Oral and maxillofacial surgery最新文献

{"title":"Fractal analysis of the mandibular ramus in class II and III patients undergoing orthognathic surgery: retrospective study trough cone-beam computed tomography.","authors":"Isabela Inoue Kussaba, Beatriz Caio Felipe, Rodrigo Lorenzi Poluha, Liogi Iwaki Filho, Mariliani Chicarelli da Silva, Lilian Cristina Vessoni Iwaki","doi":"10.1007/s10006-025-01430-7","DOIUrl":"https://doi.org/10.1007/s10006-025-01430-7","url":null,"abstract":"<p><strong>Introduction: </strong>One of the challenges of orthognathic surgery (OS) is maintaining condylar position during osteosynthesis. It is believed that the post-surgical condylar position is related to postoperative morphological changes in the temporomandibular joint (TMJ), as well as surgical stability.</p><p><strong>Objective: </strong>The aim of this study is to perform fractal analysis of the mandibular ramus in class II and class III patients undergoing OS, analyzing cone beam computed tomography (CBCT) images one month before surgery (T0), one month after surgery (T1), and six to eight months after surgery (T2).</p><p><strong>Materials and methods: </strong>Fractal analysis was performed on coronal and sagittal reconstructions. Regions of interest (ROIs) were selected for each patient and evaluated region. The ROIs underwent a processing method described by White & Rudolph in 1999. After processing, fractal analysis calculation was performed using the box-counting method by the \"Fractal Box Count\" function of the ImageJ software.</p><p><strong>Results: </strong>When examining the different periods (T0, T1, and T2) among class II and class III patients, no statistically significant differences were identified (p > 0.05). This finding suggests stability in the fractal characteristics of the analyzed region, regardless of skeletal class.</p><p><strong>Conclusion: </strong>OS for correction of Class II and Class III malocclusions did not demonstrate a significant impact on the microstructure of the mandibular ramus over time.</p>","PeriodicalId":520733,"journal":{"name":"Oral and maxillofacial surgery","volume":"29 1","pages":"135"},"PeriodicalIF":0.0,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144652077","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":"Occurrence and outcomes of retrobulbar haematoma in 2149 orbital fracture patients.","authors":"Matilda Narjus-Sterba, Tero Puolakkainen, Linda Kokko, Hanna Thorén, Johanna Snäll","doi":"10.1007/s10006-025-01427-2","DOIUrl":"10.1007/s10006-025-01427-2","url":null,"abstract":"<p><strong>Purpose: </strong>We identified the occurrence of acute retrobulbar haematoma (RBH) across a complete range of orbital fractures and determined clinical and radiological findings that could predict permanent vision loss associated with RBH.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on data from facial trauma patients, encompassing a comprehensive range of orbital fractures. The primary outcome variable was the presence of acute RBH that required surgical or medical treatment. The main predictor variables were the types of orbital fractures. We collected data on symptoms, clinical and radiological findings, treatment, and instances of vision loss to assess the relationship between these factors and vision impairment.</p><p><strong>Results: </strong>Of the 2149 patients with orbital fractures, 28 (1.3%) presented with acute RBH, including two bilateral haematomas, bringing the total number of RBHs to 30. Specific injury mechanisms were statistically associated with RBH (p = 0.005), with high-energy injuries being the most frequent cause. The prevalence of RBH was higher in bilateral than unilateral fractures (3.1% vs. 1.1%) (p = 0.023). Among unilateral fractures, RBH was most strongly linked to orbital roof and rim fractures. Tenting or tuliped-like appearance on computed tomography and absence of pupillary light reflex were more common in patients with permanent vision loss. Type of surgical approach did not affect visual outcome.</p><p><strong>Conclusion: </strong>Acute RBH appears to occur more frequently in patients with orbital fractures than previously reported. Clinicians managing facial fractures need to be trained to diagnose RBH promptly and identify indicators of potential vision loss, particularly tenting on radiological images and changes in pupillary reflex.</p>","PeriodicalId":520733,"journal":{"name":"Oral and maxillofacial surgery","volume":"29 1","pages":"134"},"PeriodicalIF":0.0,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12245962/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144602818","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":"Effects of nutritional intervention on total protein and albumin levels in patients with maxillofacial trauma receiving intermaxillary fixation: a randomized controlled trial.","authors":"Mohamed Azharudeen, Ravindran V, Shahina Kt, Ikram Bin Ismail, Midhun Sai E, Jaslin P A","doi":"10.1007/s10006-025-01429-0","DOIUrl":"https://doi.org/10.1007/s10006-025-01429-0","url":null,"abstract":"<p><strong>Background and objective: </strong>Maxillomandibular fixation (MMF) serves as a conventional approach for immobilizing jaws in the treatment of maxillofacial fractures. However, intermaxillary fixation poses challenges to nutritional status in the immediate postoperative phase, resulting in the depletion of water, fat, and protein reserves. The objective is to evaluate the variations in total protein and albumin levels at distinct intervals throughout the treatment duration, aiming to elucidate the impact of intermaxillary fixation on nutritional markers.</p><p><strong>Methodology: </strong>A total of 144 patients with jaw fractures presenting to the Oral and Maxillofacial Surgery Department of Govt. Dental College, Calicut, necessitating maxillomandibular fixation, were enrolled irrespective of etiology. They were randomly allocated into two groups: the Nutrition Intervention Group (GROUP 1) and the Nutrition Non-intervention Group (GROUP 2). Biochemical parameters including total protein and serum albumin were assessed. Measurements were conducted on the day of MMF initiation, as well as after the 2nd and 4th weeks thereafter.</p><p><strong>Results: </strong>Significant variations were observed in the protein and albumin levels, with an increase in group 1 and a decrease in group 2 patients following maxillomandibular fixation (MMF).</p><p><strong>Conclusion: </strong>This study highlights the significant impact of personalized nutritional intervention on total protein and albumin levels in patients undergoing maxillomandibular fixation (MMF) for jaw fractures. Compared to the non-intervention group, those receiving tailored dietary counselling showed marked improvements in both protein and albumin levels. This emphasizes the importance of individualized nutritional support during MMF, essential for tissue repair, immune function, and overall recovery.</p>","PeriodicalId":520733,"journal":{"name":"Oral and maxillofacial surgery","volume":"29 1","pages":"133"},"PeriodicalIF":0.0,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144593724","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":"Advancing precision in bilateral sagittal split osteotomy: a pioneering perspective on minimizing inferior alveolar nerve injury through endoscopic visualization.","authors":"Venkatesh Anehosur, Sai Meera Thotamsetty","doi":"10.1007/s10006-025-01428-1","DOIUrl":"https://doi.org/10.1007/s10006-025-01428-1","url":null,"abstract":"<p><strong>Background: </strong>Minimal invasive surgical procedures are popularized in various surgical fields, the utilization of endoscopic assisted techniques continues to grow across in the field of Maxillofacial Surgery. Orthognathic surgery is a commonly employed procedure for skeletal deformities. Bilateral sagittal split osteotomy(BSSO) is a versatile, result oriented procedure and its utility are well documented. The main pitfall is injury to the neurovascular bundle. Although various methods and modified instrumentation are advocated to minimize the injury to IAN.</p><p><strong>Purpose: </strong>The primary objective is to study the efficacy of innovative endoscopic assisted procedure for locating the nerve and preventing its injury during the BSSO.</p><p><strong>Material and methodology: </strong>This initial prospective study involving 10 patients undergoing BSSO ( advancement / setback) has explored the role of endoscopic assisted to precisely identify and safeguard the nerve during osteotomy cuts, identification and releasing of IAN while splitting the proximal and distal fragments of BSSO.</p><p><strong>Results and conclusion: </strong>Integration of the endoscopy in BSSO protocols showed more than 50% reduction in injury to Neurovascular bundle and offers a promising advancement for achieving favourable results.</p>","PeriodicalId":520733,"journal":{"name":"Oral and maxillofacial surgery","volume":"29 1","pages":"132"},"PeriodicalIF":0.0,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144586206","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":"Correction to: Pain control and adverse effects of parecoxib after wisdom teeth surgery: a quantitative systematic review.","authors":"Othoniel Hugo Aragon-Martinez, Eduardo Gómez-Sánchez, Ronell Bologna-Molina, Nelly Molina-Frechero, Sandra López-Verdín, Nicolás Serafín-Higuera, Juan Manuel Guzmán-Flores, Maikel Hermida-Rojas, Mario Alberto Isiordia-Espinoza","doi":"10.1007/s10006-025-01426-3","DOIUrl":"https://doi.org/10.1007/s10006-025-01426-3","url":null,"abstract":"","PeriodicalId":520733,"journal":{"name":"Oral and maxillofacial surgery","volume":"29 1","pages":"131"},"PeriodicalIF":0.0,"publicationDate":"2025-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144562653","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":"Global trends in the microbial profile of odontogenic infections and its practical implications: A 70-year narrative review.","authors":"Ricardo Grillo, Lázaro Caixeta, Mariana Brozoski, Fernando Melhem-Elias","doi":"10.1007/s10006-025-01425-4","DOIUrl":"https://doi.org/10.1007/s10006-025-01425-4","url":null,"abstract":"<p><strong>Objectives: </strong>Odontogenic infections represent a significant clinical challenge in maxillofacial surgery due to their potential for rapid progression and life-threatening complications. Regional variations in microbial profiles and antibiotic resistance patterns directly influence treatment efficacy, underscoring the necessity for geographically tailored antimicrobial strategies. This study systematically evaluated the global microbial epidemiology of odontogenic infections, analyzing prevalent pathogens, emerging resistance trends, and the clinical effectiveness of current antibiotic regimens across different regions.</p><p><strong>Methods: </strong>We conducted a comprehensive PubMed search, identifying 162 eligible studies comprising retrospective analyses, case series, clinical trials, and antimicrobial susceptibility tests. Extracted data included microbial identification results, antibiotic susceptibility profiles, and geographic variables. Statistical evaluation employed Pearson's correlation coefficients and Kruskal-Wallis tests.</p><p><strong>Results: </strong>The analysis encompassed 20,911 patients yielding 61,408 bacterial isolates representing 123 distinct strains. No statistically significant temporal trends in microbial prevalence were detected. Geographic variations significantly affected antibiotic selection, with regional efficacy patterns being particularly evident in severe infections. Amoxicillin-clavulanate and vancomycin demonstrated consistently high susceptibility rates (> 90%), whereas the metronidazole-penicillin combination showed limited efficacy, though this finding was constrained by insufficient data availability.</p><p><strong>Conclusions: </strong>Although surgical drainage remains the cornerstone of management, treatment outcomes can be optimized through region-specific antibiotic selection guided by local microbial patterns. Antibiograms, whenever feasible, support targeted therapy, helping address resistance patterns. Optimal antimicrobial stewardship for odontogenic infections requires continuous consideration of evolving regional resistance trends alongside potential therapeutic risks.</p>","PeriodicalId":520733,"journal":{"name":"Oral and maxillofacial surgery","volume":"29 1","pages":"130"},"PeriodicalIF":0.0,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144478571","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":"Utilising remote imaging consultation for the early detection of oral cancer: a case series and pilot study.","authors":"Nobuyuki Kaibuchi, Akira Shimasaki, Mizuho Ikeda, Reiko Wadachi, Yoko Kawase-Koga, Toshihiro Okamoto","doi":"10.1007/s10006-025-01423-6","DOIUrl":"10.1007/s10006-025-01423-6","url":null,"abstract":"<p><strong>Purpose: </strong>We have been offering 'remote imaging consultations' to local dental clinics via a mail-form service as diagnostic support for oral diseases. In this report, we present three cases in which oral cancer was detected and treated at an early stage through this project, along with associated statistical data.</p><p><strong>Methods: </strong>Between July 2017 and December 2022, local dental clinics submitted image consultation requests through a dedicated website. Two oral and maxillofacial surgeons reviewed the findings and provided reports via e-mail.</p><p><strong>Results: </strong>Of the 38 registered clinics, 15 (39.5%) utilised the service, and 114 consultations were conducted (49 men and 65 women). Post-diagnostic testing showed that the provisional diagnosis corresponded with the actual diagnosis in 28 patients (53.8%). Malignancy was suspected in 13 patients, of whom three (23.1%) - two cases of tongue cancer and one case of buccal mucosa cancer - were confirmed to have malignant tumours. A questionnaire sent to the dentists who used this service revealed that 71.4% were 'very satisfied' with the system.</p><p><strong>Conclusion: </strong>These findings suggest that remote imaging consultations may be beneficial for the early detection and treatment of oral cancer.</p>","PeriodicalId":520733,"journal":{"name":"Oral and maxillofacial surgery","volume":"29 1","pages":"128"},"PeriodicalIF":0.0,"publicationDate":"2025-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144337449","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":"Positive airway pressure settings do not predict outcomes of maxillomandibular advancement surgery in the treatment of obstructive sleep apnea.","authors":"John M Nathan, Douglas F Werkman, Cameron C Lee, Zachary S Peacock, Anita V Shelgikar, Jeffrey J Stanley, Hossein E Jazayeri, Jonathan P Troost, Sharon Aronovich","doi":"10.1007/s10006-025-01421-8","DOIUrl":"10.1007/s10006-025-01421-8","url":null,"abstract":"<p><strong>Purpose: </strong>The purpose of this study was to determine if the therapeutic continuous positive airway pressure (CPAP) setting identified during pre-surgical CPAP titration polysomnogram (PSG) is predictive of surgical success after MMA in adults with OSA.</p><p><strong>Methods: </strong>This multi-institutional retrospective study evaluated adults treated for OSA with MMA between 2000 and 2020 at Michigan Medicine and Massachusetts General Hospital. Patients included were those with a diagnosis of moderate-severe OSA (AHI > 15), a pre-operative CPAP titration PSG, and available pre-operative and postoperative PSGs. The primary predictor variable was the recommended CPAP setting from the pre-op titration PSG. Secondary predictor variables included preoperative oxygen saturation nadir, and hypoxic burden. The primary outcome variable was surgical success (achieving an AHI of < 20 and >/=50% reduction in AHI). The secondary outcome variable was change in AHI. Logistic and linear regression were used to model outcomes. Unadjusted and bivariable adjusted models were performed for predictors. Significance was set to P <.05.</p><p><strong>Results: </strong>31 subjects were included in this study (25 males, average age 42.9 ± 9.67 years). Mean pre-surgical CPAP titration setting was 10.4 cm H2O. On mixed model regression, recommended CPAP setting did not predict surgical success (adjusted ß = 0.93, P =.56), nor change in AHI (adjusted ß = 0.35, P =.51). In the latter model, age was found to be statistically significant, with each increased year of age increasing the postop AHI by 0.51/hr (P =.004). Hypoxic burden was also significant and positively correlated with AHI (adjusted ß = 0.90, P =.02).</p><p><strong>Conclusion: </strong>MMA remains an effective treatment modality for carefully selected patients with OSA, however, pre-operative therapeutic CPAP values were not a reliable predictor of surgical success.</p>","PeriodicalId":520733,"journal":{"name":"Oral and maxillofacial surgery","volume":"29 1","pages":"129"},"PeriodicalIF":0.0,"publicationDate":"2025-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12181112/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144337448","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":"Finite element analysis of stress distribution in sagittal split Ramus osteotomy: the influence of impacted third molars.","authors":"Ahmet Faruk Derin, Hilal Alan","doi":"10.1007/s10006-025-01422-7","DOIUrl":"10.1007/s10006-025-01422-7","url":null,"abstract":"<p><strong>Objective: </strong>This study aims to evaluate the effect of impacted third molars in different positions on stress distribution in the proximal and distal segments during sagittal split ramus osteotomy (SSRO) using finite element analysis.</p><p><strong>Materials and methods: </strong>Finite element stress analysis was used to create models with impacted third molars in different positions. In SSRO-applied models, a 20 N force was applied in opposite directions to the proximal and distal segments along the sagittal osteotomy line. The von Mises, Pmax, and Pmin stress values induced by the applied force in the proximal and distal segments were analyzed to assess their potential impact on the risk of unfavorable fractures.</p><p><strong>Results: </strong>Compared to the control model, the highest stress values were observed on the buccal side of the proximal segment in the distoangular model and on the lingual side of the distal segment in the horizontal model. Analyzing the von Mises, Pmax, and Pmin stress values in all models, it was found that the highest stress concentrations occurred predominantly on the buccal side of the proximal segment.</p><p><strong>Conclusion: </strong>During SSRO, horizontally positioned impacted third molars may increase stress values in the distal segment, potentially elevating the risk of unfavorable fractures. In all models, higher stress concentrations were observed in the buccal region of the proximal segment. These findings highlight the clinical importance of patient-specific evaluation of third molars prior to SSRO.</p>","PeriodicalId":520733,"journal":{"name":"Oral and maxillofacial surgery","volume":"29 1","pages":"127"},"PeriodicalIF":0.0,"publicationDate":"2025-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144334828","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":"Adjunctive use of posaconazole, hyperbaric oxygen therapy, and methylene blue for COVID-19-associated mucormycosis.","authors":"Sujata Mohanty, Neeraj Bansal, Anjali Verma, Hemavathy S, Arpit Gupta, Chayanika Sharma","doi":"10.1007/s10006-025-01419-2","DOIUrl":"10.1007/s10006-025-01419-2","url":null,"abstract":"<p><strong>Purpose: </strong>The study aimed to assess the cumulative role of oral posaconazole, post-debridement Hyperbaric Oxygen (HBO) therapy, along with local application and steam inhalation with methylene blue as an adjunct to surgery to prevent further progression of COVID-19 associated sino-maxillary or mandibular mucormycosis.</p><p><strong>Methods: </strong>A retrospective observational study was conducted on patients diagnosed with sino-maxillary or mandibular mucormycosis associated with COVID-19. A total of 38 patients underwent surgical debridement and received adjunctive treatment with posaconazole, hyperbaric oxygen therapy, and local application and steam inhalation of methylene blue. Medical records were analyzed for COVID-19-related hyperglycemia, prolonged hospitalization, immunosuppressive/steroid therapy, and the use of iron or zinc supplements, which may be linked to increased mucormycosis incidence. Outcomes were evaluated for association with any concurrent infection, complications, need for sequential debridement, and further progression of disease.</p><p><strong>Results: </strong>A total of 38 patients (range: 23-68) were included, comprising 24 males and 14 females. Isolated sino-maxillary involvement was observed in 32 cases (84.21%), and mandibular involvement in 5 cases (13.15%). No further disease progression was noted during the 2-year follow-up, based on clinical evaluation and postoperative computed tomography (CT) scans. Actinomycosis co-infection was identified in 21.05% of cases. Complications included wound dehiscence (39.47%), pus discharge (5.26%), reversible hearing impairment during HBO therapy (5.26%), and flap necrosis (2.63%). Four patients (10.52%) required sequential surgical debridement for sequestrum removal.</p><p><strong>Conclusion: </strong>It was concluded that concurrent use of oral posaconazole, adjunct HBO therapy and methylene blue prevents further progression of COVID-19 associated sino-maxillary and mandibular mucormycosis.</p>","PeriodicalId":520733,"journal":{"name":"Oral and maxillofacial surgery","volume":"29 1","pages":"126"},"PeriodicalIF":0.0,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144328487","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}