Journal of Oral and Maxillofacial Surgery最新文献

{"title":"Adenotonsillectomy Reduces Obstructive Sleep Apnea and Improves Sleep Quality in Adult Patients.","authors":"Júlia Pereira Toledo, Ana Carolina Ribeiro de Oliveira, Larissa Fontes Germano Santana, Sérgio Gomes da Silva, Fabrizio Dos Santos Cardoso","doi":"10.1016/j.joms.2025.04.001","DOIUrl":"10.1016/j.joms.2025.04.001","url":null,"abstract":"<p><strong>Background: </strong>Adenotonsillectomy is widely established as a first-line treatment for obstructive sleep apnea (OSA) in children; however, its effectiveness and clinical role in adult patients remain less well defined.</p><p><strong>Purpose: </strong>The study purpose was to measure changes in sleep quality and OSA risk in adults following adenotonsillectomy.</p><p><strong>Study design, setting, sample: </strong>This was a prospective cohort study conducted at Unimed, in Itaperuna, RJ, Brazil, including 28 adult patients diagnosed with OSA.</p><p><strong>Predictor/exposure/independent variable: </strong>The primary predictor variable was the time point (preoperative vs 2 months postoperative).</p><p><strong>Main outcome variables: </strong>The main outcome variable was therapeutic response, measured using sleep quality, OSA risk, and daytime fatigue.</p><p><strong>Covariates: </strong>Age, sex, body mass index, and baseline sleep quality.</p><p><strong>Analyses: </strong>Descriptive and inferential analyses were performed using χ², Fisher's exact, and Wilcoxon tests (P < .05).</p><p><strong>Results: </strong>The sample included 28 subjects with a mean age of 28.4 years (±9.1), of whom 15 (53.6%) were male. Adenotonsillectomy improved sleep quality and reduced OSA risk. The proportion of subjects classified as high-risk for OSA decreased from 71.73 to 0% (P < .0001). Median Pittsburgh Sleep Quality Index scores improved from 9.5 (interquartile range 6 to 11) presurgery to 2.0 (1 to 4) postsurgery (P < .0001). In addition, daytime fatigue and snoring frequency also showed marked reductions postoperatively (P < .0001).</p><p><strong>Conclusions and relevance: </strong>Among adults with significant tonsillar or adenoidal hypertrophy and OSA, adenotonsillectomy was associated with improvements in sleep quality and reduced OSA risk. It may represent a viable alternative for patients who cannot tolerate continuous positive airway pressure or present anatomical upper airway obstruction.</p>","PeriodicalId":16612,"journal":{"name":"Journal of Oral and Maxillofacial Surgery","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144021726","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 Autogenous Tooth Graft With Polylactic Co-Glycolic Acid in Postextraction Socket for Alveolar Ridge Preservation: A Randomized Control Trial.","authors":"Harshad Sharma, Amit Gupta, Birsubhra Roy, Aviral Verma, Mansi Dey, Amit Sarkar","doi":"10.1016/j.joms.2025.03.018","DOIUrl":"https://doi.org/10.1016/j.joms.2025.03.018","url":null,"abstract":"<p><strong>Background: </strong>Preservation of alveolar ridge is required postextraction of tooth. Traditional bone graft materials such as autografts, allografts, xenografts, and alloplasts have been used for this purpose.</p><p><strong>Purpose: </strong>The purpose of this study was to measure and compare clinical and radiographic parameters of autogenous tooth graft (ATG) versus resorbable bioscaffold polylactic co-glycolic acid (PLGA) for alveolar ridge preservation.</p><p><strong>Study design, setting, and sample: </strong>A prospective randomized controlled double-blind trial was conducted on patients who reported to our Department from 2019 to 2022 for the extraction of endodontically or periodontically compromised single rooted teeth. Patients with age >60 years, pregnant or lactating females, those with systemic and autoimmune diseases, parafunctional habits, history of tobacco or alcohol, and those on radiotherapy or chemotherapy in the last 12 months were excluded.</p><p><strong>Predictor variables: </strong>The predictor variable was the alveolar ridge preservation techniques and the subjects were randomly assigned to autogenous tooth grafting (ATG) and PLGA group.</p><p><strong>Main outcome variables: </strong>Main outcome variables were clinical and radiographic dimensions of alveolar ridge on postoperative day 1 and 6 months after grafting. The secondary outcomes were complications.</p><p><strong>Covariates: </strong>The demographic details were age and gender.</p><p><strong>Analyses: </strong>Bivariate analyses were performed using the parametric tests, ie, paired t-test and independent t-test for intragroup and intergroup comparison respectively, with level of statistical significance set at P value ≤ .05.</p><p><strong>Results: </strong>The study sample was composed of 20 subjects with a mean age of 47.40 ± 13.94 years. 45% (n = 9) were males and 55% (n = 11) females. On comparing bone levels, we found statistically significant difference in the horizontal dimension in the apical third between the 2 groups after 6 months of grafting (P = .01). There was also a statistically significant increase in the dimensions of alveolar ridge from baseline to 6 months in both the groups. No complications like wound dehiscence or presence of pus discharge were observed in Group A, while there was failure of regeneration in 2 patients in Group B.</p><p><strong>Conclusion and relevance: </strong>The results suggest that ATG may be better than PLGA for socket grafting due to lower risk of complications.</p>","PeriodicalId":16612,"journal":{"name":"Journal of Oral and Maxillofacial Surgery","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144022909","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":"Trends in Opioid Prescriptions to Opioid-Naïve Patients by Oral and Maxillofacial Surgeons in Massachusetts 2012-2022","authors":"Tim T. Wang DMD, MD, MPH ,&nbsp;Jessica Hao BA ,&nbsp;Cameron C. Lee DMD, MD ,&nbsp;Danielle DeNufrio Valerio MPH ,&nbsp;Netrali Dalvi MPH ,&nbsp;David A. Keith BDS, FDSRCS, DMD","doi":"10.1016/j.joms.2024.12.009","DOIUrl":"10.1016/j.joms.2024.12.009","url":null,"abstract":"<div><h3>Background</h3><div>Many oral and maxillofacial surgery patients are young, healthy adults who are opioid-naïve. Over-prescribing opioids increases the risk of subsequent misuse and diversion.</div></div><div><h3>Purpose</h3><div>The purpose of this study was to measure and compare opioid prescriptions to opioid naïve and nonnaïve patients by oral and maxillofacial surgeons in Massachusetts from 2012 to 2022.</div></div><div><h3>Study design, setting, sample</h3><div>This retrospective cohort study used the Massachusetts Prescription Monitoring Program database to identify Schedule II and III opioid prescriptions by providers with specialty of oral and maxillofacial surgery from 2012 to 2022.</div></div><div><h3>Predictor/exposure/independent variable</h3><div>The predictor variable is opioid exposure coded as opioid naïve (yes/no). Opioid-naïve status was defined as not having filled an opioid prescription in the prior 12 months.</div></div><div><h3>Main outcome variable</h3><div>The main outcome variable was the quantity of opioid prescribed by oral and maxillofacial surgeons measured using morphine milligram equivalent (MME) per prescription. The secondary outcome was days' supply prescribed.</div></div><div><h3>Covariates</h3><div>Covariates of the study included patient age and sex.</div></div><div><h3>Analyses</h3><div>Descriptive statistics and weighted linear regressions were used to analyze differences in MME per prescription and days's supply per prescription to opioid-naïve and nonnaive patients each year and throughout the study period. <em>P</em> &lt; .05 was considered statistically significant.</div></div><div><h3>Results</h3><div>The data included a total of 866,539 prescriptions to 679,616 opioid-naïve patients and 186,923 nonnaïve patients from 2012 to 2022. Compared to nonnaïve patients, the opioid-naïve cohort had a slightly higher proportion of females (<em>P</em> ≤ .01 except for 2020) and were significantly younger (35.9 vs 47.6 yrs, <em>P</em> ≤ .01 for all years). For every study year, there was no statistically significant difference in mean MME per prescription or days' supply per prescription between opioid-naïve and nonnaïve patients (<em>P</em> &gt; .05 in all years for both variables). MME per prescription (β = −7.22, 95% CI: −7.65, −6.80; R² = 0.79) and days' supply per prescription (β = −0.11, 95% CI: −0.11, −0.10; R² = 0.78) decreased at a similar rate throughout the study period for both opioid-naïve and nonnaïve patients.</div></div><div><h3>Conclusions and relevance</h3><div>Oral and maxillofacial surgeons in Massachusetts predominantly prescribed opioids to opioid-naïve patients. The quantity and duration of initial prescriptions to opioid-naïve and nonnaïve patients were similar, yet both steadily decreasing, throughout the study period. These trends are encouraging in the context of recent responsible opioid prescribing policy interventions in Massachusetts.</div></div>","PeriodicalId":16612,"journal":{"name":"Journal of Oral and Maxillofacial Surgery","volume":"83 4","pages":"Pages 407-413"},"PeriodicalIF":2.3,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142983895","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: Evaluating Artificial Intelligence Chatbots in Oral and Maxillofacial Surgery Board Exams: Performance and Potential","authors":"Shunsuke Koga MD, PhD,&nbsp;Wei Du MD, PhD","doi":"10.1016/j.joms.2024.12.015","DOIUrl":"10.1016/j.joms.2024.12.015","url":null,"abstract":"","PeriodicalId":16612,"journal":{"name":"Journal of Oral and Maxillofacial Surgery","volume":"83 4","pages":"Page 406"},"PeriodicalIF":2.3,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143746694","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":"Editorial Board Page","authors":"","doi":"10.1016/S0278-2391(25)00072-2","DOIUrl":"10.1016/S0278-2391(25)00072-2","url":null,"abstract":"","PeriodicalId":16612,"journal":{"name":"Journal of Oral and Maxillofacial Surgery","volume":"83 4","pages":"Page A3"},"PeriodicalIF":2.3,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143746975","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":"Rethinking Dysplasia: A p53 Perspective","authors":"Yen Chen Kevin Ko MD, DMD ,&nbsp;Jasjit K. Dillon DDS, MBBS","doi":"10.1016/j.joms.2024.11.019","DOIUrl":"10.1016/j.joms.2024.11.019","url":null,"abstract":"","PeriodicalId":16612,"journal":{"name":"Journal of Oral and Maxillofacial Surgery","volume":"83 4","pages":"Pages 399-401"},"PeriodicalIF":2.3,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143746979","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 Low-Level Laser Treatment Effective in Reducing Pain, Swelling, and Trismus After Removing Impacted Maxillary and Mandibular Third Molars?","authors":"Esra Sekerci, Mona Schiefersteiner, Daniel Wiedemeier, Silvio Valdec","doi":"10.1016/j.joms.2025.03.017","DOIUrl":"10.1016/j.joms.2025.03.017","url":null,"abstract":"<p><strong>Background: </strong>The most common side effects of wisdom teeth removal are postoperative pain, swelling, and trismus. The efficacy of low-level laser treatment (LLLT) in reducing these side effects remains controversial.</p><p><strong>Purpose: </strong>The purpose of this study was to evaluate the effectiveness of LLLT on pain, swelling and trismus after surgical removal of upper and lower wisdom teeth. The investigators hypothesize that the use of LLL will reduce pain, swelling and trismus compared to the mouth side treated with placebo laser (PL).</p><p><strong>Study design: </strong>This double-blind, randomized, split-mouth study involved 20 (100%) healthy patients aged 18 to 24 years with asymptomatic impacted maxillary and mandibular third molars. Exclusion criteria included pregnant or lactating women, smokers, noncompliant patients, those with infectious diseases, anticoagulated patients, or those with intraoperative oral-antrum connection or previous pericoronitis. The study was conducted at the Clinic of Cranio-Maxillofacial and Oral Surgery, Center of Dental Medicine, University of Zurich, Switzerland.</p><p><strong>Predictor variable: </strong>The predictor variable is the therapeutic intervention, LLL versus PL. Treatments were randomly assigned to LLL (ORCOS Medical AG, LASOTRONIC, Küsnacht, Switzerland) or PL.</p><p><strong>Outcome variable: </strong>The primary outcome was pain 3 days postoperatively and the secondary outcomes were swelling and trismus 3 and 7 days postoperatively after wisdom teeth removal. Pain was measured using a visual analog scale, swelling was measured with an extraoral 3-dimensional scanner, and mouth opening with a ruler. The measurements were taken preoperatively and 3 and 7 days postoperatively. Age and sex were similar between the groups.</p><p><strong>Covariates: </strong>The covariates were age and sex.</p><p><strong>Analyses: </strong>A 2-sided Wilcoxon signed-rank test with a significance level α = 0.05 was used.</p><p><strong>Results: </strong>The sample included 20 (100%) subjects with a mean age of 20.4 years (±1.9), 11 (55%) of whom were female. On day 3, the median pain score was 2.5 (interquartile range [IQR]: 3) in the LLLT group and 2.0 (IQR = 2.3) in the PL group (P = .5). The median swelling was 10,697 mm³ (IQR = 11,234 mm³) in LLLT versus 13,407 mm³ (IQR = 11,308 mm³) in PL group on day 3 (P = .1) and 2,379 mm³ (IQR = 4,322 mm³) in LLLT versus 1,553 mm³ (IQR = 3,079 mm³) in PL group on day 7 (P = .6). The median trismus was 35 mm (IQR = 9.8 mm) in LLLT versus 35.5 mm (IQR 9.5 mm) in PL group on day 3 (P = .7), and 43.5 mm (IQR = 11.3 mm) in LLLT versus 48 mm (IQR = 13 mm) in PL group on day 7 (P = .9).</p><p><strong>Conclusion: </strong>Postoperative LLLT showed no statistically significant benefits in reducing pain, swelling, and trismus after wisdom teeth removal.</p>","PeriodicalId":16612,"journal":{"name":"Journal of Oral and Maxillofacial Surgery","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144013045","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":"Modified Approach to Segmental Maxillary Surgery: Midline Osteotomy and Parasagittal Soft Tissue Incisions","authors":"Charles H. Henry DDS ,&nbsp;Pushkar Mehra BDS, DMD, MS ,&nbsp;Larry M. Wolford DMD","doi":"10.1016/j.joms.2024.12.005","DOIUrl":"10.1016/j.joms.2024.12.005","url":null,"abstract":"<div><div>Traditional surgical techniques for segmental maxillary surgery include a combination of interdental osteotomies with paramidline bony cuts while keeping the palatal soft tissue intact. Besides surgical complexity, segmental maxillary procedures have been associated with higher incidence of relapse and complications. We present our experience with specific hard- and soft-tissue modifications (midline bony osteotomy and reflection of palatal soft tissue with carefully designed incisions) which will allow surgeons to perform larger expansions with a low incidence of complications and decreased relapse.</div></div>","PeriodicalId":16612,"journal":{"name":"Journal of Oral and Maxillofacial Surgery","volume":"83 4","pages":"Pages 442-447"},"PeriodicalIF":2.3,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142921916","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":"April 2025 AAOMS News and Announcements","authors":"","doi":"10.1016/j.joms.2025.01.005","DOIUrl":"10.1016/j.joms.2025.01.005","url":null,"abstract":"","PeriodicalId":16612,"journal":{"name":"Journal of Oral and Maxillofacial Surgery","volume":"83 4","pages":"Pages 494-499"},"PeriodicalIF":2.3,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143746787","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":"Accuracy of Two Different Patient-Specific Drill/Cutting Guides for Maxillary Repositioning When Used for Minimally Invasive Bimaxillary Orthognathic Surgery","authors":"Felix Jose Amarista DDS ,&nbsp;Edward Ellis III DDS, MS","doi":"10.1016/j.joms.2025.01.001","DOIUrl":"10.1016/j.joms.2025.01.001","url":null,"abstract":"<div><h3>Background</h3><div>Minimally invasive orthognathic surgery (MIOS) involves smaller incisions and minimal tissue dissection. Most MIOS is done using interim splints to position the first jaw. The application of patient-specific implants in MIOS is difficult due to the size of traditional cutting/drill guides, which require larger incisions. As a result, MIOS guides were redesigned for this study to fit into smaller incisions.</div></div><div><h3>Purpose</h3><div>The study purpose was to estimate and compare the accuracy of the smaller and redesigned bone-borne (BB) versus bone/tooth-borne (BTB) cutting/drilling guides used in minimally invasive bimaxillary orthognathic surgery.</div></div><div><h3>Study Design, Setting, Sample</h3><div>This retrospective cohort study included consecutive MIOS patients treated by a single surgeon at the University of Texas Health San Antonio from June 2023 to September 2024. It included patients that underwent bimaxillary MIOS with complete preoperative and postoperative cone-beam computed tomographic records. Exclusion criteria included craniofacial syndromes, severe medical comorbidities, or single-jaw surgery.</div></div><div><h3>Predictor Variable</h3><div>The primary predictor variable was the type of cutting/drilling guide (BB vs BTB) used to perform maxillary osteotomy.</div></div><div><h3>Main Outcome Variable(s)</h3><div>The primary outcome variable was accuracy, defined as mean linear discrepancy that is closest to 0 mm. Linear discrepancies between planned and actual maxillary movements were measured.</div></div><div><h3>Covariates</h3><div>Demographics and malocclusion type.</div></div><div><h3>Analyses</h3><div>χ² tests compared categorical variables, and Student's t-tests assessed accuracy differences. A <em>P</em> value &lt; .05 was considered significant, with a Bonferroni correction applied for multiple comparisons.</div></div><div><h3>Results</h3><div>The sample consisted of 20 patients (15 females, 75%; 5 males, 25%; mean age 24 ± 11.3 years) evenly divided into BB (n = 10) and BTB (n = 10) guide groups. The BTB guide demonstrated superior vertical accuracy for the upper incisor (mean difference: 0.67 mm, standard deviation = 0.33, <em>P</em> = .02) and the upper left canine (mean difference: 0.11 mm, standard deviation = 0.04, <em>P</em> = .03) when comparing means. However, no significant differences were found in root mean square discrepancies (<em>P</em> &gt; .2) or other measurements (<em>P</em> &gt; .06).</div></div><div><h3>Conclusions and Relevance</h3><div>Both guides achieved acceptable accuracy overall, with the BTB guide showing superior precision for 2 of the 11 landmarks.</div></div>","PeriodicalId":16612,"journal":{"name":"Journal of Oral and Maxillofacial Surgery","volume":"83 4","pages":"Pages 421-428"},"PeriodicalIF":2.3,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143123044","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}