Reputation of Oral and Maxillofacial Surgery in the UK:the patients' perspective

Our intention is to shed theoretical and practical light on the professional reputation of Oral and Maxillofacial Surgery (OMFS) in the UK by drawing on theories from management literature, particularly concerning reputation. Since professional reputation is socially constructed by stakeholders, we used interpretivist methods to conduct a qualitative study of patients (stakeholders) to gain an insight into their view of the profession. Findings from our focus groups highlighted the importance of “soft-wired skills” and showed a perception – reality gap in the interaction between patients and doctors. They also highlighted the importance of consistency, relational coordination, mechanisms to enable transparent feedback, and professional processes of governance. To help understand how best to manage the reputation of the specialty, we also explored how this is affected by the media and the Internet

Bone-anchored titanium implants for auricular rehabilitation: case report and review of literature

CONTEXT AND OBJECTIVE: Osseointegrated implants have acquired an important role in the prosthetic rehabilitation of patients with craniofacial defects. The main indications are lack of local tissue for autogenous reconstruction, previous reconstruction failure and selection of this technique by the patient. This paper presents a clinical case and discusses indications and advantages of the osseointegrated implant technique for retention of auricular prostheses. TYPE OF STUDY: Case report, Universidade Federal de São Paulo (UNIFESP). METHODS: A female patient received three auricular implants after surgical resection of a hemangioma in her left ear. The time taken for osseointegration of the temporal bone was three months. After fabrication of the implant-retained auricular prosthesis, the patient was monitored for 12 months. RESULTS: The clinical parameters evaluated showed good postoperative healing, healthy peri-implant tissue, good hygiene and no loss of implants. Good hygiene combined with thin and immobile peri-implant soft tissues resulted in minimal complications. Craniofacial implant integration appears to be site-dependent; increasing age affects osseointegration in the temporal bone. The frequency of adverse skin reactions in peri-implant tissues is generally low. CONCLUSION: The surgical technique for rehabilitation using implant-retained auricular prostheses seems to be simple. It is associated with low rates of adverse skin reactions and long-term complications. Prostheses anchored by osseointegrated implants seem to provide better retention than do prostheses supported on spectacle frames, less risk of discoloration through the use of adhesives and better esthetic results than do prostheses anchored in the surgical cavityCONTEXTO E OBJETIVO: Os implantes osseointegrados adquiriram papel importante na reabilitação protética de pacientes com defeitos craniofaciais. As principais indicações são ausência local de tecidos para reconstrução autógena, falha anterior de reconstrução e opção do paciente. Este artigo apresenta um caso clínico e discute as indicações e vantagens da técnica de implantes osseointegrados para a retenção de próteses auriculares. TIPO DE ESTUDO E LOCAL: Relato de caso clínico, Universidade Federal de São Paulo (UNIFESP). MÉTODOS: Paciente do sexo feminino recebeu três implantes na região auricular após ressecção cirúrgica de hemangioma na orelha esquerda. O tempo de osseointegração no osso temporal foi de três meses. Após a confecção de prótese auricular implanto-suportada, a paciente foi observada por 12 meses. RESULTADOS: Os parâmetros clínicos analisados mostraram boa cicatrização pós-operatória, saúde dos tecidos adjacentes ao implante, boa higiene e nenhuma perda de implantes. A boa higiene combinada a pouca espessura e imobilidade dos tecidos moles perimplantares resulta em poucas complicações. A integração dos implantes craniofaciais parece variar conforme o local, e a idade avançada afeta a osseointegração no osso temporal. A frequência de reações adversas cutâneas nos tecidos perimplantares é geralmente baixa. CONCLUSÃO: A técnica cirúrgica para a reabilitação com próteses auriculares implanto-suportadas parece ser simples e está associada a baixos índices de reações cutâneas adversas e complicações no longo prazo. As próteses ancoradas por implantes osseointegrados parecem proporcionar melhor retenção do que as próteses suportadas nas armações de óculos, menor possibilidade de descoloração pelo uso de adesivos e melhores resultados estéticos do que as próteses ancoradas na cavidade cirúrgica.Universidade Federal de São Paulo (UNIFESP) Department of Otorhinolaryngology and Head and Neck SurgeryUniversidade Paulista Faculty of Dentistry Department of StomatologyUniversidade Federal de São Paulo (UNIFESP) Santo Amaro University School of DentistryUniversidade Federal de São Paulo (UNIFESP) Santo Amaro University Department of StomatologyUniversity of Gothenburg Department of Anatomy and Cell BiologyUniversity of Gothenburg Department of OtolaryngologyUNIFESP, Department of Otorhinolaryngology and Head and Neck SurgeryUNIFESP, Santo Amaro University School of DentistryUNIFESP, Santo Amaro University Department of StomatologySciEL

Effects of recombinant human bone morphogenetic protein 7 (rhBMP-7) on the behaviour of oral squamous cell carcinoma: a preliminary in vitro study

We investigated the effects of recombinant human bone morphogenetic protein-7 (rhBMP-7) on the behaviour of oral keratinocytes and head and neck squamous cell carcinoma (SCC) cells in vitro. Expression of all three BMP receptors was high (p < 0.01), and rhBMP-7 exhibited significant dose-related inhibitory effects on the doubling time and viability of cancer cells (p < 0.01), but not on the proliferation or viability of oral keratinocytes. It elicited no significant effect on the invasion of Matrigel in SCC of the head and neck. Results indicate that in cell culture, rhBMP-7 exerts antineoplastic effects. This should be tested in an orthotopic animal model to more closely replicate in vivo effects

Removal of partially erupted third molars using an erbium (Er): YAG laser: a randomised controlled clinical trial

We compared Erbium (Er):YAG laser with a surgical bur for removal of partially erupted lower third molars. Patients were randomised to be treated by either laser or bur. A total of 42 patients (laser=22; bur=20) were treated. A greater reduction in the range of mouth opening was found after laser than after bur treatment. Postoperative pain was more common after bur treatment. The duration of operation was considerably longer with laser than with bur. No persistent complications were encountered

The role of ultrasound in monitoring reconstruction of mandibular continuity defects using osteogenic protein-1 (rhOP- 1)

Introducing bone bioengineering concepts in craniofacial surgery demands development of novel imaging strategies, which overcome the shortcomings of radiography such as exposure to ionizing radiation. This study is aimed to investigate the usefulness of ultrasonography (US) in monitoring reconstruction of continuity osteoperiosteal mandibular defects in sheep using rhOP-1. The study was conducted on six adult sheep in which a critical size defect was created at the body of the mandible and was reconstructed using rhOP-1 with type-I collagen as a carrier. Ultrasound images were used to assess onset of bone formation, contour, and surface topography. The results were then compared to corresponding plain radiographs and to post-mortem observations. US showed bone union in all the subjects that concurred with radiographic and post-mortem examinations. US was superior to plain radiography in monitoring early events of ossification. However, it was relatively less efficient in describing the contour of the newly formed bone. It was possible to describe the pattern of bone formation and the dynamic changes in contour and surface topography via US during the follow-up period. In experienced hands, ultrasonography can offer valuable information about bone healing comparable with those obtained by plain radiography. US may replace plain radiography in becoming a routinely used tool for monitoring bone healing in selected sites of the craniofacial skeleton