Journal of Oral and Maxillofacial Surgery最新文献

{"title":"Does Varying Platelet-Rich Fibrin Centri̇fugati̇on Protocols Enhance New Bone Formati̇on in Extracti̇on Site?","authors":"Toghrul Aliyev PhD ,&nbsp;Murat Ulu PhD ,&nbsp;Xhini Rizaj PhD ,&nbsp;Onur Şahin PhD ,&nbsp;Fatma Şimşek PhD ,&nbsp;Mahammad Davudov PhD","doi":"10.1016/j.joms.2024.08.005","DOIUrl":"10.1016/j.joms.2024.08.005","url":null,"abstract":"<div><h3>Background</h3><div>Finding a protocol that could prevent bone resorption and be implemented in clinical practice would be crucial in providing sufficient bone to replace missing teeth with implants.</div></div><div><h3>Purpose</h3><div>The study aimed to determine the effectiveness of different centrifugation platelet-rich fibrin (PRF) protocols in new bone formation and bone regenerative markers.</div></div><div><h3>Study Design, Setting and Sample</h3><div>This randomized clinical trial was conducted at Izmir Katip Çelebi Research Hospital, a population-based facility in Izmir, Turkey. Study subjects were composed of patients who required extraction of anterior teeth. Exclusion criteria included periodontal disease, resorption of alveolar bone, defects, smoking, alcoholism, and systemic diseases.</div></div><div><h3>Independent Variable</h3><div>The independent variable was the PRF protocol. The subjects were randomly assigned to one of three groups: leukocyte platelet-rich fibrin (L-PRF), advanced platelet-rich fibrin (A-PRF) and control groups (healing naturally).</div></div><div><h3>Main Outcome Variable</h3><div>The primary outcome of interest was the percentage of new bone formation, determined by analyzing the staining intensity in histomorphometric assessments of bone samples collected 8 weeks after extraction. The secondary outcomes were regenerative effects measured by the immunohistochemical expression of markers such as osteocalcin, alkaline phosphatase, and proliferating cell nuclear antigen. Potential benefits were evaluated by clinical observations of pain, swelling, membrane visibility and healing.</div></div><div><h3>Covariates</h3><div>The covariates were age, sex and health conditions.</div></div><div><h3>Analyses</h3><div>Histologic comparative staining intensities and biomarkers expression between groups were evaluated by one way analysis of variance. A difference of <em>P</em> &lt; .05 was considered statistically significant.</div></div><div><h3>Results</h3><div>The study included 57 subjects, with a mean age of 45 years (±5.6); 30 were male (53%) and 27 female (47%). The control group had a mean new bone formation of 32.68% (±2.5), the A-PRF group 61.37% (±3.0), and the L-PRF group 70.74% (±3.5) (<em>P</em> &lt; .001). The A-PRF group showed significantly higher osteocalcin expression than the control group (<em>P</em> = .013). Alkaline phosphatase and proliferating cell nuclear antigen expression scores for PRF groups were significantly higher than the control group's (<em>P</em> = .001). Both groups demonstrated significantly lower pain scores, reduced gingival swelling, better membrane visibility, and healing compared to the control group.</div></div><div><h3>Conclusion and Relevance</h3><div>PRF enhanced bone formation rates, with L-PRF showing the most significant effect.</div></div>","PeriodicalId":16612,"journal":{"name":"Journal of Oral and Maxillofacial Surgery","volume":"83 1","pages":"Pages 62-69"},"PeriodicalIF":2.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142108423","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":"TMJ Concepts Patient-Fitted Temporomandibular Joint Reconstruction Prosthesis System: Results From a Food and Drug Administration Postmarket Surveillance Prospective Cohort Study","authors":"Zahid Afzal BDS, MBChB, MPhil ,&nbsp;Mikhail Umorin PHD, MS ,&nbsp;Louis G. Mercuri DDS, MS ,&nbsp;Gary Warburton MD, DDS","doi":"10.1016/j.joms.2024.10.002","DOIUrl":"10.1016/j.joms.2024.10.002","url":null,"abstract":"<div><h3>Background</h3><div>Custom-designed and patient-fitted temporomandibular joint replacement (TMJR) devices are used to manage end-stage temporomandibular joint (TMJ) pathology, distorted bony TMJ architecture, or in patients who have undergone multiple prior failed TMJ surgeries.</div></div><div><h3>Purpose</h3><div>This study aimed to measure the frequency of revision or replacement over time, estimate the 1-, 2-, and 3-year survival rate of implants, and determine what demographic, anatomical, or operative variables may be associated with a device adverse event (AE).</div></div><div><h3>Study Design, Setting, Sample</h3><div>A prospective cohort study was conducted on consenting adults who could read English, implanted with the TMJ Concepts TMJR prostheses between 2013 and 2015 by private or academic surgeons. Patients under the age of 18 and those who were incapable, unwilling, or unable to complete the perioperative forms were excluded.</div></div><div><h3>Main Outcome Variable</h3><div>The primary outcome variable was the frequency of AEs, which is defined as device revision or replacement. The secondary outcome variable was the survival rate for the TMJ Concepts devices.</div></div><div><h3>Analyses</h3><div>Device survival at 1, 2, and 3 years was estimated using the Kaplan-Meier methodology. Cox proportional hazards regression was used to analyze the effects of the predictor variables for the device survival rate. A <em>P</em> value of &lt;.05 was considered significant.</div></div><div><h3>Results</h3><div>A total of 738 subjects (1,098 joints) were enrolled in the study with 102 (14%) males and 636 (86%) females. The mean age was 45.4 (+14.8) years. The median follow-up period was 36.2 months (95% CI: 36.1 to 36.2 months). A total of 187 subjects (25.3%) were lost to follow-up during; the study period. Forty-nine devices (4.46%) were associated with an AE at 3 years. The; 3-year device survival was 95.1% (95% CI: 93.6 to 96.3%). The only significant risk factor for an AE was the asymmetry of the mandible (hazard rate ratio = 1.989, <em>P</em> = .03). The primary diagnosis was not associated with the time to an AE (<em>P</em> value = .8685). Infection (44.7%, 21 joints) and material sensitivity (12.8%, 6 joints) were the most common reasons specifically for device removal/replacement in the study cohort.</div></div><div><h3>Conclusion and Relevance</h3><div>Infection was the primary reason reported for device revision or replacement followed by material sensitivity. In the study cohort, the device survival following implantation of the TMJ Concepts prosthesis was not significantly different than reported by the TMJR stock device.</div></div>","PeriodicalId":16612,"journal":{"name":"Journal of Oral and Maxillofacial Surgery","volume":"83 1","pages":"Pages 10-16"},"PeriodicalIF":2.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142567376","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":"Depth of Invasion Threshold for Recommending Elective Neck Dissection in T1 or T2 Oral Squamous Cell Carcinoma","authors":"Hans Shih DDS, MDCM ,&nbsp;Mehak Khanna BDS, MSc ,&nbsp;Jacob Thomas DDS ,&nbsp;Nicholas Maroun Makhoul DMD, MD ,&nbsp;Michel El-Hakim DMD, MD, MSc","doi":"10.1016/j.joms.2024.10.006","DOIUrl":"10.1016/j.joms.2024.10.006","url":null,"abstract":"<div><h3>Background</h3><div>There is variability in the literature on the role of the depth of invasion (DOI) for recommending an elective neck dissection (END).</div></div><div><h3>Purpose</h3><div>The purpose of the study is to estimate the DOI threshold for recommending an END.</div></div><div><h3>Study Design, Setting, Sample</h3><div>A retrospective cohort study was performed at McGill University Health Centre from 2008 to 2018 with 5 years of follow-up. The sample was subjects with clinical T1/T2 oral squamous cell carcinoma and clinically negative neck. Subjects with previous head and neck cancer were excluded.</div></div><div><h3>Predictor Variable</h3><div>The primary predictor variable was DOI measured from the basement membrane of the adjacent normal mucosa on final pathology, coded as &lt;4 mm or ≥4 mm. DOI is a continuous variable converted to a binary variable.</div></div><div><h3>Main Outcome Variable</h3><div>The main outcome variable was time to development of neck disease (RD+) defined as the time from surgery to development of pathologic nodes. Time to RD+ for pathologic nodes discovered from the END was considered 0 months. The secondary outcome variable was overall survival.</div></div><div><h3>Covariates</h3><div>Demographics (age, sex, and smoking/alcohol history) and tumor characteristics (tumor location, clinical T, tumor differentiation, perineural invasion, and lymphovascular invasion) were analyzed.</div></div><div><h3>Analyses</h3><div>Time to RD+ and survival were analyzed using Cox hazard ratio, Kaplan-Meier curves, and log-rank test. Student’s <em>t</em>-test and χ² test were used for bivariate analyses; <em>P</em> ≤ .05 was statistically significant.</div></div><div><h3>Results</h3><div>The final sample were 64 subjects (average age 65.25 [standard deviation 13.06] years and 36 [56.2%] males). Twenty-nine subjects had DOI &lt; 4 mm, and the 5-year RD+ was 3.4% (the 1 occurrence of RD+ was at 5.3 months). Thirty-five subjects had DOI ≥ 4 mm, and the 5-year RD+ was 45.7% (15 subjects had RD+ discovered from the END, and 1 subject had RD+ at 7.6 months). DOI ≥ 4 mm had significantly higher risk of RD+ than DOI &lt; 4 mm (hazard ratio 17.91; 95% confidence interval 2.37 to 135.3; <em>P</em> = .01), which remained significant after adjusting for clinical T, tumor differentiation, perineural invasion, and lymphovascular invasion (hazard ratio 9.53; 95% confidence interval 1.12 to 81.44; <em>P</em> &lt; .05). The shallowest DOI with &gt;20% risk of RD+ was in the DOI 4 mm to 4.9 mm group.</div></div><div><h3>Conclusion and Relevance</h3><div>Among patients with oral squamous cell carcinoma of T1 or T2 and clinically negative necks, END should be considered with DOI ≥ 4 mm.</div></div>","PeriodicalId":16612,"journal":{"name":"Journal of Oral and Maxillofacial Surgery","volume":"83 1","pages":"Pages 102-112"},"PeriodicalIF":2.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142604774","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"What is the Minimal Perceptible Change for the Dimensional Alteration of Facial Structures in the Frontal View?","authors":"Katkoria Nalin Priyanka MDS ,&nbsp;Shivangi Ramteke MDS ,&nbsp;Bhaskar Nivethitha MDS ,&nbsp;Balasubramanian Madhan MDS","doi":"10.1016/j.joms.2024.08.013","DOIUrl":"10.1016/j.joms.2024.08.013","url":null,"abstract":"<div><h3>Background</h3><div>A better understanding of the perceptibility of dimensional changes in facial structures is of interest to all involved in facial esthetics.</div></div><div><h3>Purpose</h3><div>We aimed to determine the minimal perceptible change (MPC) in the dimensional alterations of the facial structures in the frontal view and the influential factors.</div></div><div><h3>Study Design, Setting, Sample</h3><div>This cross-sectional study was conducted on individuals accompanying the patients at the outpatient department of a tertiary-care hospital and students in art and science. Those with impaired cognition, craniofacial anomalies, history of esthetic facial surgeries and health professionals working on facial esthetics were excluded.</div></div><div><h3>Independent Variable</h3><div>The observers assessed the frontal photographs of 2 models and their modifications. The independent variables were the anatomic structure modified (mouth, nose, ears, eyes), the percentage change (5, 10, 15%), and the type of modification (magnification or reduction).</div></div><div><h3>Main Outcome Variables</h3><div>The outcome variables were the MPC (perceived by at least 50% of the observers) and the perceptibility of changes (Yes/No)</div></div><div><h3>Covariates</h3><div>The age of the observer, the sex of the observer and the model were the covariates.</div></div><div><h3>Analyses</h3><div>The intergroup differences in perceptibility of changes and the influence of independent variables and covariates were analyzed with χ²/Cochran's Q test and generalized estimating equations, respectively, with statistical significance set at <em>P</em> &lt; .05.</div></div><div><h3>Results</h3><div>The sample comprised 110 males and 110 females, aged 23.9 ± 5.8 years. The MPC was 5% for the mouth, nose, and eyes and 15% for the ears. The changes in the nose [OR = 0.68 (0.56 to 0.83), <em>P</em> &lt; .001], ears [OR = 0.29 (0.24 to 0.36), <em>P</em> &lt; .001], and eyes [OR = 0.78 (0.64 to 0.95), <em>P</em> = .015] were less perceptible than the mouth. The perceptibility was higher in female than male observers [OR = 1.37 (1.11 to 1.69), <em>P</em> = .003] and reduction than magnification [OR = 1.11 (1.00 to 1.23) <em>P</em> = .036]. Compared to a 5% change, the perceptibility was higher for 10 and 15% [OR = 2.00 (1.76 to 2.27), 3.33 (2.84 to 3.91), respectively, <em>P</em> &lt; .001].</div></div><div><h3>Conclusion and Relevance</h3><div>The MPC was 5% for the mouth, nose, and eyes and 15% for the ears. The perceptibility of change was influenced by the structure, the extent and type of modification and the observer's sex. These findings may be of use to all professionals involved in esthetic facial corrections.</div></div>","PeriodicalId":16612,"journal":{"name":"Journal of Oral and Maxillofacial Surgery","volume":"83 1","pages":"Pages 17-25"},"PeriodicalIF":2.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142289517","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":"Postoperative Antibiotics May Be Unnecessary in Pediatric Patients Hospitalized With Minor Odontogenic Infections","authors":"Michael V. Joachim DMD, MSc, MHA ,&nbsp;Murad AbdelRaziq MD, DMD ,&nbsp;Waseem A. Abboud MD, DMD ,&nbsp;Shareef Araidy DMD ,&nbsp;Imad Abu El Naaj DMD","doi":"10.1016/j.joms.2024.10.003","DOIUrl":"10.1016/j.joms.2024.10.003","url":null,"abstract":"<div><h3>Background</h3><div>Antibiotic overuse is a growing concern in health care. For pediatric odontogenic infections, the necessity of postoperative antibiotics lacks clear, evidence-based guidelines.</div></div><div><h3>Purpose</h3><div>The purpose of this study was to compare treatment outcomes between pediatric patients hospitalized with vestibular space odontogenic infections who received postoperative antibiotics and those who did not.</div></div><div><h3>Study Design, Setting, Sample</h3><div>This ambispective cohort study was conducted at the Baruch Padeh “Tzafon” Medical Center, Poriya, Israel (January 2010-December 2015 for retrospective and November 2018-December 2019 for prospective). The sample included 522 pediatric patients (&lt;15 years) hospitalized for odontogenic infections requiring surgical intervention. Patients with nonodontogenic infections, compromised immune systems, or infections involving deeper spaces were excluded.</div></div><div><h3>Predictor/Independent Variable</h3><div>The primary predictor was postoperative antibiotic management (administration vs no administration), decided at hospital admission.</div></div><div><h3>Main Outcome Variable(s)</h3><div>The primary outcome variable was hospital length of stay (LOS), categorized as short (1 to 2 days) or extended (≥3 days). LOS was chosen as a proxy for recovery time and symptom resolution, reflecting the overall efficacy of the treatment approach.</div></div><div><h3>Covariates</h3><div>Demographic, clinical, and laboratory data were collected.</div></div><div><h3>Analyses</h3><div>Descriptive statistics, Student t-tests, χ² tests, and multivariable logistic regression were used (<em>P</em> &lt; .05).</div></div><div><h3>Results</h3><div>Of 522 patients (411 control, 111 study), mean LOS was similar between groups: 1.7 ± 0.91 days (control) versus 1.67 ± 0.9 days (study) (<em>P</em> = .76). Short stays were not significantly different (90.99 vs 87.10%, <em>P</em> = .32). Multivariable analysis showed no association between withholding antibiotics and extended stay (odds ratio [OR] = 0.92, 95% confidence interval [CI]: 0.45 to 1.89, <em>P</em> = .82), but identified age (OR = 1.11, 95% CI: 1.02 to 1.21, <em>P</em> = .02) and initial white blood cell count (OR = 1.08, 95% CI: 1.01 to 1.15, <em>P</em> = .03) as predictors of extended stay.</div></div><div><h3>Conclusion and Relevance</h3><div>Withholding routine postoperative antibiotics in pediatric patients with odontogenic infections does not significantly impact length of hospital stay. While length of stay is not a direct measure of clinical outcome, it serves as a proxy for recovery. This approach may contribute to antibiotic stewardship efforts without compromising patient care, though future studies with direct clinical outcome measures are needed to confirm these findings.</div></div>","PeriodicalId":16612,"journal":{"name":"Journal of Oral and Maxillofacial Surgery","volume":"83 1","pages":"Pages 70-78"},"PeriodicalIF":2.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142546013","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)00921-2","DOIUrl":"10.1016/S0278-2391(24)00921-2","url":null,"abstract":"","PeriodicalId":16612,"journal":{"name":"Journal of Oral and Maxillofacial Surgery","volume":"83 1","pages":"Page A3"},"PeriodicalIF":2.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143143899","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":"January 2025: AAOMS News and Announcements","authors":"","doi":"10.1016/j.joms.2024.10.009","DOIUrl":"10.1016/j.joms.2024.10.009","url":null,"abstract":"","PeriodicalId":16612,"journal":{"name":"Journal of Oral and Maxillofacial Surgery","volume":"83 1","pages":"Pages 123-125"},"PeriodicalIF":2.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143143907","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":"Trouble, Trouble, Citing Double","authors":"Thomas B. Dodson DMD, MPH","doi":"10.1016/j.joms.2024.07.007","DOIUrl":"10.1016/j.joms.2024.07.007","url":null,"abstract":"","PeriodicalId":16612,"journal":{"name":"Journal of Oral and Maxillofacial Surgery","volume":"83 1","pages":"Pages 1-2"},"PeriodicalIF":2.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142921992","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":"Geographic Trends in the Oral and Maxillofacial Surgery Residency Match","authors":"Joshua R. Weirich DDS ,&nbsp;Sruthi Satishchandran DMD ,&nbsp;Shelly Abramowicz DMD, MPH","doi":"10.1016/j.joms.2024.08.064","DOIUrl":"10.1016/j.joms.2024.08.064","url":null,"abstract":"<div><h3>Background</h3><div>Matching into Oral and Maxillofacial Surgery (OMS) residency in the United States (US) is competitive. Various surgical and medical specialties found that a relationship exists between the geographic location where an applicant attends medical school and the location where they attend residency. However, information regarding this geographic relationship does not exist in OMS.</div></div><div><h3>Purpose</h3><div>The purpose of this study was to investigate if a relationship exists between the location of an applicant's dental school and the location of the OMS program where they match for residency.</div></div><div><h3>Study Design, Setting, Sample</h3><div>Study team conducted a cross-sectional review of all civilian OMS applicants who participated in the Postdoctoral OMS Matching Program from 2012 to 2022. US States and the District of Columbia were subdivided into a specific Region and Division as defined by the US Census Bureau.</div></div><div><h3>Predictor Variable</h3><div>The primary predictor variable was the geographic location of the applicant's dental school.</div></div><div><h3>Main Outcome Variable</h3><div>The outcome variable was the geographic location where the applicant matched for residency.</div></div><div><h3>Covariates</h3><div>There were no covariates analyzed in the study.</div></div><div><h3>Analyses</h3><div>Frequency tables were created for the expected and observed values for each possible combination of dental school and residency location. MATLAB R2023a software was used for statistical analysis. χ² test, odds ratio and confidence interval were calculated to investigate association between variables. <em>P</em> values were &lt;.05.</div></div><div><h3>Results</h3><div>1768 applicants were reviewed. The inclusion criteria consisted of civilian OMS applicants from 2012 to 2022 who matched into residency. Of the 968 applicants who met the inclusion criteria, 48.45% (469/968, <em>P</em> -value &lt; .001) matched into a residency in the same US Region as their dental school; 36.26% (351/968, <em>P</em> value &lt; .001) matched into the same US Division. Applicants were found to be significantly more likely to match into a program in the same US Region and Division as their dental school.</div></div><div><h3>Conclusion and Relevance</h3><div>It is likely that individuals will match into OMS residency in the same US Region and Division as their dental school. This information helps applicants and residency programs during the match process.</div></div>","PeriodicalId":16612,"journal":{"name":"Journal of Oral and Maxillofacial Surgery","volume":"83 1","pages":"Pages 113-122"},"PeriodicalIF":2.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142289515","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":"Association Analysis Between Albumin Level and Maxillofacial Space Infection Severity","authors":"Ying Huang MD ,&nbsp;Lei Lu MD ,&nbsp;Hetong Fei MD ,&nbsp;Jing Ma MD ,&nbsp;Jianfeng Dong MD ,&nbsp;Fuqiang Xie BM","doi":"10.1016/j.joms.2024.09.005","DOIUrl":"10.1016/j.joms.2024.09.005","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;div&gt;Early detection and treatment of maxillofacial space infection (MSI) can lead to successful outcomes; however, delayed intervention may result in severe systemic manifestations, posing a potential threat to life.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Purpose&lt;/h3&gt;&lt;div&gt;The purpose of this study was to measure the association between albumin (ALB) levels and MSI severity.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Study Design, Setting, Sample&lt;/h3&gt;&lt;div&gt;This was a retrospective cohort study including patients who were diagnosed with MSI at the Second Hospital of Lanzhou University from 2013 to 2023. Patients with unknown etiology, incomplete data, and those with psychiatric disorders and malignant tumors were excluded. Cured subjects are defined as the absence of clinical symptoms.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Predictor Variable&lt;/h3&gt;&lt;div&gt;The primary predictor variable was the ALB levels measured at the time of admission. We categorized ALB levels at admission into &lt;30 g/L, 30-35 g/L, and &gt;35 g/L.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Main Outcome Variable(s)&lt;/h3&gt;&lt;div&gt;The outcome variables were MSI severity measured by the length of stay (LOS) and death. LOS &gt;14 days was a prolonged length of hospital stay.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Covariates&lt;/h3&gt;&lt;div&gt;Covariates included age, sex, involved anatomical spaces, neutrophil proportion and white blood cell counts.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Analyses&lt;/h3&gt;&lt;div&gt;Statistical analysis was conducted using Pearson's χ&lt;sup&gt;2&lt;/sup&gt; test, one-way analysis of variance, independent sample &lt;em&gt;t&lt;/em&gt;-test, multivariate logistic regression, Fisher's exact test, Kruskal–Wallis H test, Mann–Whitney U test, and the Gamma test. The &lt;em&gt;P&lt;/em&gt; value was set at .05.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;This study encompassed 201 patients, of whom 123 were male (61.19%) and 78 were female (38.81%). Among these, 190 subjects (94.53%) were cured. The mean LOS was 16.38 ± 18.93 days, and 81 subjects (42.63%) had a LOS exceeding 14 days. There were 11 deceased patients (5.47%). The neutrophil proportion (χ&lt;sup&gt;2&lt;/sup&gt; = 8.31; &lt;em&gt;P&lt;/em&gt; &lt; .01), and white blood cell count (χ&lt;sup&gt;2&lt;/sup&gt; = 11.14; &lt;em&gt;P&lt;/em&gt; &lt; .01) were significantly higher in deceased patients compared to those who were cured, and among the deceased patients, there was a greater percentage of patients with odontogenic infections (χ&lt;sup&gt;2&lt;/sup&gt; = 7.48; &lt;em&gt;P&lt;/em&gt; = .02). There was no difference in ALB levels among the deceased patients (χ&lt;sup&gt;2&lt;/sup&gt; = 3.08 &lt;em&gt;P&lt;/em&gt; = .21). A reduction in ALB levels is associated with an increased risk of prolonged LOS (χ&lt;sup&gt;2&lt;/sup&gt; = 21.77; &lt;em&gt;P&lt;/em&gt; &lt; .001). The relative risk (RR) of LOS extension when the ALB level is between 30 and 35 g/L is 1.32 times higher than when the ALB level exceeds 35 g/L (RR = 1.32, 95% confidence interval (CI) = 0.99 to 1.76). Furthermore, when ALB levels fall below 30 g/L, the RR increases to 2.19 times higher compared to ALB levels greater than 35 g/L (RR = 2.19, 95% CI = 1.47 to 3.26). Moreover, the LOS was used to measure the se","PeriodicalId":16612,"journal":{"name":"Journal of Oral and Maxillofacial Surgery","volume":"83 1","pages":"Pages 79-88"},"PeriodicalIF":2.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142468070","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}