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RE: Aromatherapy on Anxiety, Pain, and Quality of Life Following Surgery of Mandibular Third Molars: A Randomized, Double-Blind Clinical Trial 芳香疗法对下颌第三磨牙术后焦虑、疼痛和生活质量的影响:一项随机、双盲临床试验
IF 2.6 3区 医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2026-01-01 DOI: 10.1016/j.joms.2025.07.017
Deepak Bangera MD (Naturopathy), Deenadayalan Boopalan MD (Naturopathy), N.V. Gnana Deep Tatavarti MD (Naturopathy), Raghavendra Rao Mohan PhD (Yoga and Life Sciences)
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引用次数: 0
Does Reiki Therapy ReducePreoperative Anxiety and Postoperative Pain in Third Molar Surgery? A Randomized Controlled Trial 灵气疗法能减轻第三磨牙手术的术前焦虑和术后疼痛吗?随机对照试验。
IF 2.6 3区 医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2026-01-01 DOI: 10.1016/j.joms.2025.09.003
Meltem Ozden Yuce PhD , Birant Simsek PhD , Omer Faruk Dadas PhD , Candan Efeoglu PhD

Background

Preoperative anxiety in patients undergoing third molar extraction can influence pain perception. Limited evidence suggests Reiki therapy may help manage anxiety and pain, but its effectiveness in dentistry is unclear.

Purpose

This study evaluated whether Reiki therapy reduces preoperative anxiety and postoperative pain in third molar surgery.

Study Design

A single-blind randomized controlled trial was conducted at the Ege University Faculty of Dentistry (İzmir, Türkiye) between March 2021 and February 2023. Participants were 18 to 45 years old, in good general health, with mandibular Class II-B impaction (Pell and Gregory classification), and no prior third molar extraction or Reiki therapy. Exclusion criteria included systemic disease, pregnancy, acute infection, pathological lesions, use of anxiolytic/antidepressant drugs, and inability to provide consent.

Predictor Variable

The predictor variable was the type of preoperative intervention. Participants were randomly assigned to 1 of 3 conditions: Reiki therapy, sham Reiki, or no intervention.

Main Outcome Variable

Primary outcomes were preoperative anxiety [State-Trait Anxiety Inventory I, State-Trait Anxiety Inventory II, and Beck Anxiety Inventory] and postoperative pain [visual analog scale over 7 days]. Analgesic use during the first postoperative week was recorded.

Covariates

Covariates included sex, baseline anxiety scores, surgery duration, and the quantity/timing of additional analgesic intake in the first postoperative week.

Analyses

Nonparametric tests were used with R software. The Brunner–Langer model assessed group differences in anxiety, pain, and analgesic use. Kruskal–Wallis and Wilcoxon signed-rank tests compared intergroup and intragroup outcomes (P < .05 considered significant).

Results

The sample included 180 participants (mean age 27.4 ± 6.1 years). Randomization resulted in an equal distribution of males and females across the groups. Reiki therapy did not significantly reduce preoperative anxiety (mean State-Trait Anxiety Inventory I: 36.6 ± 10.0; P = .079) compared with sham Reiki (40.1 ± 10.1) and no intervention (40.8 ± 10.8). Postoperative pain scores were significantly lower in the Reiki group (mean 2.7 ± 1.8) compared with sham Reiki (3.0 ± 1.7) and no intervention (3.5 ± 1.9) (P = .045).

Conclusion and Relevance

Reiki therapy did not reduce preoperative anxiety but was associated with lower postoperative pain. Further trials are warranted to clarify its role in oral and maxillofacial surgery.
背景:第三磨牙拔牙患者术前焦虑会影响疼痛感知。有限的证据表明灵气疗法可能有助于控制焦虑和疼痛,但其在牙科方面的有效性尚不清楚。目的:本研究评估灵气疗法是否能减轻第三磨牙手术的术前焦虑和术后疼痛。研究设计:一项单盲随机对照试验于2021年3月至2023年2月在埃格大学牙科学院(İzmir, t rkiye)进行。参与者年龄在18到45岁之间,总体健康状况良好,下颌II-B类嵌塞(Pell和Gregory分类),之前没有第三磨牙拔牙或灵气治疗。排除标准包括全身性疾病、妊娠、急性感染、病理病变、使用抗焦虑/抗抑郁药物以及无法提供同意。预测变量:预测变量为术前干预类型。参与者被随机分配到三种情况中的一种:灵气治疗、假灵气治疗或不干预。主要结局变量:主要结局为术前焦虑[状态-特质焦虑量表I、状态-特质焦虑量表II和贝克焦虑量表]和术后疼痛[超过7天的视觉模拟量表]。记录术后第一周镇痛药的使用情况。协变量:协变量包括性别、基线焦虑评分、手术持续时间和术后第一周额外止痛药摄入的数量/时间。分析:采用R软件进行非参数检验。布鲁纳-兰格模型评估各组在焦虑、疼痛和止痛药使用方面的差异。Kruskal-Wallis和Wilcoxon符号秩检验比较组间和组内结果(P < 0.05认为显著)。结果:共纳入受试者180人,平均年龄27.4±6.1岁。随机化的结果是在各组中男性和女性的分布是相等的。与假灵气(40.1±10.1)和无干预(40.8±10.8)相比,灵气治疗没有显著降低术前焦虑(平均状态-特质焦虑量表I: 36.6±10.0;P = 0.079)。灵气组术后疼痛评分(平均2.7±1.8)明显低于假灵气组(平均3.0±1.7)和未干预组(平均3.5±1.9)(P = 0.045)。结论及相关性:灵气疗法不能减轻术前焦虑,但能降低术后疼痛。需要进一步的试验来阐明其在口腔外科中的作用。
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引用次数: 0
Can Evoked Electromyography Detect Postoperative Facial Nerve Recovery Earlier Than Grading Scales Following Temporomandibular Joint Ankylosis Surgery? 诱发肌电图能比分级法更早地检测颞下颌关节强直术后面神经恢复吗?
IF 2.6 3区 医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2026-01-01 DOI: 10.1016/j.joms.2025.09.018
Abiskar Basnet MDS , Saurabh Simre MDS , Ashi Chug MDS, PhD , Prem Kumar Rathod MDS , Aparna Mahajan BDS , Poorvi Kulshrestha MD

Background

Facial nerve (FN) dysfunction is a potential postoperative complication of managing temporomandibular joint ankylosis (TMJa).

Purpose

The purpose of this study was to determine whether evoked electromyography (EEMG) detects postoperative FN function (FNF) recovery earlier than House-Brackmann scale (HBS) and Sunnybrook scale (SBS) following TMJa surgery.

Study Design, Setting, Sample

A prospective, single tertiary-care center cohort study was conducted at All India Institute of Medical Sciences, Rishikesh from October 2022 to April 2024. Patients with unilateral TMJa aged above 12 years were included. Exclusion criteria were previous surgery of parotid/temporomandibular joint, preexisting FN palsy, neuromuscular disorders, syndromic patients.

Predictor Variable

The primary predictor variable was FNF recovery monitoring tool (EEMG vs HBS vs SBS).

Main Outcome Variables

The primary outcome variable was FNF recovery time. This was recorded postoperatively at defined time-points (1 week-T1, 1 month-T2, 3 months-T3, 6 months-T4).

Covariates

Covariates included age, sex, and operative time.

Analysis

Data were analyzed using SPSSversion20. Frequencies (percentages) were compared using χ2 and Fisher's exact tests. Kaplan–Meier survival analysis and Cox-regression were used to assess recovery hazards, adjusting for covariates with level of statistical significance set at P < .05.

Results

The sample composed of 65 subjects of unilateral TMJa undergoing surgery. The mean age was 20.13 ± 7.58 years and included 27 females (42%) and 38 males (58%). Iatrogenic FN injury occurred in 15 (23%) cases. The median time to detect FNF recovery by EEMG was 6 weeks (interquartile range [IQR] 3 to 12) versus HBS 15 weeks [IQR 11 to 19] versus SBS 18 weeks [IQR 13 to 20] which was statistically significant favoring EEMG (95% CI, P < .05). Complete recovery of FNF was noted in all 15 cases. The chance of early detection of recovery by EEMG was 32% greater than with HBS and SBS (hazard ratio: 1.32, 95% CI, 1.02 to 1.72, P < .05).

Conclusion and Relevance

EEMG detects FNF recovery earlier than grading scales, and is a valid electrodiagnostic test for postoperative monitoring.
背景:面神经功能障碍是处理颞下颌关节强直(TMJa)的潜在术后并发症。目的:探讨诱发肌电图(EEMG)是否比House-Brackmann量表(HBS)和Sunnybrook量表(SBS)更早检测TMJa术后FN功能(FNF)恢复。研究设计、环境、样本:2022年10月至2024年4月,在瑞希凯什全印度医学科学研究所进行了一项前瞻性、单一三级保健中心队列研究。包括年龄在12岁以上的单侧TMJa患者。排除标准为腮腺/颞下颌关节既往手术、既往FN性麻痹、神经肌肉疾病、综合征患者。预测变量:主要预测变量为FNF恢复监测工具(EEMG vs HBS vs SBS)。主要结局变量:FNF恢复时间为主要结局变量。在术后确定的时间点(1周- t1, 1个月- t2, 3个月- t3, 6个月- t4)记录这些数据。协变量:协变量包括年龄、性别、手术时间。分析:使用SPSSversion20对数据进行分析。使用χ2和Fisher精确检验比较频率(百分比)。采用Kaplan-Meier生存分析和cox -回归评估恢复风险,校正协变量,P < 0.05为统计学显著性水平。结果:本组共65例单侧颞下颌关节受术者。平均年龄20.13±7.58岁,其中女性27例(42%),男性38例(58%)。医源性FN损伤15例(23%)。EEMG检测FNF恢复的中位时间为6周(四分位数范围[IQR] 3至12),HBS为15周[IQR 11至19],SBS为18周[IQR 13至20],EEMG具有统计学意义(95% CI, P < 0.05)。所有15例FNF均完全恢复。EEMG早期发现恢复的机会比HBS和SBS高32%(风险比:1.32,95% CI: 1.02 ~ 1.72, P < 0.05)。结论及相关性:脑电图比分级法更早发现FNF恢复,是一种有效的术后监测电诊断方法。
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引用次数: 0
AAOMS Author Disclosure forms 作者披露表
IF 2.6 3区 医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2026-01-01 DOI: 10.1016/S0278-2391(25)00886-9
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引用次数: 0
January 2026 AAOMS News and Announcements 2026年1月AAOMS新闻和公告
IF 2.6 3区 医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2026-01-01 DOI: 10.1016/j.joms.2025.10.005
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引用次数: 0
Federal Student Loan Changes Uniquely Impact 6-Year Oral and Maxillofacial Surgery Residents 联邦学生贷款变化对口腔颌面外科6年制住院医师的独特影响
IF 2.6 3区 医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2026-01-01 DOI: 10.1016/j.joms.2025.07.016
Clark D. Morgan , Samat T. Borbiev , Zachary S. Peacock DMD, MD
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引用次数: 0
Patterns of Recurrence and Oncologic Outcomes After Maxillectomy: Does Reconstructive Modality Matter? 上颌切除术后的复发模式和肿瘤预后:重建方式重要吗?
IF 2.6 3区 医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2026-01-01 DOI: 10.1016/j.joms.2025.09.021
Cameron Lee DMD, MD , Salim Abdul Wasay DDS , Glyndwr Jenkins BChD, MBBS , Kelly Moyer MD , Kyle Hatten MD , Jeffrey S. Wolf MD , Rodney Taylor MD, MSPH , Joshua Lubek DDS, MD , Donita Dyalram DDS, MD

Background

Reconstruction following maxillectomy for oral cavity malignancies is essential for restoring form and function. Obturator reconstruction facilitates direct visualization of the surgical bed, whereas flap-based reconstructions may obscure sites of potential recurrence. This has raised concern that reconstructive modality could influence the timeliness of recurrence detection, and subsequently, oncologic outcomes.

Purpose

The purpose of this study was to measure the association between reconstructive modality and time to detection of local recurrence and survival outcomes.

Study design, setting sample

This was a retrospective cohort study of all patients undergoing maxillectomy for an oral cavity malignancy at the University of Maryland between 2016 and 2024. Patients previously undergoing maxillectomy were excluded.

Predictor variable

The predictor was reconstructive modality: obturator versus native tissue reconstruction (local, regional, or free flap).

Main outcome variable

The primary outcome was local disease-free survival. Secondary outcomes included overall survival, method of recurrence detection (clinical vs radiographic), and resectability of recurrence.

Covariates

Covariates were categorized into demographic (age, sex), perioperative (Brown classification), and pathologic (margin status, tumor stage).

Analyses

Descriptive statistics were computed for study variables. Associations between study covariates and time to local recurrence were evaluated using bivariate Cox proportional hazards models.

Results

The cohort was composed of 154 subjects with a mean age of 66.5 ± 14.9 years and 90 were male (58.4%). Fifty subjects (32.5%) underwent obturator reconstruction and 104 (67.5%) underwent reconstruction with native tissue (75% free flap). Reconstructive modality was not associated with local disease-free survival (P = .9), method of detection (P = .4), or overall survival (P = .3). Local recurrence occurred in 41 subjects (26.6%), with 14 (34.1%) in the obturator group compared to 27 (65.9%) in native tissue (P = .7). The median time to local recurrence was 7.7 months (interquartile range 26.2 months). Most recurrences (75.6%) were detected clinically. Subgroup analysis of Brown 2 defects confirmed the similar findings.

Conclusions and relevance

Reconstructive modality was not associated with delayed detection of local recurrence or worse survival outcomes following maxillectomy for oral cavity malignancies.
背景:口腔恶性肿瘤上颌切除术后重建是恢复口腔形态和功能的必要条件。闭孔重建有助于手术床的直接可视化,而皮瓣重建可能会模糊潜在复发的部位。这引起了人们的关注,即重建方式可能会影响复发检测的及时性,并随后影响肿瘤预后。目的:本研究的目的是测量重建方式与局部复发检测时间和生存结果之间的关系。研究设计,设定样本:这是一项回顾性队列研究,纳入了2016年至2024年间马里兰大学所有因口腔恶性肿瘤接受上颌切除术的患者。既往行上颌切除术的患者排除在外。预测变量:预测因子是重建方式:闭孔与原生组织重建(局部、区域或自由皮瓣)。主要结局变量:主要结局为局部无病生存。次要结果包括总生存、复发检测方法(临床与放射学)和复发可切除性。协变量:协变量分为人口学(年龄、性别)、围手术期(Brown分类)和病理(边缘状态、肿瘤分期)。分析:对研究变量进行描述性统计。使用双变量Cox比例风险模型评估研究协变量与局部复发时间之间的关联。结果:研究对象154人,平均年龄66.5±14.9岁,其中男性90人(58.4%)。50例(32.5%)患者行闭孔重建,104例(67.5%)患者行原生组织重建(75%为游离皮瓣)。重建方式与局部无病生存(P = .9)、检测方法(P = .4)或总生存(P = .3)无关。局部复发41例(26.6%),其中闭孔组14例(34.1%),原生组织27例(65.9%)(P = .7)。局部复发的中位时间为7.7个月(四分位数间距26.2个月)。大多数复发(75.6%)是临床发现的。Brown 2缺陷的亚组分析证实了类似的发现。结论和相关性:口腔恶性肿瘤上颌切除术后,重建方式与延迟发现局部复发或更差的生存结果无关。
{"title":"Patterns of Recurrence and Oncologic Outcomes After Maxillectomy: Does Reconstructive Modality Matter?","authors":"Cameron Lee DMD, MD ,&nbsp;Salim Abdul Wasay DDS ,&nbsp;Glyndwr Jenkins BChD, MBBS ,&nbsp;Kelly Moyer MD ,&nbsp;Kyle Hatten MD ,&nbsp;Jeffrey S. Wolf MD ,&nbsp;Rodney Taylor MD, MSPH ,&nbsp;Joshua Lubek DDS, MD ,&nbsp;Donita Dyalram DDS, MD","doi":"10.1016/j.joms.2025.09.021","DOIUrl":"10.1016/j.joms.2025.09.021","url":null,"abstract":"<div><h3>Background</h3><div>Reconstruction following maxillectomy for oral cavity malignancies is essential for restoring form and function. Obturator reconstruction facilitates direct visualization of the surgical bed, whereas flap-based reconstructions may obscure sites of potential recurrence. This has raised concern that reconstructive modality could influence the timeliness of recurrence detection, and subsequently, oncologic outcomes.</div></div><div><h3>Purpose</h3><div>The purpose of this study was to measure the association between reconstructive modality and time to detection of local recurrence and survival outcomes.</div></div><div><h3>Study design, setting sample</h3><div>This was a retrospective cohort study of all patients undergoing maxillectomy for an oral cavity malignancy at the University of Maryland between 2016 and 2024. Patients previously undergoing maxillectomy were excluded.</div></div><div><h3>Predictor variable</h3><div>The predictor was reconstructive modality: obturator versus native tissue reconstruction (local, regional, or free flap).</div></div><div><h3>Main outcome variable</h3><div>The primary outcome was local disease-free survival. Secondary outcomes included overall survival, method of recurrence detection (clinical vs radiographic), and resectability of recurrence.</div></div><div><h3>Covariates</h3><div>Covariates were categorized into demographic (age, sex), perioperative (Brown classification), and pathologic (margin status, tumor stage).</div></div><div><h3>Analyses</h3><div>Descriptive statistics were computed for study variables. Associations between study covariates and time to local recurrence were evaluated using bivariate Cox proportional hazards models.</div></div><div><h3>Results</h3><div>The cohort was composed of 154 subjects with a mean age of 66.5 ± 14.9 years and 90 were male (58.4%). Fifty subjects (32.5%) underwent obturator reconstruction and 104 (67.5%) underwent reconstruction with native tissue (75% free flap). Reconstructive modality was not associated with local disease-free survival (<em>P</em> = .9), method of detection (<em>P</em> = .4), or overall survival (<em>P</em> = .3). Local recurrence occurred in 41 subjects (26.6%), with 14 (34.1%) in the obturator group compared to 27 (65.9%) in native tissue (<em>P</em> = .7). The median time to local recurrence was 7.7 months (interquartile range 26.2 months). Most recurrences (75.6%) were detected clinically. Subgroup analysis of Brown 2 defects confirmed the similar findings.</div></div><div><h3>Conclusions and relevance</h3><div>Reconstructive modality was not associated with delayed detection of local recurrence or worse survival outcomes following maxillectomy for oral cavity malignancies.</div></div>","PeriodicalId":16612,"journal":{"name":"Journal of Oral and Maxillofacial Surgery","volume":"84 1","pages":"Pages 115-126"},"PeriodicalIF":2.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145459092","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}
引用次数: 0
Does Dexmedetomidine Affect Opioid Consumption Following Orthognathic Surgery? 右美托咪定是否影响正颌手术后阿片类药物的消耗?
IF 2.6 3区 医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2026-01-01 DOI: 10.1016/j.joms.2025.08.015
Allen F. Champion DDS , Jung-me Lee BS , Daniel Taub DDS, MD , Yu Jin Lee DMD

Background

Despite its purported analgesic effects, controversy exists regarding dexmedetomidine's efficacy as an opioid-sparing anesthetic adjunct.

Purpose

The purpose of this study is to measure the association between dexmedetomidine (DEX) administration during orthognathic surgery and postoperative opioid consumption.

Study design, sample, and setting

A single-blind randomized prospective cohort study was implemented. Patients consenting for orthognathic surgery at Thomas Jefferson University from January 2022 to October 2024 were screened. American Society of Anesthesiologists physical status I to III individuals aged ≥14 years were included. Exclusion criteria were revision surgery, recreational drug use, opioid prescription within 2 years, and chronic pain.

Predictor variable

The predictor variable was anesthetic adjunct. Subjects were randomized to receive DEX or no DEX (control).

Main outcome variables

The primary outcome variable was 24-hour postoperative opioid consumption, which was calculated as morphine milligram equivalents (MME). Postoperative pain was assessed using a visual analog scale (VAS) at 6 hours and upon patient-controlled analgesia (PCA) discontinuation at 7:00 am the following day (VASPCA). The ratio of PCA that attempts to bolus deliveries was calculated.

Covariates

Covariates included age, sex, body mass index (BMI), and operative duration.

Analyses

Descriptive statistics were calculated. Shapiro-Wilk test was used to assess sample normality. Relationships between continuous variables and DEX were studied using t test or Wilcoxon rank-sum test; χ2 test was used for the categorical covariate. Significance was P < .05.

Results

Of 66 enrollees, 50 (75.8%) subjects completed the trial (25 DEX, 25 no DEX). The mean (SD) ages for the no DEX and DEX group cohorts were 35.9 (13.5) and 41.3 (13.6), respectively (P = .2). There were no statistically significant differences in the distribution of covariates between the 2 study groups. Median (interquartile range (IQR)) morphine milligram equivalents consumption was 16.4 (15.4) and 14.8 (12.4) for no DEX and DEX groups, respectively (P = .9). No difference in pain scores was observed at 6 hours (P = .1). Median (interquartile range) VASPCA scores were 5(1) and 4(2) for no DEX and DEX cohorts, respectively (P < .01). Median ratios of PCA that attempts to boluses administered (1.23) were identical between cohorts (P = .9).

Conclusions and relevance

The findings suggest that opioid consumption following orthognathic surgery was not associated with dexmedetomidine administration.
背景:尽管右美托咪定具有镇痛作用,但其作为一种节省阿片类药物的麻醉辅助剂的有效性仍存在争议。目的:本研究的目的是测量正颌手术期间右美托咪定(DEX)给药与术后阿片类药物消耗之间的关系。研究设计、样本和设置:采用单盲随机前瞻性队列研究。从2022年1月到2024年10月,在托马斯·杰斐逊大学同意进行正颌手术的患者进行了筛选。年龄≥14岁的美国麻醉医师协会(American Society of anesthesologists) I至III级个体纳入研究。排除标准为翻修手术、娱乐性药物使用、2年内阿片类药物处方和慢性疼痛。预测变量:预测变量为麻醉辅助。受试者随机分为服用或不服用DEX(对照组)。主要结局变量:主要结局变量为术后24小时阿片类药物消耗,以吗啡毫克当量(MME)计算。术后6小时用视觉模拟评分(VAS)评估疼痛,第二天早上7点停用患者自控镇痛(PCA) (VASPCA)。计算了PCA尝试加丸分娩的比例。协变量:协变量包括年龄、性别、体重指数(BMI)和手术时间。分析:进行描述性统计。采用Shapiro-Wilk检验评估样本正态性。采用t检验或Wilcoxon秩和检验研究连续变量与DEX的关系;分类协变量采用χ2检验。P < 0.05。结果:在66名入组者中,50名(75.8%)受试者完成了试验(25名DEX, 25名未使用DEX)。无DEX组和DEX组的平均(SD)年龄分别为35.9岁(13.5岁)和41.3岁(13.6岁)(P = 0.2)。两组间协变量分布无统计学差异。无DEX组和DEX组吗啡毫克当量的中位数(四分位间距(IQR))分别为16.4(15.4)和14.8 (12.4)(P = .9)。6小时时疼痛评分无差异(P = 0.1)。无DEX组和DEX组VASPCA评分中位数(四分位数范围)分别为5(1)和4(2),差异有统计学意义(P < 0.01)。PCA的中位数比(1.23)在队列之间是相同的(P = .9)。结论和相关性:研究结果表明,正颌手术后阿片类药物的使用与右美托咪定的使用无关。
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引用次数: 0
Rates and Determinants of Prosthodontic Rehabilitation After Segmental Jaw Surgery 颌骨节段性手术后修复康复的比率和决定因素。
IF 2.6 3区 医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2026-01-01 DOI: 10.1016/j.joms.2025.09.008
Amal Idrissi Janati DMD, MSc, PhD , Ameena Nizar Beema BDS, MSc , Jordan Gigliotti DMD, MD, CM , Nicholas Makhoul DMD, MD , Michel El-Hakim DMD, MD, MSc , Nour Karra DMD

Background

Management of maxillofacial pathologies often requires ablative surgeries of the jaw which may include the tooth-bearing segment resulting in loss of oral function. Advances in maxillomandibular reconstruction with vascularized free flaps (VFFs) and dental implants have enabled prosthodontic rehabilitation (PR) in most patients. However, the impact of these advancements on rates and barriers of PR remains unclear.

Purpose

The purpose of this study was to estimate the rate of PR and identify risk factors associated with failure to achieve PR.

Study Design, Setting, Sample

This 7-year retrospective cohort study was conducted at the Montreal General Hospital and included patients aged ≥15 years who underwent vascularized free flap reconstruction following jaw segmental resection between 2015 and 2021.

Predictor Variable

Predictor variables included age, sex, smoking, clinical diagnosis, adjuvant radiotherapy, flap type, and anterior tooth loss.

Main Outcome Variable(s)

The primary outcome is time to PR and secondary outcomes were PR status (not performed vs performed) and PR type (conventional vs implant-supported) respectively.

Covariates

NA.

Analyses

Descriptive statistics, comparison tests, Kaplan–Meier analysis, and univariate and multivariate Cox and logistic regression analyses were conducted (P < .05).

Results

The study included 184 subjects with a mean age of 58 years (SD = 17), and 52% (n = 95) were men. The median follow-up was 20 months (interquartile range = 32). Malignancy was the most common diagnosis leading to surgery (n = 106; 58%), followed by benign tumors (n = 46; 25%). Cumulative proportion of PR was 41% (n = 76), including 19.5% (n = 36) of implant-supported prostheses. Median time to start PR was 44 months (95% CI: 30 to 78) and was significantly delayed in men, ever smokers, cancer patients, and those who received radiotherapy. In multivariate analysis, radiotherapy was the main predictor of failure to receive PR overall (P = .014) and implant-supported PR specifically (P = .025).

Conclusion and Relevance

Many patients with dental morbidity after segmental jaw surgery, especially cancer patients requiring radiotherapy, did not receive PR, and even fewer received implant-supported prostheses, highlighting the need for preradiotherapy solutions.
背景:颌面部疾病的治疗通常需要对颌骨进行消融手术,其中可能包括牙齿承载段,导致口腔功能丧失。利用带血管的游离皮瓣(VFFs)和牙种植体重建上颌下颌骨的进展使大多数患者的修复康复(PR)成为可能。然而,这些进步对PR费率和障碍的影响仍不清楚。目的:本研究的目的是估计PR率,并确定与PR失败相关的危险因素。研究设计、环境、样本:这项为期7年的回顾性队列研究在蒙特利尔总医院进行,包括年龄≥15岁的患者,他们在2015年至2021年期间接受了下颌节段切除术后血管化游离腓骨(VFF)重建。预测变量:预测变量包括年龄、性别、吸烟、临床诊断、辅助放疗、皮瓣类型、前牙脱落。主要结果变量:主要结果是到PR的时间,次要结果分别是PR状态(未执行vs已执行)和PR类型(常规vs种植支持)。共:NA。分析:采用描述性统计、比较检验、Kaplan-Meier分析、单因素和多因素Cox和logistic回归分析(P < 0.05)。结果:本研究纳入184例,平均年龄58岁(SD = 17),其中52% (n = 95)为男性。中位随访时间为20个月(四分位数间距= 32)。恶性肿瘤是最常见的导致手术的诊断(n = 106, 58%),其次是良性肿瘤(n = 46, 25%)。PR累积比例为41% (n = 76),其中种植体支持假体占19.5% (n = 36)。开始PR的中位时间为44个月(95% CI: 30 - 78),在男性、曾经吸烟的患者、癌症患者和接受放疗的患者中,PR的开始时间明显延迟。在多因素分析中,放疗是总体PR失败(P = 0.014)和种植体支持PR失败(P = 0.025)的主要预测因素。结论及意义:许多颌骨节段性手术后出现牙病的患者,特别是需要放疗的癌症患者,没有接受PR治疗,更少的患者接受了种植体支持的假体,突出了放疗前解决方案的必要性。
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引用次数: 0
The Kindred Reference Form: A New Paradigm for Assessing Facial Morphology in Patients With Deformities. 亲属参考表:一种评估畸形患者面部形态的新范式。
IF 2.6 3区 医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE Pub Date : 2025-12-30 DOI: 10.1016/j.joms.2025.12.015
Yasmine Soubra, Rohan Dharia, Daeseung Kim, Jaime Gateno

Normative reference models are essential for assessing facial form, yet existing databases, stratified by ethnicity, age, and sex, have significant limitations, including incompleteness and lack of applicability for mixed-heritage patients. We propose a new paradigm, the Kindred Reference Form, which derives personalized reference morphology from a patient's nondeformed relatives. This framework provides an individualized normative standard overcoming the limitations of population datasets and proposing a new direction for patient-specific surgical planning in facial deformities.

规范的参考模型对于评估面部形态是必不可少的,然而现有的数据库,按种族、年龄和性别分层,有明显的局限性,包括不完整和缺乏对混合遗传患者的适用性。我们提出了一种新的范式,亲属参考表,它从患者的非畸形亲属中衍生出个性化的参考形态。该框架提供了一个个性化的规范标准,克服了人口数据集的局限性,并为面部畸形的患者特异性手术计划提出了新的方向。
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引用次数: 0
期刊
Journal of Oral and Maxillofacial Surgery
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