Journal of Maxillofacial & Oral Surgery最新文献

{"title":"Comparative Efficacy of Remimazolam versus Midazolam and Propofol in Oral Surgery under Intravenous Sedation: A Systematic Review and Meta-Analysis.","authors":"Toru Yamamoto, Takutoshi Inoue, Mitsuhiro Yoshida, Soju Seki, Naotaka Kishimoto, Kenji Seo","doi":"10.1007/s12663-025-02925-2","DOIUrl":"https://doi.org/10.1007/s12663-025-02925-2","url":null,"abstract":"<p><strong>Background: </strong>A novel sedative agent, remimazolam, has recently been introduced for dental sedation. Synthesis of the available clinical knowledge in dental sedation was considered important.</p><p><strong>Purpose: </strong>This systematic review and meta-analysis was conducted to evaluate whether remimazolam is superior to midazolam and propofol for intravenous sedation during oral surgery in terms of reduced onset time, time to discharge, and incidence of adverse events.</p><p><strong>Study selection: </strong>A systematic review and meta-analysis were conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A literature search was performed using PubMed, Web of Science, and the Cochrane Central Register of Controlled Trials (CENTRAL) (last search date: February 2025). English-language clinical studies assessing the effectiveness of remimazolam for intravenous sedation during oral surgery were included. Multiple reviewers independently extracted data, and of 32 studies screened, 5 studies (5/32, 15.6%) involving 398 patients met the inclusion criteria. Meta-analysis was performed using Cochrane Review Manager Web with a random-effects model, reporting effect sizes as mean differences and odds ratios.</p><p><strong>Results: </strong>As the primary outcomes, remimazolam intervention demonstrated a similar time to onset and time to discharge compared with other sedatives. However, a lower incidence of adverse events was observed (odds ratio, 0.26; 95% confidence interval, 0.05-1.39; I² = 61%).</p><p><strong>Conclusion: </strong>Remimazolam would provide comparable sedative efficacy for intravenous sedation during oral surgery, with a potential safety benefit of fewer adverse events.</p><p><strong>Supplementary information: </strong>The online version contains supplementary material available at https://doi.org/10.1007/s12663-025-02925-2.</p>","PeriodicalId":47495,"journal":{"name":"Journal of Maxillofacial & Oral Surgery","volume":"25 5","pages":"1485-1493"},"PeriodicalIF":0.7,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13627496/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149116441","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 Outcomes of Medical and Surgical Interventions in Trigeminal Neuralgia: A Systematic Review.","authors":"P S Tripthi, Rakshita Kumar","doi":"10.1007/s12663-026-03088-4","DOIUrl":"https://doi.org/10.1007/s12663-026-03088-4","url":null,"abstract":"<p><strong>Introduction: </strong>Trigeminal neuralgia is a chronic neuropathic pain disorder characterized by severe episodic facial pain and significant impairment in quality of life. Despite multiple available treatment options, comparative evidence on their clinical outcomes remains limited. This systematic review aimed to evaluate and compare outcomes of various medical and surgical treatment modalities.</p><p><strong>Methods: </strong>A systematic review was conducted in accordance with PRISMA guidelines. PubMed, Cochrane, Web of sciences and Scopus databases were searched for studies published between 2005 and 2025 using the terms \"trigeminal neuralgia\" combined with drug therapy, surgery, and radiotherapy. Randomized controlled trials and observational studies were included. Due to heterogeneity in study design, interventions and outcome reporting, findings were synthesized qualitatively. Outcomes assessed included pain relief, recurrence rate, patient satisfaction and treatment-related complications.</p><p><strong>Results: </strong>A total of 7,842 records were identified, of which 8 studies met the inclusion criteria and were included in the final qualitative synthesis. The study population demonstrated a female predominance (65.5%) with a mean age of 58.4 years and the mandibular division was most commonly affected Variability was observed across treatment modalities in terms of onset of pain relief, recurrence rates, and complication profiles. Facial numbness was the most frequent complication, occurring in approximately 16% of patients.</p><p><strong>Discussion and conclusion: </strong>Minimally invasive procedures provide effective short-term pain relief with higher recurrence rates, whereas microvascular decompression offers the most durable long-term outcomes despite greater invasiveness. Treatment should be individualized based on patient characteristics, disease etiology and expected durability of outcomes.</p><p><strong>Supplementary information: </strong>The online version contains supplementary material available at https://doi.org/10.1007/s12663-026-03088-4.</p>","PeriodicalId":47495,"journal":{"name":"Journal of Maxillofacial & Oral Surgery","volume":"25 5","pages":"1589-1602"},"PeriodicalIF":0.7,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13627582/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149116459","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":"Histological Analysis of New Bone Formation Using Bone Substitutes, with and Without Autograft: A Systematic Review.","authors":"Mohammad Hosseini Hooshiar, Zohreh Moradipour, Amir Moeintaghavi, Solmaz Akbari, Amir Yari, Ensie Teimoori","doi":"10.1007/s12663-025-02750-7","DOIUrl":"https://doi.org/10.1007/s12663-025-02750-7","url":null,"abstract":"<p><strong>Background: </strong>No definitive guidelines exist regarding the use of xenografts or allografts with or without autogenous bone grafts (ABGs) in guided bone regeneration (GBR). While radiographic systematic reviews have extensively explored this topic, a substantial knowledge gap exists in the current understanding of the histological outcomes of combining ABGs with these bone substitutes. This systematic review evaluates whether adding ABGs to xenografts or allografts improves new bone formation in histomorphometric outcomes.</p><p><strong>Purpose: </strong>It is essential to understand histological outcomes, particularly regarding new bone formation, as they offer direct evidence of the biological effectiveness of bone regeneration procedures, providing insights that radiographic assessments alone cannot provide. This systematic review poses a fundamental question: Does adding ABGs to xenografts or allografts in GBR improve new bone formation?</p><p><strong>Materials and methods: </strong>This systematic review was registered in PROSPERO (CRD42021282176). An electronic search encompassed the Scopus, Embase, Web of Science, PubMed/Medline, and Cochrane databases until August 1, 2024, with no language restrictions. The systematic review incorporated human-randomized clinical trials and animal-randomized studies focusing on GBR using bone substitutes, with and without ABGs. The percentage of new vital bone formation served as the primary outcome measure. Soft tissue formation or residual graft particles were considered secondary outcomes.</p><p><strong>Results: </strong>Initially, 2,253 studies were identified. The screening process indicated that six studies (three randomized clinical trials and three randomized animal studies) met the inclusion criteria. An animal studies meta-analysis revealed no significant differences between groups in new bone formation, soft tissue formation, or remaining graft material, with low heterogeneity. Meta-analysis was not feasible for human studies due to the high risk of bias and small sample sizes.</p><p><strong>Conclusion: </strong>A meta-analysis of animal studies (approximately 10-16 weeks) demonstrated that the addition of ABGs to xenografts or allografts in GBR did not significantly enhance new bone formation. The findings from available human clinical trials align with these results, although a meta-analysis of human studies was not feasible due to the high risk of bias and small sample sizes.</p><p><strong>Graphical abstract: </strong></p>","PeriodicalId":47495,"journal":{"name":"Journal of Maxillofacial & Oral Surgery","volume":"25 5","pages":"1397-1412"},"PeriodicalIF":0.7,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13627570/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149116681","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":"Solitary Fibrous Tumor of the Head and Neck Region: A Systematic Review of Diagnostic Approaches, Surgical Management, and Outcomes.","authors":"Rajesh Chauhan, Ajay Kumar Verma, Jishnu Mohan, Virendra Singh, Amrish Bhagol, Mohd Sabir Khan","doi":"10.1007/s12663-026-02990-1","DOIUrl":"https://doi.org/10.1007/s12663-026-02990-1","url":null,"abstract":"<p><strong>Background: </strong>Solitary fibrous tumor (SFTs) of the head and neck (H&N) are rare mesenchymal neoplasms with varied clinical behavior. Since 2019, advances in immunohistochemistry, particularly nuclear STAT6 expression, have improved diagnostic accuracy. A comprehensive update is needed to reassess clinical presentation, diagnosis, and outcomes.</p><p><strong>Purpose: </strong>The aim of this systematic review was to evaluate the clinical presentation, diagnosis, management, and outcomes of solitary fibrous tumor of the head and neck reported between June 2019 upto 10th June 2025. The review includes pooled analysis of demographics, tumor characteristics, histopathologic and immunohistochemical features, treatment approaches, recurrence rates, and follow-up outcomes among patients diagnosed with H&N SFTs.</p><p><strong>Study selection: </strong>Eligible studies were English-language case reports, case series, and observational studies that reported solitary fibrous tumor arising in the head and neck region in humans. Exclusion criteria included non-English publications, non-H&N SFTs, editorials, review articles, and studies without individual patient data. Two independent reviewers performed screening and full-text assessment based on PRISMA guidelines, resolving discrepancies by consensus. Of 503 identified studies, 103 met inclusion criteria (36.1%).</p><p><strong>Results: </strong>The review included 103 studies comprising 281 patients with head and neck SFTs. The median age was 47 years (range: 6 months-84 years); 53% were female. Common sites included the oral cavity (27.5%), orbit (18.5%), and sinonasal region (13.3%). Most patients presented with painless swelling. Histologically, tumor demonstrated spindle cell morphology; 99.1% were STAT6-positive. Surgical excision was the primary treatment in 96.4% of cases, with negative margins achieved in 85%. Recurrence occurred in 10.3%, primarily associated with positive margins, increased mitotic activity, and nuclear atypia. Adjuvant radiotherapy was administered in 5.3% of cases. Distant metastases were rare (<5%). The average follow-up period was 25 months.</p><p><strong>Conclusions: </strong>Head and neck SFTs exhibit indolent behavior but carry a risk of recurrence, especially in tumors with high-risk histologic features. STAT6 immunohistochemistry is highly sensitive and should be considered the gold standard for diagnosis. Complete surgical excision with negative margins is essential for optimal outcomes. This review underscores the need for long-term follow-up in patients with H&N SFTs to detect late recurrences or metastasis.</p><p><strong>Supplementary information: </strong>The online version contains supplementary material available at https://doi.org/10.1007/s12663-026-02990-1.</p>","PeriodicalId":47495,"journal":{"name":"Journal of Maxillofacial & Oral Surgery","volume":"25 5","pages":"1246-1281"},"PeriodicalIF":0.7,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13627592/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149116369","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 Outcome of Extraoral versus Intraoral Approaches in the Management of Isolated Zygomatic Arch Fractures: A Systematic Review.","authors":"Jitendra Kumar, Ragavi Alagarsamy, Jitendra Chawla, Hariram Sankar, Babu Lal, Anshul J Rai, Zenish R Bhatti, Dinesh Kumar Verma, Md Yunus","doi":"10.1007/s12663-025-02928-z","DOIUrl":"https://doi.org/10.1007/s12663-025-02928-z","url":null,"abstract":"<p><strong>Objective: </strong>This systematic review aimed to compare the extraoral and intraoral approaches for the closed reduction of isolated zygomatic arch fractures (IZAF) in terms of approach type, instrumentation, stabilization methods, complications, and clinical outcomes.</p><p><strong>Method: </strong>Database search was done in PubMed, Google Scholar, Semantic Scholar, and the Cochrane Library from inception to August 2024. Studies included were focusing on closed reduction of IZAF via extraoral or intraoral approaches. Data extraction included approach type, reduction instruments, stabilization methods, anesthesia type, complications, and clinical outcomes. The Joanna Briggs University tool was used to assess the risk of bias.</p><p><strong>Results: </strong>Sixty-three studies involving 726 patients were included. The Gillies temporal and Keen's intraoral approaches were the most commonly used methods. The Rowe zygomatic elevator was the most commonly used instrument for extraoral approach while extraction forceps for intraoral approach for reduction. Foleys catheter was used for stabilisation post reduction in extraroal approach. Notably, complication rates were comparable between the two approaches, indicating that both are considered safe.</p><p><strong>Conclusion: </strong>The intraoral approach can be considered as the first surgical option for managing IZAF, given its advantages, including reduced risk of nerve injury and no visible scarring. Future randomised control trails are warranted to further evaluate the effectiveness of these approaches.</p><p><strong>Supplementary information: </strong>The online version contains supplementary material available at https://doi.org/10.1007/s12663-025-02928-z.</p>","PeriodicalId":47495,"journal":{"name":"Journal of Maxillofacial & Oral Surgery","volume":"25 5","pages":"1324-1339"},"PeriodicalIF":0.7,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13627551/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149116513","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":"Bone Augmentation in Implant Dentistry: A Systematic Exploration of Techniques and Outcomes.","authors":"Subham Kumar Sinha, Asutosh Das","doi":"10.1007/s12663-025-02831-7","DOIUrl":"https://doi.org/10.1007/s12663-025-02831-7","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the outcomes of bone augmentation techniques prior to implant placement in atrophic ridges using only moderate-to-high quality evidence, and to provide a provisional decision-making aid.</p><p><strong>Methods: </strong>A systematic search of PubMed, Scopus, and Web of Science was conducted. Randomized controlled trials (RCTs), prospective cohort studies, and retrospective cohorts with ≥ 10 patients reporting implant survival and complications were included. Case reports, small case series, and studies without essential data were excluded. Study quality was assessed using the Cochrane Risk of Bias 2.0, ROBINS-I, and GRADE.</p><p><strong>Results: </strong>Of 471 identified records, 12 studies met inclusion criteria: 5 RCTs, 4 prospective, and 3 retrospective cohorts. Implant survival rates ranged from 88% to 100% depending on graft type and defect morphology. Autogenous grafts showed the highest predictability for extensive defects but had the highest donor site morbidity. GBR with xenograft-autogenous mixtures provided stable horizontal augmentation with fewer complications. Growth factor-enhanced xenografts and Ti-reinforced d-PTFE membranes offered promising results in selected cases.</p><p><strong>Conclusions: </strong>Graft selection can be guided by defect size, patient comorbidity, and morbidity tolerance. The clinical decision-making table serves as a provisional, evidence-informed reference to assist clinicians in thinking through graft choices.</p>","PeriodicalId":47495,"journal":{"name":"Journal of Maxillofacial & Oral Surgery","volume":"25 5","pages":"1424-1429"},"PeriodicalIF":0.7,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13627606/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149116494","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":"Systematic Review and Meta-analysis of the Pattern, Distribution, Etiology and Treatment of Maxillofacial Injuries from Different Geopolitical Zones in Nigeria.","authors":"Ezekiel T Adebayo, Benjamin Fomete, Uchenna P Egbunah, Timothy O Aladelusi, Adegbayi A Adekunle, Wasiu L Adeyemo","doi":"10.1007/s12663-024-02262-w","DOIUrl":"https://doi.org/10.1007/s12663-024-02262-w","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to provide a nationwide survey of maxillofacial injuries pattern, distribution, etiology and treatment based on Nigeria's geopolitical zones.</p><p><strong>Methods: </strong>This systematic review and meta-analysis included all cross-sectional, cohort, case-control and randomized controlled studies published between 2004 and 2019 (16 years). Comparisons were made between different age groups, gender, site of maxillofacial injury, associated injuries, and treatment across geopolitical zones in Nigeria: southwest(SW), south-south (SS), southeast (SE), northwest (NW), north central (NC) and northeast (NE). Proportion meta-analysis using the generic inverse variance method, risk ratio effect measure, and random-effects model was conducted.</p><p><strong>Results: </strong>A total of 35 studies including 4472 patients from four geopolitical zones across Nigeria (SW, SS, SE and NW) were included in this review. Age range was 0.3-90 years. Highest male-to-female ratio reported was 30:1. Road traffic crash (RTC) was the major risk factor for maxillofacial injuries (3.10, 95% CI 2.34-4.10), and motorcycle crash was second (0.44; 95% CI 0.29-0.66). Other aetiologic factors were assault (0.28; 95% CI 0.19-0.40), fall (0.06; 95% CI, 0.03-0.11), sports injuries (0.03; 95% CI 0.02-0.05) and others (0.04; 95% CI 0.02-0.09).</p><p><strong>Conclusions and relevance: </strong>RTC, motorcycle crash and assault constituted the most important factors for maxillofacial injuries in Nigeria. The result of this study highlights the importance of improved road safety measures and maintenance of law and order.</p>","PeriodicalId":47495,"journal":{"name":"Journal of Maxillofacial & Oral Surgery","volume":"25 5","pages":"1303-1323"},"PeriodicalIF":0.7,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13627591/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149116355","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":"Understanding the Interplay: A Descriptive Synthesis of COVID-19-Associated Mucormycosis in Diabetic Patients.","authors":"Shallu Bansal, Ashish Jakhetiya, Anil Managutti, Manjunath Rai","doi":"10.1007/s12663-026-03131-4","DOIUrl":"https://doi.org/10.1007/s12663-026-03131-4","url":null,"abstract":"<p><strong>Background: </strong>During the COVID-19 pandemic, COVID-19-associated mucormycosis (CAM) emerged as a severe and often fatal complication, particularly among patients with diabetes mellitus. The increase in invasive fungal infections has been strongly linked to diabetes, COVID-19-related immune dysregulation, hyperglycaemia, and widespread corticosteroid use. This systematic review provides a descriptive synthesis of the relationship between COVID-19, mucormycosis, and diabetes, focusing on epidemiology, clinical features, management, and outcomes.</p><p><strong>Methods: </strong>A systematic search of PubMed/MEDLINE, Scopus, Web of Science, and the Cochrane Library was conducted for studies published between 1 April 2020 and 30 November 2025. Studies reporting CAM in diabetic patients were included. Eligible designs comprised case reports, case series, and observational studies. Study selection followed PRISMA 2020 guidelines, and findings were synthesized qualitatively, with stratification by evidence level (case reports/series vs. cohort and cross-sectional studies).</p><p><strong>Results: </strong>Thirty-six studies met the inclusion criteria. Diabetes was present in most CAM cases, with poor glycaemic control and diabetic ketoacidosis frequently reported. Corticosteroid therapy was identified as a major contributing factor. Rhino-orbital-cerebral mucormycosis was the most common presentation. Early antifungal treatment, surgical debridement, and strict glycaemic control were associated with improved outcomes, whereas delayed diagnosis and cerebral involvement were linked to increased mortality. Approximately 40% of the included studies were case reports or case series (Level 4 evidence), necessitating cautious interpretation of findings.</p><p><strong>Conclusion: </strong>Diabetes significantly influences the development and outcomes of CAM. Judicious corticosteroid use, optimal glycaemic control, early diagnosis, and multidisciplinary management are essential to reduce morbidity and mortality. Although conclusions are limited by the predominance of lower-level evidence, consistent patterns highlight diabetes and corticosteroid exposure as major risk factors.</p>","PeriodicalId":47495,"journal":{"name":"Journal of Maxillofacial & Oral Surgery","volume":"25 5","pages":"1622-1632"},"PeriodicalIF":0.7,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13627485/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149116469","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":"Quality and Content of Information on YouTube About Cleft Lip and Cleft Palate: A Systematic Review and Meta-Analysis.","authors":"Shweta Dobhada, Ladusingh Rajpurohit, Preet Lunawat","doi":"10.1007/s12663-026-03261-9","DOIUrl":"https://doi.org/10.1007/s12663-026-03261-9","url":null,"abstract":"<p><strong>Background: </strong>Cleft lip and palate (CLP) is among the most common congenital anomalies, necessitating complex, multidisciplinary care from infancy through adolescence. Caregivers often turn to online resources, particularly YouTube, for supplemental guidance on presurgical management, feeding techniques, and long-term care. However, the reliability and educational value of such freely available video content remain uncertain.</p><p><strong>Methods: </strong>A systematic literature search was conducted in PubMed/MEDLINE, Scopus, Cochrane, and relevant grey literature from 2014 to 2026. Eligible studies were cross-sectional, observational and qualitative study analyses of YouTube videos related to cleft lip and/or palate, reporting content quality using standardized tools such as the Global Quality Score (GQS), DISCERN, PEMAT-AV, VIQI, MQ-VET, or custom indices.</p><p><strong>Results: </strong>A total of eight studies that met the eligibility criteria were included in the systematic review. Seven YouTube video-analysis studies that involved quantifiable methods contributed extracted data from 373 YouTube videos, whereas one study involved qualitative methods, providing narratives on the preferences of parents and their unmet educational needs. GQS was reported in two studies and analyzed exploratorily, resulting in a pooled average of 2.50/5 (95% CI 2.11-2.90; I² = 68.8%), which shows the presence of moderate to low educational quality.</p><p><strong>Conclusions: </strong>The quality and comprehensiveness of YouTube videos on cleft lip and palate remain suboptimal, with considerable variability across topics and uploader types. There is a critical need for improved, peer-reviewed, and user-centered educational resources to better support families and caregivers. Collaborative efforts among clinicians, patient advocates, and digital content creators are essential to elevate the standard of online health information in this domain.</p><p><strong>Supplementary information: </strong>The online version contains supplementary material available at https://doi.org/10.1007/s12663-026-03261-9.</p>","PeriodicalId":47495,"journal":{"name":"Journal of Maxillofacial & Oral Surgery","volume":"25 5","pages":"1507-1517"},"PeriodicalIF":0.7,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13627586/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149116700","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":"Preoperative Pain Intensity, Chronicity, and Referral as Predictors of Postoperative Complications in Impacted Third Molar Surgery: A Systematic Review and Meta-Analysis.","authors":"Chandrashekhar Chattopadhyay, Vikas Deo, Charu Chouhan, Mamta Patel, Ayush Garg, Sugandha Jain, Priti Airun","doi":"10.1007/s12663-025-02875-9","DOIUrl":"https://doi.org/10.1007/s12663-025-02875-9","url":null,"abstract":"<p><strong>Background: </strong>Impacted third-molar extraction is among the most frequently performedoral surgical procedures and remains commonly associated with postoperativecomplications such as pain, alveolar osteitis, neurosensory injury, trismus, and delayedhealing. Emerging evidence suggests that preoperative pain characteristics-intensity,chronicity, and referral patterns-may influence these outcomes throughneuroinflammatory and sensitisation mechanisms, yet findings across studies remaininconsistent.</p><p><strong>Objective: </strong>To systematically review and meta-analyse the predictive value ofpreoperative pain intensity, chronicity, and referral patterns for postoperativecomplications following impacted third-molar surgery.</p><p><strong>Methods: </strong>This review adhered to PRISMA 2020 guidelines and was prospectivelyregistered on PROSPERO (CRD420251123273). Comprehensive searches ofPubMed, Embase, Scopus, Cochrane CENTRAL, Web of Science, and grey literaturewere conducted up to June 2025. Eligible studies included prospective cohorts orrandomised controlled trials assessing preoperative pain using validated scales (VAS/NRS) in patients aged ≥16 years with a minimum follow-up of 7 days. Randomeffects meta-analyses calculated standardised mean differences (SMDs) and riskratios (RRs) with 95% confidence intervals (CIs).</p><p><strong>Results: </strong>From 3,456 records, 28 studies (n = 10,832 patients) met inclusion criteria.Severe preoperative pain (VAS > 60 mm) was associated with significantly higherpostoperative pain at 7 days (SMD 0.78, 95% CI 0.62-0.94; I² = 65%). Chronic pain(≥3 months) increased the risk of alveolar osteitis (RR 1.68, 95% CI 1.35-2.09; I² =50%) and delayed mucosal healing (mean difference 3.8 days, 95% CI 2.5-5.1; I² =70%). Referred preoperative pain doubled the risk of nerve injury (RR 2.05, 95% CI1.28-3.27; I² = 45%). Younger patients (16-19 years) demonstrated strongerassociations.</p><p><strong>Conclusion: </strong>Preoperative pain characteristics are strong and independent predictors ofpostoperative complications after impacted third-molar surgery. Standardised painassessment should be incorporated into preoperative evaluation, and patients withsevere, chronic, or referred pain warrant multimodal analgesia, nerve-sparingtechniques, and extended postoperative monitoring.</p>","PeriodicalId":47495,"journal":{"name":"Journal of Maxillofacial & Oral Surgery","volume":"25 5","pages":"1475-1484"},"PeriodicalIF":0.7,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13627626/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149116638","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}