Orthodontics, Oral & maxillofacial
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Research outputs from the Oral and Maxillofacial Surgery team at the RD&E.
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Item E-cigarette side effects in otolaryngology: unveiling the vape mirage(Springer Nature, 2023-10-20) Baniulyte, G.; Ali, K.DATA SOURCES: The following databases were searched for publications up to May 2020: Web of Science, EMBASE, CENTRAL, Medline and CINAHL. Additionally, previously published reviews were hand searched. STUDY SELECTION: Clinical studies conducted in English language were considered, encompassing cohorts of more than four vaping individuals who have encountered inadvertent side effects. Both adult and paediatric populations were included. In vitro, animal studies and systematic or literature reviews were excluded from the analysis. DATA EXTRACTION AND SYNTHESIS: Two independent reviewers screened 1125 studies following deduplication. Two-hundred and eight full-text studies were assessed for eligibility. RESULTS: Thirty-two studies met the inclusion criteria. Diverse study designs were included, comprising of cross-sectional, randomised controlled trials, case-control studies, cohort studies, case series investigations and non-randomised trials. Of note, four studies focused on paediatric patients. Most reported side effects were cough, throat and mouth irritation and intra-oral lesions. CONCLUSIONS: While the direct side effects of e-cigarettes are well-documented, the long-term effects remain uncertain.Item Appropriateness of two-week wait head and neck cancer referrals to a district general hospital(Springer Nature, 2023-09-18) Hook, H.; Baniulyte, G.; Esson, M.; Bowden, J.Objectives The NHS advise urgent referral of patients with suspected head and neck cancers to secondary care to be seen via a two-week wait pathway. The objective of this review was to analyse the two-week wait head and neck cancer referrals to a district general hospital and to identify the prevalence of oral cancer.Materials and methods Patients referred via an urgent two-week wait cancer pathway during the period of 12 October 2020 to 19 January 2022 were identified. Data were extracted and analysed for referral source, patient sex, whether or not a biopsy was undertaken, and the number of patients with a final positive cancer diagnosis.Results Overall, 883 two-week wait referrals were received. Most referrals came from general medical practitioners (50%) followed by general dental practitioners (37%). A total of 379 patients (46%) underwent a biopsy, special investigations, or internal referral to another speciality. The overall prevalence of cancer was 6.2%. Most referrals received were for commonly occurring benign conditions.Conclusion Despite many two-week wait suspected cancer referrals, only a small percentage of patients go on to be diagnosed with head and neck cancer. These results highlight the number of avoidable referrals, which ultimately impact patient waiting lists and clinician time.Item Going paperless - Qualitative monitoring of staff morale during the transition from paper to electronic health records(Elsevier, 2023-10-04) Baniulyte, G.; Rogerson, N.; Bowden, J.BACKGROUND: Organisational change is an important part of development and growth. Transitioning from paper-based hospital records to electronic health records improves efficiency and patient safety by streamlining data access and reducing the risk of errors, ultimately leading to enhanced patient care and outcomes. In October 2020, a large NHS trust underwent the transition from paper notes to a fully electronic health records system. Therefore, the purpose of this study was to monitor staff morale during this organisational change; to highlight any issues arising that may impact on the smooth transition; to encourage feedback. METHODS: A questionnaire was distributed to all members of the maxillofacial outpatients department on a regular basis. The qualitative responses were analysed using NVivo, following a framework analysis model. RESULTS: The analysis generated 1319 codes, which were placed into 68 groups. The three main themes were 'Transformational Advancements in Healthcare Delivery'; 'Obstacles to Seamless EHR Integration; 'Navigating the Transition and Evolving Perceptions'. DISCUSSION: Regular monitoring of morale and staff opinion allows for smoother transition in a large-scale organisational change. The results of this project will help future hospitals and trusts undergoing similar transitions.Item How does diabetes mellitus impact on the prognosis of dental implants?(Springer Nature, 2023-08-01) Baniulyte, G.; Ali, K.DATA SOURCES: Web of Science, Embase, PubMed and Cochrane Library databases were searched for publications up to August 2021. STUDY SELECTION: The study noted clear inclusion and exclusion criteria. Search terms were provided; only observational studies were considered. DATA EXTRACTION AND SYNTHESIS: A total of 122 studies were identified through the search strategy. Following deduplication, two reviewers conducted the screening. RESULTS: A total of 21 observational studies were included, involving cohort, case-control, and cross-sectional study designs. A meta-analysis identified increased risk of peri-implantitis in patients with diabetes mellitus and in smokers when compared to non-diabetic subjects and non-smokers. No significant association was found between poor plaque control or periodontal history and peri-implantitis. CONCLUSIONS: Patients with diabetes mellitus appear to have a higher risk of peri-implantitis.Item Vital role of clinicians in reducing the NHS carbon footprint through smarter procurement decisions(BMJ Publishing Group, 2023-08-01) Al-Hadithy, N.; Knight, K.; Gopfert, A.; Van Hove, M.; Villa Garcia, X.BACKGROUND: The NHS' impact on the environment is significant, accounting for 5.9% of the national carbon footprint of the UK and 20 million tonnes of carbon dioxide equivalent (Mt CO(2)e) emissions a year.The procurement of goods and services is responsible for 72% of the NHS carbon footprint-equivalent to 15.2Mt CO(2)e. Procurement is, therefore, a priority focus area to consider, if carbon reductions are to be made. The impact of procurement decisions extends over the 'whole life'-from identification of the need for a product or service through to the provision of the product or service and including the product's 'end of life' process (disposal).From April this year, any new procurement needs to have a 10% net zero and social value weighting. From April 2023 onward, any new procurement two times per day should incorporate carbon footprint and environmental impact.This paper aims to introduce clinicians to the concept of green procurement and illustrate the potential greenhouse gases savings possible if procurement decisions were informed by the sustainability credentials such as the carbon footprint of a product or the corporate social responsibility programme of the supplier. METHODS: While seconded at the Department of Health and Social Care, the senior author on this paper collaborated with the NHS Supply Chain to pilot carbon footprinting of one clinical item. We chose to focus on the 20-gauge 'pink' cannula as a high-volume familiar article; 25 million cannulas are purchased via the NHS Supply Chain each year, of which the most commonly used size is the 20 gauge. RESULTS: Of the seven companies approached, five sent us their CSR strategies. Four companies provided product primary data, and of these four, one provided sufficient data to carry out a carbon footprint analysis. The one set of detailed data provided was for two 20-gauge cannulas, 1 with wings and 1 without. The total carbon footprint for Cannula 1 is 33.92 g CO(2)e. The total carbon footprint for Cannula 2 is 35.45 g CO(2)e. This amounts to a 1.54 g CO(2)e difference between the 2 cannulas. CONCLUSION: It is both necessary and possible for the NHS to demonstrate leadership in reducing the carbon footprint of healthcare.We have provided an overview of NHS procurement to empower clinicians to get involved with local and national decision-making. We have demonstrated the potential carbon savings that could be made through careful choice of products. We have also highlighted the risks if clinicians do not engage with green procurement.