia,bradycardia (less than 55 times/min) were significantly higher than those of A group and B group (x2 =3.365,3.112,3.365,3.365,all P ＜ 0.05).Conclusion In oral and maxillofacial surgery anesthesia,dexmedetomidine combined with remifentanil has good anesthetic effect,with the increase of dexmedetomidine dose,sedative effect is better,but the incidence rate of adverse reaction is increased.

Oral maxillofacial-head and neck tumor and holistic integrative medicine / 中华口腔医学杂志

The advance of clinical diagnosis and treatment in oral and maxillofacial-head and neck tumors has been through the process of specialization and multidisciplinary cooperation. In most cases, a single discipline cannot meet the requirements of diagnosis and treatment, which needs the cooperation of oral and maxillofacial surgery, otolaryngology and oncology approach and therapeutic method such as surgery, radiotherapy and chemotherapy. Holistic integrative medicine aims at integrating the most effective clinical practice experience and patients' individual situation and prognosis, establishing new medical mode conforming to the modern concept and fulfilling the medical system adapting to the specific characteristics of the diseases.

Professional development of oral and maxillofacial trauma since the founding of the People's Republic of China / 中华口腔医学杂志

Oral and maxillofacial trauma surgery in modern China has experienced four stages of growth in different social and economic backgrounds: initiation, stagnation, exploring and development. It is now an important branch of oral and maxillofacial surgery with unique Chinese characteristics. This paper retrospectively summarizes the representative figures and important events, as well as the research and technology advances in each of the four growth stages. It also includes an analysis of current advantages and problems, and provides some foresights for future development of this subspecialty in China.

Oral and maxillofacial surgery residency training in the United States: what can we learn / 中华口腔医学杂志

China is currently in the process of establishing formal residency training programs in oral and maxillofacial surgery and other medical and dental specialties. Regulatory agencies, and educational and academic institutions in China are exploring mechanisms, goals and standards of residency training that meet the needs of the Chinese healthcare system. This article provides an introduction of residency training in oral and maxillofacial surgery in the United States, with emphasis on the accreditation standard by the Commission on Dental Accreditation. As there are fundamental differences in the medical and dental education systems between China and United States, the training standards in the United States may not be entirely applicable in China. A competency-based training model that focus on overall competencies in medical knowledge, clinical skills and values at the time of graduation should be taken into consideration in a Chinese residency training program in oral and maxillofacial surgery.

Improving teaching quality of oral and maxillofacial surgery with diversified discussion teaching / 中华医学教育探索杂志

To improve the students'! comprehensive quality and cultivate their innovative medical talents, we applied different forms of discussion teaching in different stages of the students. In the course of theory, the form of short discussion was adopted to improve the students'! interest and concentration. In preclinical practice stage, the method of problem centered discussion was used to consolidate the profes-sional knowledge of the students. Discussion in the clinical practice was based on the actual problem of diagnosis and treatment, in order to cultivate the students'!clinical thinking. Through the diversified practice of discussion teaching with positive teaching evaluation, students'!interest in oral and maxillofacial surgery and the quality of teaching were improved.