M Murawa, J Szydłowski, A Andruszko, B O Grabarek, T Sirek, A Fryzowicz, J Kabaciński, A Bernet, J Banaszewski
{"title":"Objective assessment of the effect of surgery on limb function after medial femoral condyle free flap harvest: biomechanical parameters.","authors":"M Murawa, J Szydłowski, A Andruszko, B O Grabarek, T Sirek, A Fryzowicz, J Kabaciński, A Bernet, J Banaszewski","doi":"10.1016/j.ijom.2024.08.028","DOIUrl":"10.1016/j.ijom.2024.08.028","url":null,"abstract":"<p><p>The aim of this study was to evaluate the influence of medial femoral condyle (MFC) free flap harvest on donor site muscle strength and kinematic parameters of gait. The study included 30 patients treated for head and neck squamous cell carcinoma who underwent reconstruction with an MFC free flap. In each case, the donor site was the left thigh. A dynamometer was used to measure muscle strength, in isokinetic bilateral mode and with concentric contraction for the extension/flexion knee pattern, at 18 months postoperative. In addition, kinematic data were obtained and evaluated. On statistical analysis, no significant difference in muscle strength of the quadriceps muscle was found between the left involved and right uninvolved lower extremities (P = 0.124). Also, when comparing hamstring strength, no statistically significant difference was found between the left involved and right uninvolved sides (P = 0.210). Moreover, spatiotemporal gait parameters did not differ significantly between the involved and uninvolved legs (all P > 0.05), and no differences in kinematic or kinetic parameters were observed. This study reports the effects of MFC free flap harvest on the knee muscle strength and locomotion of patients. For most biomechanical parameters investigated, there was no effect (positive or negative).</p>","PeriodicalId":94053,"journal":{"name":"International journal of oral and maxillofacial surgery","volume":" ","pages":"123-129"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142038093","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Accuracy of patient-specific implants versus CAD/CAM splints with the mandible-first approach in bimaxillary orthognathic surgery for skeletal Class II malocclusion.","authors":"J Yan, B Li, C Zhang, Y Qian, Z Li, X Wang","doi":"10.1016/j.ijom.2024.05.005","DOIUrl":"10.1016/j.ijom.2024.05.005","url":null,"abstract":"<p><p>This retrospective study aimed to compare the accuracy of patient-specific implants (PSI) versus mandible-first computer-aided design and manufacturing (CAD/CAM) splints for maxilla repositioning in orthognathic surgery of skeletal Class II malocclusion patients. The main predictor was the surgical method (PSI vs. splints), with the primary outcome being the discrepancy in maxilla centroid position, and secondary outcomes being translation and orientation discrepancies. A total of 82 patients were enrolled (70 female, 12 male; mean age 25.5 years), 41 in each group. The PSI group exhibited a median maxillary position discrepancy of 1.25 mm (interquartile range (IQR) 1.03 mm), significantly lower than the splint group's 1.98 mm (IQR 1.64 mm) (P < 0.001). In the PSI group, the largest median translation discrepancy was 0.74 mm (IQR 1.17 mm) in the anteroposterior direction, while the largest orientation discrepancy was 1.83° (IQR 1.63°) in pitch. In the splint group, the largest median translation discrepancy was 1.14 mm (IQR 1.37 mm) in the anteroposterior direction, while the largest orientation discrepancy was 3.03° (IQR 2.11°) in pitch. In conclusion, among patients with skeletal Class II malocclusion, the application of PSI in orthognathic surgery yielded increased precision in maxillary positioning compared to mandible-first CAD/CAM splints.</p>","PeriodicalId":94053,"journal":{"name":"International journal of oral and maxillofacial surgery","volume":" ","pages":"143-148"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141249147","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Long-term follow-up of corrective jaw surgery including distraction osteogenesis in 32 patients with juvenile idiopathic arthritis.","authors":"H Krarup, T K Pedersen, P Frid, S E Nørholt","doi":"10.1016/j.ijom.2024.06.001","DOIUrl":"10.1016/j.ijom.2024.06.001","url":null,"abstract":"<p><p>Dentofacial deformity following juvenile idiopathic arthritis (JIA) with temporomandibular joint (TMJ) involvement is associated with functional, aesthetic, and psychosocial impairment. Corrective surgical treatment includes combinations of orthognathic surgeries (OS). The aims of this study were to assess orofacial symptoms, functional and aesthetic status, and stability after OS including mandibular distraction osteogenesis (MDO). A prospective study was conducted of 32 patients with JIA of the TMJ and dentofacial deformities who underwent MDO as the only surgery or in combination with bilateral sagittal split osteotomy, Le Fort I, and/or genioplastybetween 2003 and 2018. Data from clinical examinations and cephalograms performed pre- and postoperative and at long-term (mean 4 years) were analysed. Patients experienced unchanged orofacial symptoms (all P > 0.05), short-term TMJ functional impairment (all P < 0.001), and long-term morphological improvements in SNB angle (P < 0.001), anterior facial height (P < 0.001), mandibular length (P = 0.049), overjet (P < 0.001 and P = 0.005), and posterior facial symmetry (P = 0.046). MDO as the only surgery or with secondary adjunctive OS improved dentofacial morphology in terms of mandibular advancement, anterior facial height, posterior facial symmetry, and incisal relationships without long-term deterioration in TMJ function or orofacial symptoms.</p>","PeriodicalId":94053,"journal":{"name":"International journal of oral and maxillofacial surgery","volume":" ","pages":"149-156"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141473949","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
T Thiết Sơn, P Tuấn Nghĩa, P T Việt Dung, T T Hồng Thuý, H Tuấn Anh
{"title":"An alternative reconstruction for the complex nasal and facial defect with a thinned anterolateral thigh flap.","authors":"T Thiết Sơn, P Tuấn Nghĩa, P T Việt Dung, T T Hồng Thuý, H Tuấn Anh","doi":"10.1016/j.ijom.2024.07.014","DOIUrl":"10.1016/j.ijom.2024.07.014","url":null,"abstract":"<p><p>Reconstructive surgeons often use a free radial forearm flap for nasal reconstruction when a forehead flap is not an option, but this flap has drawbacks. This article presents a series of patients with complex defects who underwent reconstruction with an anterolateral thigh (ALT) flap. Severe burns and cancer resection may lead to the loss of multiple anatomical units, including the entire nose and nearby structures. Multiple materials are required for reconstruction in those with complex total nasal defects involving adjacent areas. In this series of patients, a chimeric ALT flap was harvested and thinned to recreate the three-dimensional nasal structure and cover the adjacent area. Cartilage and alloplastic materials were used as the nasal framework, and the skin flap was folded for the mucosal lining. The results were good with an excellent contour, and no complications or airway obstruction were observed during follow-up. By thinning the ALT flap, this flap can be an alternative for complex reconstructions that require a facial or three-dimensional nasal structure.</p>","PeriodicalId":94053,"journal":{"name":"International journal of oral and maxillofacial surgery","volume":" ","pages":"130-133"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141977465","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
L Wu, L Bu, T Wu, W Deng, K Liu, B Liu, Z Shang, Z Shao
{"title":"Perforator types and anatomical characteristics of the deep circumflex iliac artery perforator flap with iliac crest: findings based on 40 clinical cases.","authors":"L Wu, L Bu, T Wu, W Deng, K Liu, B Liu, Z Shang, Z Shao","doi":"10.1016/j.ijom.2024.07.021","DOIUrl":"10.1016/j.ijom.2024.07.021","url":null,"abstract":"<p><p>The aim of this study was to report the clinical experience of repairing mandibular defects with a deep circumflex iliac artery perforator flap with iliac crest (DCIAPF) and to analyse the relevant anatomical data to guide clinical application. Forty patients with mandibular defects, who underwent reconstruction with a DCIAPF after oncological resection were included in the study. During the operation, anatomical features relevant to the structure of the DCIAPF were measured, including the position of the perforator, mobility of the skin paddle, length of the vascular pedicle, and adipose tissue thickness of the skin paddle. Three types of DCIAPF perforator were identified: type I, with a dominant perforator, which was observed in 17 patients (42.5%); type II, with a dominant perforator that divides into multiple tiny branches, in 20 patients (50%); type III, with no visible dominant perforator, in three patients (7.5%). In summary, the DCIAPF provides adequate bone tissue and satisfactory soft tissue.</p>","PeriodicalId":94053,"journal":{"name":"International journal of oral and maxillofacial surgery","volume":" ","pages":"115-122"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141997123","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Persistent pain after total temporomandibular joint replacement surgery: clinical characteristics, comorbidities, and risk factors.","authors":"S Handa, M Youness, D A Keith, A Rosén","doi":"10.1016/j.ijom.2024.08.038","DOIUrl":"10.1016/j.ijom.2024.08.038","url":null,"abstract":"<p><p>Chronic post-surgical pain (CPSP) after temporomandibular joint (TMJ) surgery is an under-recognized problem. The aim of this study was to document the characteristics of CPSP and identify patient risk factors and comorbidities associated with the development of CPSP after total TMJ replacement (TJR). This was a retrospective cohort study of patients who underwent TJR between 2000 and 2018 at Massachusetts General Hospital, Boston, USA. The primary outcome was the presence of CPSP and use of pain medications after TJR. The secondary outcome was the risk factors associated with the development of CPSP. A total 88 patients were included (79 females, 9 males). The mean follow-up was 4.2 years. Overall, 68 (77.3%) had CPSP and 20 (22.7%) had no CPSP. Of those with CPSP, 32.4% had severe pain and 45.6% continued to take pain medications. Of the 27 patients with data available on the characteristics of the pain, the majority had myofascial pain, while some developed neuropathic pain. A significant difference was noted between the CPSP and non-CPSP groups in terms of preoperative pain, smoking behavior, and use of opioids, non-steroidal anti-inflammatory drugs, muscle relaxants, and neuropathic pain medications.</p>","PeriodicalId":94053,"journal":{"name":"International journal of oral and maxillofacial surgery","volume":" ","pages":"166-173"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142142184","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"A new patient-specific helical maxillary distractor: a cadaver test.","authors":"J Gateno, S Bartlett, D Kim, A S Xue, K Gu","doi":"10.1016/j.ijom.2024.05.008","DOIUrl":"10.1016/j.ijom.2024.05.008","url":null,"abstract":"<p><p>The primary objective of this cadaver study was to assess the feasibility of a novel custom helical distraction system and a patient-specific antral maxillary distractor. The study involved two fresh cadaver heads and followed a systematic procedure. First, virtual planning was conducted for an asymmetric maxillomandibular advancement. Custom patient-specific hardware was then fabricated to enable sequential mandibular advancement and gradual maxillary distraction. The mandibular lengthening procedures were found to be highly accurate, with only minor deviations from the planned results. In terms of maxillary distraction, the patient-specific antral distractors demonstrated favorable outcomes, with two noteworthy exceptions. Ideal forward maxillary advancement was short by a modest 2-3 mm in both cadavers. Additionally, cadaver 2 exhibited an unplanned pitch malrotation. However, an excellent occlusion was achieved in cadaver 1 and an acceptable anterior occlusion in cadaver 2, albeit with bilateral posterior open bites that could be readily corrected with interdental elastics in a clinical setting. This cadaver model study provides compelling evidence for the feasibility of patient-specific antral helical distractors, highlighting their potential to yield positive outcomes. Importantly, the study results suggest that patient-specific antral distractors may offer superior results compared to the current standard of linear distractors.</p>","PeriodicalId":94053,"journal":{"name":"International journal of oral and maxillofacial surgery","volume":" ","pages":"191-197"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141186972","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
S L Newman, N B Drury, K T Lee, A K Devarakonda, A Ahmed, H K Koehn
{"title":"Pediatric mandibular malignancies: a comprehensive analysis of SEER data.","authors":"S L Newman, N B Drury, K T Lee, A K Devarakonda, A Ahmed, H K Koehn","doi":"10.1016/j.ijom.2024.08.002","DOIUrl":"10.1016/j.ijom.2024.08.002","url":null,"abstract":"<p><p>Mandibular malignancies are rare in the pediatric population and subsequently not well characterized. SEER 18 registry data was collected, applying age 0-18 years and ICD-O-3 code C41.1 ('mandible'). Univariate Cox regression analysis was conducted, and hazard ratios (HR) were calculated for overall survival (OS) and disease-specific survival (DSS) according to patient demographics, tumor characteristics, and treatment. Kaplan-Meier survival curves were generated for OS and DSS. Sixty-four patients met the inclusion criteria. The median age at diagnosis was 13.0 years, and median survival was 8.7 years. Osteosarcoma was the most common histological diagnosis (n = 22). Sex, race, age (<13 vs ≥13 years), histological type, odontogenic origin, and treatment modality were found not to be associated with OS or DSS. The SEER stage 'distant' was significantly associated with an elevated HR of 6.28 for DSS (P = 0.027) and 5.29 for OS (P = 0.025). Kaplan-Meier survival curves demonstrated significantly lower 5-year DSS (P<0.001) and OS (P<0.001) for SEER 'distant' stage. This study includes the analysis of a large number of pediatric mandibular malignancies when compared to previous studies. 'Distant' stage was associated with decreased survival. Early clinical suspicion and diagnosis are paramount for improved survival.</p>","PeriodicalId":94053,"journal":{"name":"International journal of oral and maxillofacial surgery","volume":" ","pages":"109-114"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141997122","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Comprehensive evaluation of advanced platelet-rich fibrin in common complications following sagittal split ramus osteotomy: a double-blind, split-mouth, randomized clinical trial.","authors":"Z Zhu, X Sun, K Chen, M Zhang, G Wu","doi":"10.1016/j.ijom.2024.03.005","DOIUrl":"10.1016/j.ijom.2024.03.005","url":null,"abstract":"<p><p>The sagittal split ramus osteotomy (SSRO) carries potential risks and complications. A double-blind, split-mouth, randomized clinical trial was performed, involving 30 patients undergoing mandibular setback. Advanced platelet-rich fibrin (A-PRF) was applied to one side, and the other side served as a control. The volume of postoperative drainage over 24 h was recorded. At 1, 2, and 5 days, and 3 months postsurgery, nerve recovery was assessed using the two-point discrimination test (TPD), while pain was evaluated using a visual analogue scale (VAS pain). Facial swelling was evaluated by taking linear measurements from facial reference points at the same time intervals. In the treatment group, the 24-hour drainage volume was lower (P = 0.011), pain was better on day 5 (P = 0.011), and TPD was better on day 2 (P = 0.011), day 5 (P = 0.007), and 3 months postoperatively (P = 0.020) than in the control group. There was also less facial swelling in the treatment group when compared to the baseline of 3 months postoperative (day 1, P = 0.012; day 2, P = 0.001; day 5, P = 0.011). The difference in bone mineral density (HU) at 3 months between the treatment group (469.7 ± 134.2) and the control group (348.3 ± 127.2) was statistically significant (P = 0.011), in favour of the treatment group. A-PRF may reduce postoperative complications such as neurosensory disturbance of the inferior alveolar nerve, pain, swelling, and drainage while enhancing bone healing in the osteotomy gap following SSRO. TRIAL REGISTRATION: The study was registered with the Chinese Clinical Trial Register (ChiCTR2200064534).</p>","PeriodicalId":94053,"journal":{"name":"International journal of oral and maxillofacial surgery","volume":" ","pages":"134-142"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141261280","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Y M Sillmann, J L G C Monteiro, P Eber, A M P Baggio, Z S Peacock, F P S Guastaldi
{"title":"Empowering surgeons: will artificial intelligence change oral and maxillofacial surgery?","authors":"Y M Sillmann, J L G C Monteiro, P Eber, A M P Baggio, Z S Peacock, F P S Guastaldi","doi":"10.1016/j.ijom.2024.09.004","DOIUrl":"10.1016/j.ijom.2024.09.004","url":null,"abstract":"<p><p>Artificial Intelligence (AI) can enhance the precision and efficiency of diagnostics and treatments in oral and maxillofacial surgery (OMS), leveraging advanced computational technologies to mimic intelligent human behaviors. The study aimed to examine the current state of AI in the OMS literature and highlight the urgent need for further research to optimize AI integration in clinical practice and enhance patient outcomes. A scoping review of journals related to OMS focused on OMS-related applications. PubMed was searched using terms \"artificial intelligence\", \"convolutional networks\", \"neural networks\", \"machine learning\", \"deep learning\", and \"automation\". Ninety articles were analyzed and classified into the following subcategories: pathology, orthognathic surgery, facial trauma, temporomandibular joint disorders, dentoalveolar surgery, dental implants, craniofacial deformities, reconstructive surgery, aesthetic surgery, and complications. There was a significant increase in AI-related studies published after 2019, 95.6% of the total reviewed. This surge in research reflects growing interest in AI and its potential in OMS. Among the studies, the primary uses of AI in OMS were in pathology (e.g., lesion detection, lymph node metastasis detection) and orthognathic surgery (e.g., surgical planning through facial bone segmentation). The studies predominantly employed convolutional neural networks (CNNs) and artificial neural networks (ANNs) for classification tasks, potentially improving clinical outcomes.</p>","PeriodicalId":94053,"journal":{"name":"International journal of oral and maxillofacial surgery","volume":" ","pages":"179-190"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142335216","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}