Journal of Oral and Maxillofacial Surgery最新文献

{"title":"Comparison of Occlusion Using Conventional Versus Virtual Model Surgery in Segmental Maxillary Orthognathic Surgery Using the American Board of Orthodontics Discrepancy Index","authors":"Felix Jose Amarista DDS ,&nbsp;Maria A. Bordoy DDS ,&nbsp;Dakota Miller DDS, MS ,&nbsp;Turki M. Althenyan BDS ,&nbsp;Edward Ellis III DDS, MS","doi":"10.1016/j.joms.2025.06.001","DOIUrl":"10.1016/j.joms.2025.06.001","url":null,"abstract":"<div><h3>Background</h3><div>Maxillary segmentation is essential for achieving optimal occlusion in some cases by correcting transverse discrepancies, Bolton's discrepancy, arch deformities, and alveolar angulation. Although traditional plaster model techniques are time-consuming and error-prone, many surgeons continue using them to set occlusion in segmental maxillary surgery despite the superior precision and outcomes of virtual surgical planning. Limited research has directly compared the clinical utility of virtual surgical planning–based segmentation versus traditional model surgery.</div></div><div><h3>Purpose</h3><div>The purpose of the study was to compare the planned occlusion obtained through conventional and virtual model surgeries performed on preoperative intraoral scans for segmental maxillary surgery.</div></div><div><h3>Study Design, Setting, Sample</h3><div>An in vitro study was conducted using archived, de-identified preoperative intraoral scans from patients who underwent segmental maxillary surgery. Inclusion criteria were cases requiring a 3-piece Le Fort I osteotomy. Exclusion criteria included cases with partial edentulism or cleft palate.</div></div><div><h3>Predictor Variable</h3><div>The predictor variable was the type of model surgery (conventional vs virtual) used for maxillary segmentation.</div></div><div><h3>Main Outcome Variable(s)</h3><div>The primary outcome variable was planned occlusion outcomes measured using the American Board of Orthodontics (ABO) discrepancy index assessed by 2 orthodontists blinded to the model surgery technique used.</div></div><div><h3>Covariates</h3><div>None.</div></div><div><h3>Analyses</h3><div>Parametric statistical tests compared occlusal outcomes and planning times between methods. Two-tailed <em>t</em>-tests analyzed ABO index differences and planning times, with a significance level of <em>P</em> &lt; .05.</div></div><div><h3>Results</h3><div>Two surgeons conducted both virtual and conventional model surgery for segmental maxillary procedures using random 20 intraoral scans, resulting in 80 final occlusions (40 conventional and 40 digitally planned). Two orthodontists evaluated each final bite using the ABO discrepancy index (160 assessments). The mean ABO discrepancy index was 9.99 (SD = 6.76) for conventional and 4.69 (SD = 4.60) for virtual planning, with a statistically significant difference of 5.30 (<em>P</em> &lt; .001). Virtual planning was faster, with an average time reduction of 25 minutes and 28 seconds (SD = 5:34; <em>P</em> &lt; .001).</div></div><div><h3>Conclusions and Relevance</h3><div>The findings suggest that virtual model surgery outperforms conventional methods in achieving superior preoperative occlusal outcomes while reducing overall planning time.</div></div>","PeriodicalId":16612,"journal":{"name":"Journal of Oral and Maxillofacial Surgery","volume":"83 10","pages":"Pages 1216-1222"},"PeriodicalIF":2.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144484751","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rapid and Low-Cost Mesh Shaping Technique for Orbital Fracture Reconstruction – A Technical Note","authors":"Calebe Paiva DDS ,&nbsp;Rodrygo Nunes Tavares DDS, MSC, PHD ,&nbsp;Filipe Nobre Chaves DDS, MSC, PHD ,&nbsp;Francisco Samuel Carvalho DDS, MSC, PHD","doi":"10.1016/j.joms.2025.06.205","DOIUrl":"10.1016/j.joms.2025.06.205","url":null,"abstract":"<div><div>Orbital fractures are surgically demanding due to their complex anatomy and esthetic implications. This technical innovation describes a low-cost approach using open-source software (three-dimensional Slicer and Meshmixer) to design and print templates for preoperative molding of titanium meshes in orbital reconstruction. By segmenting the defect and printing only the affected orbital region, this technique reduces time, cost, and material usage while improving fit and efficiency.</div></div>","PeriodicalId":16612,"journal":{"name":"Journal of Oral and Maxillofacial Surgery","volume":"83 10","pages":"Pages 1266-1270"},"PeriodicalIF":2.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144584205","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Effects of Different Bimaxillary Orthognathic Surgery Sequencing on the Temporomandibular Joint Space of Skeletal Class II Malocclusion Patients","authors":"Qu Deng DDS ,&nbsp;Feng Li DDS ,&nbsp;Li'an Bai DDS ,&nbsp;Xuewen Yang PhD, DDS ,&nbsp;Zhenzhen Guo DDS ,&nbsp;Qilong Wan PhD, DDS","doi":"10.1016/j.joms.2025.05.011","DOIUrl":"10.1016/j.joms.2025.05.011","url":null,"abstract":"<div><h3>Background</h3><div>Changes in the temporomandibular joint (TMJ) space are known consequences of bimaxillary surgery, and the surgery sequence may influence postoperative TMJ space or risk of relapse.</div></div><div><h3>Purpose</h3><div>The purpose of this study was to measure the association of bimaxillary surgery sequence and changes in the TMJ space over time in patients with skeletal Class II malocclusion.</div></div><div><h3>Study Design, Setting, and Sample</h3><div>A retrospective cohort study involving patients with skeletal Class II malocclusion who underwent bimaxillary orthognathic surgery was conducted at the Hospital of Stomatology, Wuhan University from 2018 to 2021. Patients without complete cone beam computed tomography were excluded.</div></div><div><h3>Predictor Variable</h3><div>The predictor variable was sequence of bimaxillary orthognathic surgery, grouped as mandible-first and maxilla-first.</div></div><div><h3>Main Outcome Variables</h3><div>The main outcome variables were radiographic linear measurements and changes in the anterior joint space, posterior joint space (PJS), and superior joint space (SJS) at 3 time points: preoperative, 1 week postoperative, and 6–12 months postoperative.</div></div><div><h3>Covariates</h3><div>The evaluated covariates included sex, age, mandibular advancement.</div></div><div><h3>Analyses</h3><div>Repeated-measures analysis of variance was used to assess changes in joint space over time and side, with surgical sequence as a between-subjects factor. Additional analyses included independent t-tests and canonical correlation. (<em>P</em> ≤ .05).</div></div><div><h3>Results</h3><div>The sample comprised 48 subjects (96 joints), with a mean age of 29.2 (8.5) years; 11 (23%) were male. At 1 week postsurgery, the Maxilla-First group showed a significantly greater radiographic increase in SJS than the Mandible-First group (mean difference: 1.3 mm; 95% CI: 0.7–2.0; <em>P</em> = .0005). At the same time point, all 3 joint spaces (SJS, anterior joint space, and PJS) increased significantly in both groups (<em>P</em> &lt; .05). By 6–12 months postoperatively, surgery sequence showed a negative effect on TMJ space changes, as SJS and PJS significantly decreased in the maxilla-first group (mean differences: 1.9 and 1.1 mm; 95% CIs: 1.2–2.5 and 0.3–1.8; <em>P</em> = .0001 and .005, respectively).</div></div><div><h3>Conclusions and Relevance</h3><div>TMJ space changes in skeletal Class II malocclusion varied over time and were associated with the order of surgery sequence, with smaller changes observed in the mandibular-first group.</div></div>","PeriodicalId":16612,"journal":{"name":"Journal of Oral and Maxillofacial Surgery","volume":"83 10","pages":"Pages 1233-1243"},"PeriodicalIF":2.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144284971","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"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 Radiological Results Between Local and Coronal Incisions in the Treatment of Zygomaticomaxillary Complex Fractures","authors":"Yu Feng DDS ,&nbsp;Bin Liu DDS ,&nbsp;Xinyuan Zhu DDS ,&nbsp;Zhen Chen DDS ,&nbsp;Rong Ren DDS, PhD ,&nbsp;Zhankui Xing MD","doi":"10.1016/j.joms.2025.06.228","DOIUrl":"10.1016/j.joms.2025.06.228","url":null,"abstract":"<div><h3>Background</h3><div>Zygomaticomaxillary complex (ZMC) fractures are commonly treated using either local or coronal incisions, each approach having distinct advantages and disadvantages.</div></div><div><h3>Purpose</h3><div>The purpose of this study was to compare treatment outcomes by imaging measurements in zygomatic fractures treated with local or coronal incision surgery.</div></div><div><h3>Study Design, Setting, Sample</h3><div>This retrospective cohort study analyzed surgically treated ZMC fractures at the Second Hospital of Lanzhou University (2021 to 2023). Inclusion criteria were as follows: patients had displaced fractures (≥1 mm) with zygomatic partial rotation secondary to trauma. Exclusions were as follows: patients with minimal displacement, incomplete data, or inadequate imaging.</div></div><div><h3>Predictor Variables</h3><div>The primary predictor variable was the surgical approach to the ZMC fracture: localized or coronal incision.</div></div><div><h3>Outcome Variables</h3><div>The primary outcome variable was fracture repair quality. We had measured the bilateral distance differences from anatomical landmarks as quality of fracture repair using computed tomography imaging. Quality of fracture repair was graded as follows: &lt;1 mm (excellent), 1 to 2 mm (good), and &gt;2 mm (general).</div></div><div><h3>Covariates</h3><div>The covariates included age, gender, trauma mechanism, preoperative waiting time, classification of ZMC fractures, eye injury, and accompanied other maxillofacial fractures.</div></div><div><h3>Analyses</h3><div>Statistical analyses were performed by t-test and the χ² test for bivariate analysis. Statistical significance was set at <em>P</em> &lt; .05.</div></div><div><h3>Results</h3><div>The study included 75 subjects with a mean age of 37 ± 4 years, comprising 52 males (69.3%) and 23 females (30.7%). Local and coronal incisions were used in 40 (53%) and 35 (47%) subjects, respectively. There was a statistically significant difference between surgical approach (local vs coronal) and fracture repair quality (<em>P</em> &lt; .0001). There was a statistically significant difference in the distance of the foramen magnum to the zygomatic surface between coronal incision (0.78 ± 0.62 mm) and local incision (1.34 ± 0.98 mm) (<em>P</em> = .003). Similarly, significant differences were observed in the distance from the midline to the zygomatic surface (coronal: 0.73 ± 0.40 mm vs local: 1.38 ± 1.21 mm; <em>P</em> = .005) and distance of the foramen magnum to the zygomatic arch (D-FZA) (coronal: 0.65 ± 0.34 mm vs local: 1.29 ± 0.81 mm; <em>P</em> &lt; .0001).</div></div><div><h3>Conclusion and Relevance</h3><div>The local incisions can achieve satisfactory outcomes in ZMC fracture surgery while avoiding additional incisions. Compared to local incisions, coronal incisions offer the advantage of accurate anatomical reduction and improved fracture repositioning.</div></div>","PeriodicalId":16612,"journal":{"name":"Journal of Oral and Maxillofacial Surgery","volume":"83 10","pages":"Pages 1258-1265"},"PeriodicalIF":2.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144637320","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"RE: What Are the Complications of Temporomandibular Joint Arthrocentesis?","authors":"Cholappadi Vijayakumar Srinivedha MDS,&nbsp;Rinku Kurian George MDS,&nbsp;Raghu Kumaravelu MDS","doi":"10.1016/j.joms.2025.05.022","DOIUrl":"10.1016/j.joms.2025.05.022","url":null,"abstract":"","PeriodicalId":16612,"journal":{"name":"Journal of Oral and Maxillofacial Surgery","volume":"83 10","pages":"Page 1198"},"PeriodicalIF":2.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145189953","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"AAOMS Author Disclosure forms","authors":"","doi":"10.1016/S0278-2391(25)00690-1","DOIUrl":"10.1016/S0278-2391(25)00690-1","url":null,"abstract":"","PeriodicalId":16612,"journal":{"name":"Journal of Oral and Maxillofacial Surgery","volume":"83 10","pages":"Pages A8-A10"},"PeriodicalIF":2.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145190106","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Is Treatment at a Level 1 Trauma Center Associated With Better Outcomes in Adults With Isolated Midface Fractures?","authors":"Lang Liang BS ,&nbsp;Tim T. Wang DMD, MD ,&nbsp;Nicholas Wilken DDS, MD ,&nbsp;Gary Warburton DMD, MD ,&nbsp;John Caccamese DMD, MD ,&nbsp;Cameron Lee DMD, MD","doi":"10.1016/j.joms.2025.06.202","DOIUrl":"10.1016/j.joms.2025.06.202","url":null,"abstract":"<div><h3>Background</h3><div>Treatment at a level 1 trauma center is associated with better outcomes for a multitude of traumatic injuries. Yet, the relationship between trauma center designation and treatment outcomes in the context of midface trauma remains poorly understood.</div></div><div><h3>Purpose</h3><div>The purpose of this study was to evaluate the association between trauma center designation and clinical outcomes in patients undergoing an operative intervention for isolated midface trauma.</div></div><div><h3>Study Design, Setting, Sample</h3><div>This was a retrospective cohort study using the American College of Surgeons National Trauma Data Bank 2018 to 2022. Adults with isolated midface trauma who underwent an operative intervention were included. Patients with polytrauma or missing data were excluded.</div></div><div><h3>Predictor Variable</h3><div>The primary predictor variable was trauma center designation (level 1 or non–level 1).</div></div><div><h3>Main Outcome Variable</h3><div>The primary outcome variable was any complication (yes or no). The secondary outcomes were return to the operating room, length of stay, adverse discharge disposition, and days to operation.</div></div><div><h3>Covariates</h3><div>Covariates were categorized as demographic (age, sex, payer), medical and injury-related (Elixhauser Comorbidity Index, fracture count), and hospital-related (teaching status, bed size).</div></div><div><h3>Analyses</h3><div>Descriptive, bivariate, and multivariable regression statistics were calculated to measure the association between trauma center designation and outcomes.</div></div><div><h3>Results</h3><div>Of the 62,437 subjects with isolated midface trauma, 8,321 (13.3%) underwent an operative intervention. There were no significant differences between operation rate between level 1 and non–level 1 trauma centers (odds ratio, 1.01; 95% CI, 0.95 to 1.08). The operative cohort had a mean age of 44.8 ± 18.5 years, and 5,941 were male (71.4%). The complication rates at level 1 and non–level 1 trauma centers were 1.1% (58) and 1.0% (33) respectively, and this difference was not significant (relative risk 1.08; 95% CI, 0.71 to 1.67, <em>P</em> = .8). After adjusting for study covariates, trauma center designation was not independently associated with complications, hospital length of stay, return to the operating room, adverse discharge disposition, or days to operation.</div></div><div><h3>Conclusion and Relevance</h3><div>Trauma center designation was not independently associated with clinical outcomes. Further studies are necessary to determine which patients would benefit most from treatment at a level 1 trauma center.</div></div>","PeriodicalId":16612,"journal":{"name":"Journal of Oral and Maxillofacial Surgery","volume":"83 10","pages":"Pages 1248-1257"},"PeriodicalIF":2.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144567503","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"How Has Your Practice Changed?","authors":"Tara Aghaloo DDS, MD, PhD (Associate Editor)","doi":"10.1016/j.joms.2025.05.020","DOIUrl":"10.1016/j.joms.2025.05.020","url":null,"abstract":"","PeriodicalId":16612,"journal":{"name":"Journal of Oral and Maxillofacial Surgery","volume":"83 10","pages":"Page 1189"},"PeriodicalIF":2.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145190096","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"RE: Selective Serotonin Reuptake Inhibitors May Increase Implant Failure","authors":"Benjamin Palla DMD, MD,&nbsp;John Anderson DDS, MD,&nbsp;Frederic Van der Cruyssen DDS, MD, MHM, PhD","doi":"10.1016/j.joms.2025.05.025","DOIUrl":"10.1016/j.joms.2025.05.025","url":null,"abstract":"","PeriodicalId":16612,"journal":{"name":"Journal of Oral and Maxillofacial Surgery","volume":"83 10","pages":"Page 1196"},"PeriodicalIF":2.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145190099","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Emergence Point of the Infratrochlear Nerve With Reference to the Nasion and Its Clinical Implications in Craniofacial Surgery","authors":"Kang-Jae Shin PhD ,&nbsp;Shin Hyo Lee PhD ,&nbsp;Hyun Jin Shin MD, PhD","doi":"10.1016/j.joms.2025.06.003","DOIUrl":"10.1016/j.joms.2025.06.003","url":null,"abstract":"<div><h3>Background</h3><div>Infratrochlear nerve (ITN) block is widely used in craniofacial surgery to provide anesthesia and reduce perioperative discomfort. Accurate localization of the emergence point of the ITN (EP-ITN) using external landmarks may improve the precision of the block.</div></div><div><h3>Purpose</h3><div>This study aimed to identify the anatomical location of the EP-ITN in the medial orbital margin with reference to the nasion, and to evaluate whether the nasion may serve as a consistent external landmark for ITN block procedure.</div></div><div><h3>Study design, Setting, Sample</h3><div>This was a cross-sectional anatomic study conducted at Dong-A University College of Medicine. Inclusion criteria were cadavers with legally obtained consent for use in anatomical research. Cadavers with evidence of facial trauma, previous craniofacial surgery, skeletal deformities, or prior dissection compromising anatomical integrity were excluded.</div></div><div><h3>Main Outcome Variables</h3><div>The primary outcome variable was defined as the vertical and horizontal distances from the EP-ITN to the nasion. Secondary outcome variables included the vertical distances from the EP-ITN to the trochlea and medial canthus.</div></div><div><h3>Covariates</h3><div>Age and sex of the cadavers, along with facial morphological dimensions, including the vertical and horizontal dimensions of the midface and orbit.</div></div><div><h3>Analyses</h3><div>Descriptive statistics were calculated. Independent and dependent t-tests evaluated sex and side differences, while Pearson's correlation analyzed relationships between facial dimensions and EP-ITN distances.</div></div><div><h3>Results</h3><div>A total of 38 hemifaces from 19 embalmed Korean cadavers were analyzed. The mean distances from the EP-ITN to the nasion, trochlea, and medial canthus were 1.6 ± 1.3 mm, 2.4 ± 1.3 mm, and 11.7 ± 2.0 mm, respectively. Horizontal facial width and orbital width were positively correlated with the EP-ITN-to-trochlea distance (r = 0.503, <em>P</em> = .008; r = 0.472, <em>P</em> = .012) but not with the EP-ITN-to-nasion distance.</div></div><div><h3>Conclusions and Relevance</h3><div>This cadaveric study quantified the spatial relationship between nasion and EP-ITN, finding the nasion averages 1.6 mm superior to EP-ITN with minimal variability across specimens. These findings suggest the nasion as a reliable external landmark for EP-ITN identification in ITN block planning.</div></div>","PeriodicalId":16612,"journal":{"name":"Journal of Oral and Maxillofacial Surgery","volume":"83 10","pages":"Pages 1209-1215"},"PeriodicalIF":2.6,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144560434","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}