Obesity has become a widespread health problem influencing people’s health, general well-being, and healthcare costs. It also represents an important risk factor for multiple comorbidities and malignancies. Objectives: the primary objective of this study was to provide notable insights to healthcare professionals regarding the management of patients with obesity, to highlight the effectiveness of bariatric surgical methods in losing excess weight, and to establish the relationship between weight loss and changes in quality of life (QoL). Material and methods: our study evaluated the QoL of 76 patients following bariatric surgery at different postoperative stages using the 36-Item Short Form Survey (SF-36) and The World Health Organization Quality of Life—BREF (WHOQOL-BREF) questionnaires. Results: regarding the type of bariatric procedure performed, out of the 76 respondents, 39.47% underwent gastric bypass surgery (RYGB), 56.57% underwent sleeve gastrectomy (LSG), and only 3.94% underwent single anastomosis duodeno-ileal switch (SADI-S). Pertaining to the SF-36 questionnaire, the lowest average scores were found in the energy/fatigue subscales and in the limitations due to mental health, which remained consistent across surgery types with a significant decrease in the SADI-S group. Concerning the WHOQOL-BREF questionnaire, the lowest mean scores were found in the environment (15.03 ± 2.37) and social relations (16.08 ± 2.22) subscales, whilst the highest average scores were in physical health (16.30 ± 2.03) and mental health (16.57 ± 2.16). Conclusions: the findings revealed that whilst bariatric surgery significantly improved physical health, it resulted in a decrease in mental health scores. Consequently, the study emphasizes the importance of adopting a holistic approach to managing obesity that considers improving both physical and mental health outcomes.

Deep neck infection is a pathology at the border of two specialties, otorhinolaryngology and maxillofacial surgery, and represents a medico-surgical emergency. In terms of its evolution, it can extend to the level of the thorax and result in mediastinitis, with difficult evolution and poor prognosis. The aims of this scoping review are to present the etiology, bacteriology, clinical manifestations, and diagnostics, as well as treatment, in light of the research published in the last 5 years on deep neck infection associated with descending necrotizing mediastinitis. The most common primary sources of deep neck infection are odontogenic and tonsillar. The other sources that are involved in deep neck infection are salivary glands, foreign bodies, malignancies, and iatrogenic causes after endoscopic maneuvers. The bacteriologic aspect is polymorphic, including both aerobic and anaerobic species. Complications that may appear include jugular vein thrombosis, airway obstruction, acute respiratory distress syndrome, sepsis, and disseminated intravascular coagulation. Timely diagnosis is important for ensuring the positive evolution of a deep neck infection. A CT scan is important for characterizing the nature of a deep neck lesion and identifying the spaces involved, and this method represents the gold standard for diagnosis of these lesions. Following the establishment of a definitive diagnosis, antibiotic therapy is initiated empirically, and is modified according to bacteriological exam results. The administration of antibiotics is an essential part of the treatment strategy for patients with a deep neck infection. Based on CT results, different surgical methods are applied under general anesthesia. The surgical strategy involves opening and draining the cervical spaces and debriding the necrotic tissue. In the cases of odontogenic causes, drainage and extraction of the infected teeth are performed. It is especially important to follow up on the dynamic progression of the patient. In the management of a deep neck infection associated with descending necrotizing mediastinitis, a multidisciplinary team is necessary.

(1) Background: Necrotizing fasciitis is known as a severe condition with a high risk of mortality, placing it among the most feared infections. In most cases, it has a polymicrobial etiology (type 1), requiring complex treatment that is continuously adapted to the evolving microbiological status. The facial localization of the disease is rare, fulminant progressing, and is often life-threatening. (2) Methods: We present the case of a patient with multiple comorbidities who, following trauma to the nasal dorsum, developed a wound with a rapid and severe progression to extensive bilateral periorbital necrosis. This was accompanied by a dramatic deterioration in their general condition, a polymicrobial biological status, and fluctuating progression despite instituted treatment (both medical and surgical). (3) Results: The patient required multiple surgical interventions by multidisciplinary teams (plastic surgery; ear, nose, and throat specialist (ENT); maxillofacial surgery; and ophthalmology), experiencing periods of a severe, life-threatening general condition, necessitating prolonged orotracheal intubation. Wounds with fluctuating progression, extensive skin necrosis, and significant post-excisional soft tissue defects required skin graft coverage. The result meant a saved life and functional and aesthetic sequelae at the level of the face. (4) Conclusions: Necrotizing fasciitis of the face is a rare and severe disease that must be recognized early and treated appropriately by a multidisciplinary team to save the patient’s life and minimize the resulting functional and aesthetic sequelae.

For facial abnormalities, recent developments in virtual surgical planning (VSP) and the virtual design of surgical splints are accessible. Software companies have worked closely with surgical teams for accurate outcomes, but they are only as reliable as the data provided to them. The current case’s aim was to show a fully digitized workflow using a combination of three digital software to correct predicted post–upward sliding genioplasty defects. To reach our goal, we presented a 28-year-old man with long-face syndrome for orthodontic treatment. Before orthognathic surgery, a clinical and paraclinical examination was performed. For a virtual surgical plan, we used the dedicated surgical planning software NemoFab (Nemotec, Madrid, Spain) and Autodesk MeshMixer (Autodesk Inc., San Rafael, CA, USA). To create the design of the digital guides, DentalCAD 3.0 Galway (exocad GmbH, Darmstadt, Germany) and Autodesk MeshMixer (Autodesk Inc., San Rafael, CA, USA) were used. The patient had undergone bilateral sagittal split osteotomy in addition to Le Fort 1 osteotomy and genioplasty, followed by mandible base recontouring ostectomy. Stable fixation was used for each osteotomy. Based on our case, the current orthognathic surgery planning software was not able to perform all the necessary operations autonomously; therefore, future updates are eagerly awaited.

The objective of this study was to report a clinical case of dental implant failure with significant bone loss that was treated using reconstructive surgical techniques. We present a 58-year-old man with a history of implant surgery and implant failure on the mandible. Data collected using cone beam computed tomography (CBCT) and intraoral scans were exported into Exoplan (exocad GmbH, Darmstadt, Germany), from which a standard tessellation file was obtained. To create a customized mandible mesh design, DentalCAD 3.0 Galway software (exocad GmbH, Darmstadt, Germany) was used. Based on guided bone regeneration, the method involved bone reconstruction and the application of a custom titanium mesh. The bone mix was obtained by combining a xenograft (Cerabone, Bottis biomaterials Gmbh, Zossen, Germany), an allograft (Max Graft, granules Bottis biomaterials Gmbh, Zossen, Germany), and an autograft. The titanium meshes were fixed to the bone using self-drilling screws and covered with a resorbable membrane. Immediately after surgery, an impression was recorded, and the next day, the patient received a milled polymethyl methacrylate interim denture. Based on our case study, the presented custom-made implant can be considered a temporary solution, during which guided bone regeneration is expected to take place.

Maxillofacial trauma, as seen from a medico-legal point of view, is an integral part of medical practice in emergency departments. Therefore, general practitioners should have sufficient knowledge about their roles and responsibilities in managing these cases. This study aimed to assess general practitioners’ knowledge, practices, and attitudes regarding managing medico-legal cases (MLCs). Material and method: This study included 113 general practitioners from St. Spiridon Hospital in Iasi, Romania. Participants completed a self-administered structured questionnaire assessing the knowledge, attitudes, and practices of general practitioners regarding the handling of medico-legal cases. Results: The scores obtained for the level of knowledge, attitudes, and practices indicate a good level of knowledge on the part of the responding doctors, with the average value being 38, in a range from 0 to 49 (min. value 28–max wave. 47). The score regarding the attitudes of doctors related to the management of medico-legal cases is modest, with the average value being 37 points out of a maximum of 60 points (min. 14–max. 51). The same situation is recorded in the case of practices regarding the management of medico-legal cases, with the average value being 68 out of a maximum value of 90 (min. 38–max. 84). Conclusion: This study’s results revealed the absence of a well-defined protocol for the recognition and handling of medico-legal cases among general practitioners from Iasi and the need to improve the level of attitudes and practices regarding the management of medico-legal cases. The limitations of this study included the relatively small sample from a single hospital and the use of a methodology based on self-administered questionnaires, which may be subjective. Accordingly, future studies should involve larger and more diverse samples to monitor changes in knowledge and practices over time and qualitative methodologies to gain deeper physician-related insights into medical case management.