Oral and Maxillofacial Surgery Research in Brazil:

Where We Are and Where We Are Going

Article from Brazil

Oral and Maxillofacial Surgery (OMFS) in Brazil has seen remarkable progress over the last decades, driven by advancements in technology, surgical techniques, and academic research. This article explores the current state of OMFS research in Brazil, highlighting key areas of investigations, major research institutions, and challenges faced by professionals in the field.

Oral and Maxillofacial Surgery is a large area of Dentistry in Brazil, and in the most places worldwide. In terms of research, OMFS address complex craniofacial conditions such as trauma, tumors, congenital anomalies, and reconstructive procedures. Brazil has made significant contributions to the development of novel surgical approaches and biomaterials, considering innovations and getting clinical outcomes to the literature and clinical surgeons.

It is essential for surgeons and all healthcare professionals to understand that clinical decision-making must be based on scientific evidence. This requires considering studies ranging from laboratory investigations, such as in vitro research (e.g., cell culture) and animal studies—also known as preclinical studies—to clinical studies, which provide the highest level of scientific evidence.

In Brazil, the vast majority of research is conducted in universities, primarily within graduate programs (Master - MSc and doctorate-PhD). These institutions serve as the backbone of scientific advancement, mirroring the structure seen in leading research-intensive countries. Below are the universities with this distinction:

• The University of São Paulo (USP) comprises three campuses, located in São Paulo city, Ribeirão Preto, and Bauru;

• University of Campinas (UNICAMP) in which its campus is located in Piracicaba – São Paulo State;

• São Paulo State University (UNESP), with two campus presenting graduate programs in OMFS: Araçatuba and Araraquara - São Paulo State;

• Federal University of Pelotas, in Rio Grande do Sul State;

• Pontifical Catholic University (PUC), in Porto Alegre, also in Rio Grande do Sul State;

• University of Pernambuco (UPE), in Recife, Pernambuco State.

The graduate programs are overseen by the Coordination for the Improvement of Higher Education Personnel (CAPES), a Brazilian federal institution responsible for continually assessing and refining these programs to ensure their excellence in relation to other research fields and international standards. The main parameters used to categorize graduate programs are the quantity and quality of high-impact publications, the placement of master's and doctoral graduates in universities, and program internationalization. These parameters classify the programs on a scale of 3 to 7, with programs scoring 5 or higher considered excellent. Most of the mentioned programs have received a score of at least 5, with the Piracicaba Dental School – UNICAMP being the only one to achieve a score of 7.

Most postgraduate programs are part of public universities, which means that students do not incur costs, and some even receive scholarships during their courses. Federal and state agencies are primarily responsible for providing scholarships and funding research projects. Key agencies include CAPES, the National Council for Scientific and Technological Development (CNPq), and state research foundations (FAPs), such as FAPESP (São Paulo), FAPEMIG (Minas Gerais), FACAP (Acre), FAPEAL (Alagoas), FAPEAP (Amapá), FAPEAM (Amazonas), FAPESB (Bahia), FUNCAP (Ceará), FAPDF (Distrito Federal), FAPES (Espiríto Santo), FAPEG (Goiás), and FAPEMA (Maranhão).

Regarding the areas of highest research priority in Brazil, the development of novel materials and surgical techniques has emerged as a key target. Notably, the following areas have garnered significant attention:

Dental Implantology and Bone Regeneration Research on osseointegration and biomaterials for dental implants has expanded significantly in Brazil. Studies on bone grafting techniques, guided bone regeneration, and stem cell applications contribute to improved patient outcomes.

Orthognathic Surgery and 3D Printing. The integration of 3D printing and computer-assisted surgical planning has revolutionized orthognathic surgery in Brazil. Several institutions have developed customized surgical guides and patient-specific implants, improving precision and reducing recovery time.

Management of Maxillofacial Trauma. Brazil has a high incidence of facial trauma due to traffic accidents and interpersonal violence. Research focuses on optimizing fracture management, minimally invasive approaches, and long-term functional outcomes.

Head and Neck Oncology Research on oral cancer, reconstructive techniques, and the role of immunotherapy in maxillofacial tumors has gained prominence. Brazilian institutions have been at the forefront of developing protocols for early detection and multidisciplinary treatment.

Temporomandibular Joint Disorders (TMD) and Surgery. Studies on minimally invasive procedures for TMD, such as arthroscopy and regenerative therapies, have improved the understanding and management of these conditions.

Despite the progress, challenges persist in OMFS research in Brazil. I think the limited funding is the major concern for us as surgeons and researchers. Furthermore, the availability of patients and the creation of Clinical Trials Centers need great advancements. In addition, future efforts should focus on increasing government and private sector investment, fostering interdisciplinary collaboration, and expanding digital technologies in surgical practice.

Research in OMFS in Brazil requires greater support from both government and private sector funding to explore emerging fields within the specialty. Areas such as cosmetic surgery and minimally invasive procedures are increasingly incorporated into clinical practice, yet many of the new techniques lack robust scientific evidence to support their safety and efficacy.

In short, Brazil continues to make significant strides in Oral and Maxillofacial Surgery research. Innovations in implantology, orthognathic surgery, trauma management, oncology, and TMD treatment position Brazil as a leading contributor to global OMFS advancements. Addressing existing challenges will further enhance the quality and impact of research in the country.

By: Leonardo Perez Faverani

Oral and Maxillofacial Surgeon, DDS, MSc, PhD

Associate Professor on Oral and Maxillofacial Surgery from Department of Oral Diagnosis, Piracicaba Dental School, Universidade Estadual de Campinas (UNICAMP), Piracicaba, São Paulo, 13414-903 Brazil.

faverani@unicamp.br; +55 18 997577610

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References

• Baeta Neves, A. A. (2020). A Pós-graduação no Brasil. Int. J. Business. Mark. (IJBMKT) 5, 23–29 [text in Portuguese].

• Conselho Nacional de Desenvolvimento Científico e Tecnológico - CNPq. Brasília: Ministério da Ciência, Tecnologia e Inovação, 2019.  Available on the website: http: cnpq.br [text in Portuguese].

• Grillo, R., Borba, A., Slusarenko da Silva, Y., Lucamba, A., & Brozoski, M. (2024). A Science Mapping Analysis of Brazilian Literature on Oral and Maxillofacial Surgery. European Journal of Therapeutics, 30(2), 102–116. https://doi.org/10.58600/eurjther1999.

• Ministério da Saúde do Brasil. (2022). National guidelines for maxillofacial trauma management. Retrieved from [government website] [text in Portuguese].

• Web of Science Group. Research in Brazil: Funding excellence: Analysis prepared on behalf of CAPES by the Web of Science Group. Clarivate Analytics. 2019.