Multiple studies have demonstrated the association between Quality of Life (QoL) and the prevalence of caries, periodontitis, and tooth loss. However, the role of the position and location of tooth loss in impacting QoL remains unclear. To evaluate the association of tooth loss, including anterior losses, with Health-Related Quality of Life (HRQoL) and Oral Health-Related Quality of Life (OHRQoL) in Chileans aged 15 years and older who participated in the ENS 2016–2017. In this cross-sectional study we included 5473 individuals enrolled in the last Chilean National Health Survey (ENS 2016–2017). HRQoL was measured using the EQ-5D questionnaire, while OHRQoL was assessed through a general question (GQ/ENS) and five specific questions (SQ/ENS). An analysis of variance test was performed to determine how difference or variation in the number(s) of teeth affected their HRQoL. Odds ratios with corresponding 95% confidence intervals were calculated using multinomial logistic regression to determine how and to what degree anterior tooth loss was associated both with HRQOL and OHRQOL in the study sample. The number of remaining teeth was significantly higher in the ‘No problems’ group across all EQ-5D dimensions, except Anxiety/Depression. The largest difference was in Self-care, where ‘No problems’ had a mean of 20.18 compared to 6.43 teeth in the ‘Problematic’ group. Anxiety/Depression showed higher odds of ‘Some problems’ with upper anterior tooth loss, while ‘Usual Activities’ showed higher odds of ‘problematic’ with lower anterior tooth loss. Participants with an ‘Excellent’ OHRQoL perception had a mean of 24.32 teeth. Also, upper and lower anterior tooth loss increased the odds of OHRQoL self-perception. Tooth loss was associated with lower HRQoL and OHRQoL in some groups, with more remaining teeth associated with better outcomes, while anterior tooth loss was- linked to worse self-perceived oral health.

Study Design: This is a retrospective observational study. Objective: To evaluate the clinical outcomes after an open reduction and internal fixation (ORIF) of condylar neck and base fractures (CNBFs) with a trapezoidal shape plate in patients using a less invasive transparotid approach. Methods: Fifteen patients with condylar fractures were classified according to the Arbeitsgemeinschaft für Osteosynthesefragen Craniomaxillofacial (AOCMF) classification system, treated by ORIF with a trapezoidal plate. All patients were evaluated by clinical examination (pain, occlusion, and mandibular dynamics) and imaging through computed axial tomography. Postoperative evaluations considered a favourable clinical outcome of fragment stability, stable occlusion, absence of pain, and regular mouth opening ranges. In addition, any signs of local infection, malocclusion, facial nerve damage, or failure of the fixation system were recorded. Results: According to the AOCMF classification for condylar fractures, eight fractures affected the condylar base and seven involved the condylar neck. No patients presented pain or joint sounds in the TMJ. All patients obtained a buccal opening greater than or equal to 35 mm. Two patients showed postoperative malocclusion which was corrected by intermaxillary elastics therapy. In addition, two patients had transient paresis during the postoperative period. One of them had paresis of the frontal and buccal branches of the facial nerve while the second patient had paresis of the zygomatic and buccal branches. Conclusions: Using trapezoidal miniplates provides functionally stable fixation for neck and base condylar fractures and allows for a less invasive surgical transparotid approach (2 cm extension). They also reduce the amount of osteosynthesis material and are easier to adapt and fix in the author’s opinion.

Orbitozygomatic fractures represent a complex surgical challenge. Given the urgent need for validated educational tools that surpass traditional learning models, this multicenter study developed and validated a novel synthetic advanced simulation model for the reconstruction of these fractures. The model integrates platinum-cured silicones and 3D-printed bony structures with prefabricated fractures, accurately replicating the anatomy and tactile properties of soft and hard tissues, including simulated herniation of orbital contents. To our knowledge, it is the only available synthetic model combining both tissue types for this training. Ten participants (faculty and residents) completed simulated procedures. Technical performance was assessed using a hand motion tracking system, the global OSATS (Objective Structured Assessment of Technical Skills) scale, and a task-specific error measurement (Specific Fault Measurement, SFM) scale. Statistically significant differences (p = 0.021) were observed in operative time and error count between novices and experts, confirming the model’s construct validity. Faculty completed the surgery in significantly less time (mean 18.16 min vs. 37.01 min for residents) and made fewer errors (mean 12.25 vs. 53.25). Face and content validity were strongly supported by participant surveys, with 100% stating they would use the simulator to practice before real surgery. A strong inverse correlation (r = –0.786, p = 0.021) between OSATS and SFM scores demonstrated concurrent validity. This model enables ethical, repeatable, and cost-effective training, supporting its implementation into surgical curricula to enhance competence and provide objective skill assessment in orbitozygomatic trauma surgery.

Introduction Orthognathic surgery is widely accepted for correcting dentofacial deformities. Due to the rich blood supply in the head and neck region, considerable bleeding can occur from the incised soft tissues and bone during orthognathic surgery. Hypotensive anesthesia is a method used in surgical practice by which blood pressure is decreased predictably and deliberately to reduce blood loss and improve surgical field. However, there is still uncertainty regarding its effectiveness and safety in orthognathic surgery. Methods We searched in Epistemonikos, the largest database of systematic reviews in health, which is maintained by screening multiple information sources, including MEDLINE, EMBASE, Cochrane, among others. We extracted data from the systematic reviews, reanalyzed data of primary studies, conducted a meta-analysis, and generated a summary of findings table using the GRADE approach. Results and Conclusions We identified three systematic reviews, including 11 studies overall, which are randomized trials. We concluded that hypotensive anesthesia may reduce intraoperative blood loss and may improve the quality of surgical field, however, the certainty of the evidence has been assessed as low. On the other hand, orthognathic surgery with HA may make little or no difference in surgical time (low certainty evidence). Finally, no studies were found that reported adverse effects or mortality.

PALABRAS CLAVE: Tercer molar; Exodoncia; Instrumental piezoeléctrico; Instrumental rotatorio; Osteotomía; Epistemonikos; GRADE