Emeka Nkenke

Gender trends in authorship in oral and maxillofacial surgery literature: A 30-year analysis

The aim of the present study was to perform a bibliometric analysis of the gender distribution of first and senior authorships in important oral and maxillofacial journals over the 30-year period from 1980 to 2010. Articles published in three representative oral and maxillofacial surgery journals were selected. The years 1980, 1990, 2000, and 2010 were chosen as representative points in time for article selection. Original research, case reports, technical notes, and reviews were included in the analysis. Case reports and technical notes were pooled in one group. For each article, the gender of the first author as well as that of the senior author was determined, based on the inspection of their first name. The type of article was determined and the country of origin of the article was documented. A total 1412 articles were subjected to the data analysis. A significant increase in female authorship in oral and maxillofacial surgery could be identified over the chosen 30-year period. However, the number of publications by male authors was still significantly higher at all points of time, exceeding those of female authors by at least 3.8 fold in 2010. As there is a trend towards feminization of medicine and dentistry, the results of the present study may serve as the basis for further analysis of the current situation, and the identification of necessary actions to accelerate the closure of the gender gap in publishing in oral and maxillofacial surgery.

Does Laser Surgery Interfere with Optical Nerve Identification in Maxillofacial Hard and Soft Tissue?—An Experimental Ex Vivo Study

The protection of sensitive structures (e.g., nerves) from iatrogenic damage is of major importance when performing laser surgical procedures. Especially in the head and neck area both function and esthetics can be affected to a great extent. Despite its many benefits, the surgical utilization of a laser is therefore still limited to superficial tissue ablation. A remote feedback system which guides the laser in a tissue-specific way would provide a remedy. In this context, it has been shown that nerval structures can be specifically recognized by their optical diffuse reflectance spectra both before and after laser ablation. However, for a translation of these findings to the actual laser ablation process, a nerve protection within the laser pulse is of utmost significance. Thus, it was the aim of the study to evaluate, if the process of Er:YAG laser surgery—which comes with spray water cooling, angulation of the probe (60°) and optical process emissions—interferes with optical tissue differentiation. For the first time, no stable conditions but the ongoing process of laser tissue ablation was examined. Therefore, six different tissue types (nerve, skin, muscle, fat, cortical and cancellous bone) were acquired from 15 pig heads. Measurements were performed during Er:YAG laser ablation. Diffuse reflectance spectra (4500, wavelength range: 350–650 nm) where acquired. Principal component analysis (PCA) and quadratic discriminant analysis (QDA) were calculated for classification purposes. The clinical highly relevant differentiation between nerve and bone was performed correctly with an AUC of 95.3% (cortial bone) respectively 92.4% (cancellous bone). The identification of nerve tissue against the biological very similar fat tissue yielded good results with an AUC value of 83.4% (sensitivity: 72.3%, specificity: of 82.3%). This clearly demonstrates that nerve identification by diffuse reflectance spectroscopy works reliably in the ongoing process of laser ablation in spite of the laser beam, spray water cooling and the tissue alterations entailed by tissue laser ablation. This is an essential step towards a clinical utilization.

Current concepts in cleft care: A multicenter analysis

The current surgical techniques used in cleft repair are well established, but different centers use different approaches. To determine the best treatment for patients, a multi-center comparative study is required. In this study, we surveyed all craniofacial departments registered with the German Society of Maxillofacial Surgery to determine which cleft repair techniques are currently in use. Our findings revealed much variation in cleft repair between different centers. Although most centers did use a two-stage approach, the operative techniques and timing of lip and palate closure were different in every center. This shows that a retrospective comparative analysis of patient outcome between the participating centers is not possible and illustrates the need for prospective comparative studies to establish the optimal technique for reconstructive cleft surgery.

Influence of gender of the teaching staff on students' acceptance of a virtual implant planning course

Acceptance of new technology is influenced by a number of situational and social factors. So far, only limited data are available on the influence of the teaching staffs gender on the acceptance of virtual dental implant planning by students. This study aimed at assessing the influence of the teaching staffs gender on the acceptance of a virtual implant planning course by male and female undergraduate dental students and their general attitude toward implantology. Two groups of third-year dental students (group 1, 9 males, 22 females; group 2, 12 males, 20 females) attended a virtual dental implant planning course. For the first group the teaching staff was all-male, while the teaching staff was all-female for the second group. After completion of the course the students filled in a technology acceptance questionnaire. An all-female teaching staff led to a degree of technology acceptance that did not differ significantly for male and female students. When the teaching staff was all-male, significant differences for technology acceptance occurred between male and female students. However, male as well as female students attributed the practice of implantology to both genders of dentists, equally, without statistically significant difference independent of the gender of the teaching staff. The more evenly distributed degree of technology acceptance of students of both genders being taught by a female staff is a favorable effect which may be explained by the more egalitarian style of women. Therefore, while feminization in dentistry proceeds, adequate measures should be taken to increase the number of female teachers.

Masticatory Rehabilitation of a Patient With Cleft Lip and Palate Malformation Using a Maxillary Full-Arch Reconstruction With a Prefabricated Fibula Flap

For full-arch reconstruction of an atrophied cleft maxilla with missing premaxilla, a prefabricated microvascular free bony flap is a relevant option. A fibula flap was prefabricated in a cleft patient who received six dental implants and an epithelial layer. Six weeks later, maxillary reconstruction was performed. The inpatient period could be confined to 2 weeks. A fixed provisional prosthesis was delivered after an additional 2 weeks. A prefabricated flap allows for the reduction of the interval without a dental prosthesis to only a few weeks, even when a complex full-arch reconstruction of the maxilla is required.