Oral and maxillofacial surgery最新文献

{"title":"Effect of a phthalocyanine mouthrinse after connective tissue graft surgery for root coverage: a randomized split-mouth clinical trial.","authors":"Rafael Sponchiado Cavallieri, Caique Andrade Santos, Rafaela Stocker Salbego, Carla Andreotti Damante, Adriana Campos Passanesi Santana, Heitor Marques Honório, Leonardo Rigoldi Bonjardim, Mariana Schutzer Ragghianti Zangrando","doi":"10.1007/s10006-026-01614-9","DOIUrl":"10.1007/s10006-026-01614-9","url":null,"abstract":"<p><strong>Objectives: </strong>To evaluate effects of self-activating phthalocyanine mouthrinse on recipient sites of subepithelial connective tissue graft (SCTG), considering clinical outcomes, professional and patient assessments and quantitative somatosensory changes.</p><p><strong>Materials and methods: </strong>This randomized controlled, crossover, split-mouth clinical trial included 20 patients treated with SCTG plus coronally advanced flap (CAF). Recipient sites received 0.12% iron phthalocyanine mouthrinse (test group-PHY) and 0.12% chlorhexidine (control group-CHX) during 14 postoperative days. The primary outcome was percentage of root coverage (%RC) at 6 months. Secondary outcomes included clinical parameters (probing depth, PD; recession depth and width, RD, RW; percentage of complete root coverage (CRC); clinical attachment level, CAL; keratinized tissue thickness and width, KTT, KTW), professional- and patient-reported outcomes, mechanical detection threshold (MDT) and mechanical pain threshold (MPT).</p><p><strong>Results: </strong>PHY and CHX groups showed significant improvements in clinical parameters, including reduced RD and RW, CAL gain, and increased KTW and KTT (p < 0.05). %RC was similar between groups, at approximately 80%. Professional- and patient-reported outcomes, including dentin hypersensitivity and esthetic perception, as well as MPT and MDT, showed no significant differences between groups. Postoperative symptoms decreased progressively, and oral health-related quality of life remained unchanged after 6 months.</p><p><strong>Conclusions: </strong>Postoperative use of phthalocyanine after CAF + SCTG resulted in clinical outcomes comparable to chlorhexidine, including similar root coverage, with no differences in professional-, patient-centered outcomes, somatosensory profile, or oral health-related quality of life.</p><p><strong>Clinical relevance: </strong>Iron phthalocyanine may represent a promising alternative for postoperative care in periodontal plastic surgeries.</p>","PeriodicalId":520733,"journal":{"name":"Oral and maxillofacial surgery","volume":"30 1","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13447545/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148681911","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":"Histomorphological alterations in human bone tissue following in vivo osteotomy: a comparative study of conventional drilling, piezosurgery, and er: YAG laser ablation.","authors":"Bistra Blagova","doi":"10.1007/s10006-026-01612-x","DOIUrl":"10.1007/s10006-026-01612-x","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to evaluate, compare, and map the specific zones of histomorphological and tissue alterations in human bone following in vivo osteotomy performed by conventional drilling, piezosurgery, and Er: YAG laser ablation, proposing a universal zonal model of bone tissue response.</p><p><strong>Materials and methods: </strong>A total of 80 human mandibular bone samples obtained during in vivo third molar extractions requiring bone removal were evaluated. The specimens were divided into three experimental groups based on the active osteotome used: conventional drilling (n = 20), piezosurgery (n = 30), and Er: YAG laser ablation (n = 30). Histological and histomorphometric screenings (Toluidine blue staining, magnifications х 10, х 20, and х 40), and scanning electron microscopy (magnification х 2500) were performed to identify, measure, and compare the zones of structural, mechanical, and collateral thermal alterations adjacent to the cutting edges.</p><p><strong>Results: </strong>Distinct microstructural tissue modification patterns were identified, with significant dependence on the physical cutting mechanism (p < 0.05). Conventional drilling produced an irregular configuration with an attached \"smear-like\" debris layer (142.0 ± 45.31 μm) and the most extensive collateral thermal necrosis zone (168.05 ± 56.42 μm). Piezosurgery produced a heavily fragmented, irregular cutting line accompanied by a loose peripheral \"satellite halo\" of micronized fragments (206.73 ± 107.42 μm) but yielded the narrowest thermal damage zone (49.03 ± 39.91 μm). Conversely, Er: YAG ablation produced 100% sharp, regular, and clean borders without debris or micro-fragment layers, demonstrating a well-demarcated photothermal modification zone (99.50 ± 67.63 μm). Cross-modality evaluation showed that the choice of device significantly determined both surface debris architecture (F = 68.361, p = 0.001) and thermal alteration depth (F = 27.374, p = 0.001).</p><p><strong>Conclusions: </strong>Different bone-cutting instruments induce distinct, predictable zones of structural and morphological alterations in vital human bone, validating a three-layered universal zonal model (Surface Interface, Transitional Reactive, and Unaltered Native Matrix). Both Er: YAG laser and piezosurgery exhibit superior atraumatic characteristics and advanced tissue-preservation capabilities in humans compared to conventional drilling, providing a powerful biological rationale for their expanded clinical implementation in bone surgery.</p>","PeriodicalId":520733,"journal":{"name":"Oral and maxillofacial surgery","volume":"30 1","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148681945","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":"Accuracy and stability of virtual surgical planning for maxillary advancement in patients with cleft lip and palate: a systematic review and meta-analysis.","authors":"Alfan Maulana Erdiansyah, Yossy Yoanita Ariestiana, Andi Tajrin","doi":"10.1007/s10006-026-01608-7","DOIUrl":"10.1007/s10006-026-01608-7","url":null,"abstract":"<p><strong>Background: </strong>Cleft lip and palate (CLP) frequently cause maxillary hypoplasia, requiring surgical advancement, and virtual surgical planning (VSP) is increasingly used to improve accuracy. This systematic review and meta-analysis synthesized the evidence on VSP-assisted maxillary advancement in patients with CLP, with surgical accuracy as the primary outcome and skeletal stability, intraoperative efficiency, complications, patient-reported outcomes, and software utility as the secondary outcomes.</p><p><strong>Methods: </strong>This review followed the PRISMA 2020 statement and was prospectively registered (PROSPERO CRD420251011475). PubMed, Scopus, Web of Science, Embase, and ScienceDirect were searched. Methodological quality and certainty of evidence were assessed. Conventional osteotomy and distraction osteogenesis were analyzed separately; an exploratory random-effects meta-analysis was performed only for the homogeneous conventional Le Fort I osteotomy subset.</p><p><strong>Results: </strong>Twelve studies were included. VSP achieved clinically acceptable accuracy, with mean linear deviations of 0.05-2.75 mm and most angular deviations below 4°. In the conventional Le Fort I subset, random-effects pooling with Hartung-Knapp adjustment gave mean absolute deviations of 0.65 mm mediolaterally (95% CI 0.58-0.73) and 1.10 mm superoinferiorly (0.49-1.71), both highly consistent (I² = 0%). Anteroposterior deviation was not pooled owing to substantial heterogeneity (I² = 88%) and ranged from 1.03 to 2.75 mm across studies. Where reported, relapse was generally 1-2 mm but heterogeneous.</p><p><strong>Conclusion: </strong>Current evidence supports the accuracy and feasibility of VSP-assisted maxillary advancement in patients with CLP; however, it is insufficient to prove reduced relapse or superiority over conventional planning. Because certainty is low to very low, VSP should be regarded as a promising adjunct rather than a proven standard of care; adequately powered prospective comparative studies with standardized outcomes are needed.</p>","PeriodicalId":520733,"journal":{"name":"Oral and maxillofacial surgery","volume":"30 1","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148655522","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":"Arthroscopy-assisted inferior compartment arthrocentesis of the temporomandibular joint.","authors":"Romualdo Cardoso Monteiro de Barros, Lucas Maia Nogueira, Helcio Yogi Ono","doi":"10.1007/s10006-026-01610-z","DOIUrl":"10.1007/s10006-026-01610-z","url":null,"abstract":"<p><strong>Purpose: </strong>Arthroscopic lysis and lavage of the temporomandibular joint (TMJ) is an established treatment for internal derangements (ID). Conventional techniques are limited to the superior compartment, although pathologies and translational movement frequently involve the inferior compartment. This prospective pilot case series describes and evaluates a reproducible needle-based arthroscopy-assisted technique for lysis and lavage of the inferior compartment, with no superior-compartment-only control group.</p><p><strong>Methods: </strong>Twenty patients with Wilkes stage IV anterior disc displacement without reduction and condylar resorption confirmed on MRI/CT were prospectively treated. Follow-up ranged from 12 to 24 months (mean 18.0 ± 5.2 months). Two 18G needles were introduced under arthroscopic guidance through the lateral discal transitional zone into the inferior compartment, enabling lavage with 100 mL of Ringer's solution. Superior compartment lysis and lavage were subsequently performed, followed by injection of high-molecular-weight hyaluronic acid. Outcomes included pain (Visual Analog Scale, VAS) and mandibular motion (maximum mouth opening and laterality).</p><p><strong>Results: </strong>VAS scores (left side) decreased from 5.15 ± 3.00 preoperatively to 0.40 ± 0.99 postoperatively. VAS scores (right side) decreased from 4.65 ± 3.01 to 0.50 ± 0.76. Maximum mouth opening improved by + 4.25 ± 4.19 mm (95% CI 2.32-6.18). Right and left laterality improved by + 3.45 ± 2.89 mm and + 2.55 ± 2.31 mm, respectively, with 85-90% of patients showing increased excursions. No major complications occurred.</p><p><strong>Conclusion: </strong>This pilot series suggests that arthroscopy-assisted needle-based access to the inferior TMJ compartment appears feasible and safe, yielding clinically meaningful improvements in pain and motion. The technique is cost-effective and reproducible, and may expand minimally invasive therapeutic options for advanced internal derangements. Controlled comparative studies are required to establish its incremental benefit over superior compartment arthroscopy alone.</p>","PeriodicalId":520733,"journal":{"name":"Oral and maxillofacial surgery","volume":"30 1","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148623309","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":"Bone healing after Le Fort I osteotomy with a new cotton-like bone graft substitute composed of β-tricalcium phosphate and a bioabsorbable polymer, polylactic-co-glycolic acid.","authors":"Koichiro Ueki, Karen Gomi, Riku Kohara, Yusuke Kurosawa, Kunio Yoshizawa, Young-Min Shin, Akinori Moroi","doi":"10.1007/s10006-026-01609-6","DOIUrl":"10.1007/s10006-026-01609-6","url":null,"abstract":"<p><strong>Objectives: </strong>This study evaluated bone healing in the maxillary anterior wall after Le Fort I osteotomy using a new cotton-like bone graft substitute (Rebossis^®), composed of beta-tricalcium phosphate and polylactic-co-glycolic acid, absorbable plates.</p><p><strong>Materials and methods: </strong>The anterior bony gap between maxillary segments was covered with Rebossis^®. Bone defect area and the area occupied by Rebossis^® were assessed using computed tomography immediately after surgery and at 1 year postoperatively.</p><p><strong>Results: </strong>The study included 40 patients (80 sides) who underwent Le Fort I and mandibular osteotomies. Absorbable plates and screws were used to fix the maxillary segments in all cases. Cases were divided into a Rebossis^® group (40 sides) and a control group (40 sides). In the Rebossis^® group, graft area significantly decreased after 1 year (p < 0.0001), and no residual bone defects were observed between segments. In the control group, although the bone defect area at 1 year was significantly smaller than that immediately after surgery in the frontal view (p < 0.0001), complete bone healing was observed in only 5 of 40 sides. No postoperative infections and related clinical symptoms were observed in any patients.</p><p><strong>Conclusion: </strong>Coverage of the intersegmental gap with Rebossis^® promotes new bone formation following Le Fort I osteotomy with absorbable plate fixation. This study was retrospective cohort study. This study was performed according to the Declaration of Helsinki, and was approved by the Ethical committee of the University of Yamanashi. Receipt number R06647.</p>","PeriodicalId":520733,"journal":{"name":"Oral and maxillofacial surgery","volume":"30 1","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148623486","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":"Excision of the internal jugular vein in uncontrolled Lemierre's syndrome: a case report and literature review.","authors":"Kazuki Hasegawa, Hideo Miyamoto, Yoshio Ohyama","doi":"10.1007/s10006-026-01607-8","DOIUrl":"10.1007/s10006-026-01607-8","url":null,"abstract":"<p><strong>Background: </strong>Lemierre's syndrome is a rare condition characterized by head and neck infection, septic thrombophlebitis of the internal jugular vein (IJV), bacteremia, and septic embolic complications. Although the classic form is usually associated with oropharyngeal infection and Fusobacterium necrophorum, odontogenic and non-Fusobacterium cases have also been reported. Most cases are controlled with source control and prolonged antimicrobial therapy, with or without anticoagulation.</p><p><strong>Case report: </strong>We report a severe case of Lemierre's syndrome following odontogenic infection in a 64-year-old man. Contrast-enhanced computed tomography revealed a deep neck space abscess and right IJV thrombosis. Cultures grew viridans group streptococci. Despite drainage, repeated irrigation, broad-spectrum antimicrobial therapy, and anticoagulation, the patient developed persistent bacteremia, septic pulmonary complications, disseminated intravascular coagulation, and acute respiratory distress syndrome. Surgical excision of the thrombosed IJV was performed as salvage treatment after multidisciplinary reassessment. Blood cultures became negative on the day following IJV excision, and the patient subsequently improved after prolonged intensive treatment.</p><p><strong>Conclusion: </strong>IJV excision remains controversial and should not be considered routine treatment for Lemierre's syndrome. However, it may be considered as a salvage option in carefully selected patients with persistent septicemia, progressive septic embolization, or clinical deterioration despite adequate source control, appropriate antimicrobial therapy, and multidisciplinary management.</p>","PeriodicalId":520733,"journal":{"name":"Oral and maxillofacial surgery","volume":"30 1","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148612431","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":"Successful management of lymphangioma circumscriptum of the tongue with sirolimus monotherapy: a case report.","authors":"Allison Salmon, Paige Reilly, Ashleigh Weyh, Nick Callahan","doi":"10.1007/s10006-026-01604-x","DOIUrl":"10.1007/s10006-026-01604-x","url":null,"abstract":"<p><p>Lymphangiomas are uncommon congenital benign tumors of the lymphatic system. They are typically diagnosed at birth and develop during the first years of life. The tongue is the most commonly affected structure in the oral cavity. Lymphangioma circumscriptum of the tongue is a common cause of macroglossia in children, and this macroglossia can lead to complications such as exclusive nasal breathing, airway obstructions, impaired oral feeding, esthetic disfigurement, and difficulties in mastication, swallowing, and speech. This report discusses the successful treatment of lymphangioma circumscriptum of the tongue with sirolimus, an immunosuppressant drug. The extent of the lesion made traditional surgical management impossible without excessive morbidity, so the patient was managed medically. This case report was unique due to its entirely nonsurgical treatment approach. The patient completed a 17-month course of sirolimus monotherapy with response to treatment monitored using T2 MRI. There was excellent response to treatment, full resolution of symptoms, and no treatment-related toxicity.</p>","PeriodicalId":520733,"journal":{"name":"Oral and maxillofacial surgery","volume":"30 1","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13402244/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148595425","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":"Activation of the kynurenine pathway in possible bruxism: associations with cortisol, TNF-α, and possible bruxism subtypes.","authors":"Ebru Afşar, Şükran Ayran, Neşe Oral, Kadir BahadırKuzzu, Efe Şanlı, Muhammed Ali Avcı, Melek Sena Göz","doi":"10.1007/s10006-026-01606-9","DOIUrl":"10.1007/s10006-026-01606-9","url":null,"abstract":"<p><strong>Objective: </strong>Bruxism (BR) is a repetitive activity of the masticatory muscles influenced by stress-related and neurophysiological mechanisms. Psychological stress activates the hypothalamic-pituitary-adrenal (HPA) axis, leading to cortisol release and modulation of immune responses and tryptophan (Trp) metabolism via the kynurenine (KYN) pathway. The KYN pathway is activated in various systemic and physiological disorders. However, whether KYN pathway activation occurs in BR remains unknown. Investigating KYN pathway activation in BR may help clarify the biochemical basis of BR. This study aimed to investigate changes in cortisol, melatonin, tryptophan (Trp), serotonin (5-hydroxytryptamine, 5-HT), KYN, tumor necrosis factor-alpha (TNF-α), and interferon-gamma (IFN-γ) levels in saliva samples taken from individuals with possible BR, and to examine whether there are differences in these parameters between individuals with possible sleep bruxism (SB) and possible combined bruxism (CB).</p><p><strong>Methods: </strong>The study included 84 individuals with possible BR and 84 age-matched healthy controls. BR symptoms were assessed with a five-item questionnaire evaluating sleep- and awake-related grinding and clenching behaviors. Morning saliva samples were collected and analyzed by ELISA to determine concentrations of cortisol, melatonin, Trp, 5-HT, KYN, TNF-α, and IFN-γ. The degradation rate of Trp was evaluated using the KYN/Trp ratio (KTR). Biochemical parameters were compared between groups. Correlation analyses assessed relationships among variables, and regression analyses identified independent predictors of bruxism subtypes.</p><p><strong>Results: </strong>Saliva cortisol, TNF-α, KYN, and KTR levels were higher, and Trp and IFN-γ levels were lower in the possible BR group than in the control group (p < 0.001 for all comparisons). Saliva cortisol, TNF-α, KYN, and KTR levels were higher (p < 0.001 for all comparisons), and melatonin levels were lower in the possible SB group than in the possible CB (p < 0.01). In the possible BR group, cortisol levels were positively correlated with KYN and KTR and negatively correlated with IFN-γ. Low Trp levels were a common independent predictor across both possible BR, while TNF-α was the only independent predictor distinguishing possible SB from possible CB.</p><p><strong>Conclusion: </strong>Our results suggest an interaction among stress-related neuroendocrine responses, immune activation, and Trp metabolism in BR. Patients with possible SB had higher levels of cortisol, KYN, KTR, and TNF-α than those with possible CB, suggesting that SB may be more closely linked to stress and inflammation. Our results may contribute to understanding the interactions among HPA axis activity, inflammation, and Trp metabolism in BR, as well as the biochemical basis of BR type differences.</p>","PeriodicalId":520733,"journal":{"name":"Oral and maxillofacial surgery","volume":"30 1","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148564317","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":"Inferior alveolar nerve dissection/repositioning during SSRO in hemimandibular hyperplasia: cases report and literature review.","authors":"Jiaqi Yue, Guoliang Sa, Zhongxing Wu","doi":"10.1007/s10006-026-01599-5","DOIUrl":"10.1007/s10006-026-01599-5","url":null,"abstract":"<p><strong>Purpose: </strong>Inferior alveolar nerve (IAN) dissection and repositioning is critical for preventing iatrogenic IAN injury during combined mandibular border resection and sagittal split ramus osteotomy (SSRO) in patients with severe hemimandibular hyperplasia (HH). Traditional IAN repositioning includes two-stage and concurrent one-stage procedures. This study introduces a modified one-stage technique and compares the respective advantages and disadvantages of these three surgical protocols.</p><p><strong>Methods: </strong>Four patients with HH were enrolled and treated with three different surgical protocols: one two-stage procedure, one conventional one-stage procedure, and two modified one-stage procedures. The modified technique features a vertical osteotomy placed 5 mm anterior to the mental foramen to protect the anterior loop of the IAN.</p><p><strong>Results: </strong>All patients achieved satisfactory facial symmetry and aesthetic improvement postoperatively. Neurosensory assessment at 6-month follow-up confirmed complete recovery of lower lip sensation without persistent numbness. Compared with the two-stage and conventional one-stage approaches, the modified technique effectively preserved the IAN anterior loop, simplified surgical procedures, and minimized bony defects by maintaining buccal cortical bone integrity.</p><p><strong>Conclusion: </strong>The modified one-stage approach is a simplified and effective technique that provides reliable neuroprotection for the anterior loop of the IAN while minimizing bony defects during SSRO in HH patients. Given the limited sample size of this case series, further large-sample and long-term studies are required to fully validate tits efficacy, long-term stability, and complication profile.</p>","PeriodicalId":520733,"journal":{"name":"Oral and maxillofacial surgery","volume":"30 1","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148521862","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":"Is inpatient monitoring necessary in pediatric patients with comorbidities following routine dental procedures? A retrospective analysis.","authors":"Max Lukas Linderkamp, Efthymios Papazacharias, Madlen Sophie Eich, Jan Gaessler, Pascal Eber, Alexander Rahman, Philipp Jehn, Fritjof Lentge, Michael-Tobias Neuhaus, Nils-Claudius Gellrich, Philippe Korn","doi":"10.1007/s10006-026-01603-y","DOIUrl":"10.1007/s10006-026-01603-y","url":null,"abstract":"<p><strong>Purpose: </strong>Children and young adults with severe pre-existing conditions frequently require dental treatment under general anesthesia (GA) and are commonly scheduled for postoperative inpatient surveillance due to presumed elevated anesthetic or surgical risks. Although this approach prioritizes safety, it may contribute to prolonged or unnecessary hospitalization, increased healthcare costs, and potential psychological burden, particularly in patients with neurodevelopmental or congenital disorders. In light of the reportedly low incidence of severe complications following dental treatment under GA, this study aims to evaluate the necessity of routine inpatient admission in pediatric patients (< 18 years of age) with comorbidities and to assess the frequency and severity of perioperative complications.</p><p><strong>Methods: </strong>All pediatric patients with pre-existing conditions who underwent planned inpatient surgical dental treatment under GA at the Department of Oral and Maxillofacial Surgery at Hannover Medical School between 2014 and 2025 were included. The indications for inpatient treatment, anesthesiological parameters such as the American Society of Anesthesiologists (ASA) classification, and severe perioperative complications (corresponding to grade ≥ 2 of the Clavien-Dindo classification) were analyzed. It was assessed whether the ASA classification or the type of pre-existing condition significantly influenced the occurrence of perioperative complications.</p><p><strong>Results: </strong>A total of 199 patients were analyzed. Patients who underwent surgery were mainly categorized as ASA II (n = 80, 40.2%) and III (n = 102, 51.3%), and mostly presented with cardiovascular (n = 68, 34.2%) or hematological/oncological preconditions (n = 47, 23.6%). Perioperative complications occurred in 8 cases (4.2%); of those, 6 were intraoperative (3.1%), and 2 were postoperative (1.0%). The probability of perioperative complications did not correlate with ASA classification or pre-existing conditions (p [Fisher] = 0.166, and p [Fisher] = 0.571, respectively). Age significantly influenced the probability of complications (U = 451.00, p = 0.050), indicating that older patients were more likely to experience complications than younger patients.</p><p><strong>Conclusion: </strong>As postoperative complications occur very rarely, even in patients with pre-existing conditions, inpatient surveillance should warrant thoughtful consideration to liberate hospital capacities. Interdisciplinary pre-, intra-, and postoperative assessment of the need for inpatient surveillance should ensure patient safety and provide further insights into risk factors for peri- and especially postoperative complications. The authors recommend validating risk scores and algorithms for decision-making regarding inpatient surveillance.</p>","PeriodicalId":520733,"journal":{"name":"Oral and maxillofacial surgery","volume":"30 1","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13379472/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148475749","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}