Introduction: Motorcycle accidents are one of the most frequent causes of trauma. Safety devices and helmets can influence the severity of injuries. Our retrospective study wants to evaluate the different effectiveness of Open-face and Full-face helmets in the prevention of craniofacial trauma. Materials and Methods: The sample consists of 440 patients admitted to two Level I Trauma Centres in Northern Italy, between January 2002 and February 2019, because of motorcycle-related craniofacial trauma. For each patient personal data were collected, as well as type and site of fractures, type of helmet, if worn, Comprehensive Facial Injury (CFI) score and Abbreviated Injury Score (AIS-Head) for head injuries. Inferential statistical analysis was then conducted. Results: Two hundred and eighty-eight patients wore Open-face helmets (69.7%) and 125 patients wore Full-face ones (30.3%). Mean CFI score (Standard deviation - SD) observed in patients with Open-face helmets was 7.0 (SD: 6.8) and surgery was required in 149 cases (51.7%); while it was 4.9 (SD: 6.0) in patients with Full-face helmets for whom surgery was required in 43 cases (34.4%) ( P < 0.0001 and P = 0.002, respectively). Multivariate analysis shows that severity of facial trauma is a significant risk factor for head injury severity with OR 1.90 (95% confidence interval: 1.43 - 2.51) and P < 0.0001. Discussion: Full-face helmets are definitely considered to be more protective for facial trauma, which is also a significant risk factor for the severity of head injuries. The type of helmet chosen influences the need of surgical treatment in case of craniofacial trauma.

The application of surgical navigation in oral and maxillo-facial surgery has been increasing over time. In fact, computer-assisted surgery provides real-time, precise, and accurate position and guidance during surgery. The purpose of our work is to introduce the evolution of surgical navigation in recent decades, describe some technical aspects of this technology, explore new possibilities of application of surgical navigation in oral surgery, and validate the accuracy of computer-assisted surgery. We included four patients in our sample who underwent virtual planning on the cone beam CT data set and surgical navigation using non-invasive fiducial markers. The first patient presented a dislocated orthodontic arch in the soft tissues of the cheek, while the other patients presented supernumerary and impacted dental elements. Among them, two patients were affected by craniofacial synostosis. We evaluated the accuracy of computer-assisted surgery, calculating the discrepancy between the real and virtual target. In all cases, the target registration error was less than or equal to 1 mm. We can affirm that surgical navigation is a valid tool to enhance oral surgery, guaranteeing an undoubted advantage in terms of the reliability and predictability of the results, especially in complex cases.

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