International journal of oral and maxillofacial surgery最新文献

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Editorial Board/Reviewing Committee 编辑委员会/评审委员会

IF 2.7 3区医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE

International journal of oral and maxillofacial surgery

Pub Date : 2026-01-24 DOI: 10.1016/S0901-5027(25)01543-7

引用次数: 0

Editorial Board/Reviewing Committee 编辑委员会/评审委员会

IF 2.7 3区医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE

International journal of oral and maxillofacial surgery

Pub Date : 2025-12-23 DOI: 10.1016/S0901-5027(25)01519-X

引用次数: 0

Editorial Board/Reviewing Committee 编辑委员会/评审委员会

IF 2.7 3区医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE

International journal of oral and maxillofacial surgery

Pub Date : 2025-10-31 DOI: 10.1016/S0901-5027(25)01484-5

引用次数: 0

Safety and efficacy of maxillomandibular fixation techniques: a network meta-analysis 上颌下颌固定技术的安全性和有效性：网络荟萃分析。

IF 2.7 3区医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE

International journal of oral and maxillofacial surgery

Pub Date : 2025-10-29 DOI: 10.1016/j.ijom.2025.10.007

P. Papócsi , A. Pál , K. Kelemen , N. Gede , B. Kerémi , G. Varga , A.S. Wenning , P. Hegyi , Z. Németh

Jaw fractures are prevalent facial injuries. Choosing the optimal intermaxillary/maxillomandibular fixation(IMF/MMF) technique is crucial for a successful conservative and surgical treatment, to achieve perfect occlusion.This network meta-analysis aimed to identify the most time-efficient and safe technique for IMF by comparing currently used techniques. A systematic search was performed in four databases, where 20,249 studies were identified; after the selection process 29 were included in the synthesis. Application time of IMF screws(IMFS)(MD -47,95% CI -62 to-33) and Hybrid Maxillomandibular Fixation(HMMF)(MD -33, 95% CI -48 to -19), and removal of IMFS (MD -16, 95% CI -23 to -8) were significantly shorter than Erich Arch Bar(EAB). EAB causes significantly fewer iatrogenic injuries than IMFS(OR: 0.30, 95% CI 0.09-0.93) or HMMF(OR 0.20, 95% CI 0.05-0.76). Both IMFS and HMMF were associated with a significantly lower risk of glove perforation and needlestick injury than EAB: OR 0.05(95% CI 0.02–0.12) and 0.08 (95% CI 0.03–0.23), respectively. In conclusion, IMF screws and HMMF are more effective than EAB in terms of application and removal time, oral hygiene, and patient acceptance. They also offer greater safety in terms of gloves and needlestick injuries, although there is a higher risk of iatrogenic injuries and hardware loosening.

颌骨骨折是常见的面部损伤。选择最佳的上颌间/上颌骨固定（IMF/MMF）技术是成功的保守和手术治疗的关键，以实现完美的咬合。本网络荟萃分析旨在通过比较目前使用的技术，为IMF确定最省时、最安全的技术。在四个数据库中进行了系统检索，其中确定了20,249项研究；经过筛选，29个被纳入合成。应用IMF螺钉（IMFS）（MD -47,95% CI -62 ~ 33）和混合型上下颌固定（HMMF）（MD -33, 95% CI -48 ~ 19）和取出IMFS （MD -16, 95% CI -23 ~ -8）的时间明显短于Erich Arch Bar（EAB）。EAB引起的医源性损伤明显少于IMFS（OR: 0.30, 95% CI 0.09-0.93）或HMMF（OR: 0.20, 95% CI 0.05-0.76）。与EAB相比，IMFS和HMMF与手套穿孔和针刺损伤的风险均显著降低：OR分别为0.05（95% CI 0.02-0.12）和0.08 （95% CI 0.03-0.23）。综上所述，IMF螺钉和HMMF在应用和取出时间、口腔卫生和患者接受度方面均优于EAB。尽管医源性损伤和硬件松动的风险较高，但它们在手套和针刺损伤方面也提供了更高的安全性。

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引用次数: 0

Free forearm flaps for head and neck reconstruction: fewer revisions and flap failures with two venous anastomoses—a 25-year prospective study 自由前臂皮瓣头颈部重建：较少的修正和皮瓣失败与两个静脉吻合-一个25年的前瞻性研究。

IF 2.7 3区医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE

International journal of oral and maxillofacial surgery

Pub Date : 2025-10-22 DOI: 10.1016/j.ijom.2025.10.003

C.J. Kuijpers , E.M. Van Cann , F.J. Dieleman , J.E. Bergsma , R.J.J. van Es , A.J.W.P. Rosenberg

Flap failure is a potential complication following head and neck reconstruction using free vascularized flaps. The value of a second venous anastomosis remains debated. This prospective cohort study included consecutive patients who underwent free forearm flap (FFF) surgery to repair head and neck defects between 1998 and 2023, and compared outcomes of FFF with one versus two venous anastomoses. Outcome parameters were surgical vascular revision and flap failure rates. In patients who received radial FFF for primary reconstruction, the rates of vascular revision and flap failure were significantly higher in flaps with one anastomosis (P = 0.045 and P = 0.018, respectively). Analysis of all forearm flaps (radial and ulnar) used for primary or secondary reconstruction, showed that flaps with one venous anastomosis had significantly higher rates of vascular revision (8.3% vs 2.8%, P = 0.031) and flap failure (6.7% vs 2.0%, P = 0.033) than those with two. Multivariable logistic regression confirmed that a single venous anastomosis was independently associated with increased odds of vascular revision (P = 0.039) and flap failure (P = 0.015). In conclusion, FFF with one venous anastomosis needed more surgical vascular revision and showed more flap failure than those with two venous anastomoses.

皮瓣失败是头颈部重建使用游离血管皮瓣的潜在并发症。二次静脉吻合术的价值仍有争议。这项前瞻性队列研究纳入了1998年至2023年间连续接受游离前臂皮瓣（FFF）手术修复头颈部缺陷的患者，并比较了FFF采用一种静脉吻合术和两种静脉吻合术的结果。结果参数为手术血管修复和皮瓣失败率。在接受桡骨FFF进行初次重建的患者中，一次吻合皮瓣的血管修复率和皮瓣失败率显著高于一次吻合皮瓣（P = 0.045和P = 0.018）。对所有前臂皮瓣（桡侧和尺侧）进行一次或二次重建的分析表明，与两个静脉吻合的皮瓣相比，一个静脉吻合的皮瓣血管修复率（8.3% vs 2.8%, P = 0.031）和皮瓣失败率（6.7% vs 2.0%, P = 0.033）显著高于两个静脉吻合的皮瓣。多变量logistic回归证实，单静脉吻合与血管翻修（P = 0.039）和皮瓣失败（P = 0.015）的几率增加独立相关。综上所述，单静脉吻合的FFF比双静脉吻合的FFF需要更多的外科血管修复术和更多的皮瓣失败。

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引用次数: 0

Performance of machine learning algorithms in predicting the need for surgical fixation in pediatric craniomaxillofacial trauma 机器学习算法在预测小儿颅颌面创伤手术固定需求中的表现。

IF 2.7 3区医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE

International journal of oral and maxillofacial surgery

Pub Date : 2025-10-18 DOI: 10.1016/j.ijom.2025.10.005

B. Thornton , K. Patel , B. Ma , J. Castro-Nunez

Machine learning offers a novel approach to improve surgical triage in pediatric craniomaxillofacial trauma, where decision-making often relies on clinician judgment without standardized criteria. This retrospective study used data from the National Trauma Data Bank (2017–2022) to evaluate the performance of machine learning algorithms in predicting the need for open surgical fixation among pediatric patients with facial fractures. Multivariable logistic regression identified fracture patterns, neurologic and dental injuries, and trauma center characteristics as significant predictors of open surgical fixation. XGBoost outperformed four other models (area under the receiver operating characteristic curve (ROC-AUC) 0.89) and demonstrated strong calibration. Shapley Additive Explanations (SHAP) confirmed that facial injury severity, mandible fractures, and fracture multiplicity were key drivers of operative predictions, aligning with clinical priorities to restore occlusion and stabilize the facial skeleton. Conversely, closed cranial base fractures and head injury severity reduced the predicted likelihood of surgery, consistent with conservative management. False positives and false negatives reflected gaps in radiographic detail and clinical context, including fracture displacement and surgical contraindications. These findings highlight the potential of machine learning to support the early identification of surgical candidates using structured data available at the time of presentation and underscore the need for multimodal approaches to further refine triage accuracy.

机器学习为改善儿童颅颌面创伤的手术分诊提供了一种新的方法，在这种情况下，决策往往依赖于临床医生的判断，而没有标准化的标准。本回顾性研究使用来自国家创伤数据库（2017-2022）的数据来评估机器学习算法在预测儿童面部骨折患者开放手术固定需求方面的性能。多变量logistic回归发现骨折类型、神经和牙齿损伤以及创伤中心特征是开放性手术固定的重要预测因素。XGBoost优于其他四种模型（接收器工作特性曲线下面积（ROC-AUC） 0.89），并显示出很强的校准能力。Shapley加性解释（SHAP）证实，面部损伤严重程度、下颌骨骨折和骨折多样性是手术预测的关键驱动因素，与临床优先事项保持一致，以恢复咬合和稳定面部骨骼。相反，闭合性颅底骨折和头部损伤严重程度降低了手术的预测可能性，与保守治疗一致。假阳性和假阴性反映了影像学细节和临床背景的差距，包括骨折移位和手术禁忌症。这些发现强调了机器学习的潜力，它可以使用展示时可用的结构化数据来支持外科候选人的早期识别，并强调了多模式方法进一步提高分诊准确性的必要性。

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引用次数: 0

Evaluation of heat generation during implant surgery by conventional and guided approach: a systematic review and meta-analysis 评估种植术中热产生的传统和引导方法：系统回顾和荟萃分析。

IF 2.7 3区医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE

International journal of oral and maxillofacial surgery

Pub Date : 2025-10-01 DOI: 10.1016/j.ijom.2025.09.006

C.P. Noronha, A.L.C. Figueiredo, E.V.F. da Silva, M.K. Mukai

This systematic review and meta-analysis investigated the difference in heat generated during guided implant surgery compared to freehand surgery. Four databases were searched with keywords for relevant studies.Included studies met the following criteria: in vitro comparison of implant surgery aided by a three-dimensionally printed surgical guide and freehand surgery with external irrigation. Risk-of-bias was assessed using QUIN. Data quantified temperature increases, categorized by device: thermocouple or infrared camera.The search yielded 1750 articles. After removing duplicates and screening, nine were included in the quantitative evaluation (meta-analysis).In the studies using a thermocouple (measurement at 1–3 mm depth), there was no statistically significant difference in temperature increase between the guided and freehand groups (pilot drill 2.0–2.35 mm, P=0.32; 2.8–3.0 mm, P=0.40). The infrared camera studies (pilot drill 2.0–2.35 mm, at 1–3 mm and 3–6 mm depth) showed a statistically significant difference in favour of freehand surgery, particularly at the greater depth: 5.97 °C (95% confidence interval 4.66–7.27 °C) more heat was generated with guided surgery (P<0.001).overall, in vitro studies showed that guided surgery resulted in significantly greater heat generation than freehand surgery, particularly at greater drilling depths.

本系统综述和荟萃分析调查了引导植入手术与徒手手术时产生的热量的差异。用关键词检索了4个数据库的相关研究。纳入的研究符合以下标准：三维打印手术指南辅助种植体手术与体外冲洗徒手手术的体外比较。使用QUIN评估偏倚风险。数据量化温度升高，按设备分类：热电偶或红外相机。搜索产生了1750篇文章。剔除重复和筛选后，9例纳入定量评价（meta分析）。在使用热电偶（1 ~ 3 mm深度测量）的研究中，引导组与徒手组（导钻2.0 ~ 2.35 mm， P=0.32; 2.8 ~ 3.0 mm， P=0.40）的温升差异无统计学意义。红外相机研究（导钻2.0-2.35 mm， 1-3 mm和3-6 mm深度）显示，徒手手术具有统计学上的显著差异，特别是在更大的深度：5.97°C（95%置信区间4.66-7.27°C）引导手术产生更多的热量(P

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引用次数: 0

Editorial Board/Reviewing Committee 编辑委员会/评审委员会

IF 2.7 3区医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE

International journal of oral and maxillofacial surgery

Pub Date : 2025-09-30 DOI: 10.1016/S0901-5027(25)01455-9

引用次数: 0

Subcutaneous pedicle island flap for complex congenital earlobe cleft correction 皮下带蒂岛状皮瓣修复复杂先天性耳垂裂。

IF 2.7 3区医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE

International journal of oral and maxillofacial surgery

Pub Date : 2025-09-30 DOI: 10.1016/j.ijom.2025.07.014

D. Li , T. Li , Z. Cai , X. Qin

Congenital cleft earlobe is rare, but earlobe clefts are nevertheless the most common lower auricular malformations. There are various types of earlobe clefts and there is no universally recognized classification scheme. Different techniques have been reported for the correction of the various types of anomaly. This paper presents a complex subtype cleft that has not previously been reported in the literature and describes the technique used to achieve a three-dimensional reconstruction with a satisfactory result.

先天性耳垂裂是罕见的，但耳垂裂是最常见的下耳畸形。耳垂裂有多种类型，目前还没有一个公认的分类方案。不同的技术已被报道用于校正各种类型的异常。本文介绍了一种复杂的亚型裂缝，以前没有在文献中报道过，并描述了用于实现三维重建的技术，结果令人满意。

引用次数: 0

Does chemotherapy improve the prognosis in patients with jaw osteosarcoma? A systematic review and meta-analysis 化疗能改善颌骨骨肉瘤患者的预后吗？系统回顾和荟萃分析。

IF 2.7 3区医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE

International journal of oral and maxillofacial surgery

Pub Date : 2025-09-29 DOI: 10.1016/j.ijom.2025.09.008

L. Zhang , Y. Guo , Y. Sumita , H. Hirai , M. Yamazaki , T. Hayashi , J.-i. Tanuma , K. Tomihara

Osteosarcoma, a rare tumour, primarily affects the long bones in young individuals. However, it can also involve the jaw, presenting as jaw osteosarcoma (JOS), which is characterized by higher local recurrence than metastasis. While advances in chemotherapy have contributed to the treatment of osteosarcoma, its role in JOS remains debated. This study was performed to evaluate the effects of chemotherapy on survival outcomes. A systematic search for studies published between 1990 and 2024 was conducted using PubMed, Embase, and Google Scholar. Eligible studies reported survival data for histologically confirmed JOS cases. Kaplan–Meier analysis and Cox regression were performed to assess survival rates and prognostic factors. The analysis included 330 patients from 20 studies. The 5-year overall survival rate was 37.1% and the 10-year rate was 10.5%. Age (≥40 years), surgical margin status (positive), and tumour size (≥5 cm) were identified as significant prognostic factors (worse prognosis). Importantly, patients with high-grade JOS treated with both surgery and chemotherapy (versus surgery without chemotherapy) demonstrated improved survival (hazard ratio 0.500, 95% confidence interval 0.262–0.954, P = 0.035). Overall, chemotherapy provided significant benefit in high-grade cases. This study provides valuable insights for refining treatment protocols for this rare tumour type.

骨肉瘤是一种罕见的肿瘤，主要影响年轻人的长骨。然而，它也可以累及颌骨，表现为颌骨骨肉瘤（JOS），其特点是局部复发高于转移。虽然化疗的进步有助于骨肉瘤的治疗，但其在骨肉瘤中的作用仍存在争议。本研究旨在评估化疗对生存结果的影响。使用PubMed、Embase和谷歌Scholar对1990年至2024年间发表的研究进行了系统搜索。符合条件的研究报告了组织学证实的JOS病例的生存数据。采用Kaplan-Meier分析和Cox回归评估生存率和预后因素。该分析包括来自20项研究的330名患者。5年生存率为37.1%，10年生存率为10.5%。年龄（≥40岁）、手术切缘状态（阳性）和肿瘤大小（≥5cm）被认为是重要的预后因素（预后较差）。重要的是，接受手术和化疗的高级别JOS患者（与不接受化疗的手术相比）的生存率有所提高（风险比0.500,95%可信区间0.262-0.954,P = 0.035）。总的来说，化疗在高等级病例中提供了显著的益处。这项研究为改进这种罕见肿瘤类型的治疗方案提供了有价值的见解。

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