Facial asymmetry may be associated with cervical spine deviation; however, a relationship has not yet been established. This study aimed to clarify an association between facial asymmetry and cervical spine deviation.
Methods
We evaluated facial asymmetry and measured cervical spine angles to determine their effects on cervical deviation in 92 female patients with jaw deformities that were assessed using computed tomography (CT). Frontal, lateral, and axial radiographs were analyzed using cephalometry. We measured distances and angles from the external occipital protuberance to reference points on an atlas and up to the fifth cervical spine. Maxillofacial morphology was constructed in three dimensions from CT images. The primary outcome measure was the cervical spine angle in association with the maxillomandibular (Mx-Md) midline angle.
Results
The cervical spine angle significantly and positively correlated with the Mx-Md midline angle (p < 0.001). Patients with Mx-Md midline angles > 2.5° or ≤ 2.5° were respectively classified as asymmetric (n = 43) and symmetric (n = 49). The average cervical spine angles were 11.21° ± 7.23° in the asymmetric group and 7.53° ± 6.05° in the symmetric group. The cervical spine angle significantly differed between the symmetric and asymmetric groups, with larger cervical spine angles corresponding to increased facial asymmetry (p < 0.001).
Conclusions
This study identified an association between cervical spine deviation and facial symmetry, which may play a role in postural distortion.
{"title":"Evaluation of facial asymmetry and cervical spine deviation: A retrospective study","authors":"Karen Gomi, Akinori Moroi, Riku Kohara, Sumire Ono, Kunio Yoshizawa, Koichiro Ueki","doi":"10.1016/j.ajoms.2025.06.010","DOIUrl":"10.1016/j.ajoms.2025.06.010","url":null,"abstract":"<div><h3>Objective</h3><div>Facial asymmetry may be associated with cervical spine deviation; however, a relationship has not yet been established. This study aimed to clarify an association between facial asymmetry and cervical spine deviation.</div></div><div><h3>Methods</h3><div>We evaluated facial asymmetry and measured cervical spine angles to determine their effects on cervical deviation in 92 female patients with jaw deformities that were assessed using computed tomography (CT). Frontal, lateral, and axial radiographs were analyzed using cephalometry. We measured distances and angles from the external occipital protuberance to reference points on an atlas and up to the fifth cervical spine. Maxillofacial morphology was constructed in three dimensions from CT images. The primary outcome measure was the cervical spine angle in association with the maxillomandibular (Mx-Md) midline angle.</div></div><div><h3>Results</h3><div>The cervical spine angle significantly and positively correlated with the Mx-Md midline angle (p < 0.001). Patients with Mx-Md midline angles > 2.5° or ≤ 2.5° were respectively classified as asymmetric (n = 43) and symmetric (n = 49). The average cervical spine angles were 11.21° ± 7.23° in the asymmetric group and 7.53° ± 6.05° in the symmetric group. The cervical spine angle significantly differed between the symmetric and asymmetric groups, with larger cervical spine angles corresponding to increased facial asymmetry (p < 0.001).</div></div><div><h3>Conclusions</h3><div>This study identified an association between cervical spine deviation and facial symmetry, which may play a role in postural distortion.</div></div>","PeriodicalId":45034,"journal":{"name":"Journal of Oral and Maxillofacial Surgery Medicine and Pathology","volume":"37 6","pages":"Pages 1220-1225"},"PeriodicalIF":0.4,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144907840","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Metastasis of oral cancer to the mandibular lymph node (MLN) is rare, particularly in the early stages. Furthermore, no consensus about surgical treatment of metastasis to the MLNs exists. Herein, we describe a case of MLN identified early on computed tomography (CT) when the patient was initially diagnosed with squamous cell carcinoma of mandibular gingiva. Since no evident malignant findings on positron emission tomography-CT (PET-CT) or cervical ultrasonography were observed, the case was regarded as normal anatomy without metastasis. A diagnosis of mandibular gingival cancer (cT2N0M0) was made; marginal mandibulectomy was performed. However, three months later, contrast-enhanced CT images revealed an enlarged 12 mm × 7 mm MLN, and fluorodeoxyglucose (FDG) accumulation (SUV max: 3.9) was observed in both the MLN and submandibular lymph nodes on FDG-PET/CT. Therefore, we performed radical neck dissection including the MLN. Extra-nodal extensions were observed in the submandibular lymph nodes. Accordingly, weekly cisplatin at a dose of 40 mg/m2 combined with radiotherapy (66 Gy) was performed as post-operative treatment. The MLN is an intercalated lymph node that may not be present in some patients or the lymph node may not be detected because it may have integrated into the tumor. However, when they are detected, even if there are no obvious malignant findings, considering them metastatic regions and proceeding with treatment accordingly are necessary.
口腔癌转移到下颌淋巴结（MLN）是罕见的，特别是在早期阶段。此外，对于转移到mln的手术治疗尚无共识。在此，我们描述一个病例，当患者最初被诊断为下颌牙龈鳞状细胞癌时，早期通过计算机断层扫描（CT）发现MLN。由于正电子发射断层扫描（PET-CT）及宫颈超声检查未见明显恶性病灶，故认为该病例解剖正常，无转移。诊断为下颌龈癌（cT2N0M0）；行下颌边缘切除术。然而，3个月后，CT增强图像显示MLN增大了12 mm × 7 mm， FDG- pet /CT显示MLN和下颌下淋巴结均有氟脱氧葡萄糖（FDG）积聚（SUV max: 3.9）。因此，我们进行了根治性颈部清扫，包括MLN。在下颌骨淋巴结中观察到结外延伸。因此，每周40 mg/m2剂量的顺铂联合放疗（66 Gy）作为术后治疗。MLN是一种插入性淋巴结，在一些患者中可能不存在，或者由于淋巴结可能已经融入肿瘤而无法检测到。然而，当它们被发现时，即使没有明显的恶性表现，也必须考虑它们是转移区并进行相应的治疗。
{"title":"A case of mandibular gingival squamous cell carcinoma with mandibular lymph node metastasis","authors":"Yusuke Urata , Norihisa Ichimura , Masahito Fujio , Satoshi Yamaguchi , Takeru Kobayashi , Ryo Ebata , Akimune Suetsugi , Hideharu Hibi","doi":"10.1016/j.ajoms.2025.06.011","DOIUrl":"10.1016/j.ajoms.2025.06.011","url":null,"abstract":"<div><div>Metastasis of oral cancer to the mandibular lymph node (MLN) is rare, particularly in the early stages. Furthermore, no consensus about surgical treatment of metastasis to the MLNs exists. Herein, we describe a case of MLN identified early on computed tomography (CT) when the patient was initially diagnosed with squamous cell carcinoma of mandibular gingiva. Since no evident malignant findings on positron emission tomography-CT (PET-CT) or cervical ultrasonography were observed, the case was regarded as normal anatomy without metastasis. A diagnosis of mandibular gingival cancer (cT2N0M0) was made; marginal mandibulectomy was performed. However, three months later, contrast-enhanced CT images revealed an enlarged 12 mm × 7 mm MLN, and fluorodeoxyglucose (FDG) accumulation (SUV max: 3.9) was observed in both the MLN and submandibular lymph nodes on FDG-PET/CT. Therefore, we performed radical neck dissection including the MLN. Extra-nodal extensions were observed in the submandibular lymph nodes. Accordingly, weekly cisplatin at a dose of 40 mg/m<sup>2</sup> combined with radiotherapy (66 Gy) was performed as post-operative treatment. The MLN is an intercalated lymph node that may not be present in some patients or the lymph node may not be detected because it may have integrated into the tumor. However, when they are detected, even if there are no obvious malignant findings, considering them metastatic regions and proceeding with treatment accordingly are necessary.</div></div>","PeriodicalId":45034,"journal":{"name":"Journal of Oral and Maxillofacial Surgery Medicine and Pathology","volume":"37 6","pages":"Pages 1244-1248"},"PeriodicalIF":0.4,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144907732","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-06-23DOI: 10.1016/j.ajoms.2025.06.009
Victor C.K. Fung , Velda L.Y. Chow , Kevin K.F. Cheng
Ameloblastoma (AM) is a histologically benign but locally aggressive odontogenic tumour that commonly affects the mandible or maxilla. A 66-year-old man with a history of recurrent AM presented with right eye floater during follow-up was found to have local recurrence over the right temporal bone and lateral orbital wall. In view of the complex craniofacial resection, a 3D-printed patient-specific implant (PSI) using polyetheretherketone (PEEK) was manufactured and deployed intraoperatively. This utilization of PSI allows for precise surgical planning and reconstruction and should be considered a viable alternative to autologous bone graft in craniofacial reconstruction for patients suffering from AM.
{"title":"Reconstruction of craniofacial defect using patient-specific polyetheretherketone (PEEK) in recurrent ameloblastoma","authors":"Victor C.K. Fung , Velda L.Y. Chow , Kevin K.F. Cheng","doi":"10.1016/j.ajoms.2025.06.009","DOIUrl":"10.1016/j.ajoms.2025.06.009","url":null,"abstract":"<div><div><span><span>Ameloblastoma<span> (AM) is a histologically benign but locally aggressive odontogenic tumour that commonly affects the mandible or </span></span>maxilla. A 66-year-old man with a history of recurrent AM presented with right </span>eye floater<span><span> during follow-up was found to have local recurrence over the right temporal bone and lateral orbital wall. In view of the complex craniofacial resection, a 3D-printed patient-specific implant (PSI) using </span>polyetheretherketone<span> (PEEK) was manufactured and deployed intraoperatively. This utilization of PSI allows for precise surgical planning and reconstruction and should be considered a viable alternative to autologous bone graft<span> in craniofacial reconstruction for patients suffering from AM.</span></span></span></div></div>","PeriodicalId":45034,"journal":{"name":"Journal of Oral and Maxillofacial Surgery Medicine and Pathology","volume":"37 6","pages":"Pages 1239-1243"},"PeriodicalIF":0.4,"publicationDate":"2025-06-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144907731","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Cold agglutinin disease (CAD) is a rare autoimmune haemolytic anaemia characterised by the presence of cold agglutinins, which are autoantibodies that agglutinate erythrocytes upon exposure to low temperatures. Although CAD patients typically develop haemolytic anaemia in response to febrile infections, no reports have been documented thus far regarding haemolytic anaemia in CAD patients resulting from odontogenic infections. A 47-year-old male patient with haemolysis because of an odontogenic infection is presented in this report. The patient had been diagnosed with CAD dating back approximately a decade, although the patient had not undergone haematological treatment. In November 2021, the patient was referred to our department from the haematology department because of haemolysis, which would have been triggered by acute right maxillary sinusitis. The sinusitis was caused by apical periodontitis of the second molar in the right maxilla. To address the condition, the patient received a red blood cell (RBC) transfusion along with antibiotics to control the sinusitis. After sinusitis had been improved, according to the suggestion from haematologists, the maxillary right second molar was extracted under local anaesthesia under body temperature control in January 2022. The patient’s body was kept warm, and infusion fluid for intravenous administration was controlled at approximately 37℃ during the peri- and postoperative period to avoid CAD. Because an odontogenic infection could be a trigger of haemolysis, maintenance of oral hygiene and early treatment of bacterial infections are important in patients with CAD.
{"title":"A case of haemolytic anemia triggered by an odontogenic infection in a patient with cold agglutinin disease","authors":"Takehiro Watanabe , Mako Yokoyama , Takuma Watanabe , Shigeki Yamanaka , Shizuko Fukuhara , Yuria Onishi , Yasuko Miyahara , Kazumasa Nakao , Makoto Hirota","doi":"10.1016/j.ajoms.2025.06.008","DOIUrl":"10.1016/j.ajoms.2025.06.008","url":null,"abstract":"<div><div>Cold agglutinin disease (CAD) is a rare autoimmune haemolytic anaemia characterised by the presence of cold agglutinins, which are autoantibodies that agglutinate erythrocytes upon exposure to low temperatures. Although CAD patients typically develop haemolytic anaemia in response to febrile infections, no reports have been documented thus far regarding haemolytic anaemia in CAD patients resulting from odontogenic infections. A 47-year-old male patient with haemolysis because of an odontogenic infection is presented in this report. The patient had been diagnosed with CAD dating back approximately a decade, although the patient had not undergone haematological treatment. In November 2021, the patient was referred to our department from the haematology department because of haemolysis, which would have been triggered by acute right maxillary sinusitis. The sinusitis was caused by apical periodontitis of the second molar in the right maxilla. To address the condition, the patient received a red blood cell (RBC) transfusion along with antibiotics to control the sinusitis. After sinusitis had been improved, according to the suggestion from haematologists, the maxillary right second molar was extracted under local anaesthesia under body temperature control in January 2022. The patient’s body was kept warm, and infusion fluid for intravenous administration was controlled at approximately 37℃ during the peri- and postoperative period to avoid CAD. Because an odontogenic infection could be a trigger of haemolysis, maintenance of oral hygiene and early treatment of bacterial infections are important in patients with CAD.</div></div>","PeriodicalId":45034,"journal":{"name":"Journal of Oral and Maxillofacial Surgery Medicine and Pathology","volume":"37 6","pages":"Pages 1269-1272"},"PeriodicalIF":0.4,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144907737","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-06-14DOI: 10.1016/j.ajoms.2025.06.007
Faheela Tamseel , Syed Saaib Hussain
{"title":"Comment on: “Anxiety and depression following facial and dental trauma – A prospective study”","authors":"Faheela Tamseel , Syed Saaib Hussain","doi":"10.1016/j.ajoms.2025.06.007","DOIUrl":"10.1016/j.ajoms.2025.06.007","url":null,"abstract":"","PeriodicalId":45034,"journal":{"name":"Journal of Oral and Maxillofacial Surgery Medicine and Pathology","volume":"37 6","pages":"Pages 1249-1250"},"PeriodicalIF":0.4,"publicationDate":"2025-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144907733","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Calcifying odontogenic cyst (COC), also known as Gorlin cyst, is a type of developmental odontogenic cyst characterized histologically according to the latest (2022) WHO classification by frequently calcifying ghost cells in epithelium. A COC is usually intraosseous but occasionally arises in soft tissue; these are called peripheral COCs (PCOCs). We describe a PCOC that manifested as a progressive growth of a gingival mass in the maxilla of a 10-year-old Japanese boy. Radiological examinations revealed no remarkable findings. An excisional biopsy was thus conducted for a definite diagnosis. The histological examination confirmed the diagnosis of PCOC with the presence of characteristic ghost cells and sporadic calcifications; no surrounding bone tissue was present. No recurrence or complication were noted at the 1-year follow-up. We also extracted 39 cases from the literature that meet the current WHO criteria and statistically analyzed the 40 cases including our patient's. A multivariate analysis showed that the gender and location (maxilla or mandible) are two major factors related to the age factor, indicating that PCOC is more common in the maxilla of younger males. Additionally, the PCOCs were smaller than the COCs and had a significantly lower calcification rate on radiography (p < 0.001), probably because PCOCs are usually resected when the lesion is small. Even if ghost cell calcification is present, it may not be large enough to be radiologically visible.
{"title":"Peripheral calcifying odontogenic cyst: A case report and literature review","authors":"Izumi Hara , Kyoichi Obata , Nana Yoshitani , Kisho Ono , Hotaka Kawai , Yuki Kunisada , Mayumi Yao , Takayoshi Miyake , Soichiro Ibaragi","doi":"10.1016/j.ajoms.2025.06.004","DOIUrl":"10.1016/j.ajoms.2025.06.004","url":null,"abstract":"<div><div>Calcifying odontogenic cyst<span> (COC), also known as Gorlin cyst, is a type of developmental odontogenic cyst characterized histologically according to the latest (2022) WHO classification by frequently calcifying ghost cells in epithelium. A COC is usually intraosseous but occasionally arises in soft tissue; these are called peripheral COCs (PCOCs). We describe a PCOC that manifested as a progressive growth of a gingival mass in the maxilla<span> of a 10-year-old Japanese boy. Radiological examinations<span> revealed no remarkable findings. An excisional biopsy was thus conducted for a definite diagnosis. The histological examination confirmed the diagnosis of PCOC with the presence of characteristic ghost cells and sporadic calcifications; no surrounding bone tissue<span> was present. No recurrence or complication were noted at the 1-year follow-up. We also extracted 39 cases from the literature that meet the current WHO criteria and statistically analyzed the 40 cases including our patient's. A multivariate analysis showed that the gender and location (maxilla or mandible) are two major factors related to the age factor, indicating that PCOC is more common in the maxilla of younger males. Additionally, the PCOCs were smaller than the COCs and had a significantly lower calcification rate on radiography (p < 0.001), probably because PCOCs are usually resected when the lesion is small. Even if ghost cell calcification is present, it may not be large enough to be radiologically visible.</span></span></span></span></div></div>","PeriodicalId":45034,"journal":{"name":"Journal of Oral and Maxillofacial Surgery Medicine and Pathology","volume":"37 6","pages":"Pages 1314-1320"},"PeriodicalIF":0.4,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144907842","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
This study aimed to determine the frequency of bisphosphonate-related osteonecrosis of the jaw (BRONJ) after tooth extraction in patients treated with bisphosphonates (BPs) and to assess the efficacy of preventive BPs discontinuation in reducing BRONJ risk.
Methods
A 26-center prospective study was conducted on 1323 patients with current or past BPs treatment (2013–2016). Patients underwent tooth extraction under a standardized protocol, and the incidence of BRONJ and adverse events were evaluated.
Results
Among 1323 cases (2371 teeth extracted), 808 were in the preventive BPs discontinuation group, and 515 were in the BPs continuation group. The overall BRONJ incidence was 1.74 %, with rates of 1.73 % and 1.75 % in the discontinuation and continuation groups, respectively (P = 1.000). The incidence rates of BRONJ in the osteoporosis and malignancy groups were 1.23 % and 28.00 %, respectively (P < 0.001). Factors associated with BRONJ development included sex, BPs indications, oral hygiene, tooth extraction site, and denosumab use. Propensity score analysis using the inverse probability weighting method showed no significant association between BRONJ development and preventive BPs discontinuation (P = 0.834; odds ratio: 1.131, 95 % confidence interval: 0.36–3.57). No fragility fractures occurred in the discontinuation group.
Conclusions
The incidence of BRONJ after tooth extraction in patients receiving BPs was 1.74 %, with no preventive effect of BPs discontinuation in the osteoporosis group. Significant risk factors included sex, denosumab use, BPs indication, oral hygiene, and extraction site.
{"title":"Multicenter prospective study on the development of bisphosphonate-related osteonecrosis of the jaw after tooth extraction in patients treated with bisphosphonates (complete translation)","authors":"Masaki Fujimori , Yoshiyuki Toriyabe , Nobuhiro Kaku , Kosuke Shimazaki , Masayoshi Miyasawa , Hiroki Mityate , Hideaki Kitada , Yuji Satoh , Hajime Misawa , Tetsuro Yamashita , Yoritoshi Nakajima , Yasushi Hariya , Ichizo Kobayashi , Satoshi Nishikata , Taishi Yoshihito , Sugiura Chihiro , Kazue Kasahiara , Yuichiro Asaka , Noriyuki Sakakibara , Masuhiko Okada , Shujiroh Makino","doi":"10.1016/j.ajoms.2025.06.006","DOIUrl":"10.1016/j.ajoms.2025.06.006","url":null,"abstract":"<div><h3>Objective</h3><div>This study aimed to determine the frequency of bisphosphonate-related osteonecrosis of the jaw (BRONJ) after tooth extraction in patients treated with bisphosphonates (BPs) and to assess the efficacy of preventive BPs discontinuation in reducing BRONJ risk.</div></div><div><h3>Methods</h3><div>A 26-center prospective study was conducted on 1323 patients with current or past BPs treatment (2013–2016). Patients underwent tooth extraction under a standardized protocol, and the incidence of BRONJ and adverse events were evaluated.</div></div><div><h3>Results</h3><div>Among 1323 cases (2371 teeth extracted), 808 were in the preventive BPs discontinuation group, and 515 were in the BPs continuation group. The overall BRONJ incidence was 1.74 %, with rates of 1.73 % and 1.75 % in the discontinuation and continuation groups, respectively (P = 1.000). The incidence rates of BRONJ in the osteoporosis and malignancy groups were 1.23 % and 28.00 %, respectively (P < 0.001). Factors associated with BRONJ development included sex, BPs indications, oral hygiene, tooth extraction site, and denosumab use. Propensity score analysis using the inverse probability weighting method showed no significant association between BRONJ development and preventive BPs discontinuation (P = 0.834; odds ratio: 1.131, 95 % confidence interval: 0.36–3.57). No fragility fractures occurred in the discontinuation group.</div></div><div><h3>Conclusions</h3><div>The incidence of BRONJ after tooth extraction in patients receiving BPs was 1.74 %, with no preventive effect of BPs discontinuation in the osteoporosis group. Significant risk factors included sex, denosumab use, BPs indication, oral hygiene, and extraction site.</div></div>","PeriodicalId":45034,"journal":{"name":"Journal of Oral and Maxillofacial Surgery Medicine and Pathology","volume":"37 6","pages":"Pages 1209-1219"},"PeriodicalIF":0.4,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144906833","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Most patients experience postoperative complications caused by the extraction of horizontally impacted mandibular third molars. The present study aimed to compare the effects of two flap designs on the reduction of postoperative complications.
Methods
A total of 188 patients with horizontally impacted mandibular third molars were included in this single-blind, multicenter, randomized control trial. The patients were assigned to either the modified envelope flap (mEF) or triangular flap (TF) group in a 1:1 ratio. The operation time and postoperative complications (pain, hemorrhage, neurosensory changes, dry socket [alveolar osteitis], and infection) were assessed for 7 ± 1 days postoperatively.
Results
In all cases, postoperative pain was significantly lower in the mEF group (P = 0.033). In the subgroup analysis, postoperative pain was significantly lower in cases of low difficulty (Pell and Gregory classification IA, IIA, IIA, IB; P = 0.018). Other factors were not significantly associated with the flap design.
Conclusions
Our study suggested that mEF resulted in less postoperative pain in cases of low difficulty of extracting horizontally impacted mandibular third molars. However, the current evidence is inadequate to recommend either flap design.
{"title":"Comparative analysis of two flap designs for the extraction of horizontally impacted mandibular third molars: A multicenter randomized controlled trial","authors":"Tomofumi Naruse , Satoshi Rokutanda , Satoshi Inokuchi , Keisuke Omori , Kohei Furukawa , Hiromasa Fukushima , Masahiro Umeda , Tomohiro Yamada","doi":"10.1016/j.ajoms.2025.06.005","DOIUrl":"10.1016/j.ajoms.2025.06.005","url":null,"abstract":"<div><h3>Objective</h3><div>Most patients experience postoperative complications caused by the extraction of horizontally impacted mandibular third molars. The present study aimed to compare the effects of two flap designs on the reduction of postoperative complications.</div></div><div><h3>Methods</h3><div>A total of 188 patients with horizontally impacted mandibular third molars were included in this single-blind, multicenter, randomized control trial. The patients were assigned to either the modified envelope flap (mEF) or triangular flap (TF) group in a 1:1 ratio. The operation time and postoperative complications (pain, hemorrhage, neurosensory changes, dry socket [alveolar osteitis], and infection) were assessed for 7 ± 1 days postoperatively.</div></div><div><h3>Results</h3><div>In all cases, postoperative pain was significantly lower in the mEF group (P = 0.033). In the subgroup analysis, postoperative pain was significantly lower in cases of low difficulty (Pell and Gregory classification IA, IIA, IIA, IB; P = 0.018). Other factors were not significantly associated with the flap design.</div></div><div><h3>Conclusions</h3><div>Our study suggested that mEF resulted in less postoperative pain in cases of low difficulty of extracting horizontally impacted mandibular third molars. However, the current evidence is inadequate to recommend either flap design.</div></div>","PeriodicalId":45034,"journal":{"name":"Journal of Oral and Maxillofacial Surgery Medicine and Pathology","volume":"37 6","pages":"Pages 1203-1208"},"PeriodicalIF":0.4,"publicationDate":"2025-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144906885","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Obstructive sleep apnea (OSA) is affected by the body position during sleep. However, the relationship between OSA and the number of times sleep position changes has not been examined. To clarify this relationship, we compared and analyzed polysomnography (PSG) results before and after oral appliance (OA) fitting, focusing on changes in the number of position changes during sleep in patients whose OSA improved due to OA use.
Methods
we retrospectively analyzed 26 OSA patients (18 males, 8 females; mean age 60.6 ± 12.0 years old) who underwent PSG at our hospital and demonstrated improvement in the apnea-hypopnea index (AHI) after OA use. Items such as the postural change index (PCI), sleep stages, wake time after sleep onset (WASO), arousal index (ArI), and 3 % oxygen desaturation index (ODI) were evaluated.
Results
After OA fitting, the PCI significantly decreased (p <0.05), indicating a reduced number of body position changes during sleep. The sleep quality improved, as evidenced by a significant decrease in N1 stage sleep (p <0.01), WASO (p <0.05), ArI (p <0.01), and 3 % ODI (p <0.01) and a significant increase in N2 stage sleep (p <0.01). The reduction in the PCI was significant in the patients with severe OSA (p <0.05). Improvements in the sleep quality were more pronounced in the PCI decrease group than in the PCI increase group.
Conclusions
OA reduces position changes and enhances sleep quality, particularly in severe cases, improving sleep stability. Further studies are needed.
梗阻性睡眠呼吸暂停（OSA）受睡眠时体位的影响。然而，阻塞性睡眠呼吸暂停与睡眠姿势变化次数之间的关系尚未得到研究。为了阐明这种关系，我们比较并分析了口腔矫具（OA）装配前后的多导睡眠图（PSG）结果，重点研究了因使用OA而改善OSA的患者睡眠期间体位变化次数的变化。方法回顾性分析26例OSA患者（男18例，女8例，平均年龄60.6±12.0岁）在我院行PSG治疗，经OA治疗后呼吸暂停低通气指数（AHI）有所改善。评估体位变化指数（PCI）、睡眠阶段、醒后时间（WASO）、觉醒指数（ArI）和3 %氧去饱和指数（ODI）等指标。结果OA拟合后PCI明显降低（p <0.05），表明睡眠中体位变化次数减少。睡眠质量得到改善，N1期睡眠显著降低（p <0.01）， WASO (p <0.05), ArI (p <0.01), 3 % ODI (p <0.01)， N2期睡眠显著增加（p <0.01）。重度OSA患者PCI降低显著（p <0.05）。睡眠质量的改善在PCI减少组比PCI增加组更明显。结论soa可减少体位变化，提高睡眠质量，尤其是重症患者，改善睡眠稳定性。需要进一步的研究。
{"title":"The association between positional changes and the sleep quality in patients with obstructive sleep apnea improved by an oral appliance","authors":"Takahiro Suzuki , Takahiro Ikemori , Shintaro Satou , Hironori Miyamoto , Kenichiro Ishibashi , Shuhei Tsuchiya , Shinichiro Kato , Yasuyuki Shibuya","doi":"10.1016/j.ajoms.2025.05.013","DOIUrl":"10.1016/j.ajoms.2025.05.013","url":null,"abstract":"<div><h3>Introduction</h3><div><span>Obstructive sleep apnea<span> (OSA) is affected by the body position during sleep. However, the relationship between OSA and the number of times sleep position changes has not been examined. To clarify this relationship, we compared and analyzed </span></span>polysomnography (PSG) results before and after oral appliance (OA) fitting, focusing on changes in the number of position changes during sleep in patients whose OSA improved due to OA use.</div></div><div><h3>Methods</h3><div>we retrospectively analyzed 26 OSA patients (18 males, 8 females; mean age 60.6 ± 12.0 years old) who underwent PSG at our hospital and demonstrated improvement in the apnea-hypopnea index (AHI) after OA use. Items such as the postural change index (PCI), sleep stages, wake time after sleep onset (WASO), arousal index (ArI), and 3 % oxygen desaturation index (ODI) were evaluated.</div></div><div><h3>Results</h3><div>After OA fitting, the PCI significantly decreased (p <0.05), indicating a reduced number of body position changes during sleep. The sleep quality improved, as evidenced by a significant decrease in N1 stage sleep (p <0.01), WASO (p <0.05), ArI (p <0.01), and 3 % ODI (p <0.01) and a significant increase in N2 stage sleep (p <0.01). The reduction in the PCI was significant in the patients with severe OSA (p <0.05). Improvements in the sleep quality were more pronounced in the PCI decrease group than in the PCI increase group.</div></div><div><h3>Conclusions</h3><div>OA reduces position changes and enhances sleep quality, particularly in severe cases, improving sleep stability. Further studies are needed.</div></div>","PeriodicalId":45034,"journal":{"name":"Journal of Oral and Maxillofacial Surgery Medicine and Pathology","volume":"37 6","pages":"Pages 1257-1262"},"PeriodicalIF":0.4,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144907735","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Odontogenic infection is the most common cause of necrotizing fasciitis of the head and neck, and underlying diseases, time to surgery, and spread of inflammation to the mediastinum are significant prognostic factors. Among them, jugular vein thrombophlebitis due to spread of a primary infection via the cervical fascia or cervical lymphatic system is rare. Herein, we report a case of Lemierre’s syndrome (LS) as a complication of a severe odontogenic infection in a patient who refrained from medical examinations for several years.
A 43-year-old man was referred to our hospital with pain and swelling in the left mandible. Based on the clinical and imaging findings, the patient was diagnosed with acute osteomyelitis, complicated with cervical cellulitis and LS. Multiple external jugular vein thromboses and distant infections were observed. Surgical drainage, sequestrectomy for mandibular osteomyelitis, and tooth extraction were performed, and antibiotics were administered for 9 weeks. No evidence of infection was observed 1 year after surgery.
{"title":"Lemierre’s syndrome associated with acute osteomyelitis: A case report and review of the literature","authors":"Masahito Hara, Tomofumi Naruse, Ayaka Takemura, Keisuke Omori, Kota Morishita, Tomohiro Yamada","doi":"10.1016/j.ajoms.2025.05.014","DOIUrl":"10.1016/j.ajoms.2025.05.014","url":null,"abstract":"<div><div>Odontogenic infection is the most common cause of necrotizing fasciitis of the head and neck, and underlying diseases, time to surgery, and spread of inflammation to the mediastinum are significant prognostic factors. Among them, jugular vein thrombophlebitis due to spread of a primary infection via the cervical fascia or cervical lymphatic system is rare. Herein, we report a case of Lemierre’s syndrome (LS) as a complication of a severe odontogenic infection in a patient who refrained from medical examinations for several years.</div><div>A 43-year-old man was referred to our hospital with pain and swelling in the left mandible. Based on the clinical and imaging findings, the patient was diagnosed with acute osteomyelitis, complicated with cervical cellulitis and LS. Multiple external jugular vein thromboses and distant infections were observed. Surgical drainage, sequestrectomy for mandibular osteomyelitis, and tooth extraction were performed, and antibiotics were administered for 9 weeks. No evidence of infection was observed 1 year after surgery.</div></div>","PeriodicalId":45034,"journal":{"name":"Journal of Oral and Maxillofacial Surgery Medicine and Pathology","volume":"37 6","pages":"Pages 1263-1268"},"PeriodicalIF":0.4,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144907736","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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