The aim of this article is to analyze dental abnormalities in unilateral cleft lip and palate patients by focusing on the role of the secondary alveolar bone graft (SABG) surgery and its outcomes on canine eruption/inclusion. A sample of 24 patients with unilateral cleft lip and palate were selected. Dental anomalies, canine eruption based on the existence of supernumeraries, agenesis elements, inclination of the major canine axis before and after surgery, distance from the occlusal plane before and after surgery, and sector classification were analyzed. Out of the 24 patients, 87.5% presented a canine spontaneously erupted in the dental arch while 12.5% needed surgical-orthodontic traction. There is also no proof that inclination of the canine significantly influenced the eruption before (P = 0.5889) and after (P = 0.4029) surgery. Also, there is no any correlation between the 2 sides (P = 0.1257). The SABG surgery showed a significant correlation with canine eruption (P = 0.009242); moreover, SABG shows a positive relationship with the radicular development of the canine (P = 0.005163). Lateral incisive (P = 0.8493) and second premolar agenesis (P = 1) are not statistically correlated with the eruption of the canine. This does not happen with supernumerary elements that are correlated with the surgical-orthodontic traction (P = 0.0004464). Agenesis does not play any role in the process of canine eruption while supernumeraries do. There is no relationship between the inclination and eruption of the canine. The SABG surgery has a key role because it contributes to create an appropriate support for the erupting canine, the nasal base and the anterior maxilla.

Background: Facial nerve injury is one of the most concerning complications of parotid gland surgery, with temporary and permanent dysfunction rates varying widely in the literature. This study aimed to identify factors associated with facial nerve injury during surgery for benign parotid tumors and assess the protective efficacy of intraoperative nerve monitoring (NIM) in preventing nerve injury. Methods: This retrospective study analyzed 329 patients who underwent parotid gland surgery between 2010 and 2023. Data collected included patient demographics, tumor characteristics (size, location, histology), surgical parameters (operation time, NIM usage), and postoperative nerve function evaluated using a modified House–Brackmann scale. Descriptive and inferential statistical analyses, including Chi-square tests and logistic regression, were employed to identify predictors of facial nerve outcomes. Results: Facial nerve injury occurred in 5.2% of patients, comprising 4.6% temporary and 0.6% permanent damage. Tumors located in the deep and inferior lobes significantly increased the risk of facial paralysis/palsy (p = 0.035), while tumor size and histology showed no significant associations. Using NIM significantly reduced the risk of facial nerve injury (p < 0.05; OR: 0.35, 95% CI: 0.25–0.50). Age was also identified as a significant predictor of nerve dysfunction (p < 0.05). Conclusions: The findings emphasize the importance of NIM in mitigating facial nerve injury, especially in anatomically complex tumor locations. Tailored surgical approaches based on tumor location and patient-specific factors, combined with the routine use of NIM, are recommended to optimize nerve preservation and improve postoperative outcomes.

Airway management in maxillofacial trauma is a critical and complex challenge, requiring both secure ventilation and optimal surgical access while minimizing risks to vital structures. This study evaluated the efficacy of submental intubation (SMI) as a minimally invasive alternative to tracheostomy in patients with complex maxillofacial fractures. A retrospective analysis of 52 patients treated between 2015 and 2023 was conducted by comparing clinical outcomes between those who underwent SMI (n = 26) and those who underwent tracheostomy (n = 26). The duration of hospitalization, infection rates, and perioperative complications were assessed using t-tests, chi-square tests, and multivariate regression. Results indicated that SMI was associated with significantly shorter hospital stays (11.15 ± 3.29 vs. 23.96 ± 6.47 days, p < 0.001) and lower infection rates (3.8% vs. 30.8%, p = 0.028). Additionally, the SMI group demonstrated fewer intraoperative (p = 0.049) and postoperative complications (p = 0.037). Multivariate analysis identified tracheostomy as an independent predictor of prolonged hospitalization and increased complications. These findings support SMI as a safe and effective alternative to tracheostomy for short-term airway management in maxillofacial trauma, providing a shorter recovery period and fewer complications. Therefore, prospective studies with larger cohorts are warranted to confirm these results and establish comprehensive guidelines.

The oral cavity poses challenges in surgical interventions due to its microbial flora. Maxillofacial trauma surgeries are vulnerable to infections, complicating recovery. Traditional methods, including antibiotic prophylaxis, have limitations, highlighting the need for complementary strategies. This study evaluated the impact of professional oral hygiene protocol on infection rates, mucosal health, and pain levels in maxillofacial trauma patients. A retrospective study analyzed 529 patients treated for maxillofacial trauma at the Maxillo-Facial Surgery Unit of "Azienda Ospedaliera Ospedali Riuniti" in Ancona, Italy, from 2018 to 2023. Patients were divided into two groups: Period 1 (2018-2020, no protocol) and Period 2 (2021-2023, protocol implemented). All patients were in good general health, with no systemic diseases compromising immunity or influencing surgical outcomes. The protocol included supragingival scaling 48 h preoperatively, chlorhexidine 0.20 % three times daily postoperatively, and standardized antibiotic and analgesic regimens. Data included infection rates, modified Beck Oral Assessment Scores and Numerical Rating Scale pain scores. Statistical analyses included independent t-tests and Chi-square tests, with significance set at p < 0.05. Period 2 showed significantly lower infection rates (13.44 % vs. 19.48 %, p = 0.023), reduced pain scores (mean NRS: 4.6 vs. 5.4, p < 0.01) and improved mucosal health (mean BOAS: 2.91 vs. 3.75, p < 0.001). The professional oral hygiene protocol reduced postoperative complications, improved oral health, and enhanced patient comfort. These findings support the integration of structured oral hygiene measures into standard maxillofacial surgical care to optimize outcomes and quality of life.

We know of few studies in the international scientific literature that specifically address the evaluation of surgical and clinical progress among physicians undergoing specialist training in maxillofacial surgery. Identifying a reliable tool to accurately assess both theoretical knowledge and surgical skills of trainees is essential. The primary aim of this study therefore was to design a comprehensive assessment tool that is capable of evaluating both the theoretical and practical skills of physicians undergoing specialist training in maxillofacial surgery. The methodology employed aims to ensure fairness and effectiveness in skills development, thereby optimising training activities. To meet this need, an evaluation and self-assessment test was developed for maxillofacial surgery trainees at the Ospedali Riuniti of Ancona. Data collection involved digitally administered evaluations and self-assessment tests focused on maxillofacial traumatology, based on AO trauma surgery references. Data were processed into graphs which revealed a progressive learning trend following an initial adjustment phase, leading to optimal outcomes in both clinical and surgical domains. The evaluation and self-assessment test proved to be a valuable learning tool with which to gauge advancements in clinical and surgical skills among maxillofacial surgery residents.