Journal of Oral and Maxillofacial Surgery最新文献

{"title":"Effect of a Thermosensitive Hydroxybutyl Chitosan Hydrogel on Postoperative Sequalae and Quality of Life After Impacted Mandibular Third Molar Extraction","authors":"","doi":"10.1016/j.joms.2024.06.165","DOIUrl":"10.1016/j.joms.2024.06.165","url":null,"abstract":"<div><h3>Background</h3><div><span>Third molar (M3) extraction is a common surgery in oral and maxillofacial surgery, and composite </span>wound dressings such as hydroxybutyl chitosan (HBC) may improve postoperative sequala following M3 removal.</div></div><div><h3>Purpose</h3><div><span>The study purpose was to measure and compare differences in pain, swelling, trismus<span>, wound healing, and </span></span>quality of life (QOL) between the HBC and the control sides in patients undergoing M3 removal.</div></div><div><h3>Study Design, Setting, Sample</h3><div><span>This study is a double-blind, split-mouth, randomized clinical trial<span>. Patients who required M3 removal between June 2022 and May 2023 were included. Exclusion criteria included seafood allergies, smoking, poor </span></span>oral hygiene<span>, and systemic diseases.</span></div></div><div><h3>Predictor Variable</h3><div>The predictor variable was the socket treatment technique. Subjects were randomly assigned to the HBC or control (physiological saline) side.</div></div><div><h3>Main Outcome Variable</h3><div>The primary outcome variables, including pain assessed by visual analog scale, swelling, and maximal incisional opening, were measured on the first, third, and seventh postoperative days. The secondary outcome variables included QOL and wound healing score measured on the third and seventh days after surgery.</div></div><div><h3>Covariates</h3><div>The covariates included age, sex, and operation time.</div></div><div><h3>Analyses</h3><div><span>The Shapiro‒Wilk test was used to evaluate the normality of the data distribution. The paired t test or Wilcoxon signed-rank test was adopted. Statistical significance was set at </span><em>P</em> &lt; .05.</div></div><div><h3>Results</h3><div>The study included 60 patients (mean age: 25.81 ± 4.91; 23 (38%) males, 37 (62%) females). A statistically significant difference in the level of pain (HBC: 37.58 ± 4.39 mm, control: 47.00 ± 4.33 mm, day 1, <em>P</em> &lt; .001; 21.88 ± 3.25 mm, 35.95 ± 1.57 mm, day 3, <em>P</em> &lt; .001), maximal incisional opening (23.92 ± 1.38 mm, 18.22 ± 1.82 mm, day 1, <em>P</em> &lt; .001; 30.00 ± 1.61 mm, 23.78 ± 1.70 mm, day 3, <em>P</em> &lt; .001), and swelling (6.86 ± 0.70 mm, 7.15 ± 0.80 mm, day 3, <em>P</em> = .006) was detected after surgery. A statistically significant difference in QOL was detected (HBC: 13.70 ± 1.65, control: 18.60 ± 2.14, day 3, <em>P</em> &lt; .001).</div></div><div><h3>Conclusion and Relevance</h3><div>The application of HBC hydrogels to wounds after impacted mandibular M3 extraction reduces postoperative sequalae, promotes wound healing and improves postoperative QOL.</div></div>","PeriodicalId":16612,"journal":{"name":"Journal of Oral and Maxillofacial Surgery","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141544950","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"AAOMS Author Disclosure forms","authors":"","doi":"10.1016/S0278-2391(24)00716-X","DOIUrl":"10.1016/S0278-2391(24)00716-X","url":null,"abstract":"","PeriodicalId":16612,"journal":{"name":"Journal of Oral and Maxillofacial Surgery","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142358838","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reply: The Triple Threat: The Quintessential Goal of Faculty Development","authors":"","doi":"10.1016/j.joms.2024.06.160","DOIUrl":"10.1016/j.joms.2024.06.160","url":null,"abstract":"","PeriodicalId":16612,"journal":{"name":"Journal of Oral and Maxillofacial Surgery","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142358833","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patient-specific Implants Improve Volumetric Surgical Accuracy Compared to Stock Reconstruction Plates in Modern Paradigm Virtual Surgical Planning of Fibular Free Flaps for Head and Neck Reconstruction","authors":"","doi":"10.1016/j.joms.2024.06.166","DOIUrl":"10.1016/j.joms.2024.06.166","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;div&gt;Virtual surgical planning (VSP) for composite microvascular free flaps&lt;span&gt; has become standard of care for oncologic head and neck reconstruction. Controversy remains as to the use of three-dimensional (3D)-printed patient-specific titanium implants (PSIs) versus hand-bent stock reconstruction plates. Proponents of PSIs cite improved surgical accuracy, reduced operative times, and improved clinical outcomes. Detractors purport increased cost associated with PSIs and presumed equivalent accuracy with less expensive stock plates.&lt;/span&gt;&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Purpose&lt;/h3&gt;&lt;div&gt;The study purpose was to measure and compare the 3D-volumetric accuracy of PSI versus stock reconstruction plates among subjects undergoing VSP-guided mandibular fibular free flap reconstruction.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Study Design, Setting, Sample&lt;/h3&gt;&lt;div&gt;A retrospective cohort study of subjects undergoing VSP-guided fibular free flap reconstructions at Mayo Clinic between 2016 and 2023 was performed. Subjects were excluded for non-VSP guidance, midfacial reconstruction, nonfibular free flaps, and lack of requisite study variables.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Predictor Variable&lt;/h3&gt;&lt;div&gt;The primary predictor was the type of reconstruction plate utilized (PSI vs stock plate).&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Main Outcome Variable&lt;/h3&gt;&lt;div&gt;The main outcome was volumetric surgical accuracy of the final reconstruction compared to the preoperative surgical plan by root mean square error (RMSE) calculation. Lower RMSE values indicated a higher surgical accuracy.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Covariates&lt;/h3&gt;&lt;div&gt;Covariates included age, sex, race, smoking status, American Society of Anesthesiologists (ASA) Physical Status Classification System, Charlson Comorbidity Index, preoperative diagnosis, and number of fibular segments.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Analyses&lt;/h3&gt;&lt;div&gt;Differences in surgical accuracy were assessed between preoperative and postoperative segmented scans using volumetric overlays from which RMSE values were calculated. Univariate and multivariate modeling of plate type to RMSE calculation was performed. Statistical significance set to &lt;em&gt;P&lt;/em&gt; &lt; .05.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;Total of 130 subjects were identified, 105 PSI and 25 stock plates. Calculated mean RMSE in millimeters (mm) for stock plates was 1.46 (standard deviation: 0.33) and 1.15 (standard deviation: 0.36) for PSIs. Univariate modeling demonstrated a statistically significant difference in RMSE of 0.31 (95% confidence interval: 0.16-0.47) (&lt;em&gt;P&lt;/em&gt; &lt; .001) equating to a 21.2% (&lt;em&gt;P&lt;/em&gt; &lt; .001) improved volumetric surgical accuracy for PSIs. The association of improved volumetric accuracy with PSIs has been maintained in all multivariate models controlling for confounding.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusion and Relevance&lt;/h3&gt;&lt;div&gt;In modern era VSP-guided head and neck fibular free flap reconstruction, patient-specific 3D-printed titanium implants confer a statistically significant improvement ","PeriodicalId":16612,"journal":{"name":"Journal of Oral and Maxillofacial Surgery","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141563590","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Can a Low-Fidelity Arthroscopic Simulator Improve Technical Expertise in Performing Temporomandibular Joint Arthroscopy?","authors":"","doi":"10.1016/j.joms.2024.06.180","DOIUrl":"10.1016/j.joms.2024.06.180","url":null,"abstract":"<div><h3>Background</h3><div>Challenges in temporomandibular joint (TMJ) arthroscopy training include the cost of operating room time, surgical risks, and the accessibility of cadavers and high-fidelity simulators. A low-fidelity simulator (LFS) was developed for initial TMJ arthroscopy training.</div></div><div><h3>Purpose</h3><div>The aim of this study was to evaluate improvement in TMJ arthroscopic skills after training with an LFS using the Arthroscopic Surgical Skill Evaluation Tool (ASSET) global rating scale.</div></div><div><h3>Study Design, Setting, Sample</h3><div>A prospective randomized controlled study was conducted. Subjects included Oral and Maxillofacial Surgery residents in postgraduate year 1–5 at Thomas Jefferson University. Chief residents actively performing TMJ arthroscopy were excluded.</div></div><div><h3>Predictor Variable</h3><div>The predictor variable was participation in LFS training. Subjects were randomly assigned to the LFS training or no LFS training group.</div></div><div><h3>Main outcome Variables</h3><div>The primary outcome variable was simulated surgical skill measured by total ASSET score (maximum score of 35). The secondary outcome variables were simulated surgical skill measured by each ASSET domain score and time to completion.</div></div><div><h3>Covariates</h3><div>The covariates included sex, age, handedness, postgraduate year, endoscopic experience, open TMJ surgery experience, and experience with musical instruments and sports.</div></div><div><h3>Analyses</h3><div>Data analyses included paired <em>T</em>-tests to determine changes in outcome variables after TMJ arthroscopy training between experimental groups, and ANOVA and χ² tests to identify associations between covariates. Inter-rater reliability of the blinded examiners was evaluated using Cronbach's alpha correlation. A <em>P</em>-value &lt; .05 was considered significant.</div></div><div><h3>Results</h3><div>The sample was composed of 10 residents: 5 (100%) males in the no LFS group, 3 (60%) males, and 2 (40%) females in the LFS group (<em>P</em> = .4). There was no significant difference between the groups in pre-TMJ arthroscopy training ASSET scores (<em>P</em> = .3). After training, the total ASSET score improved by 3.40 ± 6.87 in the no LFS group and by 6.27 ± 2.68 in the LFS group (<em>P</em> = .03).</div></div><div><h3>Conclusions and Relevance</h3><div>Study results showed that low-fidelity simulation can improve fundamental arthroscopic skills. Future research should be conducted on a larger scale to further validate this model and show the transfer of skill improvements to cadaver and live patient settings.</div></div>","PeriodicalId":16612,"journal":{"name":"Journal of Oral and Maxillofacial Surgery","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141697014","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Artificial Intelligence in Medicine: Is Oral and Maxillofacial Surgery Following the Trend?","authors":"","doi":"10.1016/j.joms.2024.05.042","DOIUrl":"10.1016/j.joms.2024.05.042","url":null,"abstract":"","PeriodicalId":16612,"journal":{"name":"Journal of Oral and Maxillofacial Surgery","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142358840","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predicting the Future Focus of Orthognathic Surgery: Outcome-Driven Planning and Treatment With Function, Esthetics, and Occlusion as Key Indicators","authors":"","doi":"10.1016/j.joms.2024.06.168","DOIUrl":"10.1016/j.joms.2024.06.168","url":null,"abstract":"<div><div>As an international group of orthognathic surgeons, we believe the next big thing in orthognathic surgery will be a clinical and research focus on patient-oriented outcomes and improved quality of life. We expect to see advances in diagnosis and treatment planning, materials development, and patient management.</div></div>","PeriodicalId":16612,"journal":{"name":"Journal of Oral and Maxillofacial Surgery","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141563571","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"RE: “Ultrasound-Guided Suprazygomatic Maxillary Nerve Block Is Effective in Reducing Postoperative Opioid Use Following Bimaxillary Osteotomy”","authors":"","doi":"10.1016/j.joms.2024.05.043","DOIUrl":"10.1016/j.joms.2024.05.043","url":null,"abstract":"","PeriodicalId":16612,"journal":{"name":"Journal of Oral and Maxillofacial Surgery","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142358834","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Are Radiographic Changes in the Mandibular Canal Associated With Bone Mineral Density?","authors":"","doi":"10.1016/j.joms.2024.06.167","DOIUrl":"10.1016/j.joms.2024.06.167","url":null,"abstract":"<div><h3>Background</h3><div>Osteoporosis, highly prevalent among postmenopausal women, significantly reduces bone density and increases the risk of fractures. Cortical bone, which constitutes the largest calcium deposit in the human skeleton, is primarily affected in various conditions, including osteoporosis. Due to its visibility in panoramic radiography, the cortical area of the mandibular canal could be valuable in assessing decreases in bone mineral density (BMD).</div></div><div><h3>Purpose</h3><div>The study aimed to characterize and compare changes in the cortices of the mandibular canal between normal, osteopenic, and osteoporotic postmenopausal women.</div></div><div><h3>Study Design, Setting, Sample</h3><div>Our cross-sectional study analyzed postmenopausal patients. We included only patients with panoramic radiographs with good quality and who underwent osteoporosis risk assessment by dual-energy x-ray absorptiometry (DXA).</div></div><div><h3>Independent Variable</h3><div>BMD was measured by DXA at 3 sites (spine, femur, and forearm) and used to classify the patients into normal, osteopenic, or osteoporotic. This classification remained consistent across all measurement sites.</div></div><div><h3>Main Outcome Variable</h3><div>The main outcome variable was BMD of the mandibular canal cortices measured using black pixel intensity.</div></div><div><h3>Covariates</h3><div>Demographic covariates, including age, weight, height, and BMD, were assessed.</div></div><div><h3>Analyses</h3><div>One-way analysis of variance between groups considering a <em>P</em> &lt; .05. The relationship between covariates and dependent variables was assessed using the Pearson correlation test.</div></div><div><h3>Results</h3><div>The sample comprised 52 postmenopausal women aged more than 40 years (mean age 61 ± 10 years), 26 (50%) normal, 18 (35%) osteopenic, and 8 (15%) osteoporotic. Significant differences were observed in the percentage of black pixels in the mandibular ramus between the groups. In this region, the average percentage of black pixels was 3.19% (± 0.65) for the normal group, 2.78% (± 0.65) for the osteopenia group, and 2.35% (± 0.65) for the osteoporosis group (<em>P</em> = .015). No significant differences were found in other mandibular regions.</div></div><div><h3>Conclusion and Relevance</h3><div>Our findings demonstrate an association between BMD assessed in the mandibular canal cortex and the presence of osteoporosis as determined by DXA. While the observed differences in black pixel percentages in the mandibular ramus are minor, they are statistically significant, suggesting that panoramic radiography may serve as an adjunctive tool for osteoporosis screening.</div></div>","PeriodicalId":16612,"journal":{"name":"Journal of Oral and Maxillofacial Surgery","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141603774","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Editorial Board Page","authors":"","doi":"10.1016/S0278-2391(24)00714-6","DOIUrl":"10.1016/S0278-2391(24)00714-6","url":null,"abstract":"","PeriodicalId":16612,"journal":{"name":"Journal of Oral and Maxillofacial Surgery","volume":null,"pages":null},"PeriodicalIF":2.3,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142358836","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}