Broken jaws in the COVID era

Dynamic Trends in Surgical Oromaxillofacial Trauma Epidemiology: A Comparative Study of Pre-COVID-19 and COVID-19 Periods in Tertiary Referral Hospitals in Madrid

Introduction: The COVID-19 pandemic has induced profound societal and healthcare transformations globally. Material and methods: This multicenter retrospective study aimed to assess potential shifts in the epidemiology and management of oromaxillofacial trauma requiring surgical intervention over a 1-year period encompassing the onset of the COVID-19 pandemic, in comparison to the preceding year. The parameters investigated included age, sex, injury mechanisms, fractured bones, and treatment modalities. The statistical significance was set at p < 0.05. Results: A notable 39.36% reduction in oromaxillofacial fractures was identified (p < 0.001), with no significant alterations in sex distribution, types of fractured bones, or treatment modalities. An appreciable increase in mean age was observed (35.92 vs. 40.26) (p = 0.006). Analysis of the causes of oromaxillofacial trauma revealed diminished incidents of interpersonal violence (41% vs. 35%) and sports-related injuries (14% vs. 8%), alongside an escalation in cases attributed to falls (27% vs. 35%), precipitation events (2% vs. 5%), and traffic accidents (12% vs. 13%). The mandible emerged as the most frequently fractured bone. Conclusion: In conclusion, the COVID-19 pandemic has decreased the number of maxillofacial fractures treated surgically and has changed the epidemiology and the etiology of facial traumas.

Improving safety in dental practices during the COVID-19 pandemic

Coronavirus disease 2019 (COVID-19) is caused by a novel coronavirus, known as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). It originated from the Chinese city of Wuhan and very quickly became a challenging public health problem. On 11 March 2020, the World Health Organization termed this potentially deadly disease a pandemic due to its rapid spread in various parts of the world, giving rise to international health emergencies. This virus is transmitted from human to human in the form of respiratory droplets, and in specific circumstances, airborne transmission may occur. Additional sources of exposure for dentists include blood and infected sharps. Due to the contagious nature of COVID-19 many health care providers have also been disproportionately affected, such as physicians, dentists, nurses, and paramedical staff. Dentists and dental staff are at high risk of cross-infection due to their nature of work. Therefore, they face a dual challenge in protecting themselves and their patients from infection transmission while ensuring that patients receive urgent dental care. In this review, the authors highlight the epidemiology, modes of cross-infection, and recent data on SARS-CoV-2 related to dental practice. The primary purpose is to make dental health care providers aware of the pathophysiology of COVID-19 and to increase their preparedness and understanding of this challenge, which will aid in controlling transmission. The information collected will be useful for the dental community in providing effective patient management through evidence-based recommendations for infection control and disinfection protocols.

Conservative Approach for Treatment of Isolated Mandibular Fractures, the Adaptations During COVID 19 Pandemic

Background

The ongoing COVID 19 pandemic brought about a sudden disruption to the way medical services are rendered in our country. Management of maxillofacial injuries, especially isolated mandibular fractures by surgical methods, became near impossibility because of the restrictions and other concerns related to the pandemic.

Methods

The individuals who suffered isolated mandibular fracture because of trauma were included, to undergo conservative treatment methods with adaptations for the pandemic. Individuals with multiple bone fractures were excluded, and the selected patients were given the choice to opt out from this treatment plan. We followed a more conservative approach with adaptations, which we have discussed in this article.

Result

The fracture healing for all the patients was as expected, and none of our team members got infected with this virus from exposure to patients.

Conclusion

The adaptations helped in limiting the possible exposure of patients, relatives and health care providers to the virus and addressed other pressing concerns related to this pandemic. We present the guideline that we formulated in our unit, which we used to manage the patients who reported to us with isolated mandibular fractures during the ongoing pandemic.

Risk Assessment of Surgical Interventions Performed on Non-Infected Patients During COVID-19 Pandemic

Background A number and a variety of surgical interventions were highly affected by the novel coronavirus disease (COVID-19) outbreak. Most of the elective operations were discontinued with the fear of exacerbating the disease in patients and spreading it among healthcare professionals. Objective The objective of this study was to report postoperative rates of COVID-19 in patients who underwent emergency and urgent surgery during the pandemic and to determine a safe algorithm in order to propose an ideal approach for surgeries. Patients and methods A total of 162 patients being operated upon emergency or urgent causes between March 11 and May 31 2020 were included in the study. Safety measures advised by the World Health Organization were applied. The patients' operative data and postoperative COVID-19 status were recorded and statistically evaluated. Results Surgical interventions were required for skin cancer, upper extremity trauma, soft tissue infections, maxillofacial trauma, lower extremity trauma and other causes. Local anesthesia was used for 127 patients (78.4%). General anesthesia was used for 28 patients (17,3%). Two of 162 patients contracted COVID-19 postoperatively on days 15 and 21, respectively. No statistical significance was found between surgery and anesthesia types regarding COVID-19 risk. Conclusion It appears that emergency and urgent surgeries can be performed safely. However, this relies upon adequate safety measures being taken with regards to screening for COVID-19 antigen positivity in patients preoperatively. Further evidence is required to determine the safety of elective surgeries.