Oral and maxillofacial surgery最新文献

{"title":"Beyond reconstruction: minimally invasive aesthetic and regenerative medicine in postoperative oral and maxillofacial surgery.","authors":"Michael Alfertshofer, Alexander G M Hopf, Kilian Kreutzer, Carolin Bestendonk, Christian Doll, Sebastian Cotofana, Norbert Neckel, Max Heiland, Marietta Hopf","doi":"10.1007/s10006-026-01651-4","DOIUrl":"10.1007/s10006-026-01651-4","url":null,"abstract":"<p><strong>Purpose: </strong>Oral and maxillofacial reconstruction restores anatomical continuity and function after tumor resection, trauma and congenital deformity, yet patients frequently remain affected by fibrosis, scar tethering, impaired oral competence, asymmetry and altered dynamic facial function. These deficits can impair quality of life, social interaction and body image. Conventional revision surgery carries additional morbidity, and minimally invasive options have emerged as a postoperative adjunct. This article reviews how minimally invasive aesthetic and regenerative medicine can extend reconstructive rehabilitation in oral and maxillofacial surgery.</p><p><strong>Methods: </strong>Current biological and clinical evidence for polynucleotides (PN), hyaluronic acid (HA) and botulinum toxin A (BoNT-A) was reviewed and integrated with selected, non-consecutive illustrative cases from a dedicated aesthetic and regenerative consultation in an academic oral and maxillofacial surgery department. Clinical applications were illustrated across four patient categories: oncological, congenital, trauma/scar and aesthetic-functional sequelae after surgery.</p><p><strong>Results: </strong>In illustrative cases from different categories, a staged approach of tissue conditioning, structural restoration and dynamic neuromodulation was associated with clinically observed and patient-reported improvements in scar pliability, tissue gliding, oral competence, dynamic symmetry and quality of life. PN were used primarily for regenerative tissue conditioning, HA for reversible structural restoration, and BoNT-A to modulate muscular imbalance and pathological wound tension. As interventions were frequently combined and no validated outcome measures or controls were used, these observations are hypothesis-generating.</p><p><strong>Conclusion: </strong>Minimally invasive regenerative and aesthetic treatment may serve as a functional extension of reconstruction rather than a cosmetic adjunct. The central concept is not volumisation, but restoration of tissue quality, dynamic balance and facial function. Prospective studies using validated functional, scar and patient-reported outcome measures are required to define its role in modern oral and maxillofacial surgery.</p>","PeriodicalId":520733,"journal":{"name":"Oral and maxillofacial surgery","volume":"30 1","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13658573/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149167808","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":"Selective preoperative lower extremity computed tomography angiography before mandibular reconstruction: Identifying patients unlikely to require fibula free flap reconstruction.","authors":"Jannik Ketschau, Jonathan Mohr, Yannik Leonhardt, Alex Grabenhorst, Hannes Singer, Helena Kram, Nils Krautkremer, Minli Niu, Katharina Pippich, Klaus-Dietrich Wolff, Lucas M Ritschl","doi":"10.1007/s10006-026-01646-1","DOIUrl":"10.1007/s10006-026-01646-1","url":null,"abstract":"<p><strong>Purpose: </strong>Not every patient undergoing mandibular continuity resection requires free fibula flap (FFF) reconstruction. Whether clinical judgment reliably identifies patients unlikely to benefit from preoperative lower-extremity computed tomography angiography (CTA) remains unknown, despite the relevance of this question for cost-conscious and resource-efficient imaging strategies.</p><p><strong>Methods: </strong>A retrospective outcome-based validation was conducted in patients undergoing mandibular continuity resection between July 2012 and June 2023. The primary outcome was secondary FFF reconstruction among patients not initially selected for CTA. Factors associated with CTA utilization were assessed by multivariable logistic regression.</p><p><strong>Results: </strong>316 consecutively operated patients were included. Prior radiotherapy (OR 2.67, p = 0.005) and smoking history (OR 1.98, p = 0.032) were independently associated with CTA utilization. Among 111 patients without primary FFF reconstruction, four (3.6%) required secondary FFF reconstruction, all of whom had undergone CTA. No patient managed without CTA subsequently required FFF reconstruction.</p><p><strong>Conclusions: </strong>In this cohort, clinical judgment was associated with successful identification of patients who did not subsequently require fibular reconstruction. Omission of CTA in carefully selected patients was not associated with subsequent reconstructive deficiency, though larger prospective studies are needed to confirm these findings.</p>","PeriodicalId":520733,"journal":{"name":"Oral and maxillofacial surgery","volume":"30 1","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13658326/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149169352","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":"Global burden of lip and oral cavity cancer attributable to behavioral risk factors, 1990-2021: a systematic analysis based on the GBD 2021 database.","authors":"Ting Qiu, Bo-Lin Lu, Jun-Yi Liu, Chang-Yong He, Chun Wang, Xiang Ji, Ke-Ru Li, Jian-Feng Wu, Li-Rong Wu","doi":"10.1007/s10006-026-01637-2","DOIUrl":"https://doi.org/10.1007/s10006-026-01637-2","url":null,"abstract":"<p><strong>Background: </strong>Lip and oral cavity cancer (LOC) is a major global public health issue, with tobacco and alcohol as key modifiable behavioral risk factors. This study analyzed global LOC burden trends (1990-2021) and predicted future burden through 2051.</p><p><strong>Methods: </strong>Data were from the Global Burden of Disease Study (GBD) 2021, including behavioral factor-attributable age-standardized disability-adjusted life year rate (ASDR) and mortality rate (ASMR). Joinpoint regression identified trend changes; Age-Period-Cohort (APC) models assessed age, period, and cohort effects. Health inequalities were evaluated via Slope Index of Inequality (SII) and Concentration Index (CI). A Bayesian APC model projected burden to 2051.</p><p><strong>Results: </strong>In 2021, global ASDR and ASMR were 16.75 (95% uncertainty interval [UI]: 12.76, 20.66) and 0.60 (95% UI: 0.46, 0.75) per 100,000. Males had higher ASDR (26.94; 95% UI:19.27, 34.36) and ASMR (0.97; 95% UI:0.70, 1.24) than females (7.22 ; 95% UI: 5.55, 9.18 and 0.28; 95% UI: 0.21, 0.35). High SDI regions showed ASR declines; low-middle SDI regions had slower reductions or increases. Tobacco was the leading risk factor, with the heaviest burden in low-middle SDI regions and South Asia. Health inequalities shifted burden to lower socio-economic groups. Projections (2051) show males will have higher ASDR (27.59; 95% CI: 5.37, 49.81]) and ASMR (1.04 ; 95% CI: 0.17, 1.91).</p><p><strong>Conclusion: </strong>Behavioral risk factors, particularly tobacco, drive global LOC burden. Strengthening tobacco/alcohol control, promoting early detection, and reducing socioeconomic disparities are crucial for prevention.</p>","PeriodicalId":520733,"journal":{"name":"Oral and maxillofacial surgery","volume":"30 1","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13653827/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149171929","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":"Outcomes of total temporomandibular joint replacement: a systematic review.","authors":"Tarangini Saran, Chandan S N, Pragya Borghate, Abhinav Kathuria","doi":"10.1007/s10006-026-01648-z","DOIUrl":"10.1007/s10006-026-01648-z","url":null,"abstract":"<p><strong>Background: </strong>Temporomandibular joint replacement (TMJR) is a reconstructive surgical modality that is available to patients with end-stage temporomandibular disorders (TMDs) that fail conservative treatment. Alloplastic prostheses are either custom-made or stock devices used to restore mandibular function and reduce pain; however, comparative data and long-term outcomes are limited. This systematic review aimed to assess post-surgical functional, pain, and quality-of-life outcomes following alloplastic total TMJR.</p><p><strong>Methods: </strong>We searched PubMed, Google Scholar, Scopus, and institutional databases through March 2025, following PRISMA guidelines, to identify outcomes of alloplastic TMJR. Three reviewers independently screened and extracted the data, and a fourth reviewer resolved discrepancies. Results were summarised narratively because of variability in clinical and methodological approaches. We used ROBINS-I to evaluate study quality and the GRADE system to rate evidence certainty.</p><p><strong>Results: </strong>Eleven studies (569 patients, follow-up 12-62 months) fulfilled the inclusion criteria. Alloplastic TMJR was consistently associated with improved MMO, reduced pain, and better patient-reported QoL, although lateral excursion and protrusion were often lower than in healthy controls. Custom-made prostheses were more prevalent than stock devices, and no evidence supported one type over the other. Transient facial nerve paresis was a rare complication, and the 5-year survival rate of prostheses was > 90%. Nine out of eleven studies were at serious or critical risk of bias; however, across all outcomes, GRADE certainty was rated very low.</p><p><strong>Conclusions: </strong>Although alloplastic TMJR holds promise of functional, pain, and quality-of-life improvements in carefully selected patients with end-stage TMD, current evidence is of very low certainty. Future multicentre trials with agreed-upon outcome measures and direct comparisons between custom and stock systems are required to reach definitive conclusions.</p>","PeriodicalId":520733,"journal":{"name":"Oral and maxillofacial surgery","volume":"30 1","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149170937","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Specialists' agreement and construct validation of a visual scale for assessing mucosal healing after third molar extraction.","authors":"Julia Gomes Lucio de Araujo, Beatriz Campos Pereira, Lais Albuquerque Fernandes, Natacha Kalline de Oliveira, Luciana Correa, Maria Cristina Zindel Deboni","doi":"10.1007/s10006-026-01647-0","DOIUrl":"10.1007/s10006-026-01647-0","url":null,"abstract":"<p><strong>Objective: </strong>To present and validate a digital visual scale for evaluating mucosal wound repair after mandibular third molar extraction. The research seeks to establish a standard-based tool to improve communication in clinical practice and research by reducing subjectivity in postoperative assessments.</p><p><strong>Materials and methods: </strong>A digital image scale using four clinical inflammatory stages (Scores 0 to 3) of recovering oral mucosa of tooth extractions sites was construct. Employing electronic forms (n = 300) were sent to dentists to assess agreement with the consensus score, and construct validity in six tooth extraction mucosal wounds examined by specialists or not. Construct validation involved specialists who evaluated the scale's utility, graphic quality, and clinical significance via a 5-point Likert scale. There was a total of eighty-three responses for the agreement consensus, and sixty-seven for construct validation.</p><p><strong>Results: </strong>The scale demonstrated a \"fair\" inter-rater agreement with a Fleiss' Kappa of 0.3018. The average agreement was 64.3%, with high agreement (> 80%) for advanced repair stages (Score 3) and greater variability for intermediate stages (Scores 1 and 2). Validation results showed high acceptance, with 96.6% of participants agreeing on the tool's utility for standardization. There was agreement between specialists and general practitioners. The initial scores may require further descriptive refinement to reduce interpretive overlap but under observer's calibration it can be used across different dental specialties.</p><p><strong>Conclusions: </strong>The proposed digital scale showed high professional acceptance and potential usefulness for standardizing the assessment of mucosal healing after third molar surgery.</p><p><strong>Clinical relevance: </strong>By providing a standardized visual reference, this scale facilitates the early detection of healing deviations or postoperative complications and rationalizes clinical documentation in professional practice.</p>","PeriodicalId":520733,"journal":{"name":"Oral and maxillofacial surgery","volume":"30 1","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13649847/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149140389","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 pedicled buccal fat pad for paranasal volume augmentation in orthognathic surgery: a case report.","authors":"Francesca Zito, Laura Tognin, Marilena Anghinoni, Tito Poli, Andrea Varazzani","doi":"10.1007/s10006-026-01653-2","DOIUrl":"10.1007/s10006-026-01653-2","url":null,"abstract":"<p><strong>Purpose: </strong>Nowadays, most patients undergo orthognathic surgery primarily for aesthetic reasons; therefore, achieving facial harmony should be a priority for the surgeon, equal in importance to the final occlusion. Le Fort I advancement and clockwise rotation can partially fill the paranasal deficiency, but at the cost of significantly increasing both the width of the nasal wings and nasal tip projection. In patients with severe maxillary hypoplasia, a hyperprojected nasal tip, and a wide alar base, these movements may be aesthetically counterproductive. Many soft-tissue ancillary procedures have been described to improve and complete orthognathic surgery. The aim of this technical note is to describe a new technique to increase the paranasal volume without worsening nasal tip hyperprojection and alar base width, when a greater maxillary advancement is not possible for occlusal or aesthetic reasons.</p><p><strong>Case report: </strong>We used a buccal fat pad to fill the paranasal region in a patient with a round face and maxillary hypoplasia that could not be advanced as far as we wanted, especially for aesthetic reasons. Evaluation criteria include: photographic analysis, clinical observation and patient satisfaction.</p><p><strong>Conclusion: </strong>We assessed whether the result of fat transposition was satisfying and clinically and radiologically stable even after 12 months. Our new technique is a good and easy compromise in Class-III patients with a round face for whom a large maxillary advancement could not be performed for dental and nasal reasons.</p>","PeriodicalId":520733,"journal":{"name":"Oral and maxillofacial surgery","volume":"30 1","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149187744","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Implementation of ultrasound surveillance following negative sentinel lymph node biopsy in early oral squamous cell carcinoma: a retrospective cohort study.","authors":"Tiam Sahraie, Emily Alexander, Sipho Simon Nhongo, James Morrison, Martin Paley, Arshad Siddiqui, Thomas Handley","doi":"10.1007/s10006-026-01650-5","DOIUrl":"10.1007/s10006-026-01650-5","url":null,"abstract":"<p><strong>Purpose: </strong>Management of the clinically node-negative neck in T1/T2 oral squamous cell carcinoma (OSCC) is controversial. While sentinel lymph node biopsy (SLNB) can highlight patients that require selective neck dissection (SND); its false-negative rate necessitates post-operative surveillance to detect missed cervical lymph node metastases (CLNM) and allow for salvage surgery. Ultrasound (US) in conjunction with clinical examination is commonly employed for this observation; however, the optimal regimen is unclear. This retrospective cohort study aimed to evaluate follow-up surveillance after negative SLNB in patients with T1/T2 OSCC at our centre.</p><p><strong>Methods: </strong>Fifty-eight patients were identified over eight years. Nine (15.5%) had a positive SLNB and underwent further treatment. In the remaining 49 patients, data was collected on US utilisation, timing, and outcome events. The primary outcome was CLNM identified by US examination.</p><p><strong>Results: </strong>A total of 51 US examinations were performed. The median time to first US was 7 months (range 2-48; n = 29), second 16.5 months (range 8-50; n = 14), third 26 months (range 14-65; n = 7) and fourth 26 months (n = 1), demonstrating considerable deviation from the local protocol. No CLNM was identified by US surveillance following negative SLNB. Three patients (3/49, 6.1%) had events during follow-up. Two developed metachronous primary tumours and one developed multiple synchronous tumours.</p><p><strong>Conclusion: </strong>US surveillance following SLNB is variably implemented at our centre. These findings highlight the need for better defined and evidence-based protocols in this patient cohort.</p>","PeriodicalId":520733,"journal":{"name":"Oral and maxillofacial surgery","volume":"30 1","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149140403","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Topical red algal-mediated zinc oxide nanoparticles infused in gel as a therapeutic strategy for oral mucositis wound healing.","authors":"Ramanathan Snega, Thoshi Tarun K, Muthupandian Saravanan","doi":"10.1007/s10006-026-01645-2","DOIUrl":"10.1007/s10006-026-01645-2","url":null,"abstract":"<p><strong>Background: </strong>Oral mucositis is a debilitating inflammatory condition requiring effective topical formulations with antimicrobial and wound healing properties. This study aimed to formulate and evaluate Gracilaria foliifera-mediated zinc oxide nanoparticles (ZnO-NPs) incorporated into a sodium alginate gel for potential oral mucosal applications.</p><p><strong>Methods: </strong>The formulated ZnO-NPs-infused gel was characterized using UV-visible spectroscopy, FT-IR, SEM, EDX, and X-ray diffraction. Physical stability was assessed based on appearance, pH, texture, and phase separation. Antioxidant, anti-inflammatory, antimicrobial, and antibiofilm activities were evaluated in vitro. Drug-release behavior and cytotoxicity were also investigated.</p><p><strong>Results: </strong>UV-visible spectroscopy showed absorption peaks at 321 and 320 nm at 0 and 24 h, respectively, indicating good nanoparticle stability within the gel matrix. SEM revealed irregularly shaped ZnO-NPs with an average size of 166 nm. EDX confirmed Zn (41.48%), O (19.7%), and C (38.7%), while X-ray diffraction showed 64.9% crystallinity. The formulation exhibited 74.3% radical-scavenging activity at 100 µg/mL and 64.07% inhibition of albumin denaturation at 400 µg/mL. It demonstrated antimicrobial activity against Streptococcus mutans, Escherichia coli, and Candida albicans and reduced S. mutans biofilm formation. Approximately 50% of the loaded ZnO-NPs were released within 12 h, while cytotoxicity assessment indicated good in vitro biocompatibility at 5-75 µg/mL.</p><p><strong>Conclusion: </strong>The ZnO-NPs-infused sodium alginate gel exhibited antioxidant, anti-inflammatory, antimicrobial, and antibiofilm properties in vitro, supporting further investigation for oral mucosal applications. However, mucosal safety and therapeutic efficacy remain to be established through in vivo studies.</p>","PeriodicalId":520733,"journal":{"name":"Oral and maxillofacial surgery","volume":"30 1","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149122890","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of multivariate linear regression and random forest model in developing mandibular chin prediction reconstruction equation.","authors":"Hui Yuh Soh, Yao Yu, Zhiheng Feng, Wen Du, Shuo Liu, Xin Peng, Wen-Bo Zhang","doi":"10.1007/s10006-026-01644-3","DOIUrl":"10.1007/s10006-026-01644-3","url":null,"abstract":"<p><strong>Purpose: </strong>Reconstruction of extensive mandibular defects that cross midline is technically challenging, as the surgeons lack normal anatomical references. This study aims to compare multivariate linear regression and machine learning (random forest) algorithms in predicting the premorbid shape of the mandibular chin to guide surgical reconstruction.</p><p><strong>Methods: </strong>Anatomical landmarks and measurements were extracted from the computed tomography (CT) data of the head. The multivariate regression model was developed based on Ordinary Least Squares (OLS), while the dataset was randomly split into training set (80%) and testing set (20%) to develop a machine learning-based algorithm.</p><p><strong>Results: </strong>Correlation was observed among the maxillary intercanine distance, distance of bilateral zygoma, width of piriform aperture and the width of chin in multivariate linear regression model, and satisfactory performance was achieved, (MAE (2.35), R² (0.25)). No significant difference was noted between the predicted width of chin and actual measurement in paired t-test. (P = 0.092) Bootstrap validation with 500 repetitions demonstrated stable performance (MAE 2.45 mm; R² = 0.17). Machine learning models using the same predictors did not improve predictive accuracy.</p><p><strong>Conclusion: </strong>Both models demonstrated comparable accuracy in predicting chin width; however, the multivariate regression model achieved lower prediction error compared with machine learning approaches using the same predictors. The interpretability and simplicity of multivariate linear regression may make it more clinically practical for reconstructing midline mandibular defects. A straightforward regression model can provide surgeons with a reliable, accessible tool for preoperative planning in complex mandibular reconstructions, especially where advanced computational resources are limited.</p>","PeriodicalId":520733,"journal":{"name":"Oral and maxillofacial surgery","volume":"30 1","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149083738","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Improving patient communication and understanding of medical reports through text simplification with ChatGPT: a comparative study.","authors":"Daniel Stephan, Sophia Schumacher, Bilal Al-Nawas, Peer W Kämmerer, Daniel G E Thiem","doi":"10.1007/s10006-026-01643-4","DOIUrl":"10.1007/s10006-026-01643-4","url":null,"abstract":"<p><strong>Purpose: </strong>Medical documentation is essential for clinical communication but is often intended for professional audiences, limiting patient understanding. This linguistic complexity can reduce health literacy and hinder shared decision-making. Large language models offer new opportunities to simplify medical texts while maintaining factual accuracy, thereby improving accessibility and comprehension. This study aimed to evaluate whether ChatGPT can simplify medical reports while preserving clinical content and to assess whether these simplifications improve patient comprehension, readability, and perceived communication quality.</p><p><strong>Methods: </strong>Five document types were analysed, including MRI, CT, surgical, pathology reports, and discharge summaries. Each original physician-written document was simplified using a standardized ChatGPT prompt instructing full content preservation and patient-oriented phrasing. Ten simplifications per text were reviewed for completeness. Readability was measured using Flesch Reading Ease (FRE) and LIX indices. A total of 576 participants without medical knowledge evaluated either a simplified or original report version and completed a standardized questionnaire assessing clarity, structure, and applicability, followed by comprehension testing.</p><p><strong>Results: </strong>Simplified reports achieved significantly higher readability (FRE 48.4 ± 5.0 vs. 22.9 ± 5.2; p < 0.0001; LIX 48.3 ± 3.2 vs. 59.2 ± 2.5; p = 0.004). Across all document types, patients rated simplified texts significantly higher in clarity, structure, and usefulness (p < 0.001), with significantly improved comprehension accuracy (e.g., MRI 80.3% vs. 53.7%; p < 0.001). No loss of medical information was observed.</p><p><strong>Conclusions: </strong>ChatGPT appears to be capable of simplifying complex medical documents while preserving clinically relevant information, leading to improvements in both perceived readability and objective understanding under the conditions of this study. AI-driven text simplification thus represents a promising tool to enhance patient communication and health literacy.</p>","PeriodicalId":520733,"journal":{"name":"Oral and maxillofacial surgery","volume":"30 1","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13614978/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149067297","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}