Impact of Covid-19 pandemic on children with special needs requiring general anaesthesia for the treatment of dental disease: the experience of the Brescia Children's Hospital, Lombardy, Italy.

PURPOSE: Special needs children presenting with dental problems were penalised during the Covid-19 pandemic due to the reduction of clinical activity and the risks of nosocomial infection. The aim of this study is to evaluate the impact of the pandemic on oral healthcare in paediatric special needs patients. METHODS: We retrospectively assessed and compared the outpatient clinic activity and dental procedures performed under general anaesthesia in children with special needs at Brescia Children's Hospital (Italy) in 2019, 2020, and 2021. Any delay between expected waiting time based on assigned priority and surgery was recorded. The efficacy of the protocol adopted to reduce the spread of Covid-19 was evaluated by reporting any infections in patients, parents, and health care providers. RESULTS: In 2020, 270 outpatient visits were performed, and 40 patients were treated under general anaesthesia, with a 26% and 65% reduction, respectively, compared to 2019. In 2021, 362 visits were performed (similar to 2019) and 48 patients were treated under general anaesthesia (58% compared to 2019). The mean delay in the planned treatment was 1.0 month in 2019 (pre-pandemic period), 2.1 months in 2020, and 1.1 month in 2021. No cases of Covid-19 infection were reported in the cohort of patients and parents or among the operators related to nosocomial infection. CONCLUSIONS: The Covid-19 pandemic has profoundly reduced the activity of general anaesthesia in paediatric special need patients during 2020, with a gradual return to normal pre-pandemic activity in 2021. The adopted protocol prevented the spread of COVID-19 during hospitalisation.

Piezoelectric surgery inserts vs conventional burst: a clinical investigation.

Piezosurgery is a new technique that can be used to cut mineralized structures without damaging adjacent soft tissues. This device has a lot of advantages: reduced surgical time, blood loss, and inferior alveolar nerve injury in bimaxillary osteotomy. Fifty patients underwent different surgical operations (orthognathic surgery, traumatic surgery, reconstructive surgery, aesthetic procedures) with 7 different kind of piezosurgery inserts in a period of 8 months. The same two surgeons performed all the procedures. All the procedures were carried out in order to improve the precision of the osteotomy and the comfort of the surgeon. Piezoelectric devices provide an innovative ultrasonic technique for safe and effective osteotomy compared with methods that use rotating instruments. Different inserts have been developed in order to achieve the utmost advantages.

Iatrogenic traumatic optic neuropathy: report of an injury occurring during a choanal atresia correction surgery treatment.

We report the case of a 36-year-old adult male patient who came to our attention for the evaluation of a possible iatrogenic injury suffered during the surgical correction of congenital choanal atresia. This case report retraces the patient's medical history and the events lapsed in the peri-operative time analyzing if any malpractice has occurred in causing the amaurosis.