Medicina Oral Patologia Oral Y Cirugia Bucal最新文献

{"title":"Somatic and psychiatric aspects of complications outside the surgical area in orthognathic surgery: A retrospective study of 429 patients.","authors":"S Kettunen, E Metsäranta, O Lappalainen, J Furuholm, J Snäll","doi":"10.4317/medoral.27718","DOIUrl":"10.4317/medoral.27718","url":null,"abstract":"<p><strong>Background: </strong>We explored postoperative non-surgical site complications in orthognathic surgery (OS) and investigated associations between outcome and patient- and surgery-related variables.</p><p><strong>Material and methods: </strong>This single-centre (Department of Oral and Maxillofacial Diseases, Helsinki University Hospital, Helsinki, Finland) retrospective study included patients ≥18 years undergoing OS between January 2016 and December 2022. Data were manually reviewed from the hospital database. Associations with the outcome were analysed using SPSS software (IBM Corporation, 28.0.0.0).</p><p><strong>Results: </strong>Of 429 patients, 16 (3.7%) had a non-surgical site complication, and a total of 19 complications were recognized. A potentially life-threatening somatic complication occurred in 0.7% of patients. The most common complication was severe psychiatric morbidity, constituting 37% of all recognized complications. In the univariate and multivariable regression model, preoperative long-term disease (aOR 4.729; 95% CI 1.510-14.812; p=.008) and alcohol/substance abuse (p=.027) predicted the outcome independently. No other evaluated variables were associated with the outcome.</p><p><strong>Conclusions: </strong>The results suggest that severe general complications are rare and are associated with patients' long-term diseases. Severe psychiatric complications comprised a significant proportion of all recognized complications. Attention should be paid to patients' somatic and psychiatric status at all stages of treatment.</p>","PeriodicalId":49016,"journal":{"name":"Medicina Oral Patologia Oral Y Cirugia Bucal","volume":" ","pages":"e224-e230"},"PeriodicalIF":2.2,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12983384/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145582674","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical study on hemorrhagic complications in antiplatelet and anticoagulated patients undergoing dental treatment.","authors":"C López-Carriches, R Taheri, C Madrigal-Martínez-Pereda","doi":"10.4317/medoral.27715","DOIUrl":"10.4317/medoral.27715","url":null,"abstract":"<p><strong>Background: </strong>Patients undergoing treatment with antiplatelet or anticoagulant drugs are attending dental consultations. Therefore, it has become essential to evaluate the patient before treatment and to conduct a thorough medical history. The goal of this study is to analyze the patients attending a dental clinic over a period of 6 months to determine how many are taking antiplatelet or anticoagulant medications, what dental treatment they seek, what hemostatic measures are taken, and whether they suffer hemorrhagic complications as a result of the treatment. This will help to prevent such complications by applying appropriate protocols, especially in the field of oral surgery.</p><p><strong>Material and methods: </strong> Over a six-month period, 867 patients attended a dental clinic in Madrid. Of these, 43 were taking antiplatelet agents or anticoagulants. A descriptive statistical analysis was conducted to gather data on age, gender, medication, dental treatment received, and hemorrhagic complications.</p><p><strong>Results: </strong> Only 4.9% of the patients attending the dental clinic were taking antiplatelet or anticoagulant medications. Specifically, 53.48% were taking antiplatelet agents, 34.8% were taking direct oral anticoagulants, and 11.62% were on vitamin K antagonist anticoagulants. After applying the appropriate clinical protocol in each case, only one patient experienced postoperative bleeding, which was not severe.</p><p><strong>Conclusions: </strong> Based on the results, it may not be necessary to withdraw antiplatelet or anticoagulant therapy due to the low incidence and non-severity of complications in simple dental procedures.</p>","PeriodicalId":49016,"journal":{"name":"Medicina Oral Patologia Oral Y Cirugia Bucal","volume":" ","pages":"e219-e223"},"PeriodicalIF":2.2,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12983381/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145582667","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A predictive model for significant periodontal disease progression: A large-scale cohort study.","authors":"G-S Chatzopoulos, L-F Wolff","doi":"10.4317/medoral.27731","DOIUrl":"10.4317/medoral.27731","url":null,"abstract":"<p><strong>Background: </strong>The progression of periodontitis is challenging to predict. This study aimed to develop and validate a machine learning model to identify patients at high risk for significant periodontal disease progression using a large dataset from electronic health records.</p><p><strong>Material and methods: </strong>This retrospective cohort study included 4,117 patients with at least two comprehensive periodontal examinations separated by a minimum of 24 months. The primary outcome was significant progression, defined as a worsening of mean Clinical Attachment Level (CAL) by ≥1mm. A Random Forest Classifier was trained and validated using baseline demographic, behavioral (smoking), systemic (diabetes, high blood pressure), and periodontal (mean probing depth, mean CAL, bleeding on probing) data. Feature importance was analyzed, and a multivariable logistic regression was performed to quantify associations.</p><p><strong>Results: </strong>Over a mean follow-up of 34.7 months, 28.0% of patients experienced significant progression. The Random Forest model demonstrated good predictive performance on the unseen test set, achieving an Area Under the Receiver Operating Characteristic Curve (AUC-ROC) of 0.82, an accuracy of 81.6%, and a recall (sensitivity) of 79.2%. The most influential predictors were baseline mean CAL, smoking status, and age. Logistic regression confirmed these findings, showing that the odds of progression were significantly increased by higher baseline CAL (OR=2.45), current smoking (OR=1.98), a 10-year increase in age (OR=1.62), and a diagnosis of diabetes (OR=1.51).</p><p><strong>Conclusions: </strong>A machine learning model using real-world clinical data can effectively predict significant periodontal disease progression. The findings confirm that a patient's initial disease severity, smoking status, age, and diabetes are the most critical determinants of future risk, highlighting the model's potential utility in personalizing periodontal care.</p>","PeriodicalId":49016,"journal":{"name":"Medicina Oral Patologia Oral Y Cirugia Bucal","volume":" ","pages":"e243-e250"},"PeriodicalIF":2.2,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12983377/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145318617","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Advantages of implantology-related preventive infra-occluded primary teeth extraction in cases of underlying agenesis: A retrospective study of 290 patients.","authors":"A Leporcq, R Nicot, G Raoul, Y Komakli, L Lauwers","doi":"10.4317/medoral.27675","DOIUrl":"10.4317/medoral.27675","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to evaluate the impact of preventive infra-occluded primary teeth extraction in patients with dental agenesis on the success of pre-implantation and implantation treatment, and the preservation of alveolar ridge height.</p><p><strong>Material and methods: </strong>This retrospective analysis included 290 patients with dental agenesis treated at Lille University Hospital between December 2019 and January 2024, including 92 patients with infra-occluded primary teeth. Clinical and radiographic data were collected, and the implant outcomes were compared between those who underwent preventive versus delayed extractions.</p><p><strong>Results: </strong>Preventive extraction was associated with 100% preservation of alveolar ridge height and eliminated the need for vertical bone grafting. In contrast, 28% of patients with delayed extractions experienced vertical bone loss and implant infraposition despite complex grafting procedures. The second primary molars were the most frequently infra-occluded (66.5%), mostly at a moderate degree. The median ages at diagnosis, extraction, and implantation were 14, 17, and 18 years, respectively.</p><p><strong>Conclusions: </strong>Compared to delayed extraction, preventive extraction of infra-occluded teeth in agenesis cases facilitates better implant positioning and reduces the need for complex pre-implant surgeries. Timely intervention is key, particularly in the maxilla, to avoid vertical bone loss and implant complications.</p>","PeriodicalId":49016,"journal":{"name":"Medicina Oral Patologia Oral Y Cirugia Bucal","volume":" ","pages":"e174-e179"},"PeriodicalIF":2.2,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12981633/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145318619","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Proposed modified Brandwein-Gensler histological risk assessment score as prognosticator in oral squamous cell carcinoma.","authors":"D Sharma, S Gupta, G Koshy, K-S Kwatra, V-K Sharma, A Kaur","doi":"10.4317/medoral.27743","DOIUrl":"10.4317/medoral.27743","url":null,"abstract":"<p><strong>Background: </strong>Histopathological parameters significantly impact the prognosis and treatment strategies of oral squamous cell carcinoma (OSCC). Various risk assessment scores and grading systems have been proposed in the past, primarily based on subjective assessment of microscopic features. To modify Brandwein-Gensler risk score by including the worst pattern of invasion-5, perineural invasion and percentage stromal tumor infiltrating lymphocytes(TILs) and evaluate the relationship of the modified score with clinicopathological variables.</p><p><strong>Material and methods: </strong>This retrospective observational study was conducted on 58 OSCC patients. The density of stromal TILs was determined on routine microscopic sections using image analysis software, thereby quantifying lymphocytic host response as percentage stromal lymphocytes. Furthermore, the modified Brandwein-Gensler risk score was derived from the assessment of the worst pattern of invasion-5, perineural invasion and percentage stromal tumor infiltrating lymphocytes. Chi-square test and Univariate analysis were used to find the association of categorical and continuous variables. The Kaplan-Meier and log-rank tests were used to estimate the survival rates.</p><p><strong>Results: </strong>A significant positive association of modified Brandwein-Gensler score was observed with pathological node (p=0.005), tumor grading (p=0.025), depth of invasion(p=0.016) and overall survival (p=0.03), signifying that high score tumors showed poor differentiation, invasive features and lower survival time.</p><p><strong>Conclusions: </strong>A modified, simplified and objective version of Brandwein Gensler histological risk assessment score is derived, revealing a significant association with tumor differentiation, depth of invasion and lymph node involvement.</p>","PeriodicalId":49016,"journal":{"name":"Medicina Oral Patologia Oral Y Cirugia Bucal","volume":" ","pages":"e268-e276"},"PeriodicalIF":2.2,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12983382/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145582705","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An italian multicenter triple-blind randomized controlled trial on photobiomodulation after third molar extraction (BIOSTOTT). A study of italian society for laser in dentistry (SILO).","authors":"I Giovannacci, U Romeo, F Spadari, M Biasotto, M Pentenero, G Pedrazzi, A-A Venuti, M Meleti, G Tenore, D Pergolini, M Porrini, M Bosotti, G Ottaviani, K Rupel, M Val, P Vescovi","doi":"10.4317/medoral.27834","DOIUrl":"10.4317/medoral.27834","url":null,"abstract":"<p><strong>Background: </strong>Surgical extraction of third molars is a common oral and maxillo-facial surgery procedure frequently associated with postoperative complications, such as pain, swelling, and trismus. Photobiomodulation (PBM), also known as Low-Level Laser Therapy (LLLT), involves the use of low-intensity laser to promote tissue healing, reduce inflammation, and relieve pain. This study evaluated the effectiveness of PBM following surgical extraction of mandibular third molars.</p><p><strong>Material and methods: </strong>This was a prospective, multicenter, randomized, triple-blind clinical trial conducted across five Italian centers. Seventy-nine patients were randomly assigned to a test group (PBM) or control group (no PBM). PBM was delivered immediately after surgery and on the following two days, using a multiband diode laser (445, 660 and 970nm). Primary outcomes were postoperative pain, facial swelling, and trismus. Secondary outcomes included health-related quality of life and analgesic consumption. Covariates included patient age, gender, the extracted tooth and the impaction classification according to Pell & Gregory and Winter. The time of the surgical procedure, measured in seconds from incision to final suture, was also documented. Descriptive statistics were calculated for all variables. Normality was assessed using the Shapiro-Wilk test, and homogeneity of variances was evaluated using Levene's test. Between-group comparisons for continuous outcomes were performed using Student's t-test or the Mann-Whitney U test, depending on data distribution. Categorical vari-ables were analyzed with chi-square or Fisher's exact test. A p-value< 0.05 was considered statistically significant.</p><p><strong>Results: </strong>No statistically significant differences were found between groups for any of the measured outcomes. However, trends favored the PBM group, particularly regarding reduced pain and improved quality of life.</p><p><strong>Conclusions: </strong>The study was powered to detect a large effect size (Cohen's d=0.8); therefore, the lack of statistical significance suggests that any true effect, if present, is likely smaller than this threshold. Further studies with larger sample sizes and standardized protocols are needed to explore smaller yet clinically relevant effects.</p>","PeriodicalId":49016,"journal":{"name":"Medicina Oral Patologia Oral Y Cirugia Bucal","volume":" ","pages":"e344-e355"},"PeriodicalIF":2.2,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12983389/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145582702","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The mouth as a window: A multi-center retrospective study of oral extraintestinal manifestations of IBD and their management.","authors":"M-A Aristizabal-Torres, M Janovska, L-P Loeb, Y Ma, R-S Rogers-Iii, F-A Farraye, A-J Bruce, V Chedid, J-G Hashash, K-J Bodiford","doi":"10.4317/medoral.27830","DOIUrl":"10.4317/medoral.27830","url":null,"abstract":"<p><strong>Background: </strong>Up to 50% of patients with inflammatory bowel disease (IBD) have associated oral extraintestinal manifestations (OEIMs). We aim to describe the prevalence of OEIMs in IBD and propose a therapeutic algorithm.</p><p><strong>Material and methods: </strong>Electronic health records of adult patients with IBD who presented with at least one oral symptom between January 2017 and November 2021 at a tri-state tertiary academic medical center were retrospectively reviewed. Data included demographics, IBD history, oral diagnoses, OEIM treatments, clinical outcomes, and comorbidities.</p><p><strong>Results: </strong>A total of 116 patients were included; 67 (57.8%) had Crohn's disease (CD) and 49 (42.2%) had ulcerative colitis (UC). Aphthous ulcers were the most common OEIM (80.2%). Frequently used treatments included compounded or mixed mouthwashes (51.7%), topical corticosteroids (33.6%), systemic corticosteroids (20.7%), and topical anesthetics (19.8%). In CD, colchicine was significantly associated with OEIM improvement (p=0.009). In UC, systemic corticosteroids (p=0.03), colchicine (p=0.048), and topical tacrolimus (p=0.048) were significantly associated with improvement.</p><p><strong>Conclusions: </strong>OEIMs are common in IBD and can influence treatment decisions. Colchicine and topical agents demonstrated benefit in selected cases. These findings support multidisciplinary care and inform a therapeutic algorithm for OEIM management in IBD.</p>","PeriodicalId":49016,"journal":{"name":"Medicina Oral Patologia Oral Y Cirugia Bucal","volume":" ","pages":"e336-e343"},"PeriodicalIF":2.2,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12983385/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145582152","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Immunological and tissue reactions to titanium particles generated by the mechanical decontamination of dental implants: In vitro and in vivo study.","authors":"J Gil, D Fonseca, M Fernández-Domínguez, P Fernández-Domínguez, S Akagi-Camacho, J Toledano-Serrabona, E Vegas-Bustamante, O Camps-Font, M-Á Sánchez-Garcés, J-M Aragoneses","doi":"10.4317/medoral.27171","DOIUrl":"10.4317/medoral.27171","url":null,"abstract":"<p><strong>Background: </strong>Mechanical decontamination of biofilm, or implantoplasty, is a commonly employed technique for managing peri-implantitis. However, the inflammatory response and in vivo behavior of tita-nium (Ti) particles released during this procedure remain underexplored. This study aimed to evaluate the cytotoxic, inflammatory, and osteogenic effects of Ti particles released during im-plantoplasty, as well as their in vivo behavior Material and Methods: Titanium particles were generated by following a standardized protocol using drills on 150 commercially pure Ti implants. Cytotoxicity thresholds were determined using THP-1 macrophages and bone marrow-derived mesenchymal stem cells (BM-MSCs). These cells were subsequently cultured with Ti particle-conditioned medium, and inflammatory responses were analyzed using RT-qPCR for markers such as CCR7, TNF-?, IL-1? (pro-inflammatory), and CD206, TGF-?, IL-10 (anti-inflammatory). Cytokine levels were quantified using ELISA. Osteogenic responses in BM-MSCs were assessed by analyzing Runx2, alkaline phosphatase (ALP), and osteocalcin (OC) expression, and ALP activity was measured colorimetrically. In vivo, Ti particles were introduced into mandibular defects in 30 Wistar rats, with histological analysis performed 20 days post-implantation Results: Ti particles elicited a pro-inflammatory response in macrophages, with increased expression of TNF-? and reduced expression of TGF-? and CD206. Cytokine analysis confirmed elevated IL-1? and reduced IL-10 levels. No significant changes in ALP activity were observed.</p><p><strong>Conclusions: </strong>Titanium particles released during implantoplasty induce pro-inflammatory responses.</p>","PeriodicalId":49016,"journal":{"name":"Medicina Oral Patologia Oral Y Cirugia Bucal","volume":" ","pages":"e11-e18"},"PeriodicalIF":2.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12743387/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145318668","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Photobiomodulation for the management of inferior alveolar nerve paresthesia after implant surgery: A randomized clinical trial.","authors":"M Gerayeli, J Sarabadani, M Jalaiean-Nasrabadi, Z Ghasemi","doi":"10.4317/medoral.27602","DOIUrl":"10.4317/medoral.27602","url":null,"abstract":"<p><strong>Background: </strong>Photobiomodulation (PBM) has shown promise for managing nerve paraesthesia. This trial assessed the efficacy of an 810-nm diode laser on deep-mechanical, superficial-mechanical and thermal sensitivity for inferior alveolar nerve paresthesia after implant surgery.</p><p><strong>Material and methods: </strong>Twenty-four adults with recent implant-related paraesthesia were randomly assigned, in a parallel design, to an intervention or control group; both groups received routine vitamin-B supplementation. The intervention group underwent eight diode-laser sessions (200 mW power and 6 J/cm2 energy density) over four weeks, directed at peri-implant mucosa and adjacent cheek skin. The control group attended identical sessions with an inactive laser. Blinded examiners recorded visual-analogue-scale (VAS) scores for the Clamp (deep mechanical), Swab (light mechanical) and Ice (thermal) tests at baseline and at two and four weeks after the final session. Data were analysed with the Shapiro-Wilk test, independent-samples t-test and Friedman test (α=0.05).</p><p><strong>Results: </strong>All twenty-four randomised participants (mean age 51±7 years) completed follow-up. Baseline VAS scores did not differ between groups (p>0.44). Although both groups improved over time, the VAS scores for paresthesia reductions in the PBM group were significantly greater than those in the control group at both follow-ups for all three tests (all p<0.001). No adverse events were reported.</p><p><strong>Conclusions: </strong>Eight sessions of 810-nm PBM produced faster and more pronounced sensory recovery than sham treatment in patients with implant-related paraesthesia.</p>","PeriodicalId":49016,"journal":{"name":"Medicina Oral Patologia Oral Y Cirugia Bucal","volume":" ","pages":"e112-e117"},"PeriodicalIF":2.1,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12742888/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145582719","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of five fixation methods for mandibular sagittal split osteotomy in a significant advancement with counterclockwise rotation: a finite element study.","authors":"G-C Mendes, G-B Klein, C Laskarides, A Viswanath, B-E Costa, O Magro-Filho, M Pereira-Silva, P-D Ribeiro-Junior","doi":"10.4317/medoral.27600","DOIUrl":"10.4317/medoral.27600","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to evaluate the biomechanical behavior of five different fixation methods used in bilateral sagittal split osteotomy (BSSO), focusing on their performance with miniplates and monocortical screws during 10-mm advancement and 20º counterclockwise rotation of the occlusal plane.</p><p><strong>Material and methods: </strong>A three-dimensional model of a human mandible, derived from computerized tomography scans and including all teeth except the third molars, was utilized. The BSSO procedure was simulated using SolidWorks 2017 CAD software (Dassault Systemes, SolidWorks Corp, USA) according to the techniques outlined by Epker. Five fixation models were tested: Model M1, one straight 4-hole miniplate with four monocortical screws; Model M2, two straight 4-hole miniplates with eight monocortical screws; Model M3, one 10-hole double miniplate with two bridges and ten monocortical screws; Model M4, one 8-hole 20º angled double miniplate with two bridges and eight monocortical screws; and Model M5, one semi-curved 6-hole miniplate with six monocortical screws. Each model was subjected to two loading patterns: 100 N posteriorly and 50 N anteriorly. The biomechanical performance was analyzed qualitatively and quantitatively, focusing on the bone, screws, and plates.</p><p><strong>Results: </strong>Models M1 and M3 exhibited the poorest biomechanical stability; Model M2 demonstrated the highest stability; and Model M5 showed the best load distribution.</p><p><strong>Conclusions: </strong>A model using two straight 4-hole plates offers more stable osteosynthesis, whereas a semi-curved plate with six nonlinear screws ensures effective load distribution with reduced stress concentration.</p>","PeriodicalId":49016,"journal":{"name":"Medicina Oral Patologia Oral Y Cirugia Bucal","volume":" ","pages":"e104-e111"},"PeriodicalIF":2.1,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12742884/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145293786","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}