Osteoradionecrosis (ORN) remains a difficult clinical problem. In large refractory cases surgery appears to be the only option but it does not guarantee a cure and is expensive. Cost analysis of 31 patients who had resection with or without reconstruction of their mandible was £892,357. The largest cost was in-patient stay, which accounted for 62% of the total. This article explores in detail the expenditure associated with major ORN surgery and its subsequent implications.

Aim: This study aims to gather information about Oral Surgery training programmes by carrying out a survey of the trainees currently in post. Materials and methods: A web-based questionnaire was sent to current Oral Surgery trainees. Questions about training environment, clinical exposure, examinations and future career aspirations were included. Results: Thirty of the 40 trainees contacted responded by part or fully completing the questionnaire. The mean time period of qualification from dental school to Oral Surgery training was 5.1 years. The majority, 80%, of trainees were on a 3-year full-time programme that entitled them to sit the Membership in Oral Surgery Examination (M Oral Surg) only. Four trainees who responded were eligible to sit both M Oral Surg and the Intercollegiate Specialty Fellowship Exam. Conclusions: The questionnaire highlighted areas Oral Surgery trainees perceived to be important for their training and development. Identification of these issues will allow attention to be focused in addressing them. Clinical relevance Scientific rationale for studyTo gain information about variations between Oral Surgery training programmes including whether trainees feel their clinical experience is sufficient and their views on their own career progression. Principal findingsThere is variation in the clinical and specifically implantology experience being gained by trainees in different training programmes. Practical implicationsWith some trainees feeling they lack clinical experience to make them competent in basic implantology, training developments should be focused towards addressing this concern. This will prevent trainees completing training with unacceptable levels of variation in their logbooks.

The COVID-19 pandemic has spread across the globe, causing millions of cases and disrupting the lives of people worldwide. The increase in the number of critically unwell patients has put healthcare systems under immense strain, requiring them to adapt their service provision to cope with increased demand. At Guy's and St Thomas' NHS Foundation Trust (GSTFT) in London, redeployment of healthcare staff has been used to relieve pressure on the most overburdened hospital sectors, and this saw clinical dental teams involved in auxiliary medical roles throughout much of 2020. On the cusp of the New Year, COVID-19 cases continued to soar and GSTFT opted to cancel routine care and re-implement a second round of clinical redeployment. Here, we discuss our experiences and present positive feedback of early-career dentists being redeployed to medical wards during the UK's greatest health crisis of recent years. CPD/Clinical Relevance: Clinical dental teams can positively contribute to the national COVID-19 response through the provision of urgent dental care, inpatient mouthcare services and auxiliary medical roles.

Solitary median maxillary central incisor (SMMCI) syndrome (OMIM #147250) is a disorder characterized by developmental defects of midline structures with variable expressivity. It presents dentally as a single symmetrical central incisor in the midline position. This is a case report of a child with the isolated dental feature of a single maxillary central incisor, with no medical features of SMMCI syndrome. Under the management of a multidisciplinary dental team, a non-invasive approach was undertaken to improve aesthetics. This case report describes the dental options for managing SMMCI including a non-invasive option that has not previously been reported in detail. CPD/Clinical Relevance: Dentists should be aware of SMMCI and its potential medical sequelae.

Aim Coronectomy of mandibular third molars deemed to be at risk of inferior alveolar nerve injury (IANI) has become an increasingly common treatment modality. The primary principle of the procedure is the removal of coronal tissue and retention of vital root(s) with non‐inflamed pulpal tissue to be surrounded by normal bone. Oncological treatment is currently considered a contraindication for coronectomy due to the theoretical assumption that there is an increased risk of infection from non‐vital coronectomy roots in patients whose oncological disease can result in the development of secondary or acquired immunodeficiency. Additionally, patients with oncological conditions who have undergone head and neck radiotherapy (RT) or received bone modulating agents could be at risk of osteonecrosis either following coronectomy or future root retrieval. This mini case series aims to investigate the outcomes following coronectomy concentrating on oncology patients. Methods Between 2011 and 2017, seven patients prior to commencing head and neck RT or chemotherapy underwent coronectomy of nine mandibular third molars (M3Ms). Results Clinical and radiographic follow up for a mean of 15 months (range 3–48) had shown healing with no report of persistent pain or infection. Fifty‐six per cent of roots demonstrated migration radiographically. No cases required root retrieval or experienced post‐operative IANI or osteonecrosis of the jaw. Conclusion This mini case series provides some early insight into the use of coronectomy in oncology patients, however, requires a larger patient population and longer follow up.