Oral and maxillofacial surgery最新文献

{"title":"Survival outcomes after orbital exenteration for recurrent or previously treated orbital malignancies: impact of margin status and metastatic spread.","authors":"M Todaro, F Perquoti, F De Lorenzis, G Gasparini, G Saponaro, G Barbera, G Savino, M G Sammarco, M M Pagliara, G Schinzari, E Rossi, L Tagliaferri, B Fionda, F Pastore, T Tartaglione, L Ausili Cefaro, X Moix Gil, V Santoro, A Moro","doi":"10.1007/s10006-026-01591-z","DOIUrl":"10.1007/s10006-026-01591-z","url":null,"abstract":"<p><strong>Background: </strong>Orbital exenteration is a radical procedure used in selected orbital malignancies, yet survival outcomes vary widely, particularly in recurrent or previously treated disease. We evaluated the association of pathological stage (nodal and/or distant metastasis status) and margin status with overall survival (OS) and disease-free survival (DFS) in patients undergoing exenteration for recurrent or previously treated orbital cancers.</p><p><strong>Methods: </strong>We retrospectively analyzed 39 patients who underwent orbital exenteration between 2017 and 2024. Patients were categorized as localized disease (pN0/pM0) or advanced disease with nodal and/or distant metastasis (pN + and/or pM+). Survival was estimated using Kaplan-Meier analysis and compared using the log-rank test. Median follow-up was 365 days. Margins were classified as R0 or R1.</p><p><strong>Results: </strong>Of the 39 patients, 24 (61.5%) had localized disease and 15 (38.5%) had advanced disease with nodal and/or distant metastasis; 6 patients (15.4%) had positive margins. 24-month OS was 78% in localized disease versus 33% in patients with nodal and/or distant metastasis (p = 0.011). Median OS was not reached in localized disease and was 13 months in patients with nodal and/or distant metastasis. 24-month DFS was 62.5% versus 33% (p = 0.017). R1 margins were associated with markedly worse outcomes: 24-month OS 0% vs. 75.8% for R0, and all R1 patients recurred within 12 months. Sensitivity analysis excluding < 6-month follow-up confirmed these findings.</p><p><strong>Conclusions: </strong>Nodal and/or distant metastatic status and positive surgical margins were associated with worse survival outcomes after orbital exenteration for recurrent or previously treated orbital malignancies. Most adverse events occurred within the first postoperative year, suggesting a clinically relevant early risk period. Given the histological heterogeneity of the cohort, these findings should be interpreted as prognostic patterns in a salvage orbital oncology population and require validation in larger disease-specific series.</p>","PeriodicalId":520733,"journal":{"name":"Oral and maxillofacial surgery","volume":"30 1","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13328222/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148379545","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":"Prevalence of oral lesions in Langerhans cell histiocytosis: a systematic review and meta-analysis.","authors":"Mario Dioguardi, Angela Pia Cazzolla, Ciro Guerra, Diego Sovereto, Angelo Martella, Lorenzo Lo Muzio, Khrystyna Zhurakivska, Angela Tisci, Roberto Lovero, Vincenzo Brescia, Giuseppe Troiano, Andrea Ballini","doi":"10.1007/s10006-026-01586-w","DOIUrl":"10.1007/s10006-026-01586-w","url":null,"abstract":"<p><strong>Background: </strong>Histiocytoses are rare diseases and represent a heterogeneous group of pathologies with variable clinical features, determined by the tissue accumulation of cells of presumed dendritic or macrophage origin. Oral manifestations may constitute an early clinical sign and sometimes the only initial evidence of the pathology. The aim of this systematic review with meta-analysis was to investigate the prevalence of oral manifestations in patients affected by LCH, describing their clinical and histopathological characteristics.</p><p><strong>Methods: </strong>A systematic search was conducted on three major databases (PubMed, Scopus and ScienceDirect) and on Google Scholar grey literature. Relevant articles were selected based on inclusion and exclusion criteria, following the guidelines of the Cochrane handbook. The primary outcome was the prevalence of oral manifestations, calculated as the proportion of affected patients compared to the total cohort in each study. A fixed-effects meta-analysis was performed. A sensitivity analysis was also performed excluding studies with high heterogeneity and a correlation analysis between the mean age at diagnosis and the prevalence of oral lesions, weighted by sample size.</p><p><strong>Results: </strong>16 studies were included for a total of 2,174 patients. The aggregate prevalence of oral manifestations was 14.86% (95% CI: 11.80-18.58%), reduced to 10.57% in sensitivity analysis. The most frequently involved sites were the mandible and the gums, with osteolytic, ulcerative or periodontal lesions. The weighted correlation analysis between age and prevalence showed a very weak and non-significant correlation (r = 0.007, p = 0.991; Spearman ρ = - 0.258, p = 0.734), confirmed even after the exclusion of outliers.</p><p><strong>Conclusions: </strong>Oral manifestations represent a relevant clinical component in LCH and may constitute an early diagnostic sign. However, the prevalence varies widely between studies. No significant correlation was observed between age at diagnosis and the presence of oral manifestations. However, the interpretation of these findings is limited by the predominance of retrospective studies and the overall moderate methodological quality of the available evidence. Therefore, further standardized prospective studies are needed to better clarify the clinical impact of oral lesions in LCH.</p>","PeriodicalId":520733,"journal":{"name":"Oral and maxillofacial surgery","volume":"30 1","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13331839/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148379538","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":"Health adjusted age and surgical outcomes in elderly oral cavity cancer patients: a case series from the Indian subcontinent.","authors":"Abrar Ahmed, Abhay K Kattepur, Gopinath S Kodaganur","doi":"10.1007/s10006-026-01595-9","DOIUrl":"10.1007/s10006-026-01595-9","url":null,"abstract":"<p><strong>Purpose: </strong>Elderly oral cavity cancer patients form a unique cohort with multiple therapeutic considerations. The Oral Cancer Survival Calculator^® has been used to estimate the risk of cancer-specific deaths in patients with oral cancer. The aim of our study was to evaluate surgical outcomes and cancer-specific survival in elderly oral cavity cancer patients using the calculator.</p><p><strong>Methods: </strong>Retrospective outcome analysis of elderly (>/=70 years) oral cavity cancer patients undergoing surgery at a rural-based tertiary academic institution was performed. The calculator was used to decipher health adjusted age (HAA), estimated 1-, 2- and 5-year overall survival (OS) and cancer specific deaths. Chronological age and HAA-related outcomes were analysed.</p><p><strong>Results: </strong>Ninety-seven elderly patients (median age: 74 years) underwent surgery. Post-operative complications were noted in 18.6%, with an overall mortality of 14.4%. Presence of comorbidities (p < 0.001) and the need for tracheostomy (p < 0.001) significantly increased complication rates. Using the calculator, the estimated 1-, 2- and 5-year OS and cancer-related deaths was 84%, 71% and 37% and 14%, 26% and 37% respectively. However, the accuracy of the calculator in predicting deaths was 55.5%. HAA, obtained from the calculator, was lower than the corresponding chronological age in 57.7% of patients and was associated with lower post-operative complications (7.1%) and re-admission (1.8%) rates.</p><p><strong>Conclusions: </strong>HAA was predictive of lower complication and re-admission rates after surgery in elderly oral cavity cancer patients. The Oral Cancer Survival Calculator ^® showed a moderate prediction for mortality. However, larger studies are needed to validate these findings.</p>","PeriodicalId":520733,"journal":{"name":"Oral and maxillofacial surgery","volume":"30 1","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148371769","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":"Endoscope-assisted transoral removal of benign midline cervical neoplasms: A preliminary study.","authors":"Yilin Peng, Yanran Shi, Xiangyu Zhou, Xingwang Li, Xiaoqian Li, Rong Wang, Hui Xu, Liang Shi","doi":"10.1007/s10006-026-01592-y","DOIUrl":"10.1007/s10006-026-01592-y","url":null,"abstract":"<p><strong>Background: </strong>Benign midline cervical tumors, such as thyroglossal duct cysts (TDCs) and dermoid cysts, are typically removed via cervical incisions, often resulting in noticeable scars. This study evaluates the feasibility, safety, and outcomes of endoscope-assisted transoral resection with concealed incisions.</p><p><strong>Methods: </strong>A retrospective analysis was performed on 24 patients who underwent endoscopic transoral excision at Qilu Hospital (2018-2024). Preoperative MRI or CT was performed to assess tumor characteristics. Incisions were made in the oral vestibule or floor of the mouth mucosa, tailored to tumor location.</p><p><strong>Results: </strong>All procedures were successfully completed endoscopically. Five patients experienced transient lower lip numbness; one patient with a thyroglossal duct fistula developed a seroma and infection, which resolved with drainage. At 3 months postoperatively, no oral dysfunction was observed. The mean Visual Analog Scale (VAS) score for cosmetic satisfaction was 9.1 ± 0.8, indicating high patient satisfaction. No recurrences were observed during follow-up.</p><p><strong>Conclusions: </strong>Transoral endoscopic resection is a feasible alternative that avoids externally visible scars for selected patients with benign midline cervical neoplasms, achieving satisfactory cosmetic and functional outcomes with no compromise to safety.</p>","PeriodicalId":520733,"journal":{"name":"Oral and maxillofacial surgery","volume":"30 1","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148348631","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":"Timing of surgery after neoadjuvant immunochemotherapy in head and neck squamous cell carcinoma: Current evidence, surgical implications, and a research agenda.","authors":"Abdullah Qahtan, Ahmed Al-Sayadi, Eslah Mohammed","doi":"10.1007/s10006-026-01587-9","DOIUrl":"10.1007/s10006-026-01587-9","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Significance: &lt;/strong&gt;Perioperative immune checkpoint blockade is rapidly moving into routine care for resectable head and neck squamous cell carcinoma (HNSCC), making timing of surgery after neoadjuvant immunotherapy (NAI) and neoadjuvant immunochemotherapy (NAIC) increasingly important clinical question rather than a purely theoretical one. Yet the literature remains dominated by studies that report feasibility or absence of delay, not by evidence that defines an optimal interval from treatment completion to surgery. Both immune-only and chemoimmunotherapy regimens are addressed, as their timing implications differ.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;To synthesize the current evidence regarding surgery timing after neoadjuvant immunotherapy and immunochemotherapy in HNSCC, with dedicated attention to oral squamous cell carcinoma (OSCC), and to propose a practical research-informed framework for current clinical use.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Evidence review: &lt;/strong&gt;This focused narrative review used targeted searches of PubMed/MEDLINE, Google Scholar, and reference lists of relevant reviews and primary studies through April 30, 2026. Priority was given to publications that explicitly reported interval to surgery, surgical delay, perioperative feasibility, pathologic response, complications, or OSCC-specific timing considerations. Consensus documents were included only to contextualize procedural guidance and were not treated as comparative timing evidence. We did not identify a systematic review whose primary aim was to define the optimal timing of surgery after neoadjuvant immunochemotherapy in HNSCC or OSCC.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Findings: &lt;/strong&gt;Previous reviews consistently show that neoadjuvant immunotherapy or chemoimmunotherapy is generally feasible and usually does not cause major surgical delay. Across prospective studies, surgery was commonly scheduled within approximately 1 to 4 weeks after the last neoadjuvant treatment, although interval definitions were heterogeneous. OSCC studies tend to use shorter intervals, often around 1 to 3 weeks. The strongest timing-specific evidence currently comes from a 2026 HNSCC study showing that surgery performed more than 3 weeks after neoadjuvant immunochemotherapy was associated with lower pathologic response, higher complication risk, and shorter disease-free survival. However, this finding remains observational and requires prospective validation.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Current evidence supports surgical feasibility after neoadjuvant immunotherapy and immunochemotherapy in HNSCC but does not establish a universally validated optimal interval. For many PD-1-based immunochemotherapy regimens, avoiding unnecessary delay beyond 3 weeks after treatment completion appears evidence-aligned when toxicity recovery, wound-healing considerations, and operative logistics permit, but this position remains provisional and requires prospective validation. Immune-only regimens may permit earlier surge","PeriodicalId":520733,"journal":{"name":"Oral and maxillofacial surgery","volume":"30 1","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148341901","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":"Intraoperative C-arm CBCT versus early postoperative MRI for the assessment of fracture reduction and osteosynthesis material positioning in cranio-maxillofacial trauma surgery.","authors":"Adib Al-Haj Husain, Sameena Sandhu, Egon Burian, Marc M Precht, Stefan Sommer, Thomas Frauenfelder, Maximilian Eberhard Hermann Wagner, Harald Essig","doi":"10.1007/s10006-026-01588-8","DOIUrl":"10.1007/s10006-026-01588-8","url":null,"abstract":"<p><strong>Purpose: </strong>To compare intraoperative C-arm cone-beam computed tomography (CBCT) with dedicated in-house-optimized magnetic resonance imaging (MRI) protocols, including CT-like and metal artifact reduction sequences (MARS), using a novel 15-channel coil for the evaluation of fracture reduction, osteosynthesis material positioning, and the depiction of plates and screws.</p><p><strong>Methods: </strong>Fifteen patients (13 men, 2 women; median age, 32 years; range, 18-65 years) with acute cranio-maxillofacial fractures underwent surgical treatment with intraoperative CBCT, followed by early postoperative MRI within 36 h. MRI protocols included 3D ultrashort echo time (UTE), slice-encoding for metal artifact correction (SEMAC), and 3D double-echo steady-state (DESS). Two independent maxillofacial surgeons performed qualitative and quantitative evaluations of fracture reduction, osteosynthesis material positioning, and implant morphology using a 5-point visual scale (5 = best; 1 = non-assessable) and dimensional measurements. Descriptive statistics were calculated, and inter-reader agreement was assessed using weighted kappa (κ) and intraclass correlation coefficients (ICC).</p><p><strong>Results: </strong>UTE and SEMAC sequences provided excellent CT-like performance in visualizing fracture reduction and implant positioning (median 5, IQR 5-5 and 4-5, respectively), with minimal absolute differences in quantitative measurements and substantial to almost perfect inter-reader agreement (κ = 0.75-1.0; ICC = 0.89-0.99; all p < 0.001). In contrast, DESS demonstrated limited utility for assessing metallic implants due to pronounced signal voids and susceptibility artifacts.</p><p><strong>Conclusion: </strong>UTE and SEMAC provide high-quality, radiation-free imaging for evaluating fracture reduction and osteosynthesis material in cranio-maxillofacial trauma. These techniques demonstrate comparable diagnostic performance to intraoperative CBCT in a postoperative setting. They may serve as a radiation-free alternative for perioperative imaging in younger patients with anticipated repeated imaging needs, pending prospective intraoperative validation.</p><p><strong>Trial registration number: </strong>Swiss National Clinical Trials Portal: SNCTP000006343, ClinicalTrials.gov ID: NCT07012850, Registration date: May 2025.</p>","PeriodicalId":520733,"journal":{"name":"Oral and maxillofacial surgery","volume":"30 1","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13309464/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148341899","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":"Commentary on: \"Cultured microbial community complexity is associated with antimicrobial resistance and Enterobacterales enrichment in adult odontogenic infections\".","authors":"Arman Abroumand Gholami, Tangirov Eldor, Azizova Feruza, Murtozayev Shakhobiddin","doi":"10.1007/s10006-026-01590-0","DOIUrl":"10.1007/s10006-026-01590-0","url":null,"abstract":"","PeriodicalId":520733,"journal":{"name":"Oral and maxillofacial surgery","volume":"30 1","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148321605","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Adjunctive postoperative vitamin B complex with ibuprofen for pain and soft-tissue healing after impacted mandibular third molar surgery: a split-mouth randomized clinical trial.","authors":"Alireza Ramadan, Kiarash Kiani, Mona Saligheh Rad, Behnaz Poorian, Farhad Noravesh","doi":"10.1007/s10006-026-01585-x","DOIUrl":"10.1007/s10006-026-01585-x","url":null,"abstract":"<p><strong>Purpose: </strong>Pain and delayed soft-tissue healing are common after mandibular third molar surgery. This study aimed to assess the effect of vitamin B complex supplementation on pain and healing after surgical extraction of mandibular third molars.</p><p><strong>Methods: </strong>This double-blind split-mouth randomized clinical trial was conducted on 17 patients requiring bilateral extraction of mandibular third molars. In each patient, one quadrant was randomly assigned to the intervention group and the contralateral quadrant to the control group. Patients received ibuprofen plus placebo after surgical extraction of the control quadrant and ibuprofen plus vitamin B complex after surgical extraction of the intervention quadrant. Postoperative pain was assessed using a visual analog scale (VAS) at 1, 6, 12, 24, 48, and 72 h after surgery. Soft-tissue healing was evaluated at 2 and 3 weeks using a 3-point healing scale. Data were analyzed using Friedman and Wilcoxon signed-rank tests with Bonferroni correction.</p><p><strong>Results: </strong>Seventeen patients completed both surgical procedures and follow-up assessments. Significant differences in postoperative pain were observed across treatment conditions and time points (P < 0.001). Compared with placebo, adjunctive vitamin B complex significantly reduced pain at 48 h (P = 0.005) and 72 h (P < 0.001), whereas no significant differences were observed at 1 h (P = 0.426), 6 h (P = 0.112), 12 h (P = 0.621), or 24 h (P = 0.077). Healing was not significantly different between groups at 2 weeks (P = 0.317); however, healing was significantly improved in the vitamin B complex group at 3 weeks (P = 0.011).</p><p><strong>Conclusions: </strong>Within the limitations of this study, postoperative vitamin B complex supplementation as an adjunct to ibuprofen was associated with reduced pain at 48-72 h and improved soft-tissue healing at 3 weeks after mandibular third molar extraction. Larger randomized clinical trials are warranted to confirm these findings.</p><p><strong>Trial registration: </strong>Iranian Registry of Clinical Trials (IRCT20251104067878N1); registered 07 November 2025.</p>","PeriodicalId":520733,"journal":{"name":"Oral and maxillofacial surgery","volume":"30 1","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148321576","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 investigation of pain threshold in the facial and cervical regions following dental implant surgery.","authors":"Kiyomi Uehashi, Shoichi Ishigaki, Ryota Takaoka, Daisuke Moriguchi, Hirofumi Yatani","doi":"10.1007/s10006-026-01584-y","DOIUrl":"10.1007/s10006-026-01584-y","url":null,"abstract":"<p><strong>Purpose: </strong>The pathogenic mechanisms and variations in individual pain susceptibility underlying neuropathic pain associated with dental implant surgery have not been fully elucidated, and objective evaluation methods for such pain remain unestablished. The objective of this study was to identify exploratory trends in subclinical sensory changes by evaluating changes in pain thresholds following dental implant surgery.</p><p><strong>Methods: </strong>The subjects included 76 outpatients who visited the Department of Fixed Prosthodontics at Osaka University Dental Hospital for dental implant surgery. Pain thresholds were recorded before and after surgery within the regions innervated by the second and third divisions of the trigeminal nerve and the upper cervical plexus. Measurements were performed using a computer-controlled thermal sensory analyzer (PATHWAY, Medoc Co. Ltd).</p><p><strong>Results: </strong>The decline of the pain threshold event detected by the thermal stimulation on the operating side occurred in 28.57-48.57%, 10.48-25.90%, 1.40-10.36% and 0.09-1.38% of subjects at 1, 2, 4, and 12 weeks post-surgery, respectively.</p><p><strong>Conclusions: </strong>This prospective cohort study evaluated the impact of dental implant surgery on pain thresholds. The findings suggest that a significant proportion of patients may experience transient post-surgical sensory changes, characterized by a decline in their pain threshold following surgery, even in the absence of subjective pain complaints.</p>","PeriodicalId":520733,"journal":{"name":"Oral and maxillofacial surgery","volume":"30 1","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13290876/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148311349","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":"The role of bioactive molecules in enhancing bone healing in oral and maxillofacial surgery: a review of current approaches and future directions.","authors":"Rayudu Naren Kishore, Sriram Kaliamoorthy, Sivaji Raju Uddarraju, Nukala Kameswari, Kalyan Kondalarao Siddu","doi":"10.1007/s10006-026-01583-z","DOIUrl":"10.1007/s10006-026-01583-z","url":null,"abstract":"<p><strong>Background: </strong>Bone regeneration in oral and maxillofacial surgery (OMFS) remains challenging, particularly in procedures such as alveolar ridge preservation, sinus floor augmentation, mandibular reconstruction, and peri implant bone regeneration. Bioactive molecules have emerged as promising therapeutic agents that enhance osteogenesis, angiogenesis, and tissue remodeling through modulation of key cellular signaling pathways.</p><p><strong>Methods: </strong>A structured literature review was conducted using PubMed, Scopus, and Web of Science databases. The search primarily focused on studies published between 2020 and 2025 to capture recent advances, while incorporating foundational studies to support key biological mechanisms. Inclusion criteria comprised peer reviewed in in vitro, in vivo, and clinical studies investigating bioactive molecules and scaffold based bone regeneration strategies in OMFS.</p><p><strong>Results: </strong>Bioactive molecules including icariin, bone morphogenetic proteins (BMPs), vascular endothelial growth factor (VEGF), and dental pulp stem cell (DPSC) derived secretomes significantly enhance osteogenic differentiation, extracellular matrix mineralization, and angiogenesis. These effects are mediated through major signaling pathways such as BMP/Smad, MAPK/ERK, PI3K/Akt, and HIF-1α pathways. Integration with biomaterial scaffolds enables controlled spatiotemporal release, improving regenerative outcomes. However, translational challenges remain, including dose-dependent adverse effects (particularly with BMPs), suboptimal release kinetics, and limitations of current experimental models in replicating mandibular biomechanics.</p><p><strong>Conclusion: </strong>Bioactive molecule-based therapies represent a promising approach for enhancing bone regeneration in OMFS. Future advancements in nanotechnology-based delivery systems, three-dimensional bioprinting, and personalized regenerative strategies are essential to bridge the gap between experimental success and clinical application.</p>","PeriodicalId":520733,"journal":{"name":"Oral and maxillofacial surgery","volume":"30 1","pages":""},"PeriodicalIF":1.8,"publicationDate":"2026-06-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148201910","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}