Pub Date : 2026-01-01DOI: 10.1016/j.jcms.2025.11.014
Haichao Wang , Yi Liu , Jingwen Wu , Wenjing Wang , Hongyi Zhang , Cunjian Yi
<div><h3>Background</h3><div>Oral squamous cell carcinoma (OSCC) is characterized by difficulties in early diagnosis and poor prognosis. m6A methylation regulators are closely associated with tumor progression, yet their prognostic value and mechanisms in OSCC remain unclear. This study was to analyze the expression patterns of m6A regulators in OSCC and their association with prognosis, elucidate their mechanisms in OSCC progression, and provide a basis for diagnosis and treatment.</div></div><div><h3>Methods</h3><div>The expression patterns and prognostic value were analyzed using the following bioinformatics methods: the optimal cluster number <em>k</em> = 2 was determined based on the silhouette coefficient, and K-means clustering was employed for sample subtype classification; the cut-off values for high/low gene expression were defined by combining the ROC curve method and the tertile method, with Kaplan-Meier (KM) survival analysis and the Log-rank test used to compare survival differences between groups; univariate Cox regression was applied to screen for potential prognostic factors, followed by multivariate Cox regression with a forward selection method to identify independent prognostic factors; the limma package was used to identify differentially expressed genes (DEGs), and the biological functions of these DEGs were annotated through GO (biological process/cellular component/molecular function) and KEGG enrichment analyses; clinical, gene, and combined models were constructed, and the C-index and Delong test were utilized to evaluate the predictive performance of the models.</div></div><div><h3>Results</h3><div>OSCC samples were classified into Group A (n = 142) and Group B (n = 83). The 5-year survival rate (SR) of Group A (70.24 %) was significantly higher than that of Group B (60.76 %) (Hazard ratio (HR) = 1.58, <em>P</em> = 0.001). Highly correlated gene pairs such as methyltransferase-like 3 (METTL3) and METTL14 (<em>r</em> = 0.78) and fat mass and obesity-associated protein (FTO) and AlkB homolog 5 (ALKBH5) (<em>r</em> = 0.65) were consistently validated in an independent dataset. METTL3 (adjusted HR = 1.38, <em>P</em> = 0.008), FTO (adjusted HR = 1.42, <em>P</em> = 0.015), and YTHDF1 (adjusted HR = 1.51, <em>P</em> = 0.004) were identified as independent predictors of poor prognosis. DEGs were enriched in immune response, cell cycle, and PI3K-Akt/MAPK signaling pathways. The combined model incorporating these three genes and clinical variables demonstrated the highest C-index (0.72), with HR fluctuations <15 %, indicating robust results.</div></div><div><h3>Conclusion</h3><div>Multivariate Cox regression confirmed that METTL3, FTO, and YTHDF1 are associated with an unfavorable prognosis in OSCC patients, suggesting their potential as independent prognostic biomarkers. The m6A methylation regulators may contribute to OSCC progression by modulating immune responses, the cell cycle, and the PI3K-Akt/MAPK signaling pathway, in
背景：口腔鳞状细胞癌（OSCC）具有早期诊断困难、预后差的特点。m6A甲基化调节因子与肿瘤进展密切相关，但其在OSCC中的预后价值和机制尚不清楚。本研究旨在分析m6A调节因子在OSCC中的表达模式及其与预后的关系，阐明其在OSCC进展中的作用机制，为OSCC的诊断和治疗提供依据。方法：采用以下生物信息学方法分析其表达模式和预后价值：根据剪影系数确定最佳聚类数k = 2，采用k均值聚类进行样本亚型分类；结合ROC曲线法和五位数法确定基因高/低表达的临界值，采用Kaplan-Meier （KM）生存分析和Log-rank检验比较组间生存差异；采用单因素Cox回归筛选潜在预后因素，再采用多因素Cox回归和正向选择方法筛选独立预后因素；利用limma包鉴定差异表达基因（deg），并通过GO（生物过程/细胞成分/分子功能）和KEGG富集分析对这些差异表达基因的生物学功能进行注释；构建临床模型、基因模型和联合模型，采用c指数和Delong检验对模型的预测性能进行评价。结果：将OSCC标本分为A组（n = 142）和B组（n = 83）。A组5年生存率（70.24%）显著高于B组（60.76%）（风险比(HR) = 1.58, P = 0.001）。高度相关的基因对，如甲基转移酶样3 （METTL3）和METTL14 （r = 0.78）以及脂肪质量和肥胖相关蛋白（FTO）和AlkB同源物5 (ALKBH5) (r = 0.65)，在一个独立的数据集中得到一致验证。METTL3（校正HR = 1.38, P = 0.008）、FTO（校正HR = 1.42, P = 0.015）、YTHDF1（校正HR = 1.51, P = 0.004）是不良预后的独立预测因子。deg在免疫应答、细胞周期和PI3K-Akt/MAPK信号通路中富集。结论：多变量Cox回归证实METTL3、FTO和YTHDF1与OSCC患者预后不良相关，提示其作为独立预后生物标志物的潜力。m6A甲基化调节剂可能通过调节免疫反应、细胞周期和PI3K-Akt/MAPK信号通路，促进OSCC的进展，这表明了精确治疗的初步潜在靶点。然而，未来还需要进一步的实验验证。
{"title":"Correlation of bioinformatics-based m6A methylation regulators with prognosis in oral squamous cell carcinoma patients","authors":"Haichao Wang , Yi Liu , Jingwen Wu , Wenjing Wang , Hongyi Zhang , Cunjian Yi","doi":"10.1016/j.jcms.2025.11.014","DOIUrl":"10.1016/j.jcms.2025.11.014","url":null,"abstract":"<div><h3>Background</h3><div>Oral squamous cell carcinoma (OSCC) is characterized by difficulties in early diagnosis and poor prognosis. m6A methylation regulators are closely associated with tumor progression, yet their prognostic value and mechanisms in OSCC remain unclear. This study was to analyze the expression patterns of m6A regulators in OSCC and their association with prognosis, elucidate their mechanisms in OSCC progression, and provide a basis for diagnosis and treatment.</div></div><div><h3>Methods</h3><div>The expression patterns and prognostic value were analyzed using the following bioinformatics methods: the optimal cluster number <em>k</em> = 2 was determined based on the silhouette coefficient, and K-means clustering was employed for sample subtype classification; the cut-off values for high/low gene expression were defined by combining the ROC curve method and the tertile method, with Kaplan-Meier (KM) survival analysis and the Log-rank test used to compare survival differences between groups; univariate Cox regression was applied to screen for potential prognostic factors, followed by multivariate Cox regression with a forward selection method to identify independent prognostic factors; the limma package was used to identify differentially expressed genes (DEGs), and the biological functions of these DEGs were annotated through GO (biological process/cellular component/molecular function) and KEGG enrichment analyses; clinical, gene, and combined models were constructed, and the C-index and Delong test were utilized to evaluate the predictive performance of the models.</div></div><div><h3>Results</h3><div>OSCC samples were classified into Group A (n = 142) and Group B (n = 83). The 5-year survival rate (SR) of Group A (70.24 %) was significantly higher than that of Group B (60.76 %) (Hazard ratio (HR) = 1.58, <em>P</em> = 0.001). Highly correlated gene pairs such as methyltransferase-like 3 (METTL3) and METTL14 (<em>r</em> = 0.78) and fat mass and obesity-associated protein (FTO) and AlkB homolog 5 (ALKBH5) (<em>r</em> = 0.65) were consistently validated in an independent dataset. METTL3 (adjusted HR = 1.38, <em>P</em> = 0.008), FTO (adjusted HR = 1.42, <em>P</em> = 0.015), and YTHDF1 (adjusted HR = 1.51, <em>P</em> = 0.004) were identified as independent predictors of poor prognosis. DEGs were enriched in immune response, cell cycle, and PI3K-Akt/MAPK signaling pathways. The combined model incorporating these three genes and clinical variables demonstrated the highest C-index (0.72), with HR fluctuations <15 %, indicating robust results.</div></div><div><h3>Conclusion</h3><div>Multivariate Cox regression confirmed that METTL3, FTO, and YTHDF1 are associated with an unfavorable prognosis in OSCC patients, suggesting their potential as independent prognostic biomarkers. The m6A methylation regulators may contribute to OSCC progression by modulating immune responses, the cell cycle, and the PI3K-Akt/MAPK signaling pathway, in","PeriodicalId":54851,"journal":{"name":"Journal of Cranio-Maxillofacial Surgery","volume":"54 1","pages":"Article 104411"},"PeriodicalIF":2.1,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145846871","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"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.jcms.2025.11.003
Meiyao Lv , Qingqian Wei , Zining Wang , Jingyi Wang , Haidong Li
Straight-line closure is a fundamental technique for repairing cleft lip (CLP), particularly suitable for mild unilateral clefts, valued for its simplicity and natural scar alignment. Understanding the biomechanical impact of surgical design, specifically incision area, is crucial for outcomes. This study utilized patient-specific 3D finite element (FE) modeling based on CT data to simulate the mechanical responses during and after straight-line repair with varying excision areas. Simulations analyzed stress/strain distributions, tissue deformation, displacement of key anatomical points (e.g., Cupid's bow peak), and incision tension. Results showed incision area significantly impacts outcomes: small incisions minimized tissue deformation, point displacement, and tension (aiding healing) but risked insufficient Cupid's bow descent; medium incisions achieved ideal Cupid's bow position, moderate deformation, acceptable and uniformly distributed tension, offering the best balance between reconstruction and healing; large incisions maximized correction but caused excessive deformation, Cupid's bow descent, high stress concentration, and significantly increased healing/scar risks due to excessive tension. The study concludes that medium-sized incisions provide the optimal compromise for anatomical reconstruction and long-term stability in straight-line CLP repair. Future work aims to integrate AI for automated biomechanical modeling and adaptive surgical plan optimization, advancing towards data-driven precision surgery.
{"title":"Data-driven surgical planning for cleft lip repair: Optimization of individualized incisions using 3D finite element simulation and clinical translational validation","authors":"Meiyao Lv , Qingqian Wei , Zining Wang , Jingyi Wang , Haidong Li","doi":"10.1016/j.jcms.2025.11.003","DOIUrl":"10.1016/j.jcms.2025.11.003","url":null,"abstract":"<div><div>Straight-line closure is a fundamental technique for repairing cleft lip (CLP), particularly suitable for mild unilateral clefts, valued for its simplicity and natural scar alignment. Understanding the biomechanical impact of surgical design, specifically incision area, is crucial for outcomes. This study utilized patient-specific 3D finite element (FE) modeling based on CT data to simulate the mechanical responses during and after straight-line repair with varying excision areas. Simulations analyzed stress/strain distributions, tissue deformation, displacement of key anatomical points (e.g., Cupid's bow peak), and incision tension. Results showed incision area significantly impacts outcomes: small incisions minimized tissue deformation, point displacement, and tension (aiding healing) but risked insufficient Cupid's bow descent; medium incisions achieved ideal Cupid's bow position, moderate deformation, acceptable and uniformly distributed tension, offering the best balance between reconstruction and healing; large incisions maximized correction but caused excessive deformation, Cupid's bow descent, high stress concentration, and significantly increased healing/scar risks due to excessive tension. The study concludes that medium-sized incisions provide the optimal compromise for anatomical reconstruction and long-term stability in straight-line CLP repair. Future work aims to integrate AI for automated biomechanical modeling and adaptive surgical plan optimization, advancing towards data-driven precision surgery.</div></div>","PeriodicalId":54851,"journal":{"name":"Journal of Cranio-Maxillofacial Surgery","volume":"54 1","pages":"Article 104400"},"PeriodicalIF":2.1,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145558120","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"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.jcms.2025.11.010
Antonio D'Agostino , Giorgio Lombardo , Annarita Signoriello , Guido Lobbia , Manlio Galiè , Lorenzo Trevisiol
The aim of this retrospective study was to evaluate dental and periodontal complications in patients who underwent Multi-Segment LeFort I osteotomy (MSLFI) as part of ortho-surgical procedure performed to correct dento-skeletal malocclusion. The study specifically focused on issues concerning the maxillary bone, maxillary soft tissues, dental pulp and dental roots. A sample of patients treated between 2008 and 2015 at the University of Verona was considered; all patients underwent MSLFI with interdental osteotomies in the area between upper lateral incisor and canine, bilaterally. The following parameters were assessed on teeth: mobility, probing pocket depth (PPD), gingival recession (GR), pain at palpation, sensitivity and vitality - through percussion test, cold test (CT) and electric pulp test (EPT) - and external root resorption (ERR). All patients underwent pre/post-operative radiographic evaluation with the use of Cone-Beam Computed Tomography (CBCT) and panoramic radiograph. In case of suspect of endodontic or periodontal lesions, or loss of tooth vitality, periapical intraoral radiographs were also performed. 420 teeth in 52 patients were evaluated with a mean follow-up of 42 months. Vascular complications or bone necrosis, unproper union of bone segments and oronasal fistulas were not reported. Despite 49 (11,67 %) teeth did not respond to CT, and 6 of them were also insensitive to the EPT, only 4 teeth (0,95 %) required root canal therapy following surgery. No dental elements showed mobility greater than grade 1; 22 GR (5,34 % of the analyzed sites) of at least 1 mm were observed in 11 patients. As segmented osteotomies are associated with a moderate incidence of dental and periodontal trauma, a proper pre-surgical plan seems to be essential in minimizing complications.
{"title":"Dental and periodontal post-operative complications in patients treated with multisegmented LeFort I (MSLFI) osteotomy in the upper maxilla: a retrospective evaluation","authors":"Antonio D'Agostino , Giorgio Lombardo , Annarita Signoriello , Guido Lobbia , Manlio Galiè , Lorenzo Trevisiol","doi":"10.1016/j.jcms.2025.11.010","DOIUrl":"10.1016/j.jcms.2025.11.010","url":null,"abstract":"<div><div>The aim of this retrospective study was to evaluate dental and periodontal complications in patients who underwent Multi-Segment LeFort I osteotomy (MSLFI) as part of ortho-surgical procedure performed to correct dento-skeletal malocclusion. The study specifically focused on issues concerning the maxillary bone, maxillary soft tissues, dental pulp and dental roots. A sample of patients treated between 2008 and 2015 at the University of Verona was considered; all patients underwent MSLFI with interdental osteotomies in the area between upper lateral incisor and canine, bilaterally. The following parameters were assessed on teeth: mobility, probing pocket depth (PPD), gingival recession (GR), pain at palpation, sensitivity and vitality - through percussion test, cold test (CT) and electric pulp test (EPT) - and external root resorption (ERR). All patients underwent pre/post-operative radiographic evaluation with the use of Cone-Beam Computed Tomography (CBCT) and panoramic radiograph. In case of suspect of endodontic or periodontal lesions, or loss of tooth vitality, periapical intraoral radiographs were also performed. 420 teeth in 52 patients were evaluated with a mean follow-up of 42 months. Vascular complications or bone necrosis, unproper union of bone segments and oronasal fistulas were not reported. Despite 49 (11,67 %) teeth did not respond to CT, and 6 of them were also insensitive to the EPT, only 4 teeth (0,95 %) required root canal therapy following surgery. No dental elements showed mobility greater than grade 1; 22 GR (5,34 % of the analyzed sites) of at least 1 mm were observed in 11 patients. As segmented osteotomies are associated with a moderate incidence of dental and periodontal trauma, a proper pre-surgical plan seems to be essential in minimizing complications.</div></div>","PeriodicalId":54851,"journal":{"name":"Journal of Cranio-Maxillofacial Surgery","volume":"54 1","pages":"Article 104407"},"PeriodicalIF":2.1,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145806413","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"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.jcms.2025.11.015
Gulsah Karatas Telli , Sara Samur Erguven , Yeliz Kilinc , Mustafa Sancar Atac , Metin Sencimen
This study aims to compare the biomechanical behavior of different fixation configurations, involving either only prebent plates or prebent plates combined with mini- or micro-L-plates, using three-dimensional (3D) finite element analysis (FEA) following Le Fort I osteotomy with 5 mm advancement and 4 mm inferior repositioning. In Model 1, two prebent plates were bilaterally positioned at the piriform aperture. Model 2 included the same configuration, supplemented with two mini-L-plates. In Model 3, the prebent plates were combined with two micro-L-plates. Static loads were applied to the models in vertical, oblique, and horizontal directions. The von Mises stresses, maximum and minimum principal stresses (Pmax and Pmin), and displacements were calculated. Model 2 had the lowest displacement values. The mini-L-plates demonstrated the lowest von Mises stress among all plates. Model 2 was found to be the most stable at all measured points. The stress values in Model 1 and Model 3 were found to be similar, indicating that combining prebent plates with micro-L-plates does not provide a significant mechanical benefit. When additional fixation to prebent plates is required, the use of mini-L-plates reduces von Mises stresses and improves stability.
本研究旨在比较不同固定配置的生物力学行为，包括仅使用预弯钢板或预弯钢板联合微型或微型l型钢板，采用Le Fort I型截骨术5 mm前移和4 mm后移的三维（3D）有限元分析（FEA）。在模型1中，在梨状孔两侧放置两个预压板。模型2包括相同的配置，补充了两个迷你l型板。在模型3中，预弯板与两个微型l型板结合。在垂直、倾斜和水平方向上对模型施加静载荷。计算了von Mises应力、最大和最小主应力（Pmax和Pmin）以及位移。模型2的位移值最低。在所有板中，迷你l型板的von Mises应力最小。模型2在所有测点上最稳定。模型1和模型3的应力值相似，说明预弯板与微l型板组合并不具有明显的力学效益。当需要对预压钢板进行额外固定时，使用迷你l型钢板可减少von Mises应力并提高稳定性。
{"title":"Comparison of the biomechanical behavior of different fixation configurations following Le Fort I advancement and inferior repositioning surgery: A three-dimensional finite element analysis","authors":"Gulsah Karatas Telli , Sara Samur Erguven , Yeliz Kilinc , Mustafa Sancar Atac , Metin Sencimen","doi":"10.1016/j.jcms.2025.11.015","DOIUrl":"10.1016/j.jcms.2025.11.015","url":null,"abstract":"<div><div>This study aims to compare the biomechanical behavior of different fixation configurations, involving either only prebent plates or prebent plates combined with mini- or micro-L-plates, using three-dimensional (3D) finite element analysis (FEA) following Le Fort I osteotomy with 5 mm advancement and 4 mm inferior repositioning. In Model 1, two prebent plates were bilaterally positioned at the piriform aperture. Model 2 included the same configuration, supplemented with two mini-L-plates. In Model 3, the prebent plates were combined with two micro-L-plates. Static loads were applied to the models in vertical, oblique, and horizontal directions. The von Mises stresses, maximum and minimum principal stresses (P<sub>max</sub> and P<sub>min</sub>), and displacements were calculated. Model 2 had the lowest displacement values. The mini-L-plates demonstrated the lowest von Mises stress among all plates. Model 2 was found to be the most stable at all measured points. The stress values in Model 1 and Model 3 were found to be similar, indicating that combining prebent plates with micro-L-plates does not provide a significant mechanical benefit. When additional fixation to prebent plates is required, the use of mini-L-plates reduces von Mises stresses and improves stability.</div></div>","PeriodicalId":54851,"journal":{"name":"Journal of Cranio-Maxillofacial Surgery","volume":"54 1","pages":"Article 104412"},"PeriodicalIF":2.1,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145806394","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"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.jcms.2025.11.016
Laura Kaprio , Junnu Leikola , Anne Saarikko , Anu Kiukkonen
This study aims to evaluate surgical treatments for craniofacial microsomia (CFM) at a national reference centre in Finland, focusing on the age of treatment and the number of surgeries performed. The aim was to describe surgical strategies, explore treatment variations, and assess intervention timing.
This retrospective cohort study reviewed the medical records of 191 patients diagnosed with CFM at the Helsinki Cleft Palate and Craniofacial Centre from 2010 to 2022. After excluding patients with insufficient data, 89 patients were included. Patients were classified using the Pruzansky–Kaban system, and their surgeries were categorized by type, indication, and age.
Of the 89 patients included, 64 patients (72 %) had undergone surgical treatment. Ear reconstruction surgeries were the most common (41 patients or 46 %), followed by soft tissue surgeries in 29 patients (33 %) and cleft-related surgeries in 21 patients (24 %). Hard tissue surgeries, including orthognathic procedures, were performed on nine patients (10 %), primarily those with severe CFM. The median age for surgeries ranged from 0.8 years for cleft surgery to 21.6 years for lipofilling. No significant gender predominance was found.
This study highlights the variety of surgical approaches required for treating CFM, with severity influencing the number and type of surgeries. A shift towards conservative treatments for younger patients and a preference for alloplastic implants over autologous grafts were observed. Further research is needed to standardize surgical protocols and treatment outcomes for CFM.
{"title":"Surgical treatment of 89 patients with craniofacial microsomia in a craniofacial national reference centre in Finland","authors":"Laura Kaprio , Junnu Leikola , Anne Saarikko , Anu Kiukkonen","doi":"10.1016/j.jcms.2025.11.016","DOIUrl":"10.1016/j.jcms.2025.11.016","url":null,"abstract":"<div><div>This study aims to evaluate surgical treatments for craniofacial microsomia (CFM) at a national reference centre in Finland, focusing on the age of treatment and the number of surgeries performed. The aim was to describe surgical strategies, explore treatment variations, and assess intervention timing.</div><div>This retrospective cohort study reviewed the medical records of 191 patients diagnosed with CFM at the Helsinki Cleft Palate and Craniofacial Centre from 2010 to 2022. After excluding patients with insufficient data, 89 patients were included. Patients were classified using the Pruzansky–Kaban system, and their surgeries were categorized by type, indication, and age.</div><div>Of the 89 patients included, 64 patients (72 %) had undergone surgical treatment. Ear reconstruction surgeries were the most common (41 patients or 46 %), followed by soft tissue surgeries in 29 patients (33 %) and cleft-related surgeries in 21 patients (24 %). Hard tissue surgeries, including orthognathic procedures, were performed on nine patients (10 %), primarily those with severe CFM. The median age for surgeries ranged from 0.8 years for cleft surgery to 21.6 years for lipofilling. No significant gender predominance was found.</div><div>This study highlights the variety of surgical approaches required for treating CFM, with severity influencing the number and type of surgeries. A shift towards conservative treatments for younger patients and a preference for alloplastic implants over autologous grafts were observed. Further research is needed to standardize surgical protocols and treatment outcomes for CFM.</div></div>","PeriodicalId":54851,"journal":{"name":"Journal of Cranio-Maxillofacial Surgery","volume":"54 1","pages":"Article 104413"},"PeriodicalIF":2.1,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145812288","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-31DOI: 10.1016/j.jcms.2025.104429
Martin Scheer , Fiona Willenberg , Alexey Surov , Benedikt Passmann , Julius Niehoff , Jan Borggrefe
Computed tomography (CT) is an essential tool for staging head and neck cancer. PCCT-detectors can convert the incoming photons directly into electrical signals. This study investigated the potential of PCCT in OSCCs and OPSCCs. The study population comprised 26 patients with an average age of 65.1 years, all of whom were receiving therapy for OSCC (n = 21) or OPSCC (n = 5). PCCT images were analysed using virtual monoenergetic reconstructions (VMIs) with energies ranging from 40 to 100 keV. Blinded VMIs were analysed using a Likert scale. Optimal tumour delineation and image quality were observed at low energies (40–45 keV). Conversely, infiltration into adjacent structures, notably the mandible, was most effectively visualized at an average energy of 80 keV. The effective dose was found to be 1.46 mSv for PCCT representing an almost 50 % reduction compared to conventional CT. However, artefacts caused by metallic restorations remain problematic in PCCT. Nevertheless PCCT has the capacity to enhance soft tissue contrast, thereby facilitating higher spatial resolution and improved diagnostic quality when staging OSCC.
{"title":"Photon-counting CT in the diagnostic workup of OSCC and OPSCC: A prospective evaluation of tumour conspicuity using virtual monoenergetic imaging","authors":"Martin Scheer , Fiona Willenberg , Alexey Surov , Benedikt Passmann , Julius Niehoff , Jan Borggrefe","doi":"10.1016/j.jcms.2025.104429","DOIUrl":"10.1016/j.jcms.2025.104429","url":null,"abstract":"<div><div>Computed tomography (CT) is an essential tool for staging head and neck cancer. PCCT-detectors can convert the incoming photons directly into electrical signals. This study investigated the potential of PCCT in OSCCs and OPSCCs. The study population comprised 26 patients with an average age of 65.1 years, all of whom were receiving therapy for OSCC (n = 21) or OPSCC (n = 5). PCCT images were analysed using virtual monoenergetic reconstructions (VMIs) with energies ranging from 40 to 100 keV. Blinded VMIs were analysed using a Likert scale. Optimal tumour delineation and image quality were observed at low energies (40–45 keV). Conversely, infiltration into adjacent structures, notably the mandible, was most effectively visualized at an average energy of 80 keV. The effective dose was found to be 1.46 mSv for PCCT representing an almost 50 % reduction compared to conventional CT. However, artefacts caused by metallic restorations remain problematic in PCCT. Nevertheless PCCT has the capacity to enhance soft tissue contrast, thereby facilitating higher spatial resolution and improved diagnostic quality when staging OSCC.</div></div>","PeriodicalId":54851,"journal":{"name":"Journal of Cranio-Maxillofacial Surgery","volume":"54 2","pages":"Article 104429"},"PeriodicalIF":2.1,"publicationDate":"2025-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145886505","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-29DOI: 10.1016/j.jcms.2025.104430
Laura Tognin , Michela Bergonzani , Louis Brochet , Giuseppe Pedrazzi , Pierre Corre , Marilena Anghinoni , Andrea Varazzani
Recent advancements in orthognathic surgery have introduced innovations in surgical techniques and in preoperative and postoperative care, with an increasing emphasis on patient-centered approaches. Our study described the current practice patterns in Italy, and compared our findings with the existing literature, particularly a recent survey conducted in France.
The questionnaire from the French study was translated into Italian, and a 46-item electronic survey was distributed. In total, 66 responses were received. Of the respondents, 78.8 % were male, and 60.6 % reported over 20 years of practical experience. The primary indication for surgery was that of occlusal disorders (92.4 %). An intermediate splint was used for surgical transfer by 90.9 % of surgeons, while virtual planning was used by 40.9 %. A maxilla-first approach was adopted by 71.2 % of surgeons. For bimaxillary surgery combined with genioplasty, the most frequently reported operating time was 3–4 h (57.6 %), and the typical hospital stay duration was 3–4 nights (53 %). Physiotherapy was primarily advised for temporomandibular joint movement re-education (69.7 %). The most commonly reported complication was trigeminal hypoesthesia (53 %).
Current orthognathic surgery practices in two European countries and the USA were compared. Further studies are needed to comprehensively enrich the existing dataset and support the development of unified European guidelines.
{"title":"Orthognathic surgery practices in Italy: a comparative analysis with the existing literature","authors":"Laura Tognin , Michela Bergonzani , Louis Brochet , Giuseppe Pedrazzi , Pierre Corre , Marilena Anghinoni , Andrea Varazzani","doi":"10.1016/j.jcms.2025.104430","DOIUrl":"10.1016/j.jcms.2025.104430","url":null,"abstract":"<div><div>Recent advancements in orthognathic surgery have introduced innovations in surgical techniques and in preoperative and postoperative care, with an increasing emphasis on patient-centered approaches. Our study described the current practice patterns in Italy, and compared our findings with the existing literature, particularly a recent survey conducted in France.</div><div>The questionnaire from the French study was translated into Italian, and a 46-item electronic survey was distributed. In total, 66 responses were received. Of the respondents, 78.8 % were male, and 60.6 % reported over 20 years of practical experience. The primary indication for surgery was that of occlusal disorders (92.4 %). An intermediate splint was used for surgical transfer by 90.9 % of surgeons, while virtual planning was used by 40.9 %. A maxilla-first approach was adopted by 71.2 % of surgeons. For bimaxillary surgery combined with genioplasty, the most frequently reported operating time was 3–4 h (57.6 %), and the typical hospital stay duration was 3–4 nights (53 %). Physiotherapy was primarily advised for temporomandibular joint movement re-education (69.7 %). The most commonly reported complication was trigeminal hypoesthesia (53 %).</div><div>Current orthognathic surgery practices in two European countries and the USA were compared. Further studies are needed to comprehensively enrich the existing dataset and support the development of unified European guidelines.</div></div>","PeriodicalId":54851,"journal":{"name":"Journal of Cranio-Maxillofacial Surgery","volume":"54 2","pages":"Article 104430"},"PeriodicalIF":2.1,"publicationDate":"2025-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145847703","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-18DOI: 10.1016/j.jcms.2025.11.022
Sead Abazi , Egzon Abazi , Michel Beyer , Lukas Seifert , Neha Sharma , Adelita Sommacal , Alexander Lunger , Dirk J. Schaefer , Florian M. Thieringer
Facial feminization surgery is a key component of gender-affirming care, with mandibular angle reduction playing an essential role in creating a more feminine facial contour. This study evaluated the accuracy and effectiveness of using patient-specific cutting guides produced through virtual surgical planning and point-of-care 3D printing. Thirteen patients who underwent mandibular angle reduction at the University Hospital Basel were included. Preoperative CT or CBCT imaging was used to design and fabricate custom cutting guides, which were employed during surgery. Postoperative scans were assessed to determine changes in mandibular volume and surface distances, and to evaluate surgical accuracy. The results showed a significant average volume reduction of 1145.70 mm3 per mandibular angle, with a mean maximum surface distance of 8.04 mm. No significant differences in outcomes were found between the left and right sides. Osteotomies closely followed the planned resection lines, with mean deviations of 0.81 mm and maximum deviations of 1.79 mm. No intraoperative or postoperative complications occurred, and all patients experienced uneventful healing. These findings demonstrate that virtual planning combined with in-house 3D printing of cutting guides provides a safe, precise, and efficient method for mandibular contouring in facial feminization surgery, offering high surgical accuracy and cost-effective workflow integration.
{"title":"Postoperative assessment of mandibular angle reduction in facial feminization surgery","authors":"Sead Abazi , Egzon Abazi , Michel Beyer , Lukas Seifert , Neha Sharma , Adelita Sommacal , Alexander Lunger , Dirk J. Schaefer , Florian M. Thieringer","doi":"10.1016/j.jcms.2025.11.022","DOIUrl":"10.1016/j.jcms.2025.11.022","url":null,"abstract":"<div><div>Facial feminization surgery is a key component of gender-affirming care, with mandibular angle reduction playing an essential role in creating a more feminine facial contour. This study evaluated the accuracy and effectiveness of using patient-specific cutting guides produced through virtual surgical planning and point-of-care 3D printing. Thirteen patients who underwent mandibular angle reduction at the University Hospital Basel were included. Preoperative CT or CBCT imaging was used to design and fabricate custom cutting guides, which were employed during surgery. Postoperative scans were assessed to determine changes in mandibular volume and surface distances, and to evaluate surgical accuracy. The results showed a significant average volume reduction of 1145.70 mm<sup>3</sup> per mandibular angle, with a mean maximum surface distance of 8.04 mm. No significant differences in outcomes were found between the left and right sides. Osteotomies closely followed the planned resection lines, with mean deviations of 0.81 mm and maximum deviations of 1.79 mm. No intraoperative or postoperative complications occurred, and all patients experienced uneventful healing. These findings demonstrate that virtual planning combined with in-house 3D printing of cutting guides provides a safe, precise, and efficient method for mandibular contouring in facial feminization surgery, offering high surgical accuracy and cost-effective workflow integration.</div></div>","PeriodicalId":54851,"journal":{"name":"Journal of Cranio-Maxillofacial Surgery","volume":"54 2","pages":"Article 104419"},"PeriodicalIF":2.1,"publicationDate":"2025-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145795398","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-18DOI: 10.1016/j.jcms.2025.11.020
Evangelos Kostares , Georgia Kostare , Michael Kostares , Fani Pitsigavdaki , Athanasios Tsakris , Christos Perisanidis , Maria Kantzanou
Outpatient parotidectomy has emerged as a potential alternative to inpatient surgery for selected patients. This systematic review and meta-analysis aimed to compare postoperative complications between outpatient and inpatient parotidectomy. A systematic search was conducted across PubMed/MedLine, Scopus, Web of Science, CENTRAL, and Google Scholar up to October 12, 2025. Observational and interventional studies comparing outpatient and inpatient parotidectomy in adults were included. Quality of studies was assessed using the Newcastle-Ottawa Scale. Pooled odds ratios (OR) with 95 % confidence intervals (CI) were calculated using random-effects model. Heterogeneity was quantified using I2, and certainty of evidence was rated using the GRADE framework. Ten retrospective cohort studies were included. Outpatient surgery was associated with significantly lower odds of hematoma (0.36, 95 % CI: 0.17–0.77), permanent facial nerve weakness (OR = 0.10, 95 % CI: 0.06–0.17), and reoperation (OR = 0.32, 95 % CI: 0.23–0.44). No significant differences were observed for seroma, sialocele, infection, Frey's syndrome, fistula, or transient facial nerve weakness. All included studies were of moderate methodological quality, and the overall certainty of evidence was very low. Outpatient parotidectomy appears safe and feasible for selected patients, with complication rates comparable to inpatient surgery. Further prospective studies are needed to confirm these findings.
{"title":"Outpatient vs inpatient parotidectomy: A systematic review and meta-analysis","authors":"Evangelos Kostares , Georgia Kostare , Michael Kostares , Fani Pitsigavdaki , Athanasios Tsakris , Christos Perisanidis , Maria Kantzanou","doi":"10.1016/j.jcms.2025.11.020","DOIUrl":"10.1016/j.jcms.2025.11.020","url":null,"abstract":"<div><div>Outpatient parotidectomy has emerged as a potential alternative to inpatient surgery for selected patients. This systematic review and meta-analysis aimed to compare postoperative complications between outpatient and inpatient parotidectomy. A systematic search was conducted across PubMed/MedLine, Scopus, Web of Science, CENTRAL, and Google Scholar up to October 12, 2025. Observational and interventional studies comparing outpatient and inpatient parotidectomy in adults were included. Quality of studies was assessed using the Newcastle-Ottawa Scale. Pooled odds ratios (OR) with 95 % confidence intervals (CI) were calculated using random-effects model. Heterogeneity was quantified using I<sup>2</sup>, and certainty of evidence was rated using the GRADE framework. Ten retrospective cohort studies were included. Outpatient surgery was associated with significantly lower odds of hematoma (0.36, 95 % CI: 0.17–0.77), permanent facial nerve weakness (OR = 0.10, 95 % CI: 0.06–0.17), and reoperation (OR = 0.32, 95 % CI: 0.23–0.44). No significant differences were observed for seroma, sialocele, infection, Frey's syndrome, fistula, or transient facial nerve weakness. All included studies were of moderate methodological quality, and the overall certainty of evidence was very low. Outpatient parotidectomy appears safe and feasible for selected patients, with complication rates comparable to inpatient surgery. Further prospective studies are needed to confirm these findings.</div></div>","PeriodicalId":54851,"journal":{"name":"Journal of Cranio-Maxillofacial Surgery","volume":"54 2","pages":"Article 104417"},"PeriodicalIF":2.1,"publicationDate":"2025-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145795450","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-18DOI: 10.1016/j.jcms.2025.11.023
Lulu Wang , Bing Chen
Objectives
Reconstruction of congenital alveolar clefts presents a uniquely complex surgical challenge. This study aimed to comprehensively evaluate the one-year clinical, radiographic, and biochemical outcomes of guided bone regeneration in patients with distinct horizontal versus vertical morphologies of congenital alveolar clefts during oral implant placement.
Materials and methods
This retrospective cohort study included 240 patients with congenital unilateral alveolar clefts treated between January 2018 and December 2023. Patients were allocated into a horizontal defect group (n = 120) or a vertical defect group (n = 120) based on cone-beam computed tomography (CBCT) classification. All patients received autogenous particulate bone grafts from the iliac crest stabilized with titanium mesh. Outcomes assessed over a 12-month period included clinical success rate, radiographic bone changes, trabecular microarchitecture, serum biomarker levels (BMP-7, TGF-β1, bFGF, and VEGF), complications, and patient-reported outcomes.
Results
At the 12-month follow-up, the vertical defect group demonstrated a significantly higher “excellent” reconstruction rate (95.8 % vs. 79.1 %, P < 0.001) and superior implant survival (98.3 % vs. 91.7 %, P = 0.021). CBCT analysis revealed that the vertical group maintained significantly greater alveolar bone height and width at 12 months (P < 0.001). The vertical group also exhibited superior trabecular maturation (P < 0.001). Serum concentrations of bone morphogenetic protein-7 (BMP-7), transforming growth factor-β1 (TGF-β1), and vascular endothelial growth factor (VEGF) were significantly higher in the vertical group at 4 and 8 weeks post-surgery. Furthermore, the vertical group reported significantly lower rates of complications and better Oral Health Impact Profile-14 (OHIP-14) scores (P < 0.01).
Conclusion
Morphology-guided bone augmentation for congenital alveolar clefts shows that vertical (“box-like”) defects yield superior one-year outcomes over horizontal (“saucer-shaped”) defects. The favorable biomechanical containment of vertical defects appears to promote enhanced graft consolidation, likely through improved neovascularization and a more robust osteogenic signaling cascade, leading to improved implant stability and patient satisfaction.
{"title":"Vertical versus horizontal morphology of congenital alveolar cleft defects: A one-year comparative study on clinical, radiographic, and biochemical outcomes","authors":"Lulu Wang , Bing Chen","doi":"10.1016/j.jcms.2025.11.023","DOIUrl":"10.1016/j.jcms.2025.11.023","url":null,"abstract":"<div><h3>Objectives</h3><div>Reconstruction of congenital alveolar clefts presents a uniquely complex surgical challenge. This study aimed to comprehensively evaluate the one-year clinical, radiographic, and biochemical outcomes of guided bone regeneration in patients with distinct horizontal versus vertical morphologies of congenital alveolar clefts during oral implant placement.</div></div><div><h3>Materials and methods</h3><div>This retrospective cohort study included 240 patients with congenital unilateral alveolar clefts treated between January 2018 and December 2023. Patients were allocated into a horizontal defect group (n = 120) or a vertical defect group (n = 120) based on cone-beam computed tomography (CBCT) classification. All patients received autogenous particulate bone grafts from the iliac crest stabilized with titanium mesh. Outcomes assessed over a 12-month period included clinical success rate, radiographic bone changes, trabecular microarchitecture, serum biomarker levels (BMP-7, TGF-β1, bFGF, and VEGF), complications, and patient-reported outcomes.</div></div><div><h3>Results</h3><div>At the 12-month follow-up, the vertical defect group demonstrated a significantly higher “excellent” reconstruction rate (95.8 % vs. 79.1 %, P < 0.001) and superior implant survival (98.3 % vs. 91.7 %, P = 0.021). CBCT analysis revealed that the vertical group maintained significantly greater alveolar bone height and width at 12 months (P < 0.001). The vertical group also exhibited superior trabecular maturation (P < 0.001). Serum concentrations of bone morphogenetic protein-7 (BMP-7), transforming growth factor-β1 (TGF-β1), and vascular endothelial growth factor (VEGF) were significantly higher in the vertical group at 4 and 8 weeks post-surgery. Furthermore, the vertical group reported significantly lower rates of complications and better Oral Health Impact Profile-14 (OHIP-14) scores (P < 0.01).</div></div><div><h3>Conclusion</h3><div>Morphology-guided bone augmentation for congenital alveolar clefts shows that vertical (“box-like”) defects yield superior one-year outcomes over horizontal (“saucer-shaped”) defects. The favorable biomechanical containment of vertical defects appears to promote enhanced graft consolidation, likely through improved neovascularization and a more robust osteogenic signaling cascade, leading to improved implant stability and patient satisfaction.</div></div>","PeriodicalId":54851,"journal":{"name":"Journal of Cranio-Maxillofacial Surgery","volume":"54 2","pages":"Article 104420"},"PeriodicalIF":2.1,"publicationDate":"2025-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145800142","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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