Maxillofacial Plastic and Reconstructive Surgery最新文献

{"title":"Correlation analysis of eye and lip canting correction after bimaxillary orthognathic surgery and orthodontic treatment.","authors":"Haemin Kim, Dong-Woo Kim, Jaeyoung Ryu, Seunggon Jung, Hong-Ju Park, Min-Suk Kook","doi":"10.1186/s40902-025-00493-6","DOIUrl":"10.1186/s40902-025-00493-6","url":null,"abstract":"<p><strong>Background: </strong>Facial asymmetry is a frequent indication for orthognathic surgery. Vertical discrepancies such as eye and lip canting strongly influence perceived facial balance. While orthognathic surgery effectively repositions skeletal structures, the extent of soft tissue canting correction remains uncertain.</p><p><strong>Methods: </strong>This retrospective study included 25 patients who underwent bimaxillary orthognathic surgery followed by orthodontic treatment between 2017 and 2023. Patients were classified into three groups: eye + lip canting (Group A, n = 10), Eye canting, lip canting, soft tissue chin deviation, and commissure height difference were measured using standardized frontal photographs and cephalometric radiographs at three time points: preoperative (T0), postoperative (T1), and post-debonding (T2). One-way ANOVA and Tukey's post hoc test were used.</p><p><strong>Results: </strong>Orthognathic surgery significantly improved both eye and lip canting (P < 0.05). Lip canting showed greater responsiveness than eye canting. Soft tissue chin deviation and commissure height difference also demonstrated significant postoperative improvements that were maintained through the debonding stage. Minimal or no further changes occurred during orthodontic treatment. Group A demonstrated the greatest overall improvement.</p><p><strong>Conclusion: </strong>Bimaxillary orthognathic surgery effectively improves soft tissue canting, particularly of the in the lower face. Most correction occurs during the surgical phase, while orthodontics contributes minimally.</p>","PeriodicalId":18357,"journal":{"name":"Maxillofacial Plastic and Reconstructive Surgery","volume":"47 1","pages":"39"},"PeriodicalIF":3.5,"publicationDate":"2025-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12618747/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145513237","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":"Unicentric Castleman disease in intraparotid lymph node: a case report.","authors":"Young Heon Jeong, Jin Seok Kim, Heonwoo Lee, Kang-Min Ahn","doi":"10.1186/s40902-025-00491-8","DOIUrl":"10.1186/s40902-025-00491-8","url":null,"abstract":"<p><strong>Background: </strong>Castleman disease (CD) is a rare lymphoproliferative disorder characterized by non-neoplastic lymph node hyperplasia. Unicentric Castleman disease (UCD), the most common clinical form, typically presents as a solitary, asymptomatic mass. Involvement of intraparotid lymph nodes is rare and often mimics salivary gland neoplasms, complicating preoperative diagnosis.</p><p><strong>Case presentation: </strong>A 35-year-old female presented with a painless, enlarging mass in the left parotid region. Contrast-enhanced CT revealed a well-demarcated, homogeneously enhancing mass with additional smaller lesions in adjacent lymph node regions. A conservative excisional approach was performed with preservation of the facial nerve. Histopathological evaluation confirmed the hyaline-vascular variant of UCD. Postoperative follow-up showed spontaneous regression of adjacent lymphadenopathy and resolution of transient facial nerve palsy.</p><p><strong>Conclusion: </strong>CD should be considered in the differential diagnosis of encapsulated parotid masses with associated lymphadenopathy. Recognizing its clinical and radiologic features may facilitate accurate diagnosis and prevent overtreatment. Complete surgical excision is curative in most UCD cases.</p>","PeriodicalId":18357,"journal":{"name":"Maxillofacial Plastic and Reconstructive Surgery","volume":"47 1","pages":"38"},"PeriodicalIF":2.8,"publicationDate":"2025-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12605938/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145489196","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":"Dental implant-associated oral squamous cell carcinoma: a clinical retrospective study of 22 cases.","authors":"Jin Seok Kim, Young Heon Jeong, Heonwoo Lee, Kang-Min Ahn","doi":"10.1186/s40902-025-00490-9","DOIUrl":"10.1186/s40902-025-00490-9","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;In oral cavity, oral squamous cell carcinoma (OSCC) is the most common malignant neoplasm. Established risk factors for OSCC include tobacco use, genetic predisposition, viral infections, and poor oral hygiene. With the increasing prevalence of dental implant (DI) procedures, reports of OSCC developing around implants have also risen. This study aims to investigate potential risk factors and clinical characteristics of OSCC occurring in association with dental implants, in order to improve understanding of its etiology and prognosis.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This retrospective study analyzed the medical records of 22 patients diagnosed with OSCC around dental implants at the Department of Oral and Maxillofacial Surgery at a single institution, between 2009 and 2024 by a single surgeon. All patients presented with persistent discomfort or abnormal lesions following implant placement and were subsequently diagnosed with OSCC via histopathological examination. Pre-treatment imaging included magnetic resonance imaging, contrast-enhanced computed tomography, PET/CT, and bone scans. The 8th edition of the American Joint Committee on Cancer (AJCC) guidelines was used to determine cancer staging. Data were collected on patient demographics, smoking and alcohol histories, implant placement date, and histopathologic findings through electronic medical records.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Result: &lt;/strong&gt;All 22 patients presented with inflammatory lesions or progressive bone loss around dental implants. Five patients had a history of malignancy in other organs or hematologic disease. Six male patients had habitual alcohol consumption and smoking. OSCC occurred predominantly in the mandible (77.3%), with 95.5% of tumors classified as T4 at diagnosis. Neck metastasis developed in 41% of patients (9/22), including four cases of delayed/occult nodal involvement. The mean interval from implant placement to OSCC diagnosis was 4.7 years, with nearly half diagnosed within 1 year. Histopathology revealed only well- or moderately differentiated tumors, with bone invasion present in 95.5% of cases. The mean depth of invasion was 13.2 mm. Twenty patients underwent surgical resection, while two received nonsurgical treatment due to systemic condition. The mean survival time was 25.7 months, and Kaplan-Meier analysis showed no significant survival difference between maxillary and mandibular OSCC.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;OSCC after dental implant placement, though uncommon, is a significant clinical issue due to its late diagnosis, aggressive bone invasion, and poor prognosis. Our findings underscore the importance of differentiating OSCC from peri-implantitis and recommend prompt biopsy when peri-implant inflammation persists despite conventional treatment. Early recognition may improve survival outcomes. The observed links with prior malignancy, chronic inflammation, and lifestyle risk factors suggest a multifactorial etiology, highl","PeriodicalId":18357,"journal":{"name":"Maxillofacial Plastic and Reconstructive Surgery","volume":"47 1","pages":"37"},"PeriodicalIF":2.8,"publicationDate":"2025-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12572468/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145401295","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":"Polyetheretherketone for craniomaxillofacial defects: cases report, evaluation of patients' satisfaction and a systematic literature review.","authors":"Yuliya Menchisheva, Alvaro Varela Morillas, Nunzianda Frascione","doi":"10.1186/s40902-025-00482-9","DOIUrl":"10.1186/s40902-025-00482-9","url":null,"abstract":"<p><strong>Background: </strong>Craniomaxillofacial reconstruction poses significant clinical challenges due to the complexity of the anatomy and the varied causes of defects. Selecting the optimal implant material remains a crucial factor in achieving successful functional and aesthetic outcomes. This study combined a systematic review and a retrospective case series conducted at the Hospital 5, Almaty, Kazakhstan. The sample consisted of 52 patients who underwent craniomaxillofacial reconstruction between 2021 and 2024, receiving either PEEK, titanium, PMMA or silicone implants. Following the surgical procedures, patients were invited to participate in an online survey to evaluate their satisfaction with long-term outcomes.</p><p><strong>Results: </strong>PEEK implants demonstrated the complication rate at 22.2%, attributable only to hematoma. Titanium implants exhibited the complication rate-22.7%, with cases of asymmetry and diplopia (4.5%), exposure (9.1%), hematoma (4.5%) and infection with rejection (9.1%). Aesthetic outcome scores, measured by the ANA scale, varied across materials. PEEK implants achieved the highest mean ANA rating with 8.86 (SD = 0.35; 8.25-9.25), showing a significant difference over PMMA, silicone and titanium.</p><p><strong>Conclusions: </strong>PEEK implants demonstrated promising clinical and aesthetic outcomes in craniomaxillofacial reconstruction. However, material selection should be personalised, considering defect location, soft tissue coverage to optimise results.</p>","PeriodicalId":18357,"journal":{"name":"Maxillofacial Plastic and Reconstructive Surgery","volume":"47 1","pages":"36"},"PeriodicalIF":2.8,"publicationDate":"2025-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12552202/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145355259","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":"Comparison of Recurrence Rates of Odontogenic Keratocyst and Ameloblastoma following surgical excision and peripheral ostectomy in the Maxilla.","authors":"Young Heon Jeong, Jin Seok Kim, Heonwoo Lee, Kang-Min Ahn","doi":"10.1186/s40902-025-00488-3","DOIUrl":"10.1186/s40902-025-00488-3","url":null,"abstract":"<p><strong>Background: </strong>Odontogenic keratocyst (OKC) and ameloblastoma are benign but locally aggressive jaw lesions that require careful surgical management. While radical resection has traditionally been the preferred treatment, conservative approaches such as surgical excision with peripheral ostectomy have gained interest to prevent significant functional and aesthetic consequences. This study aims to compare the recurrence rates of OKC and ameloblastoma in the maxilla following conservative surgical treatment.</p><p><strong>Methods: </strong>A retrospective analysis was performed on 31 patients who underwent surgical excision with peripheral ostectomy for OKC (n = 19) or ameloblastoma (n = 12) in the maxilla between 2006 and 2024. Recurrence was monitored through periodic radiographic follow-ups (mean duration: 43 months), including panoramic radiograph and cone-beam computed tomography (CBCT).</p><p><strong>Results: </strong>Among the 19 OKC cases, tumor recurred in two patients (10.5%) at 5, and 14 years post-surgery, while no recurrences were found in the ameloblastoma group. The majority of OKC (95%) were located in the posterior maxilla, whereas ameloblastoma showed an even distribution between the anterior and posterior regions, with 50% in each. Although Fisher's Exact Test did not demonstrate a statistically significant difference in recurrence rates, simple comparison suggests that OKC may have a higher tendency for recurrence than ameloblastoma following conservative treatment.</p><p><strong>Conclusion: </strong>Surgical excision with peripheral ostectomy appears to be a viable conservative treatment option for both OKC and ameloblastoma in the maxilla, with a relatively low recurrence rate observed in this study. Notably, recurrences observed even after long-term follow-up indicate the necessity for prolonged monitoring.</p>","PeriodicalId":18357,"journal":{"name":"Maxillofacial Plastic and Reconstructive Surgery","volume":"47 1","pages":"35"},"PeriodicalIF":2.8,"publicationDate":"2025-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12540222/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145336656","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":"Is Jaw in a Day® reconstruction feasible in patients undergoing robotic neck dissection for oral cancer?: a case series with comparative analysis.","authors":"Daniel Wilfredo Banegas, Jung Min Cho, Mi-Kyung Gong, Hyounmin Kim, Woong Nam, Hyung Jun Kim, Yoon Woo Koh, Dongwook Kim","doi":"10.1186/s40902-025-00489-2","DOIUrl":"10.1186/s40902-025-00489-2","url":null,"abstract":"<p><strong>Background: </strong>Immediate dental implant placement with implant-supported prostheses enables single-stage functional and aesthetic rehabilitation during jaw reconstruction, a technique referred to as \"Jaw in a Day®\" (JIAD). This study evaluated the feasibility of the JIAD technique combined with retroauricular robot-assisted neck dissection (RA-RAND) in patients with oral cancer undergoing mandibular reconstruction.</p><p><strong>Materials and methods: </strong>We retrospectively reviewed 75 patients who underwent mandibular reconstruction using fibula free flaps from September 2020 to February 2024. Among them, 31 patients were eligible for analysis. Seven patients had retroauricular robot-assisted neck dissection (RA-RAND), and 24 patients had conventional transcervical neck dissection (CTND). Two patients in the RA-RAND group and nine in the CTND group underwent the JIAD procedure. We compared the time from data acquisition to surgery, reconstruction time, total operation time, and length of hospital stay between the groups.</p><p><strong>Results: </strong>No significant differences were observed between the RA-RAND and CTND groups in terms of reconstruction time (median 431 min, IQR 274-442 vs. 310 min, IQR 236-420; p = 0.435) or hospital stay (median 20 days, IQR 17-22 vs. 20 days, IQR 18-33; p = 0.275), although the total operation time was significantly longer in the RA-RAND group (median 831 min, IQR 702-898 vs. 526 min, IQR 444-615; p = 0.002). Within the RA-RAND cohort, there were no significant differences between the JIAD and non-JIAD groups regarding time from data acquisition to surgery (median 17.5 days, IQR 14.2-20.8 vs. 13.0 days, IQR 8.0-24.0; p = 1.000), reconstruction time (median 352.5 min, IQR 311.2-393.8 vs. 431.0 min, IQR 278.0-450.0; p = 0.857), total operation time (median 863.5 min, IQR 847.2-879.8 vs. 701.5 min, IQR 649.0-751.5; p = 0.857), or length of hospital stay (median 18.5 days, IQR 15.2-21.8 vs. 20.0 days, IQR 18.0-22.0; p = 0.762).</p><p><strong>Conclusion: </strong>Based on this case series and comparative analysis, the combination of the JIAD technique with RA-RAND appears technically feasible and does not prolong the operative or postoperative course. However, larger studies are required to confirm these findings.</p>","PeriodicalId":18357,"journal":{"name":"Maxillofacial Plastic and Reconstructive Surgery","volume":"47 1","pages":"34"},"PeriodicalIF":2.8,"publicationDate":"2025-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12531366/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145301878","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":"Total joint replacement with the stock Biomet system in adult hemifacial microsomia without glenoid fossa: a case report and literature review.","authors":"Kang Hee Yu, Jeong Joon Han, Soon Jung Hwang","doi":"10.1186/s40902-025-00478-5","DOIUrl":"10.1186/s40902-025-00478-5","url":null,"abstract":"<p><strong>Background: </strong>In patients with hemifacial microsomia accompanied by mandibular fossa deficiency and severe atrophy of the mandibular ramus, customized total joint replacement (TJR) is commonly used to restore masticatory and joint function and improve facial asymmetry. However, in countries where customized TJR is not approved, or for patients for whom the cost is prohibitive, a stock TJR system must be considered. In cases with a severely medially inclined frontal ramal angle and a lack of supporting bone for the fossa component, using a stock TJR poses significant technical challenges.</p><p><strong>Case presentation: </strong>This case report describes the use of autogenous bone grafting to overcome these limitations. An 18-year-old male with HFM type IIB on the left side received staged procedures, including bone grafting between mandibular proximal and distal segments to increase the frontal ramal angle, autogenous reconstruction of the mandibular fossa to enable fixation of the TJR fossa component, and orthognathic surgery.</p><p><strong>Conclusions: </strong>The frontal ramal angle improved by approximately 6.5 degrees, and 12.42 mm advancement of the pogonion could be achieved in lateral cephalogram. Successful functional and esthetic outcomes were achieved, with stable maintenance of a stock Biomet TJR over a seven-year period.</p>","PeriodicalId":18357,"journal":{"name":"Maxillofacial Plastic and Reconstructive Surgery","volume":"47 1","pages":"32"},"PeriodicalIF":2.8,"publicationDate":"2025-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12528625/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145292557","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":"Augmented reality vs CAD/CAM system in orthognathic surgery: development and accuracy evaluation.","authors":"Federica Civita, Ilaria Rota, Diego Sergio Rossi, Alberto Sinatra, Giada Anna Beltramini, Alessandro Remigio Bolzoni","doi":"10.1186/s40902-025-00471-y","DOIUrl":"10.1186/s40902-025-00471-y","url":null,"abstract":"<p><strong>Background: </strong>Recent advancements in augmented reality (AR) have gained increasing interest in surgical applications, particularly in maxillofacial surgery. This study evaluates the accuracy and reproducibility of an AR-based navigation system using optical see-through (OST) headsets, in comparison to traditional CAD/CAM-guided approaches for Le Fort I osteotomy. Twenty identical stereolithographic skull models were divided into two groups: one group treated with OST-based AR navigation system to visualize virtual surgical lines on the skull models (n = 10) and the other treated with the conventional CAD/CAM procedure using titanium materialise surgical guides (n = 10). Virtual surgical planning (VSP) was carried out identically for both groups.</p><p><strong>Results: </strong>Surgical accuracy was assessed by measuring deviations (in mm) between planned and postoperative positions of seven cephalometric reference points. All models in the CAD group achieved deviations below the 2-mm clinical threshold (mean deviation: 0.72 ± 0.38 mm). However, only 4 out of 10 in the OST group met this threshold (mean deviation: 2.27 ± 1.24 mm). A statistical analysis using Mann-Whitney U-test with a significance level of 0.05 was carried out to compare the mean accuracy between OST and CAD groups. The results revealed a statistically significant difference between OST and CAD groups (p-value < 0.005). Nevertheless, progressive improvements in the OST group were observed, likely reflecting a learning curve associated with the new technology.</p><p><strong>Conclusions: </strong>Although CAD/CAM remains more accurate, the AR-based system offers advantages in real-time visualization and reduced costs and preoperative time by eliminating the need for 3D-printed guides. However, the current accuracy limitations highlight the need for further refinement of AR systems and increased operator training. Future studies are needed to validate the clinical applicability and reliability of AR-guided orthognathic surgery.</p>","PeriodicalId":18357,"journal":{"name":"Maxillofacial Plastic and Reconstructive Surgery","volume":"47 1","pages":"33"},"PeriodicalIF":2.8,"publicationDate":"2025-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12528609/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145292749","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":"Evaluation, prevention, and treatment of inferior alveolar nerve injury in bilateral sagittal split mandibular osteotomy.","authors":"Hao-Ran Zhao, Ning Zhao, Yao-Xiang Xu, Fu-Chen Wang, Wen-Lin Xiao","doi":"10.1186/s40902-025-00486-5","DOIUrl":"10.1186/s40902-025-00486-5","url":null,"abstract":"<p><strong>Background: </strong>Bilateral sagittal split osteotomy (BSSO) is a widely adopted surgical procedure for correcting mandibular deformities, yet neurosensory disturbance (NSD) of the inferior alveolar nerve (IAN) remains a significant postoperative complication. This complication adversely impacts patients' quality of life due to persistent sensory abnormalities in the lower lip and chin region.</p><p><strong>Main body: </strong>This narrative review summarizes anatomical risks and prevention/management strategies. Cone-beam CT (CBCT) may clarify canal anatomy and support risk stratification. Nerve-sparing osteotomy modifications are intended to limit traction and direct exposure. Fixation choice may influence surrogate and early clinical outcomes; monocortical miniplates (MCF) may be associated with lower radiographic canal penetration and earlier recovery than bicortical screws (BCF), whereas long-term clinical differences are uncertain. Piezoelectric/ultrasonic devices may improve precision and reduce tissue trauma, and virtual planning with 3D-printed guides may support safer osteotomy paths. For established IAN injury, photobiomodulation (PBM) may support earlier recovery; corticosteroid effects are route-dependent-intravenous dexamethasone mainly reduces edema with uncertain NSD benefit, while local betamethasone at closure may yield early improvement.</p><p><strong>Conclusion: </strong>Comprehensive management likely requires integrated preoperative assessment, refined technique, and postoperative adjuncts. Current evidence supports considering multimodal approaches-imaging-guided planning, nerve-sparing modifications, and PBM-to potentially reduce NSD and enhance early recovery, while standardized protocols and larger studies are needed before firm recommendations.</p>","PeriodicalId":18357,"journal":{"name":"Maxillofacial Plastic and Reconstructive Surgery","volume":"47 1","pages":"31"},"PeriodicalIF":3.5,"publicationDate":"2025-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12514085/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145275137","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":"Management of the pterygoid plate in orthognathic surgery: a narrative review.","authors":"Ji Young Hwang, Dae Seok Hwang, Borim Choi","doi":"10.1186/s40902-025-00487-4","DOIUrl":"10.1186/s40902-025-00487-4","url":null,"abstract":"<p><strong>Background: </strong>The most critical factor for successfully performing setback and superior/posterior impaction of the maxilla in orthognathic surgery is securing sufficient space. This space can be achieved through pterygoid plate fracture, removal, or grinding. However, most studies to date have provided limited investigation into the management of the pterygoid process itself.</p><p><strong>Main text: </strong>Safe manipulation of the pterygoid plate demands a precise understanding of the surrounding anatomy. The course of the internal maxillary artery demonstrates substantial anatomical and ethnic variability. In the relationship with the lateral pterygoid muscle, lateral positioning of the artery is more common in Asian populations, and symmetric courses occur more frequently than asymmetric ones. Preservation of the descending palatine artery helps maintain perfusion of the maxilla, although ligation may be indicated in certain situations. The risk of vascular injury increases when the osteotome is placed more than 15 mm superior to the most inferior point of the pterygomaxillary junction. To avoid high-level fractures, the osteotome should be positioned with its lower end at the base of the pterygomaxillary fissure and its tip directed superiorly. These anatomical considerations are essential for selecting the appropriate technique among available options, including fracture, removal, and grinding.</p><p><strong>Conclusions: </strong>All three methods of pterygoid plate management-fracture, removal, and grinding-are all effective methods that provide skeletal stability and demonstrate no significant differences in complications including bleeding. Optimal technique selection should be guided by detailed anatomical knowledge, patient-specific factors, and intraoperative findings to maximize surgical safety and effectiveness.</p>","PeriodicalId":18357,"journal":{"name":"Maxillofacial Plastic and Reconstructive Surgery","volume":"47 1","pages":"30"},"PeriodicalIF":2.8,"publicationDate":"2025-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12514081/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145275144","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}