Journal of Cranio-Maxillofacial Surgery最新文献

{"title":"Preoperative clinical and magnetic resonance imaging-based predictors of outcomes after arthroscopic discopexy for temporomandibular joint disc displacement","authors":"Arthur Yen-Hung Lin ,&nbsp;Ti-Yung Tseng ,&nbsp;Hui-Hsin Ko ,&nbsp;Ying-An Chen ,&nbsp;Pang-Yun Chou ,&nbsp;Cheng-Hong Toh ,&nbsp;Yi-Ming Wu ,&nbsp;Chih-Hua Yeh","doi":"10.1016/j.jcms.2026.104507","DOIUrl":"10.1016/j.jcms.2026.104507","url":null,"abstract":"<div><div>This study investigated whether preoperative clinical and magnetic resonance imaging (MRI) characteristics can predict disc repositioning after arthroscopic discopexy for anterior disc displacement in the temporomandibular joint (TMJ). Data corresponding to 193 TMJs were retrospectively collected from 127 patients who underwent holmium:YAG laser-assisted arthroscopic discopexy at the study hospital between 2022 and 2024. The primary outcome was postoperative disc position as assessed through MRI. Clinical and MRI data were used to develop and validate a nomogram through bootstrap resampling. Changes in disc length were measured to assess disc remodeling. Postoperative MRI revealed optimal repositioning in 112 TMJs. Multivariate analysis indicated age (odds ratio [OR]: 1.041; <em>p</em> = 0.010), absence of spontaneous disc reduction (OR: 3.164; <em>p</em> = 0.009), and rotational displacement (OR: 1.901; <em>p</em> = 0.038) as independent predictors of persistent disc displacement. The nomogram exhibited good performance (area under the receiver operating characteristic curve = 0.702). Postoperative disc elongation was strongly and negatively associated with preoperative disc length (<em>r</em> = −0.483; <em>p</em> &lt; 0.001) and positively associated with displacement distance (<em>r</em> = 0.305; <em>p</em> &lt; 0.001). These findings indicate that preoperative clinical and MRI characteristics can predict outcomes after arthroscopic discopexy.</div></div>","PeriodicalId":54851,"journal":{"name":"Journal of Cranio-Maxillofacial Surgery","volume":"54 6","pages":"Article 104507"},"PeriodicalIF":2.1,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147312521","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":"Functional and psychosocial outcomes of simultaneous condylectomy and bimaxillary orthognathic surgery for unilateral condylar hyperplasia: Retrospective study","authors":"Melis Haydarpasa-Yalcin,&nbsp;Canseda Avağ,&nbsp;Altan Varol","doi":"10.1016/j.jcms.2026.104519","DOIUrl":"10.1016/j.jcms.2026.104519","url":null,"abstract":"<div><div>Unilateral condylar hyperplasia (UCH) is a pathological growth disorder frequently associated with marked facial asymmetry. The objective of this study was to evaluate the functional and psychosocial outcomes of simultaneous high level or proportional condylectomy performed in conjunction with bimaxillary orthognathic surgery in individuals presenting with hemimandibular elongation or hyperplasia. Patient-reported outcomes were measured using the Orthognathic Quality of Life Questionnaire (OQLQ) and the Mandibular Function Impairment Questionnaire (MFIQ). Secondary outcomes included facial symmetry, aesthetic satisfaction, visibility of preauricular scars, limitation of mouth opening, temporomandibular joint (TMJ) pain and clicking, lower lip paresthesia (LLP), and facial nerve dysfunction. This retrospective analysis included 25 patients (19 females, 6 males; mean age 25.5 ± 5.41 years) who underwent simultaneous condylectomy (high level: n = 18; proportional: n = 2; with disc repositioning in 7 cases) and bimaxillary orthognathic surgery. Clinical and functional outcomes were assessed over a mean follow-up period of 3.5 ± 0.8 years. Statistically significant improvements were observed in both OQLQ and MFIQ scores following surgery (p &lt; 0.001 for both). The majority of patients reported high satisfaction regarding facial symmetry and expressed minimal concern about preauricular scarring. TMJ pain and clicking, and LLP showed notable reduction or complete resolution. No major complications, including persistent facial paralysis, were encountered. Simultaneous condylectomy with bimaxillary orthognathic surgery demonstrates predictable and stable long-term outcomes in the management of unilateral condylar hyperplasia. This single stage approach effectively addresses both functional impairment and aesthetic concerns, eliminating the requirement for staged surgical procedures.</div></div>","PeriodicalId":54851,"journal":{"name":"Journal of Cranio-Maxillofacial Surgery","volume":"54 6","pages":"Article 104519"},"PeriodicalIF":2.1,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147312564","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 patient-specific PEEK fixation system for simultaneous maxillary advancement and midfacial contour restoration in Le Fort I osteotomy: A finite element analysis","authors":"Yingjia Sun ,&nbsp;Yuanyi Li,&nbsp;Zhijian Xie,&nbsp;Lingling Hu","doi":"10.1016/j.jcms.2026.104502","DOIUrl":"10.1016/j.jcms.2026.104502","url":null,"abstract":"<div><h3>Background</h3><div>Severe maxillary hypoplasia often requires combined skeletal repositioning and midfacial contour restoration. While Le Fort I osteotomy effectively addresses dental and skeletal discrepancies, residual midfacial deficiencies — such as infraorbital depression and paranasal flatness — frequently persist, necessitating additional soft tissue or alloplastic procedures. This study introduces a novel patient-specific polyetheretherketone (PEEK) fixation system designed to simultaneously stabilize Le Fort I-advanced maxillary segments and restore midfacial morphology in a single surgical stage.</div></div><div><h3>Methods</h3><div>A customized PEEK plate was digitally designed to match both the ideal bony anatomy and the desired facial profile. Finite element (FE) models were developed to compare the biomechanical performance of the PEEK fixation system with that of a conventional titanium fixation system under simulated physiological bite forces. Outcomes assessed included intersegmental maxillary displacement, von Mises stress distribution in the bone and implants, and screw stress levels.</div></div><div><h3>Results</h3><div>The PEEK fixation system demonstrated comparable maxillary stability to titanium fixation, with reduced overall displacement (0.08416 mm vs. 0.09285 mm) and a more physiologically balanced stress distribution across the maxillary buttresses. Screw stresses were slightly higher in the PEEK system (515.8 MPa vs. 414.2 MPa), but remained well below material yield limits (titanium alloy (TC4) ≈ 860 MPa). The externally contoured PEEK plates also facilitated direct midfacial contouring, eliminating the need for secondary soft tissue augmentation. Three-dimensional axis-wise analysis showed PEEK had lower Z-axis displacement (0.03178 mm vs. 0.07787 mm) and more uniform displacement fields, further supporting its enhanced segmental stability.</div></div><div><h3>Conclusions</h3><div>This study suggests that a patient-specific PEEK fixation system can safely and effectively stabilize Le Fort I-advanced maxillary segments while concurrently addressing midfacial contour deficiencies. This integrated approach demonstrates potential advantages in postoperative stability, functional recovery, and aesthetic outcomes, supporting its future clinical application as a streamlined solution for combined skeletal and soft tissue reconstruction.</div></div>","PeriodicalId":54851,"journal":{"name":"Journal of Cranio-Maxillofacial Surgery","volume":"54 6","pages":"Article 104502"},"PeriodicalIF":2.1,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147318990","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":"Scatter radiation effects of titanium osteosynthesis plates in mandibular reconstruction: An experimental 3D-printed phantom and cell culture study","authors":"Georg Hoene ,&nbsp;Andre Tangemann ,&nbsp;Boris Schminke ,&nbsp;Lennart Gruber ,&nbsp;Martin Leu ,&nbsp;Daniela Schmitt ,&nbsp;Henning Schliephake ,&nbsp;Philipp Kauffmann","doi":"10.1016/j.jcms.2026.104520","DOIUrl":"10.1016/j.jcms.2026.104520","url":null,"abstract":"<div><div>Mandibular reconstruction with fibula free flaps commonly requires fixation using titanium osteosynthesis plates. In patients receiving adjuvant radiotherapy, scatter radiation effects from metallic hardware may alter dose distribution and affect biological responses, but systematic evidence remains limited. This experimental study examined the influence of plate geometry on scatter radiation and cell proliferation. A three-dimensional printed mandibular phantom, generated from patient CT data and combined with a water phantom, was used to simulate clinical irradiation conditions. Irradiation was performed with an Ethos linear accelerator, and dose modifications in the vicinity of different plate designs were analyzed. Human mesenchymal stromal cells (hMSC) and human umbilical vein endothelial cells (HUVEC) were irradiated under identical conditions, and proliferation was assessed using MTS assays. Distinct dose increases were detected anterior to the plates, with dose reductions in the shadowing region, depending on plate diameter and geometry. These physical changes correlated with significant differences in hMSC and HUVEC proliferation. The results indicate that osteosynthesis plate design affects both dosimetric distribution and cellular responses during radiotherapy. These findings suggest that reduced metal volume and specific plate geometries may contribute to lower local radiation perturbations and should be considered in reconstructive planning for patients undergoing adjuvant radiotherapy.</div></div>","PeriodicalId":54851,"journal":{"name":"Journal of Cranio-Maxillofacial Surgery","volume":"54 6","pages":"Article 104520"},"PeriodicalIF":2.1,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147312530","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":"Patient satisfaction in orthognathic surgery and the role of expectations","authors":"Giulio Cirignaco ,&nbsp;Mariagrazia Paglianiti ,&nbsp;Lisa Catarzi ,&nbsp;Enrico Betti ,&nbsp;Gabriele Monarchi ,&nbsp;Massimiliano Gilli ,&nbsp;Luigi Angelo Vaira ,&nbsp;Giuseppe Consorti","doi":"10.1016/j.jcms.2026.104530","DOIUrl":"10.1016/j.jcms.2026.104530","url":null,"abstract":"<div><div>Orthognathic surgery (OGS) corrects dentofacial deformities and can substantially improve quality of life (QoL). How satisfaction relates to patients’ preoperative expectations, surgical magnitude, and demographics remains a subject of debate.</div><div>Our single-centre retrospective study included consecutive OGS patients with ≥ 6-month follow-up and completed PROMs. Validated instruments comprised the Orthognathic Quality of Life Questionnaire (OQLQ) and selected FACE-Q scales; global satisfaction was rated on a 0–10 VAS. Primary endpoints were postoperative satisfaction and change in QoL.</div><div>The cohort comprised 290 patients (176 women, 114 men, mean age 23.4 years); 42% underwent single-jaw and 58% bimaxillary surgery. At a mean 12.2-month follow-up, satisfaction was high (VAS 9.1 ± 1.1), with 93.8% reporting that treatment met or exceeded expectations. OQLQ improved from 42.5 ± 17.3 preoperatively to 15.4 ± 12.1 postoperatively (<em>p</em> &lt; 0.0001), with gains across domains; FACE-Q scores were similarly high. Satisfaction did not differ by surgery type (VAS 9.0 ± 1.2 vs 9.2 ± 1.0; <em>p</em> = 0.34), expectation focus (ANOVA <em>p</em> = 0.67), sex (<em>p</em> = 0.42), or age (<em>ρ</em> = −0.05; <em>p</em> = 0.37).</div><div>OGS yields large QoL gains and very high satisfaction. When treatment plans address the patient's chief concern, satisfaction is independent of surgery magnitude, expectation focus, sex, and age. Structured preoperative counseling, paired with routine PROM monitoring, may help align expectations with achievable outcomes, and support optimal patient-centered results.</div></div>","PeriodicalId":54851,"journal":{"name":"Journal of Cranio-Maxillofacial Surgery","volume":"54 6","pages":"Article 104530"},"PeriodicalIF":2.1,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147386881","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":"MRI characteristics of the lateral pterygoid muscle and correlation with temporomandibular disorder severity: a multimodal quantitative study","authors":"Yong-Qian Liu ,&nbsp;Lan-Lan Liang ,&nbsp;Shi-Zhen He ,&nbsp;Li-Rong Yue ,&nbsp;Jian-Bo Li ,&nbsp;Chen Liu ,&nbsp;Peng Wang","doi":"10.1016/j.jcms.2026.104521","DOIUrl":"10.1016/j.jcms.2026.104521","url":null,"abstract":"<div><h3>Objective</h3><div>This study aims to investigate the correlation between MRI-derived characteristics of the lateral pterygoid muscle (LPM) and the severity of temporomandibular disorders (TMD) using advanced multimodal MRI techniques.</div></div><div><h3>Materials and methods</h3><div>TMD patients and healthy volunteers underwent bilateral temporomandibular joint (TMJ) MRI scans using a 3.0 T scanner between June 2023 to February 2024. The imaging protocol included conventional sequences, T2 mapping, and T1-weighted Dixon sequences. Participants were categorized into: healthy controls without disc displacement (NC-woDD), TMD without disc displacement (TMD-woDD), TMD with reducible disc displacement (TMD-DDwR), and TMD with irreducible disc displacement (TMD-DDwoR). LPM signal intensity parameters (T2 values, fat fraction) and morphological features (thickness, length, width) were measured by independent observers. Statistical analyses were performed to compare parameter differences among the groups and to evaluate correlations with age and BMI. Inter- and intra-observer agreement was also assessed.</div></div><div><h3>Results</h3><div>A total of 214 joints from 107 TMD patients and 78 joints from 39 healthy control subjects were assessed. Excellent inter-observer agreement was achieved. Compared with the NC-woDD group, T2 values were significantly elevated in the TMD-woDD, TMD-DDwR, and TMD-DDwoR groups (all P &lt; 0.05). Fat fractions were significantly elevated in the TMD-DDwR and TMD-DDwoR groups versus both the NC-woDD and TMD-woDD groups (P &lt; 0.05). While LPM length, width, and thickness showed a decreasing trend in TMD-DDwR and TMD-DDwoR groups compared to NC-woDD, these morphological differences were not statistically significant among other group comparisons.</div></div><div><h3>Conclusion</h3><div>Quantitative MRI parameters (T2 mapping and Dixon-based fat fraction) are sensitive indicators of LPM alterations in TMD and correlate with disorder severity. The integrated use of these quantitative and morphological MRI assessments provides a more comprehensive evaluation of LPM involvement in TMD, which may aid in early detection and progression monitoring, offering valuable insights for clinical management.</div></div>","PeriodicalId":54851,"journal":{"name":"Journal of Cranio-Maxillofacial Surgery","volume":"54 6","pages":"Article 104521"},"PeriodicalIF":2.1,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147312485","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":"Long-term effect of anterior maxillary distraction using the VINK appliance – Retropalatal and Retroglossal airway change","authors":"Vikram Shetty ,&nbsp;P. Nandakishore ,&nbsp;J. Shruthi ,&nbsp;Hermann F. Sailer","doi":"10.1016/j.jcms.2026.104500","DOIUrl":"10.1016/j.jcms.2026.104500","url":null,"abstract":"<div><div>This longitudinal retrospective study evaluated the effects of anterior maxillary distraction (AMD) using the VINK Maxillary Elongator on retropalatal (RPA) and retroglossal (RGA) airway volumes in 77 cleft lip and palate (CLP) patients. Pre-operative (T0) and eight-month post-operative (T1) lateral cephalograms and CBCT scans were analyzed to assess the correlation between antero-posterior maxillary advancement—measured as Effective Maxillary Length (EML) and airway volume changes. Statistical analyses included paired <em>t</em>-tests and Pearson's correlation tests, with <em>p</em> &lt; 0.001 considered significant. The mean EML increased significantly from 79.12 ± 6.14mm to 88.92 ± 6.49mm (<em>p</em> = 0.001), and the mean airway volume rose from 14.01 ± 6.52mm³ to 16.46 ± 6.70mm³ (<em>p</em> &lt; 0.001). A moderate positive correlation was observed between EML and airway volume change (<em>r</em> = 0.33, <em>p</em> = 0.02). The Epiglottis–Pharynx Line (EPL) increased significantly from 12.66 ± 4.31mm to 14.55 ± 4.07mm (<em>p</em> &lt; 0.001), showing a strong correlation with total airway change (<em>r</em> = 0.62, <em>p</em> = 0.001). Notably, BCLP patients demonstrated greater maxillary elongation (11.52 ± 5.79mm) than UCLP (8.82 ± 4.92mm; <em>p</em> = 0.043), though airway and EPL changes were comparable. These findings suggest that AMD-induced maxillary advancement significantly enhances airway volume by altering tongue posture, irrespective of cleft type.</div></div>","PeriodicalId":54851,"journal":{"name":"Journal of Cranio-Maxillofacial Surgery","volume":"54 6","pages":"Article 104500"},"PeriodicalIF":2.1,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147367210","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":"Postoperative MRI in cranio-maxillofacial and oral reconstruction: A prospective comparative pilot study on artifact reduction","authors":"Adib Al-Haj Husain ,&nbsp;Sameena Sandhu ,&nbsp;Maximilian Eberhard Hermann Wagner ,&nbsp;Suen An Nynke Lie ,&nbsp;Egon Burian ,&nbsp;Daniel Zedler ,&nbsp;Bernd Stadlinger ,&nbsp;Peter Kessler ,&nbsp;Harald Essig","doi":"10.1016/j.jcms.2026.104522","DOIUrl":"10.1016/j.jcms.2026.104522","url":null,"abstract":"<div><div>To assess, in a prospective pilot study, five magnetic resonance imaging (MRI) artifact reduction protocols (UTE, SEMAC, Dark Bone, DESS, and STIR) using a 15-channel dentomaxillofacial coil in trauma patients undergoing cranio-maxillofacial and oral reconstruction. Eighteen patients (15 M/3 F, 37.9 ± 17.5 years) underwent MRI within 48 h after surgery. Image quality, artifact extent, and visualization of peri-osteosynthesis tissues were qualitatively evaluated on a 5-point scale (5 = best, 1 = worst). Quantitative analysis assessed protocol-specific artifact-induced signal voids in relation to the dimensions of manufacturer-specific implants. Descriptive statistics and inter- and intra-observer reliability were evaluated using weighted kappa statistics. UTE and SEMAC consistently demonstrated highest image quality and minimal artifacts, accurately depicting peri-osteosynthesis tissues, with mean artifact deviations below 2 mm relative to ground-truth implant dimensions. STIR showed intermediate performance, providing robust fat suppression and soft-tissue contrast, whereas Dark Bone and DESS exhibited higher artifact prevalence and lower diagnostic confidence. Subgroup analysis confirmed these trends across fracture location and implant type. Inter- and intra-observer agreement ranged from substantial to perfect (κ = 0.71-1.0, <em>p</em> &lt; 0.001). Modern MRI techniques like UTE and SEMAC with specialized coils improve postoperative imaging by balancing artifact suppression, image quality, and diagnostic confidence, potentially enhancing assessment of perioperative complications, reconstructive outcomes, and oncological follow-up in cranio-maxillofacial surgery.</div></div>","PeriodicalId":54851,"journal":{"name":"Journal of Cranio-Maxillofacial Surgery","volume":"54 6","pages":"Article 104522"},"PeriodicalIF":2.1,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147312539","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":"Clinical, technical, and economic outcomes of 3D-printed bone substitutes in maxillofacial reconstruction: a systematic review and meta-analysis","authors":"Abdulmajeed Okshah ,&nbsp;Ravinder S. Saini ,&nbsp;Rayan Ibrahim H. Binduhayyim ,&nbsp;V.N.V. Madhav ,&nbsp;Ashish Kaushik ,&nbsp;Masroor Ahmed Kanji ,&nbsp;Waleed Ali F. Alshadidi ,&nbsp;Artak Heboyan ,&nbsp;Javier Flores-Fraile ,&nbsp;Mario Alberto Alarcón-Sánchez ,&nbsp;Luca Fiorillo","doi":"10.1016/j.jcms.2026.104508","DOIUrl":"10.1016/j.jcms.2026.104508","url":null,"abstract":"<div><h3>Background</h3><div>Maxillofacial reconstruction requires precise restoration of bone volume and anatomical alignment. Traditional bone grafting methods have limitations, such as donor site morbidity, limited availability, and suboptimal anatomical congruence. Three-dimensional (3D) printed bone substitutes offer patient-specific solutions that may overcome these challenges.</div></div><div><h3>Objectives</h3><div>To systematically evaluate and quantify the clinical efficacy of 3D-printed bone substitutes compared with traditional grafting techniques in maxillofacial reconstruction, focusing on outcomes including bone regeneration, surgical precision (distance and angular deviation), and operative duration.</div></div><div><h3>Methods</h3><div>A comprehensive search of PubMed, Scopus, and Cochrane Library was conducted up to March 2025. Randomized controlled trials and cohort studies comparing 3D-printed bone substitutes with traditional methods in maxillofacial or craniofacial surgery were included. Meta-analyses were performed using Comprehensive Meta-Analysis software v3.7, applying fixed- or random-effects models based on heterogeneity (<em>I</em>² threshold of 25%).</div></div><div><h3>Results</h3><div>In total, 12 studies (three RCTs and nine cohort studies) were included in the meta-analysis. 3D-printed bone substitutes demonstrated significantly superior outcomes in key surgical metrics compared with traditional methods. Bone regeneration volume was markedly higher in the 3D group, with a standardized mean difference (SMD) of 0.737 (95% CI: 0.640–0.834; <em>p</em> &lt; 0.0001), indicating a moderate-to-large effect size. Operative efficiency also improved, with a mean reduction in surgical duration of −12.32 min (95% CI: −14.08 to −10.56; <em>p</em> &lt; 0.0001). However, greater positional deviation was observed with 3D-printed plates, including distance deviation (MD = 1.328; 95% CI: 1.08–1.57; <em>p</em> &lt; 0.0001) and angular deviation (MD = 1.643°; 95% CI: 1.11–2.18; <em>p</em> &lt; 0.0001).</div></div><div><h3>Conclusions</h3><div>3D-printed bone substitutes significantly improve bone regeneration and reduce operative time in maxillofacial surgery. However, greater positional and angular deviations suggest the need for enhanced surgical navigation. These findings support the integration of 3D-printing in clinical practice, with emphasis on precision improvement in future applications.</div></div>","PeriodicalId":54851,"journal":{"name":"Journal of Cranio-Maxillofacial Surgery","volume":"54 6","pages":"Article 104508"},"PeriodicalIF":2.1,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147312348","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 nerve palsy in parotid gland surgery: A comprehensive analysis of incidence, severity, duration, and risk factors; insights from the Polish Salivary Network Database","authors":"Alicja Warda ,&nbsp;Katarzyna Radomska ,&nbsp;Wioletta Pietruszewska ,&nbsp;Izabela Olejniczak ,&nbsp;Dominik Stodulski ,&nbsp;Bogusław Mikaszewski ,&nbsp;Paweł Witkowski ,&nbsp;Jarosław Markowski ,&nbsp;Aleksandra Piernicka- Dybich ,&nbsp;Paweł Burduk ,&nbsp;Małgorzata Wierzchowska ,&nbsp;Joanna Czech ,&nbsp;Daniel Majszyk ,&nbsp;Patrycja Gazińska ,&nbsp;Jeremy Clark ,&nbsp;Hanna Klimza ,&nbsp;Małgorzata Wierzbicka","doi":"10.1016/j.jcms.2026.104497","DOIUrl":"10.1016/j.jcms.2026.104497","url":null,"abstract":"<div><h3>Background</h3><div>Facial nerve (FN) palsy is the most serious complication of parotid gland surgery, with risk influenced by tumor size, location and pathology.</div></div><div><h3>Objective</h3><div>To assess the incidence, severity, duration, and risk factors of FN palsy following parotidectomy, based on the Polish Salivary Network Database.</div></div><div><h3>Methods</h3><div>This multicenter study included 2650 patients treated surgically between 2018 and 2022. FN function was evaluated using the House–Brackmann scale, consider-ing extent, severity and duration of FN dysfunction. Multiple potential risk factors were examined.</div></div><div><h3>Results</h3><div>FN palsy occurred in 20% of patients: 17.2% transient and 4.5% permanent. The marginal mandibular branch was most frequently affected. Multivariate analysis showed that parapharyngeal space involvement, presence of malignant neoplasm and preoperative FN dysfunction independently predicted complete paralysis. Additional risk factors for more extensive, severe, and prolonged FN impairment included clinical signs of malignancy, prior radiation, non-radical margins, larger tumor size (&gt;4 cm), and advanced stage of malignancy. A greater number of affected regions (defined by the European Salivary Gland Society (ESGS) classification) was identified as the most significant adverse risk factor for both the degree and persistence of postoperative facial nerve palsy.</div></div><div><h3>Conclusion</h3><div>FN palsy remains a relevant risk in parotid surgery, particularly with large or malignant tumors. Early diagnosis and radical excision of smaller lesions are key to preserving nerve function.</div></div>","PeriodicalId":54851,"journal":{"name":"Journal of Cranio-Maxillofacial Surgery","volume":"54 6","pages":"Article 104497"},"PeriodicalIF":2.1,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147345870","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}