Advances in Oral and Maxillofacial Surgery最新文献

{"title":"Protecting the fibular free flap during break in surgery: a technique","authors":"Daniel Dilworth ,&nbsp;John Hanratty","doi":"10.1016/j.adoms.2025.100565","DOIUrl":"10.1016/j.adoms.2025.100565","url":null,"abstract":"<div><div>The use of fibular free flaps has become widespread in the reconstruction of large bony defects in the trauma and head and neck cancer patient with a high success rate. These surgeries can take a prolonged period of time, and oftentimes a break in surgery may be necessary, at which point the free flap may be vulnerable to iatrogenic damage. In this short communication, we describe a technique we regularly use at such an interval to protect the fibular free flap following soft tissue dissection and osteotomy but prior to its ligation and transfer up to the head for anastomosis, with the aim of minimising the risk of undue force being applied to the flap or any kinking or occluding of the pedicle.</div></div>","PeriodicalId":100051,"journal":{"name":"Advances in Oral and Maxillofacial Surgery","volume":"19 ","pages":"Article 100565"},"PeriodicalIF":0.0,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144633203","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Minimally invasive aesthetic management of gingival pigmentation with Er:YAG laser","authors":"Sarfi Dounia,&nbsp;Haitami Sofia,&nbsp;Ihssane Ben Yahya","doi":"10.1016/j.adoms.2025.100561","DOIUrl":"10.1016/j.adoms.2025.100561","url":null,"abstract":"<div><div>Gingival melanin pigmentation is a frequent aesthetic concern, resulting from increased melanin production by melanocytes located in the basal and suprabasal layers of the oral epithelium. Its etiology ranges from physiological pigmentation to systemic pathologies. Gingival depigmentation aims to improve smile aesthetics using various surgical techniques, among which the Er:YAG laser is recognized for its precision and minimal thermal damage.</div><div>We report the case of a 34-year-old female patient with diffuse melanin hyperpigmentation in the anterior maxillary gingiva, treated with an Er:YAG laser. The procedure led to effective pigment removal, favorable wound healing, and high patient satisfaction. Clinical follow-up showed minimal postoperative discomfort, complete re-epithelialization within two weeks, and no gingival recession. However, slight residual pigmentation was noted.</div><div>This case highlights the effectiveness of the Er:YAG laser in gingival depigmentation, offering advantages in terms of patient comfort, healing quality, and aesthetic outcomes. Nevertheless, limitations include suboptimal hemostasis and a relatively high risk of repigmentation.</div></div>","PeriodicalId":100051,"journal":{"name":"Advances in Oral and Maxillofacial Surgery","volume":"19 ","pages":"Article 100561"},"PeriodicalIF":0.0,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144757323","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Microsurgical free flap reconstruction performed by head and neck surgeons: a retrospective cohort study of 125 patients of a single institution","authors":"Paola Solis-Pazmino ,&nbsp;Luiz Osowski ,&nbsp;Bruno Zittlau ,&nbsp;Juliane Bucco Gomes ,&nbsp;Rafaela Andrade ,&nbsp;Daniel Solis- Pazmino ,&nbsp;Virgilio Gonzales Zanella","doi":"10.1016/j.adoms.2025.100564","DOIUrl":"10.1016/j.adoms.2025.100564","url":null,"abstract":"<div><h3>Background</h3><div>Microsurgical Free Flap Reconstruction (MFFR) is a keystone in head and neck surgery because it offers better functional outcomes, less donor site morbidity, improved esthetics, and higher success rates.</div></div><div><h3>Objective</h3><div>To provide a comprehensive overview of our experience with MFFR, exploring its indications, procedural details, outcomes, and emerging trends in postoperative care.</div></div><div><h3>Methods</h3><div>A retrospective cohort study was conducted on 125 patients who underwent MFFR between June 2016 and July 2024 at the Hospital Santa Casa de Misericordia, Porto Alegre, Brazil. Patient demographics, tumor characteristics, flap type, surgical details, and postoperative outcomes were analyzed, including flap survival and the need for intensive care unit (ICU) admission.</div></div><div><h3>Results</h3><div>125 patients (57.6 % male; mean age: 59 (SD 15.9)) were included. The most common tumor location was the oral cavity. The predominant diagnosis was head and neck squamous cell carcinoma (60.8 %), and the most commonly used free flap was the anterolateral thigh (ALT) flap (37.6 %). The overall flap success rate was 93.7 %, while the incidence of flap failure was 6.4 %. The main causes of flap failure were arterial thrombosis (37.5 %) and venous thrombosis (25 %). Notably, 72.2 % of patients did not require ICU admission postoperatively, with no significant difference in outcomes between patients managed in the ICU and those managed in non-ICU settings.</div></div><div><h3>Conclusion</h3><div>MFFR is a reliable technique when performed by an experienced head and neck team, achieving high success rates even when performed in non-ICU settings. Carefully selected patients can be safely managed outside the ICU, presenting a cost-effective model of care in resource-limited environments. Further studies are warranted to refine patient selection criteria and postoperative monitoring protocols.</div></div>","PeriodicalId":100051,"journal":{"name":"Advances in Oral and Maxillofacial Surgery","volume":"19 ","pages":"Article 100564"},"PeriodicalIF":0.0,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144656547","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Oral mucosal papilloma: A typical clinical case","authors":"Dounia Sarfi ,&nbsp;Ihssane BenYahya","doi":"10.1016/j.adoms.2025.100560","DOIUrl":"10.1016/j.adoms.2025.100560","url":null,"abstract":"<div><div>Oral papilloma is a benign lesion of viral origin, mainly associated with infection by human papillomavirus (HPV) types 6 and 11. Clinically, it presents as a pedunculated or sessile growth, often asymptomatic, with a papillomatous surface. This article reports a clinical case of a 31-year-old patient with no particular medical history, presenting with a verrucous lesion localized to the anterior lingual region. Surgical excision allowed for histopathological diagnosis confirming a benign oral papilloma, without signs of dysplasia or malignancy. The discussion addresses differential diagnosis with other papillomatous lesions, notably condyloma acuminatum and focal epithelial hyperplasia, and emphasizes the importance of histology in the final diagnosis. Post-operative follow-up was favorable, with no recurrence to date. This case illustrates the importance of a rigorous diagnostic approach when faced with an oral exophytic lesion, even in the absence of symptoms or risk factors.</div></div>","PeriodicalId":100051,"journal":{"name":"Advances in Oral and Maxillofacial Surgery","volume":"19 ","pages":"Article 100560"},"PeriodicalIF":0.0,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144724772","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Post-traumatic radicular cyst involving multiple anterior Teeth: Open apex management and surgical enucleation – A case report","authors":"B. Doumari,&nbsp;S. Dhoum,&nbsp;Z. EL Hajjioui,&nbsp;M. Jabri","doi":"10.1016/j.adoms.2025.100558","DOIUrl":"10.1016/j.adoms.2025.100558","url":null,"abstract":"<div><div>Radicular cysts are the most common inflammatory odontogenic cysts, typically arising from chronic periapical infection following pulp necrosis. Post-traumatic radicular cysts involving immature teeth with open apices are uncommon and present unique clinical challenges due to incomplete root formation. This case report describes the management of a large post-traumatic radicular cyst affecting multiple maxillary anterior teeth (teeth 11, 12, and 13) in a 27-year-old patient, discovered incidentally during routine radiographic examination.</div><div>Clinical examination revealed pulp necrosis and an open apex on tooth 11, with teeth 12 and 13 also non-vital. Radiographs and CBCT confirmed a well-demarcated radiolucent lesion with buccopalatal expansion and cortical bone resorption, consistent with a radicular cyst. Treatment included conventional root canal therapy for teeth 12 and 13, and apexification with Biodentine for tooth 11. Surgical enucleation of the cyst was performed via a full-thickness mucoperiosteal flap, achieving complete removal of the lesion.</div><div>Biodentine, a bioactive calcium silicate-based material, was used to create an apical plug, promoting hard tissue formation and providing a reliable apical barrier, thus facilitating root canal obturation in the immature tooth. Histopathology confirmed an inflammatory radicular cyst. At 13-month follow-up, the patient was asymptomatic, with radiographic evidence of significant bone regeneration, although a residual bony defect remained. Long-term follow-up was recommended to monitor complete healing and prevent recurrence.</div><div>This case highlights the importance of early diagnosis and a multidisciplinary approach combining modern endodontic materials and surgical intervention in managing post-traumatic radicular cysts involving open apex teeth, ultimately preserving tooth structure and function.</div></div>","PeriodicalId":100051,"journal":{"name":"Advances in Oral and Maxillofacial Surgery","volume":"19 ","pages":"Article 100558"},"PeriodicalIF":0.0,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144518870","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A single centre service evaluation of 53 MRONJ cases","authors":"Millicent Forrest ,&nbsp;Sanford Grossman ,&nbsp;Noha Seoudi ,&nbsp;Edmund Bailey ,&nbsp;Rishi Bhandari ,&nbsp;Leo Cheng ,&nbsp;Judith Jones ,&nbsp;Zoe Killick ,&nbsp;Mohammed Dungarwalla","doi":"10.1016/j.adoms.2025.100557","DOIUrl":"10.1016/j.adoms.2025.100557","url":null,"abstract":"<div><div>Medication-related osteonecrosis of the jaw (MRONJ) is a significant complication associated with antiresorptive or antiangiogenic medications, particularly bisphosphonates and denosumab, commonly used in the management of osteoporosis and metastatic bone disease.</div><div>This retrospective service evaluation assessed treatment modalities and outcomes of MRONJ patients treated at the Royal London Dental Hospital (RLDH) between 2018 and 2023. A cohort of 53 patients, primarily oncology patients, were analysed, with 60 % of MRONJ sites presenting in the posterior mandible. Tooth extractions were identified as a leading precipitating factor in MRONJ development, while poor oral hygiene exacerbated disease progression.</div><div>Management strategies included conservative and operative interventions, with surgical debridement yielding a 70.6 % success rate in healing. Antibiotic therapy was prescribed in 50 % of stage 1 patients despite a lack of infection, highlighting the need to audit such use given the lack of evidence outside infection in stages 2 and 3.</div><div>This evaluation highlights the importance of preventive dental care, patient-centred personalised treatment planning, and the role of surgical interventions in MRONJ management.</div></div>","PeriodicalId":100051,"journal":{"name":"Advances in Oral and Maxillofacial Surgery","volume":"19 ","pages":"Article 100557"},"PeriodicalIF":0.0,"publicationDate":"2025-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144632736","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The study on the construction of injectable tissue-engineered bone based on the injectable PRF combined with osteoblastic bone marrow mesenchymal stem cell sheets","authors":"L. Han ,&nbsp;X. Wu ,&nbsp;Q. Ouyang ,&nbsp;J. Hu ,&nbsp;S. Sun ,&nbsp;X. Li ,&nbsp;Z. Wang","doi":"10.1016/j.adoms.2025.100559","DOIUrl":"10.1016/j.adoms.2025.100559","url":null,"abstract":"<div><div>Injectable platelet-rich fibrin (i-PRF) has been proven to be able to promote tissue regeneration and applied in the treatment of diseases in the maxillofacial region, but whether it can be used to construct injectable tissue-engineered bone remains inconclusive. The aim of this study was to investigate whether i-PRF combined with osteoblastic bone marrow mesenchymal stem cell (BMSC) sheets can be used to construct injectable tissue-engineered bone. First, i-PRF prepared from fresh blood after a short-time and low-speed centrifugation. BMSCs, after continuous osteogenic induction for 2 weeks, formed membrane-like structures containing calcium nodules. They were mixed and then transplanted subcutaneously in nude mice by injection. the osteogenesis was evaluated through Micro-CT scanning and histological analysis after 8 weeks of transplantation. The group with BMSC sheets alone formed osteoid tissue, but the volume of new bone- and cartilage-like tissue was smaller, more sparse, and unevenly distributed. In contrast, the group with i-PRF and BMSC sheets had larger volumes of new tissue, higher bone density, more mineralized deposits, and more woven bone structures. In summary, osteoblastic BMSC sheets have the potential for ectopic osteogenesis, but i-PRF can significantly enhance their osteogenic capacity. Therefore, i-PRF combined with osteoblastic BMSC sheets can be regarded as a promising method for constructing injectable tissue-engineered bone.</div></div>","PeriodicalId":100051,"journal":{"name":"Advances in Oral and Maxillofacial Surgery","volume":"19 ","pages":"Article 100559"},"PeriodicalIF":0.0,"publicationDate":"2025-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144470958","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Modified simplified preservation quick rhinoplasty: A new proposal in rhinoplasty for Latin American Mestizo patients","authors":"Paolo Verona ,&nbsp;Valerio Finocchi ,&nbsp;Janneth Zúñiga ,&nbsp;Natalia Cardona ,&nbsp;Nicolas Solano ,&nbsp;Jesús García","doi":"10.1016/j.adoms.2025.100555","DOIUrl":"10.1016/j.adoms.2025.100555","url":null,"abstract":"<div><h3>Background</h3><div>Considering that specific anatomical features are frequently identified in Latin American Mestizo patients, it may be essential to modify existing procedures and design a rhinoplasty technique that can adjust to the anatomical needs of this population.</div></div><div><h3>Objectives</h3><div>This study aimed to propose a new modified technique in dorsal surface preservation rhinoplasty for patients with nasal morphology characteristic of Latin American Mestizo patients.</div></div><div><h3>Methods</h3><div>Patients were prospectively studied between July 2022 and July 2024. Data on age, gender, type of approach, need for touch-ups, surgery in conjunction with orthognathic surgery, and follow-up were recorded.</div></div><div><h3>Results</h3><div>We obtained a complete correction of the nasal humps with aesthetic changes, as proposed in the new technique developed and presented to 42 patients. This allowed a continuous and natural dorsum with a greater lateral definition of the dorsum, the definition of aesthetic lines, the shadow of the nasal pyramid breakage, and no evidence of bony steps of the central osteotomy.</div></div><div><h3>Conclusions</h3><div>The Modified Simplified Preservation Quick Rhinoplasty technique for Latin American Mestizo patients meets aesthetic and personalized standards without modifying the functionality and quality of life of patients. This technique enhances the morphologic qualities of the nasal anatomic structures of the patients, designing and molding the cartilaginous tissue that can be obtained efficiently.</div></div>","PeriodicalId":100051,"journal":{"name":"Advances in Oral and Maxillofacial Surgery","volume":"19 ","pages":"Article 100555"},"PeriodicalIF":0.0,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144549250","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"To evaluate the efficacy of osseodensification on primary stability and final osseointegration of implants placed in D3 and D4 type of bone","authors":"Sunil Vasudev,&nbsp;Deepak S,&nbsp;Asjadi Sheikh","doi":"10.1016/j.adoms.2025.100554","DOIUrl":"10.1016/j.adoms.2025.100554","url":null,"abstract":"<div><h3>Aim</h3><div>To evaluate efficacy of osseodensification on primary stability and final osseointegration of implants placed in areas of compromised bone density.</div></div><div><h3>Material and methods</h3><div>Study population comprised 10 patients, having D3/D4 type of bone. A total of 24 implants were placed in mandible and maxilla. The evaluation was carried out periodically for 1 year, investigating the influence of osteotomy technique using densah bur on clinical and radiographic parameters namely assessment of implant stability using torque wrench and osstell device, measurement of bone gain, bone expansion, bone density, bone surface area and crestal bone loss.</div></div><div><h3>Results</h3><div>The statistical analysis of torque wrench values at T0′ was 37.50(3.54SD) and 51.00(3.16SD) at T6 with p-value&lt;0.001. The ISQ reading at T0′ was 62.8(3.4SD) and at T6 it was 65.8(5.4SD) p = 0.15,no significant difference seen. Considerable amount of bone gain post operatively noted (approx 26.8 %)p &lt; 0.001. Evaluation of bone expansion in terms of ridge width demonstrated increase post-op(p &lt; 0.001). Analysis of bone density in HU reveals significant increase at T6 p &lt; 0.001. Bone surface area data tabulated at different intervals suggest increase post-op and at T6 (p &lt; 0.05). The statistical data of crestal bone loss calculated periodically revealed 1.38 ± 0.41 at 12 months(p &lt; 0.05).</div></div><div><h3>Conclusion</h3><div>Osseodensification using the versatile densah bur is a paradigm shift in the osteotomy preparation.</div></div>","PeriodicalId":100051,"journal":{"name":"Advances in Oral and Maxillofacial Surgery","volume":"19 ","pages":"Article 100554"},"PeriodicalIF":0.0,"publicationDate":"2025-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144330987","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Unilateral primary intraosseous carcinoma arising from odontogenic cyst associated with an impacted maxillary third molar in a patient with multifocal jaw lesions: A rare case report","authors":"T.R. Marimallappa ,&nbsp;M. Vishma Sai ,&nbsp;K.V. Prabala","doi":"10.1016/j.adoms.2025.100556","DOIUrl":"10.1016/j.adoms.2025.100556","url":null,"abstract":"<div><div>Primary intraosseous carcinoma (PIOC) is a rare malignancy arising from odontogenic epithelial remnants within cysts. A 63-year-old male presented with ulceration on the right posterior maxillary palate. Imaging showed multiple intraosseous cystic lesions in both jaws; only the cyst linked to the impacted right maxillary third molar exhibited malignant transformation into invasive squamous cell carcinoma. Diagnosis was confirmed via biopsy, histopathology, and immunohistochemistry. The patient underwent right hemi-maxillectomy with prosthetic rehabilitation.</div></div>","PeriodicalId":100051,"journal":{"name":"Advances in Oral and Maxillofacial Surgery","volume":"19 ","pages":"Article 100556"},"PeriodicalIF":0.0,"publicationDate":"2025-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144563643","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}