Craniomaxillofacial Trauma & Reconstruction最新文献

{"title":"Innovations in Clinical Maxillofacial Tissue Engineering and Reconstruction: Cellular Bone Matrix Allografts, Autografts, and Growth Factors.","authors":"Jeffrey S Marschall","doi":"10.3390/cmtr19020018","DOIUrl":"10.3390/cmtr19020018","url":null,"abstract":"<p><p>Reconstruction of craniomaxillofacial (CMF) bony defects requires individualized strategies based on defect characteristics and graft bed biology, with traditional approaches relying on autogenous non-vascularized bone grafts or vascularized free flaps that, while reliable, are associated with donor-site morbidity and operative complexity. Biologically driven reconstructive strategies, including tissue engineering, cellular bone matrix allografts (CBMs), and growth factor adjuncts, have emerged as alternatives or complements to autograft-based reconstruction. This review introduces and details these new innovations with emphasis on the current literature, thus empowering surgeons to enhance their clinical armamentarium.</p>","PeriodicalId":46447,"journal":{"name":"Craniomaxillofacial Trauma & Reconstruction","volume":"19 2","pages":""},"PeriodicalIF":1.0,"publicationDate":"2026-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13108040/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147785284","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":"A Prospective, International, Multicentre Registry of Patients Undergoing Segmental Mandibular Defect Reconstruction After Mandibular Resection for Tumours and Drug-Induced Osteonecrosis: A Study Protocol.","authors":"Rüdiger M Zimmerer, Tabea Pankow, Max Heiland, Julius Moratin, Wenko Smolka, Ali Modabber, Philippe Korn, Maria Mejia Nieto, Andreas Naros, Florian Thieringer, Rui Fernandes, Roderick Kim, Ashleigh Weyh, Eppo B Wolvius, Mohemmed Khan, Andreas Thor, Marcel Ebeling, Takahiro Kanno, Alberto Pereira, Henrique Messias, Nils-Claudius Gellrich","doi":"10.3390/cmtr19010017","DOIUrl":"10.3390/cmtr19010017","url":null,"abstract":"<p><p>Segmental mandibular resection may be indicated as a treatment in, for example, advanced stages of oral squamous cell carcinoma (OSCC). Osseous reconstruction of these defects is a fundamental part of static and dynamic masticatory rehabilitation, particularly when dental implants are required. The Segmental Mandibular Defect Reconstruction (SMDR) Registry aims to generate real-world evidence on SMDR through an international, prospective, multicentre case series designed as a registry. While OSCC is a common indication for segmental mandibular resection, the SMDR Registry also aims to capture outcomes for rarer mandibular conditions and the increasing number of collateral damage cases resulting from systemic medication therapies (antiresorptive drugs, immunotherapeutics) or irradiation, which may likewise lead to medication-related osteonecrosis of the mandible (MRONJ) or osteo(radio)necrosis with tumour-like segmental resection of the mandible, highlighting the value of an international database for these less frequent pathologies. Primary objectives are to describe the patient population and current treatment modalities, describe the outcomes and adverse events (AEs) for different treatment modalities, and identify potential predictors for successful autologous reconstruction of SMDs. Approximately 300 patients with a mandibular lesion resulting from bisphosphonate- and immunomodulatory drug-induced osteonecrosis of the mandible, ameloblastoma or osteosarcoma of the mandible, oral metastases related mandibular lesions indicated for segmental resection, or OSCC undergoing SMDR or intending to undergo one- or two-stage reconstruction will be prospectively recruited over a 36-month period. Baseline information, treatment details, and outcome measures will be documented. All treatments will be per the usual practice at participating sites. Outcome measures include clinical, patient-reported, and radiological outcomes; AEs related to the condition and/or treatment with a possible influence on the outcome will be recorded.</p>","PeriodicalId":46447,"journal":{"name":"Craniomaxillofacial Trauma & Reconstruction","volume":"19 1","pages":""},"PeriodicalIF":1.0,"publicationDate":"2026-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13025885/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147533611","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":"Accuracy and Safety of Computer-Assisted Surgery (CAS) in the Treatment of TMJ Ankylosis-Report of Several Cases and Review of the Literature.","authors":"Andrei Krasovsky, Boaz Frenkel, Michal Even Almos, Yair Israel, Dekel Shilo, Amir Bilder, Tal Capucha, Omri Emodi","doi":"10.3390/cmtr19010016","DOIUrl":"10.3390/cmtr19010016","url":null,"abstract":"<p><strong>Background: </strong>Temporomandibular joint (TMJ) ankylosis is an uncommon condition in the modern world, yet it remains a significant treatment challenge. One of the main intraoperative difficulties is accurately and safely resecting the ankylotic mass.</p><p><strong>Objective: </strong>This study seeks to share our clinical experience with various types of complications and to review the literature on the clinical and technological evidence regarding the accuracy of surgical detachment of the ankylotic mass from the skull.</p><p><strong>Methods: </strong>A literature review was conducted using PRISMA (Preferred Reporting Items for Systematic Review and Meta-Analysis) guidelines. Search strategies were categorized into search 1 for evaluating 3D-printed technology and search 2 for computer-assisted surgical navigation.</p><p><strong>Results: </strong>One study was selected for search 1 and 2 for search 2. Also, three cases of intraoperative surgical complications associated with the resection of the ankylotic mass were presented. The 3D surgical cutting guides were found to be accurate in guiding the superior, inferior, and depth of the osteotomy. Angulation control was less than optimal. Navigation guiding proved accurate in maintaining the planned thickness of the skull base and the anterior wall of the external auditory canal.</p><p><strong>Conclusion: </strong>Navigation guiding is a superior method for achieving predictable anatomical resection of the ankylotic mass.</p>","PeriodicalId":46447,"journal":{"name":"Craniomaxillofacial Trauma & Reconstruction","volume":"19 1","pages":""},"PeriodicalIF":1.0,"publicationDate":"2026-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13025388/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147533580","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":"From Resection to Rehabilitation in One Day: Digital Workflow for Mandibular Reconstruction with Fibular Free Flap and Immediate Dental Rehabilitation Using CAD/CAM Guides at the Point of Care.","authors":"Matthias Ureel, Benjamin Denoiseux, Katrien Brijs, Pieter-Jan Boderé, Nicolas Dhooghe, Renaat Coopman","doi":"10.3390/cmtr19010015","DOIUrl":"10.3390/cmtr19010015","url":null,"abstract":"<p><p>By using virtual surgical planning (VSP) and 3D printed guides, complex maxillofacial defects can be reconstructed with high accuracy and predictability. A fully digital workflow resulting in a modular all-in-one 3D printed guide system for fibula osteotomies, bone segment positioning, fully guided dental implant placement and dental prosthesis fixation for mandibular reconstruction was developed at Ghent University Hospital. A follicular ameloblastoma of the left mandible was resected in a 28-year-old male. The defect was reconstructed with a two-segment fibular free flap with immediate placement of three dental implants and immediate implant loading with a screw-retained bridge. A split thickness skin graft and Elemental PerioPlast were used as wound dressing. Comparison of the preoperative planning with the postoperative CT-scan showed a deviation immediately after surgery, which was no longer present at the 6-month follow-up. The patient achieved a stable occlusion and 44 mm mouth opening and reported high satisfaction. This case illustrates that fully digital, immediate mandibular reconstruction with simultaneous implant placement and prosthetic rehabilitation is feasible and accurate and enhances early functional recovery. Future improvements in intraoperative validation may further refine accuracy and reproducibility in complex oncologic reconstructions.</p>","PeriodicalId":46447,"journal":{"name":"Craniomaxillofacial Trauma & Reconstruction","volume":"19 1","pages":""},"PeriodicalIF":1.0,"publicationDate":"2026-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13025909/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147532548","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 Protocol for Ballistic and Other High-Energy Avulsive Facial Injuries-An Update for the 21st Century.","authors":"Thomas Pepper, Michele H Kim, Dane McMillan, Sarah Cantrell, Angel Scialdone, Angelina Nasthas, Ralph Erdmann, Paul N Manson, David B Powers","doi":"10.3390/cmtr19010014","DOIUrl":"10.3390/cmtr19010014","url":null,"abstract":"<p><p>High-energy ballistic and avulsive injuries to the face represent some of the most complex challenges in modern reconstructive surgery. Since Robertson and Manson's 1999 management protocol, extensive military experience and technological advancements have transformed the treatment principles while preserving the core tenets of staged care. This updated review synthesizes evidence from 36 studies published since 2000, encompassing over two decades of global experience in both military and civilian trauma. Advances in damage-control resuscitation, wound decontamination, and early skeletal stabilization have improved survival and functional outcomes. Modern imaging-particularly intraoperative CT and navigation-enables the precise verification of the reduction and removal of retained fragments, while virtual surgical planning and patient-specific implants allow the accurate restoration of facial buttresses. Early vascularized tissue transfer has reduced contracture and infection rates. Adjuncts such as hyperbaric oxygen therapy, permissive hypotension, and advanced hemostatic agents further optimize recovery. The updated four-phase protocol-resuscitation, reconstitution, reconstruction, and rehabilitation-emphasizes early definitive repair, multidisciplinary collaboration, and the integration of digital planning. These refinements extend Robertson and Manson's foundational principles into the era of precision surgery, achieving superior aesthetic and functional outcomes for patients with devastating facial injuries.</p>","PeriodicalId":46447,"journal":{"name":"Craniomaxillofacial Trauma & Reconstruction","volume":"19 1","pages":""},"PeriodicalIF":1.0,"publicationDate":"2026-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13026054/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147532858","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":"Surgical Performance of 3D-Printed Polyetheretherketone (PEEK) Patient-Specific Implants and Titanium Mesh in Clinically Matched Orbital Reconstruction: A Cadaveric Study.","authors":"Jokin Zubizarreta Oteiza, Dominik Haenggi, Yannick Simon Krieger, Lukas Schuebel, Daniel Seiler, Florian Markus Thieringer, Neha Sharma","doi":"10.3390/cmtr19010013","DOIUrl":"10.3390/cmtr19010013","url":null,"abstract":"<p><p>Orbital reconstruction following trauma remains challenging due to complex three-dimensional (3D) anatomy and limited surgical access. While pre-fabricated titanium mesh is standard, it requires extensive intraoperative manipulation and produces imaging artifacts. The 3D-printed polyetheretherketone (PEEK) patient-specific implants (PSIs) offer potential advantages; however, limited data exists for the acceptance of PEEK PSIs by surgeons compared to other established techniques. Fourteen surgeons performed simulated orbital reconstructions on nine cadaveric heads comparing titanium mesh and the 3D-printed PEEK PSIs. Titanium mesh was used for Class II orbital floor fractures, while the 3D-printed PEEK PSIs (native and radiopaque formulations) were used for Class IV defects. Surgeons were blinded to the PEEK formulation type. Outcomes included operative efficiency, handling characteristics, fit quality, and mechanical stability using validated 5-point Likert scales and objective timing. The 3D-printed PEEK PSIs demonstrated faster procedure times (9.5 ± 5.3 vs. 11.2 ± 5.1 min) and superior fit quality (2.00 ± 1.04 vs. 2.18 ± 0.60) and mechanical stability (1.67 ± 0.49 vs. 1.91 ± 0.54), with 100% rated stable versus 91% for the titanium mesh. Surgeons could not distinguish between the native and radiopaque PEEK formulations. Most surgeons (64.3%) preferred situation-dependent material selection. The 3D-printed PEEK PSIs demonstrated advantages in handling, fit quality, and mechanical stability for complex defects, while the titanium mesh showed a lower learning curve for simple reconstructions. Radiopaque enhancement expands PEEK's clinical utility without compromising handling.</p>","PeriodicalId":46447,"journal":{"name":"Craniomaxillofacial Trauma & Reconstruction","volume":"19 1","pages":""},"PeriodicalIF":1.0,"publicationDate":"2026-03-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13025502/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147533082","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 Reconstructive Materials in Paediatric Orbital Fractures: A Systematic Review.","authors":"Jane Chen, Anton Sklavos, Mustafa Mian, Ricky Kumar","doi":"10.3390/cmtr19010012","DOIUrl":"10.3390/cmtr19010012","url":null,"abstract":"<p><p>Paediatric orbital fractures require careful reconstruction to prevent long-term functional and aesthetic sequelae. Material selection is critical due to the anatomical and developmental considerations unique to children. Comparative data to guide decision making remain sparse and inconclusive. A systematic search was conducted in PubMed, Scopus, Web of Science, and Embase (through February 2025), following Preferred Reporting Items for Systematic Review and Meta-analyses (PRISMA) guidelines. Studies reporting outcomes and/or complications associated with implant materials used in the reconstruction of paediatric orbital fractures were included. Outcomes included postoperative diplopia, enophthalmos, restriction of eye movements, removal of material, and return to theatre (RTT). In total, 54 studies encompassing a total of 562 patients and 563 implants were included. Polymers (<i>n</i> = 169), alloplasts (<i>n</i> = 167) and autologous (<i>n</i> = 166) implants were the most commonly used reconstructive material. Late postoperative diplopia occurred in 7% of polymers (12/169), 6% of alloplasts (10/167), 29% of allografts (6/21), 24% of xenografts (6/25) and 33% of metals (2/6). Reported enophthalmos was highest in the autologous group (8%) but was only reported in 34 of the 54 studies. Infection, removal of implant material and RTT were low across all groups (1-4%). No donor site morbidity was reported. Robust studies with standardised outcomes and adequate follow-up are needed to inform evidence-based material selection in paediatric orbital reconstruction.</p>","PeriodicalId":46447,"journal":{"name":"Craniomaxillofacial Trauma & Reconstruction","volume":"19 1","pages":""},"PeriodicalIF":1.0,"publicationDate":"2026-02-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13024892/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147532335","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":"Assessing Patient Satisfaction Following Otoplasty: A Social Media Analysis.","authors":"Shervin Eskandari, Gianluca Ramirez, Benjamin Aderinwale, Robel Yohannes, David Zabel","doi":"10.3390/cmtr19010011","DOIUrl":"10.3390/cmtr19010011","url":null,"abstract":"<p><strong>Background: </strong>Otoplasty is a commonly performed cosmetic ear procedure, yet patient-reported outcome data remain limited. This study analyzes otoplasty reviews on RealSelf, a widely used aesthetic review platform that provides insight into patient experiences and outcomes.</p><p><strong>Methods: </strong>A retrospective review of otoplasty-related posts on RealSelf from January 2009 to March 2025 was performed. Reviews were manually screened and coded independently by reviewers. Extracted variables included demographics, procedure location, surgeon specialty, anesthesia type, postoperative pain, satisfaction rating (\"Worth It,\" \"Not Worth It,\" \"Not Sure\"), cost, motivations for surgery, and reasons for choosing the surgeon.</p><p><strong>Results: </strong>A total of 615 reviews met inclusion criteria, and 90.7% rated the procedure as \"Worth It.\" Protruding ears were the most common motivation for surgery (55.1%), followed by ear asymmetry (17.0%). Surgeon selection was most influenced by the consultation experience (34.4%), credentials (24.8%), and online reviews (21.6%). Positive surgeon comments emphasized comfort (32.3%), personality (27.9%), and communication (25.1%). Satisfaction was significantly associated with postoperative pain level (<i>p</i> < 0.001) and improved confidence after surgery (<i>p</i> = 0.032), but not with age, gender, procedure location, anesthesia type, or cost. Improved confidence (38.5%), enhanced ear shape (27.8%), and natural-appearing results (17.4%) were the most frequently cited reasons for being satisfied with otoplasty.</p><p><strong>Conclusion: </strong>Patient-reported satisfaction with otoplasty on RealSelf is high and is associated with favorable aesthetic results, improved self-confidence, and positive surgeon-patient interactions. In this cohort, effective communication, realistic expectation setting, and postoperative pain management were central to optimizing the patient experience.</p>","PeriodicalId":46447,"journal":{"name":"Craniomaxillofacial Trauma & Reconstruction","volume":"19 1","pages":"11"},"PeriodicalIF":1.0,"publicationDate":"2026-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12922110/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147272343","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":"Expanding Horizons in Craniomaxillofacial Reconstruction: The Role of Exoscopic Microsurgery in Head and Neck Surgery.","authors":"Khalid Abdel-Galil, Kemal Mustafa Tekeli","doi":"10.3390/cmtr19010010","DOIUrl":"10.3390/cmtr19010010","url":null,"abstract":"<p><p>Exoscopic systems are increasingly used as an alternative to the operating microscope in microsurgical reconstruction, offering high-definition visualisation, shared operative viewing, and greater flexibility in surgeon positioning. This retrospective case series describes the use of exoscopic visualisation during microsurgical reconstruction in five illustrative head and neck and reconstructive cases. Different commercially available exoscopic platforms were utilised, and feasibility, workflow integration, and surgeon-perceived ergonomic aspects were assessed descriptively. Exoscopic visualisation was feasible for completion of microvascular anastomoses across a range of complex reconstructions. From the surgeons' perspective, exoscopy allowed a more flexible working posture during prolonged microsurgical tasks and may offer advantages in training environments, particularly for junior surgeons. Further studies incorporating objective outcome measures are required to better define the role of exoscopy in microsurgical practice.</p>","PeriodicalId":46447,"journal":{"name":"Craniomaxillofacial Trauma & Reconstruction","volume":"19 1","pages":"10"},"PeriodicalIF":1.0,"publicationDate":"2026-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12921753/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147272355","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":"Finite Element Analysis of Low-Profile Reconstruction Plates for Atrophic Mandibles-Part II: A Comparison of Customized Plates with 3D Grid-Type and Conventional Designs.","authors":"Bianca Pulino, Robert Sader, Guilherme Louzada, Majeed Rana, Gabriele Millesi, Geraldo Prestes de Camargo Filho, Raphael Capelli Guerra","doi":"10.3390/cmtr19010009","DOIUrl":"10.3390/cmtr19010009","url":null,"abstract":"<p><strong>Objectives: </strong>The aim of this study was to compare the stiffness-related mechanical response and peak von Mises stress distribution of low-profile 2.4 mm mandibular reconstruction systems (a conventional reconstruction plate, a 3D grid-type plate, and a customized plate) in a virtual atrophic mandible model with a 5 cm segmental defect.</p><p><strong>Materials and methods: </strong>A CT-based three-dimensional mandible model was created and instrumented with three plate configurations (G1-G3). Linear static finite element analyses were performed under a 300-N masticatory load combined with literature-based muscle force vectors. Peak von Mises stresses were recorded for plates and screws, and the locations of maximum stress concentration were identified.</p><p><strong>Results: </strong>Peak plate stress was highest in the conventional reconstruction plate (G1: 695.5 MPa), followed by the 3D grid-type plate (G2: 595.6 MPa), and lowest in the customized plate (G3: 185.2 MPa). The peak screw stress was 692.9 MPa (G1), 898.0 MPa (G2), and 595.6 MPa (G3). The 3D grid-type plate increased construct stiffness but shifted stress concentration toward the mandibular angle and adjacent screws, whereas the customized plate reduced the peak plate stress and limited the extent of the high-stress region across the defect.</p><p><strong>Conclusions: </strong>Within the limitations of a linear static FEA (stiffness/stress distribution rather than failure load or fatigue resistance), the customized plate (G3) demonstrated the most favorable biomechanical performance (lowest peak plate stress). The 3D grid-type plate (G2) reduced peak plate stress compared with the conventional design (G1) but produced the highest peak screw stress. Practical considerations such as manufacturing lead time and resource requirements may favor off-the-shelf plates; however, a formal cost or operative-time analysis was not performed.</p>","PeriodicalId":46447,"journal":{"name":"Craniomaxillofacial Trauma & Reconstruction","volume":"19 1","pages":"9"},"PeriodicalIF":1.0,"publicationDate":"2026-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12921934/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147272288","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}