Ibraz Siddique

Occupational exposure to bodily fluids in oral and maxillofacial surgery: an evaluation of reporting practices and attitudes among staff at a major teaching hospital in the UK

Our aim was to evaluate experience, practice, and beliefs about reporting of occupational exposures to blood and other body fluids among a sample of 88 healthcare providers working in oral and maxillofacial surgery at Sheffield Teaching Hospitals. We used a cross-sectional survey to evaluate awareness of the Trusts policy for reporting occupational exposure, recent incidence of exposure, and current reporting practices. Beliefs were measured using questions derived from the theory of planned behaviour. Fifty-five people responded, 14 of whom had been exposed to bodily fluids in the previous 12 months. Of those, 10 did not report it. Fifty-three respondents were certain that the Trust had a protocol in place for reporting sharps injuries to staff. Most (n=51) said the Trust had a protocol for reporting mucocutaneous exposure to blood. Respondents placed equal importance on reporting exposures that affected both themselves and patients, but intention to report exposure of patients was significantly higher than for themselves (z score -3.18, p<0.0001). We conclude that OMFS healthcare workers generally think that occupational exposures should be reported, but there are shortcomings in practice.

Facial Deformity Correction with Bespoke PEEK, Patient Specific Implants (PSI): Journey from In-house Manufacturing to Virtual Planning and Navigational Technology

Introduction: Polyetheretherketone (PEEK) is a semicrystalline linear aromatic polymer with properties that makes it a suitable material for cranio-facial reconstruction. PEEK is versatile and is an alternative to the current implantable material available for cranio-facial reconstruction. The advances in CAD/CAM technology have made the implants accurate and reproducible. We have a case series to take you through the journey from making the PEEK implants in-house to using navigational technology. Materials & Methods: 19 patients underwent reconstruction of facial deformity between 2012 and 2015, 17 were post traumatic and 3 were congenital defects. Age ranged from 17 to 50yrs. Results: Of the 20 reconstructions, 11 were zygomatic, 8 were orbital reconstructions, and 1 was for mandibular reconstruction. Of the 20 cases 7 were manufactured with in-house techniques and 13 were manufactured purely using CAD/CAM technology. Three cases used navigation technology for placement of orbital implants. Follow up ranged from 8 weeks to 3 years 2 implants manufactured using in-house technique were removed, one was found to be too bulky and created a ledge, this was replaced with a PSI, the other had a poor fitting surface and later developed infection. Conclusions: PEEK is a versatile material for craniofacial reconstruction. The in-house manufacturing technique has multiple steps and often needed adjustments for an accurate fit. The use of CAD/CAM for patient specific implants, with the use of navigation when required, allows reproducible and accurate results. Multi-segmented interlocking implants provides the added advantage of additional stability with minimal fixation and ease of insertion.

A rare case of gingival metastases from papillary thyroid carcinoma

Highlights • The attached gingiva is a rare site for metastasis in the oral cavity.• Metastasis to the oral cavity usually indicates disseminated malignant disease.• Clinicians must be vigilant when presented with an oral soft tissue mass in patients with a known underlying malignancy.• There should be a low threshold to biopsy gingival lesions in patients with a history of carcinoma.• Early identification of distant metastases in the oral cavity is important in planning appropriate and timely palliative management.