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  1. Muhamad Imran Abdulah, Ikmal Abdul Hakim, Rosni Amin, Rosliza Parumo, Ma, Bee Chai, Noraziyah Abdul Aziz, et al.
    Q Bulletin, 2020;1(29):16-27.
    MyJurnal
    The Department of Oral & Maxillofacial Surgery at Hospital Sultanah Aminah, Johor Bahru started managing patients who lost their eyeballs with ocular prosthesis in 2013. Unfortunately, there was an increasing trend of failed ocular prosthesis from 2013-2015. The failure rate went from 28.6% in 2013 to 40% in 2014 and increased to 44.4% in 2015. Failed ocular prosthesis not only leads to dissatisfied patients but also an increase in cost due to redoing of prosthesis. The objective of this project was to reduce the incidence rate of failed ocular prosthesis. A failed case is when the prosthesis does not pass the issue stage and has to be redone from the beginning. The standard failure rate is 0%, as the average number of cases per year is only about 10 cases. We determined the contributing factors of failed ocular prosthesis by analysing retrospective data from patients’ dental and lab records. This was followed by a self-administered questionnaire on reasons for failed cases which was distributed among the dentists and lab technicians in our department. The contributing factors that were identified included insufficient knowledge or skill of dentist and lab technicians in the construction of the ocular prosthesis, as well as improper screening of new cases which was the main factor of all the failed cases. The strategies for change included improving the process of care by creating a checklist for proper screening of new patients, mentoring of new staff, and continuous training on construction of ocular prosthesis, Fabricated Iris Mould innovation technique and early referral for insertion of eye conformer. The interventions that were implemented reduced the failure rate to 20% in 2016 followed by 0% in 2017, 2018 and 2019. Ongoing efforts are being done to replicate this project in other Oral & Maxillofacial Surgery clinics in Johor.
  2. Balasundram S, Kovilpillai FJ, Royan SJ, Ma BC, Gunarajah DR, Adnan TH
    J Maxillofac Oral Surg, 2020 Jun;19(2):289-297.
    PMID: 32346242 DOI: 10.1007/s12663-019-01204-1
    Purpose: To ascertain the complications arising from open reduction and internal fixation of mandibular fractures and to elucidate if different osteosynthesis plating systems vary in treatment outcome.

    Materials and Methods: This is a retrospective study. Parameters such as patient data, injury details, osteosynthesis implant system information, stability of fracture fragments, occlusion and complications were evaluated at different time intervals and logistic regression applied to determine the association of these factors with complications.

    Results: Five hundred and ninety-three patients with mandibular fractures were included in this study (male 87.9% and female 12.1%), age range of 13-72 years (median = 22 years). Most fractures were caused by motor vehicle accidents (85.8%), assault (6.2%) and falls (4.7%). Parasymphyseal fractures were the most common (50.1%), followed by angle (35.2%) and body of mandible (25%). Median time interval between injury and intervention was 7 days (IQR 4-10). Median duration of follow-up from date of surgery was 72 days (IQR 30-230). 76.9% (456) were completely free of complications. Most complications (46%) occurred in the intermediate post-surgical period (1-6 weeks). Median interval period between surgery and complication was 15 days (IQR 7-67.5). Nerve injury and surgical site infection were the most common complications at 6.7% and 5.7%, respectively. There was a significant difference between the plating system in terms of complication outcome (p = 0.017).

    Conclusion: Whilst the miniplate dimensions may be similar across different manufacturers, the complication outcome may differ between systems.

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