Accuracy of Telemedicine Consultations in Oral and Maxillofacial Surgery During the COVID-19 Pandemic.

PURPOSE: Telemedicine has been an emerging trend over the past few years and has seen an exponential rise due to the COVID-19 pandemic. The purpose of the present study was to determine the accuracy of planned oral and maxillofacial surgery (OMS) procedures for patients seen initially by telemedicine in the department of OMS during the pandemic. METHODS: This was a retrospective cohort study. Record review of all patients who received telemedicine consultations during the pandemic time frame of March 1, 2020, to March 1, 2021, was performed. The primary outcome was the accuracy of the planned OMS procedure. Accuracy was defined as the ability to conduct the planned surgery with chosen anesthesia (local anesthesia, diazepam + local anesthesia, intravenous sedation, general anesthesia) at the immediate follow-up appointment without the need for further preoperative testing, evaluation, and consultation. The secondary outcomes were to determine the change in surgical plan, anesthesia plan, and medical plan. Predictor variables included age at the time of telemedicine consultation, gender, race, ethnicity, and the type of consult. Descriptive statistics and logistic regression analysis were executed. RESULTS: The study sample comprised 286 (64.56%) females and 157 (35.44%) males. The age range of the study population was 9 to 92 years, with a mean age of 33.88 years (standard deviation = 16.29 years). In the cohort of 443 patients who obtained telemedicine consultations, 98.19% were successfully treated at the following appointment. Four hundred thirty-one (97.3%) out of the 443 telemedicine consults pertained to dentoalveolar concerns. Logistic regression analysis showed that neither age nor gender had significant effects on the change of surgical and anesthesia plans. CONCLUSIONS: Telemedicine can be effectively utilized in performing consultations for routine OMS procedures, especially dentoalveolar surgeries. Telemedicine consultation can also be used to conduct a preoperative assessment to determine anesthesia and setting of care. However, given the lack of control group and the observational nature of this study, the results must be interpreted with caution.

Aetiology and Epidemiology of Maxillofacial Injuries during the Stay-At-Home Period Due To the COVID-19 Pandemic: a Single Center Study.

OBJECTIVES: The aim of this retrospective comparative study was to evaluate the effects of implemented social and public health measures during the COVID-19 pandemic on the incidence and aetiology of maxillofacial injuries. MATERIAL AND METHODS: A retrospective chart review of all the patients who had sustained maxillofacial injuries and presented to the emergency department of Strong Memorial Hospital between March 20th and June 24th, 2019 and 2020, were included in our study. The total study sample comprised of 335 patients (n = 140 in 2019 group, n = 195 in 2020 group). The primary outcome variables of the study were the number of cases and aetiology of maxillofacial injuries. Statistical analysis consisted of descriptive statistics, Chi-square, and two sample t-tests. RESULTS: The number of patients in the 2020 group was higher (n = 195) than the number of patients in the 2019 group (n = 140). Comparatively, there was an increase in the maxillofacial injuries during the stay-at-home period by (n = 55 [39.29%]). Although not statistically significant, the aetiology of injuries differed during the stay-at-home period compared to the normal times. CONCLUSIONS: The number of maxillofacial injuries increased during the period of implemented social and public health measures during the early months of the COVID-19 pandemic. Such knowledge can provide valuable information for the establishment of prevention programs and effective health policies and help in the decision-making process pertaining to resource allocation in a dire situation of the pandemic.

Dental care during the coronavirus disease 2019 (COVID-19) outbreak: operatory considerations and clinical aspects.

OBJECTIVES: This paper is aimed at addressing the urgent need to develop a protocol that will address the operatory and clinical aspects of dental care during the Coronavirus disease 2019 (COVID-19) outbreak. DATA SOURCES: The epidemiology, clinical signs and symptoms, and modes of transmission of COVID-19 are presented. This protocol was established as an international collaboration of three dental universities: Hadassah School of Dental Medicine, Israel; University of Rochester Medical Center, USA; and the University of Pennsylvania, USA. This protocol is based on a detailed review of the existing English language literature as well on the logistic and clinical experience of each facility and the opinion of the authors. The protocol is designed for a hospital setting and includes considerations related to dental treatment in both healthy subjects and those suspected or diagnosed with COVID-19. The first part of this review discusses operatory considerations; the second part discusses general dental clinical aspects; the third part discusses endodontic considerations; and the fourth part discusses surgical aspects. This protocol may be applicable to other future similar pandemics. CONCLUSION: Logistic and clinical steps are required to provide dental care during the COVID-19 outbreak while preventing cross-contamination and protecting the dental team during the provision of care.