Journal of Maxillofacial & Oral Surgery最新文献

{"title":"The Interrelationship Between Trigeminal Neuralgia and Dental Conditions: A Systematic Review of Diagnostic Pitfalls and Clinical Implications.","authors":"Samer H Sharkiya, Rahaf B Salem","doi":"10.1007/s12663-026-03134-1","DOIUrl":"https://doi.org/10.1007/s12663-026-03134-1","url":null,"abstract":"<p><strong>Background: </strong>Trigeminal neuralgia (TN) is a severe neuropathic pain disorder frequently misdiagnosed as odontogenic pain, often leading to unnecessary dental procedures and delayed neurological diagnosis.</p><p><strong>Methods: </strong>A systematic review was conducted in PubMed, Scopus, Web of Science, and CINAHL for English-language studies published between January 2015 and January 2025, following PRISMA 2020 guidelines. Observational studies involving human participants that examined the relationship between TN and dental conditions were included. Study quality was appraised using Joanna Briggs Institute (JBI) critical appraisal tools. Due to methodological heterogeneity, findings were synthesized narratively.</p><p><strong>Results: </strong>Ten studies were included, comprising retrospective cohorts, case series, and one cross-sectional study, with a total of 698 participants. Across studies, dental procedures-particularly extractions, endodontic treatment, and implant placement-frequently preceded TN diagnosis, most commonly reflecting misdiagnosis rather than causation. In other cases, post-procedural trigeminal neuropathic pain developed following dental interventions, suggesting iatrogenic nerve injury and inflammatory sensitization as contributing mechanisms. Overall methodological quality was moderate, limiting causal inference.</p><p><strong>Conclusion: </strong>TN and dental conditions exhibit a complex clinical overlap driven primarily by diagnostic misattribution and, in some cases, iatrogenic nerve injury. Early recognition of TN features and interdisciplinary collaboration are essential to prevent unnecessary dental interventions. Prospective studies are needed to clarify causal pathways and optimize diagnostic strategies.</p><p><strong>Supplementary information: </strong>The online version contains supplementary material available at https://doi.org/10.1007/s12663-026-03134-1.</p>","PeriodicalId":47495,"journal":{"name":"Journal of Maxillofacial & Oral Surgery","volume":"25 5","pages":"1603-1610"},"PeriodicalIF":0.7,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13627620/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149116445","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":"Evolution of Diagnostic Strategies for Temporomandibular Joint Disorders: A Scoping Review (2009-2025).","authors":"Ranokhon A Jalolova, Shukhrat A Boymuradov, Nigora A Djalalova","doi":"10.1007/s12663-026-03046-0","DOIUrl":"https://doi.org/10.1007/s12663-026-03046-0","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Diagnostic approaches to temporomandibular joint (TMJ) disorders have evolved substantially in recent years with the development of advanced imaging technologies, functional diagnostic tools, and emerging biomarker-based research.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;To evaluate temporal trends in diagnostic methods used for TMJ disorders and to examine how major diagnostic modalities have evolved between 2009 and 2025.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A scoping review was conducted using the Arksey and O'Malley methodological framework and reported according to PRISMA-ScR guidelines. A structured literature search was performed in MEDLINE/PubMed, Scopus, and Web of Science, with Google Scholar used as a supplementary source. Publications from January 2009 to December 2025 were screened. A total of 9,024 records were identified; after duplicate removal, screening, and methodological appraisal using Joanna Briggs Institute tools, 187 studies were included in the final synthesis. Studies were categorized into three time intervals (2009-2014, 2015-2019, and 2020-2025) and grouped according to four diagnostic domains: radiologic imaging, functional diagnostics, psychometric and clinical assessment, and biomarker-based approaches.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Psychometric instruments, particularly RDC/DC-TMD criteria and the Visual Analog Scale, were reported in approximately 50-60% of clinical studies. Imaging trends demonstrated a clear shift from planar radiography toward three-dimensional modalities. Reports involving CT increased from 246 to 751, and CBCT from 108 to 329, while the use of orthopantomography and cephalography declined to less than 10% in the most recent period. MRI usage nearly doubled (434-789 reports), maintaining its role as the reference standard for soft-tissue evaluation. Ultrasonography showed growing adoption as a radiation-free adjunct diagnostic method.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;TMJ diagnostics have undergone a substantial evidence-driven transition over the past sixteen years. The shift from planar radiography to three-dimensional modalities-primarily CBCT for osseous pathology and MRI for soft-tissue assessment-enables earlier detection of structural changes that directly influence treatment selection and outcomes. Progressive adoption of the DC/TMD framework has improved diagnostic consistency and supports more targeted clinical decision-making. Functional diagnostics and emerging biomarker research are expanding individualized assessment, although further standardization is required before routine implementation. Taken together, these transitions support a phenotype-oriented multimodal diagnostic strategy: CBCT for suspected osseous involvement, MRI for internal derangement or inflammatory pathology, functional tools for myofunctional presentations, and biomarker or contrast-enhanced imaging in patients with suspected systemic inflammatory disease. Integrating these modalities ","PeriodicalId":47495,"journal":{"name":"Journal of Maxillofacial & Oral Surgery","volume":"25 5","pages":"1451-1466"},"PeriodicalIF":0.7,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13627510/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149116708","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":"Custom-Made Subperiosteal Implant-Assisted Rehabilitation in Post COVID-19 Rhino-orbital Mucormycosis Defects: A Systematic Review.","authors":"Babu Lal, Dhanya Naik, Ragavi Alagarsamy, Shreeya Sharma","doi":"10.1007/s12663-026-03111-8","DOIUrl":"https://doi.org/10.1007/s12663-026-03111-8","url":null,"abstract":"<p><strong>Background: </strong>Custom-made subperiosteal dental implants (CMSDIs) have shown potential as a reconstructive solution for rehabilitating maxillary defects following post-COVID-19 rhino-orbital mucormycosis (PCROM). This systematic review evaluates the clinical outcomes of CMSDIs in such defects.</p><p><strong>Materials and methods: </strong>A systematic search was conducted across PubMed, Google Scholar, Semantic Scholar, and the Cochrane Library for studies published through March 2025. Data regarding patient demographics, implant materials, design techniques, surgical approaches, prosthetic rehabilitation, and postoperative complications were extracted. A descriptive analysis of the included studies was performed.</p><p><strong>Results: </strong>A total of seven studies (two case series and five case reports) were published between 2022 and 2024, involving 46 patients (aged 30-67 years). All studies were from India. The software used for planning and designing included Mimics^®(<i>n</i> = 2), Exocad(<i>n</i> = 1), and Geomagic(<i>n</i> = 1). Titanium implants were used, milled(<i>N</i> = 1), and 3D printed(<i>N</i> = 6). CMSDI placement was performed between 6 and 12 months post-surgery in 93.47% (43/46). Abutments were cement retained(<i>n</i> = 41) and screw-retained(<i>n</i> = 5). Rehabilitation was performed immediately(<i>n</i> = 20), < 1 month(<i>n</i> = 2), 1 to 4 months(<i>n</i> = 22), and after 4 months(<i>n</i> = 1). The overall complication rate was 26.08%(12/46), and complications were prosthetic-related (66.66%,8/12), surgical (25%, <i>n</i> = 3), and implant-related (8.33%, <i>n</i> = 1). Follow-up duration ranged from three to 12 months.</p><p><strong>Conclusion: </strong>CMSDIs demonstrate potential as a reconstructive option for PCROM defects, with a complication rate of 26.08%, predominantly prosthetic-related. However, the evidence remains preliminary, derived exclusively from case reports and case series with short follow-up and restricted to Indian populations, limiting generalizability. Well-designed multi-center prospective trials are urgently required to validate long-term effectiveness and comparative advantages of CMSDIs.</p><p><strong>Trial registration: </strong>Prospero No: CRD420251022490.</p><p><strong>Supplementary information: </strong>The online version contains supplementary material available at https://doi.org/10.1007/s12663-026-03111-8.</p>","PeriodicalId":47495,"journal":{"name":"Journal of Maxillofacial & Oral Surgery","volume":"25 5","pages":"1539-1548"},"PeriodicalIF":0.7,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13627549/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149116504","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":"Evaluating MCM3 Expression as a Diagnostic and Prognostic Marker in Oral Epithelial Dysplasia and OSCC: A Systematic Review.","authors":"Saloni Verma, Ayushi Jain, Arushi Tomar, Fahad M Samadi, Shaleen Chandra, Shalini Gupta","doi":"10.1007/s12663-025-02858-w","DOIUrl":"https://doi.org/10.1007/s12663-025-02858-w","url":null,"abstract":"<p><strong>Background: </strong>Oral squamous cell carcinoma (OSCC) is a prevalent malignancy in developing countries, with high morbidity and mortality rates. Proliferative markers play a crucial role in diagnosing and prognosticating OSCC. Among these, Minichromosome Maintenance Protein 3 (MCM3) has shown potential as a reliable marker, outperforming conventional markers like Ki-67 due to its specificity and sensitivity.</p><p><strong>Objective: </strong>To evaluate the expression of MCM3 in OSCC and its precursors, compare it with other proliferative markers, and assess its potential as a diagnostic and prognostic biomarker.</p><p><strong>Methods: </strong>An electronic literature search was conducted across databases such as PubMed, Scopus, Google Scholar, Web of Science and Cochrane Library. Studies meeting the inclusion criteria-OSCC cases, MCM3 assessment via IHC, and data on tumor grade and stage were analyzed. Risk of bias was evaluated using the JBI checklist, and quantitative data were synthesized in Microsoft Excel from nine eligible articles.</p><p><strong>Results: </strong>Positive nuclear expression of MCM3 was observed in 92.6% of OSCC cases, with higher expression intensity correlating with advanced tumor grade and stage. Compared to Ki-67, MCM3 demonstrated superior sensitivity in OSCC, with less influence from external factors like inflammation. Digital analysis revealed higher labeling indices for MCM3 in OSCC compared to controls, reinforcing its reliability as a proliferative marker.</p><p><strong>Conclusions: </strong>MCM3 is a promising biomarker for OSCC diagnosis and prognosis, offering improved sensitivity and specificity over the conventional markers. Large-scale, multi-center studies are needed to validate its clinical applicability and facilitate its integration into personalized treatment strategies.</p>","PeriodicalId":47495,"journal":{"name":"Journal of Maxillofacial & Oral Surgery","volume":"25 5","pages":"1282-1290"},"PeriodicalIF":0.7,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13627557/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149116576","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 Evidence to Action: Strengthening Evidence Synthesis in Oral and Maxillofacial Surgery.","authors":"Sonal Anchlia","doi":"10.1007/s12663-026-03281-5","DOIUrl":"https://doi.org/10.1007/s12663-026-03281-5","url":null,"abstract":"","PeriodicalId":47495,"journal":{"name":"Journal of Maxillofacial & Oral Surgery","volume":"25 5","pages":"1219-1221"},"PeriodicalIF":0.7,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13627547/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149116635","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 Systematic Review on Post-Operative Trismus Following Reconstruction of Oral Cavity Using Various Flaps.","authors":"Sakshi Gaikwad, Sonal Shah","doi":"10.1007/s12663-025-02629-7","DOIUrl":"https://doi.org/10.1007/s12663-025-02629-7","url":null,"abstract":"<p><strong>Aim: </strong>To evaluate effectiveness between various surgical modalities like free flap reconstruction (FFR) and coronoidectomy among patients with head and neck cancer.</p><p><strong>Methods: </strong>Review was adhered Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines 2020 and registered in PROSPERO-CRDXXXXX. Electronic databases were searched for randomized controlled trials (RCTs), prospective and retrospective studies evaluating the effectiveness between FFR and coronoidectomy in terms of trismus width release and maximum mouth opening (MMO) with a follow-up period of six months. Quality assessment of included studies was evaluated through Newcastle-Ottawa Scale (NOS). The standardized mean difference (SMD) was used as summary statistic measure with random effect model through Review manager (RevMan) version 5.3.</p><p><strong>Results: </strong>Four studies (3-retrospective and 1-prospective) fulfilled the eligibility criteria and were included in qualitative synthesis and for meta-analysis. All the included studies had presence of moderate to low risk of bias. Although both the surgical modalities were equally effective, meta-analysis showed that total trismus width loss on an average was 0.69 (-2.34 - 0.95) times reduced postoperatively through FFR, while coronoidectomy showed total trismus width loss of 0.24 (- 1.00 - 0.52) (<i>p</i> > 0.05). Funnel plot did not show the presence of any publication bias.</p><p><strong>Conclusion: </strong>Both the surgical modalities were equally effective; however, FFR showed more overall mean reduction in total trismus width loss postoperatively. However, furthermore comparative and prospective studies with larger sample size and greater follow-up period with vigorous methodology and proper standardization should be conducted to validate these study findings.</p>","PeriodicalId":47495,"journal":{"name":"Journal of Maxillofacial & Oral Surgery","volume":"25 5","pages":"1518-1526"},"PeriodicalIF":0.7,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13627513/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149116342","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":"Superior Orbital Fissure Syndrome Following Craniofacial Trauma: A Systematic Review of Reported Cases.","authors":"Gomati Dhandai, Satta Ram, D Shanmuga Sundaram, M Nagaraj, Shubham Chopra, Akanksha Vats, Poonam Yadav","doi":"10.1007/s12663-026-03115-4","DOIUrl":"https://doi.org/10.1007/s12663-026-03115-4","url":null,"abstract":"<p><strong>Background and purpose: </strong>Superior orbital fissure syndrome (SOFS) is a rare sequela of craniofacial trauma caused by dysfunction of cranial nerves III, IV, V1, and VI. It typically presents with ophthalmoplegia, ptosis, pupillary abnormalities, and sensory deficits. Due to its rarity and heterogeneity, optimal management remains unclear. The purpose of this study was to systematically review the literature on traumatic SOFS, focusing on demographic profile, clinical presentation, diagnostic modalities, management strategies, and outcomes.</p><p><strong>Methods: </strong>A systematic review was conducted in accordance with PRISMA guidelines. Electronic databases (PubMed/MEDLINE, Scopus, Web of Science, and Google Scholar) were searched from inception to 31 December 2025. Studies reporting traumatic SOFS with adequate clinical and outcome data were included. Extracted variables included demographics, etiology, clinical features, imaging findings, treatment modalities, and outcomes.</p><p><strong>Results: </strong>A total of 23 studies comprising 61 patients were included. The mean age was 31.9 years (range: 7-75 years), with a male predominance (2.4:1). Most cases were associated with craniofacial trauma, particularly zygomaticomaxillary complex and orbital fractures, although some occurred without fractures due to edema or hematoma. The most common clinical features were ophthalmoplegia, ptosis, fixed dilated pupil, proptosis, and sensory deficits in the ophthalmic division of the trigeminal nerve. Diagnosis was primarily based on clinical examination and computed tomography, with magnetic resonance imaging used selectively. Management included observation, corticosteroid therapy (31.1%), and surgical intervention such as open reduction and internal fixation or decompression. Favorable outcomes were observed in most cases, with most patients demonstrating complete or partial recovery within 1-6 months. Steroid therapy was associated with higher recovery rate (78.9%) compared to non-steroid management (61.9%).</p><p><strong>Conclusion: </strong>Traumatic SOFS is an uncommon but clinically significant condition with a generally favorable prognosis. Early diagnosis and individualized management remain essential for optimizing neurological and functional outcomes. Although a higher proportion of complete recovery was observed among patients receiving corticosteroid therapy, the available evidence is derived predominantly from heterogeneous, low-quality, observational, and non-comparative studies, precluding definitive conclusions regarding treatment efficacy or superiority. Accordingly, the current findings should be interpreted cautiously and considered primarily descriptive and hypothesis-generating.</p>","PeriodicalId":47495,"journal":{"name":"Journal of Maxillofacial & Oral Surgery","volume":"25 5","pages":"1340-1352"},"PeriodicalIF":0.7,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13627511/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149116380","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 Advances and Current Intraarticular Injectables in Treating Temporomandibular Joint Osteoarthritis-A Scoping Review of the Past 10 Years.","authors":"Fahad S Al Qooz, Dina N Smeirat, Mohammad S Al Olaimat, Hamzeh Z Alzoubi, Zaid R Alzoubi, Mohammed A Alkhawaldeh","doi":"10.1007/s12663-025-02673-3","DOIUrl":"https://doi.org/10.1007/s12663-025-02673-3","url":null,"abstract":"<p><strong>Background: </strong>Temporomandibular joint (TMJ) dysfunction occurs in 5-12% of the overall population. One of its well-known treatments is arthrocentesis (AC). AC has also been advocated in conjunction with the use of post-AC intraarticular injectables such as hyaluronic acid (HA), platelet-rich plasma (PRP), fibrin, and corticosteroids.</p><p><strong>Aim: </strong>The objective of this study was to review and compare current intraarticular injectables and the new agents used in the treatment of TMJ osteoarthritis.</p><p><strong>Materials and methods: </strong>Articles were screened using PubMed/Medline and Scopus. We identified 106 articles using the following Medical Subject Headings (MeSH): 'Temporomandibular Joint', 'Osteoarthritis', and 'Intraarticular Injection'. Articles were published from 2014 to September 2024. The inclusion criterion was English full-length articles that were prospective randomized control trials, including single- or double-blinded trials. Search limitations while utilizing Medical Subject Headings (MeSH) were placed to include only randomized control trials. The exclusion criterion was articles that did not fulfill the aim of our study.</p><p><strong>Results: </strong>A total of 10 articles fulfilled our inclusion criteria and included a total of 468 patients, 77% of whom were female. Patients who underwent AC with or without intraarticular injections were examined. In most studies, the best outcomes were observed in the groups that underwent AC combined with PRP and HA.</p><p><strong>Conclusion: </strong>HA combined with PRP after AC has been demonstrated to be superior to all intraarticular injectables followed by PRP after AC. Further studies need to be conducted to compare other new intraarticular injections.</p>","PeriodicalId":47495,"journal":{"name":"Journal of Maxillofacial & Oral Surgery","volume":"25 5","pages":"1443-1450"},"PeriodicalIF":0.7,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13627564/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149116484","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":"Efficacy of Facial Reanimation Surgery in Unilateral Facial Paralysis: A Systematic Review with a Focus on the Six-Month Surgical Decision Window.","authors":"Wardah Rahmatul Islamiyah, Fidiana, Indri Lakhsmi Putri, Rachmaniar Pramanasari, Yanuar Ari Pratama, Citrawati Dyah Kencono Wungu, Tedy Apriawan, Gunna Hutomo Putra, Jovian Philip Swatan","doi":"10.1007/s12663-026-03086-6","DOIUrl":"https://doi.org/10.1007/s12663-026-03086-6","url":null,"abstract":"<p><strong>Background: </strong>Unilateral facial paralysis (UFP) results in profound functional and psychosocial impairment. The six-month threshold is a critical clinical crossroads where spontaneous recovery becomes unlikely, yet mimetic muscles remain receptive to reinnervation. This systematic review evaluates the efficacy of facial reanimation surgery in patients with persistent UFP of diverse etiologies lasting at least six months.</p><p><strong>Methods: </strong>Following PRISMA guidelines, we searched PubMed, Cochrane Library, ScienceDirect, and Web of Science for studies published between 2015 and 2025. Six studies involving 133 patients met the inclusion criteria. Quality was appraised using the Newcastle Ottawa Scale (NOS). Due to substantial heterogeneity in surgical techniques and outcome measures, a qualitative narrative synthesis was performed.</p><p><strong>Results: </strong>The five retrospective cohort studies and one prospective study included in this review suggest that surgical intervention beyond the six month threshold is associated with favorable functional recovery. Nerve transfer procedures frequently linked to improved House Brackmann and Sunnybrook scores. Free gracilis muscle transfer demonstrated positive trends in smile excursion, particularly with the U-shaped technique, while direct muscle neurotization showed limited benefit. Despite a low risk of bias on the NOS, the primarily retrospective nature of these studies warrants a cautious interpretation of the observed clinical trends.</p><p><strong>Conclusions: </strong>Surgical reanimation for UFP beyond six months demonstrates promising clinical trends. However, this review does not establish the definitive superiority of any single surgical technique. Selection requires a highly individualized approach, and standardized reporting remains essential for future research to refine technique selection and optimize patient outcomes.</p><p><strong>Supplementary information: </strong>The online version contains supplementary material available at https://doi.org/10.1007/s12663-026-03086-6.</p>","PeriodicalId":47495,"journal":{"name":"Journal of Maxillofacial & Oral Surgery","volume":"25 5","pages":"1527-1538"},"PeriodicalIF":0.7,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13627588/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149116592","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":"Head and Neck Reconstruction with Distant Axial and Pedicled Flaps: Summarizing the Options. Systematic Review of the Literature.","authors":"Remo Accorona, Alice Cremasco, Virginia Dallari, Sandra Gazzini, Carola Micolitti, Domenico di Furia, Niccolò Mevio, Armando De Virgilio, Haissan Iftikhar, Luca Calabrese, Alberto Giulio Dragonetti, Luca Gazzini","doi":"10.1007/s12663-025-02774-z","DOIUrl":"https://doi.org/10.1007/s12663-025-02774-z","url":null,"abstract":"<p><strong>Introduction: </strong>Head and neck oncologic reconstruction requires adaptable flaps to restore function and esthetics. The systematic review assesses the efficacy and complications of five distant axial pedicled flaps (DAPF): pectoralis major myocutaneous flap (PMMF), supraclavicular artery island flap (SAIF), deltopectoral flap (DPF), trapezius muscle flap (TMF), and latissimus dorsi pedicled flap (LDPF).</p><p><strong>Materials and methods: </strong>Adhering to PRISMA guidelines, we reviewed data from 131 studies encompassing 5481 patients. Inclusion criteria were limited to studies evaluating adult head and neck cancer patients reconstructed with one of the five options. Parameters analyzed included size, location, early and late complications, functional and aesthetic outcomes.</p><p><strong>Results: </strong>PMMF was the most frequently used flap (77%), covering an average defect size of 67.7 cm², and proved effective for extensive and complex reconstructions. Both SAIF and DPF flaps were advantageous for medium defects, with SAIF showing superior aesthetic satisfaction and low complication rates (2%). PMMF had higher dehiscence rates (9%) and flap necrosis (< 1%).</p><p><strong>Conclusions: </strong>Pedicled flaps offer reliable reconstructive options when free flaps are contraindicated. PMMF is optimal for large defects, while SAIF is preferred for medium defects prioritizing aesthetics. Other options are rarely contemplated. Future studies should aim to standardize outcome measures and investigate long-term functional outcomes.</p>","PeriodicalId":47495,"journal":{"name":"Journal of Maxillofacial & Oral Surgery","volume":"25 5","pages":"1549-1566"},"PeriodicalIF":0.7,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13627602/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149116651","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}