Oral and maxillofacial surgery最新文献

{"title":"Alveolar ridge preservation versus unassisted socket healing following tooth extraction: a systematic review of controlled clinical studies and meta-analysis of randomised trials.","authors":"Rola Zahedah, Bircan Dinç","doi":"10.1007/s10006-026-01642-5","DOIUrl":"10.1007/s10006-026-01642-5","url":null,"abstract":"<p><strong>Purpose: </strong>To estimate early horizontal ridge-width and explicit buccal/facial vertical hard-tissue loss after alveolar ridge preservation (ARP) versus unassisted socket healing.</p><p><strong>Methods: </strong>The review was registered in PROSPERO (CRD420261432689). PubMed/MEDLINE, Scopus, Web of Science Core Collection, Embase.com, and ClinicalTrials.gov were searched on 24 June 2026; CENTRAL provided supplementary verification on 1 July 2026. Two reviewers independently selected reports. One reviewer extracted data; the second verified classifications and effect inputs. Randomised direct comparisons were pooled using REML random-effects models with Hartung-Knapp inference. Risk of bias and certainty were assessed with RoB 2 and GRADE.</p><p><strong>Results: </strong>Of 1,864 records, 1,739 were screened, and 62 underwent full-text assessment. 28 direct comparison reports were eligible; 20 randomised studies contributed quantitatively, and 8 reports were narrative-only. ARP was associated with less horizontal ridge-width loss (k = 18; MD - 1.37 mm, 95% CI - 1.80 to - 0.94; I² = 75.9%; prediction interval - 2.86 to 0.12) and less explicit buccal/facial vertical loss (k = 13; MD - 1.18 mm, 95% CI - 1.61 to - 0.75; I² = 74.3%; prediction interval - 2.54 to 0.17). Certainty was low for both. The exploratory broad vertical/buccal synthesis favoured ARP (k = 16; MD - 1.26 mm, 95% CI - 1.63 to - 0.89) with very low certainty.</p><p><strong>Conclusion: </strong>ARP may reduce early dimensional loss, but substantial heterogeneity and prediction intervals including no effect limit generalisability. Evidence does not establish universal indications, intervention superiority, or long-term implant, aesthetic, or patient-reported benefit.</p>","PeriodicalId":520733,"journal":{"name":"Oral and maxillofacial surgery","volume":"30 1","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149032964","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":"Platelet-rich fibrin after mandibular third molar extraction: a split-mouth and parallel-group stratified meta-analysis of randomized controlled trials (RCTs).","authors":"Pedro Sampaio, Sargon Shazo, Raji Ranganathan, Valentino Vellone","doi":"10.1007/s10006-026-01636-3","DOIUrl":"10.1007/s10006-026-01636-3","url":null,"abstract":"<p><strong>Background: </strong>Platelet-rich fibrin (PRF) has been increasingly used as an autologous biomaterial to enhance healing after tooth extraction because of its potential to modulate inflammation, promote angiogenesis, and stimulate tissue regeneration. However, evidence regarding its effectiveness across postoperative outcomes remains heterogeneous, and the comparative performance of PRF subtypes, particularly leukocyte-platelet-rich fibrin (L-PRF) and advanced platelet-rich fibrin (A-PRF), is not fully established. This systematic review and meta-analysis evaluated the effects of PRF on postoperative outcomes following mandibular third molar extraction, with emphasis on postoperative pain and comparison of PRF subtypes.</p><p><strong>Methods: </strong>A systematic search of PubMed, EMBASE, and the Cochrane Library was conducted from inception to March 2026. Randomized controlled trials comparing PRF with natural clot healing after mandibular third molar extraction were included. The primary outcome was postoperative pain. Secondary outcomes included alveolar osteitis (AO), edema, trismus, analgesic consumption, and bone-related outcomes. Risk of bias was assessed using RoB 2. Meta-analyses were performed using random-effects models, and heterogeneity was evaluated with the I² statistic.</p><p><strong>Results: </strong>Twenty-eight studies were included. PRF significantly reduced the incidence of AO (RR = 0.17, 95% CI: 0.06-0.49), postoperative pain from day 1 to day 7, and analgesic consumption at postoperative days 2-3. Significant improvements were also observed in trismus at all assessed timepoints. Bone density, assessed descriptively across six studies due to substantial methodological heterogeneity in imaging methods, showed a consistent trend favoring PRF, although this could not be quantitatively pooled. Edema reduction was inconsistent, with only modest short-term benefits. L-PRF demonstrated more consistent effects across outcomes than A-PRF, although evidence for A-PRF was limited to a single trial. Heterogeneity was substantial in some analyses, likely due to differences in PRF protocols and outcome assessment methods.</p><p><strong>Conclusion: </strong>PRF, particularly L-PRF, reduces postoperative morbidity after mandibular third molar extraction, although further standardized trials, particularly head-to-head comparisons of L-PRF and A-PRF, are needed to clarify subtype-specific effects.</p>","PeriodicalId":520733,"journal":{"name":"Oral and maxillofacial surgery","volume":"30 1","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149019499","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":"Longitudinal spinal accessory nerve conduction after nerve-preserving neck dissection in oral cavity squamous cell carcinoma: a prospective hierarchical mixed-effects cohort study.","authors":"Lavanya Lakshminarayan, Shabber Zaveri, Arun Thimmarayappa","doi":"10.1007/s10006-026-01640-7","DOIUrl":"10.1007/s10006-026-01640-7","url":null,"abstract":"<p><strong>Purpose: </strong>Spinal accessory nerve (SAN) dysfunction persists after nerve-preserving neck dissection. We characterized the longitudinal SAN conduction trajectory and its association with surgical extent and adjuvant therapy.</p><p><strong>Methods: </strong>This prospective study enrolled 43 patients with oral cavity squamous cell carcinoma undergoing neck dissection with SAN preservation - selective neck dissection (SND; n = 35) or modified radical neck dissection (MRND; n = 8). Compound motor action potential (CMAP) amplitude, motor latency, and a novel, exploratory Spinal Accessory Asymmetry Index (SAI) were assessed at baseline, 3 weeks, and 3 months using hierarchical linear mixed-effects (LME) models.</p><p><strong>Results: </strong>In the unilateral cohort (n = 41), CMAP amplitude fell 45.2% from baseline (9.15 ± 2.04mV) to a 3-week nadir (5.01 ± 2.47mV; p < 0.0001), with partial recovery by 3 months (6.26 ± 2.23mV; p < 0.001). The SAI showed a numerically larger but non-significant asymmetry after MRND at 3 months (17.82%; p = 0.078, n = 6) versus significant SND normalization (29.04%→15.90%; p < 0.0001). Adjuvant therapy distribution was balanced between groups (p = 0.781) but was not modelled as a covariate. Patient-level heterogeneity accounted for 46.2% of longitudinal variance (R²c = 0.4616).</p><p><strong>Conclusion: </strong>Nerve-preserving neck dissection produced a substantial subacute decline in SAN conduction with only partial recovery by 3 months, consistent with combined neuropraxic and axonal injury, though axonal loss was unconfirmed. The exploratory SAI suggested more persistent MRND asymmetry, though non-significant in this small subgroup, and should not argue against oncologically indicated neck dissection. Larger, multicentre studies with validated shoulder outcomes are needed.</p>","PeriodicalId":520733,"journal":{"name":"Oral and maxillofacial surgery","volume":"30 1","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149003285","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":"Transoral robotic reconstruction of a posterior palatal defect using an upper arm flap following polymorphous adenocarcinoma resection: a novel minimally invasive approach.","authors":"Henning Wieker, Juliane Wagner, Jörg Wiltfang, Aydin Gülses, Johannes Spille","doi":"10.1007/s10006-026-01639-0","DOIUrl":"10.1007/s10006-026-01639-0","url":null,"abstract":"<p><strong>Background: </strong>Surgical management of malignant tumors in the orofacial region frequently necessitates extensive resection, resulting in significant functional and aesthetic morbidity. In younger patients, these sequelae carry a substantial psychosocial burden, emphasizing the need for minimally invasive reconstructive strategies that preserve quality of life while maintaining oncological safety.</p><p><strong>Case presentation: </strong>A 36-year-old female patient presented with a small 1 × 1 cm swelling at the junction of the hard and soft palate on the left side. Incisional biopsy confirmed a malignant minor salivary gland tumor but did not permit definitive subtyping. The final diagnosis of a polymorphous adenocarcinoma (PAC), conventional subtype, was established only on the complete resection specimen. Following oncologically adequate resection, including partial hard palate and tuberosity removal, a 3 × 4 cm defect was reconstructed with a free upper arm flap. Supermicrovascular anastomoses to the superior labial and facial arteries (vessel diameter ~ 0.2 mm) were performed via a transoral approach using the Symani^® robotic surgical system with 20× motion scaling. Venous anastomoses to the facial vein were completed end-to-end and end-to-side via the same intraoral access. Selective lymph node sampling of the four radiologically prominent ipsilateral level II lymph nodes through a minimal cervical incision showed no metastases, both on frozen section and on final histopathology (0/4). Final histopathology demonstrated a 15 mm low-grade PAC resected in sano, without lymphovascular invasion, without unequivocal perineural infiltration and without bone invasion, classified as pT1 pN0 (0/4) cM0, R0. Postoperative course was uneventful; functional rehabilitation including speech and swallowing therapy is ongoing.</p><p><strong>Conclusions: </strong>Robotic-assisted supermicrosurgery using the Symani^® system enabled safe transoral free flap reconstruction of a posterior palatal defect with anastomoses at the sub 0.2 mm scale. This approach minimizes donor-site morbidity and demonstrates the feasibility of intraoral robotic supermicrosurgery as a novel reconstructive modality in head and neck oncology.</p>","PeriodicalId":520733,"journal":{"name":"Oral and maxillofacial surgery","volume":"30 1","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13588836/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149003320","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":"Exploring spatial heterogeneity of PD-L1 and c-MET expression in oral squamous cell carcinoma.","authors":"Cornelius Busse, Marius Hörner, Babak Saravi, Lukas Haug, Sebastian Gubik, Alexander Kübler, Urs Müller-Richter, Andreas Rosenwald, Stefan Hartmann","doi":"10.1007/s10006-026-01638-1","DOIUrl":"10.1007/s10006-026-01638-1","url":null,"abstract":"<p><strong>Background: </strong>PD-L1 expression is an established predictive biomarker for immune checkpoint inhibitor therapy in recurrent or metastatic head and neck squamous cell carcinoma (HNSCC), including oral squamous cell carcinoma (OSCC). However, the spatial heterogeneity of PD-L1 and additional biomarkers such as c-MET between primary tumors and lymph node metastases remains insufficiently characterized. Given the potential for compartment-specific biomarker differences between primary tumors and metastatic lesions, we investigated PD-L1 and c-MET expression patterns in matched primary tumors and lymph node metastases of OSCC patients.</p><p><strong>Methods: </strong>In this retrospective cohort study, PD-L1 expression (Tumor Proportion Score [TPS], Combined Positive Score [CPS]) and c-MET expression (H-score, percentage-based scoring) were analyzed by immunohistochemistry in primary tumors from 59 OSCC patients. Matched primary tumor-lymph node metastasis pairs were available for 24 patients and served as the basis for the paired spatial heterogeneity analyses. Biomarker concordance between primary tumors and metastases as well as associations with clinicopathologic parameters were evaluated.</p><p><strong>Results: </strong>Both PD-L1 and c-MET were frequently expressed in primary tumors but showed significantly lower expression levels in matched lymph node metastases. Higher PD-L1 expression in primary tumors was associated with nodal metastasis in exploratory analyses, whereas c-MET expression showed no significant association with nodal status. No significant correlation between PD-L1 and c-MET expression was observed. Furthermore, discordance of PD-L1 CPS status between primary tumors and lymph node metastases resulted in different biomarker classifications in a substantial subset of matched cases. In exploratory analyses, biomarker expression and primary tumor-lymph node discordance were not significantly associated with recurrence, although the limited number of events precludes definitive conclusions.</p><p><strong>Conclusions: </strong>Our findings demonstrate pronounced spatial heterogeneity of PD-L1 and c-MET expression in OSCC and reveal compartment-specific biomarker expression patterns between primary tumors and lymph node metastases. The observed discordance between tumor compartments warrants further investigation in larger prospective studies to determine its biological and potential clinical relevance for biomarker assessment in OSCC.</p>","PeriodicalId":520733,"journal":{"name":"Oral and maxillofacial surgery","volume":"30 1","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13582147/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148984589","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":"Assessment of temporomandibular joint space changes after orthognathic surgery in skeletal malocclusion patients: a systematic review.","authors":"Minakshi Tibrewal, Dhruv Ahuja, Puneet Batra, Sana Bint Aziz, Ashish Kumar Singh","doi":"10.1007/s10006-026-01635-4","DOIUrl":"10.1007/s10006-026-01635-4","url":null,"abstract":"<p><strong>Purpose: </strong>To interpret postoperative changes in temporomandibular joint (TMJ) joint space dimensions and condylar position following orthognathic surgery in patients with skeletal malocclusions, and to determine whether reported alterations represent clinically meaningful displacement or physiological adaptive remodeling.</p><p><strong>Materials and methods: </strong>A comprehensive search of PubMed, SCOPUS, Web of Science, EBSCOhost, and Cochrane Library was performed to assess pre- and postoperative TMJ changes using three-dimensional imaging. Joint spaces including anterior (AJS), superior (SJS), and posterior (PJS) and condylar morphology were evaluated. Methodological quality was appraised using the Joanna Briggs Institute (JBI) checklist. Due to methodological and clinical heterogeneity, findings were synthesized narratively with attention to malocclusion type and surgical movement.</p><p><strong>Results: </strong>A total of 16 studies consisting 628 patients undergoing BSSO, Le Fort I osteotomy, vertical ramus osteotomy, or bimaxillary surgery were included. Most studies reported minor, adaptive postoperative changes in AJS, SJS, and PJS. Class II patients showed more consistent increases in AJS/SJS, whereas Class III patients demonstrated variable posterior or anterior remodelling depending on surgical movement. Volumetric analyses revealed region-specific adaptations without significant condylar displacement. Postoperative temporomandibular disorder symptoms were infrequent, and no consistent evidence supported detrimental TMJ effects attributable to surgery.</p><p><strong>Conclusion: </strong>Postoperative TMJ joint space changes after orthognathic surgery primarily represent physiological adaptive remodeling rather than pathological condylar displacement, with reported variability driven by malocclusion type, surgical movement, fixation method, and imaging protocol. Recognizing these predictable patterns is essential to prevent overinterpretation of postoperative imaging and to improve clinical assessment through standardized three-dimensional and long-term evaluation strategies.</p>","PeriodicalId":520733,"journal":{"name":"Oral and maxillofacial surgery","volume":"30 1","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148979351","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":"Exploratory systematic characterization of vascular features in confocal laser endomicroscopy of cutaneous squamous cell carcinoma.","authors":"Flurin Müller-Diesing, Matti Sievert, Bharat Akhanda Panuganti, Marc Aubreville, Nils Porsche, Stephan Hackenberg, Agmal Scherzad, Philipp Winnand, Nils Vohl, Julia Brach, Markus Wirth, Miguel Goncalves","doi":"10.1007/s10006-026-01629-2","DOIUrl":"10.1007/s10006-026-01629-2","url":null,"abstract":"<p><strong>Purpose: </strong>This exploratory study aimed to systematically evaluate vascular features in confocal laser endomicroscopy (CLE) for distinguishing cutaneous squamous cell carcinoma (cSCC) from healthy skin, assessing both the overall diagnostic value of these features using a composite vascular scoring system and the performance of individual criteria.</p><p><strong>Methods: </strong>CLE video sequences of tumor and corresponding healthy skin were retrospectively analyzed in nine patients, using histopathology as the reference standard. Six vascular criteria were defined from the literature, three associated with healthy tissue and three with tumor tissue. Three experienced investigators performed a blinded assessment, and a majority decision determined the presence of each criterion. Sensitivity, specificity, predictive values, and interrater agreement were calculated. A composite vascular score (0-6) was derived, and ROC analysis was used to determine the optimal cutoff for discriminating tumor from healthy tissue.</p><p><strong>Results: </strong>The features with the highest diagnostic relevance were \"honeycomb-like capillaries\" and \"round vascular structures\" for healthy tissue, and \"leaky capillaries\" for tumor sequences. ROC analysis identified a cutoff of ≥ 3 (Youden index 0.905, AUC 0.96). Within the analyzed dataset, the composite vascular score achieved a sensitivity of 100%, specificity of 90.48%, PPV of 91.3%, and NPV of 100%.</p><p><strong>Conclusion: </strong>Vascular features captured by CLE showed promising discriminatory potential for differentiating cSCC from healthy skin. Among the individual criteria, absence of \"honeycomb-like pattern\" of capillaries and \"round vascular structures\" are particularly suitable for inclusion in a CLE-based scoring system for cSCC.</p>","PeriodicalId":520733,"journal":{"name":"Oral and maxillofacial surgery","volume":"30 1","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148922592","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":"Autologous bone grafts versus alloplastic implants for orbital floor reconstruction: a systematic review and meta-analysis.","authors":"Mohammed Ehmidat, Ahmed Samy Gad, Ahmad Omar Saleh, Mohamed Mahmoud Fathy, Abdelrahman A Ebaid, Amir Majdi Moh'd, Raneem Abuqtaish, Mahmoud Abdelbaki, Amr Elzahy, Omar Osman","doi":"10.1007/s10006-026-01634-5","DOIUrl":"10.1007/s10006-026-01634-5","url":null,"abstract":"<p><strong>Purpose: </strong>The choice of reconstructive material for orbital floor fractures remains a subject of debate. While autologous bone has historically been considered the \"gold standard,\" alloplastic implants offer potential advantages in reducing surgical morbidity. This meta-analysis aimed to compare the safety and efficacy of autologous bone grafts versus alloplastic implants in orbital floor reconstruction.</p><p><strong>Methods: </strong>A systematic review was conducted in accordance with PRISMA guidelines (PROSPERO: CRD420251140583). Electronic databases (PubMed, Scopus, Web of Science, Cochrane Library) were searched from inception to August 2025. Randomized controlled trials and comparative cohort studies evaluating functional outcomes (diplopia, enophthalmos) and complications (ectropion, infection, malposition) were included. Data were synthesized using a random-effects model, with risk ratios (RR) and 95% confidence intervals (CI) calculated.</p><p><strong>Results: </strong>Twenty studies comprising 2,119 patients were included. Alloplastic implants demonstrated statistically significant superiority in periocular safety, with a reduced risk of postoperative ectropion compared to autologous grafts (RR = 2.245; p = 0.020). In an exploratory sensitivity analysis excluding one outlier study, autologous grafts were associated with a significantly higher risk of implant malposition (RR = 2.074; p = 0.004). Autologous reconstruction was associated with a strong trend toward increased postoperative pain (p = 0.052) and inherent donor-site morbidity. No statistically significant differences were observed regarding infection (p = 0.402), enophthalmos (p = 0.201), or diplopia (p = 0.221).</p><p><strong>Conclusion: </strong>Alloplastic implants were associated with a lower risk of ectropion and implant malposition, with functional outcomes statistically comparable to autologous bone. Given the elimination of donor-site morbidity, alloplastic biomaterials represent a safe and effective alternative for orbital floor reconstruction; however, the predominance of retrospective, heterogeneous studies in the current evidence base means these findings should inform, rather than replace, individualized surgical decision-making pending further high-quality randomized trials.</p>","PeriodicalId":520733,"journal":{"name":"Oral and maxillofacial surgery","volume":"30 1","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148889060","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":"Diagnostic value of MMP-8, IL-1β and IL-6 in peri-implantitis: a systematic review and meta-analysis.","authors":"Qian Yang, Yuyan Wu, Li Li, Shixun Ma, Kangle Guo, Mingxia Cheng","doi":"10.1007/s10006-026-01632-7","DOIUrl":"10.1007/s10006-026-01632-7","url":null,"abstract":"<p><strong>Background: </strong>Although MMP-8, IL-1β, and IL-6 have been implicated in peri-implantitis, their diagnostic accuracy for detecting peri-implantitis has not been systematically quantified. This systematic review and meta-analysis aimed to evaluate the diagnostic accuracy of matrix metalloproteinase-8 (MMP-8), interleukin-1β (IL-1β), and interleukin-6 (IL-6) for the detection of peri-implantitis, and to compare their levels between peri-implantitis patients and healthy controls.</p><p><strong>Methods: </strong>A comprehensive literature search was conducted across English and Chinese Database up to May 1st, 2026. Studies reporting diagnostic accuracy data or biomarker concentrations for MMP-8, IL-1β, or IL-6 were included. Pooled standardized mean differences (SMD) with 95% confidence intervals (CI) were calculated using a random-effects model. Diagnostic performance was assessed to pool sensitivity, specificity, likelihood ratios, diagnostic odds ratio, and area under the curve (AUC). Heterogeneity was evaluated using I² statistics, and publication bias was assessed using Egger's test.</p><p><strong>Results: </strong>Twenty-five studies were included. Meta-analysis showed significantly elevated levels of MMP-8 (SMD = 1.80; 95% CI: 0.88-2.71), IL-1β (SMD = 2.07; 95% CI: 1.36-2.78), and IL-6 (SMD = 1.53; 95% CI: 0.89-2.17) in peri-implantitis patients compared to healthy controls. For diagnostic accuracy, MMP-8 demonstrated a pooled sensitivity of 0.83 (95% CI: 0.76-0.98), specificity of 0.80 (95% CI: 0.61-0.91), and AUC of 0.84 (95% CI: 0.80-0.87). IL-1β showed a sensitivity of 0.72 (95% CI: 0.63-0.80), specificity of 0.75 (95% CI: 0.67-0.81), and AUC of 0.79 (95% CI: 0.75-0.82). Leave-one-out sensitivity analyses confirmed the robustness of all pooled estimates.</p><p><strong>Conclusions: </strong>MMP-8 and IL-1β demonstrate moderate-to-good diagnostic accuracy for peri-implantitis, supporting their potential role as adjunctive diagnostic tools. However, substantial heterogeneity, lack of standardized cutoff thresholds, and the presence of publication bias limit the certainty of evidence. Further prospective studies with standardized methodologies and externally validated thresholds are warranted before clinical implementation.</p>","PeriodicalId":520733,"journal":{"name":"Oral and maxillofacial surgery","volume":"30 1","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148868877","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":"Programmed Death-Ligand 1 (PD-L1) expression and clinical outcomes in oral squamous cell carcinoma: evidence from a large clinical cohort.","authors":"Michael Alfertshofer, Maximilian Richter, Konrad Klinghammer, Christian Doll, Steffen Koerdt, Max Heiland, Friedrich Mrosk","doi":"10.1007/s10006-026-01628-3","DOIUrl":"10.1007/s10006-026-01628-3","url":null,"abstract":"<p><strong>Background: </strong>Despite the recognized biological relevance of the PD-1/PD-L1 axis in immune evasion, the prognostic significance of PD-L1 expression in surgically treated oral squamous cell cancer (OSCC) patients remains largely unclear.</p><p><strong>Objective: </strong>To investigate the prognostic significance of PD-L1 expression in a large cohort of OSCC patients primarily treated surgically in a single center.</p><p><strong>Methods: </strong>This analysis included 156 consecutive OSCC patients treated with curative-intent surgery with their clinicopathologic variables, treatment details and clinical treatment outcomes. PD-L1 expression was categorized using the Combined Positive Score (CPS), defining PD-L1 positivity as CPS ≥ 10. Sensitivity analyses were repeated at the alternative thresholds CPS ≥ 1 and CPS ≥ 20. Survival and recurrence endpoints (OS, DFS, LRCR, NCR) were evaluated using Kaplan-Meier/log-rank methods and Cox regression with multivariable adjustment for key confounders.</p><p><strong>Results: </strong>Of 156 consecutive OSCC patients, 120 (76.9%) were PD-L1-positive. PD-L1 status was not associated with any clinicopathological parameter investigated herein. At 3 years, OS (76.1% vs. 68.7%), DFS (63.5% vs. 42.6%), LRCR (77.1% vs. 75.5%), and NCR (93.0% vs. 91.0%) were comparable between PD-L1-positive and PD-L1-negative patients, respectively. Neither binary PD-L1 classification nor continuous CPS was associated with OS, DFS, LRCR, or NCR in multivariable Cox regression, with no differential effect by disease stage. In adjuvant-treatment-stratified analysis, PD-L1 positivity was associated with improved DFS in patients without adjuvant therapy, but not in those who received it. In sensitivity analyses, findings at CPS ≥ 20 were concordant with the primary analysis, whereas at CPS ≥ 1 PD-L1 positivity was associated with superior OS (HR = 0.280 [95% CI: 0.106-0.745]; p = 0.011).</p><p><strong>Conclusion: </strong>Within a mean follow-up of 15.7 ± 12.5 months, PD-L1 expression assessed by CPS was not independently associated with survival or recurrence outcomes in surgically treated OSCC at the prespecified cutoff of CPS ≥ 10, nor at CPS ≥ 20. An isolated overall survival association at CPS ≥ 1 was driven by a very small PD-L1-negative reference group and should not be regarded as robust. Taken together, these data argue against a reliable standalone prognostic value of PD-L1 in the early postoperative period while the limited observation time does not permit conclusions on late recurrence or long-term survival.</p>","PeriodicalId":520733,"journal":{"name":"Oral and maxillofacial surgery","volume":"30 1","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13525057/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148852230","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}