Advances in Oral and Maxillofacial Surgery最新文献

{"title":"Rigid external distraction– down-fracture or not, can we modify the approach?","authors":"Fahad S. Al Qooz ,&nbsp;Mohammad S. Al Olaimat ,&nbsp;Dina N. Smeirat ,&nbsp;Luma A. Al Najada ,&nbsp;Zaid R. Alzoubi ,&nbsp;Saleh E. Al Aazmi ,&nbsp;Ali S. Al Murdif","doi":"10.1016/j.adoms.2025.100589","DOIUrl":"10.1016/j.adoms.2025.100589","url":null,"abstract":"<div><h3>Background</h3><div>Distraction osteogenesis (DO) has been proposed as treatment to many craniofacial syndromes including cleft lip and palate (CLP) complicated by skeletal discrepancies. Rigid external distraction (RED) in the recent years has been advocated to treat severe form of skeletal discrepancies that cannot be corrected with conventional orthognathic surgery.</div></div><div><h3>Purpose</h3><div>The purpose of this study was to compare new approaches and surgical outcomes in treating patients with cleft lip and palate who underwent rigid external distraction.</div></div><div><h3>Patients &amp; methods</h3><div>This study was conducted at the King Hussein Medical Center, Hashemite Kingdom of Jordan, from Jan 2024 to Jan 2025, and was approved by the Research &amp; Ethics Committee of the Institute. The inclusion criteria included patients who had a history of cleft lip and palate, were diagnosed with severe hypoplastic maxilla, had reverse overjet greater than 10 mm, and had a class III skeletal discrepancy. We used the RED II device fabricated by KLS Martin (Tuttlingen, Germany). Two groups were included in this study. Group 1 accommodated patients who underwent the conventional surgical procedure with placement of the RED device. Group 2 included patients who underwent a new surgical method with RED placement. The new method involved a Le Fort I osteotomy with an additional down fracture and fixation with a double-Y miniplate after the consolidation period, whereas the conventional method did not involve a downward fracture. All patients/guardians were given the options, complications, and drawbacks of each surgery. Verbal and written consent were obtained for surgical and research purposes.</div></div><div><h3>Results</h3><div>Five patients were involved in this study, two of whom underwent the conventional method, as they preferred the conventional method, and three agreed to undergo the new approach and, finally, placement of the RED device. Pain was evaluated with the visual analog scale (VAS). Esthetics and compliance were evaluated starting on postoperative Day 7. Females had a lower pain threshold, whereas male participants had a drastic drop in pain perception. Female patients had trouble tolerating the device esthetically, with gradual acceptance of its appearance.</div></div><div><h3>Conclusion</h3><div>Our study demonstrated better tolerance to the newer approach. Although the newer method involves an additional surgical stabilization procedure, which involves the application of two titanium mini plates 2.0 mm in length, one on each side at the anterior aspect of the maxilla upon removal of the device, this new method has shown acceptance and tolerance by patients and should be further tested to aid in patient outcomes. This method has shown better pain tolerance, less time of activation, and a permanent period of the consolidation phase.</div></div>","PeriodicalId":100051,"journal":{"name":"Advances in Oral and Maxillofacial Surgery","volume":"20 ","pages":"Article 100589"},"PeriodicalIF":0.0,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145222060","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 use of condylar prostheses in head and neck reconstruction","authors":"Jeffrey Abdullah,&nbsp;Pradyumna Naredla,&nbsp;Matthew Idle,&nbsp;Prav Praveen,&nbsp;Tim Martin,&nbsp;Sat Parmar","doi":"10.1016/j.adoms.2025.100588","DOIUrl":"10.1016/j.adoms.2025.100588","url":null,"abstract":"<div><div>The replacement and reconstruction of the mandibular condyle following mandibular resection can be achieved with condylar replacement surgery. The aim of this study was to evaluate the clinical outcome of head and neck patients who underwent placement of condylar prostheses as part of their mandibular reconstructive surgery. We retrospectively reviewed 34 head and neck patients who had placement of condylar prostheses between January 01, 2009 to March 01, 2024. The measured outcomes included: patients’ occlusion, facial nerve function and data regarding return to theatres for further surgeries. We identified a total of 35 condylar replacement cases as part of mandibular reconstruction. 18 cases (51.4 %) were for malignant pathology, 17 (48.6 %) were for benign pathology.11 patients (32.4 %) received preoperative radiotherapy. 15 patients (44.1 %) underwent postoperative radiotherapy. 5 cases (14.3 %) required return to theatre post-surgery for partial removal of platework including the condylar component. Satisfactory occlusion was achieved in 25 cases (71.4 %). There were 7 patients with long term (20.6 %) unilateral facial paralysis. 4 patients (11.8 %) developed facial paralysis immediately postoperatively, and 3 patients (8.8 %) had delayed onsets. In 1 patient, the condylar prosthesis eroded through the glenoid fossa but remains asymptomatic. Consideration should be made into investigating a larger patient series, particularly comparing patients who had a condylar prosthesis and those that did not.</div></div>","PeriodicalId":100051,"journal":{"name":"Advances in Oral and Maxillofacial Surgery","volume":"20 ","pages":"Article 100588"},"PeriodicalIF":0.0,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145222740","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":"Odontogenic infections: C-reactive protein as a predictor of infection severity and inpatient trajectory","authors":"Mohamed Naqeeb ,&nbsp;Kai Lee ,&nbsp;Sipho Simon Nhongo","doi":"10.1016/j.adoms.2025.100581","DOIUrl":"10.1016/j.adoms.2025.100581","url":null,"abstract":"<div><h3>Objectives</h3><div>To determine the utility of serum C-reactive protein concentration prior to treatment as a predictor of total length of hospital stay (LOS), intensive care unit (ICU) admission, and return to theatre (RTT) for inpatients with severe odontogenic infections (such as deep neck space involvement or systemic compromise).</div></div><div><h3>Study design</h3><div>This retrospective study analysed 206 patients admitted for surgical drainage under general anaesthesia at the Western Health Oral and Maxillofacial unit between 2012 and 2020. Data collected included patient demographics, CRP on admission, clinical features and outcomes (ICU admission, LOS and RTT).</div></div><div><h3>Results</h3><div>Elevated CRP levels (≥150 mg/L) were significantly associated with increased hospital LOS (β: 2.831 days), higher ICU admission rates (OR: 5.504), and a greater likelihood of re-drainage (OR: 13.53). The study developed a new predictive model for LOS based on CRP measurement on admission: LOS = 0.023 x CRP +1.77.</div></div><div><h3>Conclusion</h3><div>Elevated CRP levels indicate higher risks of prolonged LOS, increased need for RTT and higher rates of ICU admissions. These findings can support the use of CRP in predictive modelling for patient trajectory, resource allocation and emergency patient management.</div></div>","PeriodicalId":100051,"journal":{"name":"Advances in Oral and Maxillofacial Surgery","volume":"20 ","pages":"Article 100581"},"PeriodicalIF":0.0,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145121158","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":"Maxilla augmentation with calvarial bone: immediate or delayed dental implant placement?","authors":"F. Konik ,&nbsp;G.M. Raghoebar ,&nbsp;T.F. Putters ,&nbsp;A. Vissink ,&nbsp;K. Delli ,&nbsp;J. Schortinghuis","doi":"10.1016/j.adoms.2025.100584","DOIUrl":"10.1016/j.adoms.2025.100584","url":null,"abstract":"<div><h3>Introduction</h3><div>In the severely atrophic maxilla, an augmentation is required to allow placement of dental implants to support the denture. Since 2010 calvarial bone blocks were used to augment the maxilla. Dental implants are placed after 4 months healing time, or immediate at the time of augmentation. A retrospective study was done to measure peri-implant bone loss, implant loss and influencing factors.</div></div><div><h3>Methods</h3><div>A retrospective cohort study was set up including patients that were treated from 2010 to 2020. Patient factors (age, sex, smoking, medication use), surgery factors (delayed or immediate implantation, location of implant) and radiological follow-up (peri implant bone loss, implant loss) were scored. A GEE (Generalized Estimated Equations) statistical analysis was performed to find factors influencing outcome.</div></div><div><h3>Results</h3><div>A total of 111 patients (47 male; 64 female) received 508 implants. Follow-up was 4.6 ± 2.3 years. Mean peri-implant bone loss in 26 patients with a delayed approach was 0,34 ± 0,73 mm and in 85 patients with combined augmentation and immediate implantation 0,57 ± 0,88 mm (p &lt; 0,001). Implant success was 99 % in the delayed group, and 92 % in the immediate group. Age, smoking, status of mandible (edentate/(partially) dentate) and implant location did not influence peri-implant bone loss.</div></div><div><h3>Conclusion</h3><div>When a severely athrophic maxilla is augmented with calvarial bone, immediate implant placement seems a viable option with low long-term peri-implant bone loss, and the advantage to reduce total treatment time and the need for an extra surgical procedure.</div></div>","PeriodicalId":100051,"journal":{"name":"Advances in Oral and Maxillofacial Surgery","volume":"20 ","pages":"Article 100584"},"PeriodicalIF":0.0,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145097814","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":"Proposal of additional layer in therapy for a Microcystic Adnexal Carcinoma: Report of a Case","authors":"Gilberto Antonio Aguayo-Rivera","doi":"10.1016/j.adoms.2025.100580","DOIUrl":"10.1016/j.adoms.2025.100580","url":null,"abstract":"<div><div>Microcystic adnexal carcinoma (MAC) is a very rare, low grade, malignant adnexal tumor with less than 700 cases reported worldwide that typically occurs on the head and neck, particularly the central face. Mohs micrographic surgery (MMS) was employed successfully in this case, with an additional layer after complete clearance of margins with no recurrence at 5 five year of follow-up. Therefore, the additional layer in MMS promising a long term no recurrence option.</div></div>","PeriodicalId":100051,"journal":{"name":"Advances in Oral and Maxillofacial Surgery","volume":"20 ","pages":"Article 100580"},"PeriodicalIF":0.0,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145097815","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":"Reverse-planned patient specific implant with soft tissue flap for maxillary reconstruction and immediate full-arch dental rehabilitation","authors":"Jai Parkash Ramchandani ,&nbsp;Mohammed Al-Gholmy ,&nbsp;Robert Isaac ,&nbsp;Shihab Romeed ,&nbsp;Tom Henderson ,&nbsp;Alexander Goodson","doi":"10.1016/j.adoms.2025.100579","DOIUrl":"10.1016/j.adoms.2025.100579","url":null,"abstract":"","PeriodicalId":100051,"journal":{"name":"Advances in Oral and Maxillofacial Surgery","volume":"20 ","pages":"Article 100579"},"PeriodicalIF":0.0,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145221576","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":"Palatine mucosa transplantation in eyelid reconstruction: A report of 3 cases at the bouaké university hospital (Ivory coast)","authors":"Zegbeh - N'guessan Eric Kouassi,&nbsp;Djemi Ernest Martial,&nbsp;Berete Pornan Issa Jules,&nbsp;Amenou Affoue Ba Diane,&nbsp;Dally Yassi Grace,&nbsp;Ory Opokou Alexandre De Misere","doi":"10.1016/j.adoms.2025.100586","DOIUrl":"10.1016/j.adoms.2025.100586","url":null,"abstract":"<div><h3>Introduction</h3><div>Palatal fibromucosal grafting is a technique used to reconstruct loss of conjunctival tarsal substance in the eyelid. It is the treatment of choice for the reconstruction of all or part of the posterior lamella of the lower eyelid. It is indicated as a second-line treatment for the upper eyelid, as the complication rate appears to be higher in this area. Observation: Three cases of eyelid reconstruction surgery using palatal mucosa grafting for similar indications are reported retrospectively. Discussion: The palatal mucosa was easy to harvest and was well tolerated by the underlying eyeball. The problem seemed to lie in determining the ideal size of the graft to be harvested. In a local environment with limited resources, palatal mucosa grafting is an inexpensive and relatively simple solution for conjunctival tarsal reconstruction.</div></div>","PeriodicalId":100051,"journal":{"name":"Advances in Oral and Maxillofacial Surgery","volume":"20 ","pages":"Article 100586"},"PeriodicalIF":0.0,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145222061","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":"Surgical and prosthodontic considerations and recommendations for individual patient solutions (IPS) pre-prosthetic Implants®, a case series","authors":"Carson Van Etta,&nbsp;Joshua Rockwood,&nbsp;Connor Witty","doi":"10.1016/j.adoms.2025.100582","DOIUrl":"10.1016/j.adoms.2025.100582","url":null,"abstract":"<div><div>Custom subperiosteal implants using the KLS IPS Pre-Prosthetic system offer a promising solution for the prosthetic rehabilitation of the severely atrophic maxilla and mandible. This paper presents clinical case examples illustrating key surgical and prosthodontic principles that are essential for successful use of the IPS system. The digital workflow--including virtual surgical planning--provides significant advantages over conventional subperiosteal implants, such as improved accuracy, reduced intraoperative challenges, and fewer early complications. Practical clinical and technical tips are discussed to aid in decision-making regarding implant design, soft tissue management, and prosthetic planning. While long-term data remain limited due to the recent adoption of this technology, these cases highlight its potential as a valuable and predictable treatment option in complex cases of significant alveolar ridge deficiency.</div></div>","PeriodicalId":100051,"journal":{"name":"Advances in Oral and Maxillofacial Surgery","volume":"20 ","pages":"Article 100582"},"PeriodicalIF":0.0,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145222058","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":"Effect of Locally injected PRP on RANKL and OPG in gingival fluid during orthodontic tooth movement: A Canine Model Study","authors":"Aida Jafari ,&nbsp;Shirin Zahra Farhad ,&nbsp;Nasim Esnaashari ,&nbsp;Sepehr Kobravi ,&nbsp;Hossein Jafari","doi":"10.1016/j.adoms.2025.100583","DOIUrl":"10.1016/j.adoms.2025.100583","url":null,"abstract":"<div><h3>Aims</h3><div>Blood platelet-rich plasma (PRP) contains a variety of biologically active components, including growth factors. The objective of this study was to examine the effects of topical PRP injection on osteoprotegerin (OPG) and receptor activator of nuclear factor kappa-B ligand (RANKL) mediator levels in the gingival groove fluid of dogs with orthodontic treatment.</div></div><div><h3>Methods</h3><div>In this study, six adult male dogs, 10–12 months of age, were included. Every dog was randomly assigned to either an experimental or a control group by injecting thrombin-CaCl2 and PRP into one side (experimental group) and thrombin-CaCl2 and a placebo into the opposite side (control group). During the experiment, a maxillary quadrant on one side was assigned as the experimental group and the opposing side as the control group. Maxillary first premolars were bilaterally extracted, followed by the placement of a titanium nickel spring (200 g) between the second premolar and the canine. A mixture of PRP and CaCl2-thrombin was administered to the experimental group on days 1, 21, and 42, whereas the control group received CaCl2-thrombin mixed with a placebo. Samples of gingival groove fluid were collected regularly during the study (on days 0, 1, 2, 7, 21, 42, and 63). A RANKL and OPG enzyme-linked immunosorbent assay was performed to measure the levels of the mediators.</div></div><div><h3>Results</h3><div>The experimental group exhibited consistently higher OPG levels (p &lt; 0.001), indicating that the topical injection of PRP had a notable effect on OPG levels and the associated regulatory mechanisms involved in bone remodeling. The RANKL mediator levels in the gingival fluid of orthodontic-treated teeth were increased over time in the experimental group, while the control group did not show any significant changes over time.</div></div><div><h3>Conclusion</h3><div>The topical injection of PRP demonstrated a significant influence on OPG and RANKL mediator levels, reaffirming its potential as a therapeutic approach for optimizing bone remodeling and enhancing treatment outcomes.</div></div>","PeriodicalId":100051,"journal":{"name":"Advances in Oral and Maxillofacial Surgery","volume":"20 ","pages":"Article 100583"},"PeriodicalIF":0.0,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145222059","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":"Retrospective analysis of surgical treatment of frontobasal fractures with the new bernese skull base fracture score","authors":"Christian Schedeit ,&nbsp;Ioanna Kalaitsidou ,&nbsp;Nathalie Schedeit ,&nbsp;Bradley Aebi ,&nbsp;Kotaro Sato ,&nbsp;Benoît Schaller","doi":"10.1016/j.adoms.2025.100569","DOIUrl":"10.1016/j.adoms.2025.100569","url":null,"abstract":"<div><div>The aim of this study is to evaluate the success rate and effectiveness of the subcranial approach for anterior skull base fractures in comparison to findings reported in the literature. Furthermore, a clinical recommendation for this approach will be made using the new Bernese skull base score. A total of 185 adult patients with severe comminuted fractures or cerebrospinal fluid (CSF) leaks underwent open anterior skull base surgery after trauma between 2002 and 2018 in our department. We retrospectively analyzed all of these patients by evaluating preoperative symptoms, fracture types, complication rates, and long-term outcomes. The evaluation of the results of the operations is based on the cohort of 149 patients. None of the patients with a 6-month follow-up who underwent surgery using the subcranial approach developed meningitis. Of the 9 patients (6 %) who required secondary surgery at the skull base, only 1 patient (0.7 %) required repair of a CSF leak. The most common long-term complication associated with secondary skull base surgery was mucocele formation (n = 6, 4 %). Fifteen patients developed enophthalmos (8.1 %) and eleven experienced diplopia (5.9 %). In conclusion, the subcranial approach is a safe surgical technique with a low incidence of long-term complications in comminuted fractures of the anterior skull base which is indicated for the rare severer cases.</div></div>","PeriodicalId":100051,"journal":{"name":"Advances in Oral and Maxillofacial Surgery","volume":"19 ","pages":"Article 100569"},"PeriodicalIF":0.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144922362","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}