Journal of Maxillofacial & Oral Surgery最新文献

{"title":"Clinical Outcomes of Virtual versus Conventional Planning in Orthognathic Surgery: A Systematic Review and Meta-analysis of Randomized Controlled Trials.","authors":"Muhammad Anas, Muhammad Usman Sultan, Sadique Ahmad Orakzai","doi":"10.1007/s12663-026-03236-w","DOIUrl":"https://doi.org/10.1007/s12663-026-03236-w","url":null,"abstract":"<p><strong>Objective: </strong>To synthesize evidence from randomized controlled trials (RCTs) comparing virtual surgical planning (VSP) with conventional surgical planning (CSP) in orthognathic surgery, focusing on surgical accuracy, soft-tissue prediction, operative efficiency, costs, and patient-reported outcomes.</p><p><strong>Methods: </strong>While adhering to PRISMA 2020 recommendations, this systematic review and meta-analysis was prospectively registered in PROSPERO (CRD420261279888). RCTs involving adults undergoing orthognathic surgery were identified through electronic searches of PubMed, Cochrane Library, and ScienceDirect (2000-2025). Primary outcomes included hard-tissue surgical accuracy (linear mm/angular ° deviation) and soft-tissue prediction accuracy. Secondary outcomes were planning time, surgical duration, costs, radiation exposure, and patient-reported outcomes. Random-effects meta-analyses used mean difference (MD) or standardized mean difference (SMD). Certainty of evidence was assessed with GRADE.</p><p><strong>Results: </strong>Eleven RCTs (240 patients) were included. VSP significantly reduced surgical duration compared to CSP (SMD - 2.53, 95% CI - 4.45 to - 0.60, <i>p</i> = 0.01, I²=68%, low certainty). Patient-reported outcomes showed no difference between groups (SMD 0.05, 95% CI - 0.30 to 0.40, <i>p</i> = 0.70, I²=0%, low certainty). No significant difference was found for maxillary horizontal accuracy (MD - 0.41 mm, 95% CI - 1.01 to 0.18, <i>p</i> = 0.17, I²=92%, very low certainty). For maxillary vertical accuracy, VSP showed a statistically significant but clinically modest improvement (MD - 0.46 mm, 95% CI - 0.92 to - 0.01, <i>p</i> = 0.04, I²=81%, very low certainty). Subgroup analysis revealed greater vertical accuracy benefits with guide/plate-based transfer (MD - 0.89 mm) versus splint-based transfer (MD - 0.24 mm), with significant subgroup differences (<i>p</i> = 0.001). VSP was associated with higher costs and radiation exposure.</p><p><strong>Conclusions: </strong>VSP offers statistically significant improvements in vertical accuracy and surgical duration, but benefits are modest, clinically questionable, and largely driven by advanced transfer techniques. Very low certainty evidence and increased costs limit routine recommendation. VSP may be best reserved for complex cases where precision is paramount.</p><p><strong>Supplementary information: </strong>The online version contains supplementary material available at https://doi.org/10.1007/s12663-026-03236-w.</p>","PeriodicalId":47495,"journal":{"name":"Journal of Maxillofacial & Oral Surgery","volume":"25 5","pages":"1353-1371"},"PeriodicalIF":0.7,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13627615/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149116480","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":"Survival Outcomes of Neck Management(s) Approaches in OSCC: A Systematic Review and Meta-analysis.","authors":"Ankita Tandon, Kumari Sandhya, Narendra Nath Singh, Khushboo Gupta, Amit Kumar, Ajoy Kumar Shahi","doi":"10.1007/s12663-025-02778-9","DOIUrl":"https://doi.org/10.1007/s12663-025-02778-9","url":null,"abstract":"<p><strong>Background: </strong>Oral squamous cell carcinoma (OSCC) is a growing concern due to its poor prognosis, treatment failures, andnoncompliance. Since there is significant variation in neck involvement of OSCC patients, the aim here is to identify current practicesand gaps in OSCC management strategies across various cases with distinct clinical presentations.</p><p><strong>Methodology: </strong>The literature was accessed from various sources such as PubMed, MEDLARS Online (MEDLINE), CINAHL, Web ofScience, Global Index Medicus, CENTRAL, AMED, and Embase from inception till 31 August 2024. The survival outcomes of variousneck treatments were screened and the data was extracted using the PRISMA strategy. Following this, the data was pooled using arandom effects model to analyse the effect size of interventions pertaining to overall survival, disease-free survival, 5-year/2-yearsurvival, and recurrences achieved through neck management(s). The risk of bias assessment was performed using the QUIPS tool.Heterogeneity was assessed by chi-square and I2 statistics. All the statistical analysis was conducted using STATA 18.0.</p><p><strong>Results: </strong>The initial search of 1746 records were screened and filtered to achieve an outcome of 25 studies for qualitative synthesis,out of which six studies were eligible for meta-analysis. The pooled risk ratio for the analysis was statistically significant (RR=1.73) at95% CI. The I2 test of heterogeneity was also significant (85.3%, p=0.000).</p><p><strong>Conclusion: </strong>The meta-analysis identified the need for customized treatment plans based on tumor biology and patient-specificfactors, with surgery as the mainstay of treatment to maximize survival results. However, the wait and watch approach requiresevidence in patients with N0 necks through more cohort studies and trials for evidence synthesis.</p>","PeriodicalId":47495,"journal":{"name":"Journal of Maxillofacial & Oral Surgery","volume":"25 5","pages":"1222-1232"},"PeriodicalIF":0.7,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13627523/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149116332","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":"Preliminary Evidence on the Diagnostic Accuracy of DNA-Karyometry for Oral Squamous Cell Carcinoma Detection: A Systematic Review and Meta-Analysis.","authors":"Shubhanker Singh, Shilpa Bawane, Sagar Sanjay Kadadhekar","doi":"10.1007/s12663-026-03130-5","DOIUrl":"https://doi.org/10.1007/s12663-026-03130-5","url":null,"abstract":"<p><strong>Background: </strong>Early detection of oral squamous cell carcinoma (OSCC) remains challenging due to morphological overlap between dysplastic and malignant epithelial cells. DNA-Karyometry (DNA-KM), which integrates nuclear morphometry with DNA ploidy analysis, has emerged as a potential objective diagnostic adjunct.</p><p><strong>Methods: </strong>A systematic review and meta-analysis was conducted in accordance with PRISMA-DTA 2020 guidelines. PubMed, Scopus, EBSCOhost, and Google Scholar were searched up to September 2025. Studies evaluating the diagnostic accuracy of DNA-KM in histopathologically confirmed oral cancer were included. Pooled sensitivity, specificity, likelihood ratios, and diagnostic odds ratio (DOR) were estimated using random-effects models, with heterogeneity assessed using the I² statistic.</p><p><strong>Results: </strong>Four studies comprising 398 samples were included, all originating from a single research group in Germany. The pooled sensitivity was 0.84 (95% CI: 0.26-1.00) and pooled specificity was 0.80 (95% CI: 0.23-1.00). The area under the curve (AUC) was 0.77, indicating fair diagnostic performance; however, wide confidence intervals reflected substantial statistical imprecision and uncertainty.</p><p><strong>Conclusion: </strong>DNA-KM demonstrates biologically plausible and potentially useful diagnostic characteristics for OSCC detection; however, current evidence is limited to four studies from a single research group, restricting external validity and independent validation. Therefore, findings should be interpreted as preliminary and hypothesis-generating rather than confirmatory.</p>","PeriodicalId":47495,"journal":{"name":"Journal of Maxillofacial & Oral Surgery","volume":"25 5","pages":"1233-1245"},"PeriodicalIF":0.7,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13627558/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149116678","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":"Chlorhexidine, Povidone Iodine, or Normal Saline: Which Irrigating Solution Optimizes Recovery After Mandibular Third Molar Surgery? A Systematic Review and Meta-Analysis.","authors":"Charlotte Saldanha, Usha Asnani, Srivalli Natarajan, Suraj Arjun Ahuja, Chinmay Rao, Varad Rajendra Saptarshi","doi":"10.1007/s12663-026-03055-z","DOIUrl":"https://doi.org/10.1007/s12663-026-03055-z","url":null,"abstract":"<p><strong>Purpose: </strong>This systematic review aimed to compare the efficacy of different irrigating solutions, normal saline, povidone-iodine, and chlorhexidine in reducing postoperative sequelae following surgical extraction of mandibular third molars.</p><p><strong>Methods: </strong>An electronic search of PubMed/MEDLINE, Cochrane Central, Google Scholar, and EBSCO Host was conducted (Jan 2000-Apr 2024). Included were RCTs and comparative clinical studies. Predictor variables were irrigants: chlorhexidine, povidone-iodine, and normal saline. Primary outcomes were pain, swelling, trismus, dry socket, and infection. Odds ratios (OR) and 95% confidence intervals were calculated, and <i>p</i> < 0.05 was considered statistically significant. A fixed effects model was used.</p><p><strong>Results: </strong>598 participants from 10 studies were included. Meta-analysis was possible for the incidence of dry socket and infection between the povidone-iodine and normal saline groups. Other outcomes, including postoperative pain, swelling, and trismus were summarized narratively. The odds of dry socket (OR = 2.28, 95% CI = 1.05-4.92, <i>p</i> = 0.04) and infection (OR = 1.33, 95% CI = 0.56-3.14, <i>p</i> = 0.51) were higher with povidone-iodine than with normal saline. Chlorhexidine showed improved outcomes in some studies, but quantitative synthesis was not possible due to heterogeneous study design and reporting.</p><p><strong>Conclusion: </strong>Based on the available evidence, no irrigating solution was found to be clearly superior. Though some studies reported favourable outcomes with chlorhexidine, the findings were inconsistent due to the heterogeneity of the included studies and the limited number of outcomes suitable for quantitative synthesis. Further well-designed RCTs with standardized protocols are needed.</p>","PeriodicalId":47495,"journal":{"name":"Journal of Maxillofacial & Oral Surgery","volume":"25 5","pages":"1494-1506"},"PeriodicalIF":0.7,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13627554/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149116458","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":"Assessment of Dermis Fat Graft Versus Temporalis Myofascial Flap for Interposition in Temporomandibular Joint Ankylosis: A Systematic Review and Meta-Analysis.","authors":"Priyanka Shetty, Varsha Sunil Manekar, Ashlesha Ghormode, Abhay Datarkar","doi":"10.1007/s12663-025-02674-2","DOIUrl":"https://doi.org/10.1007/s12663-025-02674-2","url":null,"abstract":"<p><strong>Background: </strong>TMJ ankylosis is a pathologic condition where the mandible is fused to the fossa by bony or fibrotic tissues. This interferes with mastication, speech, oral hygiene, and normal life activities, and can be potentially life-threatening. Gap Arthroplasty with Interposition of the graft is the treatment of choice for interpositional arthroplasty. Temporal fascia is considered the graft of choice for interpositional arthroplasty but with the disadvantage of an unesthetic appearance due to temporal hollowing, Dermis Fat graft [DFGs] has been used as an alternative. Hence, there is a need for analysis and comparison between these 2 grafts based on certain parameters.</p><p><strong>Aim: </strong>The aim of the study is to compare dermis fat graft with temporalis myofascial flap for interposition in TMJ ankylosis in view of 3 main outcomes i.e., mouth opening/Interincisal distance, pain in TMJ, reankylosis/prevalence of recurrence.</p><p><strong>Method: </strong>The PROTOCOL is registered with PROSPERO under the ID- CRD42022342297A. PRISMA guidelines for systematic reviews were followed. An electronic search was carried out through Medline, PubMed, Cochrane and Web of Sciences and relevant articles were selected based on the selected parameters. The final 3 randomized controlled trials were included in the meta-analysis, and the study was conducted.</p><p><strong>Result and conclusion: </strong>The results of the study were recorded as the mean maximal mouth opening and pain scores and recurrence were in favour of DFG within the 1st year of surgery, but when it comes to long-term results, they were statistically insignificant.</p>","PeriodicalId":47495,"journal":{"name":"Journal of Maxillofacial & Oral Surgery","volume":"25 5","pages":"1430-1442"},"PeriodicalIF":0.7,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13627563/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149116473","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":"Effectiveness of Concentrated Growth Factor in Lateral Sinus Augmentation: A Systematic Review and Meta-Analysis with Translational Considerations for Eggshell-Derived Nano-Hydroxyapatite.","authors":"Vikrant Dilip Sane, Rajesh Kshirsagar, Vivekanand Kattimani, Vivek Sunil Nair, Rashmi Vikrant Sane","doi":"10.1007/s12663-026-03192-5","DOIUrl":"https://doi.org/10.1007/s12663-026-03192-5","url":null,"abstract":"<p><strong>Background: </strong>The integration of a nano‑structured scaffold with a biologically active matrix such as Concentrated Growth Factor (CGF) offers a strategy that unites osteoconduction with growth factor-driven osteoinduction. Despite increasing clinical interest, its role in lateral sinus augmentation-particularly when combined with hydroxyapatite-has not been systematically assessed. This review therefore evaluated the effectiveness of CGF in direct sinus augmentation with hydroxyapatite and explored the translational potential of combining eggshell‑derived nano‑hydroxyapatite (EHA) with CGF.</p><p><strong>Methods: </strong>This systematic review and meta-analysis followed PRISMA 2020 guidelines and was registered with PROSPERO (CRD420251148756). Searches of PubMed, Scopus, Web of Science, Cochrane Library, ScienceDirect, and Google Scholar (inception-October 2025), supplemented by manual reference checks, identified eligible randomized controlled trials and comparative clinical studies in adults (≥ 18 years) undergoing direct sinus augmentation. Risk of bias was assessed using RoB 2 and ROBINS-I. Random-effects meta-analyses (RevMan Web) synthesized continuous outcomes as SMD/MD with 95% CIs, and certainty of evidence was appraised using GRADE.</p><p><strong>Results: </strong>Six studies (<i>n</i> = 6; 3 RCTs, 1 three-arm randomized trial, and 2 non-randomized designs) involving 185 sinuses were analyzed. CGF groups demonstrated significantly greater new bone formation than controls (pooled SMD = 0.94; 95% CI 0.30-1.57; <i>p</i> = 0.004; I²=41%). Bone height gain was similar between CGF and controls (SMD = - 0.29; 95% CI - 0.98 to 0.41; <i>p</i> = 0.41; I²=75%). Bone density favoured CGF (SMD = 0.89; 95% CI 0.44-1.34; <i>p</i> = 0.0001; I²=0%). Implant survival remained high (97-100%) without graft-related complications. GRADE certainty was high for bone formation, density, and survival, moderate for height gain. Importantly, none directly assessed EHA + CGF; pooled results reflect CGF, with EHA implications inferred from translational evidence.</p><p><strong>Conclusions: </strong>CGF-augmented sinus lifts enhance histologic new bone formation and radiographic bone density, without reducing vertical bone gain or implant survival. Although EHA exhibits strong osteoconductive potential in intraoral applications, direct randomized evidence on the combined EHA + CGF approach in lateral window sinus augmentation remains scarce. Well-designed head-to-head trials comparing EHA + CGF with deproteinized bovine bone mineral (DBBM), with or without CGF, are therefore warranted to establish comparative effectiveness and guide clinical decision-making.</p><p><strong>Registration: </strong>PROSPERO CRD420251148756.</p><p><strong>Supplementary information: </strong>The online version contains supplementary material available at https://doi.org/10.1007/s12663-026-03192-5.</p>","PeriodicalId":47495,"journal":{"name":"Journal of Maxillofacial & Oral Surgery","volume":"25 5","pages":"1386-1396"},"PeriodicalIF":0.7,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13627601/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149116556","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 of Planned Versus Actual Implant Placement Using Different Implant Systems: A Systematic Review of Angulation and Positional Deviations.","authors":"Yashika Bali, Suresh Venugopalan, Ravpreet Singh, Sourya Kumar","doi":"10.1007/s12663-026-03250-y","DOIUrl":"https://doi.org/10.1007/s12663-026-03250-y","url":null,"abstract":"<p><strong>Background: </strong>Accurate three-dimensional dental implant placement is essential for achieving predictable functional, esthetic, and biomechanical outcomes. Digital workflows incorporating static surgical guides, dynamic navigation, and robotic-assisted platforms improve implant placement accuracy. However, reported accuracy varies among these guidance modalities, warranting systematic evaluation.</p><p><strong>Methods: </strong>A systematic review was conducted in accordance with the PRISMA 2020 guidelines. Electronic searches of PubMed/MEDLINE, Scopus, Web of Science, Embase, the Cochrane Library, and Google Scholar identified clinical studies published between January 2015 and May 2025. Studies reporting angular and linear deviations between planned and actual implant positions were included. Data were extracted for freehand, static guided, dynamic navigation, and robotic-assisted implant placement. Risk of bias was assessed using the RoB 2.0 and ROBINS-I tools. Because of clinical and methodological heterogeneity, findings were synthesized narratively.</p><p><strong>Results: </strong>Eleven clinical studies met the inclusion criteria. Robotic-assisted implant placement demonstrated the lowest angular and linear deviations, with mean entry and apical deviations generally below 1 mm and angular deviations frequently below 2°. Dynamic navigation showed intermediate accuracy, whereas static guided surgery demonstrated slightly greater positional deviations. Freehand implant placement consistently showed the greatest deviations. Accuracy was influenced by anatomical location, guide support type, and operator experience.</p><p><strong>Conclusion: </strong>Guided implant placement techniques provide greater accuracy than freehand approaches. Within the available evidence, robotic-assisted systems demonstrated the lowest reported deviations, followed by dynamic navigation and static guided surgery. Guidance modality should reflect clinical complexity, anatomical considerations, and available resources.</p><p><strong>Supplementary information: </strong>The online version contains supplementary material available at https://doi.org/10.1007/s12663-026-03250-y.</p>","PeriodicalId":47495,"journal":{"name":"Journal of Maxillofacial & Oral Surgery","volume":"25 5","pages":"1413-1423"},"PeriodicalIF":0.7,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13627619/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149116367","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":"Comparative Evaluation of Stage -Specific Treatment Modalities in Oral Submucous Fibrosis: A Systematic Review.","authors":"Manali Sawant, Shilpa Patel, Niharika Swain, Jigna Pathak, Shakeeb Dhorajiwala, Anupama Warrier, Mehwish Khan, Neelam Rajpal","doi":"10.1007/s12663-026-03160-z","DOIUrl":"https://doi.org/10.1007/s12663-026-03160-z","url":null,"abstract":"<p><strong>Background: </strong>Oral submucous fibrosis is a precancerous condition of the oral cavity and can range from mild, moderate, or severe stages based on clinical and histopathological changes. Various treatment modalities are available in the management of oral submucous fibrosis. This systematic review aims to evaluate and compare the stage-specific treatment modalities in OSMF.</p><p><strong>Materials and methods: </strong>A literature search was conducted on databases such as PubMed, EBSCO, and Cochrane. Inclusion and exclusion criteria were applied, and articles were selected for the review. Systematically, data was extracted and reviewed.</p><p><strong>Results: </strong>A total of 13 studies were included with a total sample size of 800 patients comprising 666 males and 44 females with the mean age above 20 years. Different treatment modalities were reported as per the different stages of oral submucous fibrosis. Oral antioxidants and physiotherapy may be indicative in stage I & II cases; combination therapy along with intralesional injections may be effective in stages II & III. In case of advanced stages (III & IV), surgical management comprising endoscopic-assisted platysma flap may show promising results.</p><p><strong>Conclusion: </strong>The management of oral submucous fibrosis at the specific stage, including conservative, medical, and surgical treatment modalities, is crucial to enhance the quality of patient's life. If not treated, it can progress to malignancy.</p><p><strong>Supplementary information: </strong>The online version contains supplementary material available at https://doi.org/10.1007/s12663-026-03160-z.</p>","PeriodicalId":47495,"journal":{"name":"Journal of Maxillofacial & Oral Surgery","volume":"25 5","pages":"1611-1621"},"PeriodicalIF":0.7,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13627600/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149116433","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":"Optimal Timing for Surgical Intervention in Orbital Fracture Management: A Systematic Review and Meta-Analysis.","authors":"Issai Laxmi Charmila, Kavita Wadde, Abhilasha Yadav, Jayant Shivaji Landge, Sanpreet Singh Sachdev","doi":"10.1007/s12663-025-02930-5","DOIUrl":"https://doi.org/10.1007/s12663-025-02930-5","url":null,"abstract":"<p><strong>Background: </strong>The optimal timing for surgical repair of orbital floor and combined orbital wall fractures remains a subject of clinical debate. While early surgery may prevent fibrosis, muscle entrapment, and enophthalmos, delayed intervention after edema resolution can sometimes yield comparable outcomes. This systematic review and meta-analysis aimed to evaluate the influence of surgical timing on functional and esthetic outcomes following orbital fracture repair.</p><p><strong>Methods: </strong>The present systematic review followed PRISMA 2020 guidelines and was prospectively registered on PROSPERO (CRD42024502791). A comprehensive search across PubMed, Scopus, Elicit, Web of Science, ScienceDirect, Semantic Scholar, EBSCOhost, and Google Scholar identified relevant literature up to October 2025. Eligible studies included prospective and retrospective cohort designs comparing early (≤ 14 days) versus delayed (> 14 days) surgical repair. Risk of bias was assessed using the Newcastle-Ottawa Scale, and the certainty of evidence was rated via the GRADE framework. Quantitative synthesis was performed using a random-effects model.</p><p><strong>Results: </strong>Fifteen cohort studies encompassing 2666 patients were included. Early intervention (≤ 14 days) was consistently associated with superior recovery of diplopia and extraocular motility, particularly in fractures with muscle entrapment or large defects. Delayed repair beyond two weeks yielded acceptable results in select cases without entrapment. The risk of bias across studies was low to moderate, and the certainty of evidence was graded as moderate for most outcomes.</p><p><strong>Conclusion: </strong>Early surgical repair within 7-14 days offers the most favorable functional recovery in orbital fractures, though individualized timing remains essential based on defect size, entrapment severity, and clinical presentation.</p>","PeriodicalId":47495,"journal":{"name":"Journal of Maxillofacial & Oral Surgery","volume":"25 5","pages":"1291-1302"},"PeriodicalIF":0.7,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13627583/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149116623","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":"Survival Rate and Prevalence of Complications in Basal Implants: A Systematic Review and Meta Analysis.","authors":"Sakshi Panday, S M Kotrashetti, Shinju Susan John, Richa Mishra","doi":"10.1007/s12663-026-03060-2","DOIUrl":"https://doi.org/10.1007/s12663-026-03060-2","url":null,"abstract":"<p><strong>Aim: </strong>To evaluate the effectiveness of basal implants in patients with atrophic jaw or compromised alveolar bone and to assess survival rate and related complications.</p><p><strong>Methods: </strong>This review adhered to Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) 2020 guidelines and was registered in PROSPERO (CRD42024615184; https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42024615184). Databases (PubMed, SCOPUS, EBSCOhost, Google Scholar) were searched through April 2025. Screening and data extraction were performed independently by two reviewers. Quality assessment was evaluated using the Cochrane Risk of Bias (RoB-2) tool, and evidence certainty was assessed using the GRADE approach. Standardized mean difference (SMD) and risk ratio (RR) were used as summary statistics with a random-effects model, with <i>p</i> < 0.05 considered statistically significant. Analysis was performed using Review Manager (RevMan) version 5.3.</p><p><strong>Results: </strong>Five studies (1,388 implants, 140 patients) were included for qualitative synthesis and four for meta-analysis. All studies were randomized controlled trials with low to moderate risk of bias. Basal implant effectiveness was assessed for pain reduction (3rd day to 3rd month), soft tissue health indices, and survival rates at 12 and 24 months comparing healed bone sites versus fresh extraction sites. Meta-analysis revealed significant pain reduction at 3 months (SMD = 3.94, 95% CI: 3.30-4.57, <i>p</i> < 0.001) and significant improvement in soft tissue indices (SMD = 1.26, 95% CI: 0.89-1.63, <i>p</i> < 0.001). A numerical trend favored healed sites without statistical significance at 12 months (RR = 1.56, 95% CI: 0.59-4.09, <i>p</i> = 0.37) and 24 months (RR = 1.84, 95% CI: 0.79-4.29, <i>p</i> = 0.16). Complications varied considerably, with one study reporting implant bending in 30.9% of cases (376/1,019 implants), while mobility was rare (0.5%). GRADE assessment indicated moderate certainty for pain and soft tissue outcomes, and low certainty for survival outcomes.</p><p><strong>Conclusion: </strong>Basal implants demonstrate favourable healing trajectories for pain reduction and soft tissue maturation in atrophic jaws. However, significant complication rates-notably a 30.9% bending rate-and the lack of direct head-to-head comparisons with modern conventional implants necessitate a cautious clinical approach. Direct comparison with contemporary conventional implants was not possible due to a lack of eligible randomized clinical trials. Current evidence remains geographically concentrated and limited by short follow-up periods; therefore, high-impact international RCTs are required to establish definitive comparative effectiveness and long-term safety.</p><p><strong>Supplementary information: </strong>The online version contains supplementary material available at https://doi.org/10.1007/s12663-026-03060-2.</p>","PeriodicalId":47495,"journal":{"name":"Journal of Maxillofacial & Oral Surgery","volume":"25 5","pages":"1372-1385"},"PeriodicalIF":0.7,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13627560/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149116321","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}