Journal of Oral and Maxillofacial Surgery最新文献

{"title":"Balancing Occupational Demands: How Sport Selection Influences the Long-Term Health of Oral and Maxillofacial Surgeons","authors":"Ricardo Grillo PhD , Christian Klausener","doi":"10.1016/j.joms.2025.02.010","DOIUrl":"10.1016/j.joms.2025.02.010","url":null,"abstract":"","PeriodicalId":16612,"journal":{"name":"Journal of Oral and Maxillofacial Surgery","volume":"83 5","pages":"Pages 503-504"},"PeriodicalIF":2.3,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143890952","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":"REPLY: TMJ Concepts Patient-Fitted TMJ Reconstruction Prosthesis System: Results from an FDA Post-Market Surveillance Prospective Cohort Study","authors":"Zahid Afzal BDS, MBChB, MPhil, Mikhail Umorin PHD, MS, Louis G. Mercuri DDS, MS, Gary Warburton MD, DDS","doi":"10.1016/j.joms.2025.02.001","DOIUrl":"10.1016/j.joms.2025.02.001","url":null,"abstract":"","PeriodicalId":16612,"journal":{"name":"Journal of Oral and Maxillofacial Surgery","volume":"83 5","pages":"Pages 507-508"},"PeriodicalIF":2.3,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143890955","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":"Stress-Related Personality Patterns in Patients With Dentofacial Deformities and Their Evolution After Orthognathic Surgery","authors":"Nur Altıparmak DDS, PhD ,&nbsp;Sıdıka Sinem Akdeniz DDS, PhD ,&nbsp;Ezgi Ergezen DDS ,&nbsp;Alaz Enez DDS","doi":"10.1016/j.joms.2025.01.011","DOIUrl":"10.1016/j.joms.2025.01.011","url":null,"abstract":"<div><h3>Background</h3><div>Orthognathic surgery significantly influences psychosocial well-being. Individuals with dentofacial deformities may experience psychological distress, characterized by negative affectivity (NA) and social inhibition (SI). When these 2 traits coexist, they define Type D personality.</div></div><div><h3>Purpose</h3><div>The aim of this study was to estimate the prevalence of Type D personality traits in patients with Class III dentofacial deformities and assess changes in these traits, which inherently reflect variations in Type D personality, following orthognathic surgery.</div></div><div><h3>Study Design, Setting, Sample</h3><div>This prospective cohort study was conducted at Başkent University Department of Oral and Maxillofacial Surgery between November 2022 and March 2024. Sociodemographic data and psychological assessments were collected using the Type D Scale-14 preoperatively and 3 months postoperatively.</div></div><div><h3>Predictor</h3><div>The predictor variable was the preoperative personality trait, measured using the validated Type D Scale-14 questionnaire. This questionnaire comprises the following 2 subscales: NA and SI, each consisting of 7 items. Responses are scored from 0 to 4, resulting in scores ranging from 0 to 28. A score of ≥10 on both NA and SI subscales indicates a Type D personality.</div></div><div><h3>Outcome Variable</h3><div>The primary outcome variable was the postoperative personality trait, specifically changes in NA and SI, measured using the Type D Scale-14. The secondary outcomes were the prevalence of Type D personality traits before and after surgery.</div></div><div><h3>Covariates</h3><div>The covariates were age, sex, marital status, and employment status.</div></div><div><h3>Analyses</h3><div>Descriptive statistics and paired t-tests were performed to assess the differences between preoperative and postoperative results. A <em>P</em> value of &lt;.05 was considered statistically significant.</div></div><div><h3>Results</h3><div>The study sample comprised 41 participants (mean age: 22.24 ± 4.72 years), 65.9% (n = 27) of whom were female. The prevalence of Type D personality traits significantly decreased from 42.9% (n = 18) preoperatively to 17.1% (n = 7) postoperatively (<em>P</em> &lt; .05). When the subscales of NA and SI were examined, both scores showed statistically significant reductions (<em>P</em> &lt; .05).</div></div><div><h3>Conclusions</h3><div>Significant differences were observed in NA and SI before and after orthognathic surgery. This study represents the first application of the Type D Scale-14 in the context of orthognathic surgery. Observed psychological improvement highlights the importance of preoperatively assessing patients' psychosocial conditions.</div></div>","PeriodicalId":16612,"journal":{"name":"Journal of Oral and Maxillofacial Surgery","volume":"83 5","pages":"Pages 558-564"},"PeriodicalIF":2.3,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143425648","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 Postoperative Disc Position Following Double Suture Arthroscopic Discopexy Correlate With Improvements in Pain and Quality of Life?","authors":"Christopher K.B. Ward DMD, MSc ,&nbsp;Johnson Cheung DDS, MD, MSc ,&nbsp;Jonathan P. Troost PhD ,&nbsp;Sharon Aronovich DMD ,&nbsp;Mohamed A. Hakim DDS, MBA","doi":"10.1016/j.joms.2025.02.004","DOIUrl":"10.1016/j.joms.2025.02.004","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;div&gt;Temporomandibular joint intra-articular pain and dysfunction (IPD) can arise from abnormal disc position. Arthroscopic double-suture discopexy (A-DSD) aims to restore disc position, but the association between disc position and patient-reported pain and quality of life (QoL) is unclear.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Purpose&lt;/h3&gt;&lt;div&gt;This study investigated the relationship between postoperative disc position and subject QoL and pain following A-DSD.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Study Design, Setting, Sample&lt;/h3&gt;&lt;div&gt;This retrospective cohort study included subjects at the University of Michigan who required arthroscopy for IPD between November 2020 and July 2023. Eligibility included subjects aged ≥18 to 75 years with Wilkes II-V IPD who underwent A-DSD with preoperative and postoperative magnetic resonance imagings (3 months minimum).&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Predictor Variable&lt;/h3&gt;&lt;div&gt;The predictor variable was postoperative magnetic resonance imaging–based disc position: normal (ND), anteriorly displaced with reduction (ADDwR), anteriorly displaced without reduction (ADDwoR), or posteriorly displaced.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Main Outcome Variable(s)&lt;/h3&gt;&lt;div&gt;Main outcomes are changes in QoL (Jaw Functional Limitation Scale [JFLS]) and pain (visual analog scale-100) at baseline and ≥3 months post-arthroscopy.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Covariates&lt;/h3&gt;&lt;div&gt;Covariates included demographics, perioperative variables, and arthroscopic findings.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Analyses&lt;/h3&gt;&lt;div&gt;Paired &lt;em&gt;t&lt;/em&gt;-tests evaluated changes in perioperative outcomes stratified by postoperative disc position. For analysis of covariates and outcomes, linear regression was applied for JFLS (subject-level analysis); linear mixed-effects models, adjusting for nonindependent observations for bilateral cases, were used for pain (joint-level analysis). Statistical significance was &lt;em&gt;P&lt;/em&gt; &lt; .05.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;A total of 240 subjects were screened and 37 were included with mean age 33 (±14.3) years and all were female sex (100%). Median follow-up was 9 months (interquartile range, 8 to 12). Postoperative disc positions were ND (70.2%), ADDwR (15.8%), ADDwoR (8.8%), and posteriorly displaced (5.3%). Postoperative disc position was associated with JFLS (&lt;em&gt;P&lt;/em&gt; = .026) and pain (&lt;em&gt;P&lt;/em&gt; = .0002), with worse outcomes for ADDwR. ND subjects experienced significant decreases in JFLS (36.3 ± 34.6, &lt;em&gt;P&lt;/em&gt; &lt; .0001) and pain (28.7 ± 27.8, &lt;em&gt;P&lt;/em&gt; &lt; .0001). ADDwoR subjects showed significant reduction in JFLS (47.1 ± 32.0, &lt;em&gt;P&lt;/em&gt; = .03), but not pain. ADDwR subjects showed no significant outcome improvements. Subjects with systemic arthropathies (&lt;em&gt;P&lt;/em&gt; = .01), closed lock (&lt;em&gt;P&lt;/em&gt; = .03), and indirect trauma (&lt;em&gt;P&lt;/em&gt; = .03) were associated with worse JFLS.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusions and Relevance&lt;/h3&gt;&lt;div&gt;Postoperative ND and ADDwoR after A-DSD were associated with improved QoL and/or pain reduction, but postoperative ADDwR","PeriodicalId":16612,"journal":{"name":"Journal of Oral and Maxillofacial Surgery","volume":"83 5","pages":"Pages 510-527"},"PeriodicalIF":2.3,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143586112","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":"Rational Usage of Patient-Specific Implant in Orthognathic Surgery","authors":"Fabio G. Ritto DDS, MD, MS, PhD ,&nbsp;Steven M. Sullivan DDS","doi":"10.1016/j.joms.2025.01.012","DOIUrl":"10.1016/j.joms.2025.01.012","url":null,"abstract":"","PeriodicalId":16612,"journal":{"name":"Journal of Oral and Maxillofacial Surgery","volume":"83 5","pages":"Pages 505-506"},"PeriodicalIF":2.3,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143890953","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: “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,&nbsp;Srinivedha CV MDS,&nbsp;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 ,&nbsp;Gowri Sivaramakrishnan MDS, MFDS","doi":"10.1016/j.joms.2025.01.008","DOIUrl":"10.1016/j.joms.2025.01.008","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;div&gt;Osteonecrosis of the jaw (ONJ) is an adverse effect associated with medications such as monoclonal antibodies and small-molecule inhibitors.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Purpose&lt;/h3&gt;&lt;div&gt;This study assesses the association between monoclonal antibodies and small-molecule inhibitors with ONJ.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Study Design, Setting, Sample&lt;/h3&gt;&lt;div&gt;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.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Predictor Variable&lt;/h3&gt;&lt;div&gt;Not applicable.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Main Outcome Variable&lt;/h3&gt;&lt;div&gt;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.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Covariates&lt;/h3&gt;&lt;div&gt;Age and gender were the covariates included in this study.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Analyses&lt;/h3&gt;&lt;div&gt;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&lt;sup&gt;2&lt;/sup&gt; tests (χ2) at &lt;em&gt;P&lt;/em&gt; ≤ .05.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;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]; &lt;em&gt;P&lt;/em&gt; &lt; .05; and IC025: 5.1), romosozumab (ROR 4.2 [3, 6]; PRR: 4.2 [3, 6]; &lt;em&gt;P&lt;/em&gt; &lt; .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}