Journal of Oral and Maxillofacial Surgery最新文献

{"title":"Concentrated Growth Factor Constructs Improve Wound Healing After Third Molar Surgery: A Split-Mouth Randomized Controlled Trial.","authors":"Cheng Huang, Chun Zhou, Xiaodan Fan, Haixia Liu, Yuanzhi Xu","doi":"10.1016/j.joms.2025.05.012","DOIUrl":"10.1016/j.joms.2025.05.012","url":null,"abstract":"<p><strong>Background: </strong>Concentrated growth factor (CGF), an autologous platelet concentrate consists of a fibrin scaffold and its internal loading of biomolecules. Little is known about the effect of CGF on wound healing after third molar surgery.</p><p><strong>Purpose: </strong>This study compared the healing and in vitro and ex vivo levels of biomolecules after third molar surgery between CGF-treated and untreated extraction sites.</p><p><strong>Study design, setting and sample: </strong>This double-blinded split-mouth randomized controlled trial was conducted at the Department of Stomatology of Shanghai Fourth People's Hospital between December 2023 and November 2024 with patients who underwent bilaterally mandibular impacted third molar extraction. Exclusion criteria were age over 30, local inflammation and infection, medication usage, and systemic disease.</p><p><strong>Predictor variable: </strong>The predictor variable was socket management. Within each subject, one extraction socket was randomly selected as the treatment side (CGF), and the contralateral side was allowed to heal without CGF.</p><p><strong>Main outcome variable(s): </strong>The primary outcome variable was socket healing, which measured using the wound healing index measured on postoperative days 1, 3, and 7. The secondary outcome variables were the in vitro concentrations of growth factors and cytokines from the CGF membranes and the ex vivo concentrations of growth factors and cytokines in the wound fluid taken from each side measured on postoperative days 1, 3, and 7.</p><p><strong>Covariates: </strong>Age, sex, surgery duration, and extraction difficulty were covariates.</p><p><strong>Analyses: </strong>The data were analyzed by paired t test, Wilcoxon matched-pairs signed-rank test, analysis of variance, and generalized estimating equation, with statistical significance set at P < .05.</p><p><strong>Results: </strong>The study included 25 subjects, 12 (48%) women and 13 (52%) men, with a mean age of 23.72 ± 4.23 years. The wound healing index was significantly better on the test sides on days 3 (CGF vs control: 5.16 ± 0.69 vs 5.72 ± 0.79; P < .001) and 7 (CGF vs control: 4.12 ± 0.33 vs 4.56 ± 0.77; P < .05). Among all the proteins released from CGF in vitro, the total concentration of transforming growth factor-β1 was the greatest (P < .001). The concentrations of transforming growth factor-β1, platelet-derived growth factor, vascular endothelial growth factor, epidermal growth factor, fibroblast growth factor-2, and interleukins (IL)-1β, IL-6, and IL-10 were greater in the wound fluid from the CGF sockets than in that from the control sockets at all time points (P < .05).</p><p><strong>Conclusions and relevance: </strong>CGF constructs increase the biomolecule concentrations in wound fluid and are associated with improved early wound healing after impacted third molar extraction. CGF appears to be a viable biomaterial for this procedure.</p>","PeriodicalId":16612,"journal":{"name":"Journal of Oral and Maxillofacial Surgery","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-05-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144293952","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 Effects of Different Bimaxillary Orthognathic Surgery Sequencing on the Temporomandibular Joint Space of Skeletal Class II Malocclusion Patients.","authors":"Qu Deng, Feng Li, Li'an Bai, Xuewen Yang, Zhenzhen Guo, Qilong Wan","doi":"10.1016/j.joms.2025.05.011","DOIUrl":"10.1016/j.joms.2025.05.011","url":null,"abstract":"<p><strong>Background: </strong>Changes in the temporomandibular joint (TMJ) space are known consequences of bimaxillary surgery, and the surgery sequence may influence postoperative TMJ space or risk of relapse.</p><p><strong>Purpose: </strong>The purpose of this study was to measure the association of bimaxillary surgery sequence and changes in the TMJ space over time in patients with skeletal Class II malocclusion.</p><p><strong>Study design, setting, and sample: </strong>A retrospective cohort study involving patients with skeletal Class II malocclusion who underwent bimaxillary orthognathic surgery was conducted at the Hospital of Stomatology, Wuhan University from 2018 to 2021. Patients without complete cone beam computed tomography were excluded.</p><p><strong>Predictor variable: </strong>The predictor variable was sequence of bimaxillary orthognathic surgery, grouped as mandible-first and maxilla-first.</p><p><strong>Main outcome variables: </strong>The main outcome variables were radiographic linear measurements and changes in the anterior joint space, posterior joint space (PJS), and superior joint space (SJS) at 3 time points: preoperative, 1 week postoperative, and 6-12 months postoperative.</p><p><strong>Covariates: </strong>The evaluated covariates included sex, age, mandibular advancement.</p><p><strong>Analyses: </strong>Repeated-measures analysis of variance was used to assess changes in joint space over time and side, with surgical sequence as a between-subjects factor. Additional analyses included independent t-tests and canonical correlation. (P ≤ .05).</p><p><strong>Results: </strong>The sample comprised 48 subjects (96 joints), with a mean age of 29.2 (8.5) years; 11 (23%) were male. At 1 week postsurgery, the Maxilla-First group showed a significantly greater radiographic increase in SJS than the Mandible-First group (mean difference: 1.3 mm; 95% CI: 0.7-2.0; P = .0005). At the same time point, all 3 joint spaces (SJS, anterior joint space, and PJS) increased significantly in both groups (P < .05). By 6-12 months postoperatively, surgery sequence showed a negative effect on TMJ space changes, as SJS and PJS significantly decreased in the maxilla-first group (mean differences: 1.9 and 1.1 mm; 95% CIs: 1.2-2.5 and 0.3-1.8; P = .0001 and .005, respectively).</p><p><strong>Conclusions and relevance: </strong>TMJ space changes in skeletal Class II malocclusion varied over time and were associated with the order of surgery sequence, with smaller changes observed in the mandibular-first group.</p>","PeriodicalId":16612,"journal":{"name":"Journal of Oral and Maxillofacial Surgery","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144284971","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":"Effect of Photobiomodulation on the Control of Edema and Pain After Third Molar Surgery: Double-Blinded Randomized Clinical Trial.","authors":"Ana Pérez, Alejandro Rujano-Salinas, Lelis Bennett, Rafael Muñoz, Patricia Moreno-Garces, Josue Huartaja, Carlos Sanchez-Ramirez","doi":"10.1016/j.joms.2025.05.010","DOIUrl":"10.1016/j.joms.2025.05.010","url":null,"abstract":"<p><strong>Background: </strong>Side effects of third molar surgery include edema and pain. Photobiomodulation (PBM) therapy is a noninvasive technology that minimizes these symptoms.</p><p><strong>Purpose: </strong>To evaluate the effects of PBM on the control of postoperative edema and pain in patients undergoing surgical removal of third molars.</p><p><strong>Study design, setting, and sample: </strong>A split-mouth, double-blinded, placebo-controlled, randomized clinical trial was conducted at the Faculty of Dentistry, José Antonio Páez University. The study enrolled patients who required bilateral surgical extraction of the impacted and retained third molars in comparable anatomical positions. Patients with soft or hard tissue pathology or systemic inflammatory conditions that could compromise healing were excluded from the study.</p><p><strong>Predictor variable: </strong>The exposure to PBM was a predictor variable. One side of the jaw was randomly assigned as the treatment side and the opposite side as the untreated or control side. The treatment side received PBM using a 980 nm diode laser immediately after surgery and at 24, 48, and 72 hours postoperatively.</p><p><strong>Outcome variables: </strong>The primary outcome variables were edema and pain. Edema was measured using a visual analog scale (VAS) and facial measurements (using a measuring tape in maximum intercuspation). Pain was measured using only the VAS.</p><p><strong>Covariates: </strong>The covariates included age, sex, skin phototype, and analgesic use.</p><p><strong>Analyses: </strong>Two-way analysis of variance and repeated measures analysis of variance were used for comparative analysis. A P value <.05 was considered statistically significant.</p><p><strong>Results: </strong>A total of 37 patients, including 12 males (32.4%) and 25 females (67.6%), with a mean age of 22.8 ± 3.6 years, completed the study. Perceived edema, measured using a 10-cm VAS, was significantly lower in the PBM group at 24 hours (6 ± 2 vs 8 ± 2; P < .001), 48 hours (5 ± 2 cm vs 7 ± 2; P < .001), and 72 hours (3 ± 2 vs 6 ± 2; P < .001). Pain scores were also significantly reduced in the PBM group at 24 hours (4 ± 3 vs 6 ± 3; P = .002), 48 hours (4 ± 3 vs 5 ± 2; P = .003), and 72 hours (2 ± 2 vs 4 ± 2; P = .004).</p><p><strong>Conclusion: </strong>The use of PBM significantly reduced edema and pain after the third molar surgery compared with the control group.</p>","PeriodicalId":16612,"journal":{"name":"Journal of Oral and Maxillofacial Surgery","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144258303","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 Intra-articular Injection of Hyaluronic Acid, Corticosteroid or Platelet-rich Plasma Following Medical Ozone Superior to Medical Ozone Alone in the Treatment of Temporomandibular Joint Osteoarthritis?","authors":"Songül Cömert Kiliç, Umid Babayev, Nihat Kiliç","doi":"10.1016/j.joms.2025.05.009","DOIUrl":"10.1016/j.joms.2025.05.009","url":null,"abstract":"<p><strong>Background: </strong>Temporomandibular joint osteoarthritis (TMJ-OA) results in pain, limited function, and reduced quality of life. Medical ozone (MO) has been used to reduce TMJ pain and improve maximum incisal opening (MIO). However, it remains unclear whether intra-articular (IA) hyaluronic acid (HA), corticosteroid (CS), or platelet-rich plasma (PRP) injection following IA MO injection alone is superior to IA MO injection alone.</p><p><strong>Purpose: </strong>The purpose of this study was to measure and compare pain reduction and improved MIO in subjects with TMJ-OA who underwent IA injections with MO, MO + HA, MO + CS, and MO + PRP.</p><p><strong>Study design: </strong>The researchers implemented a randomized clinical trial in adult patients with TMJ-OA, Wilkes IV and V, referred to the author's clinic from January 2022 through December 2024.</p><p><strong>Predictor variable: </strong>The predictor variables were the agents for IA injection. Subjects were randomized to one of 4 injection groups: MO, MO + HA, MO + CS, or MO + PRP.</p><p><strong>Main outcome variables: </strong>The outcome variables were changes in the pain measured using the visual analog scale and range of motion (MIO) from baseline (T0) to 6 months (T2) postoperatively.</p><p><strong>Covariates: </strong>Covariates were age and sex.</p><p><strong>Analysis: </strong>The data were analyzed using repeated-measure analysis of variance and the Tukey-HSD test with significance set at P < .05.</p><p><strong>Results: </strong>The final study sample included 49 patients (mean age, 32.25 ± 13.17 years), with higher female prevalence: 11 (84.6%) in the MO group, 12 (100%) in the MO + HA group, and 11 (91.7%) in the MO + CS and the MO + PRP groups (P = .6). Pain reduced (p˂0.001), and MIO improved (p˂0.01) significantly in all groups. However, after estimating differences between 6 months and baseline outcomes, mean changes in the primary outcome variables showed no statistically significant differences among the 4 groups (pain, P = .6; MIO, P = .2).</p><p><strong>Conclusions: </strong>Within the limitations of this study, combining treatments of HA, CS, or PRP with MO was not statistically significantly associated with therapeutic effects in reducing pain or improving jaw function in patients with TMJ-OA.</p>","PeriodicalId":16612,"journal":{"name":"Journal of Oral and Maxillofacial Surgery","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144266405","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":"Patient-Specific Titanium Implants Reduce Hardware-Related Complications Compared to Stock Reconstruction Plates for Virtually Guided Fibular Free Flaps in Head and Neck Reconstruction.","authors":"Ahmed K Mohamed, Kevin Arce, John M Nathan, Robert A Vierkant, Victoria A Sears, Jonathan M Morris, Kyle S Ettinger","doi":"10.1016/j.joms.2025.05.008","DOIUrl":"10.1016/j.joms.2025.05.008","url":null,"abstract":"<p><strong>Background: </strong>Virtual surgical planning (VSP) for composite microvascular free flaps has become the standard-of-care for oncologic head and neck reconstruction. Controversy remains on the routine use of three-dimensional-printed titanium patient-specific implants (PSIs) or traditional hand-contoured stock reconstruction plates.</p><p><strong>Purpose: </strong>The purpose of this study was to compare hardware-related complications of PSIs versus stock reconstruction plates among subjects undergoing VSP-guided fibular free flap reconstructions.</p><p><strong>Study design/setting/sample: </strong>A retrospective cohort study of subjects undergoing VSP-guided fibular free flaps at Mayo Clinic between 2014 and 2023 was undertaken. Exclusion criteria included subjects not undergoing a VSP-guided surgery, bony microvascular reconstruction other than a fibular free flap, less than 1 year of postoperative follow-up, and inadequate documentation of requisite clinical variables in the electronic medical record.</p><p><strong>Predictor variable: </strong>The primary predictor variable was the type of reconstruction plate utilized (PSI vs stock plate).</p><p><strong>Main outcome variable: </strong>The main outcome variable was potential hardware-related complications defined as: hardware fracture, hardware loosening, postoperative infection, hardware extrusion, hardware removal, nonunion bone healing, and osteoradionecrosis.</p><p><strong>Covariates: </strong>Covariates included subject age, sex, and preoperative diagnosis.</p><p><strong>Analysis: </strong>Associations of complication-free survival with plate type were analyzed with Kaplan-Meier survival curves. Formal associations were calculated using Cox proportional hazards regression analysis, modeling time to complication as the outcome and plate type as the exposure.</p><p><strong>Results: </strong>A total of 265 subjects were identified, 183 (69%) receiving PSIs, and 82 (31%) receiving stock plates. Seventy-two subjects (27%) experienced at least 1 postoperative hardware-related complication. Multivariate Cox proportional hazards regression demonstrated that stock plates were nearly twice as likely to experience at least 1 hardware-related complication compared to PSIs (hazard ratio: 1.80, 95% CI: 1.11 to 2.91, P = .0171).</p><p><strong>Conclusion and relevance: </strong>Use of PSIs in the modern era of VSP-guided fibular free flap reconstruction is associated with a nearly 2-fold reduction in postoperative hardware-related complications over stock reconstruction plates.</p>","PeriodicalId":16612,"journal":{"name":"Journal of Oral and Maxillofacial Surgery","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144248370","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":"Complication Rates of the Anterior Iliac Crest Bone Graft Donor Site for 426 Pediatric Patients Undergoing Alveolar Bone Grafting.","authors":"Lane Haws, Boyu Ma, Tanner Godfrey, Peter D Waite, Brian Kinard, Kathlyn Powell","doi":"10.1016/j.joms.2025.05.006","DOIUrl":"10.1016/j.joms.2025.05.006","url":null,"abstract":"<p><strong>Background: </strong>The iliac crest bone graft (ICBG) has long been considered the gold standard for secondary alveolar reconstruction in patients with cleft lip and palate. With the advent of grafting alternatives, such as bone morphogenetic protein-2, the morbidity of the iliac crest harvest has come into question.</p><p><strong>Purpose: </strong>The purpose of this study is to estimate the frequency, types, and identify risk factors for postoperative complications of the anterior ICBG hip donor site.</p><p><strong>Study design, setting, sample: </strong>A retrospective cohort study of patients who received alveolar reconstruction with anterior ICBG by 2 surgeons over an 11-year period at the Children's of Alabama Hospital in Birmingham, Alabama, was conducted. Exclusion criteria included previous alveolar graft attempt, age greater than 18 years at the time of repair, or lack of postoperative follow-up.</p><p><strong>Predictor variable: </strong>The predictor variable was a set of risk factors associated with complications and included sex, age at surgery, and cleft type (unilateral vs bilateral).</p><p><strong>Main outcome variable: </strong>The main outcome variable was donor site morbidity defined as the presence of complications, prolonged length of stay, or readmission. Complications included gait disturbance, transient hypoesthesia, and hypertrophic scar.</p><p><strong>Covariates: </strong>Covariates included length of follow-up and alveolar cleft graft timing (secondary vs tertiary).</p><p><strong>Analyses: </strong>Descriptive and bivariate analyses were completed. The level of statistical significance was P < .05.</p><p><strong>Results: </strong>The sample size was composed of 426 subjects with a mean age of 7.9 ± 2.3 years. Of the total subjects, 211 (49.5%) patients were male and 215 (50.5%) patients were female. Overall, 11 (2.6%) subjects experienced complications associated with the anterior iliac crest donor site. The most prevalent anterior iliac crest donor site complications included transient gait disturbance 0.7% (n = 3), hypertrophic scar 0.7% (n = 3), and transient hypoesthesia 0.5% (n = 2). One subject experienced prolonged length of stay, and none required readmission. There were no study variables associated with donor site morbidity.</p><p><strong>Conclusion: </strong>The overall morbidity associated with anterior ICBG for alveolar cleft repair remains low, with a complication rate of 2.6% (n = 11) associated with the donor site. These results offer strong evidence of the overall safety and minor morbidity of the ICBG harvest for alveolar cleft repair.</p>","PeriodicalId":16612,"journal":{"name":"Journal of Oral and Maxillofacial Surgery","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144216192","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 Effect of Le Fort I Osteotomy on Nasal Tip Rotation in Dynamic Smile.","authors":"Muazzez Suzen, Bugra Duc, Emine Ogut, Sina Uckan","doi":"10.1016/j.joms.2025.05.004","DOIUrl":"10.1016/j.joms.2025.05.004","url":null,"abstract":"<p><strong>Background: </strong>The nasal region is an essential component of facial aesthetics and is a crucial evaluation parameter in orthognathic surgery planning. Although numerous studies have investigated static changes in the nasal region at rest, dynamic changes during facial expressions such as smiling following Le Fort I surgery have not yet been evaluated.</p><p><strong>Purpose: </strong>The aim of this study was to measure and compare the nasal tip rotation with smiling before and after orthognathic surgery.</p><p><strong>Study design: </strong>This retrospective study examines data from maxillary advancement patients treated at Medipol Mega University Hospital (Istanbul, Türkiye) between 2018 and 2024. Patients with segmental Le Fort I surgery, maxillary asymmetry, vertical movements greater than 2.5 mm, a history of Le Fort surgery, trauma or septoplasty/rhinoplasty, craniofacial syndrome, cleft lip/palate patients, were excluded.</p><p><strong>Predictor variables: </strong>The predictor variable was maxillary advancement magnitude (mm) and it was divided into 2 <6 mm or ≥6 mm.</p><p><strong>Main outcome variable: </strong>The outcome variable was the angle differences between the lines drawn from the nasion to the nasal tip in resting and smiling profile photographs. The timing of resting and smiling profile photographs was reported as preoperatively (T₀) and postoperatively (T₁).</p><p><strong>Covariates: </strong>Sex and age were considered covariates.</p><p><strong>Analyses: </strong>Paired t-test and Wilcoxon signed-rank test were used to compare pre-operative and postoperative differences within each group. A P value <.05 was considered significant.</p><p><strong>Results: </strong>The sample was composed of 48 subjects with a mean age of 24.23 (6.14) and 23 (47.9%) were male. The mean preoperative nasal tip rotation difference between rest and smiling was 1.57° (0.86), the mean postoperative nasal tip rotation difference was 1.30° (0.71). The nasal tip rotation difference decreased between pre-operative and postoperative periods. While the difference between the mean preoperative 1.36° (0.80) and postoperative dynamic nasal tip rotation 1.16° (0.66) in group 1 was not statistically significant (P = .2), the difference in group 2's mean preoperative 1.78° (0.88) and postoperative 1.43° (0.76) was statistically significant (P = .016).</p><p><strong>Conclusions: </strong>In patients with more than 6-mm maxillary advancement, nasal tip rotation difference was significantly reduced during dynamic smile after orthognathic surgery.</p>","PeriodicalId":16612,"journal":{"name":"Journal of Oral and Maxillofacial Surgery","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144199429","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 Shield-Like Septal Extension Graft: A Novel Technique for Nasal Tip Management in Revision Rhinoplasty.","authors":"Hüseyin Balikci, Alper Yenigun, Emre Polat, Remzi Dogan, Orhan Ozturan","doi":"10.1016/j.joms.2025.05.005","DOIUrl":"10.1016/j.joms.2025.05.005","url":null,"abstract":"<p><p>This study introduces the shield-like septal extension graft technique, a novel approach for enhancing tip support, rotation, and projection in revision rhinoplasty cases. The shield-like septal extension graft is positioned in front of the caudal septum, mimicking a shield graft to provide structural reinforcement. The study included 18 patients (12 women and 6 men) with a median follow-up of 12 months (interquartile range: 9 to 15 months). No significant complications were observed, and patients achieved satisfactory aesthetic and functional outcomes. This technique offers a reliable and reproducible solution for managing complex revision rhinoplasty cases by providing superior tip stability, midline alignment, and long-term structural support. The use of costal cartilage ensures sufficient strength, especially in patients with structural deficiencies or thick skin.</p>","PeriodicalId":16612,"journal":{"name":"Journal of Oral and Maxillofacial Surgery","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144199430","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":"Cost-Effectiveness Analysis of Immediate Tissue Engineering Bone Graft Versus Fibula-Free Flap Reconstruction for Mandibular Continuity Defects Secondary to Benign Pathology.","authors":"Sam M Anton, Andrew Gayed, Jeffrey W Chadwick, Paul Addamo, Julian N Holland, Mark E Wong, Rosa Benavidez, James C Melville","doi":"10.1016/j.joms.2025.05.002","DOIUrl":"10.1016/j.joms.2025.05.002","url":null,"abstract":"<p><strong>Background: </strong>Tissue engineering (TE) offers a potential alternative to fibula-free flap (FFF) reconstruction and may reduce surgical complexity, hospital stay, and health care costs.</p><p><strong>Purpose: </strong>The purpose of this study is to estimate and compare the cost-effectiveness of immediate TE and FFF reconstruction.</p><p><strong>Study design, setting, sample: </strong>This study was designed as a retrospective cohort conducted at the University of Texas Health Science Center at Houston from November 2015 to March 2024. Exclusion criteria included subjects with malignant pathologies, those treated with only a fasciocutaneous graft, cases of osteoradionecrosis, and those with incomplete records.</p><p><strong>Predictor variable: </strong>The primary predictor variable was the type of reconstruction method, either TE bone grafts or FFF reconstruction.</p><p><strong>Main outcome variables: </strong>The main outcome variable was cost-effectiveness which was defined as cost per successful reconstruction. Successful reconstruction was defined as complete union more than 1 year postoperatively without the need for revision surgery and the absence of postoperative complications requiring take-back surgery.</p><p><strong>Covariates: </strong>Covariates include age, sex, defect size, and American Society of Anesthesiologists classification.</p><p><strong>Analyses: </strong>R statistical software was used for data analysis. Statistical significance was defined as P < .05.</p><p><strong>Results: </strong>The sample was composed of 31 subjects with a mean age of 44.97 ± 18.46 years for TE and 41.93 ± 18.23 years for FFF (P = .7). There were 18 (58%) and 13 (42%) subjects in TE and FFF, respectively. The proportion of successful reconstructions was 95% (n = 18) for TE and 77% (n = 13) for FFF (P = .6). The mean total hospital charges for TE were $247,172 ± $54,080 (P < .001) and $423,008 ± $59,571.75 (P < .001) for FFF. The cost per successful reconstruction was $261,711.64 for TE and $549,910.40 for FFF.</p><p><strong>Conclusions and relevance: </strong>TE may be a more cost-effective alternative to FFF, providing comparable reconstructive success with reduced cost, surgical time, and hospital resource utilization.</p>","PeriodicalId":16612,"journal":{"name":"Journal of Oral and Maxillofacial Surgery","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144187238","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 Panoramic Radiography and Cone Beam Computed Tomography for Lower Third Molar Assessment Among Different Dental Specialists.","authors":"Douglas A F Couto, Jefferson L O Tanaka, Paulo H C Souza, Sergio A Ignacio, Everdan Carneiro, Luciana R A Alanis","doi":"10.1016/j.joms.2025.05.003","DOIUrl":"10.1016/j.joms.2025.05.003","url":null,"abstract":"<p><strong>Background: </strong>Variations in professional training and dental specialization can substantially influence diagnostic accuracy and clinical decision-making.</p><p><strong>Purpose: </strong>This study aimed to evaluate and compare the anatomical position and surgical indication of lower third molars (LTM) using panoramic radiography and cone beam computed tomography (CBCT) among 3 groups of dental specialists.</p><p><strong>Study design, setting, sample: </strong>This retrospective cross-sectional study involved different profiles of dental professionals with experience in diagnostic interpretation of LTM images. The study population was composed of patients who underwent both panoramic and tomographic scans for LTM extraction between 2020 and 2023. To be included, all patients had clinical indication for third molar extraction, had both LTM, and had panoramic and CBCT scans on the same day.</p><p><strong>Independent variable: </strong>The independent variable was dental provider, oral surgeons, general dentists, and oral radiologists.</p><p><strong>Main outcome variable: </strong>The main outcome variable was the anatomical position of LTM, and radiographic findings associated with risk of inferior alveolar nerve injury. Anatomical positions were evaluated according to Pell & Gregory and Winter classification. The radiographic findings associated with risk of inferior alveolar nerve injury were contact of roots to mandibular canal (MC), disruption of the cortical, narrowing and deviation, deflection and dilaceration, and retromolar canal. The secondary outcome was surgical indication.</p><p><strong>Covariates: </strong>Patient-related covariates (age and sex) were assessed.</p><p><strong>Analysis: </strong>Statistical analysis included χ² and Z-tests for intragroup comparisons, one-way analysis of variance followed by Tukey honestly significant difference post hoc test for intergroup comparisons, and Student's t-test for surgical indication. The significance level was set at 5% (P < .05).</p><p><strong>Results: </strong>The sample comprised 8 examiners who evaluated 30 panoramics and 30 CBCTs for a cohort of 30 patients. No statistically significant difference was identified between dental providers regarding anatomical position (P > .1). Oral and maxillofacial surgeons more frequently identified narrowing and deviation of MC compared with general dentists and oral radiologists (P < .05). Oral radiologists detected more root dilacerations and retromolar canals, and identified more probable contact with the MC using panoramics and CBCT (P < .05). Coronectomy was indicated more often by oral surgeons than general dentists (P < .05).</p><p><strong>Conclusions and relevance: </strong>Dental specialty influenced the interpretation of both imaging modalities for the LTM.</p>","PeriodicalId":16612,"journal":{"name":"Journal of Oral and Maxillofacial Surgery","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144187225","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}