Journal of Cranio-Maxillofacial Surgery最新文献

{"title":"Unleashing the potency of multi-segmental DCIA flap in mandibular reconstruction with the aid of virtual surgery- A retrospective cohort study.","authors":"Hao Lin, Weiwei Deng, Linzhou Zhang, Zhixiang Ge, Chunyue Ma, Tianfu Wu, Bing Liu","doi":"10.1016/j.jcms.2024.12.018","DOIUrl":"https://doi.org/10.1016/j.jcms.2024.12.018","url":null,"abstract":"<p><p>Although the deep circumflex iliac artery (DCIA) flap is a mainstay in mandibular reconstruction, its multi-segmental utilization is infrequently reported, primarily due to concerns regarding the variable cutaneous component and potentially inadequate vascular supply to multi-block segments. This retrospective study analyzed the outcomes of 86 patients undergoing mandibular reconstruction with multi-segmental DCIA flaps, compared to 167 patients who received conventional single-segmental flaps. The survival rate for multi-segmental flaps was comparable to that of single-segmental flaps (100% vs. 98.2%, p = 0.553). Multi-segmental flaps were used to reconstruct longer bony defects (median: 9 cm vs. 6.5 cm, p < 0.001). Despite the longer operation times in the multi-segmental group (368.8 vs. 326.8 min, p < 0.001), there was no significant increase in the incidence of surgical complications. Furthermore, postoperative QoL and Harris Hip scores did not show significant differences, despite the increased graft lengths and segmentation in the multi-segmental group. The study underscores the underrecognized efficacy of multi-segmental DCIA flaps in complex mandibular reconstructions, particularly for specific types of defects such as Brown III, Brown I (Ic), and Brown II (IIc), which can be effectively and reliably reconstructed with the aid of virtual surgical techniques. This research also confirms that concerns regarding soft tissue management with multi-segmental DCIA flaps can be effectively addressed.</p>","PeriodicalId":54851,"journal":{"name":"Journal of Cranio-Maxillofacial Surgery","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143061514","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":"Comparison of efficacy between micro-osteoperforations and alveolar corticotomies on the rate of orthodontic tooth movement: A systematic review and meta-analysis.","authors":"Flavia Bisconti, Marco Eva, Estelle Thevenet, Natalia Zamora-Martinez","doi":"10.1016/j.jcms.2025.01.013","DOIUrl":"https://doi.org/10.1016/j.jcms.2025.01.013","url":null,"abstract":"<p><p>Micro-osteoperforations and corticotomies are two surgical techniques commonly used to increase the rate of tooth movement. The aim of this systematic review was to respond to the question: Which method used for accelerating orthodontic tooth movement, micro-osteoperforations or alveolar corticotomy, produces a higher rate of tooth movement and present less adverse effects? Searches were performed in the electronic databases of PubMed, Scopus, Cochrane CENTRAL, Web of Science, Lilacs and Science Direct, as well as grey literature (Opengrey), up to March 2024. All the included studies were controlled, randomized clinical trials, cohort, case-control, cross-sectional, and multicentre studies of patients treated with orthodontics and corticotomies or micro-osteoperforations. Cochrane Collaboration risk of bias tool was used for quality assessment. For the quantitative analysis, studies were analyzed with a mixed-effect (random effect) meta-regresion model, with beta coefficients and R2 values, with I2 index and with Q and Egger tests. 31 articles were included for the qualitative analysis and 17 for the quantitative analysis. The rate of tooth movement of the corticotomy was 0.539 mm per month (CI95%: 0.117,0.961) higher than with micro-osteoperforations, being the values statistically significant (p = 0.012) but in a context of strong heterogeneity (89.6%). Adverse effects such as pain, quality of life impact and swelling were reported to be longer and harder after corticotomies. After corticotomy a greater rate of tooth movement has been observed during canine retraction compared to micro-osteoperforations. However, more well-designed randomized clinical trials directly comparing both techniques are needed. REGISTRATION NUMBER: CRD42020156448.</p>","PeriodicalId":54851,"journal":{"name":"Journal of Cranio-Maxillofacial Surgery","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-01-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143054356","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":"Lateral pterygoid muscle enthesis reconstruction in alloplastic total temporomandibular joint replacement: An animal experiment with histological verification.","authors":"Maurice Y Mommaerts, Frederik Deman, Denis Verwilghen, Nikolas De Meurechy","doi":"10.1016/j.jcms.2025.01.022","DOIUrl":"https://doi.org/10.1016/j.jcms.2025.01.022","url":null,"abstract":"<p><p>In current alloplastic total temporomandibular joint replacements (TMJRs) typically the lateral pterygoid muscle (LPM) insertion is sacrificed, affecting joint function. This study assesses a novel additively manufactured TMJR (CADskills BV, Gent, Belgium) designed to enable LPM reinsertion through a scaffold feature on the implant. Thirteen TMJRs were implanted in Swifter crossbreed sheep, with follow-up CT scans after 288 days to evaluate LPM reintegration. Five specimens showed a close approximation between the LPM enthesis and the scaffold. Histological analysis with Masson-Goldner staining and microscopy revealed close bony enthesis alignment with the scaffold, although true bony ingrowth was not observed. One specimen could not be fully evaluated due to preparation issues, limiting conclusions on osseointegration. Random samples from the ramal scaffold showed good integration with the native mandible, with osteogenic activity noted, but no bony ingrowth from the reattached enthesis into the bone grafted titanium scaffold. Despite this, all samples displayed a continuous fibrotic attachment, suggesting functional restoration of the LPM. Findings indicate that while the TMJR design supports fibrotic attachment, further optimization of reattachment techniques, scaffold properties, and post-operative care may improve osseointegration and functional outcomes in future human TMJRs.</p>","PeriodicalId":54851,"journal":{"name":"Journal of Cranio-Maxillofacial Surgery","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-01-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143054360","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 patterns and outcomes of patients affected by primary malignant melanoma of the oral mucosa: A European multicenter retrospective chart review.","authors":"Paolo Boffano, Francesca Neirotti, Matteo Brucoli, Muhammad Ruslin, Petia Pechalova, Nikolai Pavlov, Angel Sapundzhiev, Petar Uchikov, Juan Carlos de Vicente Rodríguez, Nerea Rodríguez Torres, Tania Rodríguez Santamarta, Christophe Meyer, Aurelien Louvrier, Alexandre Michel-Guillaneux, Eugenie Bertin, Thomas Starch-Jensen, Aleksandar Stamatoski, Ivana Mijatov, Branislav V Bajkin, Tadej Dovsak, Zan Garvas, Ana Durković, Marija Milosavljević, Vitomir Konstantinovic, Sara Degerholm, Johanna Snäll","doi":"10.1016/j.jcms.2025.01.012","DOIUrl":"https://doi.org/10.1016/j.jcms.2025.01.012","url":null,"abstract":"<p><strong>Introduction: </strong>The purpose of this European multicenter study was to describe and assess the characteristics, diagnosis, management, and recurrence of oral malignant melanoma at different European oral and maxillofacial surgery centers.</p><p><strong>Materials and methods: </strong>This study was based on a systematic computer-assisted database that allowed the recording of data for all primary oral mucosal melanomas treated in the involved surgical units across Europe between January 1, 2003 and December 31, 2022. The following data were recorded for each patient: gender, age, site, TNM staging, metastases, symptoms, imaging features, histopathological features, treatment, complications, recurrence, follow up, and survival.</p><p><strong>Results: </strong>A total of 29 patients (15 females, 14 males) with a primary oral mucosal malignant melanoma fulfilled the inclusion criteria. The mean age was 64.4 years. The most frequent primary site was the vestibular and crestal maxillary gum. Nineteen patients had been diagnosed with a T3 oral melanoma, nine patients with a T4a oral melanoma, and one patient with a T4b neoplasm. Three patients had distant metastases at diagnosis. Clinically, the most frequently observed clinical features were hyperpigmentation, nodular appearance, ulceration, and hemorrhage. Among the 27 surgical cases, radical/clear margins were obtained in 24 cases, non-radical/invaded margins were obtained in two cases, while in one case a non-specific result of margin positivity was found. The overall 2-year survival was 62%. The 2-year disease-free survival was 52%.</p><p><strong>Conclusions: </strong>Oral mucosal melanoma is an aggressive and often asymptomatic malignancy. The overall long-term survival for patients with oral mucosal melanoma is poor, with a high rate of distant metastasis, independently from the performed treatment. Prevention and early diagnosis could be crucial to improving the disease-free survival of patients with oral mucosal melanomas.</p>","PeriodicalId":54851,"journal":{"name":"Journal of Cranio-Maxillofacial Surgery","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143043432","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":"Feasibility of the preauricular transparotid approach in open reduction and internal fixation of intracapsular mandibular condyle fracture","authors":"Hojin Park,&nbsp;Su Bin Lee,&nbsp;Byung-il Lee","doi":"10.1016/j.jcms.2025.01.008","DOIUrl":"10.1016/j.jcms.2025.01.008","url":null,"abstract":"<div><div>Mandibular condyle fractures pose surgical challenges owing to their proximity to the facial nerve and the complex temporomandibular joint anatomy. Traditional approaches limit exposure and hinder effective fracture management. The preauricular transparotid approach is a potential alternative. We aimed to assess the feasibility of this approach and the postoperative complications.</div><div>A retrospective analysis of 45 patients who underwent open reduction/internal fixation (OR/IF) for intracapsular condylar fractures using a preauricular transparotid approach was conducted. Patient demographics, surgical procedures, radiological assessments, and postoperative complications were analyzed.</div><div>The preoperative computed tomography analysis revealed the fractured segment's location: 17.0 ± 2.6 mm anteriorly, 24.0 ± 4.0 mm medially, and 17.8 ± 3.7 mm inferiorly from the remaining condyle end. A cubic space of 17–24 mm from the condylar stump is necessary to reach the fractured segment end. Postoperative facial nerve weakness occurred in 14 patients but resolved within 4.5 weeks. At 5.5 months of follow-up, the mean interincisional mouth opening measured 40.5 ± 5.1 mm, without malocclusion.</div><div>The approach enhances visualization, facilitates precise fixation, and results in inconspicuous scarring during OR/IF of intracapsular condylar fractures. It requires careful surgical techniques and increases the risk of transient facial nerve weakness. Further research should compare its outcomes with those of traditional approaches and optimize surgical outcomes.</div></div>","PeriodicalId":54851,"journal":{"name":"Journal of Cranio-Maxillofacial Surgery","volume":"53 4","pages":"Pages 428-434"},"PeriodicalIF":2.1,"publicationDate":"2025-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143043376","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":"MEST: Modified electrosclerotherapy to treat AVM (Extracranial Arterio-venous malformations). Better than BEST","authors":"Giacomo Colletti ,&nbsp;Linda Rozell-Shannon ,&nbsp;Riccardo Nocini","doi":"10.1016/j.jcms.2025.01.004","DOIUrl":"10.1016/j.jcms.2025.01.004","url":null,"abstract":"<div><div>Arteriovenous Malformations (AVM) can present themselves in an ample clinical spectrum. They worsen over time, creating local complications such as ulceration, destruction, infection, pain, and severe bleeding.</div><div>Small focal AVMs can effectively be cured by surgery and/or endovascular techniques, whereas larger ones are of difficult management.</div><div>Accordingly, S3 AVMs (according to SECg staging) are particularly troublesome. Here, endovascular treatment is only episodically curative while surgery leads to significant structural and functional damage.</div><div>Electrochemotherapy is an established means to manage selected neoplasms. Recently it was successfully used to treat sclerotherapy-resistant or extensive low-flow vascular malformations (electrosclerotherapy, EST).</div><div>EST was only anectodically tried with AVMs. A conventional EST is unlikely to effectively have an AVM responding.</div><div>We conceived the Modified EST (MEST) protocol and started a pilot study.</div><div>Modification of conventional EST was done by administering bleomycin locally, under ultrasound guidance, in the tissues around the nidus. After 8 min, electroporation was started and covered the entire involved area.</div><div>MEST was adopted in 10 patients with S3 AVMs of the cervicofacial region.</div><div>Most patients received 2 sessions of MEST.</div><div>The response was significant, and the patients all had a complete or near-complete reduction in the size of the AVM. Excellent aesthetic results were achieved. On follow-up imaging the AVMs were not detectable.</div><div>Side effects were minor and easily managed.</div><div>Results were stable.</div><div>The results of the present study suggest that MEST may be the treatment of choice in selected AVMs.</div><div>However, a longer follow-up is needed to further evaluate the risk of recurrence.</div></div>","PeriodicalId":54851,"journal":{"name":"Journal of Cranio-Maxillofacial Surgery","volume":"53 4","pages":"Pages 391-398"},"PeriodicalIF":2.1,"publicationDate":"2025-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143043378","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A morphometric analysis of the cranial base in trigonocephaly","authors":"Courtney Barnes ,&nbsp;Anil Madaree ,&nbsp;Lelika Lazarus","doi":"10.1016/j.jcms.2024.12.020","DOIUrl":"10.1016/j.jcms.2024.12.020","url":null,"abstract":"<div><div>Trigonocephaly occurs when the metopic suture fuses prematurely. Few studies have documented the morphometry of the entire anterior cranium in trigonocephaly and not on the morphometric changes to the cranial fossae alone. Thus, this study aimed to determine and compare the dimensions of the anterior cranial fossa (ACF) in trigonocephaly and control groups. Additionally, volumetric assessments of the middle and posterior cranial fossae (MCF and PCF) were analysed to determine the amount of compensatory growth in these regions. Anatomical landmarks were used to measure the morphometry of the ACF, and volumes of the MCF and PCF on preoperative two-dimensional computed tomography scans of fifteen non-syndromic, isolated trigonocephaly patients between 2012 and 2023, and eight controls. Comparative assessment of the ACF revealed larger dimensions in younger more severe trigonocephaly patients when compared to the control cohort. Smaller ACF dimensions were recorded in older patients who presented with moderate and severe trigonocephaly compared to the control cohort. The volume of the MCF was found to be significant (p = 0.05), and the volume of the PCF was larger in trigonocephaly patients compared to controls. The PCF showed the largest incidence of compensatory growth (30.4%) in trigonocephaly patients. The frontal angle (FA) (p = 0.004) and endocranial bifrontal angle (EBA) were used to categorise the severity of trigonocephaly. The morphometric data obtained could assist craniofacial surgeons in understanding the changes that occur in the ACF to decide which type of corrective treatment is most suitable.</div></div>","PeriodicalId":54851,"journal":{"name":"Journal of Cranio-Maxillofacial Surgery","volume":"53 4","pages":"Pages 377-384"},"PeriodicalIF":2.1,"publicationDate":"2025-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143030290","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Change of lip-line canting following bimaxillary surgery in patients with class III skeletal patterns with increased vertical proportions and asymmetry","authors":"YoungDae Kim ,&nbsp;Seung Il Song ,&nbsp;Sarah Kim ,&nbsp;Jain Seo ,&nbsp;Vania Chan ,&nbsp;Yun Pyo Ahn ,&nbsp;Jeong Won Shin ,&nbsp;Young Ho Kim ,&nbsp;Hwa Sung Chae","doi":"10.1016/j.jcms.2025.01.010","DOIUrl":"10.1016/j.jcms.2025.01.010","url":null,"abstract":"","PeriodicalId":54851,"journal":{"name":"Journal of Cranio-Maxillofacial Surgery","volume":"53 4","pages":"Pages 406-419"},"PeriodicalIF":2.1,"publicationDate":"2025-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143030368","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":"3D planning in orthognathic surgery: A retrospective study analyzing the bone resection in maxillary impaction","authors":"S. Morand ,&nbsp;F. Bettega ,&nbsp;G. Bettega ,&nbsp;R. Lartizien","doi":"10.1016/j.jcms.2025.01.009","DOIUrl":"10.1016/j.jcms.2025.01.009","url":null,"abstract":"","PeriodicalId":54851,"journal":{"name":"Journal of Cranio-Maxillofacial Surgery","volume":"53 4","pages":"Pages 399-405"},"PeriodicalIF":2.1,"publicationDate":"2025-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143030288","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":"Nasolabial flap with mucous membrane for repairing extensive lower lip tissue defect: A case report","authors":"Huihui Yang ,&nbsp;Yitong Zhao ,&nbsp;Xingwu Zheng,&nbsp;Zhujiajun Cui,&nbsp;Tianyu Zhang,&nbsp;Yongzhen Fu,&nbsp;Qilin Liu","doi":"10.1016/j.jcms.2025.01.002","DOIUrl":"10.1016/j.jcms.2025.01.002","url":null,"abstract":"<div><div>The structural integrity of the lips is essential for both aesthetic appeal and oral functionality. Defects in this region, which may arise from a variety of causes, can significantly affect a patient's physical and psychological well-being. This case report introduces a novel surgical technique designed for the repair of substantial defects in the lower lip. The procedure utilizes a nasolabial flap in conjunction with the facial artery myomucous flap. This innovative approach addresses considerable lip-related defect challenges effectively. The report delineates the surgical steps implemented and highlights the successful reconstruction of the lower lip. Following the surgery, the patient demonstrated a positive recovery trajectory, marked by significant improvements in both lip symmetry and functionality, with no notable complications. The integration of the nasolabial flap with the mucous membrane has proven effective in the repair of extensive lip defects, particularly in the skin and mucous membrane areas adjacent to the corners of the mouth. This procedure not only facilitates the restoration of appearance and function but also reduces the risk of further surgical trauma. Additionally, the report underscores the necessity of thorough preoperative planning to mitigate complications at the donor site.</div></div>","PeriodicalId":54851,"journal":{"name":"Journal of Cranio-Maxillofacial Surgery","volume":"53 4","pages":"Pages 385-390"},"PeriodicalIF":2.1,"publicationDate":"2025-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143030376","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}