{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T12:27:28Z","timestamp":1785414448107,"version":"3.56.0"},"reference-count":43,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2026,6,10]],"date-time":"2026-06-10T00:00:00Z","timestamp":1781049600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Victor Babe\u0219 University of Medicine and Pharmacy Timi\u0219oara"},{"id":[{"id":"https:\/\/ror.org\/00afdp487","id-type":"ROR","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Background and Objectives: The SARS-CoV-2 pandemic disrupted oral and maxillofacial surgery (OMS) services worldwide because of the high aerosol-generating nature of head-and-neck procedures, restricted access to elective dental care, and systemic reallocation of hospital resources. Continuous longitudinal multi-year data covering both the pandemic and the post-pandemic phases from regional Romanian (and more broadly central and southeastern European) emergency centers remain scarce. We aimed to quantify the impact of the pandemic on OMS activity in a large Romanian regional referral center and to evaluate post-pandemic resilience. Materials and Methods: We conducted a retrospective single-center study of all inpatient admissions to the OMS Clinic of a tertiary emergency hospital in western Romania between 1 January 2018 and 31 December 2024. Three periods were pre-specified: pre-pandemic (2018\u20132019), pandemic (2020\u20132022) and post-pandemic (2023\u20132024). A Newey\u2013West segmented interrupted-time-series (ITS) regression and a negative-binomial monthly count model with Fourier seasonality were fitted; length of hospital stay was further analyzed with a multivariable gamma-log generalized linear model adjusted for age, sex, county, primary ICD-10 chapter and total ICD-10 codes. Variables analyzed included case volume, demographics, primary and secondary ICD-10 diagnoses, length of hospital stay (LOS), case complexity (total ICD-10 codes per admission) and in-hospital mortality. Results: A total of 11,628 inpatient admissions corresponding to 8084 unique patients (56.5% male; mean age 52.2 \u00b1 19.2 years) were analyzed. Compared with the pre-pandemic baseline (mean 2037 admissions\/year), annual volume dropped by 45.1% in 2020, 44.0% in 2021 and 32.3% in 2022, with a nadir of \u221276% during the first state of emergency (April 2020; n = 34 admissions). Recovery was rapid; 2024 exceeded the pre-pandemic baseline by +10.1% on raw counts and by +16.2% on admissions per 100,000 catchment population using year-specific INS denominators. The segmented ITS regression confirmed an immediate level drop of \u2212114.2 admissions\/month in March 2020 (95% CI \u2212133.1 to \u221295.3; p &lt; 0.001) and a positive post-intervention slope of +2.06 admissions\/month (95% CI 1.23\u20132.88; p &lt; 0.001), with observed monthly volume returning to the counterfactual projection by October 2023. The case mix shifted significantly (\u03c72 = 406.9, p &lt; 0.0001); elective benign neoplasm admissions were reduced from 7.2% to 2.0%, while neoplasms of uncertain behavior nearly doubled from 15.7% to 27.5%. Case complexity increased during the pandemic (mean ICD codes 4.08 \u00b1 2.42 vs. 3.44 \u00b1 2.30; p &lt; 0.001); after exclusion of administrative codes (whole Z chapter and U07.x), the difference attenuated to 3.34 vs. 3.17 codes (still p &lt; 0.001 by Kruskal\u2013Wallis), indicating that the largest portion of the unadjusted increase was driven by the new mandatory pre-admission SARS-CoV-2 screening code Z11.5 rather than true clinical complexity. Notably, the clinically interpretable proxy R63.3 (feeding difficulty) independently rose from 41.5% to 53.1%. The crude median LOS did not differ between the pre-pandemic and pandemic periods (3.07 vs. 3.06 d; p = 0.19) and dropped significantly post-pandemic (2.22 d; p &lt; 0.001); however, after multivariable adjustment for case mix, age, sex, county and code count, the LOS was 15.7% shorter during the pandemic (adjusted ratio 0.84, 95% CI 0.82\u20130.87; p &lt; 0.001) and 22.8% shorter post-pandemic (adjusted ratio 0.77, 95% CI 0.75\u20130.80; p &lt; 0.001) relative to baseline. Conclusions: The pandemic caused a severe but transient contraction of OMS activity accompanied by increased case complexity and a marked shift away from elective surgery. Inpatient volume returned to and exceeded the pre-pandemic baseline by 2024. These results support the value of standing pandemic-preparedness protocols, sustained access to preventive dental care, and integrated tele-triage pathways for future public-health crises.<\/jats:p>","DOI":"10.3390\/medicina62061129","type":"journal-article","created":{"date-parts":[[2026,6,10]],"date-time":"2026-06-10T06:33:44Z","timestamp":1781073224000},"page":"1129","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Impact of the SARS-CoV-2 Pandemic on Oral and Maxillofacial Surgery Activity: A Seven-Year Retrospective Study from a Romanian Emergency Hospital"],"prefix":"10.3390","volume":"62","author":[{"given":"George C\u0103t\u0103lin","family":"Alexandru","sequence":"first","affiliation":[{"name":"Doctoral School, \u201cVictor Babe\u0219\u201d University of Medicine and Pharmacy, Eftimie Murgu Square No. 2, 300041 Timisoara, Romania"},{"name":"Department of Infectious Diseases, Center for Diagnosis and Study of Parasitic Diseases, \u201cVictor Babe\u0219\u201d University of Medicine and Pharmacy, 300041 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Loredana-Neli","family":"Gligor","sequence":"additional","affiliation":[{"name":"Doctoral School, \u201cVictor Babe\u0219\u201d University of Medicine and Pharmacy, Eftimie Murgu Square No. 2, 300041 Timisoara, Romania"},{"name":"Department of Pulmonology, Center for Research and Innovation in Precision Medicine of Respiratory Diseases, \u201cVictor Babes\u201d University of Medicine and Pharmacy, Eftimie Murgu Square No. 2, 300041 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Doina","family":"Chioran","sequence":"additional","affiliation":[{"name":"University Clinic of Anesthesiology and Oral Surgery, \u201cVictor Babe\u0219\u201d University of Medicine and Pharmacy, Eftimie Murgu Square No. 2, 300041 Timisoara, Romania"},{"name":"Research Center of Dento-Alveolar Surgery, Anesthesia and Sedation in Dental Medicine, \u201cVictor Babe\u0219\u201d University of Medicine and Pharmacy, 300041 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marius Octavian","family":"Pricop","sequence":"additional","affiliation":[{"name":"Department of Oral and Maxillofacial Surgery, \u201cVictor Babe\u0219\u201d University of Medicine and Pharmacy, 300041 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raluca Mioara","family":"Cosoroab\u0103","sequence":"additional","affiliation":[{"name":"Faculty of Dental Medicine, \u201cVictor Babe\u0219\u201d University of Medicine and Pharmacy, Revolutiei Ave. 1989, No. 9, 300580 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5626-1064","authenticated-orcid":false,"given":"Mircea","family":"Rivi\u0219","sequence":"additional","affiliation":[{"name":"University Clinic of Anesthesiology and Oral Surgery, \u201cVictor Babe\u0219\u201d University of Medicine and Pharmacy, Eftimie Murgu Square No. 2, 300041 Timisoara, Romania"},{"name":"Research Center of Dento-Alveolar Surgery, Anesthesia and Sedation in Dental Medicine, \u201cVictor Babe\u0219\u201d University of Medicine and Pharmacy, 300041 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hora\u021biu Cristian","family":"M\u00e2nea","sequence":"additional","affiliation":[{"name":"Department I\u2014Nursing, Faculty of Nursing, University Clinic of Clinical Skills, \u201cVictor Babes\u201d University of Medicine and Pharmacy, Eftimie Murgu Square No. 2, 300041 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrei","family":"Ur\u00eetu","sequence":"additional","affiliation":[{"name":"Doctoral School, \u201cVictor Babe\u0219\u201d University of Medicine and Pharmacy, Eftimie Murgu Square No. 2, 300041 Timisoara, Romania"},{"name":"University Clinic of Anesthesiology and Oral Surgery, \u201cVictor Babe\u0219\u201d University of Medicine and Pharmacy, Eftimie Murgu Square No. 2, 300041 Timisoara, Romania"},{"name":"Research Center of Dento-Alveolar Surgery, Anesthesia and Sedation in Dental Medicine, \u201cVictor Babe\u0219\u201d University of Medicine and Pharmacy, 300041 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4790-4560","authenticated-orcid":false,"given":"Alexandra","family":"Roi","sequence":"additional","affiliation":[{"name":"University Clinic of Oral Pathology, Multidisciplinary Center for Research, Evaluation, Diagnosis and Therapies in Oral Medicine, \u201cVictor Babes\u201d University of Medicine and Pharmacy, Eftimie Murgu Square No. 2, 300041 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3214-9278","authenticated-orcid":false,"given":"Ciprian I.","family":"Roi","sequence":"additional","affiliation":[{"name":"University Clinic of Anesthesiology and Oral Surgery, \u201cVictor Babe\u0219\u201d University of Medicine and Pharmacy, Eftimie Murgu Square No. 2, 300041 Timisoara, Romania"},{"name":"Research Center of Dento-Alveolar Surgery, Anesthesia and Sedation in Dental Medicine, \u201cVictor Babe\u0219\u201d University of Medicine and Pharmacy, 300041 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1094-3729","authenticated-orcid":false,"given":"Tudor Rare\u0219","family":"Olariu","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Center for Diagnosis and Study of Parasitic Diseases, \u201cVictor Babe\u0219\u201d University of Medicine and Pharmacy, 300041 Timisoara, Romania"},{"name":"Discipline of Parasitology, Department of Infectious Diseases, \u201cVictor Babe\u0219\u201d University of Medicine and Pharmacy, 300041 Timisoara, Romania"},{"name":"Clinical Laboratory, Municipal Clinical Emergency Hospital, 300254 Timisoara, Romania"},{"name":"Patogen Preven\u021bia, 300124 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,6,10]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1002","DOI":"10.1097\/SCS.0000000000007054","article-title":"Does the lockdown influence the oral and maxillofacial surgery service in a Level 1 trauma hospital during the COVID-19 pandemic?","volume":"32","author":"Figueiredo","year":"2021","journal-title":"J. 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