Journal of Oral and Maxillofacial Surgery最新文献

{"title":"Self-Irrigation Device for Intraoral Home Care","authors":"Liszen Tang MDS (Oral & Maxillofacial Surgery) ,&nbsp;Kar Tsyeng Ng BDS ,&nbsp;Mukhriz Hamdan MClinDent (Oral & Maxillofacial Surgery) ,&nbsp;Rithuan Awang MClinDent (Oral & Maxillofacial Surgery)","doi":"10.1016/j.joms.2024.12.013","DOIUrl":"10.1016/j.joms.2024.12.013","url":null,"abstract":"<div><div>Following surgical treatment of a jaw cyst, bony cavities are formed. These cavities are prone to infection when they communicate with the oral environment. Hence, proper irrigation is a crucial aspect of postsurgical care, as it helps to reduce debris buildup and the risk of infection. However, the irrigation method of using a cannula is ineffective due to poor patient compliance. In response, we present a novel solution to this problem.</div></div>","PeriodicalId":16612,"journal":{"name":"Journal of Oral and Maxillofacial Surgery","volume":"83 4","pages":"Pages 456-458"},"PeriodicalIF":2.3,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143039623","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Role of Anticoagulation Regimen on Flap Outcome in Microvascular Head and Neck Reconstruction","authors":"Samah Mouzannar MD ,&nbsp;Amirmohsen Jalaeefar MD ,&nbsp;Mohammad Shirkhoda MD ,&nbsp;Fereidoon Memari MD ,&nbsp;Ali Arab Kheradmand MD ,&nbsp;Ata Garajei MD ,&nbsp;Arshia Zardoui MD ,&nbsp;Seyed Masoumeh Valizadeh-Otaghsara MSc ,&nbsp;Amirmohammad Bakhtiari MSc ,&nbsp;Amirsina Sharifi MD","doi":"10.1016/j.joms.2024.12.011","DOIUrl":"10.1016/j.joms.2024.12.011","url":null,"abstract":"<div><h3>Background</h3><div>Thrombus formation following flap reconstruction reduces perfusion and can lead to flap compromise. Effective anticoagulation protocols are essential to prevent this complication.</div></div><div><h3>Purpose</h3><div>The study’s purpose was to measure and compare flap compromise associated with 3 different anticoagulation protocols.</div></div><div><h3>Study Design, Setting, Sample</h3><div>This retrospective cohort study included patients with head and neck cancer who underwent flap reconstruction. Exclusion criteria included patients who did not consent to participate, did not receive the anticoagulation regimen, or had a history of adverse reactions to heparin or aspirin (ASA).</div></div><div><h3>Exposure</h3><div>The primary exposure was the anticoagulation protocol, which was divided into 3 groups: intravenous unfractionated heparin (IV-UFH), subcutaneous UFH (SC-UFH), and SC-UFH plus ASA.</div></div><div><h3>Main Outcome Variable</h3><div>The outcome variable was postoperative flap outcome coded as compromised or not.</div></div><div><h3>Covariates</h3><div>Covariates included patient demographics, cancer type, neoadjuvant therapy, flap type, surgical procedure, intensive care unit stay, medical history, and postoperative complications.</div></div><div><h3>Analyses</h3><div>χ², Mann–Whitney U, and Kruskal–Wallis tests were used for baseline data analysis. Multivariate logistic regression was conducted to examine the adjusted association between anticoagulation protocol and flap outcome. <em>P</em> values &lt; .05 were considered statistically significant.</div></div><div><h3>Results</h3><div>The study sample consisted of 300 patients who met inclusion criteria with a mean age of 48.3 (±17.69) years, 202 (67.3%) of whom were male. There were 28 (9.3%) cases of flap compromise. The unadjusted analysis showed that patients receiving IV-UFH had a significantly higher risk of flap compromise compared to those receiving SC-UFH (relative risk: 3.43 [1.62 to 7.28]). Adding ASA to SC-UFH did not result in a statistically significant reduction in the risk of flap compromise (relative risk: 0.95 [0.35 to 2.61]). After adjusting for confounding factors, the anticoagulant type was not associated with flap compromise (<em>P</em> = .05). However, in the subgroup analysis, compared to SC-UFH, subjects receiving IV-UFH still had higher odds of flap compromise (odds ratio = 2.69, 95% CI [1.003 to 7.205], <em>P</em> = .049)</div></div><div><h3>Conclusion and Relevance</h3><div>Postoperative thrombosis in head and neck microsurgery remains a significant risk factor for poor outcomes. SC-UFH administration may be a practical approach to managing these risks compared to intravenous administration; however, the choice of anticoagulation protocol is not associated with the flap compromise.</div></div>","PeriodicalId":16612,"journal":{"name":"Journal of Oral and Maxillofacial Surgery","volume":"83 4","pages":"Pages 467-475"},"PeriodicalIF":2.3,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143006918","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Influence of Fluoxetine on the Sensorimotor Function of the Sciatic Nerve in Wistar Rats after Axonotmesis: An Experimental Animal Model","authors":"Michelly Cauás de Queiroz Gatis ,&nbsp;Marcelo Moraes Valença ,&nbsp;Heitor Ferreira de Souza Neto ,&nbsp;Henrique Lima Ferreira de Souza ,&nbsp;Carlos Augusto Pereira do Lago","doi":"10.1016/j.joms.2024.12.004","DOIUrl":"10.1016/j.joms.2024.12.004","url":null,"abstract":"<div><h3>Background</h3><div>Fluoxetine, a serotonin reuptake inhibitor antidepressant, raises extracellular serotonin levels and promotes angiogenesis and neurogenesis. Numerous animal models have shown its beneficial effects on recovery from peripheral nerve injury.</div></div><div><h3>Purpose</h3><div>The primary objective of this study was to analyze the influence of fluoxetine on the sensory-motor function recovery of the sciatic nerve in Wistar rats after axonotmesis.</div></div><div><h3>Study design, setting, and sample</h3><div>This study utilized an experimental rat model, conducted in the laboratory at the Federal University of Pernambuco. The sample consisted of 40 male Wistar rats.</div></div><div><h3>Predictor variable</h3><div>The primary predictor variable was the fluoxetine exposure. The animals were randomly divided into 4 groups (control and 3 experimental groups), with 10 animals in each group. They were injected subcutaneously with saline or fluoxetine 5, 10, and 20 mg/kg/day, respectively.</div></div><div><h3>Main outcome variables</h3><div>The main outcome variables were postoperative motor and sensory sciatic nerve function. Sensory nerve function was measured using the withdrawal reflex by thermostimulation. Motor nerve function was measured using the Sciatic Nerve Recovery Index and the Static Sciatic Nerve Index (SSI).</div></div><div><h3>Covariates</h3><div>None.</div></div><div><h3>Analyses</h3><div>Descriptive statistical analysis was performed using mean and SD. Analaysis of variance (ANOVA) was used for comparisons between the groups and Dunnett's multiple comparisons test was used in case of significant differences between the groups. Statistical Analysis System was the software used for statistical analyses.</div></div><div><h3>Results</h3><div>During the study, 15 animals were lost (3 in the control group and 4 in each experimental group), with no specific cause identified. On day 35, the latency time of the withdrawal reflex was significantly different, with decreased pain perception in the 5 mg/kg/day fluoxetine group (3.80 ± 1.20, <em>P</em> &lt; .05). On day 14, the Sciatic Nerve Recovery Index showed greater deficits in the l0 and 20 mg/kg/day groups (−65.67 ± 7.20 and −63.57 ± 11.59, respectively) compared to the control group (<em>P</em> &lt; .05). The SSI also showed a delay in recovery with the 10 mg/kg/day dose (−62.50 ± 6.72, <em>P</em> &lt; .05).</div></div><div><h3>Conclusion</h3><div>The daily treatment with fluoxetine failed to bring any improvement to motor or sensory recuperation after injury to the sciatic nerve in Wistar rats.</div></div>","PeriodicalId":16612,"journal":{"name":"Journal of Oral and Maxillofacial Surgery","volume":"83 4","pages":"Pages 459-466"},"PeriodicalIF":2.3,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142895538","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of Two-Point Versus Three-Point Fixation in Treatment of Zygomaticomaxillary Complex Fractures: An Updated Meta-Analysis","authors":"Lele Guo MD ,&nbsp;Tianping Cheng MD ,&nbsp;Lixia Feng MD ,&nbsp;Jin Feng MD ,&nbsp;Xiangyun Li MD","doi":"10.1016/j.joms.2024.12.006","DOIUrl":"10.1016/j.joms.2024.12.006","url":null,"abstract":"<div><h3>Purpose</h3><div>Zygomaticomaxillary complex (ZMC) fractures are a prevalent form of craniofacial trauma. However, no universally accepted fixation method has been established to prevent postreduction displacement in ZMC fractures.</div></div><div><h3>Methods</h3><div>Computerized and additional manual searches of the Medline, Embase, Chinese National Knowledge Infrastructure, and Cochrane Central database for potential studies, published from inception to May 2024, were performed. The inclusion criteria were as follows: randomized controlled trials comparing two-point and three-point fixation for managing ZMC fractures; studies with at least 5 weeks of follow-up; sufficient data published to estimate relative risk or standardized mean difference (SMD) with a corresponding 95% CI. The following exclusion criteria were applied: nonrandomized prospective studies, retrospective studies, case series, case reports, animal and in vitro studies; letters to the editor; review articles; case reports, and studies without discrete outcomes data. The predictor variable was type of fixation. The primary outcome variables assessed in this study encompassed fracture instability, malar asymmetry grade, malar height, and vertical dystopia. These parameters were employed as quantitative measures of displacement. The secondary outcome was postoperative complications, including enophthalmos. Systematic review with meta-analyses, 2 reviewers independently extracted the relevant data, with disagreements resolved by consensus. Statistical analyses were performed using Stata, version 18.0 (StataCorp LLC, College Station, TX, USA).</div></div><div><h3>Results</h3><div>After reviewing 205 publications, the final sample was composed of 8 studies, with 189 participants in the two-point group and 187 in the three-point group. Patients were followed up for at least 5 weeks in all the studies. Fracture instability was greater with 2-point fixation than with 3-point fixation (relative risk 2.63 [95% CI: 1.95–3.56] <em>P</em> &lt; .001). Less vertical dystopia at 3 and 6 weeks were seen with 3-point fixation than with 2-point fixation (SMD 0.59, [95% CI 0.31–0.87] <em>P</em> &lt; .001) (SMD 6.30, [95% CI 3.02–9.58] <em>P</em> &lt; .001). Enophthalmos, malar asymmetry grade II (3 months), operation duration, malar height, and vertical dystopia (mm) 1 week did not differ between the groups.</div></div><div><h3>Conclusions</h3><div>Three-point fixation may provide more stability and less vertical dystopia than two-point fixation. This finding should help surgeons in making evidence-based decisions when selecting an optimal fixation pattern.</div></div>","PeriodicalId":16612,"journal":{"name":"Journal of Oral and Maxillofacial Surgery","volume":"83 4","pages":"Pages 448-455"},"PeriodicalIF":2.3,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142921894","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 Transformative Potential of Artificial Intelligence in Oral and Maxillofacial Surgery","authors":"Pascal Eber MD ,&nbsp;Yannick Martin Sillmann DDS ,&nbsp;Fernando Pozzi Semeghini Guastaldi DDS, MSc, PhD","doi":"10.1016/j.joms.2024.11.017","DOIUrl":"10.1016/j.joms.2024.11.017","url":null,"abstract":"","PeriodicalId":16612,"journal":{"name":"Journal of Oral and Maxillofacial Surgery","volume":"83 4","pages":"Pages 402-405"},"PeriodicalIF":2.3,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143746980","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association Between Type of Residency Interview, Virtual Versus In-Person, and Distance From Applicants' Dental School to Oral and Maxillofacial Surgery Program Matched: Report From the American Association of Oral and Maxillofacial Surgeons Committee on Education and Training.","authors":"Joshua D Segal, Brent B Ward, Martin B Steed, Pushkar Mehra, Deepak G Krishnan","doi":"10.1016/j.joms.2025.03.016","DOIUrl":"https://doi.org/10.1016/j.joms.2025.03.016","url":null,"abstract":"<p><strong>Background: </strong>Oral and maxillofacial surgery (OMS) residency interviews for the 2021 match during the Covid-19 pandemic were near universally virtual in contrast to in-person interviews of prior years. In deciding whether to conduct in-person or virtual interviews, it is important for residency programs to understand the association of interview type on the distance between dental school attended and the program to which the applicant matched.</p><p><strong>Purpose: </strong>The study purpose was to measure the association between the type of residency interview conducted and the distance from the dental school attended to the program which the applicant matched.</p><p><strong>Study design, setting, sample: </strong>A retrospective cohort study was designed using National Matching Services Incorporated data of all applicants to OMS residency programs who matched the year following dental school between 2019 and 2021. Those who did not match the same year as dental school graduation were excluded.</p><p><strong>Predictor variable: </strong>The predictor variable was interview type. Match years 2019 and 2020 were coded as in-person and match year 2021 coded as virtual.</p><p><strong>Outcome: </strong>The main outcome variable was the straight-line distance in miles between dental school attended and residency matched calculated from geographic coordinates.</p><p><strong>Covariates: </strong>There were no covariates.</p><p><strong>Analyses: </strong>Wilcoxon signed-rank test was performed to determine if an association existed between the interview type and the distance. The significance level was set at a P value of ≤ .05.</p><p><strong>Results: </strong>The final sample was composed of 418 applicants who matched into OMS residency between 2019 and 2021. There were 277 (66%) and 141 (34%) applicants in the in-person and virtual interview groups, respectively. The mean distances between the dental school and the resident program for the in-person and virtual applicant pools were 633.22 miles (SD = 681.12 miles) and 630 miles (SD = 710.21 miles) respectively, (P value = .6).</p><p><strong>Conclusions and relevance: </strong>While distance between dental school and residency program may play an important role in the match, that distance did not have any statistically significant association with the type of interview.</p>","PeriodicalId":16612,"journal":{"name":"Journal of Oral and Maxillofacial Surgery","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144022599","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 Postoperative Steroid Use Associated With Improved Outcomes in Severe Odontogenic Infections?","authors":"Brian J Christensen, Earl Peter Park","doi":"10.1016/j.joms.2025.03.014","DOIUrl":"https://doi.org/10.1016/j.joms.2025.03.014","url":null,"abstract":"<p><strong>Background: </strong>The use of steroids as an adjunctive therapy in odontogenic infections is common, but few studies have focused on the effect of steroids in improving outcomes in these infections.</p><p><strong>Purpose: </strong>The purpose of the study was to measure the association between postoperative steroid use and length of stay (LOS) and reoperation among patients with severe odontogenic infections.</p><p><strong>Study design, setting, sample: </strong>The authors conducted a prospective cohort study consisting of all adult patients treated in the operating room for an odontogenic infection from August 1, 2019, to December 31, 2022, at University Medical Center of New Orleans. Patients were excluded if an odontogenic source could not be confirmed.</p><p><strong>Predictor variable: </strong>The predictor variable was the use of steroids postoperatively (after conclusion of surgery until discharge), coded as a yes or no.</p><p><strong>Main outcome variable: </strong>The outcome variables were total LOS, postsurgical LOS, and reoperation.</p><p><strong>Covariates: </strong>The covariates were demographics, medical history, exam findings, diagnosis, and treatment-related variables.</p><p><strong>Analyses: </strong>Descriptive and bivariate analyses were performed, as well as linear regression analyses. A P value of ≤ .05 was considered significant.</p><p><strong>Results: </strong>The study sample consisted of 240 patients with a mean age of 40.3 ± 14.5 years and a sex distribution of 57.5% (138) male and 42.5% (102) female. Steroids were used in 114 patients (47.5%) postoperatively. The mean total LOS and postsurgical LOS were 3.7 ± 2.4 days and 3.1 ± 2.4 days, respectively. Reoperation was performed for 12 (5.0%) patients. Postoperative steroid use group was not significantly associated with total LOS (3.7 ± 2.6 days vs 3.6 ± 2.2 days, P = .59), postsurgical LOS (3.3 ± 2.6 days vs 2.9 ± 2.1 days, P = .13), or reoperation (58.3 vs 41.7%, P = .56) for the group that received steroids versus those that did not, respectively.</p><p><strong>Conclusions and relevance: </strong>Postoperative steroid use was not associated with reduced LOS, postsurgical LOS, or reoperation in patients with severe odontogenic infections.</p>","PeriodicalId":16612,"journal":{"name":"Journal of Oral and Maxillofacial Surgery","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143998631","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 Artificial Intelligence Differs From Humans in Peer Review.","authors":"Michael V Joachim, Thomas B Dodson, Amir Laviv","doi":"10.1016/j.joms.2025.03.015","DOIUrl":"10.1016/j.joms.2025.03.015","url":null,"abstract":"<p><strong>Background: </strong>The peer review process faces challenges of reviewer fatigue and bias. Artificial intelligence (AI) may help address these issues, but its application in the oral and maxillofacial surgery peer review process remains unexplored.</p><p><strong>Purpose: </strong>The purpose of the study was to measure and compare manuscript review performance among 4 large language models and human reviewers. large language models are AI systems trained on vast text datasets that can generate human-like responses.</p><p><strong>Study design/setting/sample: </strong>In this cross-sectional study, we evaluated original research articles submitted to the Journal of Oral and Maxillofacial Surgery between January and December 2023. Manuscripts were randomly selected from all submissions that received at least one external peer review.</p><p><strong>Predictor variable: </strong>The predictor variable was source of review: human reviewers or AI models. We tested 4 AI models: Generative Pretrained Transformer-4o and Generative Pretrained Transformer-o1 (OpenAI, San Francisco, CA), Claude (version 3.5; Anthropic, San Francisco, CA), and Gemini (version 1.5; Google, Mountain View, CA). These models will be referred to by their architectural design characteristics, ie, dense transformers, sparse-expert, multimodal, and base transformer, to highlight their technical differences rather than their commercial identities.</p><p><strong>Outcome variables: </strong>Primary outcomes included reviewer recommendations (accept = 3 to reject = 0) and responses to 6 Journal of Oral and Maxillofacial Surgery editor questions. Secondary outcomes comprised temporal stability (consistency of AI evaluations over time) analysis, domain-specific assessments (methodology, statistical analysis, clinical relevance, originality, and presentation clarity; 1 to 5 scale), and model clustering patterns.</p><p><strong>Analyses: </strong>Agreement between AI and human recommendations was assessed using weighted Cohen's kappa. Intermodel reliability and temporal stability (24-hour interval) were evaluated using intraclass correlation coefficients. Domain scoring patterns were analyzed using multivariate analysis of variance with post hoc comparisons and hierarchical clustering.</p><p><strong>Results: </strong>From 22 manuscripts, human reviewers rejected 15 (68.2%), while AI rejection rates were statistically significantly lower (0 to 9.1%, P < .001). AI models demonstrated high consistency in their evaluations over time (intraclass correlation coefficient = 0.88, P < .001) and showed moderate agreement with human decisions (κ = 0.38 to 0.46).</p><p><strong>Conclusions: </strong>While AI models showed reliable internal consistency, they were less likely to recommend rejection than human reviewers. This suggests their optimal use is as screening tools complementing expert human review rather than as replacements.</p>","PeriodicalId":16612,"journal":{"name":"Journal of Oral and Maxillofacial Surgery","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144004457","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":"A Half-Century Review of Male and Female Resident Outcomes in Oral and Maxillofacial Surgery: A Single-Institution Report.","authors":"Susan Keefe, Carrie Baldwin, Elda Fisher, Timothy A Turvey","doi":"10.1016/j.joms.2025.03.011","DOIUrl":"10.1016/j.joms.2025.03.011","url":null,"abstract":"<p><strong>Background: </strong>Limited comprehensive historical data exist comparing male and female residents in oral and maxillofacial surgery (OMS) residency programs. This gap underscores the need to examine sex-based differences to guide equitable policies and practices.</p><p><strong>Purpose: </strong>The purpose of this study is to measure and compare historical enrollment and graduation records between male and female residents within a single OMS residency program.</p><p><strong>Study design, setting, sample: </strong>A retrospective cohort study was conducted using the University of North Carolina OMS graduation records from 1972 to 2023. The sample was composed of all trainees admitted to the program. All residents still in training, however, were not included in the analyses of postgraduate accomplishments.</p><p><strong>Independent variable: </strong>The independent variable was sex, categorized as male or female.</p><p><strong>Outcome variables: </strong>The outcome variables were attrition and training accomplishments. We documented medical degree, board certification, postgraduate training, and postgraduate employment for each graduate.</p><p><strong>Covariates: </strong>There was no covariate in the study.</p><p><strong>Analyses: </strong>Fisher's exact and χ² tests were used, with a significance threshold of P < .05.</p><p><strong>Results: </strong>The sample was composed of 148 admitted residents. Women comprised 19.6% (29) of total enrollees. Over time, the proportion of females admitted to the program increased from 0.8% (1/12) to 50% (8/16), P = .002. Among the 115 graduates, 13% (15/115) were women. The attrition rates for male and female residents prior to 2000 were 12% (8/65) and 50% (3/6), respectively (P = .04). However, no statistically significant difference was observed after 2000, (P = .5). postgraduate training (P = .42), postgraduate employment settings (P = .42), board certification status (P = .58), and completion of a medical degree (P = .18) did not differ significantly by sex.</p><p><strong>Conclusion and relevance: </strong>The University of North Carolina OMS program has seen an increased female representation since its program inception. While female trainees in the past had higher attrition rates, current data no longer support this. Postgraduation outcomes, including postgraduate training, medical degree, board certification, and entry into academic practice-are comparable between male and female graduates. A broader national analysis is recommended to determine if these findings are consistent across other programs.</p>","PeriodicalId":16612,"journal":{"name":"Journal of Oral and Maxillofacial Surgery","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144018180","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":"Outcomes of Different Internal Fixation Strategies for Double Mandibular Fractures: A Systematic Review and Meta-analysis.","authors":"Babu Lal, Ragavi Alagarsamy, Jitendra Chawla, Edward Ellis, Ajoy Roychoudhury, Anuvindha Js, Arivarasan Barathi","doi":"10.1016/j.joms.2025.03.013","DOIUrl":"10.1016/j.joms.2025.03.013","url":null,"abstract":"<p><strong>Background: </strong>The biomechanics of double mandibular fracture (DMF) is complex, and the literature on the fixation requirements is varied. The purpose of the study was to estimate the prevalence of complications following the management of DMF and to determine whether this prevalence varies based on the fixation strategy used.</p><p><strong>Methods: </strong>A systematic review and meta-analysis was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. A comprehensive search was conducted in PubMed, Google Scholar, Semantic Scholar, and Cochrane Library to identify DMF studies until September 2024. Randomized controlled trials (RCTs), quasicontrolled trials, and retrospective studies comparing fixation schemes for DMF were included. In-vitro or animal studies were excluded. The predictor variable was the type of fixation (nonrigid, rigid, and mixed), and outcome variables were malocclusion, wound infection, wound dehiscence, and hardware failure. The risk of bias was assessed using the Joanna Briggs Institute (JBI) checklist for critical appraisal and the Risk of Bias 2.0 generic dataset for RCTs. Meta-analysis was conducted to calculate the pooled prevalence by random effects model with a 95% CI using Stata (v.16).</p><p><strong>Results: </strong>The initial search identified 2,108 publications. After applying inclusion/exclusion criteria, the final sample was composed of 11 studies and 1,747 cases. The meta-analysis indicated pooled prevalence of 3% (95% CI: 2 to 6%) for hardware failure, 3% (95% CI: 1 to 7%) for malocclusion, 3% (95% CI: 2 to 5%) for wound dehiscence and 4% (95% CI: 2 to 8%) for infection. Complication rates were 4 to 6% (95% CI: 0.01 to 0.05, P = .1) in the nonrigid fixation group, 8 to 12% (95% CI: 0.01 to 0.05, P = .3) in the rigid fixation group, and 2 to 3% (95% CI: 0.01 to 0.05, P = .1) in the mixed fixation group, with no statistically significant subgroup differences. The risk of bias was low (n = 6) and high (n = 1) in retrospective studies, while RCTs (n = 4) showed some bias.</p><p><strong>Conclusion: </strong>This meta-analysis suggests that the overall complication rate for DMF ranges from 3 to 4%, regardless of the fixation method, and that the type of fixation does not have a statistically significant impact on postoperative complication rates. Further well-designed trials are needed to confirm these findings.</p>","PeriodicalId":16612,"journal":{"name":"Journal of Oral and Maxillofacial Surgery","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144018222","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}