Journal of Oral and Maxillofacial Surgery最新文献

{"title":"The Use of Clear Aligners for Orthognathic Surgery: A Systematic Review","authors":"Hooman Shafaee DMD, MSc , Shirin Shahnaseri DMD, MSc , Mahsa Ghorbani DMD , Erfan Bardideh DMD, MSc , Seyed Amir Mousavi DMD, MSc , Sercan Akyalcin DMD, PhD","doi":"10.1016/j.joms.2025.03.009","DOIUrl":"10.1016/j.joms.2025.03.009","url":null,"abstract":"<div><h3>Purpose</h3><div>Clear aligners, known for their esthetic appeal, are now increasingly utilized in orthognathic surgery treatment, offering preoperative and postoperative benefits. This systematic review aims to answer the research question: Are clear aligners as effective as traditional fixed appliances in achieving dental and skeletal changes, improving oral health, and enhancing patient-reported satisfaction in patients requiring orthognathic surgery?</div></div><div><h3>Methods</h3><div>We conducted a systematic review following a predefined protocol. We searched databases including MEDLINE, Web of Science, EMBASE, Scopus, and Cochrane's CENTRAL from inception until September 2024, with no language or date restrictions. Studies were included based on the Population, Intervention, Comparison, and Outcome (PICO) criteria, focusing on patients requiring orthognathic surgery (Population), the use of clear aligners (Intervention), compared with traditional fixed appliances (Comparison), and outcomes related to dental and skeletal changes, oral health, and patient satisfaction (Outcome). Inclusion criteria were clinical studies addressing the PICO question, while exclusion criteria were studies not involving human subjects or unrelated to orthognathic surgery with clear aligners. The risk of bias was assessed using the Risk of Bias in Nonrandomized Studies of Interventions (ROBINS-I) and Cochrane Risk of Bias 2.0 (ROB.02) tools. Data extraction included publication year, study design, participant demographics, malocclusion type, surgical procedures, aligner specifications, treatment protocols, aligner utilization stages, treatment durations, and evaluated outcomes.</div></div><div><h3>Results</h3><div>Our comprehensive search identified 765 studies, supplemented by 12 from manual searching. After screening, 34 studies underwent full-text review, and 16 clinical studies (375 patients) were included in the qualitative review: 2 randomized clinical trial, 2 prospective, and 12 retrospective studies. Four studies using presurgical aligners reported an increase in the incisor mandibular plane angle by 3 to 15° for Class III cases, while 2 studies on postsurgical aligners noted similar decompensatory movements, such as a change in incisor mandibular plane angle exceeding 10°. The remaining 7 studies used aligners before and after surgery and sometimes during surgery to create surgical splints. Comparative results between aligners and fixed appliances indicated no significant differences in dental and skeletal changes. Aligners had higher patient satisfaction scores (3 to 5 points higher on a 10-point scale) and better periodontal health outcomes. The Peer Assessment Rating score reductions were similar (60% for aligners vs 69% for fixed appliances). Overall, clear aligners may provide similar effectiveness to fixed appliances in orthognathic surgery while enhancing periodontal health and patient satisfaction. However, due to the low quality of e","PeriodicalId":16612,"journal":{"name":"Journal of Oral and Maxillofacial Surgery","volume":"83 7","pages":"Pages 813-831"},"PeriodicalIF":2.3,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143803649","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 MDS ,&nbsp;Ragavi Alagarsamy MDS ,&nbsp;Jitendra Chawla MDS ,&nbsp;Edward Ellis III MS, DDS ,&nbsp;Ajoy Roychoudhury MDS ,&nbsp;Anuvindha JS MDS ,&nbsp;Arivarasan Barathi MD","doi":"10.1016/j.joms.2025.03.013","DOIUrl":"10.1016/j.joms.2025.03.013","url":null,"abstract":"<div><h3>Background</h3><div>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.</div></div><div><h3>Methods</h3><div>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).</div></div><div><h3>Results</h3><div>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.</div><div>Complication rates were 4 to 6% (95% CI: 0.01 to 0.05, <em>P</em> = .1) in the nonrigid fixation group, 8 to 12% (95% CI: 0.01 to 0.05, <em>P</em> = .3) in the rigid fixation group, and 2 to 3% (95% CI: 0.01 to 0.05, <em>P</em> = .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.</div></div><div><h3>Conclusion</h3><div>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.</div></div>","PeriodicalId":16612,"journal":{"name":"Journal of Oral and Maxillofacial Surgery","volume":"83 7","pages":"Pages 839-851"},"PeriodicalIF":2.3,"publicationDate":"2025-07-01","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}

{"title":"Evaluation of the Radiological Results Between Local and Coronal Incisions in the Treatment of Zygomaticomaxillary Complex Fractures.","authors":"Yu Feng, Bin Liu, Xinyuan Zhu, Zhen Chen, Rong Ren, Zhankui Xing","doi":"10.1016/j.joms.2025.06.228","DOIUrl":"https://doi.org/10.1016/j.joms.2025.06.228","url":null,"abstract":"<p><strong>Background: </strong>Zygomaticomaxillary complex (ZMC) fractures are commonly treated using either local or coronal incisions, each approach having distinct advantages and disadvantages.</p><p><strong>Purpose: </strong>The purpose of this study was to compare treatment outcomes by imaging measurements in zygomatic fractures treated with local or coronal incision surgery.</p><p><strong>Study design, setting, sample: </strong>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.</p><p><strong>Predictor variables: </strong>The primary predictor variable was the surgical approach to the ZMC fracture: localized or coronal incision.</p><p><strong>Outcome variables: </strong>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: <1 mm (excellent), 1 to 2 mm (good), and >2 mm (general).</p><p><strong>Covariates: </strong>The covariates included age, gender, trauma mechanism, preoperative waiting time, classification of ZMC fractures, eye injury, and accompanied other maxillofacial fractures.</p><p><strong>Analyses: </strong>Statistical analyses were performed by t-test and the χ² test for bivariate analysis. Statistical significance was set at P < .05.</p><p><strong>Results: </strong>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 (P < .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) (P = .003). Similarly, significant differences were observed in the distance from the midline to the zygomatic surfaced (coronal: 0.73 ± 0.40 mm vs local: 1.38 ± 1.21 mm; P = .005) and D-FZA (coronal: 0.65 ± 0.34 mm vs local: 1.29 ± 0.81 mm; P < .0001).</p><p><strong>Conclusion and relevance: </strong>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.</p>","PeriodicalId":16612,"journal":{"name":"Journal of Oral and Maxillofacial Surgery","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-06-27","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":"Is Handheld Ultrasonography Reliable as a Primary Imaging Modality for the Diagnosis of Internal Derangement and Degenerative Joint Disease of the Temporomandibular Joint?","authors":"Meagan A Brown, Adnan Shah","doi":"10.1016/j.joms.2025.06.226","DOIUrl":"https://doi.org/10.1016/j.joms.2025.06.226","url":null,"abstract":"<p><strong>Background: </strong>Magnetic resonance imaging (MRI) is the gold standard imaging modality for diagnosing internal derangement (ID) and degenerative joint disease (DJD) of the temporomandibular joint (TMJ). MRI disadvantages include cost, availability, and patient discomfort, making it worthwhile to determine if handheld ultrasonography (HHU) may reduce MRI utilization.</p><p><strong>Purpose: </strong>The purpose of this study was to measure and compare the diagnostic accuracy of HHU to the MRI gold standard for the diagnosis of ID and DJD.</p><p><strong>Study design: </strong>This retrospective, cohort, single-institutional study included participants with suspected ID and DJD referred by dentists and primary care physicians to the Oral and Maxillofacial Surgery Clinic at the Health Sciences Centre in Winnipeg, Manitoba.</p><p><strong>Predictor variable: </strong>The predictor variable was the HHU diagnosis of the TMJ for the presence or absence of anterior disc displacement (ADD) and DJD.</p><p><strong>Outcome variable: </strong>The outcome variable was the MRI diagnosis of the TMJ for the presence or absence of ADD and DJD.</p><p><strong>Covariates: </strong>Covariates include demographics, medical history, and assessments of ID and DJD based on clinical examination.</p><p><strong>Analyses: </strong>The diagnostic accuracy of HHU relative to MRI was determined using appropriate statistical tests with a significance level (P value) of ≤0.05 and a 95% CI.</p><p><strong>Results: </strong>The sample consisted of 20 subjects (mean age: 47 years, SD 13; 17 female, 85%), who were scanned using HHU and MRI. MRI was the comparative standard, and when detecting ADD without reduction, HHU demonstrated specificity of 100.00%, PPV of 100.00%, and a kappa value of .93. For ADD with reduction, HHU demonstrated specificity of 100.00%, PPV of 100.00%, and a kappa value of .79. For DJD, HHU demonstrated specificity of 89.5%, PPV of 20%, and a kappa value of .23.</p><p><strong>Conclusion: </strong>HHU demonstrated statistically significant specificity and PPV when assessing ID and shows promise as a screening tool for MRI referrals, helping to identify patients who can be maintained on conservative treatment. The diagnostic ability of HHU for the detection of DJD was not statistically significant.</p>","PeriodicalId":16612,"journal":{"name":"Journal of Oral and Maxillofacial Surgery","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144626548","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 Does Thrombocytopenia Affect Outcomes in Head and Neck Cancer Surgery With Free Flap Reconstruction?","authors":"Cameron C Lee, Tim T Wang, Lang Liang, Glyndwr Jenkins, Donita Dyalram, Joshua E Lubek","doi":"10.1016/j.joms.2025.06.225","DOIUrl":"https://doi.org/10.1016/j.joms.2025.06.225","url":null,"abstract":"<p><strong>Background: </strong>Thrombocytopenia is associated with a variety of medical comorbidities seen in patients with head and neck cancer. However, it remains unclear if and how thrombocytopenia affects surgical outcomes.</p><p><strong>Purpose: </strong>The purpose of this study was to measure the association between thrombocytopenia and 30-day adverse outcomes in patients undergoing head and neck cancer surgery with free flap reconstruction.</p><p><strong>Study design, setting sample: </strong>This was a retrospective cohort study using the 2012 to 2022 American College of Surgeons National Surgical Quality Improvement Program databases. Patients undergoing resection and free flap reconstruction for malignant pathology of the oral cavity, oropharynx, hypopharynx, larynx, and salivary glands were included. Patients undergoing emergency surgery or with missing outcomes data were excluded.</p><p><strong>Predictor/exposure/independent variable: </strong>The predictor variable was platelet count coded as a binary variable: <150k/μL (thrombocytopenia) or >150k/μL.</p><p><strong>Main outcome variable: </strong>The primary outcome variable was return to the operating room for free flap salvage or hematoma evacuation coded based on International Classification of Diseases diagnoses.</p><p><strong>Covariates: </strong>Covariates were categorized into demographic (age, sex), medical (hypertension, diabetes), and perioperative (concurrent procedures, reconstructive modality).</p><p><strong>Analyses: </strong>Descriptive, bivariate, and bootstrapped multiple logistic regression statistics were performed to evaluate the association between thrombocytopenia and adverse outcomes. Youden J analysis was used to identify a platelet value at which complications were more likely to occur. An alpha of P < .05 was significant.</p><p><strong>Results: </strong>A total of 4,993 subjects met the inclusion criteria. There were 281 subjects with thrombocytopenia (5.63%) and 213 who underwent reoperations (4.30%). In bivariate analysis, thrombocytopenia was the only significant risk factor for reoperation, and these subjects were 1.74 times more likely to return to the operating room (P = .015, relative risk = 1.74, 95% CI 1.11 to 2.71). In multivariate analysis adjusting for study covariates, thrombocytopenia was independently associated with 1.82 times greater odds of return to the operating room (P = .026, OR = 1.82, 95% CI 1.11 to 3.26). Cut point analysis suggested that a platelet value less than 136,000/μL was a risk factor for return to the operating room.</p><p><strong>Conclusions and relevance: </strong>Thrombocytopenia was independently associated with return to the operating room following ablative head and neck cancer procedures with free flap reconstruction.</p>","PeriodicalId":16612,"journal":{"name":"Journal of Oral and Maxillofacial Surgery","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144626547","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 the Hyaluronic Acid Dosage During Arthrocentesis Influence Pain Reduction and Maximal Incisal Opening?","authors":"Onur Sahar, Olgun Topal","doi":"10.1016/j.joms.2025.06.227","DOIUrl":"https://doi.org/10.1016/j.joms.2025.06.227","url":null,"abstract":"<p><strong>Background: </strong>The efficacy of hyaluronic acid (HA) after arthrocentesis in temporomandibular joint (TMJ) disorders is recognized, but the therapeutic effect of different HA doses remains unclear.</p><p><strong>Purpose: </strong>The study purpose was to measure and compare the therapeutic efficacy of different HA doses among patients with intra-articular pain and dysfunction undergoing arthrocentesis.</p><p><strong>Study design, setting, sample: </strong>Subjects with intra-articular pain and dysfunction presented to Afyonkarahisar University of Health Sciences between September 2022 and December 2023 were screened for study inclusion. The inclusion criteria were over 18 years of age, with magnetic resonance imaging-confirmed disc displacement without reduction, and classified as stage 3 to 4 according to Wilke's classification. The exclusion criteria were the presence of systemic disease, pregnancy, TMJ ankylosis, myofascial pain, hypersensitivity to local anesthetics, and a history of TMJ surgery.</p><p><strong>Predictor variable: </strong>The predictor variable was HA dose. Subjects were randomly assigned to receive 10 mg/ml (HA10) or 20 mg/ml (HA20).</p><p><strong>Outcome variable: </strong>The primary outcome variable was the therapeutic effect, which was assessed using visual analog scale (VAS) and maximum incisal opening (MIO). The secondary outcomes were lateral excursions, protrusion, and joint sounds. All measurements were recorded at baseline (T0), month 1 (T1), and month 3 (T2).</p><p><strong>Covariates: </strong>The covariates were demographics (age and sex), perioperative (Wilke's classification), and side of the arthrocentesis procedure (unilateral or bilateral).</p><p><strong>Analyses: </strong>Statistical analysis using IBM SPSS included Mann-Whitney U test, χ² test, and Fisher's exact test for group comparisons, with significance at P < .05.</p><p><strong>Results: </strong>The study sample was composed of 36 subjects with a mean age of 32.78 (SD = 9.53), and 29 (80.6%) were female. There were 18 subjects in each study group. For the TMJ, VAS scores decreased from 7.33 ± 2.06 to 0.97 ± 1.24 in HA10 and from 7.78 ± 3.26 to 1.82 ± 2.11 in HA20 (P = .3 at T0, P = .07 at T2). MIO increased from 37.44 ± 8.3 to 45.06 ± 6.8 in HA10 and from 37 ± 10.84 to 42.94 ± 10.54 in HA20 (P = .9 at T0, P = .5 at T2). No statistically significant differences were found between the groups in VAS and MIO at any time point.</p><p><strong>Conclusions and relevance: </strong>The results suggest that HA dose is not associated with therapeutic efficacy. As such, the lower price HA option is adequate.</p>","PeriodicalId":16612,"journal":{"name":"Journal of Oral and Maxillofacial Surgery","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144637319","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":"Body Mass Index Changes and Muscle Loss After Orthognathic Surgery: A Prospective Study.","authors":"Nijat Gasimov, Fatma Doğruel, Suheyb Bilge, İslam Kazımlı, Ahmet Emin Demirbaş","doi":"10.1016/j.joms.2025.06.223","DOIUrl":"https://doi.org/10.1016/j.joms.2025.06.223","url":null,"abstract":"<p><strong>Background: </strong>Orthognathic surgery is routinely performed to correct malocclusion and dentofacial deformities. However, postoperative morbidities, such as nutritional deficiencies and consequent muscle loss, can arise.</p><p><strong>Purpose: </strong>This study aimed to estimate body mass index (BMI) changes and muscle loss in patients following orthognathic surgery.</p><p><strong>Study design, setting, and sample: </strong>This prospective cohort study involved patients who underwent bimaxillary surgery at the Erciyes University Oral and Maxillofacial Surgery Hospital from April 2022 to April 2023. Exclusion criteria were contraindications for bioelectrical impedance analysis (eg, cardiovascular stents, pacemakers, joint prostheses, and severe peripheral angiopathy), refusal to participate, or systemic steroid treatment.</p><p><strong>Predictor variables: </strong>The predictor variable was time, coded as T0 (baseline), T1 (first month), T2 (third month), and T3 (sixth month) postoperatively.</p><p><strong>Main outcome variable(s): </strong>The primary outcome variable in this study was BMI, assessed at T0, postoperative T1, T2, and T3. Secondary outcomes were muscle loss, body fat percentage, measurements taken using the bioelectrical impedance analysis device (TANITA RD-545, Tanita Corp., Tokyo, Japan), handgrip strength, skinfold measurements and blood concentration levels (vitamin D3, glucose, triglycerides, albumin, ferritin, folic acid, and vitamin B12).</p><p><strong>Covariates: </strong>The study's covariates were age and sex.</p><p><strong>Analyses: </strong>Descriptive statistics and 1-way analysis of variance were used for data analysis, with statistical significance set at a P value ≤ .05.</p><p><strong>Results: </strong>The study included 60 subjects (median age: 23.0 years [interquartile range: 21.0 to 28.7]), with 18 (30%) male and 42 (70%) female participants. Preoperative weight averaged 62.47 ± 1.55 kg, with women at 59.1 ± 9.9 kg and men at 70.3 ± 13 kg (P < .001). Preoperative mean BMI was 22.14 kg/m², dropping to 21.15 kg/m² in T1 and gradually increasing to 21.83 kg/m² by T3, with statistically significant differences across time points (P < .001). Muscle mass decreased statistically significant in the postoperative period, showing a maximum mean reduction of -1.79 kg at T1 (P < .001). Although partial recovery was observed by T3 (-0.71 kg compared to baseline), preoperative levels were not fully restored.</p><p><strong>Conclusion and relevance: </strong>Weight and muscle loss persisted below preoperative levels at T3. The patient-specific nutritional plans may contribute to optimize postoperative recovery.</p>","PeriodicalId":16612,"journal":{"name":"Journal of Oral and Maxillofacial Surgery","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144608578","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 Lamonier de Oliveira Costa Paiva, Rodrygo Nunes Tavares, Filipe Nobre Chaves, Francisco Samuel Rodrigues Carvalho","doi":"10.1016/j.joms.2025.06.205","DOIUrl":"https://doi.org/10.1016/j.joms.2025.06.205","url":null,"abstract":"<p><p>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.</p>","PeriodicalId":16612,"journal":{"name":"Journal of Oral and Maxillofacial Surgery","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-06-20","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":"Characterization of Tenosynovial Giant Cell Giant Cell Tumors in the Temporomandibular Joint: A Multidisciplinary Approach to Treatment.","authors":"Sydnee R Vaughan, Andrew J Gross, Ivan A Chebib, Joseph P McCain, Daniel D Choi","doi":"10.1016/j.joms.2025.06.204","DOIUrl":"https://doi.org/10.1016/j.joms.2025.06.204","url":null,"abstract":"","PeriodicalId":16612,"journal":{"name":"Journal of Oral and Maxillofacial Surgery","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144575694","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, Tim T Wang, Nicholas Wilken, Gary Warburton, John Caccamese, Cameron Lee","doi":"10.1016/j.joms.2025.06.202","DOIUrl":"https://doi.org/10.1016/j.joms.2025.06.202","url":null,"abstract":"<p><strong>Background: </strong>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.</p><p><strong>Purpose: </strong>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.</p><p><strong>Study design, setting, sample: </strong>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.</p><p><strong>Predictor variable: </strong>The primary predictor variable was trauma center designation (level 1 or non-level 1).</p><p><strong>Main outcome variable: </strong>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.</p><p><strong>Covariates: </strong>Covariates were categorized as demographic (age, sex, payer), medical and injury-related (Elixhauser Comorbidity Index, fracture count), and hospital-related (teaching status, bed size).</p><p><strong>Analyses: </strong>Descriptive, bivariate, and multivariable regression statistics were calculated to measure the association between trauma center designation and outcomes.</p><p><strong>Results: </strong>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, P = .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.</p><p><strong>Conclusion and relevance: </strong>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.</p>","PeriodicalId":16612,"journal":{"name":"Journal of Oral and Maxillofacial Surgery","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-06-18","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}