British Journal of Oral and Maxillofacial Surgery

Facial Feminisation Surgery (FFS) is integral to the management of transgender adult females. Literature detailing the conduct and outcomes of FFS is lacking. The aim of this project was to review surgical practices in NHS Scotland.

Vitamin D (VD) levels and several variants in the vitamin D receptor (VDR) gene are associated with the occurrence of diseases of the bones and cartilage. The aim of this research was to study and compare the association of the BsmI variant in the VDR gene as well as VD levels in disc displacement with reduction (DDR) between patients and healthy controls. This was a case-control study, in which 104 patients of DDR and 102 healthy individuals were studied. The Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) was used to diagnose temporomandibular diseases.

Up until now, only a limited number of evidence-based studies with different results has evaluated traumatic nerve injury after maxillofacial surgery using piezoelectric devices versus rotary instruments. The present experiment was performed to evaluate damage to the inferior alveolar nerve (IAN), histologically, after osteotomy of the buccal cortex of the mandible using piezoelectric devices versus surgical handpieces. Forty rabbits underwent bilateral osteotomy of the mandibular buccal cortex.

To assess the safety and efficacy of endoscopic-assisted maxillary sinus elevation, a systematic review of the literature was conducted. PubMed, Embase, Web of Science and Cochrane database were searched for articles in English. Published studies involving patients undergone endoscopic-assisted maxillary sinus floor augmentation were selected. The validity of the included articles was evaluated. After going through full text, a total of 12 studies met the eligibility criteria and were included. It was concluded that endoscopic-controlled maxillary sinus floor elevation was a viable and beneficial method, providing direct visualization of the integrity of the mucosa and place of bone graft material.

Lateral crura cut and overlap (LCC) or medial crura cut and overlap (MCC) are two of the many techniques applied to ensure an adequate nasal tip projection and rotation; however, little evidence supports the long-term efficacy of these techniques.

The object of this paper was to explore the feasibility and advantages of endoscope-assisted parotid tumour resection. Three databases (PubMed, Web of Science, and Cochrane) were used to search for all related randomised controlled trials or controlled trials (up to November 2019). The key parameters for assessment included ‘Endoscope’, ‘Endoscopes’, ‘Cancer of Parotid’, and ‘Parotid Cancer’. To evaluate the feasibility and advantages of endoscope-assisted resection of parotid tumours, the data for each parameter were pooled, based on patients who received endoscope-assisted surgery and those who received conventional surgery.

In scientific fields, various statistical analysis methods such as bibliometric analysis have been used to determine the effectiveness of journals, researches and articles. The aim of this study is to conduct a bibliometric analysis to systematically and understandably characterize publications on impacted third molar surgery (ITMS) from 2000 to 2020. The articles were retrieved on the same day from the Web of Science Core Collection (WoSCC) database of the Web of Science (WoS) on January 01, 2021, to prevent biases due to the daily databases updates.

The techniques used to repair bilateral cleft lip have evolved over time, yet little data exists to compare outcomes using the various techniques. The aim of this study was to retrospectively evaluate and compare aesthetic outcomes in two types of complete bilateral cleft repair: the advancement rotation and a historic cohort repaired with a Manchester technique.

No consensus has been reached on an ideal method to objectively measure facial palsy, especially for patients with synkinesis1,2. We previously reported the use of landmarks to photogrammetrically assess ocular synkinesis3 and smile excursion in healthy individuals4. These include: the angle between the commissure, contralateral commissure and ipsilateral endocanthion (CCE); eye surface area (ESA); and midline to commissure distance (MCD). The aim of this study was to compare affected and non-affected hemi-faces of patients with facial palsy using these landmarks and assess its correlation with Sunnybrook Facial Grading System scores.

To evaluate alveolar ridge resorption using the socket shield technique (SST) without immediate dental implant placement.

Due to the risk of occult cervical metastasis, elective neck dissection (END) is recommended in the management of patients with early oral cavity squamous cell carcinoma (OSCC) and a clinically node-negative (cN0) neck. This paper presents a systematic review and meta-analysis of studies that recorded isolated regional recurrence (RR) in the pathologically node-negative neck dissection (pN0) neck following END in order to quantify the failure rate.

Odontogenic Keratocysts are benign, developmental, locally aggressive odontogenic cystic lesions with a high risk of recurrence. As such, the most effective treatment modalities remain controversial. The mainstay of treatment remains enucleation with or without decompression. The use of adjunctive therapies is widely reported.

To apply an augmented reality (AR) navigation technique based on a head- mounted display in the treatment of craniofacial fibrous dysplasia and to explore the feasibility and the value of AR in craniofacial surgery. With preoperative planning and three-dimensional simulation, the normal anatomic contours of the deformed area were recreated by superimposing the unaffected side onto the affected side. We completed the recontouring procedures in real time with the aid of an AR navigation system. The surgical outcome was assessed by superimposing the post-operative computed tomography images onto the pre-operative virtual plan.

Juvenile Idiopathic Arthritis (JIA) of the Temporomandibular Joint (TMJ) is a frequent occurrence in children, with an increasing awareness of the condition in all healthcare professionals. TMJ involvement presents a challenge in both diagnosis and treatment as late presentation can still occur as the disease often develops asymptomatically. This can result in facial deformity and/or functional difficulties including obstructive sleep apnoea. Early diagnosis is therefore essential, requiring a high index of clinical suspicion coupled with the judicious use of gadolinium contrast MRI.

Hemophilia is a recessive congenital hereditary hemorrhagic disorder characterized by the decrease in or absence of the functional activity of factor VIII (Hemophilia A) or factor IX (Hemophilia B). The hematological medical treatment for these patients is systemic replacement therapy with factor VIII or factor IX concentrates. Dental implants are considered the gold standard for the replacement of missing teeth. There is no evidence or safe protocol for their use in patients with hemophilia. The objective of this study was to evaluate the clinical osseointegration and the incidence of postoperative bleeding in patients with hemophilia.

Having just completed a botched year of foundation training, myself and five of my OMFS DCT colleagues found ourselves on the highest floor of the hospital, away from all forms of life not compatible with a ventilator. Gone were the days of prescribing co-amoxiclav 625mg TDS 5/7; we had now entered the brave new world of the coronial. We did not know what we were getting ourselves in for, but it was an experience like no other.

To investigate the clinical and MRI features of synovial chondromatosis (SC) of the temporomandibular joint (TMJ). Fourteen patients with SC of TMJ were included. Clinical and MRI features were analyzed and divided into three types based on MRI classification: type I with loose bodies, type II with homogeneous masses and type III with a mixture of loose bodies and homogeneous masses. All SCs occurred in the superior compartment of the TMJ. There were 2 patients (14%) categorized as type I, 5 patients (36%) as type II and 7 patients (50%) as type III.

Dermal metastasis (DM), by definition, is the involvement of the skin by cancer cells originating from cancer elsewhere in the body. They are considered as rare site of distant failure in head and neck cancers. They are bearers of poor outcomes. There is a limited literature available regarding dermal metastases. This study was undertaken to analyse the factors associated with incidence and outcomes.

Planning discharge from hospital following microvascular free-tissue surgery can be complex and challenging. Planning involves the patient, carers, and multiple health professionals. Poor communication and expectations can delay discharge or give a suboptimal discharge process. It was hypothesised that prompt-list modelled along the principals of the Patient Concerns Inventory (PCI) could be help in discharge planning. The aim of this study was to define the items and format of a PCI-Ward Discharge (PCI-WD) and undertake a small pilot.

Medical graduates interested in pursuing a career in Oral and Maxillofacial Surgery require attainment of Bachelor of Dental Surgery. A common question facing this cohort of junior trainees is whether to start Dentistry before or after Core Surgical Training. Both routes have advantages and disadvantages, that must be considered. Here is provide our perspective into this common dilemma.

Medication-related osteonecrosis of the jaw (MRONJ) is a challenging condition to treat. It has primarily been associated with anti-resorptive and anti-angiogenic drugs, which are increasingly being used to prevent adverse skeletally-related complications in patients with cancer and bone pathologies. Although these medications have been proven to cause osteonecrosis of the jaws (ONJ) there are also a number of other drugs that could potentially cause this condition. The aim of this systematic review is to ascertain whether there is an associated risk of osteonecrosis of the jaw (ONJ) in recreational drug users (RDU).

In head and cancer (HNC), osteoradionecrosis (ORN) is one of the most significant complications of radiotherapy (RT). With an absence of effective non-surgical treatment, prevention of the development of ORN is the best approach.

The article describes our exploration of the transfacial sialolithotomyapproach to intraparenchymal stones in the submandibular gland assisted with sialendoscopy and gland preservation. 5 patients with large intraparenchymal stones in submandibular gland were included. Ultrasonography and computer tomography (CT) scans were performed to locate the stones. As the large intraparenchymal stones failed to retrieve throughout endoscope, patients were treated by a transfacial lithotomy approach with sialendoscopy.

Adequate positioning of an orbital implant during orbital reconstruction surgery is mandatory for restoration of the pre-traumatised anatomy, but visual appraisal of the implant’s position is limited by the keyhole access and protruding soft-tissues. A positioning instrument, that attaches to the implant, was designed to provide feedback outside the orbit. The goal of this study was to evaluate the effect on implant positioning accuracy of the instrument workflow compared to visual appraisal. Ten orbits in five human cadaver heads were reconstructed twice: once using visual appraisal and once using the instrument workflow.

The purpose of this study is to explore the treatment efficacy of botulinum-A (BTX-A) in nocturnal bruxism.

Osteonecrosis of the jaw is a severe adverse condition affecting patients exposed to specific types of medications. Previous studies have highlighted that osteonecrosis of the jaw is triggered by invasive dental procedures and can be very challenging to manage, especially in oncologic patients. The primary aim of this review is to analyse all available evidence on the management (surgical and/or conservative) of medication related-osteonecrosis of the jaws (MRONJ) in patients with a history of antiangiogenic drugs therapy and not previously exposed to any antiresorptive drug treatments.

A controversy exists with regards to the influence of graft placement site in the mandible and the success of nonvascularized bone grafting. In this study, we examine the association between the compartment of mandibular defect and bone graft failure rate.

Firstly, we thank the reader for his/her interest in our article.

We thank the authors for their article “Dental implant placement through impacted teeth or residual roots as an alternative to invasive extraction surgeries: a systematic literature review” 1.

Diabetes mellitus (DM) is thought to be associated with poor outcomes in cervicofacial infections (CFI), yet little is known about the prevalence of DM in CFI. Stress hyperglycaemia (SHG), a normal physiological response to inflammation, is distinct from DM, though they overlap and may be conflated. We aimed to establish the prevalence of DM and SHG in CFI and determine the effect of each on severity of disease and outcome measures.

Pterygomaxillary (PTM) dysjunction is a technique-sensitive step in Le Fort I osteotomy. Various studies implicate improper osteotomy techniques and anatomical variations of the midface in ophthalmic/orbital complications. The aim of this study was to assess the stress distribution and its transmission to the orbit during PTM dysjunction while using different angulations of the osteotome. The study involved the generation of two virtual models from the computed tomographic images of a non-cleft and cleft patient.

The ethos of the Junior Trainees’ Group is to facilitate peer support, an important complement to pursuing our speciality of Oral and Maxillofacial Surgery. Launched in September 2020, the Buddy Scheme enables peer-led mentorship. Results demonstrate this scheme has successfully provided additional support for second-degree applicants. With further help from our senior colleagues, our ambition is to expand this scheme in 2021.

This study aimed to systematically review and critically appraise available literature concerning the effectiveness of marsupialisation and decompression on the reduction of cystic jaw lesions. The “Preferred Reporting Items for Systematic Reviews and Meta-Analysis” guidelines were followed and the study protocol was registered at the “International Prospective Register of Systematic Reviews” (CRD42019116099). Six main databases were searched: Embase, LILACS, PubMed, Scopus, The Cochrane Library, and Web of Science.

The aims of the present study were to comprehensively assess all the published cases on dislocation of the mandibular condyle into the middle cranial fossa (DMCCF) in the literature in English and describe the clinical, imaging, and therapeutic variables for this condition. An electronic search was undertaken in March 2020 using PubMed/MEDLINE, Web of Science, ScienceDirect, Springer, and Scopus databases. Eligibility criteria included publications with sufficient information to confirm the diagnosis.

The purpose of this study was to undertake a retrospective cross-sectional analysis to compare the frequency and characteristics of facial injury presentations at a UK and an Australian tertiary referral hospital during the implementation of COVID-19 social-distancing measures. The primary predictor variables were a heterogeneous set of factors grouped into logical categories: demographics, injury mechanisms and site, and management. The primary outcome variable was the presentation of a hard or soft tissue facial injury.

Traumatic mandibular fractures constitute a significant part of the Oral & Maxillofacial trauma service. There are potential variations in how they are managed. Patients are often admitted and given intravenous antibiotics prior to their definitive treatment. The evidence behind this is inconclusive.

The purpose of this study was to validate the applicability of using maxillary voxel-based dentoalveolar registration (VDAR) at long-term follow up in orthognathic surgical patients. A retrospective sample of 25 patients (skeletal class II or III) who underwent bimaxillary orthognathic surgery was recruited and divided into two groups. Group A included 15 patients (seven females, eight males, mean (SD) age 25.8 (14.4) years) with unrestored dentition and group B involved 10 patients (five females, five males, mean (SD) age: 26.2 (11.9) years) with dental restorative treatment.

Cervicofacial infection (CFI) is a common presentation to the Oral and Maxillofacial (OMFS) department and accounts for significant emergency activity. The current study aims to understand the aetiology, management, and clinical features of patients hospitalised with CFI. Our study included all patients admitted for management of CFI from May to October 2017 at 25 OMFS units across 17 UK regions. Data were collected prospectively and included age, comorbidities, prior treatment received, markers of sepsis, and presenting clinical features.

Personal and shared stand-up electronic scooters (e-scooters) have rapidly increased in popularity, leading to an increase in the number of patients with e-scooter-related trauma presenting to hospital Emergency departments. This study aimed to assess the patterns of oral and maxillofacial trauma directly related to e-scooter use and provide a cost-analysis related to the management of these patients. A retrospective, controlled interval study was conducted to examine all patients referred to the oral and maxillofacial surgical service at Christchurch Hospital, New Zealand, who sustained facial injury as a result of e-scooter accidents between 15 October 2018 and 15 April 2020.

Maxillary sinus septa increase the risk of membrane perforation during sinus floor elevation and grafting operations. This study was designed to evaluate the prevalence, morphology, localisation, aetiology, and orientation of maxillary sinus septa in dentate, completely edentulous, and partially edentulous sinus regions using cone beam computed tomography (CBCT), and possible patient-related factors were also assessed. Data from 300 patients (600 sinuses), 160 women and 140 men, with a mean (SD) age of 50.72 (13.99) years (range 20–83), who were undergoing treatment planning for implant-supported restorations in posterior maxillae, were analysed from reformatted CBCT scans.

The publisher regrets that incorrect figures where published within the above referenced article. These have been updated online and can also be found below.

It is now approaching 12 months since the WHO declared coronavirus disease 2019 (COVID-19) a global pandemic.1 Aside from the core signs and symptoms, an increasing number of less common presentations have been reported.2 A number of possible oral manifestations have also been proposed.3 We would like to present a possible association between COVID-19 and tongue swelling that has not previously been reported.

For the meanwhile second-most-frequent benign tumour of the parotid gland,1,2 the prefix “pleomorphic” reflects the cyto-/architectural diversity of these lesions, which in turn reflects the variable combinations of epithelial and myoepithelial elements, intermingled with a similarly variable mucoid, myxoid or chondroid mesenchymal tissue component. Pleomorphic adenoma (PA) of major salivary glands (in contrast to its minor salivary gland counterpart) is surrounded by a varying fibrous capsule separating it from surrounding normal parenchymal or fibroadipose connective tissue.

The cost of the NHS, wastage within it and how much trusts have overspent is a national obsession. Despite these widespread opinions, the costs of individual treatments and impacts of non-attendance appear to be little understood. There is a paucity of literature with regards to patients’ awareness of costs associated with services provided by the NHS. The authors’ aim to ascertain whether patients are aware of the costs associated with care services provided, and if this data could aid educating patients on NHS costs to reduce missed appointments.

COVID-19 has resulted in an expansion of webinar-based teaching globally. Socially distanced e-learning is the new normal. The delivery of regional OMFS teaching programmes in the UK and the Republic of Ireland, for Specialty Trainees (ST’s) under the Joint Committee on Surgical Training (JCST) and Intercollegiate Surgical Curriculum Programme (ISCP) umbrellas is variable. We recognised the need to provide additional teaching to supplement this teaching, at a time of crisis in our countries and healthcare systems, which had jointly led to significant impact on the progression of training.

The treatment of mandibular fractures by gunshot ranges from late conservative repair to more aggressive early repair in a single stage. Treatments that preserve bony architecture as much as possible should be used, minimising patient morbidity and the complexity of future surgeries. The purpose of this study was to use a systematic review to determine which method of treatment was most effective for mandibular fractures by gunshot. Searches were conducted on Medline via PubMed, Scopus, Central Cochrane, and Sigle via Open Grey up to August 2019.

Mandibular fractures are a common injury managed by Oral and Maxillofacial Surgeons. Current open reduction and internal fixation (ORIF) treatment strategies are based on Champy’s ideal line of osteosynthesis with the use of miniplate and loadsharing fixation techniques. Post-operative instructions for the duration of a soft diet has varied. This prospective, randomised study reviewed the outcomes of a patient led return to diet at 2 weeks and 4 weeks compared with 6 weeks (control group) following an ORIF of mandibular fractures.

Never events relevant to OMFS include wrong site procedures (including tooth extraction), and retained instruments and swabs. In February 2021, the list of never events was updated to exclude wrong tooth extraction as the systemic barriers to prevent these incidents are not considered ‘strong enough.’We discuss the matter, and provide some recommendations to minimise risk for wrong tooth extraction, which to date has been the commonest never event in the NHS.