<div><h3>Background</h3><div>Patients with maxillofacial fractures increasingly seek information from large language models (LLMs), yet the accuracy and readability of these responses remain uncertain.</div></div><div><h3>Purpose</h3><div>This study evaluated the performance of 5 publicly accessible LLMs in answering frequently asked questions (FAQs) about maxillomandibular fixation (MMF).</div></div><div><h3>Study Design, Setting, and Sample</h3><div>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.</div></div><div><h3>Predictor Variable</h3><div>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).</div></div><div><h3>Outcome Variables</h3><div>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.</div></div><div><h3>Covariates</h3><div>None.</div></div><div><h3>Analyses</h3><div>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 <em>P</em> < .05.</div></div><div><h3>Results</h3><div>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%) (<em>P</em> = .004). It also had a statistically significantly lower hallucination rate (5.2%) compared with DOT-2 (10.1%) and PM (9.4%) (<em>P</em> = .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; <em>P</em> < .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.</div></div><div><h3>Conclusion and Relevance</h3><div>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
{"title":"Evaluating the Effectiveness of Large Language Models in Addressing Patient Queries Regarding Maxillomandibular Fixation for Maxillofacial Fractures","authors":"Ragavi Alagarsamy MDS , Babu Lal MDS , Jitendra Chawla MDS , Ramya Arangaraju MDS , Sujata Mohanty MDS , Kaleem Fatima MDS , Arivarasan Barathi MD","doi":"10.1016/j.joms.2025.09.016","DOIUrl":"10.1016/j.joms.2025.09.016","url":null,"abstract":"<div><h3>Background</h3><div>Patients with maxillofacial fractures increasingly seek information from large language models (LLMs), yet the accuracy and readability of these responses remain uncertain.</div></div><div><h3>Purpose</h3><div>This study evaluated the performance of 5 publicly accessible LLMs in answering frequently asked questions (FAQs) about maxillomandibular fixation (MMF).</div></div><div><h3>Study Design, Setting, and Sample</h3><div>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.</div></div><div><h3>Predictor Variable</h3><div>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).</div></div><div><h3>Outcome Variables</h3><div>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.</div></div><div><h3>Covariates</h3><div>None.</div></div><div><h3>Analyses</h3><div>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 <em>P</em> < .05.</div></div><div><h3>Results</h3><div>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%) (<em>P</em> = .004). It also had a statistically significantly lower hallucination rate (5.2%) compared with DOT-2 (10.1%) and PM (9.4%) (<em>P</em> = .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; <em>P</em> < .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.</div></div><div><h3>Conclusion and Relevance</h3><div>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}
Pub Date : 2026-01-01DOI: 10.1016/j.joms.2025.07.014
Hemad Iraji Khosrowshahi DDS, Nima Masoudi MD
{"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, 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}
Pub Date : 2026-01-01DOI: 10.1016/j.joms.2025.07.012
Idean Roohani MD , Bonnie L. Padwa MD, DMD , Jeffrey A. Hammoudeh MD, DDS
{"title":"Artificial Intelligence in Oral and Maxillofacial Surgery: Transforming Practice, Precision, and Patient Care","authors":"Idean Roohani MD , Bonnie L. Padwa MD, DMD , 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}
Pub Date : 2026-01-01DOI: 10.1016/j.joms.2025.08.014
Andrew E. Bertagna DMD, MD , Frederic Van der Cruyssen MD, DDS, MHM, PhD , Michael Miloro DMD, MD
Background
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.
Purpose
The study purpose was to estimate the 1-year incidence of persistent NSD after SSO and to evaluate risk factors.
Data Sources
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.
Study Selection
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.
Data Extraction and Synthesis
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.
Results
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).
Conclusions and Relevance
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.
{"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 , Frederic Van der Cruyssen MD, DDS, MHM, PhD , 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 (I<sup>2</sup>) 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}
Pub Date : 2026-01-01DOI: 10.1016/j.joms.2025.09.020
J. David Johnson Jr. DDS , Paul J. Schwartz DMD , Andrew Herlich DMD, MD
{"title":"The 2025 ADA Dental Anesthesia Provider Summit: Patient Safety and Access to Care","authors":"J. David Johnson Jr. DDS , Paul J. Schwartz DMD , 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}
Pub Date : 2026-01-01DOI: 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)
{"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), Deenadayalan Boopalan MD (Naturopathy), N.V. Gnana Deep Tatavarti MD (Naturopathy), 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}
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。
{"title":"Does Reiki Therapy ReducePreoperative Anxiety and Postoperative Pain in Third Molar Surgery? A Randomized Controlled Trial","authors":"Meltem Ozden Yuce PhD , Birant Simsek PhD , Omer Faruk Dadas PhD , Candan Efeoglu PhD","doi":"10.1016/j.joms.2025.09.003","DOIUrl":"10.1016/j.joms.2025.09.003","url":null,"abstract":"<div><h3>Background</h3><div>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.</div></div><div><h3>Purpose</h3><div>This study evaluated whether Reiki therapy reduces preoperative anxiety and postoperative pain in third molar surgery.</div></div><div><h3>Study Design</h3><div>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.</div></div><div><h3>Predictor Variable</h3><div>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.</div></div><div><h3>Main Outcome Variable</h3><div>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.</div></div><div><h3>Covariates</h3><div>Covariates included sex, baseline anxiety scores, surgery duration, and the quantity/timing of additional analgesic intake in the first postoperative week.</div></div><div><h3>Analyses</h3><div>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 (<em>P</em> < .05 considered significant).</div></div><div><h3>Results</h3><div>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; <em>P</em> = .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) (<em>P</em> = .045).</div></div><div><h3>Conclusion and Relevance</h3><div>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.</div></div>","PeriodicalId":16612,"journal":{"name":"Journal of Oral and Maxillofacial Surgery","volume":"84 1","pages":"Pages 101-108"},"PeriodicalIF":2.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145182073","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}
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。
{"title":"Can Evoked Electromyography Detect Postoperative Facial Nerve Recovery Earlier Than Grading Scales Following Temporomandibular Joint Ankylosis Surgery?","authors":"Abiskar Basnet MDS , Saurabh Simre MDS , Ashi Chug MDS, PhD , Prem Kumar Rathod MDS , Aparna Mahajan BDS , Poorvi Kulshrestha MD","doi":"10.1016/j.joms.2025.09.018","DOIUrl":"10.1016/j.joms.2025.09.018","url":null,"abstract":"<div><h3>Background</h3><div>Facial nerve (FN) dysfunction is a potential postoperative complication of managing temporomandibular joint ankylosis (TMJa).</div></div><div><h3>Purpose</h3><div>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.</div></div><div><h3>Study Design, Setting, Sample</h3><div>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.</div></div><div><h3>Predictor Variable</h3><div>The primary predictor variable was FNF recovery monitoring tool (EEMG vs HBS vs SBS).</div></div><div><h3>Main Outcome Variables</h3><div>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).</div></div><div><h3>Covariates</h3><div>Covariates included age, sex, and operative time.</div></div><div><h3>Analysis</h3><div>Data were analyzed using SPSSversion20. Frequencies (percentages) were compared using χ<sup>2</sup> 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 <em>P</em> < .05.</div></div><div><h3>Results</h3><div>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, <em>P</em> < .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, <em>P</em> < .05).</div></div><div><h3>Conclusion and Relevance</h3><div>EEMG detects FNF recovery earlier than grading scales, and is a valid electrodiagnostic test for postoperative monitoring.</div></div>","PeriodicalId":16612,"journal":{"name":"Journal of Oral and Maxillofacial Surgery","volume":"84 1","pages":"Pages 18-24"},"PeriodicalIF":2.6,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145370267","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}
京公网安备 11010802042870号
京ICP备2023020795号-1
扫码关注我们
求助内容：
应助结果提醒方式：