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, Maria A Bordoy, Dakota Miller, Turki M Althenyan, Edward Ellis","doi":"10.1016/j.joms.2025.06.001","DOIUrl":"https://doi.org/10.1016/j.joms.2025.06.001","url":null,"abstract":"<p><strong>Background: </strong>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.</p><p><strong>Purpose: </strong>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.</p><p><strong>Study design, setting, sample: </strong>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.</p><p><strong>Predictor variable: </strong>The predictor variable was the type of model surgery (conventional vs virtual) used for maxillary segmentation.</p><p><strong>Main outcome variable(s): </strong>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.</p><p><strong>Covariates: </strong>None.</p><p><strong>Analyses: </strong>Parametric statistical tests compared occlusal outcomes and planning times between methods. Two-tailed t-tests analyzed ABO index differences and planning times, with a significance level of P < .05.</p><p><strong>Results: </strong>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 (P < .001). Virtual planning was faster, with an average time reduction of 25 minutes and 28 seconds (SD = 5:34; P < .001).</p><p><strong>Conclusions and relevance: </strong>The findings suggest that virtual model surgery outperforms conventional methods in achieving superior preoperative occlusal outcomes while reducing overall planning time.</p>","PeriodicalId":16612,"journal":{"name":"Journal of Oral and Maxillofacial Surgery","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-06-09","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":"Do Healing Rates Differ Between Medication-Related and Medication-Unrelated Osteonecrosis of the Jaw?","authors":"Masaki Fujimori, Yoshiyuki Toriyabe, Noriyuki Sakakibara, Masanori Nojima, Shujiroh Makino","doi":"10.1016/j.joms.2025.05.023","DOIUrl":"https://doi.org/10.1016/j.joms.2025.05.023","url":null,"abstract":"<p><strong>Background: </strong>The healing rates, time to complete healing, effectiveness of operative therapy, and factors associated with healing for medication-related osteonecrosis of the jaw (MRONJ) and medication-unrelated osteonecrosis of the jaw (MUONJ) remain unclear.</p><p><strong>Purpose: </strong>The study aimed to estimate and compare the healing rates between patients with MRONJ and MUONJ and identify prognostic factors associated with healing.</p><p><strong>Study design, setting, sample: </strong>A 25-center prospective cohort study was performed-the investigators enrolled patients with ONJ treated using a standardized therapeutic protocol between 2013 and 2016. Patients with a history of radiation therapy to the jaws were excluded.</p><p><strong>Predictor variable: </strong>The primary predictor variable was the ONJ diagnosis. The secondary predictors involved a set of heterogenous variables grouped into demographic, medical, clinical condition, and perioperative categories.</p><p><strong>Main outcome variables: </strong>The primary outcome variable was treatment duration, defined as the time (in months) between therapy initiation and site healing, date of the final visit, or loss to follow-up.</p><p><strong>Covariates: </strong>Not applicable.</p><p><strong>Analyses: </strong>Descriptive statistics and cumulative healing rates were calculated. P < .05 was considered significant.</p><p><strong>Results: </strong>The sample comprised 332 subjects with a mean age of 72.3 ± 11.1 years, among whom 116 (34.9%) were male. The MUONJ and MRONJ groups included 41 (12.3%) and 291 (87.7%) subjects, respectively, exhibiting 1-year cumulative healing rates of 92.1 and 47.3% (P < .01), respectively. The hazard ratio for complete healing was 3.7 (95% CI = 2.5 to 5.3, P < .01) in subjects with MUONJ compared with those with MRONJ. The median time to complete healing was 6 (3.8 to 8.2) months in the MUONJ group, while less than half of the subjects in the MRONJ group healed within 12 months. The 1-year cumulative healing rate was 92.1 and 47.3% (P < .01) in the operative therapy and nonoperative therapy groups, respectively.</p><p><strong>Conclusions and relevance: </strong>MUONJ was associated with better healing rates and a shorter time to healing compared with MRONJ. Operative therapy also showed potential benefits. Decisions for treating ONJ should be based on these findings alongside individual patient needs and conditions.</p>","PeriodicalId":16612,"journal":{"name":"Journal of Oral and Maxillofacial Surgery","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144475706","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":"What Factors Influence Success of Mandibular Reconstructions With Patient-Specific Selective Laser Melted Reconstruction Plates?","authors":"Jeffrey S Marschall, Mitchell Frerichs, Thomas Keith, Steven Fletcher, Doug Kendrick, Chris Kepros, Kirk Fridrich, Richard Burton","doi":"10.1016/j.joms.2025.05.024","DOIUrl":"https://doi.org/10.1016/j.joms.2025.05.024","url":null,"abstract":"<p><strong>Background: </strong>Patient-specific reconstruction is becoming more ubiquitous in craniomaxillofacial surgery. There is a paucity of information on what factors may influence case success.</p><p><strong>Purpose: </strong>The purpose of the study was to estimate patient-specific hardware failure rate and to identify risk factors associated with hardware failure.</p><p><strong>Study design, setting, sample: </strong>A retrospective cohort study was implemented using data from subjects treated with selectively laser melted (SLM) reconstruction plates at the University of Iowa. Subjects were excluded if follow-up was less than 3 months, data were not complete, or the subjects were not treated with an SLM plate.</p><p><strong>Predictor variables: </strong>The predictor variables were composed of heterogenous variables grouped into the following categories: demographics, etiology, mandibular characteristics, and reconstruction plate characteristics, such as number of screws proximal and distal to fracture/defect.</p><p><strong>Main outcome variable: </strong>The primary outcome variable was time to screw failure (yes/no), which was determined by examining subject radiographic data and if it was clinical reason for the removal of the reconstruction plate.</p><p><strong>Covariates: </strong>The only covariate is sex.</p><p><strong>Analyses: </strong>Descriptive statistics were calculated for each variable. Bivariate Cox regression analyses were performed to assess the association between each variable and the hazard of screw failure. Alpha = 0.05 was considered significant.</p><p><strong>Results: </strong>The sample included 131 subjects. The median follow-up time was 11.0 (interquartile range 14.0) months. There was 1 (0.8%) plate fracture and 10 (7.6%) screw failures. Subjects with 1 additional screw proximal to the fracture/defect (eg, from 3 to 4, or 4 to 5, or 5 to 6) had a 63% higher hazard of screw failure at any given time over the follow-up period (hazard ratio [HR] = 1.63; P = .04; 95% CI, 1.02 to 2.63). Subjects with 1 additional screw distal to the fracture/defect had a 58% higher hazard of screw failure (HR = 1.58; P = .01; 95% CI, 1.10 to 2.26). Among patients with continuity defects (n = 49), those who received a bone graft had an 85% lower hazard of screw failure compared to those who did not receive a graft (HR = 0.15; P = .03; 95% CI, 0.03 to 0.851).</p><p><strong>Conclusion and relevance: </strong>SLM reconstruction plate fracture is rare. Adding additional screws proximal and distal to a fracture/defect may lead to a higher hazard of hardware failure. Using a bone graft for continuity defects may lead to a lower hazard of hardware failure.</p>","PeriodicalId":16612,"journal":{"name":"Journal of Oral and Maxillofacial Surgery","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144475707","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)00201-0","DOIUrl":"10.1016/S0278-2391(25)00201-0","url":null,"abstract":"","PeriodicalId":16612,"journal":{"name":"Journal of Oral and Maxillofacial Surgery","volume":"83 6","pages":"Pages A9-A11"},"PeriodicalIF":2.3,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144184756","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":"Evidence to the Contrary","authors":"Thomas B. Dodson DMD, MPH (Editor-in-Chief)","doi":"10.1016/j.joms.2025.03.004","DOIUrl":"10.1016/j.joms.2025.03.004","url":null,"abstract":"","PeriodicalId":16612,"journal":{"name":"Journal of Oral and Maxillofacial Surgery","volume":"83 6","pages":"Pages 645-646"},"PeriodicalIF":2.3,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144184757","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: Clinical, Radiological, and Histomorphometric Comparison of the Use of Deproteinized Bovine Bone Mineral and Titanium-Prepared Platelet-Rich Fibrin in Maxillary Sinus Augmentation: A Split-Mouth Randomized Controlled Clinical Study","authors":"Carlos Fernando Mourão DMD, MS, PhD,&nbsp;Rodrigo dos Santos Pereira DDS, MSc, PhD","doi":"10.1016/j.joms.2025.01.019","DOIUrl":"10.1016/j.joms.2025.01.019","url":null,"abstract":"","PeriodicalId":16612,"journal":{"name":"Journal of Oral and Maxillofacial Surgery","volume":"83 6","pages":"Pages 655-656"},"PeriodicalIF":2.3,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144184817","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":"Custom Fabricated Subperiosteal Implants for Sectional Rehabilitation of Severely Atrophic Maxillae: A Technical Note","authors":"Luigi Angelo Vaira MD, PhD ,&nbsp;Andrea Biglio MD, DDS ,&nbsp;Giovanni Salzano MD ,&nbsp;Alberto Pispero DDS ,&nbsp;Jerome R. Lechien MD, PhD ,&nbsp;Giacomo De Riu MD","doi":"10.1016/j.joms.2025.02.007","DOIUrl":"10.1016/j.joms.2025.02.007","url":null,"abstract":"<div><div>Severe atrophy in isolated posterior maxillary sectors poses challenges for dental rehabilitation, especially in partially dentate patients where traditional graftless techniques are unsuitable. This study retrospectively analyzed the outcomes of sectional rehabilitation in 16 consecutive patients with Cawood and Howell class V to VI atrophy treated with 21 custom fabricated subperiosteal implants. Patients were followed for a median of 36 months (interquartile range: 24 to 48). Implant survival and success rates at 1 and 5 years were 95.2%, with minimal complications. Radiological assessments showed no significant bone resorption beneath abutments (mean: 0.18 mm at 1 year). Soft tissue health improved over time, with bleeding on probing affecting 10% of abutments at 6 months and only 2.5% at 4 years. These findings suggest that subperiosteal implants offer a viable graftless solution for sectional rehabilitation in partially dentate patients, combining high survival rates with favorable radiological and soft tissue outcomes. Further studies are needed to confirm long-term effectiveness.</div></div>","PeriodicalId":16612,"journal":{"name":"Journal of Oral and Maxillofacial Surgery","volume":"83 6","pages":"Pages 728-737"},"PeriodicalIF":2.3,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143586055","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":"Aromatherapy on Anxiety, Pain, and Quality of Life Following Surgery of Mandibular Third Molars: A Randomized, Double-Blind Clinical Trial","authors":"Ylana Rosa Matos DDS ,&nbsp;Maria Fernanda da Silva Nascimento DDS ,&nbsp;Maria Clara Mendes Gomes ,&nbsp;João Emanuel Sousa de Almeida DDS ,&nbsp;Paulo Goberlânio de Barros Silva DDS, MSc, PhD ,&nbsp;Edson Luiz Cetira Filho DDS, MSc, PhD","doi":"10.1016/j.joms.2025.03.003","DOIUrl":"10.1016/j.joms.2025.03.003","url":null,"abstract":"<div><h3>Background</h3><div>The control of anxiety is significant in the management of mandibular third molar removal surgery and may impact patients' pain.</div></div><div><h3>Purpose</h3><div>This study aimed to measure the effects of aromatherapy on the control of anxiety, pain, and quality of life in lower third molar removal surgery.</div></div><div><h3>Study design</h3><div>From 2023 to 2024, a double-blinded randomized clinical trial was performed on patients with indications for removal of unilateral mandibular third molars at our institution. Subjects were excluded if they received additional mandibular teeth extractions, were unable to complete the questionnaire, or had medical contraindications.</div></div><div><h3>Predictor variable</h3><div>The predictor variable is aromatherapy exposure, and subjects were randomly assigned to lavender oil or distilled water. Each patient underwent an aromatherapy session in a closed room, with the diffuser turned on 30 minutes before the patient's entry following its use during the operation.</div></div><div><h3>Main outcome variables</h3><div>The outcome variables were pain measured using a visual analog scale, anxiety measured using the Dental Anxiety Scale questionnaire, and quality of life measured using the Oral Health Impact Profile questionnaire. The outcomes were measured preoperatively and 7 days after the operation.</div></div><div><h3>Covariates</h3><div>The covariates are hemodynamic parameters, sex, age, race, educational level, and family income.</div></div><div><h3>Analyses</h3><div>Mann-Whitney independent test (between groups) or Friedman/Dunn and Wilcoxon's test (intragroup analysis); the statistical significance was set at <em>P</em> &lt; .05.</div></div><div><h3>Results</h3><div>The study sample included 32 patients (17 female [53%] and 15 male [47%], mean age 24.72 ± 4.63 years). The peak of pain in both groups was observed 2 hours after surgery, with a reduction after 12 hours, and there were no differences between the 2 groups about pain (<em>P</em> = .9). Regarding anxiety control and hemodynamic parameters, there was an improvement in both groups, with a reduction of 2 points in the score (<em>P</em> = .011).</div></div><div><h3>Conclusions</h3><div>Aromatherapy is not statistically significantly effective compared to distilled water in reducing pain and improving quality of life. However, it showed favorable results in reducing anxiety and hemodynamic parameters.</div></div>","PeriodicalId":16612,"journal":{"name":"Journal of Oral and Maxillofacial Surgery","volume":"83 6","pages":"Pages 748-756"},"PeriodicalIF":2.3,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143730531","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":"Oral and Maxillofacial Surgery Complication Rates at a Major Teaching Hospital: A 9-Year Retrospective Review","authors":"Mary Cho DDS ,&nbsp;Nagi Demian DDS, MD ,&nbsp;Brendan Moxley BS ,&nbsp;Pearl Craig DDS, MsD","doi":"10.1016/j.joms.2025.02.011","DOIUrl":"10.1016/j.joms.2025.02.011","url":null,"abstract":"<div><h3>Background</h3><div>Postoperative complications in oral and maxillofacial surgery (OMS) can prolong recovery, increase health care costs, and negatively impact patient outcomes. Identifying complication trends is crucial for improving patient care and safety, particularly in academic settings where balancing surgical training and patient safety is essential.</div></div><div><h3>Purpose</h3><div>The study purpose is to measure and identify trends in the prevalence of OMS complications over a 9-year period at a major teaching hospital.</div></div><div><h3>Study Design, Setting, Sample</h3><div>This retrospective cohort study was conducted at Memorial Hermann Hospital, Texas Medical Center, Houston. The study included 4,466 documented operations performed between July 1, 2014, and June 30, 2023, with no exclusions.</div></div><div><h3>Predictor Variable</h3><div>The primary predictor variable was date of surgery, measured in years. A secondary predictor variable was procedure type, categorized into 8 groups: trauma, infection, dentoalveolar, reconstruction, pathology, critical care, orthognathic, and temporomandibular joint disorder.</div></div><div><h3>Main Outcome Variable</h3><div>The primary outcome variable was the occurrence of postoperative complications, defined as any adverse outcome or unintended consequence resulting from medical or surgical treatment and documented as a morbidity or mortality event. A secondary outcome variable was complication type.</div></div><div><h3>Covariates</h3><div>Age and sex associated with procedures were collected.</div></div><div><h3>Analyses</h3><div>Demographic variables were computed at the subject level. Descriptive analysis at the procedure level was used to calculate the prevalence of complications. A generalized linear model assessed trends in complication prevalence, procedure volume, and complication type over time, while Fisher’s exact test examined the relationship between procedure type and complication type. A <em>P</em> value of &lt;.05 was considered statistically significant.</div></div><div><h3>Results</h3><div>The sample was composed of 4,466 operations and 4,453 subjects with a mean age of 41.4 (±4.6) and 2,724 (61%) were male. There were 325 (7.28%) complications. There was no statistically significant trend in the prevalence of complications over time (B-coefficient 0.002, 95% CI −3.9 to 0.004, <em>P</em> = .1). There was a significant association between procedure type and complication type (<em>P</em> &lt; .001). Orthognathic procedures exhibited the highest proportion of complications at 17.4% (n = 4), while critical care procedures demonstrated the lowest at 2.0% (n = 4).</div></div><div><h3>Conclusion and Relevance</h3><div>No statistically significant trend in the prevalence of complications was observed, but procedure type was associated with complication type.</div></div>","PeriodicalId":16612,"journal":{"name":"Journal of Oral and Maxillofacial Surgery","volume":"83 6","pages":"Pages 711-719"},"PeriodicalIF":2.3,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143649327","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 Lingual Fracture Pattern Following Sagittal Split With the Low and Short Medial Osteotomy","authors":"Collin A. Ritchie DMD, MD ,&nbsp;Lauren Hayes BS ,&nbsp;Guihua Zhai PhD ,&nbsp;Brian E. Kinard DMD, MD","doi":"10.1016/j.joms.2025.03.002","DOIUrl":"10.1016/j.joms.2025.03.002","url":null,"abstract":"<div><h3>Background</h3><div>The lingual split scale (LSS) following sagittal ramus osteotomy (SRO) is an objective scale where LSS1 to 3 are variations of a favorable split, while LSS4 is an unfavorable split. LSS influences postoperative bone overlap, posterior interferences, and fixation methods. There is currently no study evaluating LSS following SRO using the low and short medial osteotomy modification.</div></div><div><h3>Purpose</h3><div>The purpose of this study is to describe the lingual fracture pattern of the distal segment through the LSS following SRO using the low and short medial osteotomy modification.</div></div><div><h3>Study Design, Setting, and Sample</h3><div>A retrospective cohort study of subjects undergoing SRO with the low and short medial osteotomy by a single surgeon at The University of Alabama at Birmingham between February 2020 and July 2024. Subjects with incomplete records were excluded.</div></div><div><h3>Predictor Variables</h3><div>Anatomic predictor variables were ramus width and length and the vertical height of the lingula. Procedural predictor variables were height and angle of the medial osteotomy, medial osteotomy relative to the lingula and to the mandibular canal, and third molar removal at the time of SRO.</div></div><div><h3>Main Outcome Variable</h3><div>The primary outcome variable was the LSS. LSS1 to 3 are variations of a favorable SRO split, while LSS4 is unfavorable.</div></div><div><h3>Covariates</h3><div>Covariates include age, sex, and previous mandibular osteotomies.</div></div><div><h3>Analyses</h3><div>The significance level was defined as <em>P</em> &lt; .05. Multivariate regression analyses assessed variables that were near statistically significant (<em>P</em> &lt; .2). Hemimandibles were correlated and the subject factor was accounted for using generalized estimating equations.</div></div><div><h3>Results</h3><div>The study sample had 210 subjects (419 hemimandibles). LSS variations of favorable splits resulted in 263 (62.8%) vertical fractures (LSS1), 8 (1.9%) horizontal fractures (LSS2), and 139 (33.2%) fractures along the mandibular canal (LSS3). Nine (2.2%) unfavorable splits (LSS4) were present. No variables were found to be significantly associated with unfavorable fractures (LSS4).</div></div><div><h3>Conclusions and Relevance</h3><div>SRO using the low and short medial osteotomy resulted in predictable LSS patterns. Favorable fracture patterns (LSS1 to 3) were present in 97.8% (410) of SROs, while unfavorable fracture patterns (LSS4) were present in 2.2% (9). No variables were identified to be significantly associated with unfavorable fracture (LSS4).</div></div>","PeriodicalId":16612,"journal":{"name":"Journal of Oral and Maxillofacial Surgery","volume":"83 6","pages":"Pages 670-680"},"PeriodicalIF":2.3,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143730535","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}