Journal of Stomatology Oral and Maxillofacial Surgery最新文献

{"title":"DNA Methylation-Based Machine Learning Models for Classification of Oral Cancer and Potentially Malignant Lesions: A Proof-Of-Concept Study.","authors":"Gowri Sivaramakrishnan, Kannan Sridharan, Mohammed Abdulla AlMuharraqi","doi":"10.1016/j.jormas.2025.102594","DOIUrl":"https://doi.org/10.1016/j.jormas.2025.102594","url":null,"abstract":"<p><strong>Background: </strong>Accurate classification of oral squamous cell carcinoma (OSCC) and oral potentially malignant lesions (OPLs) is challenging due to histopathological variability and limited predictive biomarkers. DNA methylation offers a promising molecular signature, but its utility for tissue classification remains underexplored.</p><p><strong>Methods: </strong>We harmonized publicly available DNA methylation datasets (GSE97784 and GSE204943; n = 142) and selected the top 100 most variable CpG sites (variance 0.074-0.117) for analysis. Eight supervised machine learning (ML) models-logistic regression, random forest (RF), support vector machine (SVM), extreme gradient boosting (XGBoost), k-nearest neighbors (kNN), Naive Bayes, gradient boosting machine (GBM), and neural network (NN)-were trained using 10-fold cross-validation. Principal component analysis was performed to assess data dimensionality.</p><p><strong>Results: </strong>High-variance CpG sites were predominantly located within gene bodies and clustered on chromosomes 1, 2, and 6. PCA revealed complex, high-dimensional methylation patterns requiring 55 components to capture 90% of variance. Overall, RF achieved the highest accuracy (78%) and AUC-ROC (0.84), followed by GBM (76%) and XGBoost. Tumor and normal tissues were classified with relatively high sensitivity and specificity, while OPLs were difficult to detect, showing low sensitivity (<50%) across all models. GBM performed best for normal tissue detection, and Naive Bayes slightly outperformed for tumor F1-score, but RF offered the most balanced performance across classes.</p><p><strong>Conclusions: </strong>Ensemble ML models, particularly RF and GBM, demonstrate proof-of-concept potential for DNA methylation-based classification of oral tissues. While tumor and normal classification is robust, OPL detection remains challenging, highlighting the need for larger, balanced datasets and complementary biomarkers to improve early detection and clinical utility.</p>","PeriodicalId":56038,"journal":{"name":"Journal of Stomatology Oral and Maxillofacial Surgery","volume":" ","pages":"102594"},"PeriodicalIF":2.0,"publicationDate":"2025-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145240488","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":"Balanced orbital decompression for thyroid-associated orbitopathy and the role of stereotactic navigation in infraorbital nerve preservation.","authors":"Noémie Vanden Haute, Cyril Bouland, Morgan Lahon, Louis Brochet, Adélaïde Carlier, Andrea Varazzani, Pierre Bouletreau","doi":"10.1016/j.jormas.2025.102596","DOIUrl":"https://doi.org/10.1016/j.jormas.2025.102596","url":null,"abstract":"<p><strong>Introduction: </strong>Thyroid-associated orbitopathy (TAO) is the most common adult inflammatory eye disease. Proptosis is a TAO common clinical sign. Besides daily physical discomfort, TAO impacts negatively mental health. Proptosis is treated by orbital decompression surgery. Infraorbital nerve dysesthesia is a common complication. Stereotactic navigation is an imaging-guided surgery. This less invasive procedure could reduce postoperative complications and improve recovery. This study aims to evaluate the impact of navigation on patients' outcomes.</p><p><strong>Methods: </strong>A retrospective study was conducted, including TAO patients treated for unilateral or bilateral balanced orbital decompression between 2021 and 2024. One surgeon performed all the procedures. Pre, per and postoperative data such as lipectomy, surgery duration, proptosis, diplopia, symmetry of eyeball protrusion, infraorbital nerve injury with hypo or dysesthesia impacting daily life and subjective impact of the surgery on disfiguration were evaluated. Postoperative evaluation was conducted at least 6 months after the operation.</p><p><strong>Results: </strong>The current study included 91 patients and 166 orbits, respectively, 135 in the classic surgery (Cs) group, 31 in the stereotactic surgery (Sts) group. The average time spent in the operating theatre in all surgery types was longer in the Sts approach. In both cases, the improvement in right-left symmetry was statistically significant (p<0.001). Six months after surgery, 51 patients complained of hypo- or dysaesthesia (32.69%). No significant differences were observed between the Sts or Cs approaches regarding first surgery or revision cases. No significant differences between the two groups were observed regarding the onset of new diplopia (p=0.92).</p>","PeriodicalId":56038,"journal":{"name":"Journal of Stomatology Oral and Maxillofacial Surgery","volume":" ","pages":"102596"},"PeriodicalIF":2.0,"publicationDate":"2025-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145240425","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":"Finite Element Analysis of Trans-Sutural Distraction Osteogenesis on the Nasomaxillary Complex in Adolescents with Cleft Lip and Palate.","authors":"Yun He, Zhongxing Wu","doi":"10.1016/j.jormas.2025.102595","DOIUrl":"https://doi.org/10.1016/j.jormas.2025.102595","url":null,"abstract":"<p><strong>Introduction: </strong>Trans-sutural distraction osteogenesis (TSDO) has emerged as a promising treatment for midfacial hypoplasia. However, the mechanical effects on craniofacial structures remain insufficiently understood.</p><p><strong>Material & method: </strong>Finite element models (FEM) of two adolescent patients with cleft lip and palate (CLP) (aged 10 and 11) were reconstructed from CBCT data. TSDO was simulated by applying symmetrical traction forces to the maxilla. A modified surgical intervention, transanterior maxillary wall osteotomy, was also modeled to assess its biomechanical impact. Displacement and stress distribution were evaluated using total deformation, first and third principal stresses, and Von-Mises stress.</p><p><strong>Results: </strong>TSDO induced forward displacement of the midface, especially in the alveolar process, with additional movement in the nasal, infraorbital, and zygomatic regions. Stress concentrations were observed around the traction hooks, nasomaxillary suture, and nasal septum. The cleft palate model exhibited more asymmetrical and uneven stress distribution. The simulated transanterior maxillary wall osteotomy significantly reduced stress in the nasal-infraorbital-zygomatic region while preserving maxillary advancement.</p><p><strong>Discussion: </strong>TSDO effectively advances the midface in CLP patients but may result in undesirable protrusion in the nasal-infraorbital-zygomatic region. Transanterior maxillary wall osteotomy shows potential for mitigating these effects.</p>","PeriodicalId":56038,"journal":{"name":"Journal of Stomatology Oral and Maxillofacial Surgery","volume":" ","pages":"102595"},"PeriodicalIF":2.0,"publicationDate":"2025-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145240520","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":"Artificial Intelligence Outperforms a Nomogram for Osteoradionecrosis Prognostication Following Fibula Free Flap Reconstruction in Oral Cancer Patients.","authors":"Dany Y Matar, Gina A Mackert, Anthony Y Matar, Angela Chien-Yu Chen, Adriana C Panayi, Leonard Knoedler, Samuel Knoedler, Robin Yang, Leila J Mady, Huang-Kai Kao","doi":"10.1016/j.jormas.2025.102584","DOIUrl":"https://doi.org/10.1016/j.jormas.2025.102584","url":null,"abstract":"<p><strong>Background: </strong>Osteoradionecrosis (ORN) is a serious complication in oral cancer patients undergoing tumor excision and mandibular reconstruction, particularly after radiotherapy. This study compared a logistic regression-based nomogram with five machine learning (ML) algorithms to identify the most clinically useful ORN prognostication tool.</p><p><strong>Methods: </strong>We retrospectively analyzed 275 irradiated oral cancer patients who underwent segmental mandibulectomy and immediate fibula flap reconstruction at a single center. Patients were split 75:25 into training and test cohorts. 34 patient variables were used to train a nomogram and five ML models (DNN, KNN, SVC, LightGBM, Stacked Ensemble). The primary outcome was ORN within 5-10 years. Binary prediction performance on the test cohort was assessed using AUROC, Calibration and Decision Curve Analysis (DCA). Feature contribution on model prediction was assessed.</p><p><strong>Results: </strong>The Stacked model achieved the highest test AUROC (0.83, 95% CI: 0.70-0.94), outperforming the Nomogram (0.73, 95% CI: 0.57-0.86; p = 0.04), KNN (0.81), DNN (0.79), LightGBM (0.78), and SVC (0.74). DNN showed the best calibration (ICI: 0.07), followed by KNN (0.09), SVC (0.11), and the Nomogram (0.22). Pre-operative radiation therapy, post-operative wound infection, plate exposure, and surgical re-exploration were the most influential features in model predictions. DCA showed that DNN, Stacked, and SVC models provided the greatest net clinical benefit across decision thresholds.</p><p><strong>Conclusions: </strong>ML models outperformed the Nomogram in predicting ORN. They showed strong binary discrimination and effective risk stratification. These findings support use of ML models for guiding postoperative surveillance and personalized care, warranting further validation.</p>","PeriodicalId":56038,"journal":{"name":"Journal of Stomatology Oral and Maxillofacial Surgery","volume":" ","pages":"102584"},"PeriodicalIF":2.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145226400","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 non-coding RNA as a potential diagnostic biomarker in oral squamous cell carcinoma: A systematic review and meta-analysis.","authors":"Xingyu Liu, Jing Qiao, Han Qin","doi":"10.1016/j.jormas.2025.102581","DOIUrl":"https://doi.org/10.1016/j.jormas.2025.102581","url":null,"abstract":"<p><strong>Objective: </strong>This study was conducted to assess the diagnostic accuracy of long non-coding RNAs (lncRNAs) in differentiating patients with oral squamous cell carcinoma (OSCC), and to explore their potential role in early detection.</p><p><strong>Methods: </strong>A literature search was conducted in PubMed, Embase, Web of Science, and the Cochrane Library for studies published updated to 1 December 2024. Studies that explored the diagnostic accuracy of lncRNAs in OSCC were included. The risk of bias was assessed using the QUADAS-2. Diagnostic accuracy was calculated using indicators such as sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), and diagnostic odds ratio (DOR) by random effects modeling.</p><p><strong>Results: </strong>A total of eight studies were included in this meta-analysis, comprising 532 patients diagnosed with OSCC and 446 controls. The pooled sensitivity was 0.87 (95% CI: 0.61 to 0.97), and the specificity was 0.87 (95% CI: 0.76 to 0.93). The pooled PLR was 6.75 (95% CI: 3.12 to 14.58), and the NLR was 0.14 (95% CI: 0.04 to 0.57). The overall DOR was 46.87 (95% CI: 6.20 to 354.18). A higher diagnostic value was found for salivary and/or blood lncRNAs (DOR: 123.22; 95% CI: 9.79 to 1550.8) than for tissue lncRNAs (DOR: 6.24; 95% CI: 3.29 to 11.86).</p><p><strong>Conclusions: </strong>This study has demonstrated that lncRNAs were found to achieve high diagnostic accuracy for OSCC. lncRNAs expressed in body fluids have higher diagnostic value than those in tissues, and can be effectively utilized as potential biomarkers for OSCC detection.</p>","PeriodicalId":56038,"journal":{"name":"Journal of Stomatology Oral and Maxillofacial Surgery","volume":" ","pages":"102581"},"PeriodicalIF":2.0,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145187588","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":"Prevalence and clinicopathological correlation of BRAF V600E mutations in ameloblastoma:A PCR study from a tertiary centre in South India.","authors":"Logeswari Jayamani, Kavitha Bottu, Leena Dennis Joseph, Ganthimathy Sekhar","doi":"10.1016/j.jormas.2025.102575","DOIUrl":"https://doi.org/10.1016/j.jormas.2025.102575","url":null,"abstract":"<p><strong>Background: </strong>Ameloblastoma is a locally aggressive, benign epithelial odontogenic tumor characterized by unpredictable biological behavior and a high recurrence rate. The recent WHO 5th edition classification (2022) has integrated key molecular advances, prominently featuring MAPK pathway mutations such as BRAF V600E. Understanding the prevalence with its clinicopathological associations with BRAF mutations is crucial for prognostication and targeted therapy planning.</p><p><strong>Objectives: </strong>To determine the status of BRAF V600E mutation in ameloblastoma cases using quantitative real-time PCR and to correlate mutation status with demographic and clinicopathological parameters over a five-year period from a tertiary care centre.</p><p><strong>Methods: </strong>A retrospective cross-sectional study was conducted on 40 cases of histologically confirmed ameloblastoma and 5 samples of normal odontogenic epithelium (control), using archived formalin-fixed paraffin-embedded tissue. Genomic DNA was isolated and subjected to qRT-PCR for BRAF V600E mutation analysis. Associations with age, gender, site, recurrence, and histopathological type were evaluated using chi-square, Fisher's exact, and Student's t-tests.</p><p><strong>Results: </strong>BRAF V600E mutations were detected in 28 of 40 ameloblastoma cases (70.0%) and were absent in all control samples. Solid ameloblastoma demonstrated the highest mutation rate (87.5%), followed by unicystic ameloblastoma (56.5%), and adenomatoid ameloblastoma (100%). No cases of peripheral or metastasizing ameloblastoma were observed.</p><p><strong>Conclusion: </strong>BRAF V600E mutation is prevalent in ameloblastoma and varies across histopathological subtypes. Although statistical associations with clinicopathological features were limited, the mutation's high frequency underscores its diagnostic and therapeutic significance in ameloblastoma, justifying routine screening as part of a personalized management approach.</p>","PeriodicalId":56038,"journal":{"name":"Journal of Stomatology Oral and Maxillofacial Surgery","volume":" ","pages":"102575"},"PeriodicalIF":2.0,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145182365","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":"Meta-analysis authors in oral and maxillofacial surgery: True experts or mere scribes?","authors":"Poramate Pitak-Arnnop","doi":"10.1016/j.jormas.2025.102578","DOIUrl":"https://doi.org/10.1016/j.jormas.2025.102578","url":null,"abstract":"","PeriodicalId":56038,"journal":{"name":"Journal of Stomatology Oral and Maxillofacial Surgery","volume":" ","pages":"102578"},"PeriodicalIF":2.0,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145182380","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":"Novel flap designs for reconstructing the exenterated orbital cavity - A systematic review.","authors":"Raffaele Aguglia, Lucas Ungerer, Nadia Benmoussa","doi":"10.1016/j.jormas.2025.102576","DOIUrl":"https://doi.org/10.1016/j.jormas.2025.102576","url":null,"abstract":"<p><p>Orbital exenteration is an extremely mutilating procedure for patients, and reconstruction is mandatory in most cases. The inverted cone shape of the exenterated orbit poses a significant challenge for reconstructive surgeons and anaplastologists, who must collaborate closely to achieve a satisfactory outcome that enables patients to reintegrate social life more easily. This systematic review followed the 2020 PRISMA guidelines and its protocol was pre-registered in PROSPERO (ID: CRD420251149891). The study focuses on the latest flap design strategies aimed at meeting the complex geometric requirements inherent to reconstruction of this region. Eleven 11 studies were selected among the PubMed and Google Scholar databases presenting genuine innovations in flap conformation for orbital exenteration reconstruction. A total of 64 patients were included, with a reevaluation of both pedicled and free flap techniques, including the temporalis muscle flap, galeal flap, forehead flap, radial forearm free flap, and flaps based on the lateral circumflex femoral artery system. These techniques show promise, with a combined prosthetic rehabilitation rate of 50%. By synthesizing contemporary surgical methods and highlighting novel approaches, this review provides reconstructive surgeons with an updated framework for planning orbital exenteration reconstruction that restores both form and function, ultimately improving patient quality of life.</p>","PeriodicalId":56038,"journal":{"name":"Journal of Stomatology Oral and Maxillofacial Surgery","volume":" ","pages":"102576"},"PeriodicalIF":2.0,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145179981","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":"Postoperative stability of the hybrid method of rigid internal fixation in Sagittal Split Osteotomy for orthognathic surgery: A systematic review.","authors":"Sandro Bornelli Moreira, Mariana Aparecida Brozoski, Ricardo Grillo, Daniel Falbo Martins de Souza, Alexandre Meireles Borba, Maria da Graça Naclério-Homem","doi":"10.1016/j.jormas.2025.102577","DOIUrl":"https://doi.org/10.1016/j.jormas.2025.102577","url":null,"abstract":"<p><strong>Objectives: </strong>Bilateral sagittal split ramus osteotomy (BSSO) is a cornerstone of orthognathic surgery, yet the optimal fixation method for ensuring long-term stability remains debated, with hybrid fixation (combining monocortical plates and bicortical screws) emerging as a promising technique that balances rigidity and safety.</p><p><strong>Material and methods: </strong>This systematic review attempted to assess whether the hybrid fixation system for bilateral sagittal split osteotomy in orthognathic surgery provides adequate long-term stability by summarizing the results of clinical studies. This systematic review was prepared according to the PRISMA guidelines and registered in PROSPERO under the number CRD42022331540. Evidence searches were performed by two independent investigators in MEDLINE/PubMed, Web of Science, Embase, LILACS, Scopus, Cochrane databases, gray literature, and manual search to verify if patients who have undergone orthognathic surgery with bilateral sagittal split osteotomy fixed with the hybrid system, achieve satisfactory mandibular long-term stability, regardless of comparisons between other fixation systems.</p><p><strong>Results: </strong>All studies included in this review attributed the long-term stability to the hybrid fixation system of the bilateral sagittal split osteotomy. Our findings indicate a positive relationship between long-term stability and hybrid fixation when accessing mandibular asymmetries. Methodological differences were found in the included studies, particularly in relation to the assessment of surgical outcomes, as well as a small number of participants studied.</p><p><strong>Conclusion: </strong>The current evidence for hybrid fixation is too limited and biased to confirm superiority, highlighting an urgent need for robust, prospective trials.</p>","PeriodicalId":56038,"journal":{"name":"Journal of Stomatology Oral and Maxillofacial Surgery","volume":" ","pages":"102577"},"PeriodicalIF":2.0,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145180037","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":"Comment on: \"Dysbiosis and interactions of the salivary bacteriome in obese individuals: A human cross-sectional study\".","authors":"Mengting Zhang","doi":"10.1016/j.jormas.2025.102565","DOIUrl":"https://doi.org/10.1016/j.jormas.2025.102565","url":null,"abstract":"","PeriodicalId":56038,"journal":{"name":"Journal of Stomatology Oral and Maxillofacial Surgery","volume":" ","pages":"102565"},"PeriodicalIF":2.0,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145139532","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}