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Doğan SSA, Doğan Ö, Doğan Ö, Başkurt NA. Protective potential of different mouthguard thicknesses against perianaesthetic dental trauma: a patient specific-finite element study. Comput Methods Biomech Biomed Engin 2024; 27:1346-1356. [PMID: 37592845 DOI: 10.1080/10255842.2023.2247515] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2023] [Accepted: 05/22/2023] [Indexed: 08/19/2023]
Abstract
Perianaesthetic dental trauma is a common anaesthesia-related complication. Theprevious studies have shown a lack of knowledge regarding mouthguard usage and controversial results related to perianaesthetic dental trauma prevention. This study aimed to conduct a finite element analysis of the compressive and tensile stresses on the tooth-periodontal ligament-bone complex using custom-made mouthguards of different thicknesses and glass fibre splints to prevent perianaesthetic dental trauma. Custom-fitted ethylene-vinyl acetate mouthguards of two different thicknesses (2 and 3 mm) and glass fibre splint were modelled. A linear static finite element analysis was performed by applying a rigid Macintosh laryngoscope to the palatal surface of the maxillary central incisors at 150 N. The model without a mouthguard and glass fibre splint showed the highest stress values at the palatinal root surfaces during the impact. Increasing the mouthguard thickness significantly decreased the stress-strain values regardless of the presence of the glass fibre splint. Maximum stresses in the group using the 3 mm mouthguard were the lowest compared with the other groups.
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Affiliation(s)
- Suat Serhan Altıntepe Doğan
- University of Afyonkarahisar Health Science, Faculty of Dentistry, Department of Periodontology, Afyonkarahisar, Turkey
| | - Özgür Doğan
- University of Afyonkarahisar Health Science, Faculty of Dentistry, Department of Pediatric Dentistry, Afyonkarahisar, Turkey
| | - Özge Doğan
- Emergency Department, University of Health Sciences, Istanbul Training and Research Hospital, Istanbul, Turkey
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Doğan Ö, Altıntepe Doğan SS, Altıntepe N, Şahin ND, Çelik İH. An analysis of anesthetists' awareness, knowledge, and attitudes toward peri-anesthetic dental trauma. Dent Traumatol 2021; 37:786-794. [PMID: 34216178 DOI: 10.1111/edt.12702] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Revised: 06/01/2021] [Accepted: 06/02/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND/AIM Peri-anesthetic dental trauma is a common anesthesia-related complication. It is the reason for a significant number of malpractice lawsuits against anesthetists through insurance companies. The frequency, outcomes, and risk factors related to peri-anesthetic dental trauma have been well documented. The aim of this study was to evaluate anesthetists' awareness, knowledge, and attitudes toward peri-anesthetic dental trauma. MATERIAL AND METHODS This nationwide, cross-sectional, descriptive study comprising 220 anesthetists was conducted in Turkey between June 2019 and May 2020. A specific questionnaire was created using Google Forms and delivered to 591 participants via WhatsApp. Pearson's Chi-squared test and the Fisher-Freeman-Halton tests were used to analyze the results. RESULTS The overall response rate was 37.2% (220 out of 591 participants). Of the 80.5% of the participants who encountered peri-anesthetic dental trauma during their practice, 32.8% had encountered avulsion and 32.8% reported that they had caused soft tissue injuries. More than one-third of the participants (38.9%) stated that the patient group that was the most at-risk for peri-anesthetic dental trauma was older people with missing teeth. Half of the participants (50.9%) stated that avulsed teeth could be replanted; among them, 21.8% and 11.8% specified that the ideal replantation time was <30 min and that the ideal storage medium for the avulsed tooth was fresh milk, respectively. Furthermore, 88.1% of the participants noted that peri-anesthetic dental trauma occurred more frequently during emergency intubations and only 20.9% were aware of custom-made mouthguards. CONCLUSIONS Anesthetists lack knowledge around peri-anesthetic dental trauma and its interventions.
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Affiliation(s)
- Özgür Doğan
- Department of Pediatric Dentistry Afyonkarahisar, School of Dentistry, Afyonkarahisar Health Sciences University, Afyonkarahisar, Turkey
| | - Suat Serhan Altıntepe Doğan
- Department of Periodontology Afyonkarahisar, School of Dentistry, Afyonkarahisar Health Sciences University, Afyonkarahisar, Turkey
| | - Nihan Altıntepe
- Department of Anaesthesiology and Reanimation, Cemil Taşcıoğlu, City Hospital, University of Health Sciences, Istanbul, Turkey
| | - Necibe Damla Şahin
- Department of Pediatric Dentistry Tokat, School of Dentistry, Tokat Gaziosmanpasa University, Afyonkarahisar, Turkey
| | - İsmail Haktan Çelik
- Department of Pediatric Dentistry Afyonkarahisar, School of Dentistry, Afyonkarahisar Health Sciences University, Afyonkarahisar, Turkey
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Boehm F, Graesslin R, Theodoraki MN, Schild L, Greve J, Hoffmann TK, Schuler PJ. Current Advances in Robotics for Head and Neck Surgery-A Systematic Review. Cancers (Basel) 2021; 13:1398. [PMID: 33808621 PMCID: PMC8003460 DOI: 10.3390/cancers13061398] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2021] [Revised: 03/15/2021] [Accepted: 03/17/2021] [Indexed: 02/07/2023] Open
Abstract
Background. In the past few years, surgical robots have recently entered the medical field, particularly in urology, gynecology, and general surgery. However, the clinical effectiveness and safety of robot-assisted surgery (RAS) in the field of head and neck surgery has not been clearly established. In this review, we evaluate to what extent RAS can potentially be applied in head and neck surgery, in which fields it is already daily routine and what advantages can be seen in comparison to conventional surgery. Data sources. For this purpose, we conducted a systematic review of trials published between 2000 and 2021, as well as currently ongoing trials registered in clinicaltrials.gov. The results were structured according to anatomical regions, for the topics "Costs," "current clinical trials," and "robotic research" we added separate sections for the sake of clarity. Results. Our findings show a lack of large-scale systematic randomized trials on the use of robots in head and neck surgery. Most studies include small case series or lack a control arm which enables a comparison with established standard procedures. Conclusion. The question of financial reimbursement is still not answered and the systems on the market still require some specific improvements for the use in head and neck surgery.
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Affiliation(s)
- Felix Boehm
- Department of Otorhinolaryngology, Head and Neck Surgery, Ulm University Medical Center, 89075 Ulm, Germany; (R.G.); (M.-N.T.); (L.S.); (J.G.); (T.K.H.)
- Surgical Oncology Ulm, i2SOUL Consortium, 89075 Ulm, Germany
| | - Rene Graesslin
- Department of Otorhinolaryngology, Head and Neck Surgery, Ulm University Medical Center, 89075 Ulm, Germany; (R.G.); (M.-N.T.); (L.S.); (J.G.); (T.K.H.)
- Surgical Oncology Ulm, i2SOUL Consortium, 89075 Ulm, Germany
| | - Marie-Nicole Theodoraki
- Department of Otorhinolaryngology, Head and Neck Surgery, Ulm University Medical Center, 89075 Ulm, Germany; (R.G.); (M.-N.T.); (L.S.); (J.G.); (T.K.H.)
- Surgical Oncology Ulm, i2SOUL Consortium, 89075 Ulm, Germany
| | - Leon Schild
- Department of Otorhinolaryngology, Head and Neck Surgery, Ulm University Medical Center, 89075 Ulm, Germany; (R.G.); (M.-N.T.); (L.S.); (J.G.); (T.K.H.)
- Surgical Oncology Ulm, i2SOUL Consortium, 89075 Ulm, Germany
| | - Jens Greve
- Department of Otorhinolaryngology, Head and Neck Surgery, Ulm University Medical Center, 89075 Ulm, Germany; (R.G.); (M.-N.T.); (L.S.); (J.G.); (T.K.H.)
- Surgical Oncology Ulm, i2SOUL Consortium, 89075 Ulm, Germany
| | - Thomas K. Hoffmann
- Department of Otorhinolaryngology, Head and Neck Surgery, Ulm University Medical Center, 89075 Ulm, Germany; (R.G.); (M.-N.T.); (L.S.); (J.G.); (T.K.H.)
- Surgical Oncology Ulm, i2SOUL Consortium, 89075 Ulm, Germany
| | - Patrick J. Schuler
- Department of Otorhinolaryngology, Head and Neck Surgery, Ulm University Medical Center, 89075 Ulm, Germany; (R.G.); (M.-N.T.); (L.S.); (J.G.); (T.K.H.)
- Surgical Oncology Ulm, i2SOUL Consortium, 89075 Ulm, Germany
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Abstract
Robot-assisted surgery (RAS) has already been approved for several clinical applications in head and neck surgery. In some Anglo-American regions, RAS is currently the common standard for treatment of oropharyngeal diseases. Systematic randomized studies comparing established surgical procedures with RAS in a large number of patients are unavailable so far. Experimental publications rather describe how to reach poorly accessible anatomical regions using RAS, or represent feasibility studies on the use of transoral robotic surgery (TORS) in established surgical operations. With general application of RAS in clinical practice, the question of financial reimbursement arises. Furthermore, the technical applications currently on the market still require some specific improvements for routine use in head and neck surgery.
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