{"title":"Optimizing prosthetic outcomes in navigation-assisted zygomatic implant surgery: a novel protocol for real-time screw channel alignment.","authors":"S-H Chen, H-H Ko, T-H Ho","doi":"10.1016/j.ijom.2026.04.030","DOIUrl":"https://doi.org/10.1016/j.ijom.2026.04.030","url":null,"abstract":"<p><p>Current dynamic navigation systems often fail to display the real-time rotational phase (timing) of the implant. This limitation is particularly critical for the NobelZygoma 45° implant (Nobel Biocare), where the 45° angle between the prosthetic platform and the implant axis necessitates precise rotational control. Failure to visualize this orientation can lead to significant deviations in the prosthetic screw channel trajectory, complicating immediate provisionalization. This technical note describes a digital workflow integrating DTX Studio Implant planning software (Nobel Biocare) and the X-Guide navigation system (X-Nav Technologies) to address this limitation. By creating a custom 'angle measurement tool' and merging it with the diagnostic wax-up within a unified coordinate system, clinicians can visualize the target screw channel trajectory intraoperatively. This protocol enables the quantification of rotational deviation, ensuring that the screw channel alignment remains within a clinically acceptable range to enhance the accuracy and structural integrity of prefabricated provisional prostheses.</p>","PeriodicalId":94053,"journal":{"name":"International journal of oral and maxillofacial surgery","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147857915","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":"Quantitative MRI analysis of the lateral pterygoid muscle in temporomandibular joint disc displacement: attachment type, volume, and signal intensity.","authors":"B Bilgen","doi":"10.1016/j.ijom.2026.04.015","DOIUrl":"https://doi.org/10.1016/j.ijom.2026.04.015","url":null,"abstract":"<p><p>The role of morphological and radiological characteristics of the lateral pterygoid muscle (LPM) in the progression of temporomandibular joint (TMJ) disc displacement remains uncertain. This study was performed to investigate the association between LPM attachment type, volume, and signal intensity ratios (SIRs) and disc displacement with reduction (DDwR) and without reduction (DDwoR). A total of 188 TMJs from 94 patients were categorized into three groups: healthy controls (n = 62), DDwR (n = 62), and DDwoR (n = 64). LPM attachment type, superior and inferior LPM volumes, and SIRs were assessed using MRI. Receiver operating characteristics (ROC) analyses were applied to evaluate the discriminative ability of volumetric and SIR parameters. LPM attachment type did not differ among the groups (P = 0.36). In contrast, SIRs and superior head volume showed significant intergroup differences, reaching their highest values in the DDwoR group (all P < 0.001). ROC analyses demonstrated good discriminative performance for SIRs and superior head volume in identifying disc displacement, with stronger diagnostic accuracy for DDwoR compared with DDwR. Although a causal relationship cannot be established, the progressive increase in SIRs and superior head volume with increasing severity of disc displacement suggests that these changes reflect secondary adaptive or inflammatory responses of the LPM to altered TMJ biomechanics, associated with disc displacement. Evaluating radiological and morphological LPM characteristics alongside disc position may provide insights into the soft tissue pathophysiology accompanying disc displacement progression.</p>","PeriodicalId":94053,"journal":{"name":"International journal of oral and maxillofacial surgery","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147857888","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 W Guthua, M N Mwasha, M Kamau, K Sarna, K Gathukia, H Koops, M Y Mommaerts
{"title":"A complex and debilitating case of craniofacial fibrous dysplasia: challenging resection, reconstruction and prosthetic rehabilitation.","authors":"S W Guthua, M N Mwasha, M Kamau, K Sarna, K Gathukia, H Koops, M Y Mommaerts","doi":"10.1016/j.ijom.2026.04.028","DOIUrl":"https://doi.org/10.1016/j.ijom.2026.04.028","url":null,"abstract":"<p><p>Craniofacial fibrous dysplasia (CFD) presents a significant surgical challenge when extensive lesions compromise both function and aesthetics. This case report concerns a 28-year-old female presenting with massive recurrent CFD involving the entire viscerocranium, producing airway obstruction, severe malnutrition, and disfigurement. A multidisciplinary team planned a total viscerocranial resection followed by full facial reconstruction using computer-designed, custom-made titanium patient-specific implants (PSIs). This case demonstrates that the integration of digital design, multidisciplinary planning, and PSI-based reconstruction enables the successful rehabilitation of extensive CFD. These techniques expand the frontiers of maxillofacial surgery in complex deformities.</p>","PeriodicalId":94053,"journal":{"name":"International journal of oral and maxillofacial surgery","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147857871","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}
C J Kuijpers, E M Van Cann, F J Dieleman, J E Bergsma, R J J van Es, A J W P Rosenberg
{"title":"Response to the comment on \"Free forearm flaps for head and neck reconstruction: fewer revisions and flap failures with two venous anastomoses-a 25-year prospective study\".","authors":"C J Kuijpers, E M Van Cann, F J Dieleman, J E Bergsma, R J J van Es, A J W P Rosenberg","doi":"10.1016/j.ijom.2026.04.023","DOIUrl":"https://doi.org/10.1016/j.ijom.2026.04.023","url":null,"abstract":"","PeriodicalId":94053,"journal":{"name":"International journal of oral and maxillofacial surgery","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147857893","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":"Piano technique for frontal sinus setback: a technical note.","authors":"M Etemadi Sh, G Tajmiri, T Fattahi","doi":"10.1016/j.ijom.2026.04.036","DOIUrl":"https://doi.org/10.1016/j.ijom.2026.04.036","url":null,"abstract":"<p><p>Frontal sinus setback is a procedure used for addressing severe protrusion of the frontal area. Various surgical techniques have been developed over time to address frontal sinus abnormalities with varying etiologies and severity. The present article introduces the piano technique as a novel method for frontal sinus setback with less aggressiveness and complexity compared to other available methods, while being efficient in providing substantial long-term improvements in aesthetic outcomes. In this method, the anterior wall of the frontal sinus is divided into numerous rectangular bony segments attached to the superior area (like piano keys), which makes the process of shaping the frontal area easier, with the resultant more natural appearance post-surgically and eliminating the need for application of technical modifications and/or bone cement for filing the bone gap as used in conventional methods.</p>","PeriodicalId":94053,"journal":{"name":"International journal of oral and maxillofacial surgery","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147857923","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":"Versatility of local flaps in restoring anterior tongue defects.","authors":"N Mannapperuma, T Ganesarajah, V Ilankovan","doi":"10.1016/j.ijom.2026.04.016","DOIUrl":"https://doi.org/10.1016/j.ijom.2026.04.016","url":null,"abstract":"<p><p>The repair of small to medium-sized tongue defects is controversial among surgeons. This can be achieved using various local, regional, and microvascular free flaps. In this Technical Note, the authors introduce a new classification system for tongue defects based on the subunit principle and describe a technique using a modified local rhomboid flap, which is aimed at restoring both the volume and function of the anterior tongue.</p>","PeriodicalId":94053,"journal":{"name":"International journal of oral and maxillofacial surgery","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147857905","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}
X Hong, G-M Zhou, J Li, X Ye, Y-T Lin, Y-L Chen, Y-L Deng, F Wang, G-Y Yu, H-Y Yang
{"title":"A clinicopathological study on the associations between ranulas and autoimmune diseases.","authors":"X Hong, G-M Zhou, J Li, X Ye, Y-T Lin, Y-L Chen, Y-L Deng, F Wang, G-Y Yu, H-Y Yang","doi":"10.1016/j.ijom.2026.03.029","DOIUrl":"https://doi.org/10.1016/j.ijom.2026.03.029","url":null,"abstract":"<p><p>The study aimed to investigate autoimmune disease (AD) prevalence in ranula patients, analyse their clinicopathological features, and explore the associations between ADs and ranulas. This cross-sectional study enrolled surgically treated ranula patients between 2021 and 2023. AD diagnosis was established. Clinical, serological, and histopathological features were compared. Among the 102 patients, 36.3% had confirmed ADs (predominantly primary Sjögren syndrome and undifferentiated connective tissue disease), 42.2% had no ADs, and 21.6% were suspected of ADs. In the confirmed AD group, 83.8% developed ranulas before AD diagnosis, and exhibited higher female proportion, older age, reduced salivary function, and positive autoantibodies versus the non-AD group. Sublingual gland pathology revealed multifocal lymphocytic infiltration, fatty replacement, ductal epithelial destruction, and periductal collagen proliferation in confirmed and suspected AD groups, rarely in the non-AD group. Focus score was significantly higher in the confirmed AD group, correlating with mucus extravasation foci (r = 0.718, P < 0.01). Grade 3/4 lesions (Chisholm-Mason system) and lymphoepithelial lesions were significantly associated with ADs (P < 0.001, P = 0.033, respectively). In conclusion, a significant proportion of ranulas are associated with ADs, with distinct clinicopathological features. Characteristic histopathological changes in the sublingual gland may indicate ADs, which could potentially contribute to ranula development.</p>","PeriodicalId":94053,"journal":{"name":"International journal of oral and maxillofacial surgery","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147847858","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}
R Labrador Carrillo, M F Muñoz Guerra, R J Sánchez Moreno
{"title":"Novel approach for the treatment of temporomandibular joint disc displacement: eminectomy associated with a soft anchor meniscopexy technique.","authors":"R Labrador Carrillo, M F Muñoz Guerra, R J Sánchez Moreno","doi":"10.1016/j.ijom.2026.04.024","DOIUrl":"https://doi.org/10.1016/j.ijom.2026.04.024","url":null,"abstract":"<p><p>Temporomandibular joint (TMJ) dysfunction due to disc displacement without reduction is a challenging condition that can cause pain, restricted mouth opening, and functional limitation. Although conservative treatment is the first-line approach, some patients require surgical intervention when symptoms persist. Despite the existence of multiple surgical strategies, there is no clear consensus on the optimal procedure for these cases. This technical note describes a combined surgical technique involving meniscopexy using a soft anchor system and eminectomy for the management of selected TMJ disorders. This technique is based on two key principles: increasing the anterior joint space and providing stable fixation of the disc-condyle complex. These elements help restore joint biomechanics and condylar translation. This combined approach may represent a promising therapeutic option for the management of selected cases of TMJ dysfunction.</p>","PeriodicalId":94053,"journal":{"name":"International journal of oral and maxillofacial surgery","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147848015","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":"In Reply to the comment on \"Ten-year-plus follow-up study on coronectomy of the mandibular third molar-methodological considerations and future directions\".","authors":"J T W Li, Y Y Leung","doi":"10.1016/j.ijom.2026.03.032","DOIUrl":"https://doi.org/10.1016/j.ijom.2026.03.032","url":null,"abstract":"","PeriodicalId":94053,"journal":{"name":"International journal of oral and maxillofacial surgery","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147848006","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}
H-J Kim, J-S Oh, K-W Kim, J-S Kim, J Kim, S-Y Moon
{"title":"Clinical outcomes of internal oblique muscle free flap reconstruction following oral cancer resection.","authors":"H-J Kim, J-S Oh, K-W Kim, J-S Kim, J Kim, S-Y Moon","doi":"10.1016/j.ijom.2026.04.013","DOIUrl":"https://doi.org/10.1016/j.ijom.2026.04.013","url":null,"abstract":"<p><p>The internal oblique muscle free flap, based on the deep circumflex iliac artery, has emerged as a valuable option for oral reconstruction, due to its flexibility and the option to use it as a composite flap with iliac crest bone, for simultaneous bone and soft tissue reconstruction. However, clinical studies on the epithelialization process and factors influencing healing are limited. This retrospective study was performed to analyse the healing process in 29 patients who underwent reconstruction using internal oblique muscle free flaps following oral cancer resection at Chosun University Dental Hospital, between 2013 and 2022. Clinical photographs were evaluated to determine the times to epithelialization and surface maturation. The mean time to epithelialization was 5.6 ± 1.6 weeks, while surface maturation required 19.4 ± 10.9 weeks. Tongue defects showed the longest surface maturation period (30.3 weeks) and floor of the mouth defects the shortest (11.3 weeks), although there was no significant difference in this period between the various lesion sites. Pearson correlation revealed a strong positive relationship between time to epithelialization and time to surface maturation (r = 0.530, P = 0.003). Secondary trimming procedures were necessary in eight (27.6%) patients and significantly prolonged both epithelialization (P = 0.016) and surface maturation (P = 0.003). Age, lesion size, and other clinical variables did not significantly affect healing. The internal oblique muscle free flap demonstrated excellent outcomes with a 97.2% success rate and predictable healing patterns. This study established important healing benchmarks for patient counselling in oral reconstruction.</p>","PeriodicalId":94053,"journal":{"name":"International journal of oral and maxillofacial surgery","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147848001","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}