Oral and Maxillofacial Surgery-Heidelberg最新文献

{"title":"Radioanatomical characteristics of zygoma for planning of quad zygoma implants: a cross sectional study.","authors":"Shashti Balaji, Karthik Kattur Premkumar, Deepak Abraham Pandyan, Satheesh Chandran, Deenadayalan Narasimman, Balamurugan Rajendran, George Samyo Stephenson","doi":"10.1007/s10006-025-01361-3","DOIUrl":"https://doi.org/10.1007/s10006-025-01361-3","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the radioanatomical measurements of the zygoma as a guide for treatment planning of quad zygomatic implant placement.</p><p><strong>Methods: </strong>This cross sectional study was carried on 17 patients of 34 zygomatic regions reported with atrophic maxilla for placement of zygomatic implants. The zygomatic implants were placed virtually in a quad approach using \"Real Guide\" version 3.0\" and, the following parameters were assessed at 20 points in antero- superior, antero-inferior, postero-superior and postero-inferior regions. The thickness of zygomatic bone, Installation angle of zygomatic implants, Length of the installed zygomatic implants and Distance between the zygomatic implants on each side were measured using Cone Beam Computed Tomography (CBCT) on a virtual planning software \"Materialise Mimics\" version 15.</p><p><strong>Results: </strong>The mesial implant can be emerged in antero-superior region and the distal implant can be emerged in antero-inferior region on the right side zygoma since the maximum thickness of zygomatic bone was seen in D2, A1, A3 and D4 directions. Similarly in the left side of zygoma, the mesial implant can emerge in postero-superior region and distal implant can be emerge in postero-inferior region since the maximum thickness was seen in D2 and A3 directions (P > 0.05). The installation angle for mesial implant in right and left side was 45⁰ and the distal implant angle for right and left side was 45⁰ and 46⁰ (P < 0.05). The mesial zygomatic implant length for right and left side was 55.88 mm and 56.18 mm while, the distal zygomatic implant length for right and left side was 44.56 mm and 45.59 mm (P > 0.05). The distance between the two zygomatic implants in right and left side was 5.06 mm and 4.54 mm (P > 0.05).</p><p><strong>Conclusion: </strong>Virtual planning for placement of implants in quad zygoma approach would be a feasible requirement as it eases out the surgeon's practice and prevents the possibilities of causing intrusion complications intraoperatively. Hence, quad zygoma implants remains a promising viable option for patients presenting with severe atrophic maxilla.</p><p><strong>Clinical trial number: </strong>Not Applicable.</p>","PeriodicalId":47251,"journal":{"name":"Oral and Maxillofacial Surgery-Heidelberg","volume":"29 1","pages":"64"},"PeriodicalIF":1.7,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143606629","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":"An unusual case of multiple primary tumours involving the long bone and oral cavity.","authors":"Karthick Sekar, Anand Ramanathan, Rafiq Khalid, Kein Seong Mun, Valliammai Valliappan, Siti Mazlipah Ismail","doi":"10.1007/s10006-025-01356-0","DOIUrl":"https://doi.org/10.1007/s10006-025-01356-0","url":null,"abstract":"<p><strong>Purpose of review: </strong>Multiple primary tumours (MPTs) are a rare clinical entity, and the co-occurrence of synchronous and metachronous MPTs in a single patient is even more exceptional. In the context of Erdheim-Chester Disease (ECD), an already uncommon disorder, the presentation of this disease in the oral cavity is notably rare. Furthermore, the simultaneous presence of ECD in the oral cavity and a Giant Cell Tumour (GCT) in a long bone has not been previously reported in medical literature.</p><p><strong>Recent findings: </strong>This case report presents the first documented instance of such a unique clinical scenario. The marked histological disparities between GCT and ECD further underscore the enigmatic nature of this case. The intricate interplay of genetic, environmental, and pathophysiological factors that led to the simultaneous development of two distinct neoplasms in the same patient is yet to be fully elucidated. This case not only challenges our understanding of the etiology of these conditions but also emphasizes the importance of a multidisciplinary approach to the evaluation and management of such complex cases. The confluence of rare entities, the diagnostic complexities they introduce, and the imperative need for tailored treatment strategies exemplify the intricate landscape of oncological care. This case serves as a compelling reminder of the many unknown facets of disease etiology and the significance of collaborative medical efforts in offering the best possible care for patients confronting exceptionally rare clinical presentations.</p>","PeriodicalId":47251,"journal":{"name":"Oral and Maxillofacial Surgery-Heidelberg","volume":"29 1","pages":"62"},"PeriodicalIF":1.7,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143568468","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":"The lip split: a retrospective outcomes study of central and lateral lip split access for head and neck reconstructive surgery.","authors":"Peter Gearing, Maxim Devine, Siyuan Pang, Felix Sim, Anand Ramakrishnan","doi":"10.1007/s10006-025-01355-1","DOIUrl":"10.1007/s10006-025-01355-1","url":null,"abstract":"<p><strong>Purpose: </strong>Surgical resection of oral cancers requires meticulous planning to achieve clear margins and minimize potential morbidity. This study aimed to compare postoperative surgical and functional outcomes following central and lateral lip-split approaches used for resection and reconstruction of oral tumours.</p><p><strong>Methods: </strong>A retrospective review of 79 cases involving lip-split procedures for head and neck cancers was conducted. Data were collected from a prospectively recorded database (December 2015 to December 2022). Statistical analyses compared patient demographics, intraoperative characteristics, and postoperative outcomes between central and lateral lip-split cohorts.</p><p><strong>Results: </strong>Lateral lip splits were associated with higher rates of postoperative complications (p = 0.008), including return to theatre (p = 0.015), and functional issues including asymmetric smile (p = 0.009). No significant differences were observed in readmission rates, length of stay, or time to oral diet commencement (p > 0.05).</p><p><strong>Conclusions: </strong>Lip-split procedures remain valuable for resection and reconstruction of oral and oropharyngeal tumours. Lateral lip splits are associated with poorer outcomes when compared to central approaches. Appropriate selection of lip splitting approaches should consider tumour location, resection margins, patient comorbidities and preferences, and surgical preferences.</p>","PeriodicalId":47251,"journal":{"name":"Oral and Maxillofacial Surgery-Heidelberg","volume":"29 1","pages":"63"},"PeriodicalIF":1.7,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11885361/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143568479","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 oral and maxillofacial surgery lagging behind other specialties on X?","authors":"Boyu Ma, Jamie Rose, Edwin M Rojas, Jaime Castro-Núñez","doi":"10.1007/s10006-025-01359-x","DOIUrl":"10.1007/s10006-025-01359-x","url":null,"abstract":"<p><strong>Purpose: </strong>X, formerly known as Twitter, is a popular social media platform that facilitates oral and maxillofacial surgeons to disseminate a wide array of information to a global audience. The purpose of this study is to identify the top influencers in oral and maxillofacial surgery on X, characterize who they are, and relate their social media influence to academic influence.</p><p><strong>Methods: </strong>We utilized the \"BuzzSumo\" Application Programming Interface to identify the most followed accounts for the topic search \"oral and maxillofacial surgery.\" A secondary calculator from the Mention API was used to assign a numerical score of \"influence\" based on their algorithm. The top 100 accounts associated with the highest engagement scores were characterized by name, status as an oral and maxillofacial surgeon/organization, location, and academic h-index.</p><p><strong>Results: </strong>We found that 52/100 (52%) of users/organizations were oral and maxillofacial surgeons/residents. There was no significant correlation between the h-index and the X engagement score, R² = 0.8316 (P = 0.088). In comparison, other specialties have a higher percentage of practitioners using X and have found a correlation between h-index and X engagement score.</p><p><strong>Conclusion: </strong>Our results indicate there is a demonstrated need for the creation of more educational content from high-ranking academic sources.</p>","PeriodicalId":47251,"journal":{"name":"Oral and Maxillofacial Surgery-Heidelberg","volume":"29 1","pages":"61"},"PeriodicalIF":1.7,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11882611/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143558355","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":"Comparing academic productivity and Instagram presence in oral and maxillofacial surgery training programs.","authors":"Jamie Rose, Boyu Ma, Edwin M Rojas, Jaime Castro-Núñez","doi":"10.1007/s10006-025-01354-2","DOIUrl":"10.1007/s10006-025-01354-2","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Social media has become an increasingly important tool in how surgeons collaborate with one another, disseminate educational information, and communicate with patients.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Purpose: &lt;/strong&gt;The purpose of this study was to assess the relationship between academic productivity and social media (Instagram) presence amongst oral and maxillofacial surgery programs.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Study design, setting, sample: &lt;/strong&gt;A cross-sectional study was used to identify oral and maxillofacial surgery programs and their respective residency Instagram accounts. Information regarding number of followers, posts, and likes were recorded for each program. Academic productivity metrics for each faculty including H-index, number of publications, and number of citations were recorded.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Predictor/exposure/independent variable: &lt;/strong&gt;The independent variable was the type of residency program: certificate, dual-degree, or combined track.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Main outcome variable(s): &lt;/strong&gt;The main outcome variable was the academic influence quantified by h-index, citations, and publications of the programs and their social media influence quantified by number of followers/posts.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Covariates: &lt;/strong&gt;Instagram posts were categorized into departmental posts, educational, social, professional and miscellaneous. Engagement was further quantified by the number of likes.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Analyses: &lt;/strong&gt;Descriptive statistics, one-way ANOVA, Tukey's Multiple Comparisons tests, ROUT's outlier test (Q = 0.1%), and linear regression plots with a P value &lt; 0.05.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Instagram accounts were identified for 65 (73%) of the 89 programs. There was a statistically significant moderately positive correlation between the number of followers for a program's Instagram account compared with the number of publications (r = 0.5110, P  &lt; 0.001). There was a statistically significant weakly positive correlation between the number of followers for a program's Instagram account compared with average faculty h-index(r = 0.4982, P  &lt; 0.001), and number of citations (r = 0.4300, P  &lt; 0.001). There was a statistically significant weakly positive correlation between the number of posts for a program's Instagram account compared with average faculty h-index (r = 0.3438, P &lt; 0.001), number of publications (r = 0.3580, P = 0.001), and number of citations (r = 0.3973, P  &lt; 0.001). Across all programs combined, educational posts garnered more likes compared to miscellaneous (P = 0.0129), social (P = 0.0018), departmental (P = 0.0005), and professional posts (P &lt; 0.0001).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion/relevance: &lt;/strong&gt;There was a moderately positive correlation between average faculty H-index and number of followers for an oral and maxillofacial surgery program's Instagram account. There was a weak positive correlation between other measures of academic productivity and social media presence. Educational content ","PeriodicalId":47251,"journal":{"name":"Oral and Maxillofacial Surgery-Heidelberg","volume":"29 1","pages":"60"},"PeriodicalIF":1.7,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11880069/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143544009","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 of two stable internal fixation techniques in mandibular ramus sagittal osteotomy: a three-dimensional finite element study.","authors":"Kaline de Moura Silva, Leonardo Mendes Ribeiro Machado, Milena Gomes Melo Leite, Pedro Yoshito Noritomi, Giorge Pessoa de Jesus, Andrezza Lauria de Moura","doi":"10.1007/s10006-025-01357-z","DOIUrl":"https://doi.org/10.1007/s10006-025-01357-z","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate and compare, using finite elements three-dimensional (3D) analysis, two techniques of stable internal fixation in 2 patterns of sagittal split ramus osteotomy (SSRO) and the repercussions of occlusal load distribution in the postoperative period.</p><p><strong>Methods: </strong>A 3D finite element model of a hemimandible was created. The models were divided into 2 split patterns of SSRO advanced 5 mm forward, a split pattern (1) following the Epker osteotomy design and another split pattern (2) following Posnick osteotomy design, simulated by CAD (Computer Aided Engineering) Rhinoceros 3D^®. Two internal fixation techniques were simulated by HyperMesh: A- one titanium miniplate of the Arnett system (1 mm) for orthognathic surgery fixed with four monocortical screws; B- one titanium plate fixed with four monocortical screws and one bicortical screw. Resistance, stress and displacement were analyzed applying a 200 N vertical load to the occlusal surface region of the mandibular first molar and a 100 N to the incisal surface of the mandibular central incisor.</p><p><strong>Results: </strong>The results were presented through the von Mises stress analysis. A difference in the displacement of the models fixed with only one miniplate and four monocortical screws was observed. The models with split pattern (2) presented smaller displacements when compared to the split pattern (1). For metallic components, the split pattern (2) exhibits lower strain values, although it has no significant difference.</p><p><strong>Conclusion: </strong>The fixation technique B proved to be more rigid and lower stress values both in the bone and in the plate, as well as lower deformation and displacements were shown in comparison to fixation technique A for all mandibular movements and forces.</p>","PeriodicalId":47251,"journal":{"name":"Oral and Maxillofacial Surgery-Heidelberg","volume":"29 1","pages":"59"},"PeriodicalIF":1.7,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143517015","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":"Role of stereotactic radiotherapy for head neck cancer.","authors":"Shrikant B Mali","doi":"10.1007/s10006-024-01314-2","DOIUrl":"https://doi.org/10.1007/s10006-024-01314-2","url":null,"abstract":"<p><strong>Aim: </strong>In recent years, stereotactic ablative radiotherapy (SABR) has been created. Using one or a small number of dosage fractions, SABR enables the hypofractionated treatment of extracranial tumours, delivering a high biologically effective dose with little damage. This review article explores role of stereotactic ablative radiotherapy in head neck cancers.</p><p><strong>Material methods: </strong>Using the search parameters SABR, stereotactic radiotherapy, and targeted radiation, the publications were found on PubMed and Scopus. For this review, the closest publications to SABR were consulted from the search results that were returned.</p><p><strong>Conclusion: </strong>In the treatment of patients with recurring and/or previously irradiated head and neck malignancies, SABR is technically possible, well-tolerated, and performs comparably to other salvage therapy options. It also offers the benefit of a quicker course of therapy. Timetable, increased adherence, and secure delivery in the outpatient context. This presents a chance to provide SABR as a therapy option for a limited number of patients. In order to properly administer a highly conformal ablative dosage to targets (or tumours) in the body, SBRT requires sophisticated technologies in radiation planning and imaging guiding. Because of its highly conformal dose distributions and stereotactic spatial precision in administration, SABR is being employed more and more to treat a range of head and neck tumours.</p>","PeriodicalId":47251,"journal":{"name":"Oral and Maxillofacial Surgery-Heidelberg","volume":"29 1","pages":"58"},"PeriodicalIF":1.7,"publicationDate":"2025-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143504799","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":"Comparative analysis of lip morphology in Brazilian caucasian individuals between 20 and 50 years old using stereophotogrammetry.","authors":"Karolyn Sales Fioravanti, Maria Gabriela Robles Mengoa, Laura Vidoto Paludetto, Guilherme Yukio Arakaki Murayama, Thaís Marchini Oliveira, Chiarella Sforza, Karin Hermana Neppelenbroek, Simone Soares","doi":"10.1007/s10006-025-01349-z","DOIUrl":"https://doi.org/10.1007/s10006-025-01349-z","url":null,"abstract":"<p><strong>Purpose: </strong>This observational, cross-sectional study evaluated healthy Caucasian Brazilian individuals' normal lip dimensions according to sex and age (20-50 years) using stereophotogrammetry.</p><p><strong>Methods: </strong>A total of 130 individuals divided into four groups according to sex and age were analyzed using stereophotogrammetry. Ten linear lip, five angular lip, and three lip surface measurements (upper, lower, and total lip vermilion) were obtained. Comparisons were performed using two-way ANOVA.</p><p><strong>Results: </strong>Mouth width, philtrum width, and lower lip cutaneous height were significantly greater in men than women. The upper lip height, upper lip cutaneous height, and average lower vermilion lip angle were significantly larger in men than women and increased with age (group), with medium or large effect sizes. A sex × group interaction was present for total vermilion height, upper vermilion height, total lip height, lower lip height, average upper vermilion lip angle, average Cupid's bow angle, mentolabial angle, and upper and total vermilion lip areas. When factors interact (sex/group), one affects the outcome of the other.</p><p><strong>Conclusions: </strong>Relevant linear lip measures were greater in men than women and increased with age in a mixed population from 20 to 50 years old. Thus, the lip and mouth are severly impacted by aging.</p>","PeriodicalId":47251,"journal":{"name":"Oral and Maxillofacial Surgery-Heidelberg","volume":"29 1","pages":"57"},"PeriodicalIF":1.7,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143442256","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":"Bizarre parosteal osteochondromatous proliferation in the jaws: a systematic review.","authors":"Silvia Helena Villela Castro de Paula, Paula de Sousa Lopes Cascaes, Mariela Peralta-Mamani, Andresa Borges Soares, José Luiz Junqueira, Mariana Quirino Silveira Soares","doi":"10.1007/s10006-025-01352-4","DOIUrl":"https://doi.org/10.1007/s10006-025-01352-4","url":null,"abstract":"<p><strong>Purpose: </strong>The bizarre parosteal osteochondromatous proliferation (bpop) is a rare lesion that affects long tubular bones of the feet and hands. Since these lesions are even rarer in the jaws, this systematic review aimed to summarize the up-to-date scientific evidence that can guide health professionals on the diagnosis and treatment of bpop in the jaws.</p><p><strong>Methods: </strong>This prisma-guided and prospero-registered (crd42024524576) review included case reports with confirmed anatomopathological diagnosis of bpop. The articles were searched in november 2024 in the pubmed, scopus, web of science, scielo, cochrane library, embase, and livivo databases and the academic repositories (proquest, open grey, ibict/bdt, and google scholar) without language or publication date restrictions.</p><p><strong>Results: </strong>Twelve cases of patients aged between 2 and 72 years (mean 26.5 ± 19.8 years) with equal gender distribution were included. Most lesions were clinically described as nodules or swellings (83.5%), asymptomatic (58.3%), with a mean diameter of 15.8 ± 16.2 mm, located in the mandible (58.3%) and anterior region of the jaws (75%). Radiographically, 66.7% of the lesions had well-defined borders and 91.7% were in continuity with the cortical bone. Histopathological findings revealed pleomorphic chondrocytes (83.3%), hypercellular cartilage (83.3%), and 'blue bone' (50%). All bpop lesions were surgically excised and recurrence was observed in 41.7% of cases with a mean follow-up of 8.8 months.</p><p><strong>Conclusion: </strong>Since bpop demonstrates a recurrent behavior, further investigations with long-term follow-up periods are needed to address its malignancy potential.</p>","PeriodicalId":47251,"journal":{"name":"Oral and Maxillofacial Surgery-Heidelberg","volume":"29 1","pages":"56"},"PeriodicalIF":1.7,"publicationDate":"2025-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143415827","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":"Postoperative anticoagulation in patients with microvascular reconstruction - a systematic review.","authors":"Moritz Bleymehl, Julius Moratin, Maximilian Smielowski, Gregor Schnug, Thomas Rückschloß, Cornelius Busch, Michael Engel, Jürgen Hoffmann, Oliver Ristow","doi":"10.1007/s10006-025-01351-5","DOIUrl":"https://doi.org/10.1007/s10006-025-01351-5","url":null,"abstract":"<p><strong>Objective: </strong>To assess the currently applied regimens of antithrombotic therapy after microvascular reconstruction.</p><p><strong>Methods: </strong>A systematic literature review was performed using the MEDLINE/PubMed Database for work published until September 2022. Data synthesis and risk of bias were reported in accordance with NIH Study Quality Assessment Tools guidelines.</p><p><strong>Results: </strong>204 articles were found including the keywords either in the abstract or in the title. After screening their abstracts and titles, 41 articles were identified as suitable and the full texts were retrieved. 23 studies were included in this review. No gold standard could be shown; on the contrary, the applied antithrombotic regimens varied widely. A broad consensus could be obtained that Dextran should no longer be used after an increased complication rate was proven. The most commonly used agents are unfractionated (UFH) as well as low molecular weight (LMWH) heparin and acetylsalecylic acid (ASA), although the literature results are partly contradictory.</p><p><strong>Conclusions: </strong>A consensus could be found that it is useful to perform thromboprophylaxis when the patient is immobilized, but there is no evidence for a survival advantage of the flap by chemical prophylaxis. On the contrary, it has been shown that there is an increased rate of bleeding complications and flap loss combined with the simultaneous use of multiple chemical anticoagulants. In conclusion the generalized use of anticoagulation is explained less by microvascular grafting than by general medical risk factors. Thus, large prospective RCTs will be needed to establish a gold standard therapeutic regimen.</p>","PeriodicalId":47251,"journal":{"name":"Oral and Maxillofacial Surgery-Heidelberg","volume":"29 1","pages":"55"},"PeriodicalIF":1.7,"publicationDate":"2025-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143400360","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}