Journal of Cranio-Maxillofacial Surgery最新文献

{"title":"Magnetic resonance imaging in dental, oral and maxillofacial trauma: A systematic review.","authors":"Adib Al-Haj Husain, Suen An Nynke Lie, Sameena Sandhu, Maximilian Eberhard Hermann Wagner, Bernd Stadlinger, Egon Burian, Thomas Frauenfelder, Nicolin Hainc, Peter Kessler, Harald Essig","doi":"10.1016/j.jcms.2025.05.016","DOIUrl":"https://doi.org/10.1016/j.jcms.2025.05.016","url":null,"abstract":"<p><p>This systematic review evaluates the current literature on state-of-the-art radiation-free MRI techniques for managing dental, oral, and maxillofacial trauma, comparing their diagnostic performance to conventional X-ray-based imaging. Two reviewers conducted an investigation using the PICOS search strategy across multiple databases, including MEDLINE, EMBASE, BIOSIS, Web of Science, Cochrane Library, LILACS, and BBO Dentistry. Twenty-nine studies were included: 12 on orbital trauma, 10 on condylar, subcondylar, or TMJ trauma, five on mandibular fractures, and one each on temporal bone and dental trauma. MRI was performed at post-traumatic, postoperative, or both stages. Despite variability in scan parameters, field strengths, and coil configurations, the results highlight MRI's growing potential in trauma assessment. CT-like and Black Bone MRI sequences enable simultaneous visualization of hard and soft tissues at trauma sites, providing diagnostic insights comparable to X-ray-based techniques. However, despite their superior soft-tissue assessment, they remain less effective at depicting intricate bony pathoanatomical conditions. This diagnostic approach can improve the long-term benefit-to-risk ratio, particularly for younger, radio-sensitive patients requiring repeated imaging and long-term follow-up. However, a modality- and protocol-oriented approach is essential to balance clinical conditions, radiation exposure, and diagnostic accuracy and efficiency, to ensure optimal patient outcomes in comprehensive trauma management.</p>","PeriodicalId":54851,"journal":{"name":"Journal of Cranio-Maxillofacial Surgery","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144369592","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Analyzing the candidate pool for Vascularized Composite Allotransplantation - A multi-center OPTN study with a focus on face transplant candidates.","authors":"Leonard Knoedler, Jakob Fenske, Thomas Schaschinger, Tobias Niederegger, Javier Gonzalez, Curtis L Cetrulo, Maxime Jeljeli, Max Heiland, Alexandre G Lellouch","doi":"10.1016/j.jcms.2025.05.023","DOIUrl":"https://doi.org/10.1016/j.jcms.2025.05.023","url":null,"abstract":"<p><p>Vascularized Composite Allotransplantation (VCA) provides reconstructive options for patients with severe tissue trauma, yet multi-center analyses of VCA candidates remain scarce. This study analyzed the Organ Procurement and Transplantation Network (OPTN) database to assess the VCA candidate pool and comparatively analyzed facial VCA (fVCA) and non-fVCA to better understand their specific characteristics. The OPTN database was searched from 2008 to 2024, including all VCA types and excluding patients under 18 years or with extreme body mass indices (BMI; <7 kg/m² or >250 kg/m²). Demographic, immunological and listing-related variables were examined, exploratorily comparing fVCA candidates to other VCA candidates. Overall, 46 candidates were listed with an average age of 38 ± 12 years. fVCA candidates were significantly older (54 ± 4 years vs. 45 ± 11 years; p < 0.0001) with a higher BMI (30 ± 3 kg/m² vs. 25 ± 8 kg/m²; p = 0.02). Average listing time was 949 ± 686 days, with 13 % dying during listing. fVCA candidates had longer waiting times (1129 ± 772 days). This analysis highlights the limited VCA candidate pool, with fVCA candidates, albeit limited in sample size, being older, having higher BMIs and longer average listing times. Overall, these insights call for cross-disciplinary efforts to make VCA more accessible and optimize patient recruitment and selection.</p>","PeriodicalId":54851,"journal":{"name":"Journal of Cranio-Maxillofacial Surgery","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144340665","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnosis and management of central giant cell granulomas of the jaws: a European and multicenter study.","authors":"Paolo Boffano, Francesca Neirotti, Matteo Brucoli, Muhammad Ruslin, Panagiotis Stathopoulos, Konstantina Tsekoura, Jan Laco, Radovan Mottl, Emil Dediol, Boris Kos, Adam Michcik, Adam Polcyn, Petia Pechalova, Nikolai Pavlov, Angel Sapundzhiev, Juan Carlos de Vicente, Tania Rodríguez Santamarta, Thomas Starch-Jensen, Ivana Mijatov, Branislav V Bajkin, Aleksandra Fejsa Levakov, Sophie Dugast, Helios Bertin, Pierre Corre, József Szalma, Jaana Rautava, Johanna Snäll, Lily Pourcelly, Aurelien Louvrier, Eugenie Bertin, Christophe Meyer","doi":"10.1016/j.jcms.2025.05.017","DOIUrl":"https://doi.org/10.1016/j.jcms.2025.05.017","url":null,"abstract":"<p><strong>Introduction: </strong>Central giant cell granulomas (CGCGs) are benign but locally aggressive rare neoplasms that affect the bony skeleton, particularly the maxillofacial region. The purpose of this European multicenter study was to describe and assess the characteristics, diagnosis, management, and recurrence of CGCGs at different European oral and maxillofacial surgery centers.</p><p><strong>Methods: </strong>The data from all the treated CGCGs from the involved oral and maxillofacial surgical units across Europe between January 1st^, 2014 and December 31st^, 2023 were recorded.</p><p><strong>Results: </strong>A total of 76 patients, including 37 males and 39 females diagnosed with CGCG met the inclusion criteria and were included. The mean age of the study population at diagnosis was 41.8 years. Fifty-three lesions were found in the mandible, with the most frequently involved subsite being the mandibular parasymphysis. Overall, 75.0 % of included CGCGs were unilocular. The most frequent treatment option was surgery alone. A total of 12 recurrences (15.8 %) were observed with a mean follow up of 41 months.</p><p><strong>Discussion: </strong>Further genetic and molecular studies regarding the pathways underlying CGCGs are needed, in order to predict their natural history and to direct non-surgical therapies. In the meantime, surgeons should balance the risks of higher recurrence rates associated with lower surgical morbidity, performing an individualized treatment plan, taking into consideration the clinical and radiological features together with the patients' age and comorbidities. A radiographic follow-up of patients with treated CGCGs could advised for the first 5 years.</p>","PeriodicalId":54851,"journal":{"name":"Journal of Cranio-Maxillofacial Surgery","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144340666","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Epta-innervation for facial reanimation: seven donor nerves to extremize the concept of multiple innervation and supercharging.","authors":"Federico Biglioli, Federico Bolognesi, Filippo Tarabbia, Alessandro Lozza, Silvia Cupello, Antonino Previtera, Fabiana Allevi","doi":"10.1016/j.jcms.2025.05.009","DOIUrl":"https://doi.org/10.1016/j.jcms.2025.05.009","url":null,"abstract":"<p><p>Surgical 'restitutio ad integrum' after facial palsy remains a fantasy. Facial reanimation for recent permanent paralyses - those where muscles still fibrillate on EMG - is based on new neural input. Among these cases, while static symmetry is frequently addressed, the whole spectrum of mimetic movements remains limited and never equal to the healthy side. A new technique is proposed, based on utilizing seven donor nerves, with the aim to improve neglected movements and minimize asymmetry during talking and mimetic expressions. Donor nerves are harvested and utilized according to their proven best yield for facial reanimation. Our study reviewed 15 patients affected by recent unilateral facial palsy, and who underwent this new technique. They had a minimum follow-up of 12 months, and pre- and postoperative assessment via the e-FACE grading system was performed for each patient. The preliminary results seem to be encouraging, but extensive cases series will be needed to obtain more significant data and guide future technical corrections. This would be the only way to edge towards future 'restitutio ad integrum' of face morphology and function, which remains the ultimate desire of these unfortunate patients.</p>","PeriodicalId":54851,"journal":{"name":"Journal of Cranio-Maxillofacial Surgery","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144337274","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Does orthognathic surgery affect sleep quality? Evaluation of the effects of orthognathic surgery on subjective and objective OSA parameters in skeletal class III patients.","authors":"Wichuda Kongsong, Sunisa Rochanavibhata, Chidsanu Changsiripun, Phonkit Sinpitaksakul, Naricha Chirakalwasan","doi":"10.1016/j.jcms.2025.05.015","DOIUrl":"10.1016/j.jcms.2025.05.015","url":null,"abstract":"<p><p>This study aimed to assess the impact of orthognathic surgery on both subjective and objective obstructive sleep apnea (OSA) parameters and sleep quality in patients with skeletal class III. An upper airway evaluation was conducted using cone-beam computed tomography. Sleep quality was evaluated subjectively and objectively using the screening OSA questionnaires, the Functional Outcomes of Sleep Questionnaire, and sleep study testing. Data were collected from 23 patients at three time points: within 1 month before surgery (T0), within 1 month after surgery (T1), and 6 months after surgery (T2). Overall, there was a significant decrease in airway volume and minimal cross-sectional area at T1 and T2. Although there was partial recovery of these parameters at T2, they were not fully restored. No changes in subjective parameters were observed. Objective parameters showed significant increases in total apnea-hypopnea index (AHI) and obstructive AHI (ObsAHI) at T1. However, by T2, these values had decreased and were not significantly different from T0. Multivariable linear regression analysis found no associated variables for the change in ObsAHI. These findings suggest that while orthognathic surgery may initially impact upper airway morphology and objective sleep quality, some recovery and adaptation occur over time, though not to pre-surgery levels.</p>","PeriodicalId":54851,"journal":{"name":"Journal of Cranio-Maxillofacial Surgery","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144334498","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Facial asymmetry in syndromic craniosynostosis patients undergoing midface surgery compared to a large general population.","authors":"P Rostamzad, X Liu, E B Wolvius, M M Pleumeekers, G Roshchupkin, T Abdel-Alim","doi":"10.1016/j.jcms.2025.04.022","DOIUrl":"https://doi.org/10.1016/j.jcms.2025.04.022","url":null,"abstract":"<p><p>This study aimed to assess mean facial asymmetry (MFA) before and after midface surgery (Le Fort III, monobloc, or facial bipartition) in syndromic craniosynostosis patients and compare it to the general population. This retrospective study included 55 patients (22 Apert, 23 Crouzon, 10 craniofrontonasal dysplasia (CFNS)) with a mean age of 11.5 ± 5.5 at midface surgery, and 2304 general children from the Generation R study (ages 9 and 13 years). An automated algorithm quantified MFA from three-dimensional (3D) meshes created from preoperative CT-scans, registered to the postoperative scans, and from 3D images in the control population, generating a MFA value in millimeters to reflect the degree of asymmetry. Preoperative MFA was 2-2.5 times higher in patients than in controls, with the highest values in Apert (1.18 ± 0.36 mm), followed by CFNS (1.12 ± 0.48 mm), Crouzon (1.02 ± 0.50 mm), and controls (0.45 ± 0.10 mm at age 9 years and 0.47 ± 0.10 mm at age 13 years). Postoperatively, MFA increased in 32 patients (58.2 %) and decreased in 23 (41.2 %). MFA was higher in the study population, especially in Apert syndrome, with variability across syndromes and surgical groups. An automated framework for 3D MFA analysis was presented, aiding objective studies and understanding of facial asymmetry changes in syndromic craniosynostosis.</p>","PeriodicalId":54851,"journal":{"name":"Journal of Cranio-Maxillofacial Surgery","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144276745","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"EACMFS Prizes & Awards","authors":"","doi":"10.1016/S1010-5182(25)00194-5","DOIUrl":"10.1016/S1010-5182(25)00194-5","url":null,"abstract":"","PeriodicalId":54851,"journal":{"name":"Journal of Cranio-Maxillofacial Surgery","volume":"53 7","pages":"Pages 1024-1025"},"PeriodicalIF":2.1,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144222182","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Iliac crest free flap versus fibula free flap for mandibular reconstruction: Cost-effectiveness analysis in a Chinese population.","authors":"Xinyi Zhao, Meiyu Ding, Drissa Diarra, Simin Ouyang, Hao Lin, Renbin Zhou, Bang Zeng, Lei Ma, Bing Liu, Tianfu Wu","doi":"10.1016/j.jcms.2025.05.007","DOIUrl":"https://doi.org/10.1016/j.jcms.2025.05.007","url":null,"abstract":"<p><p>Mandibular reconstruction is vital in oral and maxillofacial surgery to restore aesthetics and function after tumor resection or trauma. The iliac crest-free flap (ICFF) and fibula-free flap (FFF) are widely used, but their cost-effectiveness and impact on quality of life (QoL) are debated. A retrospective study of 142 patients (2012-2018) compared ICFF and FFF, analyzing direct costs (surgical, medication, hospitalization) and indirect costs (surgery duration, hospital stay). QoL was assessed using the UW-QOL questionnaire, and incremental cost-effectiveness ratios (ICER) were calculated. ICFF patients had shorter surgery times (370.47 ± 10.02 vs. 481.59 ± 115.77 min, P < 0.01) and lower hospitalization costs ($11,992.77 ± 2130.24vs.$14,294.74 ± 2976.95, P < 0.001). ICFF showed better QoL in appearance and emotional domains, while FFF performed slightly better in salivary function and swallowing. ICER analysis confirmed ICFF as more cost-effective, with superior QoL outcomes. ICFF is ideal for younger patients with moderate defects, offering shorter stays and improved mood-related QoL, whereas FFF is preferred for large defects. Tailored decisions based on defect type, age, and expected outcomes can optimize satisfaction and resource use.</p>","PeriodicalId":54851,"journal":{"name":"Journal of Cranio-Maxillofacial Surgery","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144235919","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A new method of transoral endoscopic-assisted treatment for mandibular subcondylar fractures using a template-guided patient-specific osteosynthesis implant: the Ulm protocol.","authors":"Andreas Sakkas, Johannes Schulze, Frank Wilde, Tobias Daut, Marcel Ebeling, Robin Kasper, Alexander Schramm, Mario Scheurer","doi":"10.1016/j.jcms.2025.05.014","DOIUrl":"https://doi.org/10.1016/j.jcms.2025.05.014","url":null,"abstract":"<p><p>Intraoral subcondylar fracture repair still remains one of the most controversial and discussed topics in the field of maxillofacial trauma. Despite transoral endoscopic-assisted reduction and internal fixation has attracted wide attention, the surgical approach still is technically challenging and specialised instruments are mandatory. Trauma surgeons need to go through a shallow learning curve in order to achieve suitable and predictable surgical results comparable to the standard extraoral approaches. In our clinic the transoral endoscopic-assisted approach without the use of transbuccal trocars for reduction and osteosynthesis of non comminuted subcondylar fractures has been exclusively practising for more than 17 years. The current work presents a novel concept for surgical treatment of subcondylar fractures, namely the preoperatively CAD/CAM planned, template-guided, patient-specific osteosynthesis to facilitate precise and effective outcome. At first step, a preoperative 1 mm-layer CT imaging is used for the segmentation and virtual 3D reduction of the dislocated condyle fragment. At second step, CAD/CAM techniques are applied for manufacturing of a patient-specific osteosynthesis implant (PSOI) according the \"backward planning\" concept with the \"one-fit-only\" design at the condylar fragment and patient-specific surgical guide for positioning at the ascending ramus to replace the conventional osteosynthesis miniplates in the trajectory area of the ascending ramus according to established osteosynthesis principles. The patient- and fracture-morphologically individualized implant design allows the development of a reliable workflow to ensure maximum surgical precision and predictability of the anatomical and functional outcome combined with possible shortening of operation duration and reduction of perioperative complications. Hereby, the technically demanding fracture treatment can be significantly simplified by using a patient-specific reduction and osteosynthesis tool. This workflow was shown to be applied predictably and accurately in a clinical setting. The patient- and fracture-morphologically individualized \"one-fit-only\" implant design could allow the development of a reliable workflow to ensure maximal surgical precision intraoperatively. We consider this novel method of template-guided, patient-specific osteosynthesis of subcondylar fractures combined with modern CAD/CAM technology as evolution for the transoral endoscopic-assisted approach.</p>","PeriodicalId":54851,"journal":{"name":"Journal of Cranio-Maxillofacial Surgery","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144227734","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Influence of different lingual split patterns on skeletal stability after bilateral sagittal split osteotomy in patients with skeletal Class III malocclusion.","authors":"Chenxinzi Lin, Mingjuan Li, Jingyuan Zhang, Siyuan Wang, Chongjie Zhu, Qilong Wan","doi":"10.1016/j.jcms.2025.05.006","DOIUrl":"https://doi.org/10.1016/j.jcms.2025.05.006","url":null,"abstract":"<p><p>This retrospective cohort study investigated the influence of differences in the pattern of lingual split on skeletal stability after bilateral sagittal split osteotomy (BSSO) in patients with skeletal Class III malocclusion. The study sample comprised patients who underwent double surgery between November 2016 and December 2024 and presented with the same type of postoperative bilateral lingual split fracture, classified according to the Lingual Split Scale (LSS). Lateral cephalograms were evaluated at three-time points: preoperative (T0), one week postoperative (T1), and six months postoperative (T2). Analyses of variance (ANOVA) and chi-square (χ²) tests were employed to compare skeletal stability among the groups. The study included 159 patients, with 88 (55.35 %) in the LSS1 group, 43 (27.04 %) in the LSS2 group, and 28 (17.61 %) in the LSS3 group. Postoperative analysis revealed a counterclockwise relapse of the mandible. The maxilla showed good skeletal stability after BSSO, while the LSS2 group presented more severe forward mandibular relapse than the LSS1 and LSS3 groups (P = 0.011). Notably, the Frankfort mandibular plane angle (FMA) increased more significantly in the LSS2 group postoperatively (P = 0.003). Significant intergroup differences were observed regarding the influence of different lingual split patterns on skeletal stability after BSSO in patients with skeletal Class III malocclusions. Notably, the LSS2 group exhibited a more severe relapse compared to both the LSS1 and LSS3 groups.</p>","PeriodicalId":54851,"journal":{"name":"Journal of Cranio-Maxillofacial Surgery","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144227735","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}