The British journal of oral & maxillofacial surgery
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Br J Oral Maxillofac Surg · Dec 2012
ReviewA review of trauma and trauma-related papers published in the British Journal of Oral and Maxillofacial Surgery in 2010-2011.
This review summarises all trauma and related papers published in the British Journal of Oral and Maxillofacial Surgery (BJOMS) from January 2010 to December 2011. In total 45 articles were published, of which 42% (19) were full-length articles. These articles primarily focused on the management of mandibular condyle and orbital fractures, with several papers discussing maxillofacial surgery by the British military. ⋯ The remaining papers included short communications, technical notes, and letters; and provided discussion of interesting cases, new surgical techniques and fracture classifications. The number of trauma papers published in BJOMS appears to be less than other sub-specialties such as head and neck oncology. The number of prospective and randomised studies remains low, highlighting a need to foster further research within maxillofacial trauma.
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Br J Oral Maxillofac Surg · Sep 2012
Towards a classification system for complex craniofacial fractures.
The complexity of facial fractures has changed considerably in recent years together with more commonly observed high velocity trauma. Traditional classification systems describe fractures in an isolated manner but fail to recognise those that affect more than one region. We applied four conceptual scoring systems for craniofacial trauma to a cohort of patients in east London. We exposed the limitations of the systems and developed a new scoring system that encompasses elements of all of the models and is capable of overcoming previous limitations.
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Br J Oral Maxillofac Surg · Sep 2012
Cardiac output monitoring to guide fluid replacement in head and neck microvascular free flap surgery-what is current practice in the UK?
Appropriate fluid balance is an important factor in the survival of free flaps, and recently there has been a shift towards more conservative fluid regimens. Several surgical specialties have made extensive use of the relatively non-invasive method of measuring cardiac output (CO) to optimise fluid balance during and after surgery, which has resulted in a shorter hospital stay, but little has been published in head and neck surgery. To ascertain its use in the head and neck we sent a postal questionnaire to the anaesthetic departments of 40 major head and neck units identified from the 2010 database of the British Association of Oral and Maxillofacial Surgeons (BAOMS). ⋯ As with other specialties, it is likely that CO monitoring will become widely used in head and neck reconstructive surgery. Not only does it enhance fluid optimisation, but it may also reduce hospital stay and morbidity. Appropriate clinical studies are urgently needed to evaluate its use in our specialty.
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Br J Oral Maxillofac Surg · Jul 2012
Randomized Controlled Trial Comparative StudyEfficacy of liposome-encapsulated 0.5% ropivacaine in maxillary dental anaesthesia.
The aim of this study was to evaluate the effectiveness of liposome-encapsulated ropivacaine (0.5%) in dental anaesthesia. This randomised, double-blind, crossover, four-period treatment study included 40 volunteers who were given 1.8 ml of the following local anaesthetics into the buccal sulcus at the right level of the upper canine: 0.5% ropivacaine; 0.5% ropivacaine with 1:200,000 adrenaline; liposome-encapsulated 0.5% ropivacaine; and 2% lignocaine with 1:100,000 adrenaline. Onset of pulpal anaesthesia; the success of anaesthesia; and the duration of labial, gingival, and pulpal anaesthesia involving the upper right canine and first premolar were evaluated. ⋯ Ropivacaine and adrenaline and lignocaine and adrenaline gave a significantly longer duration of pulpal anaesthesia. VAS showed no significant differences among the groups tested. The results showed that encapsulation of liposome did not improve the anaesthetic efficacy of ropivacaine.