Journal of Oral and Maxillofacial Surgery最新文献

{"title":"Standardization of Dental Clearance Pathway for Preoperative Cardiac Transplant Preparation","authors":"Ariana Benedetto DDS , Ariel Blanchard DMD , Gwendolyn Reeve DMD","doi":"10.1016/j.joms.2025.02.013","DOIUrl":"10.1016/j.joms.2025.02.013","url":null,"abstract":"","PeriodicalId":16612,"journal":{"name":"Journal of Oral and Maxillofacial Surgery","volume":"83 6","pages":"Pages 647-650"},"PeriodicalIF":2.3,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144184758","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":"Are Orbital Fracture Location, Visual Disturbances, and Head Injury Associated With Severe Ocular and Periocular Injuries? A Retrospective Cohort Study","authors":"David Lopez Oliver MD ,&nbsp;Steven Gernandt MD, DMD ,&nbsp;Romain Aymon ,&nbsp;Paolo Scolozzi MD, DMD","doi":"10.1016/j.joms.2025.03.012","DOIUrl":"10.1016/j.joms.2025.03.012","url":null,"abstract":"<div><h3>Background</h3><div>Cranio-maxillofacial fractures involving the orbits are common and may be associated with severe ocular and periocular injuries (OPOIs) requiring prompt management.</div></div><div><h3>Purpose</h3><div>The purpose of the study was to measure the association between orbital fracture (OF) location, visual disturbances (VDs), head injury (HI), and OPOI severity.</div></div><div><h3>Study Design, Setting, and Sample</h3><div>A retrospective cohort study was conducted at the University Hospital of Geneva (2008–2021). Inclusion criteria are as follows: subjects ≥18 years with OF due to blunt trauma, who underwent head computed tomography, comprehensive ophthalmological assessment, and had ≥1-year follow-up. Exclusion criteria: subjects &lt;18 years, prior orbital/ophthalmic surgery, penetrating trauma, prior monocular or nonstereoscopic vision, lack of ophthalmological assessment, insufficient clinical data, or follow-up &lt;1 year.</div></div><div><h3>Predictor Variables</h3><div>Predictors included OFs (categorized by anatomic location), VD (subjective/objective visual acuity decrease or diplopia), and HI, defined as (a) loss of consciousness, (b) Glasgow Coma Scale score, and/or (c) intracranial hemorrhage.</div></div><div><h3>Main Outcome Variable</h3><div>The primary outcome was OPOI severity. Severe OPOI was defined as requiring immediate ophthalmic treatment (performed without delay or within 6 hours), while nonsevere OPOI did not require immediate intervention.</div></div><div><h3>Covariates</h3><div>Covariates included demographic and injury-related parameters.</div></div><div><h3>Analyses</h3><div>Descriptive, bivariate, and multivariate multinomial logistic regression analyses were performed to identify factors associated with OPOIs. Statistical significance was set at <em>P</em> ≤ .05.</div></div><div><h3>Results</h3><div>The study included 824 patients (mean age: 47.2 ± 23.6 years), the majority of whom were male (n = 580; 70.4%). Adjusted analysis showed severe OPOIs were associated with medial orbital wall fractures (odds ratio [OR], 3.54; 95% CI, 1.78-7.07; <em>P</em> &lt; .01); VD (OR, 3.57; 95% CI, 1.92-6.66; <em>P</em> &lt; .01); HI (OR, 1.99; 95% CI, 1.06-3.74; <em>P</em> = .03) and older age (OR: 1.02; 95% CI: 1.01–1.03; <em>P</em> &lt; .01).</div></div><div><h3>Conclusion and Relevance</h3><div>Within the limitations of the study, it appears that medial OFs, VD, HI, and older age are associated with severe OPOIs. These findings may help guide early risk assessment and management in patients with OFs.</div></div>","PeriodicalId":16612,"journal":{"name":"Journal of Oral and Maxillofacial Surgery","volume":"83 6","pages":"Pages 700-710"},"PeriodicalIF":2.3,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144005704","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: The Modified Caldwell-Luc Approach for Treating Odontogenic Maxillary Sinusitis Without Need for Functional Endoscopic Sinus Surgery: A Retrospective Study","authors":"Christian Bacci DDS, PhD, MMSc","doi":"10.1016/j.joms.2025.02.009","DOIUrl":"10.1016/j.joms.2025.02.009","url":null,"abstract":"","PeriodicalId":16612,"journal":{"name":"Journal of Oral and Maxillofacial Surgery","volume":"83 6","pages":"Pages 656-657"},"PeriodicalIF":2.3,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144184818","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":"June 2025 AAOMS News and Announcements","authors":"","doi":"10.1016/j.joms.2025.03.006","DOIUrl":"10.1016/j.joms.2025.03.006","url":null,"abstract":"","PeriodicalId":16612,"journal":{"name":"Journal of Oral and Maxillofacial Surgery","volume":"83 6","pages":"Pages 776-780"},"PeriodicalIF":2.3,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144184993","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":"Pretreatment Pain as a Prognostic Predictor in Oral Tongue Squamous Cell Carcinoma: The Mediating Role of Perineural Invasion","authors":"Sisi Liu MD ,&nbsp;Jia Kang MD ,&nbsp;Guanzheng Chen MD ,&nbsp;Xiaohong Yuan MD ,&nbsp;Chang Liu MD ,&nbsp;Zhien Feng PhD ,&nbsp;Zhengxue Han PhD","doi":"10.1016/j.joms.2025.03.010","DOIUrl":"10.1016/j.joms.2025.03.010","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;div&gt;The potential effects of pretreatment pain on prognosis of tongue squamous cell carcinoma (TSCC) and the role that perineural invasion (PNI) plays in this process remains unclear.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Purpose&lt;/h3&gt;&lt;div&gt;The purposes of this study are to estimate the prognostic value of pretreatment pain and identify whether PNI is a mediating factor in the relationship between pretreatment pain and prognosis in TSCC.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Study Design, Setting, Sample&lt;/h3&gt;&lt;div&gt;This retrospective cohort study included TSCC patients who underwent first resections of primary lesions at the Beijing Stomatological Hospital of Capital Medical University between January 2009 and December 2019. Patients who had incomplete medical records and pathological data, received neoadjuvant radiotherapy and chemotherapy before surgery, and did not receive a TSCC diagnosis, were excluded.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Predictor Variable&lt;/h3&gt;&lt;div&gt;The predictor variables are pretreatment pain and PNI. The visual analog scale (VAS) was used to assess pretreatment pain levels, and the PNI status was evaluated by pathological section.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Main Outcome Variable(s)&lt;/h3&gt;&lt;div&gt;The main outcome variables were the 3-year disease-specific survival (DSS) and disease-free survival (DFS).&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Covariates&lt;/h3&gt;&lt;div&gt;Covariates included age, sex, smoking history, alcohol history, growth pattern, and T-stage.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Analyses&lt;/h3&gt;&lt;div&gt;The χ&lt;sup&gt;2&lt;/sup&gt; test was used to describe the baseline data. Kaplan-Meier analysis was used to estimate the 3-year DSS and DFS. The Cox regression model was adapted for univariate and multivariate analysis. The association between VAS score and PNI was analyzed using logistic regression analysis and mediation analysis. &lt;em&gt;P&lt;/em&gt; value less than .05 indicated statistical significance.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;The study included 307 subjects with a mean age of 52 (±12.1) years, and 164 (53.4%) were male. There were 65 (21.2%) with high VAS (&gt;5) and 242 (78.8%) with low VAS (≤5). The DSS and DFS of high VAS were 64.6% (95% CI: 23.6 to 80.9%) and 52.3% (95% CI: 35.3 to 92.8%), of patients with PNI were 62.7% (95% CI: 19.6 to 64.5%) and 46.7% (95% CI: 25.9 to 66.9%), respectively. The group high VAS/with PNI had lower DSS and DFS than group high VAS/without PNI (55.3 and 40.4% vs 88.9 and 83.3%). The VAS and PNI were identified as independent factors associated with prognosis (&lt;em&gt;P&lt;/em&gt; &lt; .05). Mediation analysis revealed that the indirect effect of VAS on DFS was 0.071 (95% CI: 0.011 to 0.135, &lt;em&gt;P&lt;/em&gt; = .024), while the total effect was 0.187 (95% CI: 0.074 to 0.296, &lt;em&gt;P&lt;/em&gt; &lt; .001), VAS score affected the DFS of TSCC through the mediating effect of PNI.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusion and Relevance&lt;/h3&gt;&lt;div&gt;Our findings confirmed that pretreatment pain is associated with worse outcomes in TSCC. Patients with TSCC and severe pretreatment pain are more likely to be diagnosed","PeriodicalId":16612,"journal":{"name":"Journal of Oral and Maxillofacial Surgery","volume":"83 6","pages":"Pages 757-767"},"PeriodicalIF":2.3,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143811640","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":"Navigation-Guided Management of Comminuted Zygomaticomaxillary Complex Fracture Concurrent With Orbital Reconstruction","authors":"Shuo Zhang MD ,&nbsp;Fan Yang MD ,&nbsp;Zhengkang Li MD ,&nbsp;Yuan Deng MD, PhD","doi":"10.1016/j.joms.2025.03.008","DOIUrl":"10.1016/j.joms.2025.03.008","url":null,"abstract":"<div><h3>Background</h3><div>Comminuted zygomaticomaxillary complex (ZMC-C) fracture with orbital reconstruction poses challenges for surgeons. Navigation-guided technique may be valuable for surgical reduction.</div></div><div><h3>Purpose</h3><div>This study aimed to measure the difference error between planned and actual reduction of ZMC-C fracture with orbital reconstruction using navigation-guided technique.</div></div><div><h3>Study Design, Setting, Sample</h3><div>This retrospective single-arm cohort study involved subjects with ZMC-C and orbital fractures from Jan 2017 to Jun 2019 at the Department of Ophthalmology, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, China. Subjects with brain damage, unstable vital signs, allergy to titanium alloy implants, trauma to other facial bones or postoperative facial trauma were excluded.</div></div><div><h3>Main Outcome Variables</h3><div>The primary outcome variable was the mean 3-dimensional (3D) (Euclidean) distance error between surgical plan and actual outcome. Secondary outcomes included mean absolute distance error in transverse, vertical and anterior–posterior planes, visual analog scale score of subjects' self-satisfaction with facial aesthetics and function, orbital volume, exophthalmometry, position of bilateral zygomatic bones and surgical complications.</div></div><div><h3>Covariates</h3><div>Covariates included age and sex.</div></div><div><h3>Analyses</h3><div>Outcomes were tested using t-tests with significance at <em>P</em> &lt; .05 to determine differences between preoperative and postoperative measurements and symmetry.</div></div><div><h3>Results</h3><div>The sample included 20 subjects with a median age of 39 years (interquartile range = 24.5) and 19 (95%) were male. The mean 3D distance errors were 0.5 ± 0.3 mm at the midpoint of the fracture line at the zygomatic frontal suture, 0.7 ± 0.3 mm at the most prominent point on the surface of zygoma and 0.6 ± 0.4 mm at the intersection point of the zygomatic alveolar buttress and fracture line. The maximum mean absolute distance error was 0.8 ± 0.2 mm. Postoperative visual analog scale score improved in all subjects. Mean orbital volume was reduced by 2.2 ± 0.6 cm³, and enophthalmos improved to 0.4 ± 0.3 mm (all <em>P</em> &lt; .01). There were no significant differences in exophthalmometry, orbital volume and position of bilateral zygomatic bones between the affected and unaffected sides (<em>P</em> &gt; .05).</div></div><div><h3>Conclusion and Relevance</h3><div>Deficient movement in the anterior–posterior plane mainly contributes to 3D distance error. The mean distance error was clinically acceptable with the aid of navigation-guided technique in managing ZMC-C fracture with orbital reconstruction.</div></div>","PeriodicalId":16612,"journal":{"name":"Journal of Oral and Maxillofacial Surgery","volume":"83 6","pages":"Pages 691-699"},"PeriodicalIF":2.3,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143788539","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 Training Programs Should Adopt a Standardized Model of Graded Surgical Autonomy","authors":"Akshay Govind DMD, MD, MPH ,&nbsp;Joseph Zwischenberger MD ,&nbsp;Phillip Harrison DDS, MD","doi":"10.1016/j.joms.2025.02.008","DOIUrl":"10.1016/j.joms.2025.02.008","url":null,"abstract":"","PeriodicalId":16612,"journal":{"name":"Journal of Oral and Maxillofacial Surgery","volume":"83 6","pages":"Pages 651-654"},"PeriodicalIF":2.3,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144184759","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":"Does Combining Arthrocentesis With Injectable Platelet-Rich Fibrin Outperform Arthrocentesis or Injectable Platelet-Rich Fibrin Alone in Alleviating Pain and Improving Function in Temporomandibular Joint Dysfunction?","authors":"Ram Sundar Chaulagain BDS, MDS (OMFS) ,&nbsp;Saurabh S. Simre BDS, MDS ,&nbsp;Sagrika Shukla BDS, MDS ,&nbsp;Prem Kumar Rathod BDS, MDS ,&nbsp;Adity Bansal BDS, MDS ,&nbsp;Ashi Chug BDS, MDS, PhD","doi":"10.1016/j.joms.2025.02.006","DOIUrl":"10.1016/j.joms.2025.02.006","url":null,"abstract":"<div><h3>Background</h3><div>Arthrocentesis (AC), with/without intra-articular agents like hyaluronic acid, steroids, platelet-rich plasma, and platelet-rich fibrin, is used with varying effectiveness to manage temporomandibular joint (TMJ) intra-articular pain and dysfunction (IPD).</div></div><div><h3>Purpose</h3><div>The purpose of this study was to measure changes in pain, range of motion, and quality of life (QOL) in subjects with IPD who underwent AC/injectable platelet-rich fibrin (i-PRF)/AC + i-PRF injection.</div><div><strong>Study design, setting and sample:</strong> A single-centre randomized clinical trial was conducted at All India Institute of Medical Sciences, Rishikesh, on patients with unilateral IPD (Wilkes II, III, and IV) confirmed by magnetic resonance imaging. Exclusion criteria included age below 18/above 50 years, autoimmune diseases, magnetic resonance imaging contraindications, previous TMJ surgery, congenital/developmental TMJ disorders, and TMJ lesions.</div></div><div><h3>Predictor variable</h3><div>Predictor variables were treatment modalities (AC/i-PRF/AC + i-PRF) assigned using computer generated randomization.</div></div><div><h3>Main outcome variable</h3><div>The primary outcome was TMJ pain at 3 months measured with visual analog scale. Secondary outcomes included range of motion, muscle tenderness, and QOL. Data was collected preoperatively (T0) and postoperatively at 10 days (T1), 1 month (T2), and 3 months (T3) by a blinded observer.</div></div><div><h3>Covariates</h3><div>Covariates included age, sex, and involved joint (right/left) and Wilkes staging.</div></div><div><h3>Analyses</h3><div>Repeated measure analysis of variance with post hoc analysis was used (<em>P</em> &lt; .05).</div></div><div><h3>Results</h3><div>The study included 48 patients with mean ages of 29.9 ± 7.8 years (AC), 36.5 ± 10.9 years (i-PRF), and 27.2 ± 8.5 years (AC + i-PRF) (<em>P</em> = .019), with a higher female prevalence: 68.8% in AC and i-PRF, and 87.5% in AC + i-PRF (<em>P</em> = .4). TMJ pain significantly reduced at T3 in AC + i-PRF compared to AC (mean difference[MD]: 2.1, 95% confidence interval [CI]: 3.3 to 0.9; <em>P</em> &lt; .01) and i-PRF (MD: 1.5, 95% CI: 2.7 to 0.3; <em>P</em> = .012).AC + i-PRF also showed significant improvement in mouth opening (MD: 3.9, 95% CI: 1.1 to 6.8; <em>P</em> = .005) and QOL compared to AC (MD: −4.3, 95% CI: −7.7 to −0.9; <em>P</em> = .009) and i-PRF (MD: −3.6, 95% CI: −6.9 to −0.2; <em>P</em> = .03).</div></div><div><h3>Conclusion</h3><div>AC + i-PRF outperforms AC/i-PRF alone in improving pain, range of motion and overall QOL in Wilkes II, III, and IV, making it a promising treatment option for TMJ IPD.</div></div>","PeriodicalId":16612,"journal":{"name":"Journal of Oral and Maxillofacial Surgery","volume":"83 6","pages":"Pages 658-669"},"PeriodicalIF":2.3,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143586111","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":"Comparing the Infection Rates of Strut Versus Straight Plates in Sagittal Split Osteotomies","authors":"Stephen E. Higgins Jr DMD, MPH ,&nbsp;Valmont Desa DDS, MD","doi":"10.1016/j.joms.2025.03.001","DOIUrl":"10.1016/j.joms.2025.03.001","url":null,"abstract":"<div><h3>Background</h3><div>Sagittal split osteotomies can be rigidly fixated through various methods. Unfortunately, infection remains a common postoperative complication.</div></div><div><h3>Purpose</h3><div>The purpose was to estimate postoperative infection rates between strut and straight plates for internal fixation of sagittal split osteotomies.</div></div><div><h3>Study Design, Setting, Sample</h3><div>We implemented a retrospective cohort study and included a consecutive series of patients with sagittal split osteotomies performed at the University of Nebraska Medical Center. The cases were performed by a single surgeon with a chief as resident surgeon. Exclusion criteria included any patient with unilateral surgery, mandibular midline osteotomy, previous mandible reconstruction, distraction osteogenesis, previous facial trauma history, and less than 12 weeks of follow-up.</div></div><div><h3>Predictor Variable</h3><div>Primary predictor variable was plate type (strut vs straight). The choice of plate was not based on the surgical plan.</div></div><div><h3>Main Outcome Variable(s)</h3><div>The primary outcome variable was postoperative infection. This was defined as purulent discharge, incision and drainage, or prescription of antibiotics. Secondary outcomes include hardware removal and neurosensory function.</div></div><div><h3>Covariates</h3><div>Covariates included demographics, smoking, alcohol and drug use, single/double jaw, advancement/setback, length of movement, and perioperative third molar extraction.</div></div><div><h3>Analyses</h3><div>Fisher’s exact test, χ² test, and Student’s <em>t</em> test were computed to measure bivariate association. The relative risks (RRs) and their 95% CIs were reported. <em>P</em> values &lt; .05 were considered statistically significant.</div></div><div><h3>Results</h3><div>The sample comprised 112 subjects. There were 51 (45.5%) straight plate and 61 (54.5%) strut plate. There were 32 (62.7%) women in the straight plate group, mean age 25.55 ± 13.34 years and 39 women (63.9%) in the strut plate group, mean age 29.02 ± 11.97 years. Postoperative infection was the most common reason for plate removal (n = 10). Strut plates, relative to straight plates, were associated with a 23% increase (RR 1.23, 95%, CI 0.47 to 2.16, <em>P</em> &lt; .7) in infections, a 25% increase (RR 1.25, 95%, CI 0.45 to 2.27, <em>P</em> &lt; .5) in hardware removal, and a 17% increase (RR 1.17, 95% CI 0.33 to 2.44, <em>P</em> &lt; .7) in postoperative neurosensory disturbance at 3 months for sagittal split osteotomies.</div></div><div><h3>Conclusions and Relevance</h3><div>The choice of internal fixation plate, strut versus straight, was not associated with postoperative infection, hardware removal, or postoperative neurosensory function deficit.</div></div>","PeriodicalId":16612,"journal":{"name":"Journal of Oral and Maxillofacial Surgery","volume":"83 6","pages":"Pages 681-690"},"PeriodicalIF":2.3,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143700654","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":"Effectiveness of Concentrated Growth Factor on Improving Postoperative Comfort in Patients Undergoing Coronectomy for Impacted Lower Third Molars: A Double-Blinded Split-Mouth Randomized Controlled Clinical Study","authors":"Muharrem Ergun Dudak DDS ,&nbsp;Aylin Calis DDS, PhD ,&nbsp;Huseyin Koca DDS, PhD","doi":"10.1016/j.joms.2025.03.005","DOIUrl":"10.1016/j.joms.2025.03.005","url":null,"abstract":"<div><h3>Background</h3><div>Following coronectomy, pain and edema are adverse side effects. Concentrated growth factor (CGF) is recognized for its potential to enhance wound healing, reduce inflammation and may help to improve postoperative comfort following coronectomy.</div></div><div><h3>Purpose</h3><div>The study purpose was to measure and compare postoperative pain and edema between CGF and control treatments in patients undergoing bilateral coronectomies.</div></div><div><h3>Study Design, Setting, and Sample</h3><div>In this split-mouth, double-blind, randomized controlled study conducted at Ege University Faculty of Dentistry, Department of Oral and Maxillofacial Surgery in Izmir, Turkey, patients aged 18 to 65 years at risk of mandibular nerve injury underwent bilateral coronectomy. Patients over 65 years of age or those with systemic conditions contraindicating surgery were excluded. Patients and the researcher responsible for data collection and analysis were blinded to the intervention.</div></div><div><h3>Independent Variable</h3><div>The independent variable was wound management. Within subjects, the treatment sides were randomly assigned to CGF treatment or control.</div></div><div><h3>Main Outcome Variable</h3><div>The outcome variable was postoperative comfort measured using pain and edema. Pain was measured using the visual analog scale for 7 days after surgery. Edema was quantified in millimeters in 3 planes preoperatively and on postoperative days 2 and 7.</div></div><div><h3>Covariates</h3><div>Age, sex, and depth of impaction were covariates.</div></div><div><h3>Analyses</h3><div>The conformity of edema measurements to normal distribution was assessed with the Shapiro-Wilk test, analysis of variance for repeated measures and Bonferroni correction, and supported by paired two-sample <em>t</em> test (significant interaction); since pain levels did not fit the normal distribution (ordinal scale), the nonparametric Brunner and Langer model (LD-F2) and Benjamini-Hochberg procedure were used. Statistical significance was defined as (<em>P</em> &lt; .01).</div></div><div><h3>Results</h3><div>The sample included 35 subjects, comprising 12 (34.3%) males and 23 (65.7%) females, with a mean age of 32.7 ± 11.42 (standard deviation). Visual analog scale scores were significantly lower on the CGF side for the first 6 days (<em>P</em> &lt; .001) but not on day 7 (<em>P</em> = .6). Postoperative second day edema was statistically significantly lower in the 2 planes on the CGF side (<em>P</em> &lt; .001, <em>P</em> = .007, <em>P</em> = .8) but not on day 7 in any plane (<em>P</em> = .5, <em>P</em> = .8, <em>P</em> = .1).</div></div><div><h3>Conclusions and Relevance</h3><div>Our study shows that CGF enhances postoperative comfort by minimizing pain and edema. Additional interventions may be necessary for patients undergoing coronectomy due to the potential for significant postoperative discomfort.</div></div>","PeriodicalId":16612,"journal":{"name":"Journal of Oral and Maxillofacial Surgery","volume":"83 6","pages":"Pages 738-747"},"PeriodicalIF":2.3,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143743044","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}