Journal of Oral and Maxillofacial Surgery最新文献

{"title":"Distinguishing Postoperative Pain Development Trajectory After Orthognathic Surgery","authors":"Li-Kuan Wang MD ,&nbsp;Xu-Dong Yang MD, PHD ,&nbsp;Hai-Yin Wu MD, PHD ,&nbsp;Dan Zhou MD","doi":"10.1016/j.joms.2025.09.010","DOIUrl":"10.1016/j.joms.2025.09.010","url":null,"abstract":"<div><h3>Background</h3><div>The lack of understanding of postoperative pain patterns makes it challenging to adopt refined pain management for orthognathic patients.</div></div><div><h3>Purpose</h3><div>The purpose was to characterize pain trajectories for the first 5 days following orthognathic surgery and identify factors associated with the trajectories.</div></div><div><h3>Study design, setting, and sample</h3><div>This retrospective cohort study was conducted at Peking University Hospital of Stomatology and included individuals aged ≥18 years who underwent orthognathic surgery. Patients with neuropsychiatric disorders or missing postoperative pain data were excluded.</div></div><div><h3>Predictor variables</h3><div>The predictor variable was postoperative pain intensity, assessed daily from days 1 to 5 after surgery using numerical rating scale.</div></div><div><h3>Main outcome variables</h3><div>The outcome variable was pain trajectory, determined by group modeling of self-reported pain over the first 5 postoperative days.</div></div><div><h3>Covariates</h3><div>Covariates comprised demographic, psychological, surgical, and perioperative variables.</div></div><div><h3>Analyses</h3><div>Descriptive statistics were calculated for each variable. Group-based modeling determined and clustered pain trajectories, and logistic regression identified independent factors. A <em>P</em> value of &lt; .05 was considered significant.</div></div><div><h3>Results</h3><div>The sample was composed of 371 subjects with a median age of 25 years [21 to 29] and 272 (73.3%) were female. We identified three pain trajectories, and there were 208 (56.1%), 111 (29.9%), 52 (14%) subjects in Trajectories 1, 2, and 3 groups, respectively. Trajectory 1 showed gradually decreasing pain. Trajectory 2 showed mild pain that decreased until day 3 and then increased slightly on days 4 to 5. Trajectory 3 showed moderate pain decreasing until day 3, increasing to moderate on day 4 and severe on day 5. Increased Pain Catastrophizing Scale score (adjusted odds ratio (OR), 1.033, 95% confidence interval (CI), 1.006 to 1.060, <em>P</em> = .015), American Society of Anesthesiologists classification I (adjusted OR, 2.593, 95% CI, 1.102 to 6.100, <em>P</em> = .029), increased remifentanil dose (adjusted OR, 1.301, 95% CI, 1.038 to 1.632, <em>P</em> = .023), and dezocine used in the analgesia pump (adjusted OR, 4.883, 95% CI, 1.953 to 12.209, <em>P</em> = .001) were associated with increased likelihood of Trajectory 3. Male had significantly lower risk of Trajectory 2 (adjusted OR, 0.424, 95% CI, 0.264 to 0.680, <em>P</em> &lt; .001) and Trajectory 3 (adjusted OR, 0.489, 95% CI, 0.287 to 0.834, <em>P</em> = .009).</div></div><div><h3>Conclusion</h3><div>Distinct pain trajectories were exhibited after orthognathic surgery. It recommends patient-specific management across different trajectories.</div></div>","PeriodicalId":16612,"journal":{"name":"Journal of Oral and Maxillofacial Surgery","volume":"84 1","pages":"Pages 45-59"},"PeriodicalIF":2.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145228497","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":"Is Same Day Discharge Associated With Readmission After Orthognathic Surgery?","authors":"Tim T. Wang DMD, MD, MPH ,&nbsp;Lang Liang BS ,&nbsp;Nicholas Wilken DDS, MD ,&nbsp;Gary Warburton DDS, MD ,&nbsp;John Caccamese DMD, MD ,&nbsp;Cameron Lee DMD, MD","doi":"10.1016/j.joms.2025.09.017","DOIUrl":"10.1016/j.joms.2025.09.017","url":null,"abstract":"<div><h3>Background</h3><div>Same day discharge pathways have the potential to reduce health care expenditures and improve access to care for patients undergoing orthognathic surgery. However, the effect of same day discharge on safety and postoperative outcomes is poorly understood.</div></div><div><h3>Purpose</h3><div>The purpose of this study was to measure the association between discharge pathway and 30-day hospital readmission, as well as evaluate trends in same day discharge over time in patients undergoing orthognathic surgery.</div></div><div><h3>Study design, setting sample</h3><div>This was a retrospective cohort study using the 2011 to 2023 American College of Surgeons National Surgical Quality Improvement Program databases. Patients undergoing orthognathic surgery were included. Patients with missing data or undergoing concurrent temporomandibular joint or facial cosmetic procedures were excluded.</div></div><div><h3>Predictor variable</h3><div>The predictor was discharge pathway, categorized as either same day discharge from the hospital or inpatient admission.</div></div><div><h3>Main outcome variable</h3><div>The primary outcome was hospital readmission within 30 days of surgery.</div></div><div><h3>Covariates</h3><div>Covariates were categorized into demographic (age, sex), medical (hypertension, diabetes), and perioperative (type of surgery, operative time).</div></div><div><h3>Analyses</h3><div>Descriptive and bivariate statistics were performed to evaluate the association between discharge pathway and readmission. Linear regression was utilized to analyze trends in discharge pathway over time.</div></div><div><h3>Results</h3><div>The cohort was composed of 2,056 subjects with a mean age of 28.8 ± 10.8 years, and 1,035 were male (50.3%). Of these, 468 (22.8%) were discharged the same day and 1,588 (77.2%) were admitted. Readmission rates were 0.40% (n = 2) for same day discharge and 1.10% (n = 17) for inpatient admission (relative risk 0.4, 95% CI 0.09 to 1.72, <em>P</em> = .3). In bivariate analysis, no study covariates including discharge pathway were associated with readmission. The mean time between discharge and readmission for the same day discharge and inpatient admission groups were 7.5 ± 6.4 days and 12.2 ± 9.0 days, respectively (<em>P</em> = .4). The frequency of same day discharge increased during the study period from 10.7% in 2011 to 23.1% in 2023 (<em>P</em> = .03).</div></div><div><h3>Conclusions and relevance</h3><div>Same day discharge was not associated with an increased risk of 30-day readmission in appropriately selected patients.</div></div>","PeriodicalId":16612,"journal":{"name":"Journal of Oral and Maxillofacial Surgery","volume":"84 1","pages":"Pages 60-67"},"PeriodicalIF":2.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145345577","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":"Contemplating One’s Novel","authors":"Thomas B. Dodson DMD, MPH (Editor-in-Chief)","doi":"10.1016/j.joms.2025.09.004","DOIUrl":"10.1016/j.joms.2025.09.004","url":null,"abstract":"","PeriodicalId":16612,"journal":{"name":"Journal of Oral and Maxillofacial Surgery","volume":"84 1","pages":"Pages 1-2"},"PeriodicalIF":2.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145860745","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":"Evaluating the Effectiveness of Large Language Models in Addressing Patient Queries Regarding Maxillomandibular Fixation for Maxillofacial Fractures","authors":"Ragavi Alagarsamy MDS ,&nbsp;Babu Lal MDS ,&nbsp;Jitendra Chawla MDS ,&nbsp;Ramya Arangaraju MDS ,&nbsp;Sujata Mohanty MDS ,&nbsp;Kaleem Fatima MDS ,&nbsp;Arivarasan Barathi MD","doi":"10.1016/j.joms.2025.09.016","DOIUrl":"10.1016/j.joms.2025.09.016","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Background&lt;/h3&gt;&lt;div&gt;Patients with maxillofacial fractures increasingly seek information from large language models (LLMs), yet the accuracy and readability of these responses remain uncertain.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Purpose&lt;/h3&gt;&lt;div&gt;This study evaluated the performance of 5 publicly accessible LLMs in answering frequently asked questions (FAQs) about maxillomandibular fixation (MMF).&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Study Design, Setting, and Sample&lt;/h3&gt;&lt;div&gt;This in-silico cross-sectional study, conducted in January 2025, evaluated 47 FAQs and yielded 235 responses from 5 open-access LLMs, excluding subscription-based models.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Predictor Variable&lt;/h3&gt;&lt;div&gt;The predictor variable was LLM architecture: decoder-only transformer models (DOT-1, DOT-2), a multimodal transformer model (MTM), a productivity-focused model (PM), and a constitutional artificial intelligence (AI)-based model (CAM).&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Outcome Variables&lt;/h3&gt;&lt;div&gt;The primary outcome was LLM performance, measured with the QUEST (Quality of information, Understanding and reasoning, Expression style and persona, Safety and harm, and Trust and confidence) framework. Domains assessed were accuracy (Likert ≥4), hallucination (presence/absence of fabricated content), usefulness, clarity, trust, and satisfaction (Likert 1 to 5), and readability (Flesch–Kincaid Reading Ease [FKRE] and Grade Level [FKGL]). Responses were rated independently by 7 evaluators (5 oral and maxillofacial surgeons and 2 residents) in a blinded manner.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Covariates&lt;/h3&gt;&lt;div&gt;None.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Analyses&lt;/h3&gt;&lt;div&gt;Ordinal outcomes were analyzed with the Friedman test and pairwise Wilcoxon signed-rank tests. Readability was compared with one-way ANOVA. Inter-rater reliability was measured with Fleiss' kappa. Statistical significance was set at &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;The sample included 235 LLM-generated responses. DOT-1 showed the highest accuracy (88.5 ± 6.2%), which was statistically significantly greater than DOT-2 (79.6 ± 10.1%) and PM (81.2 ± 9.3%) (&lt;em&gt;P&lt;/em&gt; = .004). It also had a statistically significantly lower hallucination rate (5.2%) compared with DOT-2 (10.1%) and PM (9.4%) (&lt;em&gt;P&lt;/em&gt; = .013). CAM performed comparably in accuracy (86.3 ± 7.1%); however, its readability was statistically significantly poorer (Flesch–Kincaid Grade Level = 22.7 ± 12.9; &lt;em&gt;P&lt;/em&gt; &lt; .001). Multimodal transformer model showed intermediate performance. Inter-rater agreement was almost perfect for accuracy (κ = 0.79 to 1.00) and hallucination (κ = 0.91 to 1.00) and moderate to substantial for ordinal variables.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusion and Relevance&lt;/h3&gt;&lt;div&gt;LLMs can provide accurate responses to maxillomandibular fixation queries, but readability remains limited and model-dependent. These findings underscore the need for developing more patient-friendly artificial intelligence (AI) outputs and highlight the importance of clinician oversight in gu","PeriodicalId":16612,"journal":{"name":"Journal of Oral and Maxillofacial Surgery","volume":"84 1","pages":"Pages 68-79"},"PeriodicalIF":2.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145370339","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: Does Combining Arthrocentesis With Injectable Platelet-Rich Fibrin Outperform Arthrocentesis or Injectable Platelet-Rich Fibrin Alone in Alleviating Pain and Improving Function in Temporomandibular Joint Dysfunction?","authors":"Hemad Iraji Khosrowshahi DDS,&nbsp;Nima Masoudi MD","doi":"10.1016/j.joms.2025.07.014","DOIUrl":"10.1016/j.joms.2025.07.014","url":null,"abstract":"","PeriodicalId":16612,"journal":{"name":"Journal of Oral and Maxillofacial Surgery","volume":"84 1","pages":"Page 11"},"PeriodicalIF":2.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145860744","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(25)00884-5","DOIUrl":"10.1016/S0278-2391(25)00884-5","url":null,"abstract":"","PeriodicalId":16612,"journal":{"name":"Journal of Oral and Maxillofacial Surgery","volume":"84 1","pages":"Page A2"},"PeriodicalIF":2.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145860221","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 Oral and Maxillofacial Surgery: Transforming Practice, Precision, and Patient Care","authors":"Idean Roohani MD ,&nbsp;Bonnie L. Padwa MD, DMD ,&nbsp;Jeffrey A. Hammoudeh MD, DDS","doi":"10.1016/j.joms.2025.07.012","DOIUrl":"10.1016/j.joms.2025.07.012","url":null,"abstract":"","PeriodicalId":16612,"journal":{"name":"Journal of Oral and Maxillofacial Surgery","volume":"84 1","pages":"Pages 3-5"},"PeriodicalIF":2.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145860740","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":"Persistent Neurosensory Disturbance Following Sagittal Split Osteotomy: A Systematic Review and Meta-Analysis of One-Year Outcomes and Risk Factors","authors":"Andrew E. Bertagna DMD, MD ,&nbsp;Frederic Van der Cruyssen MD, DDS, MHM, PhD ,&nbsp;Michael Miloro DMD, MD","doi":"10.1016/j.joms.2025.08.014","DOIUrl":"10.1016/j.joms.2025.08.014","url":null,"abstract":"<div><h3>Background</h3><div>Sagittal split osteotomy (SSO) is widely performed for mandibular repositioning; however, inferior alveolar nerve injury may result in persistent neurosensory disturbance (NSD) that affects quality of life. The true 1-year incidence and associated risk factors remain uncertain.</div></div><div><h3>Purpose</h3><div>The study purpose was to estimate the 1-year incidence of persistent NSD after SSO and to evaluate risk factors.</div></div><div><h3>Data Sources</h3><div>We systematically searched PubMed and Embase (1998 to February 2025). Eligible human studies (randomized, prospective, retrospective) reporting NSD outcomes after SSO and possible risk factors in English language were included.</div></div><div><h3>Study Selection</h3><div>Randomized controlled trials and prospective and retrospective cohort studies with a minimum follow-up of 3 months, reporting NSD incidence and potential predictors, were included. Nonhuman studies, case reports, and studies with alternative osteotomy techniques or incomplete NSD assessment were excluded. Study selection was performed by 2 independent reviewers.</div></div><div><h3>Data Extraction and Synthesis</h3><div>Following PRISMA, we extracted study characteristics, variable definitions, NSD assessment methods, and 1-year outcomes. “Persistent NSD” was defined as any NSD reported or assessed at 12 months postoperatively. Random- and fixed-effects models estimated pooled 1-year incidence; heterogeneity (I²) and small-study effects were assessed.</div></div><div><h3>Results</h3><div>The final sample comprised 47 studies (5,406 patients). The pooled 1-year incidence of persistent NSD was 21% (95% CI, 13%-32%). Older age (statistically significant in 5 out of 9 studies), greater mandibular advancement (significant in 2 out of 2 studies), and intraoperative nerve exposure/manipulation (significant in 2 out of 3 studies) were statistically significantly associated with a higher risk of persistent NSD across contributing adequately powered studies. Across the available evidence, persistent NSD was not significantly associated with sex (8/9 studies), skeletal class (4/5), fixation method (1/2), third molar presence (1/1), or concomitant genioplasty (3/5).</div></div><div><h3>Conclusions and Relevance</h3><div>NSD following SSO persists in 1 in 5 patients at 1 year. Larger mandibular advancements and nerve manipulation increase persistent NSD risk. Standardized NSD assessments and adequately powered studies are essential to refine risk stratification and optimize surgical techniques.</div></div>","PeriodicalId":16612,"journal":{"name":"Journal of Oral and Maxillofacial Surgery","volume":"84 1","pages":"Pages 25-44"},"PeriodicalIF":2.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145124968","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":"The 2025 ADA Dental Anesthesia Provider Summit: Patient Safety and Access to Care","authors":"J. David Johnson Jr. DDS ,&nbsp;Paul J. Schwartz DMD ,&nbsp;Andrew Herlich DMD, MD","doi":"10.1016/j.joms.2025.09.020","DOIUrl":"10.1016/j.joms.2025.09.020","url":null,"abstract":"","PeriodicalId":16612,"journal":{"name":"Journal of Oral and Maxillofacial Surgery","volume":"84 1","pages":"Pages 138-140"},"PeriodicalIF":2.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145274872","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: Aromatherapy on Anxiety, Pain, and Quality of Life Following Surgery of Mandibular Third Molars: A Randomized, Double-Blind Clinical Trial","authors":"Deepak Bangera MD (Naturopathy),&nbsp;Deenadayalan Boopalan MD (Naturopathy),&nbsp;N.V. Gnana Deep Tatavarti MD (Naturopathy),&nbsp;Raghavendra Rao Mohan PhD (Yoga and Life Sciences)","doi":"10.1016/j.joms.2025.07.017","DOIUrl":"10.1016/j.joms.2025.07.017","url":null,"abstract":"","PeriodicalId":16612,"journal":{"name":"Journal of Oral and Maxillofacial Surgery","volume":"84 1","pages":"Page 12"},"PeriodicalIF":2.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145860743","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}