Journal of Craniofacial Surgery最新文献

{"title":"Two-Plate Reconstruction of Lateral-Posterior Wall Defects for Functional Recovery of the Maxillary Sinus.","authors":"Ji-Song Park, Mi Young Eo, Kezia Rachellea Mustakim, Muhammad Ruslin, Soung Min Kim","doi":"10.1097/SCS.0000000000013478","DOIUrl":"https://doi.org/10.1097/SCS.0000000000013478","url":null,"abstract":"<p><strong>Introduction: </strong>Mucociliary clearance (MCC) is essential for the normal physiological function of the maxillary sinus. Maxillary sinus lateral-posterior wall defects, often caused by benign tumor excision or cyst enucleation in the posterior maxilla, can severely impair MCC. Therefore, reconstruction of these defects is necessary to restore sinus function and maintain its original volume. This study introduces a technique for maxillary sinus lateral-posterior wall reconstruction using 2 plates and evaluates its efficacy in maintaining normal sinus function and volume.</p><p><strong>Methods: </strong>This retrospective study included 19 patients who underwent removal of benign tumors or cysts in the posterior maxilla, followed by 2-plate reconstruction of the maxillary sinus lateral-posterior wall. Waters view radiographs were obtained preoperatively (T0), immediately postoperatively (T1), and at 1 month (T2), 3 to 4 months (T3) and 6 to 10 months (T4) postoperatively. The volume and radiopacity of the maxillary sinus were evaluated using Waters view. Sinus density and dimensional changes were analyzed using Adobe Photoshop 2022 (Adobe Systems Inc., San Jose, CA). Anatomical reconstruction was verified through radiographic analysis, while changes in physiological function and clinical outcomes were assessed via patient symptom evaluation.</p><p><strong>Results: </strong>Radiographic haziness increased at T1 compared to T0, followed by a gradually decreasing trend; however, there was no statistically significant difference between T0 and T4. No significant postoperative changes in maxillary sinus volume were observed, demonstrating stable volume maintenance. At 10 months postoperatively, the number of patients experiencing clinical discomfort significantly decreased. In 11 patients, the plates were removed at an average of 2.5 years after the initial surgery.</p><p><strong>Conclusion: </strong>In patients with lateral-posterior wall defects of the maxillary sinus, 2-plate reconstruction effectively maintains the original sinus volume by preventing hypertrophic fibrous scarring, thereby restoring normal mucociliary function.</p>","PeriodicalId":15462,"journal":{"name":"Journal of Craniofacial Surgery","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2026-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149110440","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predicting Infection After Emergency Craniofacial Trauma Surgery.","authors":"Zhicheng Sun, Fei Chang","doi":"10.1097/SCS.0000000000013446","DOIUrl":"https://doi.org/10.1097/SCS.0000000000013446","url":null,"abstract":"<p><strong>Objective: </strong>To develop and internally validate a clinically interpretable prediction model for 30-day postoperative infectious complications after emergency craniofacial trauma surgery.</p><p><strong>Methods: </strong>This retrospective cohort-style prediction model study included 720 emergency craniofacial trauma surgery records. Patients were randomly assigned to a training set (n=504) and an internal validation set (n=216). Candidate predictors included host factors, injury severity, fracture and wound characteristics, airway intervention, antibiotic timing, operative duration, transfusion, and adequacy of initial debridement. The primary outcome was any 30-day infectious complication, including surgical site infection, fixation-related infection, pneumonia, deep orbital infection, or intracranial infection. Model performance was assessed with area under the receiver operating characteristic curve (AUC), calibration, Brier score, risk stratification, and decision curve analysis.</p><p><strong>Results: </strong>The cohort included 720 patients, of whom 103 (14.3%) developed infectious complications. Important predictors included open fracture, oral wound communication, moderate or severe contamination, higher Injury Severity Score, longer operative duration, current smoking, delayed antibiotic administration, transfusion, airway intervention, and inadequate debridement. The model showed an AUC of 0.836 (0.783-0.888) in the training set and 0.738 (0.623-0.833) in the validation set. The validation Brier score was 0.093. Infection rates in low-, medium-, and high-risk strata were 5.6%, 9.7%, and 22.2%, respectively.</p><p><strong>Conclusions: </strong>A model based on routinely available emergency and perioperative variables demonstrated acceptable internal validity and clinical interpretability. The findings support risk-stratified infection surveillance and provide a structured framework for subsequent external validation.</p>","PeriodicalId":15462,"journal":{"name":"Journal of Craniofacial Surgery","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2026-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149110487","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Stability Behavior of 2 Different Designs of Implants Placed in Pterygoid Bone: An Anatomical Cadaveric Study.","authors":"Ismail Doruk Kocyigit, Seda Kocyigit, Kaan Orhan","doi":"10.1097/SCS.0000000000013458","DOIUrl":"https://doi.org/10.1097/SCS.0000000000013458","url":null,"abstract":"<p><strong>Objective: </strong>Implant placement to the pterygoid bone has become more popular in implant-supported prosthetic rehabilitation of full arch or posterior edentulous areas. However, this type of implant placement, which has anchorage points on the maxillary bone and pterygoid bone, sometimes poses difficulties for the clinician due to differences in bone density. For a stable implant placement, the macro design of the implant and related factors affect the success as much as the success of the clinician. In this article, the authors aimed to evaluate the 2 different dental implant macro-design behaviors in the pterygoid bone. For the clinician, it is difficult to place an implant in the pterygoid bone due to the anatomic position of the bone. Because of that, most of the time, a clinician has only one chance to prepare and place the implant in this bone. Because of this situation, it is important to know the behavior of the implant macro design and the effect of the design to the primary stability.</p><p><strong>Materials and methods: </strong>Tapered and parallel implant types (NobelActive and NobelParallel, Nobel Biocare, Gothenburg, Sweden) were placed on the right and left sides of the maxilla of 10 fresh human cadavers. Using Osstell Mentor III and SmartPegs (Integration Diagnostics, Göteborg, Sweden), the resonance frequency measurements were made immediately after the implant placement. The 2 different macro-design types of implants were compared in terms of implant stability quotients (ISQ) values.</p><p><strong>Results: </strong>Our study showed that the pterygoid bone was ideal for biomechanical stability scenario in managing the edentulous solutions of posterior maxilla with the tapered and parallel types of dental implants. However, a significant difference was observed in terms of ISQ values between group 1 and group 2. Group 2 measurement values were significantly lower (P<0.05) with total standard deviation of 5.36.</p><p><strong>Conclusions: </strong>Tapered macro-design implants showed better ISQ values than the parallel macro-design implants according to primary stability. Clinicians must evaluate the implant macro-design type to get better primary stability on the pterygoid bone due to the clinical complexity of the area. Results and their clinical impacts are also discussed in the study.</p>","PeriodicalId":15462,"journal":{"name":"Journal of Craniofacial Surgery","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2026-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149110442","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Facing the Risks: Complications, Prevention, and Management of Alloplastic Facial Implants in Aesthetic Surgery.","authors":"Shangtao Wu, Jonathan P Yasmeh, Albert Ting, Stuti Garg, Benjamin Slavin, Susan Taghioff, Shahin Javaheri","doi":"10.1097/SCS.0000000000013384","DOIUrl":"https://doi.org/10.1097/SCS.0000000000013384","url":null,"abstract":"<p><p>Alloplastic facial implants provide durable, customizable skeletal augmentation without donor-site morbidity. However, infection, wound dehiscence, migration, extrusion, neurosensory injury, fluid collections, and pressure-related bony remodeling remain important concerns. This comprehensive review summarizes reported complications and practical strategies for prevention, recognition, and management in aesthetic facial implant surgery. PubMed was searched for studies published from February 23, 2016, through February 23, 2026, that evaluated alloplastic implants used for aesthetic facial skeletal augmentation and reported complication-related outcomes. Reference lists were screened manually. Twenty-two studies were included and synthesized narratively because of heterogeneity in implant location, material, surgical approach, and outcome reporting. Reported complication rates varied widely: infection, 2.6% to 23.8%; wound dehiscence, 1% to 23.8%; neurosensory disturbances, 0.28% to 19%; early fluid or vascular complications, 0.28% to 1.42%; and extrusion, 0.28%. Pressure-related bony remodeling was frequently observed radiographically but was generally asymptomatic. Intraoral approaches were associated with greater infection and dehiscence risk in the reviewed studies. Most transient sensory changes resolved with observation, whereas persistent infection, extrusion, and clinically significant migration often required revision or explantation. Careful patient selection, medical and dental optimization, meticulous sterile technique, precise pocket creation, secure fixation, dead-space control, and structured postoperative surveillance are central to reducing complications and improving outcomes.</p>","PeriodicalId":15462,"journal":{"name":"Journal of Craniofacial Surgery","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2026-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149110461","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An Integrated Silicone Splint and Nostril Retainer for Postoperative Rhinoplasty Care: The Tezel Splinting Technique.","authors":"Erdem Tezel, Şeyda Güray","doi":"10.1097/SCS.0000000000013439","DOIUrl":"https://doi.org/10.1097/SCS.0000000000013439","url":null,"abstract":"<p><p>Rhinoplasty procedures involving septal reconstruction and lower nasal third deformities may require simultaneous support of the septum, external nasal valve, and nostril contour during the early postoperative period. However, concurrent use of conventional intranasal silicone splints and nostril retainers may be limited by the available intranasal space. This study describes the Tezel Splinting Technique, a technical modification that integrates a commercially available nostril retainer with an intranasal silicone splint to provide simultaneous postoperative support. A retrospective consecutive series of 127 patients who underwent primary, secondary, tertiary, post-traumatic, or cleft-related rhinoplasty between 2023 and 2025 was reviewed. The integrated system was maintained for 7 days in 98 patients (77.2%) and for 10 days in 29 patients (22.8%). Asymmetric nostril retainer sizing was required in 34 patients (26.8%). The technique was successfully assembled and applied in all patients and remained stable throughout the intended splinting period without unplanned early removal. Transient nasal airway obstruction occurred in 12 patients (9.4%) because of a reduction in the effective internal diameter of the splint airway and resolved after removal of the integrated system. No major device-related complications were observed. The Tezel Splinting Technique provides a practical method for combining septal stabilization and lower nasal third support within a single postoperative construct. This clinical series demonstrates its technical feasibility and short-term clinical applicability across a heterogeneous rhinoplasty population without establishing comparative efficacy over conventional postoperative splinting methods.</p>","PeriodicalId":15462,"journal":{"name":"Journal of Craniofacial Surgery","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2026-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149110430","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cleft Palate Repair in a Socially Vulnerable Area: Analysis of Sociodemographic Differences on Surgical Timing.","authors":"Kendall C Pitre, Shelley R Edwards, Laura Galarza, Laura S Humphries, Ian C Hoppe","doi":"10.1097/SCS.0000000000013460","DOIUrl":"https://doi.org/10.1097/SCS.0000000000013460","url":null,"abstract":"<p><strong>Introduction: </strong>Timely cleft palate repair is essential for optimal speech development and reducing long-term morbidity. Children from socially vulnerable or underserved populations often experience delays in surgical care. This study examines the impact of race, insurance, and social vulnerability index (SVI) on the timing of primary cleft palate repair in a state with significant health care disparities.</p><p><strong>Methods: </strong>A retrospective review was conducted for 147 patients who underwent primary palatoplasty between 2011 and 2021 at the state's only ACPA-approved center. Demographic variables, cleft characteristics, surgical details, and timing of repair were collected. Categorical variables were compared using the χ2 or Fisher-Freeman-Halton test. Nonparametric tests and linear regression models were used for continuous variables.</p><p><strong>Results: </strong>Standard-timing repair was most common (42.2%), followed by early (36.1%) and late repairs (21.8%). Race and SVI were not associated with surgical timing. Insurance status was associated with the distribution of repair timing (P=0.04), with government-insured children more frequently undergoing repair in the standard window; however, their proportion of late repairs was not higher than that of private-insured children. Procedure type also differed by timing (P<0.001). Multivariable analyses found no independent associations between race, insurance status, SVI, or Veau classification and either age at repair or late repair.</p><p><strong>Conclusion: </strong>Insurance status and operative technique were associated with the unadjusted distribution of repair timing; however, race, insurance status, SVI, and Veau classification were not independently associated with age at repair or late repair. Centralized cleft team care may have contributed to the absence of observed differences by race and SVI.</p>","PeriodicalId":15462,"journal":{"name":"Journal of Craniofacial Surgery","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2026-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149110455","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Superior Auricular Artery Fascial Flap for Second Stage Microtia Reconstruction.","authors":"Magdy A Abd-Al Moktader, Abdou M A Darwish, Mohamed M Abdel Hafeez Abdo","doi":"10.1097/SCS.0000000000013479","DOIUrl":"https://doi.org/10.1097/SCS.0000000000013479","url":null,"abstract":"<p><strong>Introduction: </strong>The prevalence of microtia is high among the population, and 2-stage costochondral reconstruction using the Nagata technique is widely accepted. The second stage includes elevation of the previously carved framework to create the postauricular sulcus. Many techniques were described. The use of mastoid retroauricular fascia based on the superior auricular artery, not used previously up to our knowledge for microtia second stage frame elevation.</p><p><strong>Aim of the study: </strong>Using the mastoid fascia based on the superior auricular artery for the second stage of microtia elevation, evaluating the viability of the flaps and long-term results of the reconstructed ear and postauricular sulcus.</p><p><strong>Patients and methods: </strong>Twenty patients underwent first-stage microtia reconstruction with costochondral cartilage graft, prepared for second-stage frame elevation, using the fascial flap from the mastoid area based on the superior auricular artery as a pedicle for the superiorly based fascial flap.</p><p><strong>Results: </strong>The retroauricular and mastoid fascial flap based on the superior auricular artery was a good option, with uneventful results regarding flap viability and very minimal donor site morbidity; the artery is present in the majority of cases (90%).</p><p><strong>Conclusion: </strong>Superior auricular artery-based postauricular fascia flap covered with skin graft is a reliable option for the second stage microtia reconstruction with fine aesthetic outcomes, less donor site morbidity, and keeps the temporoparietal fascia (TPF) intact as a backup plan.</p><p><strong>Level of evidence: </strong>Level II-therapeutic study.</p>","PeriodicalId":15462,"journal":{"name":"Journal of Craniofacial Surgery","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2026-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149110435","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"KCTD1 p.Gly62Asp Variant in Scalp-Ear-Nipple Syndrome: Phenotypic and Structural Insights.","authors":"Yu Zhang, Qifeng Wu, Baofu Yu, Jiao Wei, Chuanchang Dai","doi":"10.1097/SCS.0000000000013438","DOIUrl":"https://doi.org/10.1097/SCS.0000000000013438","url":null,"abstract":"<p><p>Pathogenic variants in the potassium channel tetramerization domain-containing 1 (KCTD1) gene cause scalp-ear-nipple syndrome (SENS), a rare autosomal dominant developmental disorder. Although the recurrent p.Gly62Asp variant has been previously reported, its genotype-phenotype correlation and structural pathogenic mechanism remain poorly understood. Here, we describe a 10-year-old boy with classical SENS who additionally presented with severe craniofacial abnormalities, including marked hypertelorism, short palpebral fissures, depressed nasal bridge, and nasal bone hypoplasia, together with multicystic dysplastic kidney and myopia. Whole-exome sequencing identified a de novo heterozygous KCTD1 variant (c.185G>A; p.Gly62Asp), which was confirmed by Sanger sequencing. Functional annotation demonstrated that KCTD1 is preferentially expressed in tissues affected by SENS and participates in transcription factor AP-2 (TFAP2)-mediated transcriptional regulation and developmental signaling. Structural analysis using AlphaFold3 showed that the p.Gly62Asp substitution preserved the overall protein fold but induced localized conformational changes within the Broad-complex, Tramtrack, and Bric-à-brac (BTB) domain, whereas DynaMut2 predicted reduced protein stability. PolyPhen-2 further classified this variant as probably damaging. Together, these findings expand the clinical spectrum of the recurrent KCTD1 p.Gly62Asp variant and provide structural insights into its pathogenic effects, highlighting the importance of KCTD1 dysfunction in craniofacial and renal development.</p>","PeriodicalId":15462,"journal":{"name":"Journal of Craniofacial Surgery","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2026-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149110472","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Triphasic Evolution of Spontaneous Calvarial Neo-Ossification After Decompressive Craniectomy: A 15-Year Serial Imaging Study.","authors":"Kaiyan Song, Min Wei, Hengzhu Zhang","doi":"10.1097/SCS.0000000000013456","DOIUrl":"https://doi.org/10.1097/SCS.0000000000013456","url":null,"abstract":"<p><p>Spontaneous cranial bone regeneration after decompressive craniectomy (DC) is rare in adults and has uniformly been described as a unidirectional, progressive process. The authors report the first case of a triphasic, nonlinear evolution-formation, resorption, and reactivation-of spontaneous calvarial neo-ossification in an adult. A 24-year-old man underwent bilateral DC for severe traumatic brain injury; the native dura was preserved almost intact on the left side, whereas the right side underwent extensive durotomy with expansile duraplasty. Serial computed tomography at 8 time points over 15 years revealed, on the left, patchy neo-ossification by day 107 that peaked around day 133, resorbed to a nadir at 9 months, reactivated at 23 months, and formed a continuous bony plate bridging the native bone margin by 15 years. The right side showed only 2 punctate bone islands at 15 years. Spontaneous neo-ossification in adults may be nonlinearly and reversibly regulated by the local biomechanical microenvironment, and the integrity of the native dura seems to be a key prerequisite for its initiation. These findings have implications for the timing of cranioplasty, choice of implant material, and duration of imaging follow-up.</p>","PeriodicalId":15462,"journal":{"name":"Journal of Craniofacial Surgery","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2026-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149110451","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hypertonic Dextrose in Aesthetic Dermatology: Route-Dependent Evidence, Biological Rationale, and Research Priorities.","authors":"Kyu-Ho Yi, Jong Keun Song, Han Earl Lee, Olena Sydorchuk","doi":"10.1097/SCS.0000000000013471","DOIUrl":"https://doi.org/10.1097/SCS.0000000000013471","url":null,"abstract":"<p><strong>Objective: </strong>To critically evaluate whether local hypertonic dextrose has sufficient biological and clinical support to be considered an independent dermal biostimulant in aesthetic dermatology.</p><p><strong>Methods: </strong>PubMed/MEDLINE was searched from inception through June, 2026, with backward and forward citation tracking. Direct evidence included human aesthetic or dermatologic studies using local dextrose and translational studies examining dermal delivery or tissue response. Evidence was appraised by design, comparator, blinding, cointerventions, outcome validity, follow-up, and directness to a dextrose-specific effect.</p><p><strong>Results: </strong>Six human reports enrolled 125 participants in aggregate, and 2 translational studies examined pneumatic delivery. Favorable signals were reported for facial laxity, atrophic lesions, pores, fine wrinkles, and acne-scar volume. However, every human protocol included pneumatic pressure, microneedling, focused ultrasound, hyaluronic acid, or another active cointervention. A 5% versus 20% split-face study supports a concentration-dependent or osmolarity-dependent signal within pneumatic delivery, not glucose-specific neocollagenesis. Translational studies demonstrate device-induced tissue injury and penetration into fat and fascia. Reported adverse events were mainly transient; 2 cases of postinflammatory hyperpigmentation occurred in one 30-patient series.</p><p><strong>Conclusion: </strong>Hypertonic dextrose should be regarded as an investigational, route-dependent adjunct rather than an established stand-alone biostimulant. Controlled trials should isolate device, vehicle, osmolarity, and glucose-specific effects and include objective structural endpoints and long-term safety follow-up.</p>","PeriodicalId":15462,"journal":{"name":"Journal of Craniofacial Surgery","volume":" ","pages":""},"PeriodicalIF":1.1,"publicationDate":"2026-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149110448","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}