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Abstract: The aim of this study was to understand the impact of the COVID-19 pandemic on the epidemiology of maxillofacial trauma in a regional trauma center in L'Aquila, Abruzzo, Italy, during the first wave of the pandemic and comparted it to an equivalent period from 2015 to 2018. The authorshave retrospectively analyzed personal data, site of trauma, etiology, and mechanism of injury. Statistical analysis has been carried out utilizing IBM SPSS Statistics software (IBM Corp., Armonk, NY) and significance was accepted for P values of <0.05. From January 2015 to December 2020, a total of 296 were analyzed. In Pre-COVID era, 195 patients were evaluated, 130 males (66.6%) and 65 females (33.4%). Zygomatic-malar complex fractures were the most common site of trauma in both genders (53%), followed by mandibular fractures (23%) and orbital ones (15%). The highest incidences of injuries were recorded between 15 and 34 years (21%) with the most common etiology attributed to road accidents traumas (49%). In COVID19 era, the authors recorded 101 traumas, 58 males (57.4%), 43 females (42.6%). Zygomatic-malar complex fractures were confirmed as the most common ones in both genders (41%). The most common etiology was related to casual domestic accident and assaults (37% and 30%, respectively). There was no statistically significant difference in terms of incidence in the comparison of Pre-COVID19 and COVID19 periods (P > 0.05) as opposed to the etiology in which the road traffic accidents decreased in favor of domestic accidents and interpersonal assaults (P < 0.05). Our scientific study represents the first epidemiologic study related to the impact of COVID-19 on maxillo-facial trauma in the Province of L'Aquila, Abruzzo, Italy. A decrease in the number of Maxillofacial injuries related to road traffic accidents can be demonstrated as the benefit of lockdown, however, a significant increase in the number of physical assaults shows how isolation and restrictions have had a highly negative psychological impact on society., Competing Interests: The authors report no conflicts of interest., (Copyright © 2022 by Mutaz B. Habal, MD.)

The technology adoption and creation of a multidisciplinary team have helped to overcome the complexity associated. Craniofacial surgery has thus emerged from the valuable contributions of neurosurgery, maxillofacial surgery, plastic surgery, eyes, nose, and throat as well as head and neck surgery. A patient with trigonocephaly may present a prominent "keel" forehead, accompanied by recession of the lateral orbit rims, hypotelorism, and constriction of the anterior frontal fossa when the metopic suture fuses before 6 months of age. In a period between 2007 and 2011, in the Salesi Children's Hospital, were treated for nonsyndromic variety of metopic synostosis 11 infants; their ages ranged from 6 months to 9 months, and 7 were males and 4 females. The most important aims of our new surgical technique are the achievement of symmetry as well as normal proportion and reconstruction of the frontoforehead unit but remaining in a very conservative treatment. The morphology and position of the supraorbital ridge-lateral orbital rim region are key elements of upper facial esthetics. This new "open-wings" technique for the reconfiguration of the bilateral emisupraorbital bar requires a midline incomplete osteotomy that involves only the internal cortex of the frontonasal region. Hence, both lateral orbital walls are bent inwardly and tilting forward, as in computed tomographic scan planning, with a greenstick fracture pivoting on the preserved medial frontonasal region. This open-wings conservative technique allows the avoidance of the most important complication that may result in the traditional way such as dead space in the anterior cranial fossa, infections, and blood loss but with an achievement of satisfactory craniofacial form and aesthetic result.