Leander Dubois

Introduction: According to Dutch dental trauma guidelines (DTG), optimal outcomes for avulsed permanent teeth are achieved when replantation or professional treatment occurs within 30 to 60 min following trauma. However, studies suggest that patients in the Netherlands often seek care well beyond the critical window for effective intervention, reducing the chances of successful reimplantation. This delay may be partly due to limited public awareness of appropriate first‐aid measures for dental avulsion. Objective: This study assesses awareness and perceived urgency in managing dental avulsion among Dutch students, focusing on knowledge gaps and their variation across different educational levels. Participants included secondary school students and individuals in higher education with both medical and non‐medical backgrounds. Methods: A 16‐item questionnaire, incorporating a case‐based scenario, was designed to evaluate general awareness and urgency perception. The questionnaire was distributed in educational settings between December 2024 and February 2025 and completed by students. Results: A total of 348 responses were included. Only 49% of participants correctly identified the recommended treatment timeframe of 30 min or less. Those with a dental background scored highest overall ( p < 0.001), while secondary school students scored lowest. Medical students showed significantly greater general knowledge of avulsion management (“awareness”) than secondary school students ( p < 0.05); however, they did not differ considerably in recognizing the urgency of treatment or in taking correct immediate actions (“sense of urgency”). Notably, only 17% of participants answered all six key management questions correctly according to national guidelines, highlighting substantial knowledge gaps, even among higher‐education groups. Conclusion: The findings of this study indicate significant knowledge deficits regarding the emergency management of dental avulsion across all educational levels. These results highlight the urgent need for targeted educational strategies to enhance first‐aid awareness, particularly among adolescents and medical students, with an emphasis on timely and appropriate response.

Panfacial fractures are complex fractures involving multiple regions of the facial skeleton and may require multiple surgeries over a relatively short period. They are often associated with polytrauma and other injuries including neurotrauma, which require either immediate (ATLS) airway management, prolonged intubation, or repeated intubations for staged surgeries. The choice of airway for the surgical management of these fractures is difficult, as an assessment of the occlusion is required, and the central nasal complex and/or skull base may be involved, making classical orotracheal or nasotracheal intubation problematic. Submental intubation is increasingly reported as a method of airway management with the aim of avoiding a tracheostomy and its related complications. A review of the different techniques of airway management in the elective treatment of panfacial fractures was performed, focusing on the pros and cons of each method. Most articles were retrospective studies, with only one prospective study comparing submental intubation to tracheostomy in panfacial fractures. An algorithm for the management of the airway in panfacial fractures was presented, based on a sequential assessment of the existing airway, the surgical access required, and the need for prolonged or repeated intubation. Front of neck access, orotracheal and nasotracheal intubation, and submental intubation are all appropriate techniques in different circumstances, and the advantages and disadvantages of each are presented.

Orbital reconstruction is one of the most complex procedures in maxillofacial surgery. It becomes even more complex when all references to the original anatomy are lost. The purpose of this article is to provide an overview of techniques for complex three- and four-wall orbital reconstructions. Preoperative virtual surgical planning is essential when considering different reconstruction possibilities. The considerations that may lead to different approaches are described, and the advantages and drawbacks of each technique are evaluated. It is recommended to reconstruct solitary three-wall or four-wall orbital defects with multiple patientspecific implants. Optimizations of this treatment protocol are suggested, and their effects on predictability are demonstrated in a case presentation of a four-wall defect reconstruction with multiple patient-specific implants.

Naar schatting heeft 20-30% van de 18-jarigen ooit een vorm van tandletsel opgelopen. Een derde hiervan moet de rest van zijn leven met de consequenties...