Journal of Oral and Maxillofacial Surgery最新文献

{"title":"RE: “Photobiomodulation With Infrared and Dual Wavelength Laser Induces Similar Repair and Control of Inflammation After Third Molar Extraction: A Double Blinded Split Mouth Randomized Control Trial”","authors":"Rinku K. George MDS, Srinivedha CV MDS, Raja S. Cheeman MDS","doi":"10.1016/j.joms.2024.12.016","DOIUrl":"10.1016/j.joms.2024.12.016","url":null,"abstract":"","PeriodicalId":16612,"journal":{"name":"Journal of Oral and Maxillofacial Surgery","volume":"83 5","pages":"Pages 508-509"},"PeriodicalIF":2.3,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143890956","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":"Monoclonal Antibodies and Small-Molecule Inhibitors Associated Osteonecrosis of Jaw: A Retrospective Pharmacovigilance Study","authors":"Kannan Sridharan MD, DM , Gowri Sivaramakrishnan MDS, MFDS","doi":"10.1016/j.joms.2025.01.008","DOIUrl":"10.1016/j.joms.2025.01.008","url":null,"abstract":"<div><h3>Background</h3><div>Osteonecrosis of the jaw (ONJ) is an adverse effect associated with medications such as monoclonal antibodies and small-molecule inhibitors.</div></div><div><h3>Purpose</h3><div>This study assesses the association between monoclonal antibodies and small-molecule inhibitors with ONJ.</div></div><div><h3>Study Design, Setting, Sample</h3><div>The study design was a retrospective pharmacovigilance case series. The sample was derived from the United States Food and Drug Administration Adverse Event Reporting System database reporting ONJ from March 2004 to March 2024. The inclusion criteria were the reports relating ONJ occurrence with exposure to monoclonal antibodies (trastuzumab, bevacizumab, denosumab, elotuzumab, isatuximab, pertuzumab, ramucirumab, romosozumab, and ado-trastuzumab emtansine) and small-molecule inhibitors (abemaciclib, alpelisib, axitinib, cabozantinib, lapatinib, lenvatinib, palbociclib, ribociclib, and sunitinib). The exclusion criteria were the reports associating the role of monoclonal antibodies and small molecule inhibitors to ONJ with roles other than primary suspicion.</div></div><div><h3>Predictor Variable</h3><div>Not applicable.</div></div><div><h3>Main Outcome Variable</h3><div>The outcome variable is the case status divided into case and noncase. Cases were defined as reports with ONJ associated with monoclonal antibodies or small-molecule inhibitors while noncases were the reports with other adverse events. Secondary outcome variables were death, hospitalization, and disability observed with monoclonal antibodies/small-molecule inhibitors–associated ONJ.</div></div><div><h3>Covariates</h3><div>Age and gender were the covariates included in this study.</div></div><div><h3>Analyses</h3><div>The case–noncase approach was applied for signal detection, using frequentist (reporting odds ratio [ROR] and proportional reporting ratio [PRR]) and Bayesian methods (lower limit of 95% CI of Information component [IC025]). The ROR is determined by comparing the odds of ONJ being reported for a given drug to the odds of the same event being reported for all other drugs and PRR is estimated by the ratio of proportion of reports for a specific drug with ONJ over the proportion of reports with ONJ for all other drugs. The information component is defined as defined as the logarithmic ratio of the observed ONJ with the primary suspected drug relative to the expected frequency of the drug-ONJ pair based on overall reporting rates in the database. Outcomes were analyzed with statistical comparisons using χ<sup>2</sup> tests (χ2) at <em>P</em> ≤ .05.</div></div><div><h3>Results</h3><div>A total of 7,402 reports were included with median age ranging between 61 and 76 years with female preponderance. Denosumab (ROR: 64.7 [62.5, 67]; PRR: 61.9 [59.9, 64.1]; <em>P</em> < .05; and IC025: 5.1), romosozumab (ROR 4.2 [3, 6]; PRR: 4.2 [3, 6]; <em>P</em> < .05; and IC025: 1.5), and lenvatinib (ROR: 3.1 [2.3, 4.2","PeriodicalId":16612,"journal":{"name":"Journal of Oral and Maxillofacial Surgery","volume":"83 5","pages":"Pages 616-624"},"PeriodicalIF":2.3,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143374358","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 Association of Fracture Displacement and Surgical Intervention in Isolated Zygomatic Arch Fractures","authors":"Margaret R. Wang BS ,&nbsp;Madeline G. Chin MD ,&nbsp;Damon R.T. McIntire MD ,&nbsp;Kenny Chang BS ,&nbsp;Leon Zhao BS ,&nbsp;Daniel K. Kwan MD","doi":"10.1016/j.joms.2025.01.006","DOIUrl":"10.1016/j.joms.2025.01.006","url":null,"abstract":"<div><h3>Background</h3><div>In the evaluation of isolated zygomatic arch (ZA) fractures, a standardized guideline for recommending operative intervention is lacking.</div></div><div><h3>Purpose</h3><div>The study purpose was to measure the association between fracture displacement and operative treatment following isolated ZA fractures.</div></div><div><h3>Study design, setting, sample</h3><div>This is a retrospective cohort study identifying adult subjects with isolated ZA fractures presenting to the emergency department between September 2011 and October 2022. Subjects with non-ZA zygomaticomaxillary complex fractures or concurrent facial fractures were excluded.</div></div><div><h3>Predictor/exposure/independent variable</h3><div>The predictor is maximal fracture displacement in centimeters measured on axial computed tomography imaging.</div></div><div><h3>Main outcome variable(s)</h3><div>The main outcome variable is operative management defined as recommendation of operative versus nonoperative intervention.</div></div><div><h3>Covariates</h3><div>Covariates collected include patient demographics; consisting of age, sex, past medical history (hypertension and diabetes); injury mechanism; social history (tobacco and alcohol use); presenting signs and symptoms (trismus, facial swelling, paresthesias, malar depression, and bony-step offs). Native overlying soft-tissue thickness was also measured on computed tomography imaging.</div></div><div><h3>Analyses</h3><div>Bivariate statistical analyses were used to investigate differences between nonoperative and operative groups. Receiver operating characteristic curve was utilized to determine the discriminative fracture displacement for operative intervention. All statistical tests were performed with a significance level set at <em>P</em> &lt; .05.</div></div><div><h3>Results</h3><div>The sample was composed of 86 subjects with an average age of 47.0 ± 19.1 years old. The mean fracture displacement was 0.29 ± 0.21 cm. Overall, 22 (25.6%) subjects were recommended operative intervention while 64 (74.4%) were managed nonoperatively. On bivariate analysis, mean fracture displacement was higher in the operative (0.51 ± 0.14 cm) versus nonoperative groups (0.21 ± 0.18 cm, <em>P</em> &lt; .001). A significantly greater number of patients in the operative cohort presented with trismus, facial swelling and malar depression. Native soft-tissue thickness was not associated with operative intervention. On receiver operating characteristic curve analysis, the displacement that discriminated operative intervention was 0.36 cm with a sensitivity of 86.4% and specificity of 81.3% (area under the curve 0.9).</div></div><div><h3>Conclusions and relevance</h3><div>Isolated ZA fractures with a displacement of 0.36 cm or greater are associated with operative intervention. Measurement of fracture displacement may aid in clinical decision-making.</div></div>","PeriodicalId":16612,"journal":{"name":"Journal of Oral and Maxillofacial Surgery","volume":"83 5","pages":"Pages 565-575"},"PeriodicalIF":2.3,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143189393","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":"Endoscopic-Assisted Pterygomandibular Approach for Parapharyngeal Tumor Resection: A Case Series","authors":"Xiaoqiong Wang MD ,&nbsp;Lei Zheng MD ,&nbsp;Bo Zheng MD ,&nbsp;Xuejun Liu PhD","doi":"10.1016/j.joms.2025.01.007","DOIUrl":"10.1016/j.joms.2025.01.007","url":null,"abstract":"<div><h3>Background</h3><div>The endoscope-assisted pterygomandibular ligament approach for the resection of parapharyngeal space (PPS) tumors has been reported in a limited number of cases, with insufficiently detailed procedural descriptions.</div></div><div><h3>Purpose</h3><div>The study purpose was to report clinically relevant outcomes among patients who underwent endoscopy-assisted pterygomandibular ligament resection for PPS tumors.</div></div><div><h3>Study Design, Setting, and Sample</h3><div>This study was a retrospective case series analyzing patients treated between January 2018 and July 2021 at the Department of Otolaryngology, Second Affiliated Hospital of Wenzhou Medical University. The sample consisted of patients who underwent endoscopy-assisted pterygomandibular ligament resection for PPS tumors. Patients with incomplete medical records or loss of follow-up were excluded.</div></div><div><h3>Main Outcome Variable</h3><div>The primary outcomes included successful tumor resection, intraoperative blood loss, operation duration, hospital stay, complications, recurrence, and follow-up duration.</div></div><div><h3>Covariates</h3><div>Demographic characteristics, tumor size, pathology, postoperative pain score were collected and analyzed.</div></div><div><h3>Analyses</h3><div>Data were summarized using descriptive statistics.</div></div><div><h3>Results</h3><div>The sample was composed of 9 patients (4 males, 5 females). The operation time ranged from 30 to 240 minutes, with operation blood loss between 5 and 200 mL. The average length of hospital stay was 8.45 days. The average pain score at the first postoperative day was 3.5. No complications, such as infection, bleeding, or nerve damage, were observed. No tumor recurrence was detected over a median follow-up of 53 months (interquartile range: 32.5).</div></div><div><h3>Conclusion</h3><div>The endoscope-assisted pterygomandibular ligament internal approach appears to be a good strategy for PPS tumor resection.</div></div>","PeriodicalId":16612,"journal":{"name":"Journal of Oral and Maxillofacial Surgery","volume":"83 5","pages":"Pages 625-631"},"PeriodicalIF":2.3,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143374354","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":"Coronectomy in Lower Third Molar Surgery: A Systematic Review and Meta-Analysis","authors":"Fei Wu Kang DDS, PhD ,&nbsp;Xin Rui Yuan BDS ,&nbsp;Gong Cheng Li MDS ,&nbsp;Yi Fan Zhou Yang MDS ,&nbsp;Xue Ming Zhang PhD ,&nbsp;Guang Yu Hou MDS","doi":"10.1016/j.joms.2025.01.014","DOIUrl":"10.1016/j.joms.2025.01.014","url":null,"abstract":"<div><h3>Purpose</h3><div>Coronectomy is an alternative approach to the complete removal of an impacted mandibular third molar. The present study conducted a systematic review and meta-analysis to compare coronectomy with extraction concerning complications associated with the inferior alveolar nerve injury (IANI).</div></div><div><h3>Methods</h3><div>This review followed the principles of systematic reviews and meta-analyses. We conducted a comprehensive literature search of 5 databases according to PRISMA guidelines. Research articles published in English before April 30, 2024 were reviewed. The keywords consisted of “coronectomy and lower third molar.” In this study, Rayyan online software was used to identify and eliminate duplicate articles, and another reviewer was invited to screen the articles independently. The included articles' data were extracted, and conclusions were drawn after cross-comparison. The forest plot was drawn after analysis by the R program (JJ Allaire, Boston, Massachusetts, USA). The primary outcome variable of the present study was evaluating the incidence of IANI, and secondly, the lingual nerve injury (LNI), dry socket, postoperative infection, the necessity for surgical reintervention, root migration, root extraction, and coronectomy failure rate. These assessments were made concerning patients' chosen operative technique for managing third molars, either coronectomy or extraction, as predictor variables.</div></div><div><h3>Results</h3><div>After applying inclusion and exclusion criteria, 34 of the 564 articles were included in this study (24 cohort studies and 10 case‒control studies), with 7,115 wisdom teeth from 4,477 patients in different countries. Meta-analysis showed that coronectomy reduced the risk of IANI: relative risk (RR): 0.1; 95% confidence interval (CI): 0.0-0.2; I² (inconsistency index) = 0%; <em>P</em> &lt; .0001, the risk of LNI (RR: 0.2; 95% CI: 0.0-0.7; I² = 0%; <em>P</em> = .01), dry socket (RR: 0.4; 95% CI: 0.3-0.7; I² = 0%; <em>P</em> = .002), and postoperative infection (RR: 1.0; 95% CI: 0.5-2.1; I² = 27%; <em>P</em> = .9). However, coronectomy exhibited a higher risk of surgical reintervention of 3.63% (111 of 3,055), root exposure of 2.66% (61 of 2,290), and a specific failure rate of 2.79% (119 of 4,261).</div></div><div><h3>Conclusion</h3><div>When the mandibular third molar with a higher risk of IANI needs to be removed, coronectomy can reduce the risk of IANI and LNI and the incidence of dry socket compared with traditional extraction. There was no significant difference in postoperative infection between the 2 groups. However, coronectomy exhibited a specific failure rate and higher odds of secondary surgical intervention. Guided bone regeneration can slow down the movement of residual roots and reduce the incidence of secondary surgery.</div></div>","PeriodicalId":16612,"journal":{"name":"Journal of Oral and Maxillofacial Surgery","volume":"83 5","pages":"Pages 601-615"},"PeriodicalIF":2.3,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143433048","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":"Five-Year Experience With Routine Use of Intraoperative Cone-Beam Computed Tomography in Zygomaticomaxillary Complex Fractures","authors":"Dominique Korner ,&nbsp;Daphne Schönegg Dr Med, Dr Med Dent ,&nbsp;Daniel Wiedemeier PhD ,&nbsp;Maximilian Eberhard Hermann Wagner PD Dr Med, Dr Med Dent ,&nbsp;Harald Essig Prof Dr Med, Dr Med Dent ,&nbsp;Michael Blumer PD Dr Med, Dr Med Dent","doi":"10.1016/j.joms.2025.01.013","DOIUrl":"10.1016/j.joms.2025.01.013","url":null,"abstract":"<div><h3>Background</h3><div>Intraoperative cone-beam computed tomography (CBCT) during open reduction and internal fixation of zygomaticomaxillary complex (ZMC) fractures may facilitate the re-establishment of a complex 3-dimensional anatomy.</div></div><div><h3>Purpose</h3><div>This study was conducted to measure the occurrence of malpositions after ZMC fracture reduction and intraoperative revision rates after conducting intraoperative CBCT.</div></div><div><h3>Study design, setting, sample</h3><div>This retrospective case series included subjects treated for ZMC fractures with intraoperative CBCT at the Department of Maxillofacial Surgery of the University Hospital Zurich (Switzerland) over a 5-year period (January 2015 to December 2019). The exclusion criteria were a history of facial fracture and incomplete data.</div></div><div><h3>Predictor variable</h3><div>Not applicable.</div></div><div><h3>Main outcome variables</h3><div>The primary outcome variable was malpositioning after ZMC fracture reduction on intraoperative 3-dimensional imaging. Further variables—including intraoperative revisions of ZMC malpositions, osteosynthesis material revisions, and intraoperative assessments of orbital reconstruction—were analyzed.</div></div><div><h3>Covariates</h3><div>Demographic (age and sex) and clinical (associated with facial fractures) characteristics were assessed.</div></div><div><h3>Analyses</h3><div>The analyses included Spearman's rank correlations, mosaic plots, χ² tests, and Fisher's exact tests. The confidence level for hypothesis testing was set at <em>P</em> &lt; .05.</div></div><div><h3>Results</h3><div>The sample included 337 subjects, and 589 intraoperative CBCT scans were obtained. ZMC malposition after reduction was observed in 154 (45.7%) subjects; the most common malpositions were caudal displacement, underprojection, and inward rotation of the ZMC. Intraoperative revisions were conducted in 150 (44.5%) subjects: 105 (31.2%) subjects exhibited a ZMC malposition, 13 (3.9%) subjects needed revisions of the osteosynthesis material placement, and 32 (9.5%) subjects required intraoperative orbital floor reconstruction. No secondary revision surgeries were required, excluding 25 secondary orbital floor reconstructions. Preoperative and intraoperative radiographic findings did not correlate regarding indications for orbital floor reconstruction.</div></div><div><h3>Conclusion and relevance</h3><div>The 44.5% intraoperative revision rate underscores the challenges of ZMC fracture surgery. Clinical evaluation of fracture reduction at the latero-orbital rim is recommended to identify caudal displacements, and intraoperative CBCT helps identify candidates for primary orbital floor reconstruction. This technique may enhance quality control and precision, thereby potentially improving patient outcomes.</div></div>","PeriodicalId":16612,"journal":{"name":"Journal of Oral and Maxillofacial Surgery","volume":"83 5","pages":"Pages 576-584"},"PeriodicalIF":2.3,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143433069","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":"Comparison of Lip Revision Rates in Traditional Versus Early Cleft Lip Repair: An Institutional Review","authors":"Idean Roohani ,&nbsp;Marvee Turk MD, MPH ,&nbsp;Dylan G. Choi ,&nbsp;Collean Trotter MAT, MD ,&nbsp;Sarah Alfeerawi ,&nbsp;Naikhoba C.O. Munabi MD, MPH ,&nbsp;William P. Magee III MD, DDS ,&nbsp;Jeffrey A. Hammoudeh MD, DDS","doi":"10.1016/j.joms.2025.01.015","DOIUrl":"10.1016/j.joms.2025.01.015","url":null,"abstract":"<div><h3>Background</h3><div>Traditional cleft lip repair (TLR) is performed between 3 and 6 months of age. For over 10 years, our institution has transitioned from offering presurgical nasoalveolar molding (NAM) before cleft lip repair to performing early cleft lip repair (ECLR) within 2 to 5 weeks of life, circumventing the use of NAM.</div></div><div><h3>Purpose</h3><div>This study aimed to estimate and compare the lip revision rates between patients who underwent ECLR versus TLR ± NAM.</div></div><div><h3>Study design, setting, sample</h3><div>A retrospective cohort study was conducted. Patients with nonsyndromic unilateral cleft lip who underwent primary repair between 2004 and 2021 at Children’s Hospital Los Angeles were included. Exclusion criteria were as follows: American Society of Anesthesiologists classification III or higher, syndromic or bilateral cases, gestational-corrected age of more than 6 months at lip repair, and less than 2 years of follow-up.</div></div><div><h3>Predictor variable</h3><div>The predictor variable was the timing of primary cleft lip repair. Subjects were allocated to 1 of 2 treatment cohorts: ECLR (&lt;3 months) and TLR ± NAM (3 to 6 months).</div></div><div><h3>Main outcome variable</h3><div>The primary outcome was lip revision surgery at any time during the patient’s cleft care. Secondary outcomes included the extent and timing of the revision surgeries.</div></div><div><h3>Covariates</h3><div>Data collection included presurgical NAM use, surgeon, cleft phenotype, and cleft width ratio.</div></div><div><h3>Analyses</h3><div>A 2-phased coarsened exact matching process was performed to match cohorts based on surgeon, cleft phenotype, and cleft width ratio at a 1:1 ratio. Kaplan-Meier analyses were used to estimate and compare the revision rates.</div></div><div><h3>Results</h3><div>A total of 1,101 patients underwent primary repair during the study period. After applying the exclusion criteria, 362 patients remained before matching. Among these, 154 patients (77 ECLR, 77 TLR ± NAM) were included after matching. Kaplan-Meier analysis estimated a lower 5-year revision rate for the ECLR cohort compared to the TLR ± NAM cohort (17.3 vs 32.6%, log-rank <em>P</em> &lt; .05). Median follow-up time was 6.6 years [interquartile range 4.4 to 9.2].</div></div><div><h3>Conclusions and relevance</h3><div>ECLR resulted in approximately a 2-fold reduction in lip revision rates compared with TLR ± NAM. These findings suggest that cleft lip repair at approximately 1 month of age may decrease the burden of secondary procedures later in life.</div></div>","PeriodicalId":16612,"journal":{"name":"Journal of Oral and Maxillofacial Surgery","volume":"83 5","pages":"Pages 528-542"},"PeriodicalIF":2.3,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143472500","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 A Surgeon’s Self-Perceived Level of Anxiety Associated With the Type of Surgical Procedure Being Performed?","authors":"Onur Odabaşı DMD ,&nbsp;Mehmet Emrah Polat DMD","doi":"10.1016/j.joms.2025.01.016","DOIUrl":"10.1016/j.joms.2025.01.016","url":null,"abstract":"<div><h3>Background</h3><div>Surgical procedures result in some level of anxiety for the surgeon. It is unclear if the type of surgical procedure being performed by oral and maxillofacial surgeons influences the self-perceive level of anxiety.</div></div><div><h3>Purpose</h3><div>The purpose of this study was to measure the association between different oral and maxillofacial surgical procedures and anxiety levels, and to identify procedures associated with the highest level of performance anxiety.</div></div><div><h3>Study design, setting, sample</h3><div>A retrospective cross-sectional survey was conducted among oral and maxillofacial surgeons in Turkey, distributing surveys electronically via social media platforms, including Instagram and WhatsApp.</div></div><div><h3>Predictor variable</h3><div>The primary predictor variable was surgical procedure. The procedures were 15 different operations, including simple and complex tooth extraction, impacted mandibular and maxillary canine–premolar extraction, impacted mandibular and maxillary third molar extraction, dental implant surgery, sinus lifting, grafting (simple and complex), cyst operations, Le Fort I surgery, sagittal split ramus osteotomy, genioplasty, and temporomandibular joint (TMJ) surgery.</div></div><div><h3>Main outcome variable</h3><div>The main outcome variable was self-reported anxiety level during various surgical procedures, assessed using an 11-point Likert scale ranging from 0 (no anxiety) to 10 (extreme anxiety).</div></div><div><h3>Covariates</h3><div>Covariates included demographics (age and sex), experience (years) and institution type (public universities, private universities, private clinics, private health institutions, and Ministry of Health-affiliated hospitals.)</div></div><div><h3>Analyses</h3><div>Normality was tested with the Shapiro-Wilks test. Anxiety scores were compared among categorical variables with more than 2 categories using the Kruskal–Wallis test, and by sex using the Mann–Whitney U test. Statistical significance was indicated by <em>P</em> value &lt; .05.</div></div><div><h3>Results</h3><div>A total of 154 surveys were distributed, and 96 responses (62.3%) were received and analyzed. Among the respondents, 34 (35.4%) were female and 62 (64.6%) were male. Anxiety levels differed significantly by surgical procedure (<em>P</em> &lt; .001), with the highest mean in TMJ surgery (8.10 ± 2.23) and the lowest mean in simple tooth extraction (1.44 ± 1.86).</div></div><div><h3>Conclusions and relevance</h3><div>The anxiety levels associated with different oral and maxillofacial surgical procedures vary for surgeons. Developing targeted anxiety management strategies is important, especially for procedures with high anxiety levels, such as TMJ surgery and bilateral sagittal split ramus osteotomy.</div></div>","PeriodicalId":16612,"journal":{"name":"Journal of Oral and Maxillofacial Surgery","volume":"83 5","pages":"Pages 632-639"},"PeriodicalIF":2.3,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143492363","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":"Alveoloplasty: A Paradigm Shift to a More Efficient Surgical Technique.","authors":"Jason A Buschman","doi":"10.1016/j.joms.2025.04.016","DOIUrl":"10.1016/j.joms.2025.04.016","url":null,"abstract":"<p><p>Preprosthetic surgery has been an integral part of the oral and maxillofacial surgeon's practice since first described by Obwegeser in the 1970s. Since then, minimal changes or advancements in techniques have been described and are still taught in dental schools. Recent advancements in research now highlight areas of greatest force on alveolar bone during mastication. With this knowledge, surgical planning can improve, helping to avoid buccal bone fractures and other complications that reduce the patient's ability to wear a prosthesis. It has also been demonstrated that longer surgical times increase complication risks, thus the surgeon's goal should be to reduce complications, preserve adequate bone, reshape the alveolar ridge, and minimize surgical time. This technical method introduces a new technique for performing alveoloplasty with extractions, enhancing the surgeon's ability to meet these goals.</p>","PeriodicalId":16612,"journal":{"name":"Journal of Oral and Maxillofacial Surgery","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144094125","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 Pediatric Maxillofacial Giant Cell Lesion Management in Syndromic Versus Nonsyndromic Patients: A 21-Year Review.","authors":"Asli Pekcan, Raina Patel, Melanie Bakovic, Valeria Mejia, Priyanka Naidu, Pasha Shakoori, Jeffrey Hammoudeh","doi":"10.1016/j.joms.2025.04.017","DOIUrl":"10.1016/j.joms.2025.04.017","url":null,"abstract":"<p><strong>Background: </strong>Maxillofacial giant cell lesions (GCLs) may occur in isolation or as a part of a genetic syndrome, where they are often multifocal. The functional deficits and psychosocial impact necessitate urgent treatment; however, a consensus on management is lacking given the rarity and the variable presentation in children.</p><p><strong>Purpose: </strong>This study aims to compare the treatment and outcomes of pediatric maxillofacial GCLs in syndromic and nonsyndromic subjects.</p><p><strong>Study design, setting, and sample: </strong>A retrospective cohort study of pediatric subjects with histologically confirmed maxillofacial GCLs at a tertiary children's hospital between 2003 and 2024 was performed. Patients with incomplete documentation and less than 6 months of follow-up were excluded.</p><p><strong>Predictor variable: </strong>The predictor variable was syndromic diagnosis.</p><p><strong>Main outcomes variable(s): </strong>The primary outcome was tumor recurrence. The secondary outcome was final disease status (remission, progressive, or nonprogressive lesion).</p><p><strong>Covariates: </strong>Demographic characteristics including syndromic diagnosis, tumor characteristics, and adjuvant pharmacologic therapy (APT), including duration of treatment and side effects, were collected. Lesions were classified as aggressive or nonaggressive according to Chuong et al. ANALYSES: Univariate and bivariate statistics were used to compare treatment characteristics and outcomes between syndromic and nonsyndromic cohorts, with statistical significance determined by P values less than .05. Time to tumor recurrence was estimated using Kaplan-Meier analysis.</p><p><strong>Results: </strong>The sample was composed of 28 subjects (16 nonsyndromic, 12 syndromic), with a mean age of 10.7 ± 4.8 years and 17 (60.7%) were male. Overall, 96.4% of lesions were aggressive. Nonsyndromic subjects were more frequently treated with APT compared to syndromic subjects (75.0 vs 25.0%, P = .020). Recurrence occurred in one nonsyndromic subject (6.2%) and 50% of syndromic subjects (P = .008). The estimated median time to recurrence was 89 weeks. Remission was achieved in 100% of the nonsyndromic cohort and only 8.3% of the syndromic cohort (P < .001).</p><p><strong>Conclusion: </strong>The results of this study demonstrated that syndromic subjects were less likely to receive APT for the management of pediatric maxillofacial GCLs, and exhibited higher recurrence and lower remission rates compared to their nonsyndromic counterparts. These findings emphasize the importance of long-term surveillance and anticipatory counseling for families of syndromic patients.</p>","PeriodicalId":16612,"journal":{"name":"Journal of Oral and Maxillofacial Surgery","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144086222","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}