Improper Treatments in the Field of Oral and Maxillofacial Surgery: A Clinical Cohort Study of 55 Cases

Abstract

Objective: To underscore the significance of dentistrybased education in oral and maxillofacial surgery (OMFS), fostering interdisciplinary communication and collaboration for effective treatments. Material and Methods: Fifty five improper OMFS treatment cases directed to us from different centers were investigated. Cases were categorized into dentoalveolar and maxillofacial interventions. Clinical records and patient files were analyzed for age, gender, etiology, improper treatment classification, treating clinician, previous interventions, complications, and orofacial outcomes. Results: During the 25-year survey (1990-2015), 55 out of 12,452 cases were studied. Case ages range from 3 to 70 years (Average: 33.4), with 33 (60%) males and 22 (40%) females. Dentoalveolar interventions accounted for 22 cases, while maxillofacial cases accounted for 33. Private practices performed 32 interventions, whereas state or university hospitals performed 23. Dentists carried out 22 procedures, plastic surgeons 22, and ear nose throat specialists 11. The most common improper treatments were tooth extraction-related (21 cases), followed by jaw fracture treatment (15 cases), and misdiagnosed odontogenic tumor as infection (8 cases). The top 3 reasons for patient referrals were facial asymmetry and malocclusion (21 cases), root migration to anatomical spaces (11 cases), and nerve injury (9 cases). The most common sequelae after the first intervention were facial asymmetry and malocclusion (24 cases), infection in the area (22 cases), and nerve injury (12 cases). Conclusion: Improper treatments are common in OMFS, necessitating awareness among all surgeons. Reducing such cases requires physicians to take responsibility throughout the preoperative, intraoperative, and postoperative phases, being fully aware of their authority and skills. Additionally, addressing authority conflicts, improving dentistry-based secondary education, and promoting specialization in the field are vital factors.