Maxillofacial Plastic and Reconstructive Surgery最新文献

{"title":"Preoperative anthropometric assessment of nasal aesthetic parameters in iranian rhinoplasty candidates: deviation from conventional normative standards.","authors":"Ata Aharipour, Maryam Behdarvandi, Saeed Shirafkan","doi":"10.1186/s40902-026-00528-6","DOIUrl":"10.1186/s40902-026-00528-6","url":null,"abstract":"<p><strong>Background: </strong>Conventional nasal anthropometric norms are widely used in aesthetic analysis; however, their applicability across different populations remains uncertain. This study aimed to perform a preoperative anthropometric assessment of nasal aesthetic parameters in rhinoplasty candidates and to describe the frequency and pattern of deviations from conventional normative criteria.</p><p><strong>Methods: </strong>In this retrospective descriptive cross-sectional study, preoperative facial photographs of 60 rhinoplasty candidates from private oral and maxillofacial surgery clinics and Imam Khomeini Hospital in Ahvaz, Iran, were evaluated. Preoperative profile and frontal facial photographs meeting predefined quality and positioning criteria were analyzed. Nasal aesthetic parameters were classified as within or outside predefined conventional criteria. Findings were summarized using frequencies, percentages, and exact 95% binomial confidence intervals for the proportions of findings outside the conventional criteria.</p><p><strong>Results: </strong>The study included 60 rhinoplasty candidates, comprising 32 males (53.3%) and 28 females (46.7%). The most frequent findings outside the conventional criteria were anterior-posterior radix position in 57 patients (95.0%), tip projection in 56 (93.3%), nasofrontal angle in 55 (91.7%), dorsal hump in 54 (90.0%), and alar base width in 47 (78.3%). Vertical radix position, nasolabial angle, and columellar show had relatively balanced distributions within and outside the conventional criteria. The supratip/infratip break criterion was not met in 8 patients (13.3%), and nasal dorsal deviation was present in 11 patients (18.3%).</p><p><strong>Conclusion: </strong>The findings support the use of anthropometric assessment as a descriptive component of surgical planning, while emphasizing that conventional standards should not be used as the sole determinants of aesthetic suitability. Preoperative evaluation should integrate objective nasal assessment with each patient's individual goals and cultural preferences.</p>","PeriodicalId":18357,"journal":{"name":"Maxillofacial Plastic and Reconstructive Surgery","volume":"48 1","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13661824/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149182836","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Maxillary avascular necrosis after Le Fort I osteotomy: a systematic review of ischemic complications.","authors":"Chung-Woo Lee, Sung-Yun Hwang, Ladan Esmaeili, Dae-Seok Hwang","doi":"10.1186/s40902-026-00523-x","DOIUrl":"https://doi.org/10.1186/s40902-026-00523-x","url":null,"abstract":"<p><strong>Background: </strong>Maxillary avascular necrosis (AVN) after Le Fort I osteotomy is rare but potentially devastating. Although injury to the descending palatine artery has traditionally been regarded as a major cause, the relative contribution of individual vascular and surgical factors remains unclear. This systematic review aimed to synthesize the clinical evidence on maxillary AVN after orthognathic surgery and to evaluate whether postoperative ischemic complications are better explained by isolated arterial injury or cumulative vascular compromise.</p><p><strong>Main body: </strong>A systematic literature search of PubMed, Scopus, Web of Science, and Embase was performed from database inception to May 2026 in accordance with PRISMA 2020 guidelines. English-language retrospective cohort studies, prospective cohort studies, and case series reporting maxillary AVN or ischemic complications associated with orthognathic surgery were included. Single-case reports, reviews, conference abstracts, editorials, and studies with insufficient clinical data were excluded. Seven studies were included in the qualitative synthesis. Reported ischemic manifestations ranged from tooth discoloration and pulpal necrosis to gingival necrosis, dentoalveolar sequestration, partial maxillary necrosis, and anterior segment AVN. Among cohort studies, clinically significant ischemic complications were uncommon, with reported rates ranging from 0.2% to 3.3%, whereas tooth discoloration reflecting pulpal ischemia was reported in 3.4% of orthognathic surgery patients. Segmented or multisegment Le Fort I osteotomy, transverse expansion, large maxillary advancement, palatal soft-tissue compromise, cleft-related scarring, and previous palatal surgery were repeatedly described among affected patients. However, no single factor consistently explained all reported cases. The relationship between descending palatine artery injury and ischemic complications was inconsistent, and ligation alone was not uniformly associated with AVN.</p><p><strong>Conclusion: </strong>Maxillary AVN after Le Fort I osteotomy is an exceptionally rare but serious complication. The available evidence supports a multifactorial mechanism in which multiple vascular insults cumulatively impair collateral perfusion rather than a mechanism driven by isolated descending palatine artery injury. Surgical prevention should therefore emphasize preservation of overall maxillary perfusion and collateral soft-tissue attachments.</p>","PeriodicalId":18357,"journal":{"name":"Maxillofacial Plastic and Reconstructive Surgery","volume":"48 1","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13493723/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148795036","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tenting screw (tent pole) technique in vertical and horizontal alveolar ridge augmentations: a systematic review and meta-analysis.","authors":"Bita Sarfaraz, Reza Amid, Ali Azadi, Mahdi Kadkhodazadeh, Amir-Ali Yousefi-Koma","doi":"10.1186/s40902-026-00522-y","DOIUrl":"https://doi.org/10.1186/s40902-026-00522-y","url":null,"abstract":"<p><strong>Purpose: </strong>Providing an overview on tenting screws/tent-pole technique for space-maintenance in vertical and horizontal alveolar ridge augmentation.</p><p><strong>Methods: </strong>The protocol was registered at PROSPERO (CRD420251178321). PRISMA-2020 guidelines were applied. Medline via PubMed, Web of Science, Scopus, Embase, and Cochrane Library were all searched/screened. Randomized and non-randomized human studies with at least 10 patients were eligible. Random-effects model analysis was used in all cases. The risk of publication bias was assessed using a funnel plot and the Egger's test. All statistical analyses were executed using STATA 17.0.</p><p><strong>Results: </strong>Four randomized, 7 non-randomized and 13 cohort studies were included; 23 were selected for meta-analysis. Overall vertical and horizontal bone gains using tenting screws/tent-pole as the sole space-maintenance technique were at 5.43 mm (95% CI: 3.79-7.07) and 3.62 mm (95% CI: 3.21-4.02), respectively. One-staged augmentations/dental implantation showed significantly higher vertical gain compared to two-staged procedures (P = 0.03). Regarding complementary grafted bone materials/particles, autografts (with/without xenografts) had significantly higher vertical gains than allografts (with/without xenografts) (P = 0.00). Five cohorts compared the outcomes of tenting technique against conventional GBR (with no bone-blocks) in horizontal reconstruction; tenting technique significantly outperformed with 0.49 mm (95% CI: 0.00-0.97) superiority (P = 0.05); GRADE certainty assessment reported as moderate. There were no signs of publication bias in any of the analyses (P = 0.75, P = 0.75, and P = 0.23, respectively).</p><p><strong>Conclusions: </strong>Tent-pole technique is desirable for space-maintenance without the complexity and surgical/healing complications of onlay-bone-blocks and titanium meshes. More RCTs are required to reach reliable conclusions.</p>","PeriodicalId":18357,"journal":{"name":"Maxillofacial Plastic and Reconstructive Surgery","volume":"48 1","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13476430/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148764950","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Short-term outcomes of virtual surgical planning-assisted mandibular reconstruction using a patient-specific reconstruction plate and split rib bundle bone graft: a prospective single-arm study.","authors":"Mohamed Abdeldayem, Shady Hassan, Mariam Mohamed, Naglaa Shoukry","doi":"10.1186/s40902-026-00520-0","DOIUrl":"10.1186/s40902-026-00520-0","url":null,"abstract":"<p><strong>Background: </strong>Mandibular reconstruction requires restoration of continuity, contour, and occlusion to achieve acceptable functional and aesthetic outcomes. Virtual surgical planning (VSP) and patient-specific reconstruction plates may improve preoperative planning and intraoperative reproduction of mandibular alignment. This study evaluated the short-term outcomes of VSP-assisted mandibular reconstruction using a patient-specific reconstruction plate and split rib bundle bone graft (SRBG) in selected patients with benign mandibular lesions.</p><p><strong>Methods: </strong>This prospective single-arm clinical study included 30 adult patients with benign mandibular lesions requiring segmental mandibulectomy and immediate reconstruction. All patients underwent preoperative thin-slice computed tomography, virtual surgical planning, and fabrication of a patient-specific reconstruction plate. Reconstruction was performed using a split rib bundle graft. Clinical and radiographic follow-up was conducted for 12 months. Outcomes included mandibular symmetry, landmark-based radiographic discrepancy, graft-volume change, postoperative pain, occlusion, 12-month graft survival, patient satisfaction, and complications.</p><p><strong>Results: </strong>The mean age was 37.23 ± 10.15 years, and 56.7% of patients were male. Postoperative asymmetry indices were lower than preoperative values at all measured landmarks (all p < 0.001), with the overall mean asymmetry index decreasing from 41.91 ± 5.32 preoperatively to 6.48 ± 2.46 postoperatively. Landmark-based discrepancy between the virtual plan and postoperative CT was low, with menton deviation of 0.053 ± 0.266. Mean graft volume decreased significantly over time from 15.61 ± 2.22 cm³ at baseline to 14.11 ± 2.13 cm³ at 12 months (p < 0.001). Stable postoperative occlusion was achieved in 28 patients (93.3%). Twelve-month graft survival was observed in 29 of 30 patients (96.7%), and 76.7% of patients were very satisfied, while 13.3% were satisfied. Complications were uncommon; one patient (3.3%) developed late plate loosening/removal requiring secondary surgical intervention.</p><p><strong>Conclusion: </strong>VSP-assisted mandibular reconstruction using a patient-specific reconstruction plate and split rib bundle graft was feasible in this selected cohort of benign, nonirradiated mandibular defects, with acceptable short-term clinical and radiographic findings over 12 months. Because this was a single-arm study without a control group, with landmark-based radiographic assessment and limited follow-up, the results should be interpreted as descriptive feasibility data and should not be considered evidence of superiority, equivalence, or non-inferiority compared with conventional reconstruction, standard plates, or vascularized free-flap reconstruction.</p>","PeriodicalId":18357,"journal":{"name":"Maxillofacial Plastic and Reconstructive Surgery","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13388575/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148536219","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction: Ophthalmic complications following maxillofacial and midface fractures: a systematic review\".","authors":"Rawan Affat Alanazi, Abdulaziz Almutairi, Sarah Almuwarraee, Sarah Amuatrafi, Shaden Bahatheq, Ahmed Saad Al Zomia, Raghad Alotaibi, Rudaynah Haddad, Mashael Bajunaid, Rund Almohaish, Jana Batarji, Zainab Alasfour, Shaikha Aleid","doi":"10.1186/s40902-026-00517-9","DOIUrl":"10.1186/s40902-026-00517-9","url":null,"abstract":"","PeriodicalId":18357,"journal":{"name":"Maxillofacial Plastic and Reconstructive Surgery","volume":"48 1","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13373146/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148448010","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Failure rate and treatment plan options of dental implants in patients with fibro-osseous lesions: a systematic review.","authors":"Fazele Atarbashi-Moghadam, Amirali Farahani Afsaryeh, Saede Atarbashi-Moghadam, Amir-Ali Yousefi-Koma, Ali Azadi, Mahdi Kadkhodazadeh","doi":"10.1186/s40902-026-00519-7","DOIUrl":"10.1186/s40902-026-00519-7","url":null,"abstract":"<p><strong>Background: </strong>Dental implant placement requires prerequisites, such as the quality and quantity of the available bone. Oral and maxillofacial fibro-osseous lesions (FOLs) are a group of intraosseous benign lesions, consisting of cemento-osseous dysplasia (COD), fibrous dysplasia (FD), and cemento-ossifying fibroma (COF), characterized by progressive replacement of normal bone tissue by fibrous connective tissue comprising varying amounts of mineralized substances, and consequently, the quality of the bone tissue. The aim of this study is to provide information for clinicians on the risks of implant insertion into these types of lesions.</p><p><strong>Main text: </strong>The ISI Web of Science, PubMed, and Scopus databases were searched based on the following PICO: The PICO question of the present study is as follows: What are the failure rates and treatment plan options (O) of implant placement (I) in patients with a fibro-osseous lesion who need an implant treatment at the site of the lesion (P)? Of the 301 identified studies, 39 eligible studies (16 on COD, 14 on FD, and nine on COF) were included in the present systematic review. Overall, 40 and 56 implants were placed in healthy areas near the lesions, in the grafted tissues placed in the location of the removed lesions, or within the COD and FD lesions, respectively. All of the 29 implants in the group of COF lesions were placed in the healed or grafted tissue, replacing the resected COF-affected areas. The failure rate of implants placed in the studies investigating COD, FD, and COF lesions were 22.50%, 7.14%, and 10.34%, respectively. Treatment options for implant placement in COD and FD lesions were reported as removing the lesion and waiting for the bone to be healed (with or without grafting), placing implant in the healthy bone near the lesion, or placing the implant embedded in the lesion. However, all of COF lesions were removed (mostly with resection) and dental implants were placed in the grafted tissue.</p><p><strong>Conclusion: </strong>Considering the limitations of the present study, it can be concluded that it would be more appropriate to avoid placing dental implants into the COD and FD lesions and inserting the implants in the surrounding healthy bone, healed, or grafted bone tissues are preferred. However, due to the neoplastic nature of COF removing the lesions prior to the implant insertion is crucial.</p>","PeriodicalId":18357,"journal":{"name":"Maxillofacial Plastic and Reconstructive Surgery","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13379526/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148437344","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patient-specific arthroplasty guide in paediatric temporomandibular joint ankylosis management. An accuracy-based case series.","authors":"Yehia El-Mahallawy, Nourhan M Abdelmoneim, Heba Wagih Marei, Ibrahim Mohamed Abdelhamed","doi":"10.1186/s40902-026-00518-8","DOIUrl":"10.1186/s40902-026-00518-8","url":null,"abstract":"<p><strong>Aim: </strong>To evaluate the accuracy, safety, and short-term functional outcomes of a patient-specific arthroplasty guide for the management of paediatric Temporomandibular Joint Ankylosis (TMJ-A).</p><p><strong>Methods: </strong>A prospective case series study was conducted on 7 children with TMJ-A. Virtual surgical planning and CAD/CAM fabrication were used to design a patient-specific arthroplasty guide with narrower osteotomy slits (width 5 mm) to allow precise bone removal and improved condylar fit. Preoperative and postoperative tomographic scans were utilized to measure the procedural accuracy of the computer-assisted operation. Functional outcomes included complication rate and maximal interincisal opening (MIO).</p><p><strong>Results: </strong>All children achieved satisfactory intraoperative mouth opening (> 30 mm). No intraoperative injury to the skull base or neurovascular structures was encountered. A 2.36 ± 0.18° of SMA deviation was reported on the right side, and 1.90 ± 0.46° on the left SMA. Regarding the linear VRH, 1.57 ± 0.33 mm deviation was reported in the right side, and 0.95 ± 0.46 mm in the left ramus length. Good agreement between planned and postoperative measurements for both parameters. Temporary facial nerve weakness occurred in 1 patient, which resolved within 8 weeks.</p><p><strong>Conclusion: </strong>Patient-specific arthroplasty guide with direction-dictating slits allowed accurate and safe gap arthroplasty in paediatric cohort, facilitating stable intraoperative and early postoperative outcomes. This technique may reduce surgical variability and improve safety in paediatric TMJ surgery.</p><p><strong>Trial registration: </strong>Retrospective registration was performed at clinicaltrials.gov [NCT07320911/2026-1-6].</p>","PeriodicalId":18357,"journal":{"name":"Maxillofacial Plastic and Reconstructive Surgery","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-07-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13346373/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148391292","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical characteristics of medication-related osteonecrosis of the jaw in breast cancer patients receiving zoledronic acid versus denosumab: a retrospective cohort study.","authors":"Jin Seok Kim, Yoojeong Hwang, SeungHun Baek, Kang-Min Ahn","doi":"10.1186/s40902-026-00516-w","DOIUrl":"https://doi.org/10.1186/s40902-026-00516-w","url":null,"abstract":"<p><strong>Background: </strong>Breast cancer is the most common malignancy in women worldwide, and bone-targeting agents (BTAs) - particularly zoledronic acid and denosumab - are widely administered for bone metastasis, carrying a recognized risk of medication-related osteonecrosis of the jaw (MRONJ) with reported incidence rates of 1-15% in oncologic populations. Drug-dependent differences in MRONJ characteristics, anatomical distribution, and the causal role of dentoalveolar procedures remain incompletely characterized in breast cancer patients.</p><p><strong>Methods: </strong>This single-center retrospective cohort study included 101 breast cancer patients diagnosed with MRONJ per 2022 AAOMS criteria, who received zoledronic acid (n = 66) or denosumab (n = 35) exclusively at this institution between January 2009 and December 2025. All diagnoses were confirmed by a single board-certified oral and maxillofacial surgeon. Between-group comparisons were performed using the Mann-Whitney U, chi-square, and Fisher's exact tests as appropriate.</p><p><strong>Results: </strong>Cumulative BTA dose count at MRONJ onset did not differ significantly between groups (mean 38.9 vs. 25.7; p = 0.076). The denosumab group developed MRONJ at an older mean age than the zoledronic acid group (59.5 vs. 55.7 years; p = 0.013). A significant drug-dependent anatomical difference was observed: mandibular predominance in the zoledronic acid group (59.1%) versus maxillary predominance in the denosumab group (54.3%; p = 0.015). The majority of patients developed MRONJ without prior dentoalveolar procedures (53.0% zoledronic acid; 65.7% denosumab). Periodontal disease prevalence was comparable between groups (60.5%; p = 1.000).</p><p><strong>Conclusion: </strong>Cumulative injection count alone does not reliably predict MRONJ onset in oncologic populations. The majority of cases arose without prior dentoalveolar procedures, challenging the paradigm of tooth extraction as the primary causative trigger. A drug-dependent MRONJ predilection in jaws- mandibular in zoledronic acid users, maxillary in denosumab users - warrants validation in larger prospective cohorts.</p>","PeriodicalId":18357,"journal":{"name":"Maxillofacial Plastic and Reconstructive Surgery","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148226307","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hydrogel soft tissue expander for gingiva-periosteal expansion: a narrative literature review.","authors":"Chang Youn Lee, Bongju Kim, Sung-Ho Lee, Kezia Rachellea Mustakim, Mi Young Eo, Chiyun Won, Jong-Ho Lee, Soung Min Kim","doi":"10.1186/s40902-026-00515-x","DOIUrl":"10.1186/s40902-026-00515-x","url":null,"abstract":"<p><strong>Background: </strong>Soft tissue expanders (STEs) are used in reconstructive surgeries to stretch tissues gradually, providing space for implants or facilitating bone augmentation. These devices have evolved from traditional silicone balloon expanders to modern self-inflating osmotic systems, which offer more controlled and less invasive expansion. This review explores the advancements in STEs, particularly the use of hydrogels, and their applications in clinical settings.</p><p><strong>Main text: </strong>Recent studies indicate that tissue expansion facilitates soft tissue growth through mechanical stretch and biological creep, enhancing vascularity and promoting fibroblast proliferation. The extracellular matrix transmits mechanical forces that influence cell behavior, while excessive pressure may lead to bone resorption, soft tissue necrosis, and expander exposure. Modern STEs include hydrogel-based, self-inflating types that absorb interstitial fluids to enable gradual expansion. These devices offer advantages such as biocompatibility, minimal scarring, and simplified surgical procedures. However, complications such as temporary deformity, hypoxia, allergic reactions, and infection remain important clinical concerns.</p><p><strong>Conclusion: </strong>Hydrogels in STEs need to balance effective expansion with minimal toxicity or morbidity. A key challenge is finding a patient-compliant, economic solution for tissue expansion before bone augmentation. Proper understanding and application of STEs can lead to successful outcomes in reconstructive surgery. Despite the usefulness of STEs, a comprehensive synthesis of their underlying biological mechanisms, clinical applications, and recent research developments is currently lacking. This review aims to fill that gap by summarizing the molecular and physical mechanisms of soft tissue growth, highlighting key factors that regulate expansion, and providing an updated overview of STEs and hydrogel technologies.</p>","PeriodicalId":18357,"journal":{"name":"Maxillofacial Plastic and Reconstructive Surgery","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13246980/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148150017","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Three-dimensional analysis of maxillary asymmetry in patients with mandibular prognathism.","authors":"Chihiro Atarashi, Kazuaki Osawa, Daisuke Saito, Hideyoshi Nishiyama, Kei Tomihara, Isao Saito, Jun Nihara","doi":"10.1186/s40902-026-00506-y","DOIUrl":"10.1186/s40902-026-00506-y","url":null,"abstract":"<p><strong>Background: </strong>Jaw deviation is a common feature of skeletal mandibular prognathism and often extends to the maxilla, complicating diagnosis and treatment planning in surgical orthodontic treatment. Since occlusion and maxillary morphology strongly influence mandibular position and facial balance, accurate evaluation of maxillary asymmetry is essential. Three-dimensional computed tomography (3D-CT) is more reliable than conventional two-dimensional cephalometric analysis, which is limited by distortion and structural overlap. This study aimed to quantify maxillary deviation in yawing and rolling directions and to classify morphological patterns using cluster analysis of 3D-CT data.</p><p><strong>Results: </strong>One hundred patients with skeletal mandibular prognathism were analyzed using 3D-CT. Eleven anatomical landmarks were digitized, and twelve asymmetry indices were calculated. Cluster analysis of yawing deviation produced three groups: mild deviation (70 patients), moderate deviation (23 patients), and severe deviation (7 patients). Rolling deviation also yielded three groups: mild deviation (39 patients), moderate deviation (52 patients), and severe deviation (9 patients). Combined analysis classified all cases into nine subgroups. Of those, 31% showed nearly symmetrical morphology, while 69% demonstrated varying degrees of maxillary asymmetry. Characteristic patterns included rolling deviation at the greater palatine foramen, yawing deviation in the posterior alveolar process, and mandibular fossa deviation with mild rolling features. Less frequent subgroups reflected complex and severe morphologies.</p><p><strong>Conclusion: </strong>Approximately two-thirds of patients with mandibular prognathism exhibited maxillary asymmetry, predominantly in posterior alveolar and basal regions. Classification into nine subgroups clarified distinct deviation patterns, with four groups demonstrating clinically relevant characteristics. These results emphasize the critical role of maxillary morphology in jaw deviation and highlight the value of standardized 3D evaluation. Incorporating maxillary asymmetry patterns into treatment planning may enhance diagnostic accuracy, improve surgical orthodontic outcomes, and contribute to more predictable facial symmetry.</p>","PeriodicalId":18357,"journal":{"name":"Maxillofacial Plastic and Reconstructive Surgery","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13287193/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148150153","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}