Advances in Oral and Maxillofacial Surgery最新文献_第6页

Retrospective analysis of surgical treatment of frontobasal fractures with the new bernese skull base fracture score 应用新bernese颅底骨折评分对额基底骨折手术治疗的回顾性分析

Advances in Oral and Maxillofacial Surgery

Pub Date : 2025-09-01 Epub Date: 2025-08-07 DOI: 10.1016/j.adoms.2025.100569

Christian Schedeit , Ioanna Kalaitsidou , Nathalie Schedeit , Bradley Aebi , Kotaro Sato , Benoît Schaller

The aim of this study is to evaluate the success rate and effectiveness of the subcranial approach for anterior skull base fractures in comparison to findings reported in the literature. Furthermore, a clinical recommendation for this approach will be made using the new Bernese skull base score. A total of 185 adult patients with severe comminuted fractures or cerebrospinal fluid (CSF) leaks underwent open anterior skull base surgery after trauma between 2002 and 2018 in our department. We retrospectively analyzed all of these patients by evaluating preoperative symptoms, fracture types, complication rates, and long-term outcomes. The evaluation of the results of the operations is based on the cohort of 149 patients. None of the patients with a 6-month follow-up who underwent surgery using the subcranial approach developed meningitis. Of the 9 patients (6 %) who required secondary surgery at the skull base, only 1 patient (0.7 %) required repair of a CSF leak. The most common long-term complication associated with secondary skull base surgery was mucocele formation (n = 6, 4 %). Fifteen patients developed enophthalmos (8.1 %) and eleven experienced diplopia (5.9 %). In conclusion, the subcranial approach is a safe surgical technique with a low incidence of long-term complications in comminuted fractures of the anterior skull base which is indicated for the rare severer cases.

本研究的目的是评估颅下入路治疗前颅底骨折的成功率和有效性，并与文献报道的结果进行比较。此外，将使用新的Bernese颅底评分对该方法进行临床推荐。2002年至2018年，我科共收治185例严重粉碎性骨折或脑脊液（CSF）泄漏的成人外伤后开放性颅底手术患者。我们通过评估术前症状、骨折类型、并发症发生率和长期预后对所有患者进行回顾性分析。手术结果的评估是基于149例患者的队列。在6个月的随访中，接受颅下入路手术的患者无一发生脑膜炎。在9例（6%）需要颅底二次手术的患者中，只有1例（0.7%）需要修复脑脊液泄漏。与二次颅底手术相关的最常见的长期并发症是粘液囊肿形成（n = 6,4 %）。15例出现眼内陷（8.1%），11例出现复视（5.9%）。综上所述，颅下入路是治疗前颅底粉碎性骨折的一种安全、长期并发症发生率低的手术方法，适用于罕见的重症病例。

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引用次数: 0

Aesthetic chin lines in women: A visual guide for gender-sensitive orthognathic surgery planning 女性的下巴线条美学：对性别敏感的正颌手术计划的视觉指南

Advances in Oral and Maxillofacial Surgery

Pub Date : 2025-09-01 Epub Date: 2025-08-04 DOI: 10.1016/j.adoms.2025.100570

María G. Barrón Barrera, Emmanuel Guerrero Soto

Facial harmony is strongly influenced by the projection of the chin, particularly in the lower third of the face. This study applies the visual diagnostic tool known as Aesthetic Chin Lines (ACL), previously validated in men, to a sample of attractive adult women. A total of 200 high-resolution profile photographs were analyzed to evaluate the position of the Pogonion in relation to two perpendicular reference lines: one from the subnasale and another from the incisal edge of the upper central incisor. The results revealed that only 40.5 % of the Pogonions were within the ACL, while 56 % were located posterior to the incisor line and 3.5 % anterior to the subnasale line. These findings differ significantly from those observed in men, where 84 % fell within the ACL. This supports the hypothesis that gender influences aesthetic norms for chin projection and suggests the need for tailored aesthetic guidelines in orthognathic planning for women.

面部的和谐很大程度上受下巴的突出程度的影响，尤其是在脸的下三分之一。这项研究将视觉诊断工具——审美下巴线（ACL）应用于有吸引力的成年女性样本，该工具之前在男性身上得到了验证。我们分析了总共200张高分辨率的侧面照片，以评估Pogonion相对于两条垂直的参考线的位置：一条来自鼻下，另一条来自上中切牙的切缘。结果显示，仅40.5%的毒瘤位于前交叉韧带内，56%位于切牙线后，3.5%位于鼻下线前。这些结果与在男性中观察到的结果有很大的不同，其中84%的患者落在前交叉韧带内。这支持了性别影响下巴突出的审美规范的假设，并建议在女性正颌规划中需要量身定制的审美指南。

引用次数: 0

Ameloblastoma: Retrospective single institute study and analysis of 86 subjects 成釉细胞瘤：回顾性单机构研究与分析86例

Advances in Oral and Maxillofacial Surgery

Pub Date : 2025-09-01 Epub Date: 2025-05-10 DOI: 10.1016/j.adoms.2025.100551

Pengleang Cheang , Amit Dattani , Lykheang Lou , Sandeth Phan

The aim of this study was to investigate the results of ameloblastoma treated at a single Cambodian institute during a 6-year period (Jan 2018–Dec 2023). A retrospective study was designed to include all patients who had been diagnosed with ameloblastoma and treated at the Department of Oral and Maxillofacial Surgery, Preah Ang Duong Hospital, Phnom Penh, Cambodia. Demographic details, location and size of lesion, histological classification of lesion by subtype, radiographic appearance, treatment and recurrence rates for up to 5 years were collated by using patients’ records and the histopathology database. 86 patients were included in the study. 75 (87.2 %) were located in the mandible, the most common size of ameloblastoma at presentation was 3.1–6 cm in 38 patients (44.2 %). By the 2022 WHO Classification of ameloblastomas, conventional ameloblastomas were reported in 55 patients (64 %). 11 patients (13 %) underwent marsupialization with 9 patients (60 %) having a recurrence within 2 years. 10 patients (12 %) underwent enucleation with 6 patients having recurrence within 3 years. 46 patients (53 %) underwent radical resection with 6 patients having recurrence within 5 years. 19 patients (22 %) declined treatment. Overall, 15/67 treated patients (22.3 %) had some form of recurrence in which radical resection had the lowest rate of recurrence.

本研究的目的是调查6年期间（2018年1月至2023年12月）在柬埔寨一家研究所治疗成釉细胞瘤的结果。一项回顾性研究旨在纳入所有被诊断为成釉细胞瘤并在柬埔寨金边Preah Ang Duong医院口腔颌面外科接受治疗的患者。利用患者病历和组织病理学数据库，整理患者的人口统计学细节、病变位置和大小、病变亚型的组织学分类、影像学表现、治疗和5年复发率。86名患者被纳入研究。75例（87.2%）位于下颌骨，38例（44.2%）患者的成釉细胞瘤最常见的大小为3.1 ~ 6cm。根据2022年WHO成釉细胞瘤分类，55例（64%）患者报告了常规成釉细胞瘤。11例患者（13%）接受了有袋化手术，9例患者（60%）在2年内复发。10例患者（12%）接受了去核手术，6例患者在3年内复发。46例（53%）行根治性手术，6例5年内复发。19例患者（22%）拒绝治疗。总体而言，接受治疗的患者中有15/67（22.3%）出现某种形式的复发，其中根治性切除的复发率最低。

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引用次数: 0

To evaluate the efficacy of osseodensification on primary stability and final osseointegration of implants placed in D3 and D4 type of bone 评价骨密度对D3型和D4型骨种植体初级稳定性和最终骨整合的影响

Advances in Oral and Maxillofacial Surgery

Pub Date : 2025-09-01 Epub Date: 2025-06-15 DOI: 10.1016/j.adoms.2025.100554

Sunil Vasudev, Deepak S, Asjadi Sheikh

Aim

To evaluate efficacy of osseodensification on primary stability and final osseointegration of implants placed in areas of compromised bone density.

Material and methods

Study population comprised 10 patients, having D3/D4 type of bone. A total of 24 implants were placed in mandible and maxilla. The evaluation was carried out periodically for 1 year, investigating the influence of osteotomy technique using densah bur on clinical and radiographic parameters namely assessment of implant stability using torque wrench and osstell device, measurement of bone gain, bone expansion, bone density, bone surface area and crestal bone loss.

Results

The statistical analysis of torque wrench values at T0′ was 37.50(3.54SD) and 51.00(3.16SD) at T6 with p-value<0.001. The ISQ reading at T0′ was 62.8(3.4SD) and at T6 it was 65.8(5.4SD) p = 0.15,no significant difference seen. Considerable amount of bone gain post operatively noted (approx 26.8 %)p < 0.001. Evaluation of bone expansion in terms of ridge width demonstrated increase post-op(p < 0.001). Analysis of bone density in HU reveals significant increase at T6 p < 0.001. Bone surface area data tabulated at different intervals suggest increase post-op and at T6 (p < 0.05). The statistical data of crestal bone loss calculated periodically revealed 1.38 ± 0.41 at 12 months(p < 0.05).

Conclusion

Osseodensification using the versatile densah bur is a paradigm shift in the osteotomy preparation.

目的评价骨密度受损区骨增密对种植体初期稳定性和最终骨整合的影响。材料与方法研究人群为10例D3/D4型骨。在下颌骨和上颌骨共放置24个种植体。为期1年的定期评估，研究使用densah bur的截骨技术对临床和影像学参数的影响，即使用扭矩扳手和osstell装置评估种植体稳定性，测量骨增重、骨膨胀、骨密度、骨表面积和嵴骨损失。结果T0′时扭矩扳手值为37.50(3.54SD)， T6时为51.00(3.16SD)， p值为0.001。T0′时ISQ读数为62.8(3.4SD)， T6时为65.8(5.4SD), p = 0.15，差异无统计学意义。术后观察到相当数量的骨增重（约26.8%）p <；0.001. 根据脊宽评估骨扩张显示术后增加(p <；0.001)。HU骨密度分析显示T6 p <显著增高；0.001. 不同时间间隔骨表面积数据显示术后和T6时骨表面积增加(p <；0.05)。定期计算牙冠骨质流失统计数据：12个月1.38±0.41 (p <；0.05)。结论应用多用途骨密度器进行骨致密化是截骨准备的一种范式转变。

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引用次数: 0

A single centre service evaluation of 53 MRONJ cases 53例MRONJ病例单中心服务评价

Advances in Oral and Maxillofacial Surgery

Pub Date : 2025-09-01 Epub Date: 2025-06-20 DOI: 10.1016/j.adoms.2025.100557

Millicent Forrest , Sanford Grossman , Noha Seoudi , Edmund Bailey , Rishi Bhandari , Leo Cheng , Judith Jones , Zoe Killick , Mohammed Dungarwalla

Medication-related osteonecrosis of the jaw (MRONJ) is a significant complication associated with antiresorptive or antiangiogenic medications, particularly bisphosphonates and denosumab, commonly used in the management of osteoporosis and metastatic bone disease.

This retrospective service evaluation assessed treatment modalities and outcomes of MRONJ patients treated at the Royal London Dental Hospital (RLDH) between 2018 and 2023. A cohort of 53 patients, primarily oncology patients, were analysed, with 60 % of MRONJ sites presenting in the posterior mandible. Tooth extractions were identified as a leading precipitating factor in MRONJ development, while poor oral hygiene exacerbated disease progression.

Management strategies included conservative and operative interventions, with surgical debridement yielding a 70.6 % success rate in healing. Antibiotic therapy was prescribed in 50 % of stage 1 patients despite a lack of infection, highlighting the need to audit such use given the lack of evidence outside infection in stages 2 and 3.

This evaluation highlights the importance of preventive dental care, patient-centred personalised treatment planning, and the role of surgical interventions in MRONJ management.

药物相关性颌骨骨坏死（MRONJ）是与抗吸收或抗血管生成药物相关的重要并发症，特别是双磷酸盐和地诺单抗，通常用于骨质疏松症和转移性骨病的治疗。这项回顾性服务评估评估了2018年至2023年在皇家伦敦牙科医院（RLDH）治疗的MRONJ患者的治疗方式和结果。我们分析了53例患者，主要是肿瘤患者，其中60%的MRONJ位点出现在下颌骨后部。拔牙被确定为MRONJ发展的主要诱发因素，而不良的口腔卫生加剧了疾病的进展。治疗策略包括保守和手术干预，手术清创愈合成功率为70.6%。尽管没有感染，但仍有50%的1期患者开了抗生素治疗，这突出了考虑到2期和3期缺乏外部感染的证据，需要对这种使用进行审核。该评估强调了预防性牙科保健、以患者为中心的个性化治疗计划以及手术干预在MRONJ管理中的作用的重要性。

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引用次数: 0

Erratum regarding missing “Consent statements” in previously published articles 关于先前发表的文章中缺少“同意声明”的勘误表

Advances in Oral and Maxillofacial Surgery

Pub Date : 2025-09-01 Epub Date: 2025-03-23 DOI: 10.1016/j.adoms.2025.100536

引用次数: 0

A Christmas “Sock Market” Analysis 圣诞“袜子市场”分析

Advances in Oral and Maxillofacial Surgery

Pub Date : 2025-09-01 Epub Date: 2025-01-27 DOI: 10.1016/j.adoms.2025.100520

Sooda Rehman, Alice Cameron, Andrea N. Beech

Aim

To identify whether seniority of surgeons, in head and neck surgery, is an indicator for sock choice in the operating theatre environment. We discuss our results in line with the literature on patient perceptions of clinicians’ workwear and standard infection control policy.

Materials and methods

Surgeons sock choices were examined at the start of December 2023 and November 2024, in Gloucestershire Hospitals NHS Foundation Trust. Details were recorded of grade of surgeon, sub-specialty and the specifics of the socks worn in the theatre environment.

Results

Senior surgeons seemed to wear more colourful socks, while junior members of the surgical team wore plain socks. Several senior surgeons wore Christmas-themed socks or those that showed an element of humour.

Conclusions

More senior surgeons sampled seemed to wear more whimsical socks. The reasons for this are unclear but it may reflect more junior team members wishing not to draw attention to themselves by colleagues and not to come across flippant in their roles. While uniform policy is likely to vary across workplaces and guidance about socks may or may not be commented upon, NHS England's Guidance for NHS employers on uniforms and workwear outlines that uniforms must be professional in appearance.

目的确定头颈外科医生的资历是否为手术室环境中袜子选择的指标。我们讨论我们的结果与文献对临床医生的工作服和标准感染控制政策的病人的看法一致。材料和方法在格洛斯特郡医院NHS基金会信托基金，于2023年12月初和2024年11月对外科医生选择的袜子进行了检查。详细记录了外科医生的等级，专科和在手术室环境中穿的袜子的细节。结果：资深外科医生似乎穿颜色更鲜艳的袜子，而初级外科医生则穿普通的袜子。几位资深外科医生穿着圣诞主题的袜子或带有幽默元素的袜子。结论更多的资深外科医生似乎穿了更多的异想天开的袜子。这样做的原因尚不清楚，但这可能反映出更多的初级团队成员不希望引起同事的注意，也不希望在自己的角色中表现得轻率。虽然不同工作场所的统一政策可能有所不同，关于袜子的指导可能会被评论，也可能不会被评论，但英国国家医疗服务体系（NHS England）关于制服和工作服的雇主指南概述了制服必须在外观上专业。

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引用次数: 0

Modified simplified preservation quick rhinoplasty: A new proposal in rhinoplasty for Latin American Mestizo patients 改良简化保存快速鼻成形术：拉丁美洲混血患者鼻成形术的新建议

Advances in Oral and Maxillofacial Surgery

Pub Date : 2025-09-01 Epub Date: 2025-06-18 DOI: 10.1016/j.adoms.2025.100555

Paolo Verona , Valerio Finocchi , Janneth Zúñiga , Natalia Cardona , Nicolas Solano , Jesús García

Background

Considering that specific anatomical features are frequently identified in Latin American Mestizo patients, it may be essential to modify existing procedures and design a rhinoplasty technique that can adjust to the anatomical needs of this population.

Objectives

This study aimed to propose a new modified technique in dorsal surface preservation rhinoplasty for patients with nasal morphology characteristic of Latin American Mestizo patients.

Methods

Patients were prospectively studied between July 2022 and July 2024. Data on age, gender, type of approach, need for touch-ups, surgery in conjunction with orthognathic surgery, and follow-up were recorded.

Results

We obtained a complete correction of the nasal humps with aesthetic changes, as proposed in the new technique developed and presented to 42 patients. This allowed a continuous and natural dorsum with a greater lateral definition of the dorsum, the definition of aesthetic lines, the shadow of the nasal pyramid breakage, and no evidence of bony steps of the central osteotomy.

Conclusions

The Modified Simplified Preservation Quick Rhinoplasty technique for Latin American Mestizo patients meets aesthetic and personalized standards without modifying the functionality and quality of life of patients. This technique enhances the morphologic qualities of the nasal anatomic structures of the patients, designing and molding the cartilaginous tissue that can be obtained efficiently.

背景：考虑到拉丁美洲混血人患者经常被识别出特定的解剖特征，可能有必要修改现有的手术程序并设计一种能够适应这一人群解剖需求的鼻整形技术。目的针对拉丁美洲混血儿鼻形态特点，提出一种新的保留鼻背面整形技术。方法于2022年7月至2024年7月对患者进行前瞻性研究。记录年龄、性别、入路类型、补片需求、手术与正颌手术结合以及随访等数据。结果我们获得了完整的鼻峰矫正与美学改变，在新技术中提出，并提出了42例患者。这允许一个连续和自然的背，更大的背侧轮廓，美学线条的定义，鼻金字塔断裂的阴影，没有中央截骨的骨台阶的证据。结论改进的简化保存快速隆鼻术在不改变患者功能和生活质量的情况下，满足拉丁美洲混血儿患者的审美和个性化标准。该技术提高了患者鼻解剖结构的形态学质量，有效地设计和塑造了可获得的软骨组织。

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引用次数: 0

Effects of piezoelectric versus rotary handpiece on postoperative sequelae following surgical removal of impacted mandibular third molars; A comparative study 压电式与旋转式手机对下颌阻生第三磨牙术后后遗症的影响比较研究

Advances in Oral and Maxillofacial Surgery

Pub Date : 2025-09-01 Epub Date: 2025-08-09 DOI: 10.1016/j.adoms.2025.100568

Ochuko Ebrorhie , Michael Olayinka Adeyemi , Olawale Olatubosun Adamson , Emmanuel Onyebuchi Onuoha , Wasiu Lanre Adeyemo

Background

Bone removal is a key step in surgically extracting the impacted mandibular third molar and is chiefly responsible for the postoperative sequelae. The piezoelectric drill was introduced to help lessen the severity of these sequelae. This study aimed to compare the effects of using either a piezoelectric drill or a conventional rotary instrument on postoperative sequelae and complications following impacted mandibular third molar surgery.

Methodology

The study was a prospective randomised clinical trial. Impacted mandibular third molars were surgically removed using either a piezoelectric drill or a conventional drill. The primary outcome measured included postoperative sequelae (pain, swelling, and trismus) over one week postoperatively, while the secondary outcome involved postoperative complications.

Results

One hundred and twenty subjects completed the study, with 60 subjects in each group. The median postoperative pain scores were lower in the piezo group, and this difference was statistically significant on the 6th and 7th days (p = 0.004 and 0.011, respectively). Postoperative swelling was also less in the piezo group compared to the rotary group on days 1 and 3 (p < 0.001). No statistically significant difference was observed in the postoperative interincisal distance between the two groups. Nine subjects experienced complications in the rotary group, whereas none did in the piezo group. This difference was statistically significant (p = 0.002).

Conclusion

The Piezoelectric drill resulted in faster recovery of postoperative sequelae and a lower incidence of postoperative complications following the removal of the impacted mandibular third molar.

摘骨术是下颌阻生第三磨牙拔除的关键步骤，也是造成术后后遗症的主要原因。压电钻头的引入有助于减轻这些后遗症的严重程度。本研究旨在比较使用压电钻头或传统旋转器械对下颌阻生第三磨牙术后并发症和后遗症的影响。方法：本研究为前瞻性随机临床试验。下颌阻生第三磨牙采用压电钻或常规钻进行手术切除。测量的主要结果包括术后一周内的术后后遗症（疼痛、肿胀和牙关），而次要结果包括术后并发症。结果120名受试者完成研究，每组60名。压电组术后中位疼痛评分较低，第6、7天差异有统计学意义（p分别为0.004、0.011）。与旋转组相比，压电组术后第1天和第3天的肿胀也更少(p <；0.001)。两组术后切间距离差异无统计学意义。旋转组有9名受试者出现并发症，而压电组没有出现并发症。差异有统计学意义（p = 0.002）。结论采用压电钻头拔除下颌阻生第三磨牙后，术后后遗症恢复快，并发症发生率低。

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引用次数: 0

The study on the construction of injectable tissue-engineered bone based on the injectable PRF combined with osteoblastic bone marrow mesenchymal stem cell sheets 基于可注射PRF结合成骨骨髓间充质干细胞片构建可注射组织工程骨的研究

Advances in Oral and Maxillofacial Surgery

Pub Date : 2025-09-01 Epub Date: 2025-06-20 DOI: 10.1016/j.adoms.2025.100559

L. Han , X. Wu , Q. Ouyang , J. Hu , S. Sun , X. Li , Z. Wang

Injectable platelet-rich fibrin (i-PRF) has been proven to be able to promote tissue regeneration and applied in the treatment of diseases in the maxillofacial region, but whether it can be used to construct injectable tissue-engineered bone remains inconclusive. The aim of this study was to investigate whether i-PRF combined with osteoblastic bone marrow mesenchymal stem cell (BMSC) sheets can be used to construct injectable tissue-engineered bone. First, i-PRF prepared from fresh blood after a short-time and low-speed centrifugation. BMSCs, after continuous osteogenic induction for 2 weeks, formed membrane-like structures containing calcium nodules. They were mixed and then transplanted subcutaneously in nude mice by injection. the osteogenesis was evaluated through Micro-CT scanning and histological analysis after 8 weeks of transplantation. The group with BMSC sheets alone formed osteoid tissue, but the volume of new bone- and cartilage-like tissue was smaller, more sparse, and unevenly distributed. In contrast, the group with i-PRF and BMSC sheets had larger volumes of new tissue, higher bone density, more mineralized deposits, and more woven bone structures. In summary, osteoblastic BMSC sheets have the potential for ectopic osteogenesis, but i-PRF can significantly enhance their osteogenic capacity. Therefore, i-PRF combined with osteoblastic BMSC sheets can be regarded as a promising method for constructing injectable tissue-engineered bone.

可注射的富血小板纤维蛋白（i-PRF）已被证明能够促进组织再生并应用于颌面部区域疾病的治疗，但它是否可以用于构建可注射的组织工程骨仍然没有定论。本研究的目的是探讨i-PRF与成骨细胞骨髓间充质干细胞（BMSC）片是否可以用于构建可注射的组织工程骨。首先，从新鲜血液中提取短时间低速离心后制备i-PRF。骨髓间充质干细胞在连续成骨诱导2周后，形成含钙结节的膜样结构。将它们混合后注射到裸鼠皮下。移植8周后通过显微ct扫描和组织学分析评估成骨情况。单独使用BMSC片的组形成了类骨组织，但新生骨和软骨样组织体积更小，更稀疏，分布不均匀。相比之下，使用i-PRF和BMSC片的组具有更大的新组织体积，更高的骨密度，更多的矿化沉积物和更多的编织骨结构。综上所述，成骨骨髓间充质干细胞薄片具有异位成骨的潜力，但i-PRF可显著增强其成骨能力。因此，i-PRF与成骨骨髓间充质干细胞片相结合是一种很有前景的构建可注射组织工程骨的方法。

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引用次数: 0