Bill Klaproth (host): This is an AAOMS On the Go podcast. I'm Bill Klaproth and today we welcome Dr. Joseph Cillo, the Craniomaxillofacial Trauma Section Editor for the Journal of Oral and Maxillofacial Surgery, or JOMS, as we talk about the JOMS Craniomaxillofacial Trauma Section.

Dr. Cillo, welcome.

Joseph E. Cillo, Jr., DMD, PhD, MPH, FACS: Thanks, Bill. Great to be here.

Host: Yeah, great to talk with you. So, can you give us an overview of the types of studies and research themes that are generally featured in your section of the journal?

Joseph E. Cillo, Jr., DMD, PhD, MPH, FACS: Yes, the craniomaxillofacial trauma section primarily deals with acquired injuries to the maxillofacial oral region generally looking at both injuries to the soft tissue and hard tissue. Such things, you know, mandible fractures, maxillary fractures, panfacial fractures, soft tissue, orbital fractures, anything that's going to be involved in treating and outcomes that are involved with the trauma in that region of the face.

Host: So among recent articles that you've published, is there one that specifically stands out to you and its potential impact on clinical practice and what makes it significant?

Joseph E. Cillo, Jr., DMD, PhD, MPH, FACS: There's a lot of articles that have come out that have been really pragmatic and really helped with the flow with the way maxillofacial trauma is treated. One article in general is a multi-center study which really looked at the use of technology in treating these acute injuries, which really is at the forefront of research in traumatology.

And what it looked at was basically developing a digital workflow that would allow for treatment of these individuals in a more timely manner. One of the issues with maxillofacial trauma as opposed to other elective and congenital deformities, is that you have a limited time frame in which to treat these injuries.

So this article looked at the outcomes and accuracy of the digital workflow that they had developed and with using that able to basically print out with these clinic printers, the plates and screws and models that they needed in order to treat these fractures. And they found about a 93 percent accuracy in these types of devices that they were using on their digital workflow. So it really shows that technology in maxillofacial trauma is something that can be done expeditiously and very accurately.

Host: So, you're just talking about the digital workflow. From your perspective as an editor, Dr. Cillo, are there other emerging trends or topics or things in oral and maxillofacial surgery research that you're most excited about?

Joseph E. Cillo, Jr., DMD, PhD, MPH, FACS: Well, the, technology certainly is probably the most exciting aspect of that since it changes quite frequently. But really the use of not just technology, but also biological devices, drugs that are used in managing injuries, nerve repairs, nerve injuries, things of that nature that can be seen and are usually treated by oral and maxillofacial surgeons.

So it's a combination of technologies, but different types of technologies, not just the digital and computer aspects of it, which tend to change quite frequently, but also the biological aspects that are being seen in a lot of traumatology research.

Host: Well, I know you get a lot of submissions, so how do you ensure the research published in your section is both scientifically rigorous, but then you also have to choose subject matter that is relevant to practicing OMSs. How do you do that?

Joseph E. Cillo, Jr., DMD, PhD, MPH, FACS: Well, a lot of that has to do with our reviewers who have to be very scientifically savvy in determining what is good research and what is lacking research, shall we say. And really, it's understanding what a good research study is able to accomplish. And a lot of that has to do with the, basically the anatomy of a research paper, whether it has a good hypothesis, something that's novel, something that hasn't been done extensively, something that's going to add something to the literature that's going to be able to be used by contemporary surgeons who are dealing with maxillofacial trauma.

So the way we edit and review these journals is a very systematic way so that everything that comes out in the journal has been vetted by experts in these fields and in a very rigorous scientific way so that when you read the manuscripts that are in the Journal of Oral and Maxillofacial Surgery, you can be assured that it's something that's been thoroughly vetted, thoroughly researched so that it is uh, something can be pragmatic and something that can be believed as opposed to just anecdotal evidence with that.

Host: Yeah, so then, what kind of difficulties or challenges do you face when it comes to curating content then for this section of the Journal, especially with the advancements in technology that you've been talking about and techniques in oral and maxillofacial surgery?

Joseph E. Cillo, Jr., DMD, PhD, MPH, FACS: Well, think that's the key point right there, is keeping up with the technology. Because just as with any other field, you know, even in audio recordings for podcasts, I'm sure that the technology changes quite rapidly and improvements are made in that – can't remember what the computer term is – but it changes every 90 days, or 90 days it becomes obsolete or something to that effect.

And the same thing can be done for trauma. What we're doing today is not the same thing necessarily that we were doing 10 years ago from a standpoint of particularly technology. Now with 3D reconstructions and virtual reality, things that were just really science fiction even five, 10 years ago. Certainly, when I was a resident, we didn't have any of that.

Even the imaging is much more improved now than it has been and stuff like that can just continue to improve. And that really adds to the vigorous amount of research that can be done in maxillofacial traumatology. So that those new technologies, those new aspects of one diagnosing and looking at injuries to the maxillofacial region – some of which we may not even have been able to see previously – can now be explored and have different ways of treating them, such as with virtual reality, where you can actually walk through the facial skeleton and put bones and tissues back together. And then once you've reconstructed that, take that to the patient on the operating table and then perform those very accurate procedures that you may not have been able to do as accurately previously and do them with precision and consistency.

Host: So, Dr. Cillo, then, what advice would you give to researchers looking to publish in JOMS? Are there key criteria that you look for when approving submissions for publication? And are there particular areas where you're looking for more submissions?

Joseph E. Cillo, Jr., DMD, PhD, MPH, FACS: Yes, there's a very strict criteria for publishing in the Journal of Oral and Maxillofacial Surgery. This can be found in the Guidelines for Authors, and it's very important that, first off, the authors of any manuscript that's being submitted, follow that to the T so that there's no delay or rejection of the manuscript.

So first off, I would say it's very important to learn what the guidelines for the authors are because that will help guide you. But in other than writing the actual research, what I would recommend for any researcher in maxillofacial traumatology is to look at the, a novel procedure or novel technology that is being used in a different way that can help improve what we know and how we treat maxillofacial trauma at this point.

So once you have a novel idea or a novel technique, then you develop that into a strong research protocol. And it's very important to understand the research protocols that are involved in having a good hypothesis, asking a good research question, being able to design a study that is ideally prospective and that is able to be repeatable.

So, in looking at those aspects of developing research, it's very important to not just the novelty, but have to be scientifically valid and rigorous in your design of the study and then your interpretation and the proper statistics. Statistics can be one thing that's, which can be infuriating to a lot of people but not all of us are, can be experts in statistics, actually there's very few.

So another recommendation I would give is to have a biostatistician help you before you even begin a study. Having a good question and a good hypothesis is great, but if you don't develop a good study and have good statistics in order to develop and carry out the research for that study, it's going to be kind of garbage in, garbage out.

So, if you start good in the beginning, start with a well-designed hypothesis, good statistics, know how many subjects you need in your study to determine a difference if there is one, and then analyzing that data and then developing it into a concise conclusion that can be used pragmatically by contemporary oral maxillofacial surgeons.

So that's kind of a long-winded way of saying being able to scientifically be valid and rigorous in your studies.

Host: Yeah, no, that's really good advice, and that's what people are looking for. And as you said, it starts with that novel procedure or technology and then build from there. Let me ask you this, Dr. Cillo, how important is it for practicing OMSs to stay informed about research findings published in the Journal?

Joseph E. Cillo, Jr., DMD, PhD, MPH, FACS: Oh, I think it's very important because things are changing so rapidly. Even if you're somebody who may not be doing maxillofacial trauma or any kind of large OR cases, shall we say, things change constantly in other aspects of the Journal as well, too, and staying abreast of that research and what the new developing technologies are, can help you be a better surgeon and provide better care to your patients. And it doesn't need to be necessarily the tip of the spear, cutting edge kind of research. That type of research can grow. So it's something that you may see may be inconsequential to you, but eventually that may develop into something that may impact your practice or may impact you or your patients.

So it doesn't necessarily have to be for you the forefront of technology, shall we say, but eventually will lead up to that. So staying abreast and staying informed about what is happening and reading the Journal and the manuscripts that are in it can really help in the longterm in helping you decide on what you should and should not be doing in your practice.

Host: Right. Well, this has really been informative, Dr. Cillo. Thank you. Before we wrap up, is there anything you want to add at all?

Joseph E. Cillo, Jr., DMD, PhD, MPH, FACS: I would encourage everybody, one, to read the Journal, understand the manuscripts that are in it, and to take from that what they can to help make their practice and their service to their patients be more accurate and maintain a good outcome with that. Because a lot of the manuscripts that are in the journal can provide – even though they may not seem it initially – some of them can provide you with a good foundation and base in order to develop new avenues in your practice in order to help you maintain your level of quality.

Host: Yeah, very well said. Dr. Cillo, this has really been interesting. Thank you so much for your time today.

Joseph E. Cillo, Jr., DMD, PhD, MPH, FACS: Well, thank you, Bill. I'm glad I could be here.

Host: Absolutely, and once again, that is Dr. Joseph Cillo, and for more information on the study, please visit AAOMS.org/JOMS, and that's J-O-M-S, JOMS. And if you enjoyed this podcast, please share it on your social channels, and make sure you subscribe so you don't miss an episode.

Thanks for listening.