V Trachoo, U Taetragool, C Khanijoh, P Saepong, F Sae-Tae, K Warin
{"title":"Machine learning classification and FAQs retrieval for postoperative oral surgery questions.","authors":"V Trachoo, U Taetragool, C Khanijoh, P Saepong, F Sae-Tae, K Warin","doi":"10.1016/j.ijom.2026.09.002","DOIUrl":"https://doi.org/10.1016/j.ijom.2026.09.002","url":null,"abstract":"<p><p>An artificial intelligence (AI)-based classification and retrieval system has the potential to map postoperative oral surgery questions to evidence-based answers to improve access to consistent information on postoperative conditions and management. This study was undertaken to show the development of an AI-based classification and retrieval system specifically designed to address inquiries related to postoperative oral surgery. The AI system was trained on a dataset encompassing 689 questions associated with various oral surgery procedures and employed machine learning algorithms such as Random Forest and Naïve Bayes models to accurately predict the corresponding operation for each query. Additionally, an augmentation technique was implemented to broaden the variety of oral surgery questions to train the model. The results indicated that the chatbot's performance achieved a moderate accuracy, ranging from 36.0% to 71.0% with the normal dataset. However, when trained with the augmented dataset, the chatbot's accuracy improved significantly, reaching between 88.0% and 97.0% in response to postoperative oral surgery questions. In conclusion, this AI-based classification and retrieval system demonstrates the potential to accurately classify postoperative oral surgery inquiries and, pending clinical validation, represents a beneficial future resource.</p>","PeriodicalId":94053,"journal":{"name":"International journal of oral and maxillofacial surgery","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148979259","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}
M Itotagawa, N Ito, F Obayashi, M Higaki, S Yanamoto
{"title":"Radiological maxillary sinus mucosal extension is associated with prognosis in upper gingiva and hard palate squamous cell carcinoma.","authors":"M Itotagawa, N Ito, F Obayashi, M Higaki, S Yanamoto","doi":"10.1016/j.ijom.2026.09.004","DOIUrl":"https://doi.org/10.1016/j.ijom.2026.09.004","url":null,"abstract":"<p><p>Squamous cell carcinoma of the upper gingiva and hard palate (UGHP SCC) often invades adjacent structures, such as the maxillary sinus, which poses challenges for establishing local control. Although maxillary sinus mucosal extension has been suggested as a prognostic indicator, its clinical significance remains controversial because of potential confounding by bone invasion. The data from 66 patients with UGHP SCC, who underwent curative surgery at Hiroshima University Hospital between April 2000 and March 2023, were retrospectively analysed. Preoperative computed tomography (CT)/magnetic resonance imaging (MRI) was used to assess the extension of the tumour, including any vertical extension to the mucosa of the maxillary sinus. Overall survival (OS), disease-specific survival (DSS), and local control rate (LCR) were analysed using the Kaplan-Meier method. To address the potential confounding effect of bone invasion, an additional subgroup analysis was performed that was restricted to tumours with radiological bone invasion (T4). Cox proportional hazards models, adjusted for surgical margin status, were constructed to explore the association with DSS. Radiological maxillary sinus mucosal extension (RSME) was identified in 16 of 66 patients and was significantly associated with poorer DSS and OS. In the subgroup with radiological bone invasion only (n = 27), DSS remained significantly worse in patients with RSME (log-rank test, P = 0.048). The association between RSME and DSS was attenuated after adjustment for surgical margin status.</p>","PeriodicalId":94053,"journal":{"name":"International journal of oral and maxillofacial surgery","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148957663","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}
D A Diniz, P H H Sales, P G B Silva, I Giovannacci, P Vescovi, J C Leão
{"title":"Effectiveness of pterygoid dental implants in the complete arch rehabilitation of the edentulous maxilla: a systematic review and meta-analysis.","authors":"D A Diniz, P H H Sales, P G B Silva, I Giovannacci, P Vescovi, J C Leão","doi":"10.1016/j.ijom.2026.08.036","DOIUrl":"https://doi.org/10.1016/j.ijom.2026.08.036","url":null,"abstract":"<p><p>The aim of this systematic review was to determine the clinical effectiveness of pterygoid dental implants in the rehabilitation of the atrophic maxilla. Database searches were performed up to April 2026 to identify randomized, non-randomized, and observational human studies comparing pterygoid implants to conventional implants for full maxillary rehabilitation. Outcomes were implant survival and marginal bone loss (MBL). The meta-analysis was conducted using RevMan 5.4. Risk of bias was assessed using the Newcastle-Ottawa Scale. Overall, 466 articles were identified, of which six were included. These studies encompassed 466 participants and 3844 implants (904 pterygoid, 2940 conventional). The implant survival rate was 95.25% for pterygoid implants and 97.88% for conventional implants. The risk of implant loss was significantly higher for pterygoid implants when compared to conventional implants (risk ratio 1.54, 95% confidence interval 1.05-2.24, P = 0.030; no significant heterogeneity, I² = 13%). Only one study assessed MBL, finding similar values for pterygoid implants (0.64-0.68 mm) and conventional implants (0.61-0.62 mm). Immediate loading was reported in one study, but details were insufficient to compare implant survival rates. Three studies presented a low risk of bias and three a high risk of bias. Pterygoid implants may be considered a potential treatment approach for rehabilitation of the atrophic maxilla, showing relatively high implant survival rates. However, the slightly lower survival compared to conventional implants and the methodological limitations of the included studies highlight the need for further high-quality controlled trials.</p>","PeriodicalId":94053,"journal":{"name":"International journal of oral and maxillofacial surgery","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148946428","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":"The 'sausage technique' for the repair of large maxillary sinus membrane perforations.","authors":"H Lv, Y Sun, R Rong, Y Sa","doi":"10.1016/j.ijom.2026.08.037","DOIUrl":"https://doi.org/10.1016/j.ijom.2026.08.037","url":null,"abstract":"<p><p>Maxillary sinus membrane perforation is a common complication of lateral window sinus floor elevation and causes significant therapeutic challenges. A novel intrasinus 'sausage technique' is presented that involves spanning a collagen membrane across the osteotomy window with dual internal-external fixation. A stable protective membrane is used to encapsulate the bone grafts, simultaneously isolating perforations and preserving sinus floor vascularity. Clinical applications of this technique have demonstrated its ability to reliably repair large or complete perforations and improve success rates for sinus floor elevation.</p>","PeriodicalId":94053,"journal":{"name":"International journal of oral and maxillofacial surgery","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148932278","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":"Comparative evaluation of mixed reality, CTA-based digital guide, and hand-held Doppler for anterolateral thigh perforator localization in head and neck reconstruction.","authors":"H Zhu, Z Tang, W Zhang, X Peng, J Su, Y Yu","doi":"10.1016/j.ijom.2026.08.032","DOIUrl":"https://doi.org/10.1016/j.ijom.2026.08.032","url":null,"abstract":"<p><p>Accurate perforator localization is critical for safe and efficient harvest of the anterolateral thigh perforator flap (ALTF) in head and neck reconstruction. This study evaluated the feasibility and accuracy of computed tomography angiography (CTA) with integrated mixed reality (CTA-MR) for perforator localization compared with hand-held Doppler ultrasound (HHD) and CTA-based digital guides (CTA-guide). Twelve patients requiring ALTF reconstruction following oral and maxillofacial tumour resection were enrolled. Each patient underwent preoperative perforator mapping using HHD, CTA-guide, and CTA-MR. The intraoperatively confirmed fascial emergence point of each perforator was used as the reference standard. Localization accuracy, sensitivity, distance error, preparation and localization times, and postoperative outcomes were analysed. Thirty-two perforators were confirmed intraoperatively. The accuracy of perforator localization was 75.7% for HHD, 85.3% for CTA-guide, and 91.2% for CTA-MR; sensitivity was 87.5%, 90.6%, and 96.9%, respectively. Localization error differed significantly among the three methods (linear mixed-effects model, P < 0.001). The estimated marginal mean localization error was 11.56 ± 0.94 mm for HHD (95% confidence interval (CI) 9.69-13.42), 8.01 ± 0.92 mm for CTA-guide (95% CI 6.18-9.84), and 5.82 ± 0.89 mm for CTA-MR (95% CI 4.05-7.59). CTA-MR required less preparation time than guide fabrication but a longer intraoperative localization time than guide placement. All flaps survived; no donor site complications were observed. CTA-MR appears to be a feasible method for ALTF perforator localization and demonstrated favourable localization performance in this exploratory cohort. Further studies are needed to confirm its clinical utility and potential advantages over established localization techniques.</p>","PeriodicalId":94053,"journal":{"name":"International journal of oral and maxillofacial surgery","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148922392","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}
F Bouffleur, C A J Bauer, R Kühle, N Hagen, S Richter, J Hoffmann, C Freudlsperger, H Dickhaus, U Eisenmann
{"title":"A prototype computer-assisted system for automatic three-dimensional orthognathic surgery planning: an initial retrospective study.","authors":"F Bouffleur, C A J Bauer, R Kühle, N Hagen, S Richter, J Hoffmann, C Freudlsperger, H Dickhaus, U Eisenmann","doi":"10.1016/j.ijom.2026.08.031","DOIUrl":"https://doi.org/10.1016/j.ijom.2026.08.031","url":null,"abstract":"<p><p>Preoperative planning is crucial in orthognathic surgery, addressing both functional and aesthetic aspects in young adults. The current state-of-the-art still relies on fully manual virtual surgery planning despite the availability of detailed three-dimensional imaging. A prototype system for orthognathic surgery planning was developed that transforms manually identified landmarks into automated planning proposals by embedding established cephalometric rules, photoanalysis and clinical expert knowledge into an algorithmic framework. To evaluate the prototype, an initial retrospective study including 20 patients who underwent bimaxillary orthognathic surgery was performed. The study population was balanced for gender and skeletal class. For each case automatic planning proposals were compared with state-of-the-art virtual surgery planning. Quantitative differences between both planning approaches were analysed across all six degrees of freedom. In addition, a subgroup analysis according to skeletal class (class II vs class III) was conducted to assess potential class-specific deviations. Statistical comparisons were performed using t-tests or Mann-Whitney U-tests depending on data distribution (P < 0.05). Agreement between prototype and expert planning was assessed using Bland-Altman analysis and intra-class correlation coefficients. Results showed good agreement in most degrees of freedom. Statistically significant differences in planning results were noted in the Pitch dimension (Expert: 0.88° ± 4.46; Planning system: 5.72° ± 5.7; P = 0.0049; CI: 1.56, 8.12). The prototype generally produced clinically reasonable planning propositions within the scope of the preliminary evaluation study. Incorporating additional cephalometric analyses and optimising the algorithm will likely enhance the systems performance.</p>","PeriodicalId":94053,"journal":{"name":"International journal of oral and maxillofacial surgery","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148914188","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":"Robot-assisted brachytherapy targeting the stylomastoid foramen for parotid adenoid cystic carcinoma with facial nerve involvement: a retrospective study.","authors":"Z Li, N Jin, L Zhu, H Zhang","doi":"10.1016/j.ijom.2026.08.033","DOIUrl":"https://doi.org/10.1016/j.ijom.2026.08.033","url":null,"abstract":"<p><p>The objective was to evaluate the technical feasibility, geometric accuracy, and preliminary short-term safety of using a multimodal, image-guided, robot-assisted iodine-125 seed implantation targeting the stylomastoid foramen and high-risk perilesional regions in selected patients with parotid adenoid cystic carcinoma with facial nerve involvement. A total of 23 consecutive patients treated between January 2020 and January 2023 were reviewed. Preoperative puncture planning was conducted using fused computed tomography (CT)/magnetic resonance imaging datasets. Intraoperative percutaneous needle placement and radioactive seed implantation were performed under robotic navigation. Postoperative CT imaging was obtained within 24 h to quantify implantation accuracy by calculating the spatial deviation between planned and actual seed positions. All patients were followed for up to 3 years, during which neurological function and intracranial tumor progression were systematically evaluated using clinical assessment and imaging. All surgeries were completed successfully without intraoperative incidents or significant perioperative complications. The mean particle placement error was 1.46 ± 0.85 mm (95% confidence interval: 1.09-1.83 mm), with intraoperative blood loss of 2-3 mL. During subsequent follow-up, no further neurological deficits were observed, and serial imaging revealed stable disease in 16 patients, partial response in six, and local progression without intracranial extension in one. The employment of robot-assisted iodine-125 brachytherapy has the potential to offer a safe, accurate, and minimally invasive clinical option for focal neural-pathway irradiation in a selected group of high-risk parotid adenoid cystic carcinoma patients. However, the confirmation of long-term oncological and neurological benefits necessitates the performance of prospective controlled studies.</p>","PeriodicalId":94053,"journal":{"name":"International journal of oral and maxillofacial surgery","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148914679","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":"Comment on: \"Evaluating the performance of general vs retrieval-augmented generation large language models on oral and maxillofacial surgery board examinations\".","authors":"C M Ardila","doi":"10.1016/j.ijom.2026.08.034","DOIUrl":"https://doi.org/10.1016/j.ijom.2026.08.034","url":null,"abstract":"","PeriodicalId":94053,"journal":{"name":"International journal of oral and maxillofacial surgery","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148914662","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 Kubota, T Kaneuji, T Ishizuka, K Kai, Y Yamashita, Y Hishikawa
{"title":"Extracellular volume fraction and tumour fibrosis as non-invasive prognostic biomarkers in tongue squamous cell carcinoma.","authors":"T Kubota, T Kaneuji, T Ishizuka, K Kai, Y Yamashita, Y Hishikawa","doi":"10.1016/j.ijom.2026.08.021","DOIUrl":"https://doi.org/10.1016/j.ijom.2026.08.021","url":null,"abstract":"<p><p>Cancer-associated fibroblasts (CAFs) influence the tumour microenvironment and promote tumour growth and metastasis. In recent years, the extracellular volume (ECV) fraction derived from contrast-enhanced computed tomography (CECT) has been recognized as a useful, non-invasive imaging biomarker for assessing tissue fibrosis. The aim of this study was to evaluate the clinical significance of the ECV fraction in tongue squamous cell carcinoma (TSCC) by examining its association with histopathological fibrosis. This retrospective observational cohort study analysed 63 patients with TSCC diagnosed between 2015 and 2023. CAFs and tumour microenvironment activity were assessed immunohistochemically using α-SMA, FAP, and TGF-β1. Associations among ECV fraction, fibrosis, and clinical factors were examined. ECV fraction was significantly associated with tumour size, cervical lymph node metastasis, and depth of invasion (all P < 0.001). Receiver operating characteristic curve analysis identified an optimal ECV fraction cut-off of 19.2% for predicting cervical lymph node metastasis. Kaplan-Meier analysis using this cut-off showed that a high ECV fraction was associated with significantly poorer overall survival (P = 0.032). Kaplan-Meier analysis showed that patients with a high ECV fraction experienced significantly poorer overall survival (P = 0.032). Subgroup analysis of early-stage tumours (T1/T2) demonstrated a comparable prognostic value (cut-off = 19.3%), showing a similar prognostic trend. The ECV fraction is a non-invasive imaging biomarker that reflects stromal fibrosis and is associated with tumour progression and cervical lymph node metastasis in TSCC. The ECV fraction cut-off value served as a reliable prognostic indicator, including in early-stage cases. The integration of ECV fraction with the evaluation of histological fibrosis and CAFs may facilitate personalized risk assessment and guide clinical decisions such as elective neck dissection.</p>","PeriodicalId":94053,"journal":{"name":"International journal of oral and maxillofacial surgery","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148889809","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 Maikaeo, W Kasemsarn, Y Kriangcherdsak, N Srimaneekarn, A Hayter, T Thongngam
{"title":"Comparison of neurosensory disturbance after using preoperative cone-beam computed tomography and panoramic radiography to locate the inferior alveolar nerve in bilateral sagittal split ramus osteotomy.","authors":"S Maikaeo, W Kasemsarn, Y Kriangcherdsak, N Srimaneekarn, A Hayter, T Thongngam","doi":"10.1016/j.ijom.2026.08.030","DOIUrl":"https://doi.org/10.1016/j.ijom.2026.08.030","url":null,"abstract":"<p><p>Inferior alveolar nerve (IAN) injury is the most common side effect of bilateral sagittal split ramus osteotomy (BSSRO), often caused by anatomical variability and the proximity of the nerve to the buccal cortex. This study was performed to compare functional sensory recovery (FSR) times when using cone-beam computed tomography (CBCT) vs panoramic radiographs (OPG) preoperatively to locate the IAN in patients undergoing BSSRO. A split-mouth randomized design was used. Twenty patients who underwent BSSRO in the Faculty of Dentistry, Mahidol University, between January 2023 and July 2024 were included. CBCT and OPG images were obtained preoperatively. Subjective and objective neurosensory evaluations were performed preoperatively, immediately postoperative, and at 1, 3, 6, and 9 months postoperative. The median time to FSR in the lip area was 2 days in the CBCT group and 35 days in the OPG group (P = 0.050; borderline significant difference), while in the chin area it was significantly shorter in the CBCT group (CBCT 2 days vs OPG 63 days; P = 0.026). Patients subjectively reported more neurosensory disturbances when compared to the FSR results (lip and chin region, both P < 0.001). Neither the IAN-to-buccal cortex distance nor the magnitude of the mandibular movement was significantly associated with time to FSR in either the lip or chin area (all P > 0.05). CBCT appears to be a useful modality to support safer surgical approaches, promote faster sensory recovery, and enhance patient satisfaction following BSSRO.</p>","PeriodicalId":94053,"journal":{"name":"International journal of oral and maxillofacial surgery","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148882336","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}