Journal of Oral and Maxillofacial Surgery最新文献

{"title":"Comparison of Two-Point Versus Three-Point Fixation in Treatment of Zygomaticomaxillary Complex Fractures: An Updated Meta-Analysis","authors":"Lele Guo MD ,&nbsp;Tianping Cheng MD ,&nbsp;Lixia Feng MD ,&nbsp;Jin Feng MD ,&nbsp;Xiangyun Li MD","doi":"10.1016/j.joms.2024.12.006","DOIUrl":"10.1016/j.joms.2024.12.006","url":null,"abstract":"<div><h3>Purpose</h3><div>Zygomaticomaxillary complex (ZMC) fractures are a prevalent form of craniofacial trauma. However, no universally accepted fixation method has been established to prevent postreduction displacement in ZMC fractures.</div></div><div><h3>Methods</h3><div>Computerized and additional manual searches of the Medline, Embase, Chinese National Knowledge Infrastructure, and Cochrane Central database for potential studies, published from inception to May 2024, were performed. The inclusion criteria were as follows: randomized controlled trials comparing two-point and three-point fixation for managing ZMC fractures; studies with at least 5 weeks of follow-up; sufficient data published to estimate relative risk or standardized mean difference (SMD) with a corresponding 95% CI. The following exclusion criteria were applied: nonrandomized prospective studies, retrospective studies, case series, case reports, animal and in vitro studies; letters to the editor; review articles; case reports, and studies without discrete outcomes data. The predictor variable was type of fixation. The primary outcome variables assessed in this study encompassed fracture instability, malar asymmetry grade, malar height, and vertical dystopia. These parameters were employed as quantitative measures of displacement. The secondary outcome was postoperative complications, including enophthalmos. Systematic review with meta-analyses, 2 reviewers independently extracted the relevant data, with disagreements resolved by consensus. Statistical analyses were performed using Stata, version 18.0 (StataCorp LLC, College Station, TX, USA).</div></div><div><h3>Results</h3><div>After reviewing 205 publications, the final sample was composed of 8 studies, with 189 participants in the two-point group and 187 in the three-point group. Patients were followed up for at least 5 weeks in all the studies. Fracture instability was greater with 2-point fixation than with 3-point fixation (relative risk 2.63 [95% CI: 1.95–3.56] <em>P</em> &lt; .001). Less vertical dystopia at 3 and 6 weeks were seen with 3-point fixation than with 2-point fixation (SMD 0.59, [95% CI 0.31–0.87] <em>P</em> &lt; .001) (SMD 6.30, [95% CI 3.02–9.58] <em>P</em> &lt; .001). Enophthalmos, malar asymmetry grade II (3 months), operation duration, malar height, and vertical dystopia (mm) 1 week did not differ between the groups.</div></div><div><h3>Conclusions</h3><div>Three-point fixation may provide more stability and less vertical dystopia than two-point fixation. This finding should help surgeons in making evidence-based decisions when selecting an optimal fixation pattern.</div></div>","PeriodicalId":16612,"journal":{"name":"Journal of Oral and Maxillofacial Surgery","volume":"83 4","pages":"Pages 448-455"},"PeriodicalIF":2.3,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142921894","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 Transformative Potential of Artificial Intelligence in Oral and Maxillofacial Surgery","authors":"Pascal Eber MD ,&nbsp;Yannick Martin Sillmann DDS ,&nbsp;Fernando Pozzi Semeghini Guastaldi DDS, MSc, PhD","doi":"10.1016/j.joms.2024.11.017","DOIUrl":"10.1016/j.joms.2024.11.017","url":null,"abstract":"","PeriodicalId":16612,"journal":{"name":"Journal of Oral and Maxillofacial Surgery","volume":"83 4","pages":"Pages 402-405"},"PeriodicalIF":2.3,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143746980","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":"Association Between Type of Residency Interview, Virtual Versus In-Person, and Distance From Applicants' Dental School to Oral and Maxillofacial Surgery Program Matched: Report From the American Association of Oral and Maxillofacial Surgeons Committee on Education and Training.","authors":"Joshua D Segal, Brent B Ward, Martin B Steed, Pushkar Mehra, Deepak G Krishnan","doi":"10.1016/j.joms.2025.03.016","DOIUrl":"https://doi.org/10.1016/j.joms.2025.03.016","url":null,"abstract":"<p><strong>Background: </strong>Oral and maxillofacial surgery (OMS) residency interviews for the 2021 match during the Covid-19 pandemic were near universally virtual in contrast to in-person interviews of prior years. In deciding whether to conduct in-person or virtual interviews, it is important for residency programs to understand the association of interview type on the distance between dental school attended and the program to which the applicant matched.</p><p><strong>Purpose: </strong>The study purpose was to measure the association between the type of residency interview conducted and the distance from the dental school attended to the program which the applicant matched.</p><p><strong>Study design, setting, sample: </strong>A retrospective cohort study was designed using National Matching Services Incorporated data of all applicants to OMS residency programs who matched the year following dental school between 2019 and 2021. Those who did not match the same year as dental school graduation were excluded.</p><p><strong>Predictor variable: </strong>The predictor variable was interview type. Match years 2019 and 2020 were coded as in-person and match year 2021 coded as virtual.</p><p><strong>Outcome: </strong>The main outcome variable was the straight-line distance in miles between dental school attended and residency matched calculated from geographic coordinates.</p><p><strong>Covariates: </strong>There were no covariates.</p><p><strong>Analyses: </strong>Wilcoxon signed-rank test was performed to determine if an association existed between the interview type and the distance. The significance level was set at a P value of ≤ .05.</p><p><strong>Results: </strong>The final sample was composed of 418 applicants who matched into OMS residency between 2019 and 2021. There were 277 (66%) and 141 (34%) applicants in the in-person and virtual interview groups, respectively. The mean distances between the dental school and the resident program for the in-person and virtual applicant pools were 633.22 miles (SD = 681.12 miles) and 630 miles (SD = 710.21 miles) respectively, (P value = .6).</p><p><strong>Conclusions and relevance: </strong>While distance between dental school and residency program may play an important role in the match, that distance did not have any statistically significant association with the type of interview.</p>","PeriodicalId":16612,"journal":{"name":"Journal of Oral and Maxillofacial Surgery","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144022599","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 Postoperative Steroid Use Associated With Improved Outcomes in Severe Odontogenic Infections?","authors":"Brian J Christensen, Earl Peter Park","doi":"10.1016/j.joms.2025.03.014","DOIUrl":"https://doi.org/10.1016/j.joms.2025.03.014","url":null,"abstract":"<p><strong>Background: </strong>The use of steroids as an adjunctive therapy in odontogenic infections is common, but few studies have focused on the effect of steroids in improving outcomes in these infections.</p><p><strong>Purpose: </strong>The purpose of the study was to measure the association between postoperative steroid use and length of stay (LOS) and reoperation among patients with severe odontogenic infections.</p><p><strong>Study design, setting, sample: </strong>The authors conducted a prospective cohort study consisting of all adult patients treated in the operating room for an odontogenic infection from August 1, 2019, to December 31, 2022, at University Medical Center of New Orleans. Patients were excluded if an odontogenic source could not be confirmed.</p><p><strong>Predictor variable: </strong>The predictor variable was the use of steroids postoperatively (after conclusion of surgery until discharge), coded as a yes or no.</p><p><strong>Main outcome variable: </strong>The outcome variables were total LOS, postsurgical LOS, and reoperation.</p><p><strong>Covariates: </strong>The covariates were demographics, medical history, exam findings, diagnosis, and treatment-related variables.</p><p><strong>Analyses: </strong>Descriptive and bivariate analyses were performed, as well as linear regression analyses. A P value of ≤ .05 was considered significant.</p><p><strong>Results: </strong>The study sample consisted of 240 patients with a mean age of 40.3 ± 14.5 years and a sex distribution of 57.5% (138) male and 42.5% (102) female. Steroids were used in 114 patients (47.5%) postoperatively. The mean total LOS and postsurgical LOS were 3.7 ± 2.4 days and 3.1 ± 2.4 days, respectively. Reoperation was performed for 12 (5.0%) patients. Postoperative steroid use group was not significantly associated with total LOS (3.7 ± 2.6 days vs 3.6 ± 2.2 days, P = .59), postsurgical LOS (3.3 ± 2.6 days vs 2.9 ± 2.1 days, P = .13), or reoperation (58.3 vs 41.7%, P = .56) for the group that received steroids versus those that did not, respectively.</p><p><strong>Conclusions and relevance: </strong>Postoperative steroid use was not associated with reduced LOS, postsurgical LOS, or reoperation in patients with severe odontogenic infections.</p>","PeriodicalId":16612,"journal":{"name":"Journal of Oral and Maxillofacial Surgery","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143998631","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"How Artificial Intelligence Differs From Humans in Peer Review.","authors":"Michael V Joachim, Thomas B Dodson, Amir Laviv","doi":"10.1016/j.joms.2025.03.015","DOIUrl":"10.1016/j.joms.2025.03.015","url":null,"abstract":"<p><strong>Background: </strong>The peer review process faces challenges of reviewer fatigue and bias. Artificial intelligence (AI) may help address these issues, but its application in the oral and maxillofacial surgery peer review process remains unexplored.</p><p><strong>Purpose: </strong>The purpose of the study was to measure and compare manuscript review performance among 4 large language models and human reviewers. large language models are AI systems trained on vast text datasets that can generate human-like responses.</p><p><strong>Study design/setting/sample: </strong>In this cross-sectional study, we evaluated original research articles submitted to the Journal of Oral and Maxillofacial Surgery between January and December 2023. Manuscripts were randomly selected from all submissions that received at least one external peer review.</p><p><strong>Predictor variable: </strong>The predictor variable was source of review: human reviewers or AI models. We tested 4 AI models: Generative Pretrained Transformer-4o and Generative Pretrained Transformer-o1 (OpenAI, San Francisco, CA), Claude (version 3.5; Anthropic, San Francisco, CA), and Gemini (version 1.5; Google, Mountain View, CA). These models will be referred to by their architectural design characteristics, ie, dense transformers, sparse-expert, multimodal, and base transformer, to highlight their technical differences rather than their commercial identities.</p><p><strong>Outcome variables: </strong>Primary outcomes included reviewer recommendations (accept = 3 to reject = 0) and responses to 6 Journal of Oral and Maxillofacial Surgery editor questions. Secondary outcomes comprised temporal stability (consistency of AI evaluations over time) analysis, domain-specific assessments (methodology, statistical analysis, clinical relevance, originality, and presentation clarity; 1 to 5 scale), and model clustering patterns.</p><p><strong>Analyses: </strong>Agreement between AI and human recommendations was assessed using weighted Cohen's kappa. Intermodel reliability and temporal stability (24-hour interval) were evaluated using intraclass correlation coefficients. Domain scoring patterns were analyzed using multivariate analysis of variance with post hoc comparisons and hierarchical clustering.</p><p><strong>Results: </strong>From 22 manuscripts, human reviewers rejected 15 (68.2%), while AI rejection rates were statistically significantly lower (0 to 9.1%, P < .001). AI models demonstrated high consistency in their evaluations over time (intraclass correlation coefficient = 0.88, P < .001) and showed moderate agreement with human decisions (κ = 0.38 to 0.46).</p><p><strong>Conclusions: </strong>While AI models showed reliable internal consistency, they were less likely to recommend rejection than human reviewers. This suggests their optimal use is as screening tools complementing expert human review rather than as replacements.</p>","PeriodicalId":16612,"journal":{"name":"Journal of Oral and Maxillofacial Surgery","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144004457","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":"A Half-Century Review of Male and Female Resident Outcomes in Oral and Maxillofacial Surgery: A Single-Institution Report.","authors":"Susan Keefe, Carrie Baldwin, Elda Fisher, Timothy A Turvey","doi":"10.1016/j.joms.2025.03.011","DOIUrl":"https://doi.org/10.1016/j.joms.2025.03.011","url":null,"abstract":"<p><strong>Background: </strong>Limited comprehensive historical data exist comparing male and female residents in oral and maxillofacial surgery (OMS) residency programs. This gap underscores the need to examine sex-based differences to guide equitable policies and practices.</p><p><strong>Purpose: </strong>The purpose of this study is to measure and compare historical enrollment and graduation records between male and female residents within a single OMS residency program.</p><p><strong>Study design, setting, sample: </strong>A retrospective cohort study was conducted using the University of North Carolina OMS graduation records from 1972 to 2023. The sample was composed of all trainees admitted to the program. All residents still in training, however, were not included in the analyses of postgraduate accomplishments.</p><p><strong>Independent variable: </strong>The independent variable was sex, categorized as male or female.</p><p><strong>Outcome variables: </strong>The outcome variables were attrition and training accomplishments. We documented medical degree, board certification, postgraduate training, and postgraduate employment for each graduate.</p><p><strong>Covariates: </strong>There was no covariate in the study.</p><p><strong>Analyses: </strong>Fisher's exact and χ² tests were used, with a significance threshold of P < .05.</p><p><strong>Results: </strong>The sample was composed of 148 admitted residents. Women comprised 19.6% (29) of total enrollees. Over time, the proportion of females admitted to the program increased from 0.8% (1/12) to 50% (8/16), P = .002. Among the 115 graduates, 13% (15/115) were women. The attrition rates for male and female residents prior to 2000 were 12% (8/65) and 50% (3/6), respectively (P = .04). However, no statistically significant difference was observed after 2000, (P = .5). postgraduate training (P = .42), postgraduate employment settings (P = .42), board certification status (P = .58), and completion of a medical degree (P = .18) did not differ significantly by sex.</p><p><strong>Conclusion and relevance: </strong>The University of North Carolina OMS program has seen an increased female representation since its program inception. While female trainees in the past had higher attrition rates, current data no longer support this. Postgraduation outcomes, including postgraduate training, medical degree, board certification, and entry into academic practice-are comparable between male and female graduates. A broader national analysis is recommended to determine if these findings are consistent across other programs.</p>","PeriodicalId":16612,"journal":{"name":"Journal of Oral and Maxillofacial Surgery","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144018180","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Outcomes of Different Internal Fixation Strategies for Double Mandibular Fractures: A Systematic Review and Meta-analysis.","authors":"Babu Lal, Ragavi Alagarsamy, Jitendra Chawla, Edward Ellis, Ajoy Roychoudhury, Anuvindha Js, Arivarasan Barathi","doi":"10.1016/j.joms.2025.03.013","DOIUrl":"10.1016/j.joms.2025.03.013","url":null,"abstract":"<p><strong>Background: </strong>The biomechanics of double mandibular fracture (DMF) is complex, and the literature on the fixation requirements is varied. The purpose of the study was to estimate the prevalence of complications following the management of DMF and to determine whether this prevalence varies based on the fixation strategy used.</p><p><strong>Methods: </strong>A systematic review and meta-analysis was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. A comprehensive search was conducted in PubMed, Google Scholar, Semantic Scholar, and Cochrane Library to identify DMF studies until September 2024. Randomized controlled trials (RCTs), quasicontrolled trials, and retrospective studies comparing fixation schemes for DMF were included. In-vitro or animal studies were excluded. The predictor variable was the type of fixation (nonrigid, rigid, and mixed), and outcome variables were malocclusion, wound infection, wound dehiscence, and hardware failure. The risk of bias was assessed using the Joanna Briggs Institute (JBI) checklist for critical appraisal and the Risk of Bias 2.0 generic dataset for RCTs. Meta-analysis was conducted to calculate the pooled prevalence by random effects model with a 95% CI using Stata (v.16).</p><p><strong>Results: </strong>The initial search identified 2,108 publications. After applying inclusion/exclusion criteria, the final sample was composed of 11 studies and 1,747 cases. The meta-analysis indicated pooled prevalence of 3% (95% CI: 2 to 6%) for hardware failure, 3% (95% CI: 1 to 7%) for malocclusion, 3% (95% CI: 2 to 5%) for wound dehiscence and 4% (95% CI: 2 to 8%) for infection. Complication rates were 4 to 6% (95% CI: 0.01 to 0.05, P = .1) in the nonrigid fixation group, 8 to 12% (95% CI: 0.01 to 0.05, P = .3) in the rigid fixation group, and 2 to 3% (95% CI: 0.01 to 0.05, P = .1) in the mixed fixation group, with no statistically significant subgroup differences. The risk of bias was low (n = 6) and high (n = 1) in retrospective studies, while RCTs (n = 4) showed some bias.</p><p><strong>Conclusion: </strong>This meta-analysis suggests that the overall complication rate for DMF ranges from 3 to 4%, regardless of the fixation method, and that the type of fixation does not have a statistically significant impact on postoperative complication rates. Further well-designed trials are needed to confirm these findings.</p>","PeriodicalId":16612,"journal":{"name":"Journal of Oral and Maxillofacial Surgery","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144018222","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Use of Clear Aligners for Orthognathic Surgery: A Systematic Review.","authors":"Hooman Shafaee, Shirin Shahnaseri, Mahsa Ghorbani, Erfan Bardideh, Seyed Amir Mousavi, Sercan Akyalcin","doi":"10.1016/j.joms.2025.03.009","DOIUrl":"10.1016/j.joms.2025.03.009","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Purpose: &lt;/strong&gt;Clear aligners, known for their esthetic appeal, are now increasingly utilized in orthognathic surgery treatment, offering preoperative and postoperative benefits. This systematic review aims to answer the research question: Are clear aligners as effective as traditional fixed appliances in achieving dental and skeletal changes, improving oral health, and enhancing patient-reported satisfaction in patients requiring orthognathic surgery?&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;We conducted a systematic review following a predefined protocol. We searched databases including MEDLINE, Web of Science, EMBASE, Scopus, and Cochrane's CENTRAL from inception until September 2024, with no language or date restrictions. Studies were included based on the Population, Intervention, Comparison, and Outcome (PICO) criteria, focusing on patients requiring orthognathic surgery (Population), the use of clear aligners (Intervention), compared with traditional fixed appliances (Comparison), and outcomes related to dental and skeletal changes, oral health, and patient satisfaction (Outcome). Inclusion criteria were clinical studies addressing the PICO question, while exclusion criteria were studies not involving human subjects or unrelated to orthognathic surgery with clear aligners. The risk of bias was assessed using the Risk of Bias in Nonrandomized Studies of Interventions (ROBINS-I) and Cochrane Risk of Bias 2.0 (ROB.02) tools. Data extraction included publication year, study design, participant demographics, malocclusion type, surgical procedures, aligner specifications, treatment protocols, aligner utilization stages, treatment durations, and evaluated outcomes.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Our comprehensive search identified 765 studies, supplemented by 12 from manual searching. After screening, 34 studies underwent full-text review, and 16 clinical studies (375 patients) were included in the qualitative review: 2 randomized clinical trial, 2 prospective, and 12 retrospective studies. Four studies using presurgical aligners reported an increase in the incisor mandibular plane angle by 3 to 15° for Class III cases, while 2 studies on postsurgical aligners noted similar decompensatory movements, such as a change in incisor mandibular plane angle exceeding 10°. The remaining 7 studies used aligners before and after surgery and sometimes during surgery to create surgical splints. Comparative results between aligners and fixed appliances indicated no significant differences in dental and skeletal changes. Aligners had higher patient satisfaction scores (3 to 5 points higher on a 10-point scale) and better periodontal health outcomes. The Peer Assessment Rating score reductions were similar (60% for aligners vs 69% for fixed appliances). Overall, clear aligners may provide similar effectiveness to fixed appliances in orthognathic surgery while enhancing periodontal health and patient satisfaction. However, due to the low quality of evidence","PeriodicalId":16612,"journal":{"name":"Journal of Oral and Maxillofacial Surgery","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143803649","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Comparative Study of Speech and Swallowing Postoperative Outcomes in Oral Cancer: Impact of Lateral Mandibular Continuity Restoration","authors":"Abhipsa Mishra MDS ,&nbsp;Raveena R. Nair MS ,&nbsp;Sandeep Vijay MS ,&nbsp;Anoop Attakkil MS ,&nbsp;Aswin Mullath MDS ,&nbsp;Aby K. Babu MDS","doi":"10.1016/j.joms.2024.10.020","DOIUrl":"10.1016/j.joms.2024.10.020","url":null,"abstract":"<div><h3>Background</h3><div>Surgical resection with mandibulectomy in advanced oral cancer results in complex defects. The influence of reconstruction of mandibular continuity on postoperative speech and swallowing function, though crucial, is not widely studied.</div></div><div><h3>Purpose</h3><div>The purpose of study was to compare the speech and swallowing outcomes of oral squamous cell carcinoma (OSCC) patients with lateral mandibulectomy, with or without the restoration of mandibular continuity.</div></div><div><h3>Study Design, Setting, Sample</h3><div>This retrospective cohort study was performed at the Malabar Cancer Centre, Kerala, India, on patients who had undergone lateral mandibulectomy for OSCC from January 2016 to December 2021. Patients with recurrent or second primary OSCC, or with psychiatric disorders and cognitive impairment, or in whom any type of glossectomy was done, were excluded from the study.</div></div><div><h3>Predictor Variable</h3><div>The predictor variable was reconstruction status of mandibular continuity, coded as yes when it is restored and no for vice-versa.</div></div><div><h3>Main Outcome Variable(s)</h3><div>The outcome variables were postoperative speech outcome measured with a 7-point rating speech intelligibility scale and swallowing outcome measured with functional oral intake scale.</div></div><div><h3>Covariates</h3><div>Covariates included age, sex, tumor subsite, mandibular defect, and adjuvant treatment.</div></div><div><h3>Analyses</h3><div>Data analyses included χ², Fisher's exact test, independent t test, Spearman's correlation test, and one-way analysis of variance test. <em>P</em> values &lt; .05 were considered statistically significant.</div></div><div><h3>Results</h3><div>The study sample had 201 patients, with continuity restored in 74 (36.82%) patients and vice versa in 127 (63.18%) patients. The mean age in the continuity restored group was 54.97 ± 9.68 years, and in the continuity not restored group, it was 59.49 ± 9.95 years (<em>P</em> &lt; .05). Both the groups had more male patients (<em>P</em> = .15). The speech scores in both groups at 1 month (<em>P</em> = .66), 3 months (<em>P</em> = .45), and 6 months (<em>P</em> = .33) of postoperative period were compared and had no statistically significant difference. The swallowing scores in groups at 1 month (<em>P</em> = .5), 3 months (<em>P</em> = .5), and 6 months (<em>P</em> = .7) of postoperative period were also compared and had no statistically significant difference.</div></div><div><h3>Conclusion and Relevance</h3><div>Reconstruction of lateral mandibular continuity was not associated with improved postoperative speech and swallowing.</div></div>","PeriodicalId":16612,"journal":{"name":"Journal of Oral and Maxillofacial Surgery","volume":"83 3","pages":"Pages 374-381"},"PeriodicalIF":2.3,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142693234","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":"Photobiomodulation With Infrared and Dual-Wavelength Laser Induces Similar Repair and Control of Inflammation After Third Molar Extraction: A Double-Blinded Split-Mouth Randomized Controlled Trial","authors":"Davisson Alves Pereira PhD, DDS ,&nbsp;Mariana Silva Bonatto PhD, DDS ,&nbsp;Eduvaldo Campos Soares Jr. PhD, DDS ,&nbsp;Pedro Gomes Junqueira Mendes MSc ,&nbsp;Roberto Sales e Pessoa PhD, DDS ,&nbsp;Guilherme José Pimentel Lopes de Oliveira PhD, DDS","doi":"10.1016/j.joms.2024.11.009","DOIUrl":"10.1016/j.joms.2024.11.009","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;div&gt;Photobiomodulation therapy (PBMT) has been showed to have beneficial effects on the healing and control of inflammation associated with oral surgical wounds. However, different PBMT protocols have been proposed and it is not clear if different protocols impact the hard and soft tissues healing equally.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Purpose&lt;/h3&gt;&lt;div&gt;To compare the tissue repair of postextraction alveoli of third molars between treated with dual-wavelength PBMT (red and infrared) or PBMT with infrared laser (IRL) alone.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Study Design, Setting, Sample&lt;/h3&gt;&lt;div&gt;This split mouth randomized controlled trial enrolled 20 patients, who were submitted to the extraction of the 4 partially erupted or fully impacted third molars between August 2023 and December 2023 at the clinic of the INPES postgraduate school (Institute for Clinical Health Research), and at the Federal University of Uberlândia. Adult with all the 4 molars were included in this study, while patients with systemic diseases/conditions, with less than 4 third molars were excluded of this study.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Exposure Variable&lt;/h3&gt;&lt;div&gt;The exposure variable is PBMT treatment. Treatment side was randomly allocated to according to the PBMT protocol applied on the postextraction sockets: IRL-PBMT: irradiation with PBMT with an IRL (808 nm) and IRL-RL-PBMT: irradiation with dual-wavelength PBMT (660 and 808 nm).&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Main Outcome Variable(s)&lt;/h3&gt;&lt;div&gt;The primary outcome variable was the bone tissue healing that was measured using the fractal analysis and bone tissue density assessed using the radiographic images. The secondary outcome variable was soft tissue healing measured assessing the facial dimensions variations and a healing index that assessed the tissue consistence, color, exudation, bleeding, and edema. Additionally, the analyses centered on the patients’ perceptions was assessed by the application of a visual analogic scale to assess pain, bleeding, edema, difficulty in chewing, and mouth opening conditions. Subjects were clinically evaluated at 3, 7, 14, 30, and 90 days after the surgical procedure.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Covariates&lt;/h3&gt;&lt;div&gt;The covariates are the tooth position, and the demographic data (age and sex).&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Analyses&lt;/h3&gt;&lt;div&gt;The evaluation of the effects of the independent variables (Treatment and period of evaluation) on the primary and secondary outcomes was performed through the application of the repeated measures ANOVA (&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;The sample was composed of 20 subjects with a mean age of 28.58 ± 8.94 years, and 12 (60%) were females. There were no statistically significant differences between the 2 treatments for any outcome variables (&lt;em&gt;P&lt;/em&gt; &gt; .10).&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusion and Relevance&lt;/h3&gt;&lt;div&gt;It can be concluded that PBMT with dual wavelengths (red and infrared) and an IRL alone induced similar postoperative clinical results after","PeriodicalId":16612,"journal":{"name":"Journal of Oral and Maxillofacial Surgery","volume":"83 3","pages":"Pages 332-343"},"PeriodicalIF":2.3,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142791807","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}