Oral and maxillofacial surgery最新文献

{"title":"In vitro comparison of fixation techniques for stabilization of Le Fort I osteotomy in short and large advancements of the maxilla.","authors":"Misha L Tan, Max P A Balkenende, Damir Delic, Karel Kuik, Cornelis J Kleverlaan, Jan de Lange, Jean-Pierre T F Ho","doi":"10.1007/s10006-026-01596-8","DOIUrl":"10.1007/s10006-026-01596-8","url":null,"abstract":"<p><strong>Purpose: </strong>Le Fort I osteotomy is widely performed in orthognathic surgery for maxillary repositioning and for the treatment of dentofacial deformities and obstructive sleep apnea (OSA). Postoperative relapse remains a concern, particularly after large maxillary advancements, highlighting the importance of rigid fixation. This study aimed to determine which fixation technique provides the greatest rigidity.</p><p><strong>Methods: </strong>In this in vitro study, the biomechanical rigidity of five commonly used fixation techniques for Le Fort I osteotomies was evaluated using 150 polyurethane specimens with advancements of 5 mm and 10 mm. The techniques included two L-plates (A), four L-plates of different thicknesses (B and C), two precontoured Le Fort I plates (D), and a hybrid configuration with two precontoured Le Fort I plates combined with two L-plates (E). Resistance to vertical displacement was measured at 1, 3, and 5 mm using a biomechanical testing machine.</p><p><strong>Results: </strong>Fixation E consistently showed the highest resistance across both advancement distances and all displacement intervals, significantly outperforming fixations A, C, and D. Fixation B demonstrated resistance comparable to fixation E, whereas fixation C showed inferior performance despite a similar configuration. Fixations A and D showed the lowest resistance, particularly at 10 mm advancement.</p><p><strong>Conclusion: </strong>Overall, fixation E provided the greatest rigidity, while techniques relying on only two plates were biomechanically less effective. Further clinical studies are required to determine the clinical relevance of these findings.</p>","PeriodicalId":520733,"journal":{"name":"Oral and maxillofacial surgery","volume":"30 1","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13379497/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148475747","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":"An immunohistochemical based assessment of murine double minute 2 (MDM2) and cyclin-dependent kinase 4 (CDK4) in jaw osteosarcoma and benign osseous lesions.","authors":"Spriha Jha, Aadithya B Urs, Jeyaseelan Augustine, Priya Kumar","doi":"10.1007/s10006-026-01605-w","DOIUrl":"10.1007/s10006-026-01605-w","url":null,"abstract":"<p><p>The diagnosis of primary bone tumours of the jaw often presents as a diagnostic dilemma. Overlap in clinical, radiological, and histological features between benign lesions like juvenile trabecular ossifying fibroma (JTOF); osteoblastoma (OB) and malignant tumours like low-grade osteosarcoma (LGOS) makes the diagnosis challenging. While osteosarcoma is a malignant tumour with poor prognosis requiring aggressive treatment, benign lesions have generally favourable outcome. This study aimed to assess the immunohistochemical expression of murine double minute 2 (MDM2) and Cyclin-dependent kinase 4 (CDK4) in low-grade osteosarcoma and benign osseous lesions.</p><p><strong>Methodology: </strong>Immunohistochemical analysis was performed on tissue samples from diagnosed cases of LGOS, JTOF, and OB. The expression levels of MDM2 and CDK4 were analysed and compared across the three groups.</p><p><strong>Results: </strong>We found significantly higher expression of MDM2 and CDK4 in low-grade osteosarcoma compared to JTOF which showed negative expression in all of the cases. Osteoblastoma showed inconsistent and focal positivity contrary to OS where strong and diffuse expression of both the markers was observed. A strong co-expression of both the markers was also noted in 94% of OS cases.</p><p><strong>Conclusion: </strong>Immunohistochemistry for MDM2 and CDK4 is a valuable diagnostic tool in differentiating low-grade osteosarcoma from benign mimics. This approach provides a cost-effective, reliable, and accurate means for diagnosing jaw bone tumours, particularly when tissue samples are insufficient or on small incisional biopsies where accurate diagnosis is of prime importance.</p>","PeriodicalId":520733,"journal":{"name":"Oral and maxillofacial surgery","volume":"30 1","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148475730","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 for the prevention of medication-related osteonecrosis of the jaw after tooth extraction: a systematic review and meta-analysis.","authors":"Pedro Sampaio, Sargon Shazo, Valentino Vellone, Luciano Barreto Silva","doi":"10.1007/s10006-026-01602-z","DOIUrl":"10.1007/s10006-026-01602-z","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Medication-related osteonecrosis of the jaw (MRONJ) is a serious complication associated with antiresorptive and antiangiogenic therapies, particularly following tooth extraction. Platelet-rich fibrin (PRF) has been proposed as a biologically active adjunct capable of enhancing tissue repair and potentially reducing the risk of MRONJ. This systematic review and meta-analysis evaluated the effectiveness of PRF in preventing MRONJ and improving postoperative healing in patients undergoing tooth extraction while receiving these medications.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A comprehensive search of PubMed, EMBASE, and CENTRAL was conducted from inception to 1 June 2026. Studies comparing tooth extraction with PRF versus tooth extraction alone in patients receiving antiresorptive and/or antiangiogenic therapy were included. Risk ratios (RRs) with 95% confidence intervals (CIs) were pooled using random-effects models. An exploratory subgroup analysis by PRF subtype (L-PRF versus A-PRF) was conducted for the healing outcome, and a sensitivity analysis restricted to studies with moderate risk of bias was performed for the MRONJ outcome. The certainty of evidence was assessed using the GRADE approach. The primary outcome was MRONJ occurrence, and the secondary outcome was postoperative healing.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Seven studies were included in the qualitative synthesis, and seven contributed data to at least one meta-analysis. For MRONJ, six study cohorts involving 370 patients were analysed. PRF was associated with a significantly lower risk of MRONJ compared with extraction alone (RR = 0.29; 95% CI: 0.15-0.57; p = 0.0003; I² = 30%). A sensitivity analysis restricted to the two moderate-risk-of-bias studies yielded a consistent directional effect (RR = 0.13; 95% CI: 0.02-0.69; p = 0.02; I² = 0%), though based on very limited data. For postoperative healing, six studies involving 512 patients were included. PRF was associated with improved healing outcomes overall (RR = 1.31; 95% CI: 1.11-1.54; p = 0.001; I² = 69%). Subgroup analysis by PRF subtype demonstrated a significant effect for L-PRF (RR = 1.36; 95% CI: 1.07-1.73; p = 0.01; I² = 75%) but not for A-PRF (RR = 1.22; 95% CI: 0.99-1.52; p = 0.07; I² = 31%), with no statistically significant difference between subgroups (p = 0.51). The certainty of evidence was rated as Very Low for both outcomes according to GRADE.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;Current evidence suggests that adjunctive PRF may be associated with a reduced risk of MRONJ and improved healing following tooth extraction in patients receiving antiresorptive and/or antiangiogenic medications. However, these findings are based predominantly on observational studies with serious risk of bias and relatively small sample sizes, and the certainty of evidence is Very Low. Further well-designed randomised controlled trials are needed to confirm the magnitude and consistency of these potential benefi","PeriodicalId":520733,"journal":{"name":"Oral and maxillofacial surgery","volume":"30 1","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148458244","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":"Response to the letter to the editor.","authors":"Alina Marie Schmitz, Nils Lucca Kern, Homam Ward, Marius Sauerbrey, Friedrich Mrosk, Oliver Wagendorf, Susanne Nahles, Carsten Rendenbach, Norbert Neckel, Max Heiland, Steffen Koerdt","doi":"10.1007/s10006-026-01589-7","DOIUrl":"10.1007/s10006-026-01589-7","url":null,"abstract":"","PeriodicalId":520733,"journal":{"name":"Oral and maxillofacial surgery","volume":"30 1","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13372916/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148458261","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":"Incidental pulmonary nodules in oral squamous cell carcinoma - A retrospective cohort study.","authors":"Matthew Gilmore, Aleeza Baker, Omar Breik","doi":"10.1007/s10006-026-01601-0","DOIUrl":"10.1007/s10006-026-01601-0","url":null,"abstract":"<p><strong>Purpose: </strong>Incidental pulmonary nodules are frequently identified on staging imaging for oral cavity squamous cell carcinoma (SCC). These may represent metastases, lung primaries, or benign lesions. Existing risk stratification guidelines are not specific to head and neck cancer. This retrospective cohort study evaluated survival differences between patients with and without pulmonary nodules and explored follow-up imaging practices.</p><p><strong>Methods: </strong>This single-centre retrospective cohort study included adults with oral mucosal SCC managed with curative intent between 2011 and 2018. Clinical, demographic, and radiographic data, including nodule characteristics and follow-up imaging, were extracted from electronic records. Primary outcomes were overall survival and metastatic disease-related death, analysed using Fisher's exact test, Kaplan-Meier survival with log-rank testing, and multivariable Cox regression.</p><p><strong>Results: </strong>Of 4563 clinic patients screened, 372 met inclusion criteria (mean age 58.3 years, 62.9% male). Pulmonary imaging was available in 84.1% of patients; among those with baseline thoracic imaging, pulmonary nodules were present in 25.6%, predominantly measuring < 6 mm and radiographically indeterminate. Pulmonary nodules were not independently associated with metastatic disease-related death or reduced overall survival within this cohort. Nodule size and multiplicity did not demonstrate statistically significant associations with metastatic disease-related death. Older age, nodal disease, and perineural invasion were independently associated with poorer survival.</p><p><strong>Conclusion: </strong>Pulmonary nodules were common but were not independently associated with overall survival or metastatic mortality within this cohort. Established oncologic factors remained the dominant prognostic determinants. Small incidental pulmonary nodules identified on staging imaging should not, in isolation, alter curative treatment intent. Further prospective studies are required to clarify the prognostic significance of pulmonary nodules, particularly larger or radiologically suspicious lesions, and to determine the role of surveillance imaging strategies.</p>","PeriodicalId":520733,"journal":{"name":"Oral and maxillofacial surgery","volume":"30 1","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13364876/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148431931","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":"Modified Le Fort I osteotomy techniques for vertical maxillary excess: a comparative systematic review.","authors":"Sajal Khare, Veera Bhosale, Gunika Tayal, Abhilash Sahu, Mansoor Kachwala, Vinit Swami","doi":"10.1007/s10006-026-01600-1","DOIUrl":"10.1007/s10006-026-01600-1","url":null,"abstract":"<p><strong>Introduction: </strong>Importance: Vertical maxillary excess (VME) is a common dentofacial deformity that causes downward growth of the maxilla, leading to an elongated lower face, anterior open bite, and excessive gingival display. Although conventional Le Fort I osteotomy remains the gold standard for correcting vertical maxillary excess, it is associated with certain risks, including possible injury to the descending palatine artery (DPA). To improve surgical safety and treatment predictability, several modified osteotomy techniques have been introduced.</p><p><strong>Objectives: </strong>To systematically review and compare the clinical effectiveness, postoperative stability and safety of modified Le Fort I osteotomy techniques in treating VME.</p><p><strong>Materials & method: </strong>Data Sources: A systematic search was conducted using PubMed, Medline, Google Scholar, and Web of Science databases for studies published between 2016 and 2024. The review protocol was registered with PROSPERO (CRD42025616635).</p><p><strong>Study selection: </strong>Studies involving adults with vertical maxillary excess (VME) were included. Eligible studies evaluated modified Le Fort I osteotomy techniques-specifically conventional horseshoe, modified horseshoe, unilateral horseshoe, pyramidal, or U-shaped osteotomies-in patients undergoing orthognathic surgery. A total of 10 studies comprising 117 patients met the inclusion criteria.</p><p><strong>Data extraction and synthesis: </strong>Data extraction and synthesis were performed systematically to obtain information regarding surgical techniques, intraoperative and postoperative complications, maxillary repositioning accuracy, and long-term stability outcomes. Given the methodological and clinical heterogeneity among the included studies, a qualitative synthesis of the findings was undertaken.</p><p><strong>Main outcomes and measures: </strong>Primary outcome measures included successful maxillary repositioning, intraoperative or postoperative complications (particularly vascular injuries), and skeletal stability over at least one year.</p><p><strong>Results: </strong>Results: The electronic search identified 1,190 articles, of which 10 studies met the inclusion criteria. All reviewed modified Le Fort I techniques achieved intended repositioning without major complications. Notably, there were no significant vascular injuries, and skeletal stability was maintained for at least 12 months.</p><p><strong>Conclusion: </strong>Conclusion and Relevance: Modified Le Fort I osteotomies represent safe and effective alternatives to traditional methods, reducing risks while ensuring stable outcomes. Tailoring techniques to individual patient needs is crucial for optimizing aesthetic and functional results in VME management, ultimately improving patient satisfaction and quality of life. PROSPERO (CRD42025616635).</p>","PeriodicalId":520733,"journal":{"name":"Oral and maxillofacial surgery","volume":"30 1","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148431933","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":"Preoperative neoadjuvant chemotherapy was associated with improved local control in selected cases of locally advanced or invasive oral squamous cell carcinoma: a retrospective single-center study.","authors":"Hironori Sakai, Kiriko Matsuzawa, Yuji Kusafuka, Kazuya Miyamoto, Hiroshi Kurita","doi":"10.1007/s10006-026-01593-x","DOIUrl":"10.1007/s10006-026-01593-x","url":null,"abstract":"<p><strong>Purpose: </strong>We reviewed patients with resectable advanced OSCC who underwent curative surgery with or without NAC.</p><p><strong>Methods: </strong>This study reviewed 159 patients (NAC, 58; no-NAC, 101 patients). NAC with docetaxel and nedaplatin was administered before curative surgery for cases suspected of OSCC with high clinical and histological malignancy. The impact of NAC on overall survival (OS), local, and latent metastasis was analyzed by uni- and multivariate analysis. A decision tree analysis was performed to explore cases where NAC is expected to be effective.</p><p><strong>Results: </strong>N-classification and histologic differentiation significantly affected OS; NAC showed a near-significant impact, especially in invasive OSCC without nodal metastasis. On multivariate analysis, NAC and T-classification were significantly associated with local control, with NAC potentially effective for T4 or other invasive tumors; however, this association with local control did not translate into a significant difference in overall survival between the NAC and no-NAC groups. NAC did not prevent latent metastasis but had no negative effect on planned treatment.</p><p><strong>Conclusion: </strong>In this retrospective single-center cohort, NAC administered before curative surgery was associated with improved local control in selected patients with advanced OSCC, particularly those with T4 tumors or high-grade histological invasion (Yamamoto-Kohama grade 4). However, this association did not translate into a significant overall survival benefit. The findings should be interpreted as hypothesis-generating given the observational design and substantial baseline imbalances between groups, and prospective validation is required before clinical recommendations can be made.</p>","PeriodicalId":520733,"journal":{"name":"Oral and maxillofacial surgery","volume":"30 1","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148428493","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":"Evaluation of pre and postoperative inflammatory biomarkers through proximity extension assay in tongue squamous cell carcinoma : a pilot study.","authors":"Nanae Yatagai, Akira Kimoto, Junya Yamashita, Yui Enomoto, Yumi Muraki, Takumi Hasegawa, Masaya Akashi","doi":"10.1007/s10006-026-01594-w","DOIUrl":"10.1007/s10006-026-01594-w","url":null,"abstract":"<p><strong>Background: </strong>Although prognostic biomarkers in patients with oral squamous cell carcinoma (SCC) have previously been explored, none have yet been established for clinical use for oral SCC. This study evaluated plasma inflammatory cytokines using the proximity extension assay (PEA) in patients with tongue SCC before and after surgery to investigate relationships between disease status and cytokine levels.</p><p><strong>Methods: </strong>Plasma samples from 19 patients who underwent surgery for tongue SCC were collected pre- and postoperatively. Inflammatory cytokine levels were quantified by PEA. Cytokine levels were compared between preoperative patients with early- and advanced-stage cancer, patients with recurrence after surgery and with no recurrence, and as well as between patients of each stage grouped by prognosis.</p><p><strong>Results: </strong>No difference in preoperative cytokine levels was found between early- and advanced-stage patients. Levels of fms-related receptor tyrosine kinase 3 ligand (FLT3LG) were significantly lower in the postoperative recurrent group as compared with the nonrecurrent group (p = 0.049). Amongst the advanced-stage patients with recurrence or metastasis in postoperative, the reduction in interleukin-6 (IL-6), hepatocyte growth factor (HGF), and tumor necrosis factor (TNF) levels following surgery was less pronounced compared with the patients with no evidence of disease. (IL-6: p = 0.037, HGF: p = 0.020, TNF: p = 0.037).</p><p><strong>Conclusions: </strong>This pilot study indicates that FLT3LG, IL-6, HGF, and TNF may serve as promising biomarker candidates for evaluating disease status and prognosis in patients with tongue SCC using PEA technology, though validation in larger and adequately powered cohorts is warranted.</p>","PeriodicalId":520733,"journal":{"name":"Oral and maxillofacial surgery","volume":"30 1","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148428484","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 of template-guided zygomatic implant placement: a retrospective case series using cone-beam computed tomography.","authors":"Giovanni Battista Menchini-Fabris, Paolo Toti, Young Min Park, Frank Leusink, Saverio Cosola, Tommaso Grandi","doi":"10.1007/s10006-026-01598-6","DOIUrl":"10.1007/s10006-026-01598-6","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the three-dimensional accuracy of template-guided zygomatic implant placement using cone-beam computed tomography (CBCT) and to characterize linear, angular, and directional discrepancies between planned and actual implant positions.</p><p><strong>Methods: </strong>This retrospective case series included 14 patients rehabilitated with 21 zygomatic implants using static, bone-supported, stereolithographic surgical guides. Preoperative virtual plans (.stl files) were compared with postoperative CBCT scans through voxel-based registration. The positions of planned (P₁, P₂) and actual (P₃, P₄) implant necks and apices were analyzed to compute vertical (v₃,v₄) and horizontal (h₃, h₄) offsets, angular deviation (θ), and differential parameters describing deviation propagation (Δv = v₄-v₃, Δh = h₄-h₃). A vector-based geometric model was used to separately quantify axial and radial deviations along the implant trajectory. Nonparametric tests were performed (Wilcoxon signed-rank, p < 0.05).</p><p><strong>Results: </strong>Median deviations were as follows: v₃ = + 0.12 mm, h₃ = 1.18 mm, v₄ = - 0.05 mm, h₄ = 1.98 mm, and θ = 1.05°. The change in offsets revealed Δv = - 0.35 mm and Δh = + 0.81 mm. Horizontal deviations were significantly greater at the apex than at the neck (p = 0.0002), whereas vertical deviations differed significantly between the two implant levels (p = 0.0057). Most implants (≈ 71%) showed a Q₄ pattern (-Δv, +Δh), indicating reduced axial insertion depth associated with increased lateral displacement along the implant axis. Overall, deviations remained below 2 mm and 2°, confirming clinically acceptable precision for prosthetically driven zygomatic implant placement.</p><p><strong>Conclusion: </strong>Static template-guided zygomatic implant surgery achieved high spatial accuracy with limited angular and linear deviations. The vector-based analysis demonstrated a predominant Q₄ deviation pattern characterized by mild lateral amplification associated with reduced axial insertion depth. Despite higher variability than conventional implant sites, the results support the clinical reliability of static CBCT-based guidance for zygomatic implant rehabilitation.</p>","PeriodicalId":520733,"journal":{"name":"Oral and maxillofacial surgery","volume":"30 1","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148414700","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":"Career orientation among medical students in Germany: perceived motivating factors and barriers to pursuing oral and maxillofacial surgery - a nationwide survey.","authors":"Lisa Joana Fleck, Philipp Becker, Frederic Bouffleur, Nicolas Haverkamp, Lukas Benedikt Seifert, Florian Recker","doi":"10.1007/s10006-026-01597-7","DOIUrl":"10.1007/s10006-026-01597-7","url":null,"abstract":"<p><strong>Background: </strong>Oral and maxillofacial surgery (OMFS) faces increasing challenges arising from evolving healthcare demands, rising case complexity, and ongoing workforce recruitment challenges, necessitating the long-term preservation of specialized expertise. Although training pathways are well established, career trajectories among medical students remain highly heterogeneous. This study addresses the structural recruitment challenge in OMFS in Germany. It focuses on the mismatch between presumably strong interest in OMFS among medical students, and key barriers, particularly dual-degree requirements.</p><p><strong>Materials and methods: </strong>A cross-sectional, nationwide online survey was distributed by the Young Forum of the German Association of Oral and Maxillofacial Surgery (Junges Forum der DGMKG) across German medical schools to assess factors influencing career decisions for or against OMFS. The questionnaire covered demographic characteristics, career planning, knowledge and practical experience, and perceived stigma related to OMFS.</p><p><strong>Results: </strong>The study included 108 medical students (69% female; mean age 25 years), including 64% clinical students, 25% preclinical students, and 11% students in their final practical year. The primary outcome was self-reported interest in OMFS as a potential specialty choice. Interest was highest for OMFS (25%), followed by pediatrics (16%) and gynecology and obstetrics (12%). Completion of an OMFS internship and higher self-rated OMFS knowledge were independently associated with greater interest in OMFS, with internship completion associated with more than sixfold higher odds of naming OMFS as the preferred specialty (OR 6.65, p = 0.013). Female participants showed lower odds of preferring OMFS in the exploratory multivariable model and were also less willing to pursue a second dental degree (p < 0.001). While perception of training burden did not differ significantly by gender, it varied across training phases. Prior dental education showed a strong bivariate association with OMFS interest (Cramér's V = 0.50). Operative activity and reconstructive surgery emerged as the main motivators, whereas training duration and dual-degree requirement represented the dominant perceived barriers across all training phases.</p><p><strong>Conclusion: </strong>Within this exploratory sample of medical students, OMFS was frequently named as a specialty of interest. However, structural and environmental barriers may contribute to reduced willingness to pursue specialist training. Earlier OMFS exposure and greater specialty-specific knowledge were associated with increased interest, whereas the dual-degree requirement, prolonged training duration, and financial burden were perceived as barriers. These findings highlight the importance of earlier curricular exposure, structured practical experience, and targeted support strategies to improve long-term recruitment in OMFS.</p>","PeriodicalId":520733,"journal":{"name":"Oral and maxillofacial surgery","volume":"30 1","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13341896/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148400429","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}