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}
Pub Date : 2025-12-18DOI: 10.1016/j.jcms.2025.12.004
Filip Koneski, Danica Popovik Monevska, Icko Gjorgoski, Aleksandar Stamatoski, Suzana Dvojakovska, Antonio Kirkov, Aleksandar Grchev, Goran Panchevski, Sanela Idoska, Aleksandar Iliev, Jana Trambulova
Bisphosphonates are widely used antiresorptive agents for osteoporosis, metastatic bone disease, and other disorders of bone metabolism, but their use may lead to medication-related osteonecrosis of the jaw (MRONJ), a condition associated with impaired post-extraction healing. Statins, beyond their cholesterol-lowering effects, exhibit pleiotropic properties including anti-inflammatory, antimicrobial, and bone-regenerative activity, suggesting a potential therapeutic role in counteracting bisphosphonate-induced complications. The present study investigated the effects of local and systemic administration of atorvastatin on post-extraction wound healing, inflammatory markers, and antioxidant capacity in Wistar rats pretreated with zoledronic acid. Thirty rats were randomized into six groups, including positive and negative controls, and four experimental groups receiving different combinations of zoledronic acid and atorvastatin. Macroscopic evaluation, cone-beam computed tomography, cytokine assays, and enzymatic analyses were performed. Rats treated solely with zoledronic acid demonstrated impaired healing, necrotic bone exposure, elevated TNF-α and IL-1β, and reduced catalase, superoxide dismutase, and glutathione reductase activity. In contrast, both local and systemic atorvastatin significantly improved wound healing, reduced cytokine levels, and restored antioxidant capacity, with effects comparable or superior to the positive control group. These findings suggest that atorvastatin may mitigate zoledronic acid-induced oxidative and inflammatory imbalance, supporting its potential application for wound healing.
{"title":"Atorvastatin improves postextraction wound healing and decreases inflammation in rats previously treated with zoledronic acid.","authors":"Filip Koneski, Danica Popovik Monevska, Icko Gjorgoski, Aleksandar Stamatoski, Suzana Dvojakovska, Antonio Kirkov, Aleksandar Grchev, Goran Panchevski, Sanela Idoska, Aleksandar Iliev, Jana Trambulova","doi":"10.1016/j.jcms.2025.12.004","DOIUrl":"https://doi.org/10.1016/j.jcms.2025.12.004","url":null,"abstract":"<p><p>Bisphosphonates are widely used antiresorptive agents for osteoporosis, metastatic bone disease, and other disorders of bone metabolism, but their use may lead to medication-related osteonecrosis of the jaw (MRONJ), a condition associated with impaired post-extraction healing. Statins, beyond their cholesterol-lowering effects, exhibit pleiotropic properties including anti-inflammatory, antimicrobial, and bone-regenerative activity, suggesting a potential therapeutic role in counteracting bisphosphonate-induced complications. The present study investigated the effects of local and systemic administration of atorvastatin on post-extraction wound healing, inflammatory markers, and antioxidant capacity in Wistar rats pretreated with zoledronic acid. Thirty rats were randomized into six groups, including positive and negative controls, and four experimental groups receiving different combinations of zoledronic acid and atorvastatin. Macroscopic evaluation, cone-beam computed tomography, cytokine assays, and enzymatic analyses were performed. Rats treated solely with zoledronic acid demonstrated impaired healing, necrotic bone exposure, elevated TNF-α and IL-1β, and reduced catalase, superoxide dismutase, and glutathione reductase activity. In contrast, both local and systemic atorvastatin significantly improved wound healing, reduced cytokine levels, and restored antioxidant capacity, with effects comparable or superior to the positive control group. These findings suggest that atorvastatin may mitigate zoledronic acid-induced oxidative and inflammatory imbalance, supporting its potential application for wound healing.</p>","PeriodicalId":54851,"journal":{"name":"Journal of Cranio-Maxillofacial Surgery","volume":" ","pages":"104425"},"PeriodicalIF":2.1,"publicationDate":"2025-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145800919","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}
This study aimed to investigate the effects of articular disc perforation (DP) on condylar remodeling following disc repositioning surgery in adults with anterior disc displacement without reduction (ADDWoR). We included 77 patients with 113 joints diagnosed with ADDWoR, stratified into perforated (44 joints) and non-perforated (69 joints) groups. Three-dimensional condylar morphology was analyzed preoperatively and 6-months postoperatively using CBCT. Visual Analogue Scale (VAS) for pain relief and maximum mouth opening (MMO) were used to evaluate clinical efficacy. Statistical analyses included independent t-test and multivariate regression. No significant differences in condylar volume, height, mediolateral diameter, pain relief, or MMO was observed between groups. The increase of the anteroposterior condylar diameter was greater in the non-perforated group [0.5644 ± 1.092 mm vs. 0.1413 ± 0.8434 mm; P < 0.05]. A significant inverse correlation existed between patient age and volume change (R2 = 0.117, P < 0.001), with patients under 30 years exhibiting superior remodeling [53.02 ± 114.8 mm3 vs. -17.08 ± 148.8 mm3;P < 0.01]. DP did not adversely affect condylar remodeling in adult ADDWoR after disc repositioning surgery. Age emerged as the critical prognostic factor, with significant bone regeneration attenuated beyond 30 years, suggesting age-stratified surgical planning, potentially prioritizing disc repositioning in younger patients while exploring adjuvant biologics for elder cohorts.
本研究旨在探讨成人前盘无复位移位（ADDWoR）椎间盘复位手术后关节盘穿孔（DP）对髁突重塑的影响。我们纳入77例确诊为ADDWoR的患者，共113个关节，分为穿孔组（44个关节）和非穿孔组（69个关节）。术前及术后6个月采用CBCT分析髁突三维形态。采用视觉模拟评分法（VAS）评估疼痛缓解程度和最大开口度（MMO）。统计分析包括独立t检验和多元回归。两组间髁突体积、高度、内外侧直径、疼痛缓解或MMO均无显著差异。未穿孔组前、后髁直径增加幅度更大[0.5644±1.092 mm vs. 0.1413±0.8434 mm；P < 2 = 0.117, P < 3 = -17.08±148.8 mm3；P
{"title":"Prognostic impact of disc perforation on condylar remodeling following temporomandibular joint disc repositioning surgery in adult patients with ADDWoR: a single-center cohort study.","authors":"Siqi Chen, Ruijia Liu, Jiexin Zhang, Pinyin Cao, Songsong Zhu, Ruiye Bi","doi":"10.1016/j.jcms.2025.12.003","DOIUrl":"https://doi.org/10.1016/j.jcms.2025.12.003","url":null,"abstract":"<p><p>This study aimed to investigate the effects of articular disc perforation (DP) on condylar remodeling following disc repositioning surgery in adults with anterior disc displacement without reduction (ADDWoR). We included 77 patients with 113 joints diagnosed with ADDWoR, stratified into perforated (44 joints) and non-perforated (69 joints) groups. Three-dimensional condylar morphology was analyzed preoperatively and 6-months postoperatively using CBCT. Visual Analogue Scale (VAS) for pain relief and maximum mouth opening (MMO) were used to evaluate clinical efficacy. Statistical analyses included independent t-test and multivariate regression. No significant differences in condylar volume, height, mediolateral diameter, pain relief, or MMO was observed between groups. The increase of the anteroposterior condylar diameter was greater in the non-perforated group [0.5644 ± 1.092 mm vs. 0.1413 ± 0.8434 mm; P < 0.05]. A significant inverse correlation existed between patient age and volume change (R<sup>2</sup> = 0.117, P < 0.001), with patients under 30 years exhibiting superior remodeling [53.02 ± 114.8 mm<sup>3</sup> vs. -17.08 ± 148.8 mm<sup>3</sup>;P < 0.01]. DP did not adversely affect condylar remodeling in adult ADDWoR after disc repositioning surgery. Age emerged as the critical prognostic factor, with significant bone regeneration attenuated beyond 30 years, suggesting age-stratified surgical planning, potentially prioritizing disc repositioning in younger patients while exploring adjuvant biologics for elder cohorts.</p>","PeriodicalId":54851,"journal":{"name":"Journal of Cranio-Maxillofacial Surgery","volume":" ","pages":"104424"},"PeriodicalIF":2.1,"publicationDate":"2025-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145800900","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.2025.11.024
Güven Ozan Kaplan , Yusuf Irmak , Elif Günay Bulut , Mert Calis
This study aims to quantitatively evaluate the bone quality of orthognathic surgery patients with and without cleft lip and palate. Bone thickness and bone density were measured from standard anatomical points on computed tomography images and compared among cleft orthognathic patients (Group I), non-cleft orthognathic patients (Group II), and a healthy control group (Group III). Each group consisted of 24 patients, and there were no statistically significant differences among the groups regarding gender distribution or age. Group I exhibited significantly lower bone density and thickness in both the medial and lateral buttresses compared to Groups II and III. However, no significant differences in bone density or thickness were observed between Groups II and III. Within Group I, the lateral buttress density and thickness were significantly higher than those of the medial buttress. Additionally, both medial and lateral buttress density and thickness on the cleft side were significantly lower than on the non-cleft side. In cleft patients, the bone quality of both buttresses is decreased, with the cleft side and medial buttress being more affected than the non-cleft side and lateral buttress. Therefore, special attention should be given during the fixation of the medial buttress and cleft side.
{"title":"Is bone quality decreased in cleft patients? A comparison of cleft and non-cleft orthognathic surgery patients using radiological measurements","authors":"Güven Ozan Kaplan , Yusuf Irmak , Elif Günay Bulut , Mert Calis","doi":"10.1016/j.jcms.2025.11.024","DOIUrl":"10.1016/j.jcms.2025.11.024","url":null,"abstract":"<div><div>This study aims to quantitatively evaluate the bone quality of orthognathic surgery patients with and without cleft lip and palate. Bone thickness and bone density were measured from standard anatomical points on computed tomography images and compared among cleft orthognathic patients (Group I), non-cleft orthognathic patients (Group II), and a healthy control group (Group III). Each group consisted of 24 patients, and there were no statistically significant differences among the groups regarding gender distribution or age. Group I exhibited significantly lower bone density and thickness in both the medial and lateral buttresses compared to Groups II and III. However, no significant differences in bone density or thickness were observed between Groups II and III. Within Group I, the lateral buttress density and thickness were significantly higher than those of the medial buttress. Additionally, both medial and lateral buttress density and thickness on the cleft side were significantly lower than on the non-cleft side. In cleft patients, the bone quality of both buttresses is decreased, with the cleft side and medial buttress being more affected than the non-cleft side and lateral buttress. Therefore, special attention should be given during the fixation of the medial buttress and cleft side.</div></div>","PeriodicalId":54851,"journal":{"name":"Journal of Cranio-Maxillofacial Surgery","volume":"54 2","pages":"Article 104421"},"PeriodicalIF":2.1,"publicationDate":"2025-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145800897","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}
The aim of this study was to evaluate whether using hyaluronic acid (HA) after arthroscopic discopexy with resorbable pins offers additional benefits compared to the same technique without HA infiltration.
A retrospective study was performed, including 29 patients who underwent arthroscopic discopexy with HA infiltration and 31 patients who underwent the procedure without any additional substance between 2009 and 2017.
The evaluated parameters were: maximum interincisal opening (MIO), lateral movements (LM), protrusive movement (PM), joint pain (VAS scale), joint locking, and clicking. All patients were followed up at 1, 3, 6, and 12 months.
MIO improved in both groups, with an average improvement of 7.4 mm for the HA group and 8.03 mm for the control group at the 1-year follow-up. Pain scores (VAS) decreased from moderate to mild in both groups with a p-value <0.000, showing better scores for the HA group (11.88 ± 16.17) after one year. Protrusive movement improved significantly in both groups. Joint noise improved in both groups; the HA group saw a reduction from 56.3 % to 17.24 % (p-value = 0.001) at the 1-year follow-up, whereas the control group persisted at 12.9 % from the 55.6 % reported before the intervention. The HA group had better outcomes regarding joint locking, with no blocking events up to 6 months, compared to two patients in the control group experiencing blocking at the 1-year follow-up.
In conclusion, HA infiltration showed a beneficial trend in joint locking and pain scores, although the difference in joint locking was not statistically significant. However, improvements in MIO, protrusive movement, lateral movement, and joint noise in both groups are attributed to the positive effects of arthroscopic discopexy.
{"title":"Effects of the use of hyaluronic acid in arthroscopic discopexy with resorbable pins: A comparative study","authors":"Diana Marcela Bernal Bermúdez , Simona Barone , Carlota Mazo Amorós , Alejandro Encinas Bascones , Alejandrina Millón-Cruz , Rafael Martin-Granizo","doi":"10.1016/j.jcms.2025.11.021","DOIUrl":"10.1016/j.jcms.2025.11.021","url":null,"abstract":"<div><div>The aim of this study was to evaluate whether using hyaluronic acid (HA) after arthroscopic discopexy with resorbable pins offers additional benefits compared to the same technique without HA infiltration.</div><div>A retrospective study was performed, including 29 patients who underwent arthroscopic discopexy with HA infiltration and 31 patients who underwent the procedure without any additional substance between 2009 and 2017.</div><div>The evaluated parameters were: maximum interincisal opening (MIO), lateral movements (LM), protrusive movement (PM), joint pain (VAS scale), joint locking, and clicking. All patients were followed up at 1, 3, 6, and 12 months.</div><div>MIO improved in both groups, with an average improvement of 7.4 mm for the HA group and 8.03 mm for the control group at the 1-year follow-up. Pain scores (VAS) decreased from moderate to mild in both groups with a p-value <0.000, showing better scores for the HA group (11.88 ± 16.17) after one year. Protrusive movement improved significantly in both groups. Joint noise improved in both groups; the HA group saw a reduction from 56.3 % to 17.24 % (p-value = 0.001) at the 1-year follow-up, whereas the control group persisted at 12.9 % from the 55.6 % reported before the intervention. The HA group had better outcomes regarding joint locking, with no blocking events up to 6 months, compared to two patients in the control group experiencing blocking at the 1-year follow-up.</div><div>In conclusion, HA infiltration showed a beneficial trend in joint locking and pain scores, although the difference in joint locking was not statistically significant. However, improvements in MIO, protrusive movement, lateral movement, and joint noise in both groups are attributed to the positive effects of arthroscopic discopexy.</div></div>","PeriodicalId":54851,"journal":{"name":"Journal of Cranio-Maxillofacial Surgery","volume":"54 2","pages":"Article 104418"},"PeriodicalIF":2.1,"publicationDate":"2025-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145800914","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.2025.104427
Subhas Konar , Joel John , Dhaval Shukla , Neil Manjunath Salian , Dwarakanath Srivinias , Girish Rao
While previous studies have focused on quantitative assessments and surgeon-reported surgical outcomes, limited research exists on parent-reported outcomes following surgical correction of craniosynostosis. Our study assessed both surgeon-assessed and parent-reported outcomes in children who underwent craniosynostosis correction surgery. A retrospective observational study analyzed the outcomes of 103 children who underwent craniosynostosis surgery between January 2009 and June 2022. First the surgeon assessed the outcome using the Sloan outcome classification system, which ranks cosmetic results on a six-point ordinal scale ranging from excellent correction (Class 1) to compromised correction requiring revision surgery (Class 7). Second, a non-structured patient-reported outcome measurement (PROM) evaluating subjective postoperative changes in cosmetic appearance, vision, oropharyngeal symptoms, scholastic performance, and quality of life (QOL) for both the child and parent was carried out. PROM responses were categorized as A (worsened), B (unchanged), C (moderately improved), or D (significantly improved). Fifty-eight children (56.3 %) achieved a Sloan Class 1 outcome, indicating excellent correction with no visible or palpable deformity. Children with metopic suture synostosis showed the highest improvement (85.7 %). Subjective outcome assessment using PROM revealed statistically significant differences between syndromic (S) and nonsyndromic (NS) craniosynostosis groups across multiple domains. There was a strong correlation between surgeon-reported outcomes and PROM domains of cosmesis, as well as parent and child quality of life. Our study highlights the importance of incorporating both objective and subjective measures in assessing outcomes of craniosynostosis surgery.
{"title":"Surgeon- and parent-reported outcome after surgery for craniosynostosis","authors":"Subhas Konar , Joel John , Dhaval Shukla , Neil Manjunath Salian , Dwarakanath Srivinias , Girish Rao","doi":"10.1016/j.jcms.2025.104427","DOIUrl":"10.1016/j.jcms.2025.104427","url":null,"abstract":"<div><div>While previous studies have focused on quantitative assessments and surgeon-reported surgical outcomes, limited research exists on parent-reported outcomes following surgical correction of craniosynostosis. Our study assessed both surgeon-assessed and parent-reported outcomes in children who underwent craniosynostosis correction surgery. A retrospective observational study analyzed the outcomes of 103 children who underwent craniosynostosis surgery between January 2009 and June 2022. First the surgeon assessed the outcome using the Sloan outcome classification system, which ranks cosmetic results on a six-point ordinal scale ranging from excellent correction (Class 1) to compromised correction requiring revision surgery (Class 7). Second, a non-structured patient-reported outcome measurement (PROM) evaluating subjective postoperative changes in cosmetic appearance, vision, oropharyngeal symptoms, scholastic performance, and quality of life (QOL) for both the child and parent was carried out. PROM responses were categorized as A (worsened), B (unchanged), C (moderately improved), or D (significantly improved). Fifty-eight children (56.3 %) achieved a Sloan Class 1 outcome, indicating excellent correction with no visible or palpable deformity. Children with metopic suture synostosis showed the highest improvement (85.7 %). Subjective outcome assessment using PROM revealed statistically significant differences between syndromic (S) and nonsyndromic (NS) craniosynostosis groups across multiple domains. There was a strong correlation between surgeon-reported outcomes and PROM domains of cosmesis, as well as parent and child quality of life. Our study highlights the importance of incorporating both objective and subjective measures in assessing outcomes of craniosynostosis surgery.</div></div>","PeriodicalId":54851,"journal":{"name":"Journal of Cranio-Maxillofacial Surgery","volume":"54 1","pages":"Article 104427"},"PeriodicalIF":2.1,"publicationDate":"2025-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145799786","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}
This study aims to investigate the postoperative maxillofacial growth and bone formation after gingivoperiosteoplasty (GPP) performed in early childhood for patients with bilateral cleft lip and palate (BCLP). Thirty non-syndromic patients with complete BCLP who underwent a two-stage palatoplasty protocol were enrolled. Their alveolar cleft sides were categorized into two groups based on whether GPP was applied at the timing of hard palate closure (GPP group, n = 33) or not (non-GPP group, n = 27). Computed tomography (CT) and lateral cephalograms both taken at 8 years of age were analysed. Bone bridge formation was significantly higher in the GPP group (93.9 %) compared to the non-GPP group (11.1 %). However, the mean proportion of the bone created within the alveolar cleft site measured at multiple vertical levels in the GPP group was 54.4 %. Lateral cephalometric analysis revealed that the GPP group showed both anteroposterior length of the maxilla (GPP: 46.5 ± 3.0 mm, non-GPP: 50.2 ± 2.3 mm) and ANB (GPP: 3.4 ± 3.0°, non-GPP: 6.6 ± 2.5°) significantly smaller than the non-GPP group. These results demonstrated that GPP, performed at 1.5 years of age for BCLP, resulted in insufficient new bone formation and negatively impacted maxillary development. Based on these findings, we have discontinued our GPP protocol for patients with BCLP.
{"title":"Clinical outcomes of gingivoperiosteoplasty performed in early childhood in patients with bilateral cleft lip and palate","authors":"Yuki Arimura , Tadashi Yamanishi , Takahiro Nishio , Setsuko Uematsu , Aiko Hyodo , Katsuhiko Amano , Seiji Iida , Juntaro Nishio","doi":"10.1016/j.jcms.2025.12.002","DOIUrl":"10.1016/j.jcms.2025.12.002","url":null,"abstract":"<div><div>This study aims to investigate the postoperative maxillofacial growth and bone formation after gingivoperiosteoplasty (GPP) performed in early childhood for patients with bilateral cleft lip and palate (BCLP). Thirty non-syndromic patients with complete BCLP who underwent a two-stage palatoplasty protocol were enrolled. Their alveolar cleft sides were categorized into two groups based on whether GPP was applied at the timing of hard palate closure (GPP group, n = 33) or not (non-GPP group, n = 27). Computed tomography (CT) and lateral cephalograms both taken at 8 years of age were analysed. Bone bridge formation was significantly higher in the GPP group (93.9 %) compared to the non-GPP group (11.1 %). However, the mean proportion of the bone created within the alveolar cleft site measured at multiple vertical levels in the GPP group was 54.4 %. Lateral cephalometric analysis revealed that the GPP group showed both anteroposterior length of the maxilla (GPP: 46.5 ± 3.0 mm, non-GPP: 50.2 ± 2.3 mm) and ANB (GPP: 3.4 ± 3.0°, non-GPP: 6.6 ± 2.5°) significantly smaller than the non-GPP group. These results demonstrated that GPP, performed at 1.5 years of age for BCLP, resulted in insufficient new bone formation and negatively impacted maxillary development. Based on these findings, we have discontinued our GPP protocol for patients with BCLP.</div></div>","PeriodicalId":54851,"journal":{"name":"Journal of Cranio-Maxillofacial Surgery","volume":"54 2","pages":"Article 104423"},"PeriodicalIF":2.1,"publicationDate":"2025-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145800898","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.2025.11.018
Zhen Zhu , Junhui Yuan , Xu Zhang , Liyuan Dai , Wei Du , Xiaoli Liu
Recurrent high-grade salivary gland carcinomas (SGCs) have limited treatment options, and immunotherapy's role remains unclear. This study evaluated radiologic and pathologic responses to immunotherapy in resectable recurrent high-grade SGCs. We retrospectively analyzed 108 patients from a tertiary center: 41 received neoadjuvant immunotherapy, while 67 underwent upfront surgery. Radiologic response (RECIST 1.1) and pathologic response (immune-related criteria) were discordant—34.1 % showed partial radiologic responses, but only 9.8 % achieved partial pathologic responses, with no complete responses. PD-L1 amplification correlated with response (25 % vs. 8.1 % in non-responders, p = 0.042), whereas B2M loss (29.3 % post-treatment, p = 0.032) and TP53/PIK3CA co-mutations (37.8 % in non-responders) were linked to resistance. Survival did not differ between groups (3-year event-free survival: 19.5 % vs. 23.9 %, p = 0.447; overall survival: 26.8 % vs. 31.3 %, p = 0.593). These findings highlight immunotherapy's limited pathologic efficacy in recurrent high-grade SGCs, with response rates lower on pathologic than radiologic assessment. PD-L1 and B2M alterations underscore the need for biomarker-driven strategies. This study provides a foundation for improving outcomes in this aggressive disease.
复发性高级别唾液腺癌（SGCs）的治疗选择有限，免疫治疗的作用尚不清楚。本研究评估了可切除复发的高级别SGCs的放射学和病理反应。我们回顾性分析了来自三级中心的108例患者：41例接受了新辅助免疫治疗，67例接受了前期手术。放射反应（RECIST 1.1）和病理反应（免疫相关标准）不一致- 34.1%显示部分放射反应，但只有9.8%达到部分病理反应，没有完全反应。PD-L1扩增与应答相关（25% vs. 8.1%，无应答者，p = 0.042），而B2M丢失（治疗后29.3%,p = 0.032）和TP53/PIK3CA共突变（无应答者，37.8%）与耐药性相关。两组间生存率无差异（3年无事件生存率：19.5% vs. 23.9%, p = 0.447；总生存率：26.8% vs. 31.3%, p = 0.593）。这些发现强调了免疫疗法对复发性高级别SGCs的有限病理疗效，病理评估的反应率低于放射评估。PD-L1和B2M的改变强调了生物标志物驱动策略的必要性。本研究为改善这种侵袭性疾病的预后提供了基础。
{"title":"Pathologic assessment Reveals limited efficacy of immunotherapy in recurrent high-grade salivary gland carcinomas: A clinicopathologic and genomic study","authors":"Zhen Zhu , Junhui Yuan , Xu Zhang , Liyuan Dai , Wei Du , Xiaoli Liu","doi":"10.1016/j.jcms.2025.11.018","DOIUrl":"10.1016/j.jcms.2025.11.018","url":null,"abstract":"<div><div>Recurrent high-grade salivary gland carcinomas (SGCs) have limited treatment options, and immunotherapy's role remains unclear. This study evaluated radiologic and pathologic responses to immunotherapy in resectable recurrent high-grade SGCs. We retrospectively analyzed 108 patients from a tertiary center: 41 received neoadjuvant immunotherapy, while 67 underwent upfront surgery. Radiologic response (RECIST 1.1) and pathologic response (immune-related criteria) were discordant—34.1 % showed partial radiologic responses, but only 9.8 % achieved partial pathologic responses, with no complete responses. PD-L1 amplification correlated with response (25 % vs. 8.1 % in non-responders, p = 0.042), whereas B2M loss (29.3 % post-treatment, p = 0.032) and TP53/PIK3CA co-mutations (37.8 % in non-responders) were linked to resistance. Survival did not differ between groups (3-year event-free survival: 19.5 % vs. 23.9 %, p = 0.447; overall survival: 26.8 % vs. 31.3 %, p = 0.593). These findings highlight immunotherapy's limited pathologic efficacy in recurrent high-grade SGCs, with response rates lower on pathologic than radiologic assessment. PD-L1 and B2M alterations underscore the need for biomarker-driven strategies. This study provides a foundation for improving outcomes in this aggressive disease.</div></div>","PeriodicalId":54851,"journal":{"name":"Journal of Cranio-Maxillofacial Surgery","volume":"54 2","pages":"Article 104415"},"PeriodicalIF":2.1,"publicationDate":"2025-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145800920","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}
Hemifacial Microsomia (HFM) is the second most common craniofacial malformation after clefts and it is characterized by mandibular hypoplasia and facial asymmetry.
This retrospective study aimed to evaluate mandibular morphology in growing HFM patients using three-dimensional (3D) computed tomography (CBCT), focusing on volumetric asymmetries.
A total of 26 patients aged 5–13 years with unilateral HFM were analyzed. They were stratified into two age groups (5–8 and 9–13 years) and classified according to Pruzansky-Kaban system in two severity categories (mild/severe deformity). CBCT data were processed to reconstruct 3D mandibular models, segmenting the condylar, coronoid and gonion regions. Volumetric differences between affected and unaffected sides were compared across age and severity subgroups.
Results showed that all the three functional units were significantly smaller on the affected side, especially in severe HFM cases. However, no statistically significant differences were found between the two age groups, suggesting that mandibular asymmetry remains substantively unchanged over the two consecutive time points examined. Multivariable regression confirmed that HFM severity was strongly associated with condylar and gonial volume discrepancies.
This study highlights the value of CBCT-based 3D reconstruction for precise assessment of mandibular morphology and supports its role in individualized diagnosis and treatment planning for HFM patients.
{"title":"Evaluation of mandibular morphology in untreated growing patients with hemifacial Microsomia: a 3D computed tomography study","authors":"Roberto Uomo , Wanda Maldonato , Alessandra Putrino , Luca Borro , Marta Cecchitelli , Lucilla Ravà , Aurelio Secinaro , Angela Galeotti","doi":"10.1016/j.jcms.2025.11.019","DOIUrl":"10.1016/j.jcms.2025.11.019","url":null,"abstract":"<div><div>Hemifacial Microsomia (HFM) is the second most common craniofacial malformation after clefts and it is characterized by mandibular hypoplasia and facial asymmetry.</div><div>This retrospective study aimed to evaluate mandibular morphology in growing HFM patients using three-dimensional (3D) computed tomography (CBCT), focusing on volumetric asymmetries.</div><div>A total of 26 patients aged 5–13 years with unilateral HFM were analyzed. They were stratified into two age groups (5–8 and 9–13 years) and classified according to Pruzansky-Kaban system in two severity categories (mild/severe deformity). CBCT data were processed to reconstruct 3D mandibular models, segmenting the condylar, coronoid and gonion regions. Volumetric differences between affected and unaffected sides were compared across age and severity subgroups.</div><div>Results showed that all the three functional units were significantly smaller on the affected side, especially in severe HFM cases. However, no statistically significant differences were found between the two age groups, suggesting that mandibular asymmetry remains substantively unchanged over the two consecutive time points examined. Multivariable regression confirmed that HFM severity was strongly associated with condylar and gonial volume discrepancies.</div><div>This study highlights the value of CBCT-based 3D reconstruction for precise assessment of mandibular morphology and supports its role in individualized diagnosis and treatment planning for HFM patients.</div></div>","PeriodicalId":54851,"journal":{"name":"Journal of Cranio-Maxillofacial Surgery","volume":"54 2","pages":"Article 104416"},"PeriodicalIF":2.1,"publicationDate":"2025-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145866678","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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