Do steroid abusers have more temporomandibular joint symptoms? A study with 97 bodybuilders.

OBJECTIVES: Anabolic androgenic steroids (AAS) are derivatives of testosterone, used to treat gonadal disturbances, performance enhancement, and aesthetic purposes. AAS abuse can lead to side effects, including androgenic, cardiovascular, and liver disturbances, effects on libido, gynecomastia, and behavioral effects. There is a hypothesis that some joint tissues may be targets for sex hormones, and the use of AAS without medical follow-up may exacerbate temporomandibular joint problems in patients seeking performance and aesthetics. METHODS: In this study, a cross-sectional survey was conducted on AAS abusers who voluntarily presented themselves for clinical evaluation. Patients were subdivided by sex and age group, and the length of AAS use and symptoms such as headache, tinnitus, and temporomandibular joint pain were evaluated. RESULTS: It was observed that drug usage is related to symptoms. CONCLUSION: The results suggest that AAS use without medical follow-up may exacerbate temporomandibular joint problems, especially in patients with low estrogen levels.

Is ChatGPT a reliable source of scientific information regarding third-molar surgery?

BACKGROUND: ChatGPT (OpenAI) is a large language model. This model uses artificial intelligence and machine learning techniques to generate humanlike language and responses, even to complex questions. The authors aimed to assess the reliability of responses provided via ChatGPT and evaluate its trustworthiness as a means of obtaining information about third-molar surgery. METHODS: The authors assessed the 10 most frequently asked questions about mandibular third-molar extraction. A validated questionnaire (Chatbot Usability Questionnaire) was used and 2 oral and maxillofacial surgeons compared the answers provided with the literature. RESULTS: Most of the responses (90.63%) provided via the ChatGPT platform were considered safe and accurate and followed what was the stated in the English-language literature. CONCLUSIONS: The ChatGPT platform offers accurate and scientifically backed answers to inquiries about third-molar surgical extraction, making it a dependable and easy-to-use resource for both patients and the general public. However, the platform should provide references with the responses to validate the information. PRACTICAL IMPLICATIONS: Patients worldwide are exposed to reliable information sources. Oral surgeons and health care providers should always advise patients to be aware of the information source and that the ChatGPT platform offers a reliable solution.

Penetrating Orbital Trauma by Large Foreign Body: Case Series Study with Treatment Guidelines and Literature Review.

Purpose: The present study aims to describe a case study of large penetrating orbital trauma and treatment guidelines associated with a review of English-language literature of large foreign bodies impacting the orbit from 1997 to 2020. Patients and Methods: Five patients suffered large penetrating orbital trauma and required emergency surgical procedures. Results: Together with this present study, a total of 33 cases were selected. The present work has data similar to the literature, and emergency surgical treatment was required in the majority of the cases. Conclusion: Penetrating orbital trauma by large objects is a challenge. The initial assessment and treatment are fundamental to determine the case severity. The large foreign body should be surgically removed by a trained and experienced team in an advanced hospital unit as soon as possible to minimize visual, functional and aesthetic sequelae.

Ultrasound protocol in odontogenic infections: a new proposal

Background: Point-of-care-ultrasound can be applied to preview a difficult airway, detect the presence of fluid collection, and soft-tissue edema, and guide the drainage location, although is rarely used. The purpose of this study is to validate a protocol for the assessment of these clinical features on patients with severe odontogenic infections.Material and methods: This was a single-group prospective cohort study (n=20) including patients with the diagnosis of deep-neck propagation of odontogenic infection. A transcervical linear high-frequency probe transducer (13-6 MHz) was used to scan the structures of the upper airway and the infectious collections. The drainage was guided by ultrasound and the patients were daily evaluated, according to the protocol. The data were extracted and the airway volume, midline deviation, and other important data such as length of hospital stay, dysphagia, voice alteration, raised floor of the mouth, dyspnea, and neck swelling were registered.Results: The ultrasound examination was correlated with multiple clinical findings, such as dyslalia (p=0,069), dysphagia (p=0,028), dyspnea (p=0,001), among others. This protocol has an advantage as it can be used at bedside evaluation, allowing the assessment of severe and unstable patients, and predicting the increase of the hospitalization time (p=0,019).Conclusions: This protocol is reliable for the assessment of the upper airway, even in an emergency, predicting not only the severity of the clinical features but aids in the determination of the length of the hospitalization time. (AU)

Double blind randomized clinical trial comparing minimally- invasive envelope flap and conventional envelope flap on impacted lower third molar surgery

Background: The latest trend in surgery is to look for minimally invasive procedures, with fewer complications and a shorter recovery time. This study aims to compare the minimally- invasive envelope flap, with smaller incision and fewer dissection and the conventional envelope flap, with a 20mm incision, on impacted mandibular third molar surgery, focusing on the hypothesis that there were no differences in postoperative outcomes. Material and methods: A double-blind randomized clinical trial was designed to compare both incisions, focused on determining the approach with minor postoperative side-effects and minor impact on quality-of-life. A total of 60 patients were enrolled for the study if their presented impacted mandibular third molar and was 18-years-old or more. Both groups were evaluated from time elapsed on the surgery, maximum mouth opening, swelling and quality of life assessment. Results: The flap choice influenced facial swelling (p=0,03), pain on the first three days (p=0,037), interference with oral hygiene (p=0,019) and discomfort on speech (p=0,07). Chewing, swallowing, trismus, pain after seven days, postoperative complications and other quality-of-life arrangements were no different between groups. Conclusions: The minimally- invasive envelope flap could lead to a less painful experience for the patient, with fewer impact on the oral hygiene and speech discomfort. (AU)

Does the Lockdown Influence the Oral and Maxillofacial Surgery Service in a Level 1 Trauma Hospital During the COVID-19 Pandemic?

ABSTRACT: The pandemic status of the Novel Coronavirus 2019 has affected many countries around the world, due to the high virulence of the SARS-CoV-2, the recommended protocol to prevent infection is social isolation. The purpose of this study was to compare the number of patients admitted and their epidemiological data on a Level 1 Trauma Hospital after the declaration of the pandemic status and the first week of mandatory lockdown, with the same period of time in the last year. This was a retrospective study of medical records from the patients admitted in the Oral and Maxillofacial Surgery of the João XXIII Hospital, between the March 24 and March 31 of 2020 and the same period of the last year. There was a 52.27% decrease in the total number of patients and 76.34% decrease in the total consultations of the service of oral and maxillofacial surgery during the lockdown. All the groups presented a decrease in significance with motor vehicle accidents events, the group 11 to 20 years old presented an increase on the correlation with violence (P = 0.019) and falls (P = 0.002). When comparing both sex with the etiologies, the male one presented an increase in the correlation with violence and falls. The female sex presented correlations only with the minor causes. No valid significance was observed when comparing females with violence events. The lockdown is an effective way to reduce the transmission of the COVID-19, the hospital usage and occupation.

Ultrasonography on the Early Postoperative Control of Severe Odontogenic Infections.

The management of odontogenic infections remains an important segment of the oral-maxillofacial surgical practice. The implementation of ultrasonography (US) imaging for the diagnosis of head and neck infections increases the possibility of visualizing the abscess collections in the deep neck spaces of lateral pharyngeal, masticator, and submandibular areas. The US imaging can detect the presence of fluid collections and edema, which may indicate local inflammation. Signs of deeper infections, such as subcutaneous emphysema and perifascial fluid, may also be apparent via US imaging. We present a new technique that uses US imaging to evaluate the deep neck infections after drainage from the early postoperative time to determine the locations of the drains inside the collection area and the edema of adjacent tissues. This technique is less costly than computed tomography or magnetic resonance imaging and allows for early assessment of adjacent tissues, leading to an earlier extubation and reduced hospitalization time and costs.

What Do We Know About COVID-19?: Maxillofacial Surgeons Survey.

Coronavírus disease 2019 (COVID-19) is a virus of mass dissemination, with an impact on international public health, leading to hospitalizations and death. The main symptoms of COVID-19 are fever, fatigue, dry cough; however, myalgia and dyspnea and the transmission routes include direct transmission by cough, sneeze, droplet inhalation, or contact transmission with the oral, nasal, or eye mucous membranes. The dental professionals are the main risk group to COVID-19 due to the transmission routes that are directly related to the dental practice. In addition, the oral and maxillofacial surgeons (OMFS) are even more exposed, due to increased contact with the population in hospitals and emergency services. OMFS should be able to identify a suspected case of COVID-19, its symptoms, risk groups, disease severity, laboratorial and computed tomography alterations, and treatment guidelines. In the present study, the authors performed a nationwide survey with Brazilian OMFS to evaluate the knowledge of these professionals about the pandemic status of the COVID-19. A total of 142 OMFS replied the survey and the results brings light to an incomparable health public problem that the OMFS in Brazil are no able to protect itself, diagnose the suspicious and probable cases, request and interpret the correct laboratorial examinations for the treatment of the COVID-19 patients.

New Device For Submental Endotracheal Intubation.

The submental intubation is a well-described technique as an alternative for the tracheostomy in the airway management in patients with contraindications for the nasotracheal and cannot remain in the orotracheal position due to the need to maintain the intermaxillary fixation. Residents and young oral and maxillofacial surgeons could have experienced some difficulty performing the technique first described by Altemir (1986). This report aims to describe a new device designed to facilitate and simplify the technique helping surgeons on the submental endotracheal intubation.

Supernumerary nasal tooth removed with a modified maxillary vestibular approach: case report and literature review.

PURPOSE: The aim of this present study is to describe a case of supernumerary nasal tooth removed with a modified maxillary vestibular approach with subperiosteal dissection. METHODS: Also, a review of English-language literature of supernumerary nasal teeth from 1959 to 2018 was performed. RESULTS: This study demonstrated that the modified maxillary approach with subperiosteal intranasal dissection is a useful approach for the exposure and removal of teeth impacted in the floor of the nasal cavity. The advantage of its use versus the other techniques is the lower risk of complications and postoperative morbidity. The use of computed tomography is essential to determinate the position of the tooth and to help in the surgical planning. CONCLUSIONS: The transoral approaches are more natural to the oral and maxillofacial surgeons than the transnasal or endoscopic ones.