Journal of Oral and Maxillofacial Surgery最新文献

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IF 2.6 3区医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE

Journal of Oral and Maxillofacial Surgery

Pub Date : 2026-02-01 DOI: 10.1016/S0278-2391(25)00961-9

引用次数: 0

Do You Recycle? 你会回收吗？

IF 2.6 3区医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE

Journal of Oral and Maxillofacial Surgery

Pub Date : 2026-02-01 DOI: 10.1016/j.joms.2025.11.004

Tara Aghaloo DDS, MD, PhD

引用次数: 0

Advanced Standing Oral and Maxillofacial Surgery Curriculum for MD Applicants: University of Tennessee Knoxville Program 高级口腔颌面外科医学博士申请者课程：田纳西大学诺克斯维尔计划

IF 2.6 3区医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE

Journal of Oral and Maxillofacial Surgery

Pub Date : 2026-02-01 DOI: 10.1016/j.joms.2025.07.018

Bruce Zhang DMD , Benjamin Kim MD, DMD , Michael L. Winstead DMD, MD, MBA , Eric R. Carlson DMD, MD, EdM

引用次数: 0

REPLY: Does Suction Catheter-Guided Nasotracheal Intubation Reduce Nasal Bleeding? 吸痰导管引导下的鼻气管插管是否能减少鼻出血？

IF 2.6 3区医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE

Journal of Oral and Maxillofacial Surgery

Pub Date : 2026-02-01 DOI: 10.1016/j.joms.2025.09.024

Duangdee Rummasak MD, Pattamon Leelachaikul DDS, Thepharat Lertwisettheerakun MD, Jirayus Akaraprasertkul MD

引用次数: 0

RE: “Does Suction Catheter-Guided Nasotracheal Intubation Reduce Nasal Bleeding?” RE：“吸管引导下的鼻气管插管能减少鼻出血吗？”

IF 2.6 3区医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE

Journal of Oral and Maxillofacial Surgery

Pub Date : 2026-02-01 DOI: 10.1016/j.joms.2025.09.023

Akshay Govind DMD, MD, MPH

引用次数: 0

Is Intraoperative Flap Perfusion a Predictive Factor for Postoperative Flap Revision of Anterolateral Thigh Flaps and Fibula Free Flaps in Microvascular Head and Neck Reconstruction? 术中皮瓣灌注是微血管头颈部重建中大腿前外侧皮瓣和腓骨游离皮瓣术后皮瓣翻修的预测因素吗？

IF 2.6 3区医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE

Journal of Oral and Maxillofacial Surgery

Pub Date : 2026-02-01 DOI: 10.1016/j.joms.2025.10.011

Mark Ooms MD, DMD, PhD , Philipp Winnand MD, DMD , Marius Heitzer MD, DMD, PhD , Johannes Bickenbach MD, PhD , Frank Hölzle MD, DMD, PhD , Ali Modabber MD, DMD, PhD

Background

The prediction of postoperative flap revision by intraoperative flap perfusion measurement in microvascular head and neck reconstruction could improve postoperative flap monitoring.

Purpose

The study purpose was to measure the association between intraoperative flap perfusion and postoperative flap revision.

Study Design, Setting, Sample

This study was conducted as a retrospective cohort study at the Department of Oral and Maxillofacial Surgery at the University Hospital RWTH Aachen, Germany. The sample was composed of subjects reconstructed with anterolateral thigh flaps or fibula free flaps in the head and neck region between 2011 and 2022. Exclusion criteria were an age below 18 years, incomplete data records, and flap revision within 12 hours postoperatively.

Predictor Variable

The predictor variable was flap perfusion measured intraoperatively as blood flow, hemoglobin concentration, and hemoglobin oxygen saturation.

Main Outcome Variable

The main outcome variable was postoperative flap revision coded as yes or no.

Covariates

Covariates were sex, age, flap type, flap ischemia duration, mean arterial blood pressure, and catecholamine dose.

Analyses

Covariates were compared for perfusion parameters by Mann–Whitney test. Subjects with and without flap revision were compared for covariates by χ² test or Mann–Whitney test and for perfusion parameters by Mann–Whitney test and multivariable regression analysis, and cut-off values for predicting flap revision were determined using receiver operating characteristics. P > .05 was considered significant.

Results

The sample (median age 66 [interquartile range 18] years) was composed of 239 (93%) subjects without and 18 (7%) subjects with flap revision. Blood flow at 8 mm and hemoglobin oxygen saturation at 2 mm tissue depth were lower, and hemoglobin concentration at 8 mm tissue depth was higher in subjects with flap revision (P = .008; P = .030; P = .001). The cut-off values for blood flow, hemoglobin oxygen saturation, and hemoglobin concentration for predicting flap revision were <76.5 arbitrary units, <64.5%, and >34.5 arbitrary units (area under the curve 0.687, 0.653, 0.728; P = .10, P = .014, P < .001; sensitivity 72, 89, 83%; specificity 70, 44, 53%; positive predictive value 15, 11, 12%; negative predictive value 97, 98, 98%).

Conclusion and Relevance

Intraoperative flap perfusion was associated with postoperative flap revision related to cut-off values (highest predictive accuracy for blood flow). Prospective confirmatory studies are necessary.

背景：微血管头颈部重建术中皮瓣灌注测量预测术后皮瓣翻修，可改善术后皮瓣监测。目的：探讨术中皮瓣灌注与术后皮瓣翻修的关系。研究设计、环境、样本：本研究是在德国亚琛工业大学医院口腔颌面外科进行的回顾性队列研究。样本由2011年至2022年间在头颈部区域使用大腿前外侧皮瓣或腓骨游离皮瓣重建的受试者组成。排除标准为年龄小于18岁，资料记录不完整，术后12小时内皮瓣修复。预测变量：预测变量为术中测量的皮瓣灌注，如血流量、血红蛋白浓度和血红蛋白氧饱和度。主要结果变量：主要结果变量为术后皮瓣翻修，编码为“是”或“否”。协变量：性别、年龄、皮瓣类型、皮瓣缺血时间、平均动脉血压、儿茶酚胺剂量。分析：采用Mann-Whitney检验比较灌注参数的协变量。采用χ2检验或Mann-Whitney检验比较进行皮瓣修复的受试者和未进行皮瓣修复的受试者的协变量，采用Mann-Whitney检验和多变量回归分析比较灌注参数，并利用受试者工作特征确定预测皮瓣修复的截止值。P > .05被认为是显著的。结果：样本（中位年龄66 [IQR 18]岁）由239例（93%）未做皮瓣修补者和18例（7%）做皮瓣修补者组成。皮瓣修复组8 mm血流量和2 mm组织深度血红蛋白氧饱和度较低，8 mm组织深度血红蛋白浓度较高（P = 0.008; P = 0.030; P = 0.001）。预测皮瓣修复的血流量、血红蛋白氧饱和度和血红蛋白浓度的临界值为34.5任意单位（曲线下面积0.687、0.653、0.728;P = 0.10、P = 0.014, P < 0.001；敏感性72、89、83%；特异性70、44、53%；PPV 15、11、12%;NPV 97、98、98%）。结论及相关性：术中皮瓣灌注与术后皮瓣翻修相关，与截断值相关（血流预测精度最高）。前瞻性确证研究是必要的。

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引用次数: 0

February 2026 AAOMS News and Announcements 2026年2月AAOMS新闻和公告

IF 2.6 3区医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE

Journal of Oral and Maxillofacial Surgery

Pub Date : 2026-02-01 DOI: 10.1016/j.joms.2025.11.009

引用次数: 0

Artificial Intelligence and Statistical Analysis in Oral and Maxillofacial Surgery Research: An Ally, Not a Replacement 人工智能和统计分析在口腔颌面外科研究：盟友，而不是替代品

IF 2.6 3区医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE

Journal of Oral and Maxillofacial Surgery

Pub Date : 2026-02-01 DOI: 10.1016/j.joms.2025.07.019

Lang Liang , Huan Liang MS , Daniel D. Choi DDS, MD , Sung-Kiang Chuang DMD, MD, DMSc

引用次数: 0

Does Lateral Pterygoid Muscle Reattach After Ramus-Condyle Unit Reconstruction in Temporomandibular Joint Ankylosis Patients? 颞下颌关节强直患者行支髁单元重建后外侧翼状肌能重新附着吗？

IF 2.6 3区医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE

Journal of Oral and Maxillofacial Surgery

Pub Date : 2026-02-01 DOI: 10.1016/j.joms.2025.10.001

Kamalpreet Kaur MDS , Ongkila Bhutia MDS , Smita Manchanda MD , Ashu Seith Bhalla MD , Rahul Yadav MDS , Krushna Bhatt MDS , Ajoy Roychoudhury MDS

<div><h3>Background</h3><div>The removal of ankylotic bone requires detachment of lateral pterygoid muscle (LPM) from the ankylosed condyle. Whether spontaneous reattachment of LPM occurs or not following autogenous ramus-condyle unit (RCU) reconstruction in temporomandibular joint ankylosis (TMJA) is not yet known.</div></div><div><h3>Purpose</h3><div>The study purpose was to measure and compare the incidence of spontaneous LPM reattachment following 2 RCU reconstruction techniques-costochondral graft (CCG) and transport disc distraction osteogenesis (TDDO) and its implications on postoperative jaw motion.</div></div><div><h3>Study design, setting, sample</h3><div>A double-blind randomized clinical trial was implemented. Pediatric TMJA patients aged 3 to 16 years who consented for ankylosis release and RCU reconstruction were included. Patients were excluded if they had diagnosis other than TMJA, had bilateral/recurrent TMJA, underwent RCU reconstruction using modality other than CCG or TDDO, or did not give consent to come for follow-up/participate in this study.</div></div><div><h3>Predictor variable</h3><div>The primary predictor variable was the RCU reconstruction method (CCG or TDDO).</div></div><div><h3>Outcome variable</h3><div>Primary outcome variables included the presence (yes/no) and anatomical site of LPM reattachment. Secondary outcomes were anatomic (reconstituted condyle formed, volume of LPM, temporalis muscle reattachment and its site) and functional (laterotrusion and maximal interincisal opening).</div></div><div><h3>Covariates</h3><div>The covariates included demographics (age, sex) and perioperative (ankylosis classification, etiology, magnetic resonance imaging evaluation time).</div></div><div><h3>Analyses</h3><div>Nonparametric continuous variables were analyzed using the Wilcoxon rank-sum test, categorical variables with the χ<sup>2</sup> test, and within-group comparisons using the signed-rank test. A <em>P</em> value <.05 was considered statistically significant.</div></div><div><h3>Results</h3><div>The study sample had 12 subjects (median age = 11.5 years (interquartile range (IQR) = 4.5); M:F = 7:5). RCU reconstruction was done with CCG (n = 5 (41.7%)) or TDDO (n = 7 (58.3%)). On magnetic resonance imaging evaluation at median 237 days, the LPM (n = 12/12,100%) and temporalis muscles (n = 11/11,100%) showed spontaneous reattachment. Different sites of LPM reattachment were noticed, ie, on reconstituted condyle neck [n = 3 (25%),CCG = 1 (20%),TDDO = 2 (28.6%)], on reconstituted condyle head [n = 4 (33.3%),CCG = 1 (20%),TDDO = 3 (42.9%); no resorption], and on ramal cut surface [n = 5 (41.7%),CCG = 3 (60%),TDDO = 2 (28.6%) (<em>P</em> = .8)], with lower ipsilateral side volume. At 3 years follow-up, an improvement in median maximal interincisal opening (Preoperative = 9.5 mm (IQR = 2.5),Follow-up = 35 mm (IQR = 6), (<em>P</em> = .002)) and laterotrusion (Ipsilateral:Preoperative = 3 mm (IQR = 10),Follow-up = 10 mm (

背景：移除强直性骨需要从强直性髁上剥离外侧翼状肌（LPM）。颞下颌关节强直（TMJA）患者自体支髁单元（RCU）重建后，LPM是否会自发再附着尚不清楚。目的：研究目的是测量和比较2种RCU重建技术-肋软骨移植（CCG）和运输盘牵张成骨（TDDO）后自发性LPM再附着的发生率及其对术后颌骨运动的影响。研究设计、环境、样本：采用双盲随机临床试验。本研究纳入了3 - 16岁同意解除强直和RCU重建的儿童TMJA患者。排除除TMJA以外的诊断，双侧/复发性TMJA，采用CCG或TDDO以外的方式进行RCU重建，或不同意来随访/参与本研究的患者。预测变量：主要预测变量为RCU重建方法（CCG或TDDO）。结果变量：主要结果变量包括LPM再附着的存在（是/否）和解剖位置。次要结果是解剖（重建髁形成，LPM的体积，颞肌再附着及其位置）和功能（侧突和最大切开口）。协变量：协变量包括人口统计学（年龄、性别）和围手术期（强直分类、病因、磁共振成像评估时间）。分析：非参数连续变量采用Wilcoxon秩和检验，分类变量采用χ2检验，组内比较采用符号秩检验。结果：研究样本有12名受试者，年龄中位数= 11.5岁（四分位数间距(IQR) = 4.5）；M: f = 7:5)。用CCG （n = 5(41.7%)）或TDDO （n = 7(58.3%)）重建RCU。在中位237天的磁共振成像评估中，LPM （n = 12/ 12100%）和颞肌（n = 11/ 11100 %）显示自发再附着。LPM再植部位不同，即重建髁颈[n = 3 (25%),CCG = 1 (20%),TDDO = 2(28.6%)]，重建髁头[n = 4 (33.3%),CCG = 1 (20%),TDDO = 3 (42.9%)]；无吸收]，在侧颊切面[n = 5 (41.7%),CCG = 3 (60%),TDDO = 2 (28.6%) (P = 0.8)]，同侧体积较小。在3年的随访中，中位最大切牙开口(术前= 9.5 mm (IQR = 2.5)，随访= 35 mm (IQR = 6), （P = 0.002）和侧突(同侧：术前= 3 mm (IQR = 10)，随访= 10 mm (IQR = 5), （P = .9）有所改善；对侧：术前：0 mm (IQR = 0)，随访：2 mm (IQR = 5), （P = 0.01）。结论及意义：LPM可自发再附着，改善侧突。再附着部位在髁突和冠状骨重建中起着重要作用。

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引用次数: 0

Is Patient-Specific Hardware for Orthognathic Surgery More Frequently Removed Than Stock Plates? 在正颌手术中，患者专用的植入物比普通钢板移除的频率更高吗？

IF 2.6 3区医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE

Journal of Oral and Maxillofacial Surgery

Pub Date : 2026-02-01 DOI: 10.1016/j.joms.2025.10.009

Si Kun Wang BS , Michael C. Britt BS , Lisa Nussbaum MS, MBA , Cory M. Resnick DMD, MD , Bonnie L. Padwa DMD, MD , Mark A. Green DDS, MD

Background

Patient-specific implants (PSIs) offer predictability, accuracy, and ease of use, but their removal requirements after orthognathic surgery are unclear. Removing hardware has both a health care cost and negative impact on patients.

Purpose

The purpose of this study was to compare hardware removal between orthognathic fixation with either PSIs or stock plates and identify risk factors associated with removal.

Study design, setting, sample

This retrospective cohort study included patients with skeletal malocclusion who underwent orthognathic surgery with plate fixation between 2008 and 2024 at Boston Children's Hospital. Patients with less than 3 months of follow-up or incomplete records were excluded.

Predictor variable

The primary predictor variable was the type of hardware used (PSI vs stock).

Outcome variable

The primary outcome was time from plate fixation to plate removal.

Covariates

Covariates included age, sex, presence of cleft lip/palate, procedure type and length, ancillary procedures during the same anesthetic, presence of postoperative malocclusion, hardware lifespan, reason for removal, and plate location.

Analyses

Independent samples t tests, tests of medians, χ² tests, and Fisher exact tests were used to evaluate sample characteristics. Kaplan-Meier analyses and Cox proportional hazards were used to generate hazard ratios. P values of less than .05 were significant.

Results

The sample included 675 subjects with a mean age of 19.40 years (standard deviation (SD) = 3.29) and 47.9% (n = 323) males. Overall, 8.6% (n = 58) required plate removal, and PSIs were removed more frequently than stock plates (12.8% (n = 33) vs 6.0% (n = 25), respectively, P = .002; unadjusted HR = 3.99, 95% confidence interval (CI): (2.30, 6.93), P < .001). After adjusting for procedure type, ancillary procedures, and postoperative malocclusion, PSIs were associated with a risk of plate removal 8.82 (95% confidence interval (CI): (4.27, 18.20), P < .001) times that of the stock group. Procedure type, procedure length, ancillary procedures during the same anesthetic, and postoperative malocclusion were also associated with removal. The most common reasons for removal included a future procedure and infection, with no difference between cohorts.

Conclusions and relevance

PSIs were associated with an increased risk for hardware removal compared to stock plates for subjects who underwent orthognathic surgery. The benefits and risks of PSIs should be weighed and clinical judgment exercised accordingly.

背景：患者特异性种植体（psi）具有可预测性、准确性和易用性，但其在正颌手术后的移除要求尚不清楚。移除硬件不仅会增加医疗成本，还会对患者产生负面影响。目的：本研究的目的是比较正颌内固定与PSIs或钢板内固定之间的内固定拆除，并确定与拆除相关的危险因素。研究设计、背景、样本：这项回顾性队列研究包括2008年至2024年间在波士顿儿童医院接受正颌手术钢板固定的骨骼错颌患者。随访时间少于3个月或记录不完整的患者排除在外。预测变量：主要预测变量是使用的硬件类型（PSI vs库存）。结局变量：主要结局为从钢板固定到取出钢板的时间。协变量：协变量包括年龄、性别、唇裂/腭裂的存在、手术类型和长度、同一麻醉期间的辅助手术、术后错颌的存在、硬体使用寿命、取出原因和钢板位置。分析：采用独立样本t检验、中位数检验、χ2检验和Fisher精确检验评价样本特征。Kaplan-Meier分析和Cox比例风险用于产生风险比。P值小于。0.05有显著性差异。结果：样本包括675名受试者，平均年龄19.40岁（标准差(SD) = 3.29），男性占47.9% （n = 323）。总体而言，8.6% （n = 58）的患者需要取板，而psi的取板频率高于stock plate(分别为12.8% （n = 33）和6.0% (n = 25), P = 0.002；未经调整的HR = 3.99, 95%可信区间（CI）：（2.30, 6.93）， P < 0.001)。在调整手术类型、辅助手术和术后错牙合后，PSIs与钢板取出风险的相关性是普通组的8.82倍（95%可信区间（CI）：（4.27, 18.20）， P < 0.001）。手术类型、手术时间、相同麻醉期间的辅助手术和术后错颌畸形也与拔除有关。最常见的切除原因包括未来的手术和感染，在队列之间没有差异。结论和相关性：接受正颌手术的患者，与普通钢板相比，psi与硬体取出的风险增加有关。应权衡psi的益处和风险，并据此进行临床判断。

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