Longitudinal Assessment of the Quality of Life in Oral Squamous Cell Carcinoma Patients.

Background Studies evaluating the quality of life (QoL) among oral cancer patients in the Indian population are scarce. Regular follow-ups and QoL assessment in oral squamous cell carcinoma (OSCC) patients can aid in comprehensive support strategies to improve their QoL outcomes. Aim and objectives This study aimed to assess the QoL of oral cancer patients and correlate the QoL with demographic and treatment parameters.  Materials and methods The study included oral cancer patients who had previously reported to the Department of Oral and Maxillofacial Surgery. QoL assessment was done using the EORTC QLQ-C30 and QLQ-HN43 questionnaires before and after treatment. The clinico-demographic details, treatment data, follow-up data, and recorded mean QoL were procured from the patient records in Dental Information Archival Software. Assessment of QoL was done before treatment and at intervals of one month, three months, six months, 12 months, 24 months, and 36 months postoperatively after treatment. Statistical analysis was performed using IBM SPSS Statistics for Windows, Version 23 (released 2015; IBM Corp., Armonk, New York, United States). A repeated measures analysis of variance (ANOVA) was utilized for comparing the average QoL scores and frequency of follow-ups across various intervals. Chi-square tests assessed differences in mean QoL among genders, across different sites, and between primary closure and graft placement. The significance was set at a p-value of less than 0.05. Results A total of 90 OSCC patients had reported to the department. A preoperative assessment of QoL was done for 90 (100%) patients. Out of these patients, surgery has been performed on 41 (45%). Twenty-five out of 41 (60%) patients had responded to regular follow-up, and QoL was assessed for these patients. After the immediate postoperative phase, only 12 (48%) had reported after three months. Only six (24%) had a 12-month follow-up, five (20%) had a two-year follow-up, and one (4%) had a three-year follow-up. There was a constant decrease in the number of follow-ups after the treatment of OSCC (p=0.00). Prior to treatment, the mean QoL index was 4.64. Females had a slightly higher preoperative QoL of 4.76 compared to males, with a score of 4.67 (p=0.157). Immediately after the treatment of OSCC, a decline in QoL scores was noted, with a mean score of 4.25 (p=0.32). Patients who underwent primary closure after excision had a mean post-op QoL score of 4.9, while patients who underwent graft placement had a mean score of 4.6 (p=0.157). Conclusion This study highlights the enduring impact of oral cancer on a patient's quality of life and emphasizes the need for ongoing research to explore specific interventions that can contribute to sustained improvement in QoL. It emphasizes personalized, holistic care approaches for such patients.

The use of artificial intelligence to detect voided medication orders in oral and maxillofacial surgery inpatients.

OBJECTIVE: The aim of this study is to determine if supervised machine learning algorithms can accurately predict voided computerized physician order entry in oral and maxillofacial surgery inpatients. METHODS: Data from Electronic Medical Record included patient demographics, comorbidities, procedures, vital signs, laboratory values, and medication orders were retrospectively collected. Predictor variables included patient demographics, comorbidities, procedures, vital signs, and laboratory values. Outcome of interest is if a medication order was voided or not. Data was cleaned and processed using Microsoft Excel and Python v3.12. Gradient Boosted Decision Trees, Random Forest, K-Nearest Neighbor, and Naïve Bayes were trained, validated, and tested for accuracy of the prediction of voided medication orders. RESULTS: 37,493 medication orders from 1,204 patient admissions over 5 years were used for this study. 3,892 (10.4%) medication orders were voided. Gradient Boosted Decision Trees, Random Forest, K-Nearest Neighbor, and Naïve Bayes had an Area Under the Receiver Operating Curve of 0.802 with 95% CI [0.787, 0.825], 0.746 with 95% CI [0.722, 0.765], 0.685 with 95% CI [0.667, 0.699], and 0.505 with 95% CI [0.489, 0.539], respectively. Area Under the Precision Recall Curve was 0.684 with 95% CI [0.679, 0.702], 0.647 with 95% CI [0.638, 0.664], 0.429 with 95% CI [0.417, 0.434], and 0.551 with 95% CI [0.551, 0.552], respectively. CONCLUSION: Gradient Boosted Decision Trees was the best performing model of the supervised machine learning algorithms with satisfactory outcomes in the test cohort for predicting voided Computerized Physician Order Entry in Oral and Maxillofacial Surgery inpatients.

Utility of Cadaveric Porcine Heads for Teaching Oral Surgical Procedures in an Australian Dental School: A Pilot Study.

Background/Objectives: Cadaveric models have traditionally been a mainstay of dental and medical education worldwide since their inception. In Australia, educators at dental schools were among the first to use cadaveric porcine heads in formal teaching in oral surgery. This practice has since fallen out of favour in most modern dental curricula. The aim of this pilot study was to determine the utility of cadaveric porcine models for oral surgery training from a student perspective (Griffith University, Gold Coast, Australia). Methods: Thirty participants who were all third-year dental students attended a two-hour session comprising a 30 min lecture followed by a 90 min practical workshop. The lecture outlined the steps and supervision of students during the practical and was provided by a consultant maxillofacial surgeon. At the conclusion of the workshop, participants were asked to anonymously complete a printed questionnaire with eight questions related to their experience. Results: Prior to the workshop, two-thirds (61%) of participants felt that they had been taught the surgical procedure for raising mucoperiosteal flaps adequately in their dental school curriculum during their third year, although only 43% of students had assisted specialty residents in raising a mucoperiosteal flap and 14% reported having performed the procedure themselves. Almost all students (96%) agreed that the porcine model was useful for their dental education and that they would practice the exercise using the model again if provided with the opportunity. The questionnaire had a 93.33% completion rate. Conclusions: This pilot study indicates that porcine heads present a useful, low-cost adjunct in the learning of basic oral surgical procedures.

Development of a porcine training model for microvascular fasciocutaneous free flap reconstruction.

BACKGROUND: In reconstructive surgery, improvements are needed in the effective teaching of free flap surgery. There is a need for easily accessible and widely available training without high financial costs or ethical concerns while still providing a realistic experience. Our aim was to develop an appropriate training model for microvascular flaps. METHODS: We identified pig head halves as most appropriate regarding availability, cost, and realism. These accrue largely by the food industry, so no animals need to be sacrificed, making it more ethical from an animal welfare perspective. We evaluated the suitability as flap donor site and analyzed the vascular anatomy of 51 specimens. RESULTS: Anatomical evaluation revealed a reliable and constant vascular anatomy, allowing the design of a flap model that can effectively illustrate the entire process of microvascular flap surgery. The process was divided into 6 key steps. The flap can be harvested after marking the vascular pedicle 5.3 cm from the lateral corner of the mouth. Skin island design and subsequent tissue dissection follow until a fasciocutaneous flap is raised, similar to a radial flap. Upon completion of flap harvesting, it can be freely transferred for defect reconstruction. Microvascular anastomosis can be performed on recipient vessels in the cervical region, and the difficulty can be individually adjusted. CONCLUSIONS: The developed training model is a reasonable compromise in terms of surgical realism, availability, didactic value, and cost/time effectiveness. We believe it is a powerful and effective tool with high potential for improving surgical education and training.

Throat packing via nasopharyngeal airway for severe trismus cases requiring surgical intervention under general anesthesia: A simplified and innovative approach.

Throat packing is essential in oral and maxillofacial surgeries to prevent blood and tissue debris aspiration, reducing postoperative complications. Traditional oral route methods are often inadequate, especially in severe trismus cases like Oral Submucous Fibrosis (OSMF), TMJ Ankylosis, and post-traumatic conditions due to limited mouth opening. This study introduces a novel technique using a nasopharyngeal airway (NPA) for throat packing. The method involves inserting a hemostatic dressing through an NPA, ensuring minimal invasiveness and effective airway management. Proper positioning is confirmed with a laryngoscope or fiberoptic scope, and the dressing is secured to prevent dislodgement. This technique is easy, reproducible, and less injurious compared to traditional methods. At our center, throat packing via NPA was performed on 35 patients undergoing surgery under general anesthesia, resulting in high satisfaction and no reported complications.

Multidisciplinary full-mouth rehabilitation using minimally invasive dental implant therapy: a report on three different clinical scenarios.

Conventional operative dental procedures are being revisited with an approach that seeks to preserve the original tissue as much as possible. Implant dentistry has also seen the advent of various techniques which make minimal alteration to natural tissue. The flapless technique involves implant placement either through a freshly extracted socket or through a tansmucosal punch hole, without elevating mucoperiosteal flap. This paper presents a report on three cases of patient centric, conventional dental implant-based full-mouth rehabilitation, which was successfully carried out using the flapless technique, under varied clinical situations. Each case showed a favourable outcome in terms of restoration of the form and function of the patient's dentition.

Clinical Dental Student Perception of Oral and Maxillofacial Surgery as a Specialty at Qassim University.

The objective of the current research was to assess and gain insight into the perceptions held by dental students enrolled in the clinical program at Qassim University regarding the specialty of oral and maxillofacial surgery (OMFS). A survey-based cross-sectional study was carried out at the dental clinics of Qassim University, following approval from the Dental Research Center of the university. The study targeted a population consisting of 80 dental interns and undergraduate students (BDS) enrolled at Qassim University. From each academic year (third year to interns), a random selection of 20 students was made, ensuring representation from both male and female sections. Upon analyzing the data regarding the intern and class year of dental students, it was found that there were no statistically significant associations with regard to question 3: "What do you perceive as the most commonly performed procedure by oral and maxillofacial surgeons in practice?" (P = 0.759a). Among intern and dental students, a significant majority identified extraction of the third molars as the most frequent procedure carried out. The lowest percentage (70.4%) was reported among the intern classes, whereas the highest percentage (91.7%) was reported among the fourth-year students. The perceptions of dental students toward OMFS undergo changes during their undergraduate training. By gaining a deeper understanding of these perceptions, the academic faculty specialized in OMFS can enhance their ability to educate students and, in turn, strengthen the overall specialty.

Evaluation of Lingual Foramen in the South Indian Population Using Cone-Beam Computed Tomography: A Prospective Cross-Sectional Study.

Background: Surgical procedures in the anterior mandibular region require a profound understanding of the complex anatomical structures to ensure patient safety. The lingual foramen (LF) and its intra-osseous canal are pivotal structures, supplying vascular and neural support to the mental region. The prevalence of LF is widely recognized, with variations among populations. Methods: The study involved 650 adult participants. Data were collected using high-resolution cone-beam computed tomography (CBCT), and statistical analysis was conducted, establishing inter-rater agreement. Results: The population had a varied age distribution, with males comprising 53.23% and females comprising 46.77%. The median lingual canal was found in the Supra and Infra spinosum (65.38%). Most participants had lateral lingual canals (60.92%). The most prevalent lingual foramina was 4 (30.62%). The study found no significant associations between gender and LF diameter, distribution in different travel directions, or LF locations. However, males had a slightly larger diameter. Conclusion: The findings provide valuable insights into LF variations based on anatomical locations, and there were no statistically significant differences in measurements across different age groups. This knowledge contributes to the evolving field of oral and maxillofacial surgery, ensuring better patient outcomes.

A recurrence odontogenic keratocyst formation of mandible with distinctive features: a case report.

Introduction and importance: Odontogenic keratocyst (OKC) is a distinctive form of developmental odontogenic cyst that deserves special consideration because of its specific clinical behaviour and histopathologic features. The clinical and radiographic features of OKC are indefinite; while some may be associated with pain, swelling or drainage, most of them are asymptomatic. This case reports rare radiographic and histopathological features of recurrence OKC. Case presentation: A 47-years-old male patient presented with a main complaint of a painful mass in the oral cavity with a history of previous lesions that occurred in the posterior portion of the mandible related to extraction of impacted third molar. The oral examination revealed a swelling in the molar region of the right mandible with lingual plate expansion. The radiographic and histopathologic were consistent with the diagnosis of OKC. Consequently, the lesion was surgically removed, and no clinical or radiological recurrence was observed during the 8-month postoperative follow-up. Clinical discussion: This case explained the clinical differences between OKC and other lesions and highlights the distinctive radiologic and microscopic features that a conflict with previous studies concerning the symptoms that may related to naevoid basal cell carcinoma syndrome, and revealed the proper treatment depending on the recurrence appearance and the treatment methods that used previously. Conclusions: This case highlights a rare multilocular appearance of recurrent OKC in the mandible with no naevoid basal cell carcinoma syndrome related, supports the marginal resection as an effective procedure in the management of recurrent OKCs cases.

United Kingdom oral and maxillofacial surgeons support changes to current specialty recruitment process, which could include 'Walport' style local selection and national benchmarking.

Recruitment to oral and maxillofacial Surgical (OMFS) specialty training was centralised in 2010. The 'flexibility' for OMFS to respond to specialty specific recruitment issues is reducing and many Specialty Trainees' (ST) posts are left unfilled. The National Institute for Health and Care Research (NIHR) appointment process designed to address the problem of recruiting and appointing academic surgeons with local selection with national benchmarking has worked. Using a database of all UK OMFS consultants/trainees, an electronic questionnaire was shared by e-mail, WhatsApp, and other social media. Of 306 replies, 125 (41%) were Consultants/post-certificate of completion training (CCT) individuals, 66 (22%) ST, 61 (20%) second degree students, 27 (9%) pre-second degree, 26 (9%) dual degree pre-ST trainees, and one did not indicate their status. A total of 249 (76%) studied dentistry first and 230 (75%) were male. Of those replying, 147 (48%) had no direct experience of national selection. 120 (39%) had experience as a candidate, 20 (7%) as a selector only, 17 (6%) as a candidate and selector, and two did not record their experience. Of 250 expressing an opinion, 156 (62%) supported local selection with 140 (56%) supporting local selection and national benchmarking, which is a process used for research training posts by the NIHR. Geographical continuity was most important for 78% of pre-second-degree trainees, 45% of STs, and 54% of second-degree students. A total of 57 respondents completed free text comments. There is support for changes in OMFS ST selection including creating OMFS posts which include Foundation and second-degree training in NIHR style locally recruited nationally benchmarked posts.

Adult Tessier cleft 30: technical case report and review of literature.

Atypical facial clefts are rare anomalies that occur due to the failure of embryonic fusion of the branchial arches. The midline mandibular cleft or Tessier 30 cleft is one such rare anomaly. Such anomalies are diagnosed at birth and treated within a few months of age by establishing soft tissue and bony continuity, followed by orthognathic treatment in adulthood. It is very rare for such clefts to go untreated until adulthood. We present one such case report and our technique of management in a patient who presented to us at 25 years of age with a lower lip and mandible cleft with ankyloglossia, which was managed with a single-staged reconstruction.

Unicystic ameloblastoma appeared as a massive multilocular entity: A case report with long-term follow-up.

INTRODUCTION: Unicystic ameloblastomas are a rare variant of ameloblastomas, which are characterized by slow growth and being relatively locally aggressive, with the main site of origin being the posterior portion of the mandible, it also refers to those cystic lesions that show clinical, radiographic, or gross features of a jaw cyst. PRESENTATION OF CASE: A 27-year-old female patient presented with a chief complaint of extensive mass of mandible along with severe swelling and numbness of right lips and chin. The oral examination revealed a swelling in the molar region of the right mandible with buccal plate expansion. The radiographic and histopathologic features were consistent with the diagnosis of unicystic ameloblastoma. Consequently, the lesion was surgically removed, and no clinical or radiological recurrence was detected during 5 years post-operative follow-up. DISCUSSION: While previous reports of unicystic ameloblastoma in the posterior portion of the jaw showed favorable prognosis lesions appeared as a unilocular entity, this case reports multilocular appearance and aggressive behavior of expansive unicystic ameloblastoma. Furthermore, while some studies linked the unilocular appearance of unicystic ameloblastoma to impacted tooth, our case suggests a possible traumatic link of preexisting lesion into multilocular unicystic ameloblastoma related to impacted tooth. CONCLUSIONS: This case presents a rare multilocular unicystic ameloblastoma appearance, notably with impacted tooth involvement. It also indicates the potential transformation of solid ameloblastoma into unicystic ameloblastom.

The perception of the scope of oral and maxillofacial surgery and differentiation from similar specialities among dental students, medical students, trainee interns and pre-vocational junior doctors.

PURPOSE: To explore the ability of Dental Students (DS), Medical Students (MS), Trainee Interns (TI) and Pre-vocational Junior Doctors (JD) in identifying procedures performed by Oral and Maxillofacial Surgery (OMS), the scope of practice (SOP) of OMS and ability to differentiate OMS from similar specialities. METHODS: The study included 282 complete responses to a survey consisting of: 9 demographic questions, 11 OMS awareness, professional ambition, teaching and exposure, confidence in identifying and referring questions and 70 procedural/scenario questions across four domains. Collected data was qualitatively and statistically analysed using SPSS V29. RESULTS: OMS awareness was limited. 92.2% reported None to Small amount of OMS teaching and exposure during university, with 66.0% preferring to have had a Fair to Significant amount. DS experienced more than medical respondents (2.1 vs. 1.5, p < 0.001). Most respondents reported No to Low confidence in identifying the SOP and procedures performed by OMS (67.7%) and referring to OMS (62.4%) compared to similar specialities (32.4% and 33.2%, respectively). 52.9% of procedures performed by OMS were correctly identified as being performed by OMS. The ability to identify the OMS SOP (8.7%) and differentiate OMS from similar specialities (5.0%) was low, however better among DS than medical respondents (14.9% vs. 6.3%, p = 0.002 and 12.2% vs. 2.2%, p < 0.001). CONCLUSION: The study has highlighted a deficit in the understanding of OMS with potential implications in the public and private healthcare sector. Identification of procedures, OMS SOP and ability to differentiate OMS from similar specialities is limited however slightly better among DS.

Resorbable Patient-Specific Implants of Molybdenum for Pediatric Craniofacial Surgery-Proof of Concept in an In Vivo Pilot Study.

Titanium continues to be the gold standard in the field of osteosynthesis materials. This also applies to pediatric craniofacial surgery. Various resorbable materials have already been developed in order to avoid costly and risky second operations to remove metal in children. However, none of these resorbable materials have been able to completely replace the previous gold standard, titanium, in a satisfactory manner. This has led to the need for a new resorbable osteosynthesis material that fulfills the requirements for biocompatibility, stability, and uniform resorption. In our previous in vitro and in vivo work, we were able to show that molybdenum fulfills these requirements. To further confirm these results, we conducted a proof of concept in four domestic pigs, each of which was implanted with a resorbable molybdenum implant. The animals were then examined daily for local inflammatory parameters. After 54 days, the animals were euthanized with subsequent computer tomography imaging. We also removed the implants together with the surrounding tissue and parts of the spleen, liver, and kidney for histopathological evaluation. The molybdenum implants were also analyzed metallographically and using scanning electron microscopy. A blood sample was taken pre- and post-operatively. None of the animals showed clinical signs of inflammation over the entire test period. Histopathologically, good tissue compatibility was found. Early signs of degradation were observed after 54 days, which were not sufficient for major resorption. Resorption is expected with longer in situ residence times based on results of similar earlier investigations.

Short-term treatment of skeletal class III malocclusion by surgery-first approach with SDU protocol.

The aim of this case series is to present the successful treatments and long-term results of three adult skeletal class III patients treated with the surgery-first (SF) approach by applying the SDU (Suleyman Demirel University) protocol and to discuss the differences, advantages and disadvantages compared with other methods. Although there were differences in the treatment planning and surgical procedures of the three patients in the case series, the same protocol was followed in all three patients. The desired aesthetic result and functional occlusion were achieved with the SF approach. Significant improvement was observed in the patients' profile and facial appearance in a short time. The total duration of treatment for all cases was less than a year.

The application of virtual reality and augmented reality in dentistry - a literature review.

In recent times, dentistry has seen significant technological advancements that have transformed various specialized areas within the field. Developed into applications for mobile devices, augmented reality (AR) seamlessly merges digital components with the physical world, enhancing both realms while maintaining their individual separateness. On the other hand, virtual reality (VR) relies on advanced, tailored software to visualize a digital 3D environment stimulating the operator's senses through computer generated sensations and feedback. The current advances use the application of VR, haptic simulators, the use of an AI algorithm and many more that provides new opportunities for smart learning and enhance the teaching environment. As this technology continues to evolve, it is poised to become even more remarkable, enabling specialists to potentially visualize both soft and hard tissues within the patient's body for effective treatment planning. This literature aims to present the newest advancements and ongoing development of AR and VR in dentistry and medicine. It highlights their diverse applications while identifying areas needing further research for effective integration into clinical practice.

UK OMFS consultants and trainees strongly support the recommendations of the 2008 Postgraduate Medical Education and Training Board (PMETB) Review of Training in OMFS. The time for delivering them is now.

When the Postgraduate Medical Education and Training Board's (PMETB) Review of Oral and Maxillofacial Surgery (OMFS) Training was published in 2008 it contained five recommendations about OMFS training. As yet, none of these recommendations has been delivered. An online survey was designed to assess awareness of the PMETB review and the current views of OMFS trainees and consultants about its recommendations. Replies were invited using email and social media (WhatsApp, Twitter, and Facebook). As a result of using social media no denominator for the response rate was possible. A total of 304 responses were received, eight of which were anonymous. There was strong support for all the OMFS-specific recommendations: 1: the OMFS specialty should remain a dual medical and dental degree specialty (255, 84%); 2: OMFS training should be shortened (283, 93%); 3: OMFS training should start at the beginning of the second degree (203, 67%); 4: there should be a single medical regulator (General Medical Council) for OMFS (258, 85%); and 6: the need for a second Foundation Year should be removed (260, 86%). Other suggestions about improving OMFS training were also made by participants in the survey. There remains strong support within the specialty for the recommendations of the review. This support is present across consultants, specialty trainees, and those aiming for OMFS specialty training. Some of the original legislative obstructions to delivery of the recommendations have been removed by Brexit creating a unique opportunity for them to be delivered.

Oral and Maxillofacial Surgery: Availability of Specialist Training and Different Training Pathways across Africa.

Background: Oral and maxillofacial surgery (OMFS) is the surgical specialty concerned with the treatment of a broad range of conditions that affect the head, face, mouth, neck, and jaw. In Africa, there is a paucity of information about the specialist training available to aspiring African Oral and Maxillofacial Surgeons. Objective: This paper aimed at shedding light on the available OMFS specialist training programmes and training pathways across Africa. Materials and Methods: The authors searched on PubMed, AJOL, and Google Scholar using the keywords "Africa," "Oral and Maxillofacial Surgery," "Residency," "Postgraduate," and "Education" and the individual African countries in English and official languages from inception till July 11, 2022. The authors utilised a questionnaire to interview native oral and maxillofacial surgeons and dentists in African countries where there were no published data on OMFS specialist training. Results: A total of 21 (38.8%) African countries had OMFS specialist training programmes (n = 69). The duration of training varies between 2 and 7 years. The number of training programmes per country ranges between one and thirteen. Countries with the most training programmes for OMFS in Africa are Nigeria, Egypt, Sudan, and Algeria. Northern Africa and Central Africa had the most and least numbers of specialist training programmes in OMFS, respectively. Conclusion: There remains a disparity in the number of specialist training programmes available to aspiring African Oral and Maxillofacial Surgeons as compared with other parts of the world. This paper is intended to function both as a means of advocacy to increase funding and resources in support of the infrastructure and development of facilities for African OMFS specialist training programmes and also serve as a valuable reference for future research in OMFS.

Surveillance and Resistance of Community-Onset Extended-Spectrum ß-Lactamase-Producing Escherichia coli and Klebsiella pneumonia in Oral and Maxillofacial Surgery Site Infections.

Background: The prevalence of community-onset infections of extended spectrum ß-lactamase (ESBL)-producing strains has increased globally, yet surveillance and resistance in patients with oral and maxillofacial surgery site infections is less investigated. Patients and Methods: A retrospective cohort study was performed to investigate risk factors and resistance of ESBL-producing Escherichia coli (ESBL-EC) and ESBL-producing Klebsiella pneumonia (ESBL-KP) among community-onset patients with oral and maxillofacial surgery during January 2010 to December 2016. Demographic features, predisposing factors, clinical outcomes, and antibiotic agent costs were analyzed. Antimicrobial susceptibility testing of nine antimicrobial agents against ESBL-KP and ESBL-EC were measured. Results: Among 2,183 cultures from infection sites in patients with oral and maxillofacial surgery site (45 cases [2.06%]) were confirmed with community-onset ESBL-KP (24; 1.10%) or ESBL-EC (21; 0.96%) infection. Multivariable analysis showed the independent risk factors for ESBL-producing bacterial infection were prior history of hospitalization (adjusted odds ratio [aOR], 10.984; 95% confidence interval [CI], 5.965-59.879; p = 0.025) and malignant condition (aOR, 3.373; 95% CI 2.947-7.634; p = 0.024). Based on antimicrobial susceptibility testing, 57.8% ESBL-KP and ESBL-EC were found receiving inappropriate antimicrobial therapy, and antibiotic agent costs were higher than non-ESBL-producing bacterial infections ($493.8 ± $367.3 vs. $304.1 ± $334.7; p = 0.031). Conclusions: Infections caused by ESBL-KP and ESBL-EC among patients in sites with oral and maxillofacial surgery are associated with prior history of hospitalization and malignant conditions. Prompt detection and appropriate antibiotic administration for community-onset infections of ESBLs are necessary for such populations.