Oral Health and Maxillofacial Research

Perception and awareness of oral and maxillofacial surgery speciality among medical postgraduate trainees 

Waleed Ali, Muhammad Sulaiman, Muslim Khan, Atta Ur Rehman, Tahir Saeed and Farrukh Jehan

Objective: To assess the perception and awareness of the Oral and Maxillofacial Surgery (OMFS) specialty among medical postgraduate trainees. Material and methods: This survey was conducted at Qazi hussain medical Complex, Nowshera, employing non-probability sampling technique. A questionnaire on OMFS perception and awareness was manually distributed to 188 participants. Participants meeting inclusion criteria were second-year or senior trainees of the FCPS program, Pakistani nationals, and engaged in medical or allied field training. Exclusions comprised surgery and allied trainees, individuals treated by maxillofacial surgeons, and those with a maxillofacial surgeon first-degree relative. The questionnaire featured scenarios related to oral and maxillofacial surgery, assessing participants' perceptions of appropriate specialties for various clinical situations. Data analysis, included mean age computation, gender and awareness level distribution analysis, and chi- square tests for gender-awareness association. Results: The mean age was 30.79±3.54 years. Males (n=120, 63.83%) were more than females (n=68, 36.17%). While 47.87% identified oral and maxillofacial surgery for temporomandibular joint issues, 51.60% recognized it for cleft lip and palate repairs. Similarly, 44.68% considered OMFS for facial space infections, 44.15% for jaw deformities, and 44.68% for wisdom tooth extraction. Gender disparities were evident in TMJ problem management (p=0.019). Conclusion: Medical postgraduates lack awareness of the diverse services offered by OMFS, emphasizing the need to enhance public perception, raise awareness, and improve healthcare accessibility and efficiency.

The potential of plant-based nanoparticles (PBNPs) for managing dental and orofacial infections within the antimicrobial resistance (AMR) crisis 

Akheen Pal

The emergence of antimicrobial resistance (AMR) has significantly compromised the management of dental and orofacial infections, including periodontitis, peri-implantitis, dental caries, and oral candidiasis. The overuse of antibiotics in dental practice has contributed to the rise of multidrug-resistant pathogens, necessitating alternative antimicrobial strategies. Plant-derived nanoparticles, synthesized using medicinal plant extracts rich in bioactive compounds such as flavonoids, terpenoids, and phenolic acids, have demonstrated promising antimicrobial activity and biocompatibility. Green synthesis methods allow the fabrication of metal nanoparticles without hazardous reagents, improving their safety and ecological profile. These nanoparticles exert antimicrobial effects through multiple mechanisms, including disruption of microbial biofilms, induction of reactive oxygen species (ROS), interference with DNA replication, and compromise of microbial membrane integrity. Their broad-spectrum activity has been validated in preclinical studies targeting oral pathogens such as Streptococcus mutans, Porphyromonas gingivalis, and Candida albicans. Applications in dentistry include their incorporation into periodontal gels, implant coatings, and anticariogenic agents. In vitro studies on oral cell lines and limited in vivo models report minimal cytotoxic effects, supporting their potential for clinical use. However, the lack of standardized synthesis protocols, formulation stability data, and long-term toxicity assessments pose barriers to translation. Regulatory pathways for herbal nanotherapeutics remain underdeveloped, and well-designed randomized clinical trials are required to evaluate safety, efficacy, and pharmacokinetic behavior in humans. Future efforts should focus on optimizing nanoparticle formulation for dental applications, conducting comparative studies with existing antimicrobials, and developing delivery systems tailored to intraoral use. Plant-based nanoparticles represent a potential adjunct or alternative to conventional antimicrobial agents in dental care, offering a strategy to manage infections without exacerbating resistance. Their successful clinical integration will depend on addressing current limitations through collaborative translational research and regulatory support.

Emerging antibiotic resistance and its impact on dental and orofacial infection management 

Akheen Pal

Antibiotic resistance in odontogenic infections has become a critical challenge within dental and maxillofacial practice, compromising the effectiveness of established antimicrobial protocols. The inappropriate and excessive prescription of antibiotics, often administered empirically without microbiological confirmation, has facilitated the rise of multidrug-resistant oral pathogens, leading to increased morbidity, treatment failures, and higher healthcare costs. A targeted literature search was performed using PubMed, ScienceDirect, and Scopus, focusing on publications from 2010 to 2024. Keywords included “odontogenic infections,” “antibiotic resistance,” “oral microbiota,” and “antimicrobial stewardship.” Eligible studies were limited to human clinical research, systematic reviews, and meta-analyses; experimental and non-English studies were excluded. Key resistant pathogens identified include Streptococcus spp., methicillin-resistant Staphylococcus aureus (MRSA), Prevotella spp., and Fusobacterium spp., showing decreased susceptibility to penicillin, amoxicillin, and clindamycin. Resistance mechanisms involve β-lactamase production, efflux pumps, biofilm formation, and target modifications. Clinically, these patterns complicate management, requiring broader-spectrum or adjunctive therapies and increasing disease burden and costs. Antimicrobial stewardship initiatives have proven essential in optimizing antibiotic use and preserving efficacy. Limitations include the lack of standardized dental prescribing guidelines and insufficient resistance surveillance. Future research should emphasize rapid diagnostics and the development of novel therapeutics to improve infection management in dental practice. This review aims to provide dental professionals with an updated understanding of antibiotic resistance in odontogenic infections, emphasizing the importance of required antibiotic use and the potential of novel therapeutic approaches to mitigate resistance development.