Journal of Craniofacial Surgery最新文献

{"title":"Comparison of Accuracy in Mandible-First and Maxilla-First Approaches in Bimaxillary Orthognathic Surgery: A Meta-Analysis.","authors":"Chenjie Zhao, Tianyi Gu, Xueshan Bai, Jianjian Lu, Li Teng, Liya Yang","doi":"10.1097/SCS.0000000000011066","DOIUrl":"10.1097/SCS.0000000000011066","url":null,"abstract":"<p><p>This meta-analysis compares the accuracy of mandible-first and maxilla-first approaches in bimaxillary orthognathic surgery to improve clinical decision-making. A systematic search was performed in PubMed, Web of Science, Embase, and Cochrane databases up to August 2024. The analysis included randomized controlled trials and cohort studies with a minimum of 10 patients. Data extraction followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, and pooled effect estimates for continuous outcomes were calculated using weighted mean difference (WMD) with 95% CIs. Heterogeneity was assessed using Cochran I2 and Q statistics, with a random-effect model applied when I2 exceeded 50%. Seven studies involving 316 patients were included. The analysis showed no significant differences in vertical (WMD: -0.05, 95% CI: -0.57 to 0.48, P = 0.86), transverse (WMD: -0.17, 95% CI: -0.43 to 0.09, P = 0.21), and sagittal (WMD: -0.41, 95% CI: -0.98 to 0.15, P = 0.15) surgical errors between the two approaches. Rotational surgical errors were also similar, including pitch (WMD: 0.07, 95% CI: -0.11 to 0.25, P = 0.29), roll (WMD: 0.01, 95% CI: -0.18 to 0.25, P = 0.69), and yaw (WMD: 0.12, 95% CI: -0.56 to 0.81, P = 0.72). The findings suggest that there is no significant difference in surgical accuracy between mandible-first and maxilla-first approaches. Therefore, the choice of sequence should be based on patient-specific factors rather than a presumed advantage of one method over the other. Further research, including large-scale randomized controlled trials, is needed to confirm these results and evaluate long-term outcomes.</p>","PeriodicalId":15462,"journal":{"name":"Journal of Craniofacial Surgery","volume":" ","pages":"e459-e464"},"PeriodicalIF":1.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142949584","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":"Isolated Temporomandibular Arthritis as Presentation of Juvenile Idiopathic Arthritis.","authors":"Luca Bernardo, Alessandro Visioli, Emanuela Del Giudice, Vittoria Carlotta Magenes, Francesca Casini, Giovanni Chiaffoni, Martina Sandini, Valentina Ansuini, Riccardo Lubrano, Angela Mauro","doi":"10.1097/SCS.0000000000011000","DOIUrl":"10.1097/SCS.0000000000011000","url":null,"abstract":"<p><p>Involvement of the temporomandibular joint (TMJ) in patients with juvenile idiopathic arthritis (JIA) has been increasingly reported, affecting up to 87% of cases. This involvement generally occurs after the diagnosis of JIA has been established; however, in the authors' cases, as in a few others documented in the literature, patients presented with isolated TMJ arthritis as the sole joint involvement. The authors performed a narrative literature review on TMJ involvement in JIA and reported 2 cases that presented with isolated TMJ arthritis as the initial manifestation of JIA. Although isolated TMJ involvement may be rare, it can lead to severe complications, such as complete loss of TMJ function. Thus, clinicians should be aware of this potential presentation to conduct necessary investigations and provide appropriate treatment.</p>","PeriodicalId":15462,"journal":{"name":"Journal of Craniofacial Surgery","volume":" ","pages":"e422-e425"},"PeriodicalIF":1.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142931928","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":"Complex Scalp Reconstruction in Moyamoya Disease Using Distant Flap After Free Tissue Transfer Failure.","authors":"Rah Yoon Kim, Chang Jun Lee, Sang Oon Baek","doi":"10.1097/SCS.0000000000010879","DOIUrl":"10.1097/SCS.0000000000010879","url":null,"abstract":"<p><p>A preferred option among many surgeons for treating large defects in the head and neck area is reconstruction using autologous tissue, particularly free tissue transfer with microvascular anastomosis. However, some defects cannot be resolved with conventional microvascular techniques or algorithmic approaches. In this case study, a 55-year-old female, who previously underwent bypass surgery for Moyamoya disease, presented with a large scalp defect following surgical necrosis. After initial coverage using a free anterolateral thigh flap, partial necrosis developed, leaving a persistent 2×4 cm² defect. To resolve this, a distant thenar flap was harvested and successfully used for reconstruction. Postoperatively, the patient exhibited full recovery without complications. This case highlights the effectiveness of distant flap techniques, particularly when microvascular surgery is not feasible or has failed. The historical significance and continued applicability of distant flaps in challenging cases underscore their importance in the reconstructive armamentarium.</p>","PeriodicalId":15462,"journal":{"name":"Journal of Craniofacial Surgery","volume":" ","pages":"e390-e392"},"PeriodicalIF":1.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143006225","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":"Long-Term Series of Custom-Bone Hydroxyapatite Cranioplasty: Outcomes and Survival at 15 Years.","authors":"Riccardo Carbonaro, Gaia Ghiringhelli, Angelo Nataloni, Francesco Amendola, Simone Catapano, Luca Vaienti, Giuseppe E Umana, Marco Fricia, Nicola Zingaretti, Bruno Zanotti","doi":"10.1097/SCS.0000000000011061","DOIUrl":"10.1097/SCS.0000000000011061","url":null,"abstract":"<p><strong>Introduction: </strong>Cranioplasty (CP) is a surgical procedure used to repair or reconstruct bone defects in the skull. As CP is not without risk, identifying the safest reconstruction technique is essential to achieve optimal functional recovery. While heterologous prostheses such as HA address issues related to storage and preservation of autograft and help prevent bone resorption, they are associated with a specific spectrum of risks, including infection, dislocation, and fracture. The aim of our article is to evaluate the safety and performance of HA cranioplasty through a retrospective study conducted at 2 centres with extended follow-up of up to 15 years. This study represents one of the most comprehensive and long-term analyses available and provides important insights into the efficacy of this material in clinical practice.</p><p><strong>Methods: </strong>Data were collected from patients who underwent CP between December 2001 and December 2008. The authors conducted a retrospective study of a case series of 101 adult and paediatric patients who received custom-made HA implants after craniotomy for various reasons. The primary endpoint was to evaluate prosthesis survival and explantation rates. Secondary endpoints included the incidence of adverse events and the rate of surgical revision.</p><p><strong>Results: </strong>Over a period of 7 years (from December 2001 to December 2018), a total of 101 patients who underwent CP with custom-made HA prostheses. Skull reconstruction with CP was performed immediately in 22 cases. All patients were initially evaluated 30 days after CP, with subsequent follow-ups at 6 months, 12 months, 24 months, and then at 3, 4, 5, 10, and 15 years. Major complications requiring explantation were observed in 9 patients: The reasons for explantation were as follows: 3 cases of infection, 2 cases of tumour recurrence, 2 cases of fracture, 1 case of cicatrial retraction, and 1 case of cerebral hemorrhage. Minor complications occurred in 10 cases and resolved without the need for explantation of the HA prosthesis. At the 15-year follow-up, radiographic and clinical evaluations of 41 patients confirmed optimal results, with complete and stable integration of the implant into the surrounding bone and no significant resorption or migration.</p><p><strong>Conclusions: </strong>This study provides a comprehensive long-term evaluation of custom HA CP, providing valuable insight into its efficacy and safety over a 15-year follow-up period. Our findings support the viability of HA as a material for cranial reconstruction, demonstrating a high prosthesis survival rate with stable integration in the majority of patients.</p>","PeriodicalId":15462,"journal":{"name":"Journal of Craniofacial Surgery","volume":" ","pages":"1263-1266"},"PeriodicalIF":1.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143425429","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":"Maxillary Jaw-in-a-Day: The Role of Point-of-Care Manufacturing and Implant Stability Quotient in Centrofacial Chondrosarcoma.","authors":"Gonzalo Ruiz-de-Leon, Carlos Navarro-Cuellar, Manuel Tousidonis","doi":"10.1097/SCS.0000000000011142","DOIUrl":"10.1097/SCS.0000000000011142","url":null,"abstract":"<p><p>Chondrosarcoma is a rare malignant tumor of epithelial origin, with fewer than 0.1% of cases affecting the nasal septum. Maxillofacial oncological surgery presents significant challenges, particularly in maxillary reconstruction, often requiring complex rehabilitation. This case report describes the use of point-of-care manufacturing, customized cutting guides, and 3D printing technology for fibular-free flap reconstruction and guided dental implant placement in a 42-year-old male with centrofacial nasal chondrosarcoma. After a bilateral maxillectomy, continuity across the maxillomalar buttress was restored using a fibular-free flap and a patient-specific reconstruction plate. Immediate implant placement and prosthetic loading were performed, supported by the Implant Stability Quotient (ISQ), which provided objective data on implant stability, allowing immediate loading due to high primary stability. The integration of point-of-care manufacturing and ISQ enhances precision in guided surgery, facilitating quicker functional and esthetic rehabilitation, and offering faster recovery and improved quality of life for oncological patients requiring complex maxillofacial reconstruction.</p>","PeriodicalId":15462,"journal":{"name":"Journal of Craniofacial Surgery","volume":" ","pages":"e481-e483"},"PeriodicalIF":1.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143414391","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":"Recurrent Giant Subcutaneous Tumor in Juvenile Hyaline Fibromatosis.","authors":"Xinyao Wang, Jia Wei, Xiaoqiang Wang","doi":"10.1097/SCS.0000000000011062","DOIUrl":"10.1097/SCS.0000000000011062","url":null,"abstract":"<p><p>This case report presents a 5-year-old boy diagnosed with juvenile hyaline fibromatosis (JHF), an extremely rare autosomal recessive disorder characterized by the abnormal accumulation of collagen. The patient exhibited a recurrent giant subcutaneous tumor measuring 20 cm in diameter, along with multiple tumors in the oral cavity, gingiva, and joints, leading to significant facial deformity and functional impairments. Previous surgeries at ages 1 and 2 for tumor removal resulted in recurrence. Surgical intervention was performed to excise the large tumor and alleviate symptoms. Pathologic analysis confirmed the diagnosis of JHF. This case highlights the challenges in managing JHF and the need for multidisciplinary approaches in treatment.</p>","PeriodicalId":15462,"journal":{"name":"Journal of Craniofacial Surgery","volume":" ","pages":"e473-e475"},"PeriodicalIF":1.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143441047","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":"Secondary Cleft Rhinoplasty Using Circumferential Alar Rim Cartilage Graft: Surgical Technique and Morphometric Study.","authors":"S Moltaji, A Wang, F Cardemil, J A Fialkov","doi":"10.1097/SCS.0000000000011086","DOIUrl":"10.1097/SCS.0000000000011086","url":null,"abstract":"<p><strong>Background: </strong>Achieving symmetry in secondary cleft rhinoplasty is challenging even for the most skilled surgeon. The authors present their technique and outcomes of using a circumferential alar rim graft to relocate the cleft-sided anterior ala superiorly and anteriorly. The graft, under tension, is anchored to the septum at one end and the intermediate crus at the other, exerting an upward and anteriorly projected force.</p><p><strong>Methods: </strong>Adult patients with unilateral cleft lip and palate who underwent secondary cleft rhinoplasty between 2013 and 2022, using the circumferential alar rim graft (CARG) technique, were included. Standardized photographs were used to obtain morphometric measurements. Ratios of cleft side to non-cleft side nostril height, width, and area, as well as tip projection, were compared preoperatively and postoperatively. Wilcoxon signed-rank test evaluated statistically significant differences between the measurements.</p><p><strong>Results: </strong>Twenty-seven patients were included, with a mean age of 26.9 years (range 19-42). Most were female (n=18), with left-sided clefts (n=20). Nostril height symmetry, expressed as a ratio of cleft side over the non-cleft side (with 1 being perfect symmetry), improved significantly by 10% ( P <0.001). Nostril width symmetry improved significantly by 22% ( P =0.012), and nostril area symmetry improved significantly by 21% ( P =0.008). When preoperative and postoperative subnasale-pronasale over inter-alar width ratios were compared, tip projection was found to increase significantly by 10% ( P =0.029). Five CARG-related complications occurred, including 2 graft detachments and 1 graft fracture.</p><p><strong>Conclusions: </strong>Using a circumferential alar rim graft in secondary cleft rhinoplasty significantly improved nasal symmetry in terms of nostril height and area.</p>","PeriodicalId":15462,"journal":{"name":"Journal of Craniofacial Surgery","volume":" ","pages":"1137-1142"},"PeriodicalIF":1.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143542125","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":"Utilization of Bonney's Blue Dye as an Adjunct to Orthognathic Surgery Augmented by Virtual Surgical Planning.","authors":"Matthew A Brett, Natalie M Plana, Andrea Torroni, Roberto L Flores","doi":"10.1097/SCS.0000000000011192","DOIUrl":"10.1097/SCS.0000000000011192","url":null,"abstract":"<p><p>Virtual surgical planning (VSP) has revolutionized orthognathic and craniomaxillofacial surgeries by enabling precise 3-dimensional analysis, detailed osteotomy planning, and custom fabrication of surgical guides and fixation hardware. However, the visualization of registration holes-critical for accurate plate fixation-remains challenging, especially in a blood-filled surgical field. This paper presents a novel technique to enhance the visibility of registration holes using Bonney's blue dye. The technique involves injecting micro-aliquots of Bonney's blue dye (a mixture of crystal violet and brilliant green) into the registration holes before performing osteotomies. This approach ensures that the holes remain clearly marked despite potential visual contamination in the surgical field. The dye helps to identify screw placements and align patient-specific fixation plates more accurately. The proposed method addresses common difficulties in aligning registration holes with patient-specific plates during surgery. Bonney's blue dye provides a clear contrast against the bone, making the registration holes more visible and easier to locate. This improvement is particularly advantageous in a bloody surgical field and benefits less experienced surgeons by offering a straightforward solution to enhance accuracy and efficiency. The technique can also reduce overall operative time by minimizing the time spent locating and aligning the registration holes. Utilizing Bonney's blue dye in virtual surgical planning significantly improves the visibility and alignment of registration holes in orthognathic surgeries. This simple, cost-effective method enhances surgical precision and efficiency and can be applied to other computer-assisted surgical procedures in craniofacial surgery.</p>","PeriodicalId":15462,"journal":{"name":"Journal of Craniofacial Surgery","volume":" ","pages":"1365-1367"},"PeriodicalIF":1.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143624901","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":"Evaluation of the Awareness and Knowledge Levels of Dentists Regarding Bisphosphonates and Bisphosphonate-Related Jaw Necrosis.","authors":"Ridvan Guler, Emine Yalcin","doi":"10.1097/SCS.0000000000010870","DOIUrl":"https://doi.org/10.1097/SCS.0000000000010870","url":null,"abstract":"<p><p>Bisphosphonates are used in the treatment of osteoporosis, bone metastases, and metabolic bone diseases. Long-term use of bisphosphonates increases the risk of osteonecrosis in patients undergoing dental surgery. This study aimed to evaluate dentists' knowledge about bisphosphonates and bisphosphonate-related osteonecrosis of the jaw (BRONJ) and their treatment approaches in patients using oral and intravenous bisphosphonates. In this study, a 25-question questionnaire was applied to dentists working in different institutions regarding their knowledge and experience about bisphosphonates and BRONJ, and treatment approaches for different surgical procedures in patients using bisphosphonates. The obtained data were statistically analyzed and evaluated. In total, 90.5% of the dentists identified osteoporosis, 79.8% identified bone metastases, 52.4% identified osteitis deformans, and 39.3% identified multiple myeloma as conditions in which bisphosphonates are used, thus answering correctly in a significant proportion. When participants were asked about treatment options according to the stages of BRONJ, participation in the \"I'm not sure\" option increased as the stages progressed, indicating that dentists were not sufficiently familiar with the treatments for different stages of BRONJ. In total, 88.5% of the participants stated that when they see an exposed bone area in patients they examine, they consider bisphosphonate use as a possible cause. There was a statistically significant difference between dentists with and without prior BRONJ experience regarding their ages (P=0.039) and years of practice (P=0.001). There was a statistically significant difference between dentists with and without BRONJ experience regarding whether they inquired about bisphosphonate use (P=0.001). It was found that dentists have serious deficiencies in knowledge regarding bisphosphonates, their side effects, and treatment approaches for patients using bisphosphonates. Increasing dentists' knowledge and awareness of this issue would help reduce the risk of developing BRONJ.</p>","PeriodicalId":15462,"journal":{"name":"Journal of Craniofacial Surgery","volume":"36 4","pages":"e376-e382"},"PeriodicalIF":1.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144215980","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":"Discussion on Rehabilitation in Oral Cancer Patients From Surgery to Final Prosthesis.","authors":"Andrea Balercia, Giulio Cirignaco, Paolo Balercia","doi":"10.1097/SCS.0000000000010939","DOIUrl":"10.1097/SCS.0000000000010939","url":null,"abstract":"","PeriodicalId":15462,"journal":{"name":"Journal of Craniofacial Surgery","volume":" ","pages":"1437-1439"},"PeriodicalIF":1.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142769474","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}