Journal of Stomatology Oral and Maxillofacial Surgery最新文献

{"title":"Buccal pad of fat, advanced platelet-rich fibrin, fibrin glue, and oxidized cellulose plug in the management of oroantral communication: A comparative clinical study","authors":"Nermine Ramadan Mahmoud","doi":"10.1016/j.jormas.2025.102376","DOIUrl":"10.1016/j.jormas.2025.102376","url":null,"abstract":"<div><div><span><span><span><span>Oroantral communication (OAC) is a significant complication following the removal of maxillary posterior teeth that is a consequence of them being close to the </span>maxillary sinus floor. The current study evaluated the efficacy of four treatment modalities for OAC management: buccal fat pads (BFPs), advanced platelet-rich fibrin (A-PRF), </span>fibrin glue, and </span>oxidized regenerated cellulose plugs. Twenty-four patients with OAC were randomly assigned to four treatment groups (</span><em>n</em><span><span><span> = 6 each) and clinically assessed for facial swelling, healing outcomes, and patient-reported pain at baseline, on day 3, and at weekly intervals for 4 weeks after their respective treatments. A linear mixed-effects model found a significant reduction in pain over time in all groups. Intergroup and intragroup comparisons of postoperative pain showed statistically significant differences between the groups at baseline and after 1 week. The BFP group had the highest scores for initial pain, while the A-PRF group had the least, with a consistent reduction throughout the study. The BFP group displayed significantly increased facial swelling on day 3, which had subsided after 2 weeks; the </span>fibrin glue group followed a similar pattern but stabilized quickly. The A-PRF group showed minimal swelling and rapid </span>tissue regeneration<span>, while the oxidized regenerated cellulose group displayed less responsiveness for larger OACs. The choice of therapeutic technique for managing OACs should therefore be chosen according to the defect size and anatomical considerations. While BFP and fibrin glue were more efficacious for larger defects, the A-PRF technique showed rapid healing and less discomfort.</span></span></div></div>","PeriodicalId":55993,"journal":{"name":"Journal of Stomatology Oral and Maxillofacial Surgery","volume":"126 5","pages":"Article 102376"},"PeriodicalIF":2.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144058960","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Volume and morphological characteristics of masticatory muscles in patients with unilateral disc displacement without reduction and asymptomatic individuals","authors":"Berk Bilgen ,&nbsp;Selahattin Durmaz ,&nbsp;Mehmet Barburoğlu ,&nbsp;Sina Saygılı ,&nbsp;Tonguç Sülün","doi":"10.1016/j.jormas.2025.102405","DOIUrl":"10.1016/j.jormas.2025.102405","url":null,"abstract":"<div><h3>Background</h3><div><span>The temporomandibular joint (TMJ) functions as an integrated unit, therefore pathology affecting one side may affect the other. This cross-sectional study aimed to evaluate the effect of unilateral disc displacement without reduction (DDWoR) on the volumes of three </span>masticatory muscles<span>. Additionally, it investigated the relationship between lateral pterygoid muscle (LPM) attachment type, its volume and DDWoR.</span></div></div><div><h3>Methods</h3><div>A total of 84 TMJ MRI samples were analyzed. The control group consisted of 44 TMJ MRI samples, obtained separately from both TMJs of 22 bilaterally healthy individuals. The study group included 20 patients with unilateral DDWoR; MRI samples of unaffected TMJs formed the first study group (<em>n</em> = 20) and MRI samples of the affected TMJs formed the second study group (<em>n</em><span> = 20). In all groups, the LPM, masseter (MM), and medial pterygoid (MPM) muscle volumes were measured and LPM attachment types were classified. One-way ANOVA, Fisher’s Exact and Chi-square tests were applied, while MANCOVA assessed the effects of gender, age and body-mass index (BMI) on muscle volume and the estimated marginal means were calculated accordingly.</span></div></div><div><h3>Results</h3><div>The MM volume was significantly higher in the control group compared to study groups (<em>p</em> = 0.002), with no difference between the two study groups (<em>p</em> = 1.000). LPM (<em>p</em><span> = 0.688) and MPM (</span><em>p</em> = 0.348) volumes showed no significant differences between groups. No casual relationship was identified between LPM attachment type and DDWoR (<em>p</em> = 0,981). Type-III attachment was associated with higher muscle volume.</div></div><div><h3>Conclusion</h3><div>Unilateral DDWoR may affect MM morphology, highlighting the importance of evaluating masticatory muscles during treatment planning. Additionally, reduced MM volume may serve as a marker in the clinical diagnosis of DDWoR.</div></div>","PeriodicalId":55993,"journal":{"name":"Journal of Stomatology Oral and Maxillofacial Surgery","volume":"126 5","pages":"Article 102405"},"PeriodicalIF":2.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144082347","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessment of pediatric mandibular fracture management in France","authors":"Thomas Didier ,&nbsp;Anne Morice ,&nbsp;Boris Laure ,&nbsp;Aline Joly","doi":"10.1016/j.jormas.2025.102389","DOIUrl":"10.1016/j.jormas.2025.102389","url":null,"abstract":"<div><div><span><span>Mandibular fractures<span> in children present management challenges due to pediatric-specific factors such as mandibular growth and the presence of dental germs. There are few surgeons specifically trained to treat these fractures, and there are no national or international guidelines. Management depends on several factors, including the child’s age and the location of the fracture. Treatment options include functional treatment, closed reduction with or without immobilization, and surgery. The aim of this study was to assess the current management strategies for </span></span>pediatric mandibular fractures in France, based on a national survey. A questionnaire based on two clinical cases of children of different ages, presenting mandibular fractures in different locations, was sent to the referring pediatric surgeon of 25 centers in France that manage pediatric </span>maxillofacial trauma<span><span>. The questions focused on the choice of treatment, postoperative instructions, and follow-up. The data were analyzed descriptively. Off the 25 centers, all responded to the questionnaire. For the first patient, 92 % of the surgeons hospitalized the child. Among them, 76 % opted for open reduction<span> and internal fixation (ORIF) for the parasymphyseal fracture, and 72 % adopted the same approach for the mandibular body fracture. In most cases, the fixation material was left in place for at least three months. For the second patient, 88 % of the surgeons also hospitalized the child. For condylar fractures, 84 % chose functional treatment. 56 % of practitioners opted for ORIF for the mandibular body fracture. Regarding the use of resorbable plates, only 1 out of 25 centers used this type of material. Concerning the specific training of surgeons, the study shows that among the 25 centers: 52 % reported having surgeons with specific pediatric training. 48 % of the centers had access to a dental </span></span>prosthetist capable of fabricating retention splints. This study is the first on this subject in France. It highlights significant variability in the management of pediatric mandibular fractures in France and underscore the need for standardized treatment protocols. Future studies should focus on developing standardized guidelines and evaluated long-term outcome to improve both surgical and conservative approaches</span></div></div>","PeriodicalId":55993,"journal":{"name":"Journal of Stomatology Oral and Maxillofacial Surgery","volume":"126 5","pages":"Article 102389"},"PeriodicalIF":2.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144013781","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-term evaluation of progressive condylar resorption after orthognathic surgery in mandibular retrognathism with high mandibular plane angle: An analysis of three-dimensional computed tomography","authors":"Hoyoung Kim ,&nbsp;Joonyoung Huh ,&nbsp;Jiwon Do ,&nbsp;Hoon Joo Yang","doi":"10.1016/j.jormas.2025.102428","DOIUrl":"10.1016/j.jormas.2025.102428","url":null,"abstract":"<div><h3>Introduction</h3><div>The purposes of this study were to analyze the volumetric change of condyle in postoperative progressive condylar resorption (PCR) using three-dimensional computed tomography<span><span> (3D CT) over a long-term follow-up period of at least 2 years after mandibular advancement surgery, and the correlation between changes in the condylar volume in 3D CT and the condylar size in </span>orthopantomogram (OPG).</span></div></div><div><h3>Material and methods</h3><div><span>In 14 female patients with mandibular retrognathism<span> and a high mandibular plane angle who underwent orthognathic surgery, OPGs, lateral </span></span>cephalograms, and 3D CT scans were acquired before the surgery, immediately after the surgery, and at a follow-up of at least 2 years. Surgical movements and postoperative skeletal changes in lateral cephalogram, change of condylar size in OPG, and changes of condylar position and volume in CT were measured and statistically analyzed.</div></div><div><h3>Results</h3><div>The average reduction in condylar volume was 154.3 mm³ (19.1 %). Postoperative PCR was observed in a total of 12 condyles in eight patients. The change in condylar volume positively correlated with changes in condylar width (<em>p</em> &lt; 0.01) but not with changes in the condylar height on OPG.</div></div><div><h3>Discussion</h3><div>The condylar width should be evaluated, instead of the height, when diagnosing PCR using OPG.</div></div>","PeriodicalId":55993,"journal":{"name":"Journal of Stomatology Oral and Maxillofacial Surgery","volume":"126 5","pages":"Article 102428"},"PeriodicalIF":2.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144477981","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development of a prognostic tool using machine learning to identify high-risk mucoepidermoid carcinoma patients across diverse anatomical sites","authors":"Yun Lei,&nbsp;Wan-Shan Li","doi":"10.1016/j.jormas.2025.102490","DOIUrl":"10.1016/j.jormas.2025.102490","url":null,"abstract":"<div><h3>Objective</h3><div>Mucoepidermoid carcinoma (MEC), typically arising in the salivary glands, has been documented in various anatomical locations. This study aimed to develop machine learning models for efficient prognosis prediction in patients with MEC across different anatomical sites and to create a novel tool for identifying high-risk patients in clinical settings.</div></div><div><h3>Methods</h3><div>A retrospective cohort study involving 6280 patients with MEC from diverse anatomical sites was conducted. COX regression analysis identified prognostic variables. Five machine learning models—Support Vector Machine (SVM), Random Forest (RF), Generalized Additive Model (GAM), Extreme Gradient Boosting (XGBoost), and Light Gradient Boosting Machine (LightGBM)—were constructed. Model performance was assessed using accuracy, recall, precision, and the area under the curve (AUC) of receiver operating characteristic (ROC) curves. However, the external validation was not performed. The best-performing model was developed into a prognostic tool.</div></div><div><h3>Results</h3><div>The GAM outperformed the other models, and a web-based tool was developed for identifying patients with varying prognostic risks across MEC cases from different anatomical locations, supporting clinical decision-making, personalizing therapeutic strategies based on clinical characteristics, ensuring tailored treatment schedules and optimizing resource allocation. Extension, age, pathological grade, clinical stage, and N-stage were the most significant variables in the final model.</div></div><div><h3>Conclusion</h3><div>This study established an online tool utilizing GAM to aid in identifying high-risk patients with MEC and enhancing prognostic accuracy in clinical practice. The anatomical site did not significantly influence survival outcomes, offering valuable insights into the shared pathogenesis of MEC.</div></div>","PeriodicalId":55993,"journal":{"name":"Journal of Stomatology Oral and Maxillofacial Surgery","volume":"126 5","pages":"Article 102490"},"PeriodicalIF":2.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144621259","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Spontaneous bone regeneration of post-enucleation defects of osteolytic lesions in the mandible: A digital three-dimensional morphometric analysis","authors":"Pierluigi Mariani ,&nbsp;Diana Russo ,&nbsp;Lucio Lo Russo ,&nbsp;Gabriele Liberti ,&nbsp;Dardo Menditti ,&nbsp;Luigi Laino","doi":"10.1016/j.jormas.2025.102411","DOIUrl":"10.1016/j.jormas.2025.102411","url":null,"abstract":"<div><h3>Background</h3><div>Spontaneous bone regeneration after enucleation of osteolytic lesions in the mandible is crucial for healing bone defects. understanding when spontaneous bone regeneration suffices can help clinicians make informed decisions.</div></div><div><h3>Purpose</h3><div>This study aimed to assess the extent of spontaneous bone regeneration in post-enucleation mandibular osteolytic lesion cavities using a 3D digital approach. Secondary objectives included identifying factors like age, lesion size, and anatomical site that could influence regeneration.</div></div><div><h3>Study design</h3><div>The study included patients aged 18–65 years who underwent enucleation of an osteolytic mandibular lesion, with available pre-treatment and follow-up CBCT scans.</div></div><div><h3>Main outcomes</h3><div>The primary outcome was the percentage of regenerated bone volume ( %RBV), calculated using 3D-volumetric analysis. Secondary outcomes included age, gender, lesion volume and site, number of extracted teeth, bone-wall involvement, and follow-up.</div></div><div><h3>Results</h3><div>The study involved 20 patients, with a mean age of 40.1 ± 16.06 years. %RBV ranged from 32 % to 97 %, with a mean of 66.95 %. Significant predictors of regeneration included age, lesion site, and bone wall involvement.</div></div><div><h3>Conclusions</h3><div>Spontaneous bone regeneration can often achieve significant healing even in large defects; understanding the factors influencing this process can guide treatment strategies and improve clinical outcomes.</div></div>","PeriodicalId":55993,"journal":{"name":"Journal of Stomatology Oral and Maxillofacial Surgery","volume":"126 5","pages":"Article 102411"},"PeriodicalIF":2.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144144546","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bioinformatics analysis of hub genes and oxidative stress-related pathways in odontogenic keratocysts","authors":"Hao Zhou ,&nbsp;Rui-Fang Li ,&nbsp;Qi-Wen Man","doi":"10.1016/j.jormas.2025.102423","DOIUrl":"10.1016/j.jormas.2025.102423","url":null,"abstract":"<div><h3>Objective</h3><div><span>The study aimed to examine the hub genes and oxidative stress-related pathways in </span>odontogenic keratocysts (OKCs) and predict transcription factors associated with the hub genes.</div></div><div><h3>Methods</h3><div><span><span>The GSE38494 dataset, which includes 12 OKC tissues and 4 normal oral mucosa tissues, was retrieved from the </span>Gene Expression Omnibus<span><span><span> (GEO) database. The limma package in the R programming language was utilized to identify differentially expressed genes (DEGs). In addition, Gene Ontology (GO) analysis was performed specifically for genes associated with </span>oxidative stress<span>. Utilizing Database for Annotation, Visualization, and Integrated Discovery (DAVID), Metascape, and Gene Set Enrichment Analysis (GSEA), we comprehensively analyzed the GO terms and </span></span>signaling pathways<span> related to oxidative stress. The Degree algorithm in </span></span></span>Cytoscape<span> was employed to identify hub genes. The STRING database was leveraged to construct the protein-protein interaction (PPI) network. Finally, the transcription factors (TFs) of the hub genes were identified using the NetworkAnalyst web tool. scRNA data of OKC (GSE176351) was used for correlation analysis between oxidative stress-related hub genes and IL-β gene by Pearson correlation analysis.</span></div></div><div><h3>Results</h3><div><span><span><span><span><span>A total of 465 genes associated with oxidative stress were identified in the GSE38494 and GO databases, and 60 genes were significantly differentially expressed. The majority of these genes were involved in multiple </span>signaling pathways, such as </span>microRNAs<span> in cancers, chemical carcinogenesis<span>, reactive oxygen species, and the </span></span></span>arachidonic acid<span><span><span> metabolism signaling pathway. The ten most important hub genes were MAPK3, </span>HMOX1<span>, GPX6, GPX7, GCLM, COL1A1, TXN, </span></span>PDGFRB, NQO1, and </span></span>MMP2<span>. FOXC1, HNF4A, and GATA2 may be the key regulatory factors of the hub genes. Additionally, there is a weak postitive correlation between oxidative stress-related genes and IL-1β in epithelial cells of OKC (</span></span><em>R</em> = 0.26).</div></div><div><h3>Conclusions</h3><div>Through bioinformatics analysis, we identified several oxidative stress-related hub genes and signaling pathways in OKC which was related to IL-1β expression.</div></div>","PeriodicalId":55993,"journal":{"name":"Journal of Stomatology Oral and Maxillofacial Surgery","volume":"126 5","pages":"Article 102423"},"PeriodicalIF":2.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144287203","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The effect of local applications of hyaluronic acid gels on post-operative pain, trismus and soft tissue edema following third molar extraction: A systematic review","authors":"Ignas Mickevičius,&nbsp;Greta Volosevičiūtė,&nbsp;Rūta Rastenienė","doi":"10.1016/j.jormas.2025.102481","DOIUrl":"10.1016/j.jormas.2025.102481","url":null,"abstract":"<div><h3>Objective</h3><div><span><span>Third molar<span> extraction is a common surgical procedure, often resulting in postoperative pain, </span></span>trismus<span>, and swelling. Hyaluronic acid (HA) is a naturally occurring </span></span>biopolymer<span><span> with wound-healing and anti-inflammatory properties. Due to these characteristics, HA may offer clinical benefits when applied after tooth extraction. This study aims to systematically review the literature to evaluate the effects of HA gel application on postoperative pain, </span>trismus, and soft tissue edema following third molar extraction.</span></div></div><div><h3>Methods</h3><div><span>A systematic literature review followed the PRISMA guidelines. An electronic search was performed in the PubMed, ScienceDirect, and Scopus databases using keywords: ‘hyaluronic acid’ OR ‘hyaluronan’ AND ‘gel’ AND ‘extraction’. Inclusion criteria were studies published in 2019–2024, in English, with full-text access, and </span>randomized controlled trials (RCTs). Publications involved patients who underwent third molar extraction and assessed the effects of HA application on postoperative pain, trismus, and/or soft tissue edema compared to a control group.</div></div><div><h3>Results</h3><div>1183 articles were identified, 1163 screened after removing duplicates, and 10 publications selected for analysis after applying inclusion criteria.</div></div><div><h3>Conclusions</h3><div>Local application of HA gel following third molar extraction appears to contribute to postoperative pain reduction; however, its effectiveness in managing trismus and soft tissue edema remains inconclusive. Due to high methodological heterogeneity and risk of bias in the included studies, the overall robustness of the results is limited. Further well-designed, large-scale, and homogeneous clinical trials and systematic reviews are necessary to confirm the therapeutic benefits of HA gel in oral surgery.</div></div>","PeriodicalId":55993,"journal":{"name":"Journal of Stomatology Oral and Maxillofacial Surgery","volume":"126 5","pages":"Article 102481"},"PeriodicalIF":2.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144531289","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Haploinsufficiency of SF3B2 revealed by a craniofacial microsomia with atypical presentation: a case report","authors":"Antoine Octau ,&nbsp;Cindy Colson ,&nbsp;Joel Ferri","doi":"10.1016/j.jormas.2025.102486","DOIUrl":"10.1016/j.jormas.2025.102486","url":null,"abstract":"<div><div>Otomandibular syndrome is primarily characterised by craniofacial microsomia (CFM). Pathogenic loss-of-function variants of the <em>SF3B2</em> gene, which encodes the U2 subunit of the spliceosome, can cause CFM through a haploinsufficiency mechanism. This study aims to present the clinical phenotype and maxillofacial management of a patient carrying a novel <em>SF3B2</em> gene variant.</div><div>We present the case of a patient with a heterozygous de novo pathogenic variant of the <em>SF3B2</em> gene who presented with an otomandibular syndrome accompanied by progressive camptodactyly of the extremities, which had not been described previously. Particularly low maxillary and mandibular bone density was observed during bimaxillary osteotomy, necessitating adaptation of the surgical protocol.</div><div>This case expands the phenotypic spectrum of anomalies associated with the <em>SF3B2</em> gene by indicating potential subclinical acral and bone involvement. It also emphasises the importance of genetic analysis in complex craniofacial malformations.</div></div>","PeriodicalId":55993,"journal":{"name":"Journal of Stomatology Oral and Maxillofacial Surgery","volume":"126 5","pages":"Article 102486"},"PeriodicalIF":2.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144565470","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Biomechanical evaluation of zygomatic-orbital-maxillary complex fractures following internal fixation","authors":"Yan Li,&nbsp;Wei-Hao Zhou,&nbsp;Yu-Ran Ding,&nbsp;Ping He,&nbsp;Chen-Cheng Mo,&nbsp;Xiang-Dong Qi","doi":"10.1016/j.jormas.2025.102323","DOIUrl":"10.1016/j.jormas.2025.102323","url":null,"abstract":"<div><h3>Purpose</h3><div>The aim of this study is to develop effective treatment strategies for zygomatic-orbital-maxillary complex (ZOMC) fractures using finite element analysis (FEA) and investigate the mechanical properties and stress distribution of different internal fixators.</div></div><div><h3>Methods</h3><div><span>A three-dimensional (3D) model was created from CT images of a patient with a unilateral ZOMC fracture, and the preinjury craniofacial structure was reconstructed. A cylindrical impactor was used to simulate facial impact. Biomechanical analysis was performed to assess the stability of internal fixation of the fracture lines at the frontal process of the zygomatic bone (FPZB), inferior orbital rim (IOR), and upper and lower parts of the zygomaticomaxillary suture (ZMS). The impact of different fixation methods on the anterior-inferior wall of the </span>maxillary sinus (AIWMS) was also assessed in this study. A 120 N load was used to simulate physiological muscle force, and the maximum von Mises stress and maximum displacement for the fracture ends were assessed.</div></div><div><h3>Results</h3><div>The stress distribution on the impact model was similar to that on the patient's fracture lines, with all internal fixation devices experiencing maximum stress below the yield stress. The model exhibiting the largest displacement of the zygomatic body, IOR, and FPZB had not undergone internal fixation of the FPZB. The greatest maximum displacement value was recorded for the maxilla, at the non-fixed lower ZMS. The maximum displacement value was lower for 2 fixators placed at the AIWMS than for a single fixator placed at the fracture midline.</div></div><div><h3>Conclusions</h3><div>The placement of 2 internal fixators along the zygomaticomaxillary (NMB) and nasomaxillary buttresses (NMB) provides greater stability than the placement of a single device does. Moreover, stabilizing the fracture lines in the FPZB is essential, as doing so reduces the extent of displacement of free fracture ends by counteracting the masseter muscle force.</div></div>","PeriodicalId":55993,"journal":{"name":"Journal of Stomatology Oral and Maxillofacial Surgery","volume":"126 5","pages":"Article 102323"},"PeriodicalIF":2.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143744526","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}