Head & Face Medicine最新文献

{"title":"Systematic gene expression analysis of putative target genes linked to miR-31 in 83 oral squamous cell carcinoma samples.","authors":"Carolin Feldges, Susanne Jung, Nikolai Purcz, Christoph Sproll, Johannes Kleinheinz, Sonja Sielker","doi":"10.1186/s13005-024-00443-z","DOIUrl":"10.1186/s13005-024-00443-z","url":null,"abstract":"<p><strong>Background: </strong>The development of oral squamous cell carcinoma on the molecular level and the resulting prognosis for patients have remained poorly understood. While AngiomiR-31 was implicated in the progression and metastasis of OSCC. However, this connection has not yet been investigated in more detail and tested for its significance with regard to new therapies and the prognosis of patients.</p><p><strong>Methods: </strong>Through a systemic analysis of putative target genes of AngiomiR-31 in OSCC, this study aimed to highlight possible prognostic markers and genes that might improve prognostic predictability in patients with oral squamous cell carcinoma, especially regarding AngiomiR-31 as an outstanding mediator of angiogenesis. The study is based on gene data from 83 OSCC samples. Potentially relevant genes were selected and sorted by TNM, grading and UICC in these 83 OSCC whole-genome microarray datasets. Data was analysed and tested for significance.</p><p><strong>Results: </strong>Through our investigation 20 potential target genes, including tumor suppressor genes, oncogenes and genes not yet categorized, were found and their expression correlated significantly with the expression of AngiomiR-31.</p><p><strong>Conclusion: </strong>These findings contribute to a more profound understanding of the molecular mechanisms underlying OSCC progression and may have implications for the development of novel therapeutic strategies targeting AngiomiR-31 in OSCC. Further validation of these genes is needed to validate their clinical relevance and potential as prognostic markers or therapeutic targets in OSCC.</p>","PeriodicalId":12994,"journal":{"name":"Head & Face Medicine","volume":"21 1","pages":"10"},"PeriodicalIF":2.4,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11853977/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143491792","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Influence of orthodontic archwire (nickel-titanium versus copper-nickel-titanium) on pain in adult patients in the aligning phase of treatment with self-ligating brackets (two months of follow-up): a prospective observational pilot study.","authors":"Raquel Marzal, Alberto Albaladejo, Daniel Curto, Adrián Curto","doi":"10.1186/s13005-025-00483-z","DOIUrl":"10.1186/s13005-025-00483-z","url":null,"abstract":"<p><strong>Background: </strong>The aim of this pilot study was to analyze the influence of a nickel-titanium archwire (NiTi) and a copper-nickel-titanium archwire (Cu-NiTi) on pain levels in adult patients during the first two months of orthodontic treatment with self-ligating brackets.</p><p><strong>Methods: </strong>This prospective observational pilot study was carried out at the Dental Clinic of the University of Salamanca between 2023 and 2024. This study analyzed 30 adult orthodontic patients who began treatment with self-ligating brackets. The participants were distributed into two study groups (n = 15) for treatment with initial NiTi and Cu-NiTi archwires. At the beginning, a 0.014-inch archwire was used, and a 0.016-inch archwire was used after a month. The level of pain was measured using a visual analog scale (VAS) at the beginning of treatment (T0), at one month (T1), and at two months (T2). At each time point (T0, T1, and T2), pain was measured at baseline and at 4, 24, and 48 h after archwire placement or replacement. The data were analyzed using Spearman's correlation coefficient and the Mann-Whitney test (p < 0.05).</p><p><strong>Results: </strong>The mean age of the participants (n = 30) was 31.34 (± 6.05) years. The maximum pain peak was in the first 48 h after placing the initial archwire (5.57 ± 1.72). The age and sex of the participants did not influence the pain levels in the sample studied. The composition of the orthodontic archwire only influenced the pain levels at the beginning of treatment (T0) (p < 0.05); in this case, the NiTi group (1.73 ± 1.53) described a higher level of pain than that of the Cu-NiTi group (1.07 ± 1.36); in the rest of the follow-up period, no significant differences were observed.</p><p><strong>Conclusions: </strong>Within the limitations of this study, we observed that the orthodontic archwire material (nickel-titanium versus copper-nickel-titanium) only influenced pain levels at the beginning of orthodontic treatment.</p>","PeriodicalId":12994,"journal":{"name":"Head & Face Medicine","volume":"21 1","pages":"9"},"PeriodicalIF":2.4,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11853181/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143491791","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of the usefulness of platelet-rich fibrin (PRF) in mandibular third molar surgery with 3D facial swelling analysis: a split-mouth randomized clinical trial.","authors":"Selene Barone, Francesco Bennardo, Marianna Salviati, Alessandro Antonelli, Amerigo Giudice","doi":"10.1186/s13005-025-00482-0","DOIUrl":"10.1186/s13005-025-00482-0","url":null,"abstract":"<p><strong>Background: </strong>Third molar surgery is associated with various postoperative complications (PC). Different strategies, including the application of platelet-rich fibrin (PRF), have been implemented to reduce PC. Digital technologies have proven useful in objectively assessing postoperative facial swelling. This study aimed to evaluate the effect of PRF on reducing facial swelling after lower third molar surgery using a 3D face scanner.</p><p><strong>Methods: </strong>A randomized split-mouth clinical trial was set up and 32 patients (18 to 32 years), requiring extraction of both mandibular third molars, were recruited at the Oral Surgery Clinic of the Magna Graecia University of Catanzaro. The primary predictive variable was the application or not of PRF plugs and membranes in the post-extraction socket. Primary outcome variable was facial swelling recorded with a face scanner preoperatively (T0), after three (T1) and seven (T2) days. Qualitative and quantitative data analysis were conducted following an automated and standardized imaging analysis workflow using the 3D Slicer software. Secondary outcome variables were trismus, recorded by measuring the maximum buccal opening with a caliper, pain, recorded using a visual analogue scale (VAS), and duration of the surgery. Descriptive and bivariate analysis were performed by setting the significance level [Formula: see text] = 0.05.</p><p><strong>Results: </strong>All patients exhibited a significant increase in facial swelling at T1, followed by a subsequent reduction from day 3 to day 7, with a slight persistence of edema observed on the seventh day. No significant data emerged from the statistical analysis conducted. Linear differences in PRF group reported improved values of postoperative swelling only in the T1-T2 and T0-T2 phases of analysis. Volumetric differences favored PRF group compared with control group in all phases. VAS was lower in PRF group only at T2, compared with control group.</p><p><strong>Conclusions: </strong>Application of PRF in post-extraction sockets showed effectiveness in reducing facial swelling. Its advantages, including accessibility, cost-effectiveness, and absence of adverse reactions, make it an optimal treatment choice in reducing post-surgical sequelae.</p>","PeriodicalId":12994,"journal":{"name":"Head & Face Medicine","volume":"21 1","pages":"8"},"PeriodicalIF":2.4,"publicationDate":"2025-02-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11846411/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143476141","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical characteristics of patients with pulsatile tinnitus accompanied by ethmoid sinus lesions and high jugular bulb.","authors":"Hongwei Zhu, Zhimin Zhu, Zheng Wang, Xin Zhou, Luying Yang, Xiaoqing Yin, Jiwei Hao, Lu Wang, Yijie Cui, Zeyan Cui, Xiaomeng Fan, Zhiqiang Zhou","doi":"10.1186/s13005-024-00472-8","DOIUrl":"10.1186/s13005-024-00472-8","url":null,"abstract":"<p><strong>Objective: </strong>Exploring the temporal bone Computed Tomography (CT) features and clinical characteristics of patients with ethmoid sinus lesions (ESL) combined with high jugular bulb (HJB) and pulsatile tinnitus symptoms.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on the clinical data of pulsatile tinnitus (PT) patients. Patients with both ESL and HJB were classified into the combined group, while others were assigned to the non-combined group. The severity of tinnitus was assessed using the Tinnitus Evaluation Questionnaire (TEQ), along with the comparison of the clinical characteristics and treatment outcomes. Meanwhile, univariate analysis and multivariate regression analysis were performed to identify factors affecting the prognosis of patients.</p><p><strong>Results: </strong>Among patients with hearing loss in the combined group, the severity of hearing impairment was primarily moderate (65.85%), while that in the non-combined group was mainly mild (49.61%), with differences between the two groups (P < 0.05). In the hearing threshold curve classification, meanwhile, the combined group predominantly showed high-frequency hearing loss (64.63%), with the non-combined group mainly exhibiting low-frequency hearing loss (58.10%), and the differences between the two groups were significant (P < 0.05). The overall response rate of treatment in the combined group was lower than that in the non-combined group (P < 0.05). Moreover, prognostic regression analysis suggested the severity of hearing loss and the presence of ESL + HJB as independent risk factors affecting the prognosis of PT patients (P < 0.05).</p><p><strong>Conclusion: </strong>PT patients are predominantly affected on the right side, primarily manifested as intermittent tinnitus. The severity of hearing loss and the presence of ESL + HJB are independent factors affecting the prognosis of PT patients.</p>","PeriodicalId":12994,"journal":{"name":"Head & Face Medicine","volume":"21 1","pages":"7"},"PeriodicalIF":2.4,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11840973/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143467857","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Migraine and MRI: uncovering potential associations.","authors":"Khalid Abdalla, Khaled Z Alawneh, Mohammad Al-Bdour, Abdel Qader Abu-Salih","doi":"10.1186/s13005-024-00478-2","DOIUrl":"10.1186/s13005-024-00478-2","url":null,"abstract":"<p><strong>Objective: </strong>This study aims to investigate the association between patients with migraine headaches and brain magnetic resonance imaging (MRI) findings.</p><p><strong>Background: </strong>Migraine is a frequently encountered primary headache disorder with a disproportionate female predominance. Diagnosis is usually based on the patient's clinical history with neuroimaging reserved for severe or atypical presentations to exclude other pathologies. Migraine patients often experience a profound impact on their quality of life.</p><p><strong>Methods: </strong>A retrospective study was conducted at King Abdullah University Hospital, Jordan, involving patients with a clinical diagnosis of migraine who had undergone MRI brain imaging between January 2021 to March 2023. Descriptive data were documented, with two independent neuro-radiologists interpreting MRI findings.</p><p><strong>Results: </strong>Our study included 670 migraine patients (510 females; mean age, 40.3 years). White matter hyperintensity lesions were found in 309 patients (46.1%), significantly affecting older age groups with a mean age of 46.8 years (p > 0.001). Additionally, gender played a role, with a higher prevalence of these lesions in female migraine patients, accounting for 79.6% (p = 0.05). Multiple logistic regression analysis proved age to be an independent risk factor for the presence of white matter hyperintensity lesions (OR: 1.0688, 95% CI: 1.0546-1.0831, p > 0.001).</p><p><strong>Conclusion: </strong>White matter hyperintensity lesions were seen in the MRI imaging of a subset of migraine patients. Patients with these lesions tend to be older and of female gender. However, the clinical significance of these findings remains unclear.</p>","PeriodicalId":12994,"journal":{"name":"Head & Face Medicine","volume":"21 1","pages":"6"},"PeriodicalIF":2.4,"publicationDate":"2025-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11830205/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143425280","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Oropharyngeal abscesses with repeated health care visits - the characteristics in patients with odontogenic and peritonsillar abscesses.","authors":"Hanna-Riikka Ahde, Suvi-Tuuli Vilén, Johanna Uittamo, Antti Mäkitie, Johanna Snäll, Miika Toivari","doi":"10.1186/s13005-025-00480-2","DOIUrl":"10.1186/s13005-025-00480-2","url":null,"abstract":"<p><strong>Purpose: </strong>Deep neck infection is a potentially life-threatening condition, and thus, early identification and treatment are essential. This study explored the diagnostic challenges and preceding treatment in patients with repeated healthcare contacts due to an odontogenic or a peritonsillar abscess.</p><p><strong>Methods: </strong>A retrospective study of oropharyngeal abscesses in hospitalized patients was conducted. Included were inpatients with an odontogenic or a peritonsillar abscess during 2019. Excluded were patients with other infection type and patients with an odontogenic abscess preceded by tooth removal. The main outcome variable was repeated healthcare visit(s) due to the current infection prior to hospitalization. The primary predictor variable was source of infection. Explanatory variables comprised age, sex, duration of symptoms (days), clinical findings, and referring unit. Additional analyses were conducted for patients with repeated healthcare visits. Study groups were compared using Fisher's exact test, Student's t-test, test where appropriate. A 2 × 2 risk analysis was performed.</p><p><strong>Results: </strong>Altogether 294 patients, 153 (52.0%) with an odontogenic abscess and 141 (48.0%) with a peritonsillar abscess, were included in the study. Source of infection was unidentified more often in patients with an odontogenic than a peritonsillar abscess (P < .001). In all, 106 patients (36.1%) had repeated healthcare visits prior to hospitalization, which was significantly associated with an odontogenic abscess (P = .039). Active intervention was conducted in only 34.0% of the patients with repeated healthcare visits.</p><p><strong>Conclusions: </strong>Clinicians have challenges in recognizing a developing odontogenic abscess, which remains essential for prompt and effective surgical intervention.</p>","PeriodicalId":12994,"journal":{"name":"Head & Face Medicine","volume":"21 1","pages":"5"},"PeriodicalIF":2.4,"publicationDate":"2025-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11829418/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143425315","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Optimal needle characteristics for classical inferior alveolar nerve block anesthesia: a systematic review.","authors":"Mennat Allah Ashraf Abd-Elsabour, Ayat Gamal-AbdelNaser","doi":"10.1186/s13005-025-00481-1","DOIUrl":"10.1186/s13005-025-00481-1","url":null,"abstract":"<p><strong>Objectives: </strong>Although frequently applied, inferior alveolar nerve block (IANB) is associated with high rate of complications, beside its unpredictable success; partly due to improper needle choice. Evidence of the ideal needle contradicts in literature. Therefore, this review aims to assess the effect of needle characteristics on the outcomes of IANB.</p><p><strong>Materials and methods: </strong>A systematic search was performed on MedLine via Pubmed, Cochrane Library, LILACS, Science Open, EBSCOhost, Scopus, Egyptian Knowledge Bank (EKB), and Google scholar; beside searching grey literature and hand searching. The review included randomized controlled trials comparing needles of difference in any of the characteristics (gauge, length, bevel, alloy) used for IANB regarding their effects on pain, success of anesthesia and aspiration. The authors ran the search, selected the eligible studies, assessed the risk of bias using RoB 1 and extracted the data of the finally included studies. All the steps were performed in duplicates.</p><p><strong>Results: </strong>The search yielded a total of 2,812 records. After de-duplication and excluding ineligible studies by title and abstract then by full text, the review included nine eligible studies. The compared needle interventions included: gauges (23G, 24G, 25G, 26G, 27G and 30G), lengths (12 mm, 25 mm, 32 mm, 35 mm, 42 mm), and internal diameters (0.265 mm, 0.215 mm, 0.3 mm and 0.4 mm). All studies had high risk of bias, adopted different assessment methods for the outcomes, and included participants with differences in baseline characteristics.</p><p><strong>Conclusions: </strong>The level of the available evidence introduced by primary studies hinder concluding the optimal needle characteristics; keeping the research question unanswered. However, within the limitations of the heterogenous studies, available data favors thinner needles for less pain during needle insertion; otherwise, data of the other outcomes was inconclusive.</p><p><strong>Clinical relevance: </strong>Thinner needles are favored for less pain during insertion; but standardized future studies are essentially needed for solid conclusions. A detailed standard protocol is, therefore, proposed.</p>","PeriodicalId":12994,"journal":{"name":"Head & Face Medicine","volume":"21 1","pages":"4"},"PeriodicalIF":2.4,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11789294/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143122806","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Enhanced precision in stone localization and intraoral removal in sialolithiasis: the role of preoperative computer tomographic scanning in surgical planning.","authors":"Soo Yeon Jung, Mi Sun Chun, Yu Jin Go, Ju Hyun Yun, Han Su Kim","doi":"10.1186/s13005-024-00479-1","DOIUrl":"10.1186/s13005-024-00479-1","url":null,"abstract":"<p><strong>Background: </strong>The precise localization of stones within the submandibular duct is crucial for the successful intraoral removal in sialolithiasis. Customizing surgical approaches based on the stone's ductal location is imperative. Particularly challenging are stones beneath the lingual nerve, requiring a landmark-guided approach due to their non-palpable nature. This study aimed to comprehend stone positioning, location-specific characteristics, and develop suitable surgical approaches. We conducted a thorough analysis of numerous preoperative computed tomography (CT) scans for this purpose.</p><p><strong>Methods: </strong>We performed a retrospective review of the medical records of patients who underwent intraoral stone removal between 2006 and 2022. Two different surgical approaches were applied based on the stone location as determined by preoperative CT scans. The mediolingual approach was used for superficial stones, while the laterogingival approach was reserved for deeper stones. Patient demographics, sialolithiasis features, and postoperative complications were analyzed. T-test was performed to compare stone characteristics between different locations, and a receiver operating characteristic curve analysis was used to identify the critical size threshold for predicting stone location.</p><p><strong>Results: </strong>Medical records of 465 patients were reviewed. Out of 616 stones, 614 were successfully removed with two distinct surgical approaches guided by preoperative CT scans. Two patients reported retention, and 11 experienced postoperative tongue sensation changes. The hilum was the most common stone location, and deeper stones, approached laterolingually, were generally larger. Analysis identified a 4.25 mm width as the most sensitive and specific threshold for deep stones. Stone volume showed no statistically significant difference between smokers and non-smokers, alcohol consumers and non-consumer.</p><p><strong>Conclusion: </strong>The result of the study underscore the significance of precise stone localization and endorse the efficacy of landmark-guided surgical approaches in managing sialolithiasis.</p>","PeriodicalId":12994,"journal":{"name":"Head & Face Medicine","volume":"21 1","pages":"3"},"PeriodicalIF":2.4,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11786450/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143074738","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A comprehensive overview of FFRG and IHCC allograft cartilages in revision rhinoplasty: a systematic review.","authors":"Mahtab Hosseini, Seied Omid Keyhan","doi":"10.1186/s13005-024-00473-7","DOIUrl":"10.1186/s13005-024-00473-7","url":null,"abstract":"<p><strong>Background: </strong>This study aims to compare the complications and satisfaction associated with favorable allografts, Fresh Frozen Rib Graft (FFRG) and Irradiated Homologous Costal Cartilage (IHCC), in revision rhinoplasty.</p><p><strong>Methods: </strong>The PRISMA guidelines were adhered to in the conduct of this systematic review. No limitations were applied to the types of studies included. Studies in English were selected without any time limitations. Five databases, PubMed/Medline, Cochrane Library, Embase, Scopus, Google Scholar, and also, the reference lists of included studies were searched. The ROBINS-I was employed for risk of bias assessment. Patients who underwent revision rhinoplasty utilizing allografts (FFRG and IHCC) were considered.</p><p><strong>Results: </strong>The initial search yielded a total of 503 studies. After duplicate removal and paper screening, 7 studies were included. A total of 406 patients for FFRG and 66 patients for IHCC who underwent revision rhinoplasty with the use of FFRG and IHCC were incorporated. Various complications were assessed, including warping, infective/noninfective resorption, infection, extrusion/displacement, and other less common occurrences. The overall complication rates were 9.25% and 15.7% for FFRG and IHCC, respectively. The main complication associated with the two was infection. Notably, both FFRG and IHCC demonstrated significant improvements in patient satisfaction following revision surgery across all subjected studies.</p><p><strong>Conclusion: </strong>Based on this review, FFRGs present a lower rate of complications in comparison with IHCCs. However, the biocompatibility makes the autologous rib cartilage the gold standard graft, but in case of donor site limitations to harvesting, FFRG and IHCC would be a safe and reliable alternative.</p>","PeriodicalId":12994,"journal":{"name":"Head & Face Medicine","volume":"21 1","pages":"2"},"PeriodicalIF":2.4,"publicationDate":"2025-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11744856/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143004596","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Novel CAD/CAM-splint-based navigation protocol enhances intraoperative maxillary position control in orthognathic surgery: a case control study.","authors":"Felix Schrader, Leonardo Saigo, Norbert Kübler, Majeed Rana, Max Wilkat","doi":"10.1186/s13005-024-00477-3","DOIUrl":"10.1186/s13005-024-00477-3","url":null,"abstract":"<p><strong>Background: </strong>Virtual surgical planning for orthognathic surgery typically relies on two methods for intraoperative plan transfer: CAD/CAM occlusal splints and patient-specific implants (PSI). While CAD/CAM splints may offer limited accuracy, particularly in the vertical dimension, PSIs are constrained by higher costs and extended preparation times. Surgical navigation has emerged as a potential alternative, but existing protocols often involve invasive registration or lack transparent evaluation. This study introduces a novel protocol for point-based optical navigation using modified CAD/CAM splints for non-invasive registration and transparent intraoperative evaluation, assessing its effectiveness in maxillary positioning.</p><p><strong>Methods: </strong>This prospective case-control study included 20 patients undergoing bimaxillary orthognathic surgery. The experimental group employed surgical navigation with modified CAD/CAM splints, while the control group used standard CAD/CAM splints. Surgical accuracy was evaluated by measuring translational and rotational discrepancies between the planned and achieved maxillary positions. A mixed ANOVA was conducted to assess other factors, aside from surgical navigation, that might influence surgical accuracy.</p><p><strong>Results: </strong>Surgical navigation significantly improved accuracy in translational movements along the x-axis (right-left: -0.81 mm; p = 0.021) and z-axis (down-up: -0.82 mm; p = 0.014), as well as in yaw rotation (-0.45°; p = 0.045). Other movements also showed improved precision in the navigated group, though not statistically significant; y-axis (back-front): -0.60 mm (p = 0.094); pitch rotation: -0.70° (p = 0.071); roll rotation: -0.04° (p = 0.428). Besides the use of surgical navigation, the amount of planned movement significantly impacted surgical accuracy, although no specific factors could be identified to predict which cases would particularly benefit from surgical navigation.</p><p><strong>Conclusions: </strong>Surgical navigation with modified CAD/CAM splints enhances surgical accuracy without requiring invasive procedures, offering a straightforward and transparent protocol suitable for routine clinical practice that allows intraoperative evaluation of maxillary positioning. However, the clinical significance and cost-effectiveness compared to PSI need further investigation. These findings suggest new directions for future developments, especially with advancements in mixed reality technologies, which could broaden the application of surgical navigation.</p><p><strong>Trial registration: </strong>Retrospectively registered with the German Clinical Trials Register (DRKS00034795).</p>","PeriodicalId":12994,"journal":{"name":"Head & Face Medicine","volume":"21 1","pages":"1"},"PeriodicalIF":2.4,"publicationDate":"2025-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11721267/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142964567","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}