Journal of Cranio-Maxillofacial Surgery最新文献_第6页

Exploring the potential of minimally invasive sagittal split ramus osteotomy to transform patient outcomes: A randomized, double-blind, controlled, split-mouth study 探索微创矢状分叉支截骨术改变患者预后的潜力：一项随机、双盲、对照、裂口研究

IF 2.1 2区医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE

Journal of Cranio-Maxillofacial Surgery

Pub Date : 2025-12-18 DOI: 10.1016/j.jcms.2025.104426

Ahmet Emin Demirbaş , Yusuf Nuri Kaba , İbrahim Mert Erkan , Gökhan Çoban

Sagittal split ramus osteotomy is a widely used procedure in orthognathic surgery; however, conventional techniques are associated with notable morbidity, including bleeding, edema, and pain. Recently, minimally invasive techniques have been described to reduce surgery-related morbidities and improve patients’ outcomes. This randomized, double-blind, controlled, split-mouth trial aimed to compare the conventional approach with a minimally invasive sagittal split osteotomy (MISSRO) in terms of surgical efficiency and postoperative outcomes. In each of the thirty-six patients included in the study, a conventional sagittal split osteotomy (SSRO) was performed on one side of the mandible, and a MISSRO was performed on the contralateral side. The MISSRO technique was characterized by a short mucosal incision, minimal soft-tissue dissection, and a low and short osteotomy. Operative time and bleeding were statistically significantly lower on the minimally invasive side (p < 0.001). Postoperative edema measurements on days 1, 7, 14, and 30 were also statistically significantly reduced (p < 0.001). Pain scores were statistically significantly lower at the first postoperative hour (p = 0.002) on the minimally invasive side, with no differences at later time points. The findings suggest that MISSRO is a safe and effective alternative to the conventional method, enhancing recovery by reducing tissue trauma and improving perioperative outcomes.

矢状分叉支截骨术是一种广泛应用于正颌手术的方法；然而，传统技术与显著的发病率相关，包括出血、水肿和疼痛。最近，微创技术已被描述为减少手术相关的发病率和改善患者的结果。这项随机、双盲、对照、裂口试验旨在比较传统入路与微创矢状劈开截骨术（MISSRO）在手术效率和术后结果方面的差异。在研究中包括的36例患者中，每个患者在一侧下颌骨进行常规矢状劈开截骨术（SSRO），并在对侧进行misro。misro技术的特点是短的粘膜切口，最小的软组织剥离，低而短的截骨。微创侧手术时间和出血量显著低于微创侧（p < 0.001）。术后第1、7、14和30天的水肿测量值也有统计学意义上的显著降低（p < 0.001）。微创侧患者术后1小时疼痛评分差异有统计学意义（p = 0.002），后续时间点差异无统计学意义。研究结果表明，misro是一种安全有效的替代传统方法，通过减少组织创伤和改善围手术期预后来促进恢复。

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引用次数: 0

Evaluation of bite force recovery in patients with maxillofacial fracture 评估颌面部骨折患者咬合力的恢复情况。

IF 2.1 2区医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE

Journal of Cranio-Maxillofacial Surgery

Pub Date : 2025-12-01 DOI: 10.1016/j.jcms.2021.02.017

Hamed Gheibollahi , Ehsan Aliabadi , Mohammad Saleh Khaghaninejad , Sona Mousavi , Ali Peyravi , Amirhossein Babaei

The aim of this study was to measure the maximum voluntary bite force and recovery time in patients treated for different types of the maxillofacial fracture.

Patients aged between 18 and 60 years, who received surgical treatment for a single isolated fracture of the maxillofacial structure, were included in this study. Healthy individuals without any maxillofacial abnormality were selected as the control group. Bite force (in kg) was measured at the first incisor tooth, bilaterally, prior to surgery and 2 weeks, 6 weeks, 3 months, and 6 months after surgery.

Of 120 patients, 89 (74.17%) were male and 31 (25.83%) were female. Mean patient age (±SD) was 31.21 (±11.64) years. Bite forces relating to fractures of the zygomaticomaxillary complex (ZMC) with involvement of the arch and zygomaticofrontal suture reached normal levels after 6 weeks (from 3.89 (±1.11) to 10.82 (±1.29); p = 0.296 and from 4.20 (±0.93) to 10.70 (±1.70); p = 0.192, respectively). Bite force returned to normal after 3 months in fractures of the symphysis (from 2.05 (±0.97) to 12.18 (±0.77); p = 0.222), body (from 2.21 (±1.26) to 11.9 (±0.73); p = 0.750), angle (from 2.45 (±1.24) to 11.89 (±0.76); p = 0.769), condyle (from 2.45 (±1.27) to 11.25 (±0.82); p = 0.968), and ZMC with and without infraorbital rim involvement (from 3.83 (±0.93) to 11.92 (±0.84); p = 0.724 and from 3.7 (±1.21) to 12.03 (±0.82); p = 0.482, respectively).

Patients with ZMC fracture involving the arch and zygomaticofrontal suture require fewer follow-ups in comparison with those with other maxillofacial fractures. Measurement of maximal bite force can help to evaluate dentofacial deformities before and after surgical treatment.

本研究旨在测量不同类型颌面部骨折患者的最大自主咬合力和恢复时间。研究对象包括年龄在 18 至 60 岁之间、因颌面部结构单一孤立骨折而接受手术治疗的患者。没有任何颌面部异常的健康人被选作对照组。在手术前、手术后 2 周、6 周、3 个月和 6 个月，测量双侧第一颗门牙的咬合力（单位：千克）。在 120 名患者中，89 名（74.17%）为男性，31 名（25.83%）为女性。患者平均年龄（±SD）为 31.21（±11.64）岁。涉及牙弓和颧额缝的颧颌面复合体（ZMC）骨折的咬合力在 6 周后达到正常水平（分别从 3.89 (±1.11) 到 10.82 (±1.29); p = 0.296 和从 4.20 (±0.93) 到 10.70 (±1.70); p = 0.192）。干骺端骨折（从 2.05 (±0.97) 到 12.18 (±0.77); p = 0.222）、本体骨折（从 2.21 (±1.26) 到 11.9 (±0.73); p = 0.750）、角骨折（从 2.45 (±1.24) 到 11.89 (±0.76); p = 0.769）、髁突（从 2.45（±1.27）到 11.25（±0.82）；p = 0.968）以及眶下缘受累和未受累的 ZMC（分别从 3.83（±0.93）到 11.92（±0.84）；p = 0.724 和从 3.7（±1.21）到 12.03（±0.82）；p = 0.482）。与其他颌面部骨折患者相比，涉及牙弓和颧额缝的 ZMC 骨折患者需要的随访次数较少。测量最大咬合力有助于评估手术治疗前后的颌面部畸形。

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引用次数: 0

Mechanistic insights into MRONJ from the role of type H vessels and bone density changes 从H型血管的作用和骨密度变化看MRONJ的机制。

IF 2.1 2区医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE

Journal of Cranio-Maxillofacial Surgery

Pub Date : 2025-12-01 DOI: 10.1016/j.jcms.2025.11.004

Jiahui Shen , Yuzhu Wu , Xiaomin Zhao , Junxing Xu , Xiaoyuan Huang , Xiaolong Zang , Zhijian Xie , Yanhua Lan

This study investigated how ossification patterns influence type H vessel formation and bone mineral density in bisphosphonate (BIS)-treated bones, aiming to explain jawbones' heightened susceptibility to medication-related osteonecrosis (MRONJ).

A cross-sectional analysis of mandibular bone radiodensity was conducted using cone-beam computed tomography (CBCT) in 68 MRONJ patients and 71 controls. An early-stage MRONJ murine model was established through alendronate sodium administration. Mandibular and tibial samples were subjected to micro-CT analysis and immunohistochemical staining of type H vessels (CD31^hi Endomucin^hi) to evaluate osteogenic angiogenesis patterns.

MRONJ patients exhibited elevated alveolar (RDa: 591.79 ± 266.67 vs. 396.62 ± 196.64 HU) and mandibular body (RDb: 435.624 ± 329.64 vs. 207.97 ± 165.12 HU) radiodensities compared to controls, while condylar radiodensity remained comparable (RDc: 314.81 ± 140.38 vs. 353.77 ± 144.26 HU). The RDa/RDc ratio demonstrated a over two-fold increase in MRONJ cases (2.37 ± 1.83 vs. 1.32 ± 0.97). BIS treatment preserved type H vessel density in intramembranous ossification-derived alveolar bone but increased it in endochondral ossification-originating condyles and tibias.

The RDa/RDc ratio may serve as a diagnostic biomarker for BIS-related mandibular changes. Differential MRONJ risk correlates with embryological ossification patterns and type H vessel responses to BIS.

本研究探讨了骨化模式如何影响双膦酸盐（BIS）处理骨的H型血管形成和骨矿物质密度，旨在解释颌骨对药物相关性骨坏死（MRONJ）的高易感。使用锥形束计算机断层扫描（CBCT）对68例MRONJ患者和71例对照组进行了下颌骨放射密度的横断面分析。通过给药阿仑膦酸钠建立早期MRONJ小鼠模型。对下颌骨和胫骨标本进行显微ct分析和H型血管（CD31hi Endomucinhi）免疫组化染色，以评估成骨血管生成模式。MRONJ患者的牙槽（RDa: 591.79±266.67 vs. 396.62±196.64 HU）和下颌体（RDb: 435.624±329.64 vs. 207.97±165.12 HU）放射密度与对照组相比升高，而髁突放射密度保持相当（RDc: 314.81±140.38 vs. 353.77±144.26 HU）。MRONJ病例的RDa/RDc比增加了两倍多（2.37±1.83比1.32±0.97）。BIS治疗保留了膜内骨化源性牙槽骨的H型血管密度，但增加了软骨内骨化源性髁突和胫骨的H型血管密度。RDa/RDc比值可作为bis相关下颌病变的诊断性生物标志物。不同MRONJ风险与胚胎学骨化模式和H型血管对BIS的反应相关。

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引用次数: 0

The impact of Coronavirus Disease 2019 on maxillofacial surgery training in Portugal: The resident's perspective 2019冠状病毒病对葡萄牙颌面外科训练的影响：居民视角

IF 2.1 2区医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE

Journal of Cranio-Maxillofacial Surgery

Pub Date : 2025-12-01 DOI: 10.1016/j.jcms.2021.02.003

Pedro Gomes de Oliveira , Cátia Mateus , João Barros , Eduardo Ventura , José Soares , Helena Rodrigues , Paulo Valejo Coelho

Introduction

The COVID-19 pandemic has forced Portuguese healthcare institutions to adapt management protocols and prioritize resources. These adjustments had a significant impact, affecting both clinical care and also training programs. The aim of this study was to access the maxillofacial surgery resident's perspective on the pandemic's impact on specialty training.

Methods

We designed a nationwide questionnaire to evaluate surgical activity of maxillofacial surgery residents, the impact on surgical training and the perceived effect on their future.

Results

We collected results of all maxillofacial surgery residents currently in training. Three out of 32 reported a decline in surgical activity of 90–100%, 11 stated a reduction of 75%, 12 expressed a decrease of 50% and 6 described a decline of 25%.

Discussion

The majority of residents stated the need to consider an extension of training time. Alternative training tools such as virtual activities and simulation training should be considered as formal complements to residency programs.

Conclusion

We found a significant decrease in surgical activity among all trainees coupled with a unanimous concern regarding their training progression.

2019冠状病毒病大流行迫使葡萄牙医疗机构调整管理方案并优先考虑资源。这些调整对临床护理和培训项目都产生了重大影响。本研究的目的是了解颌面外科住院医生对大流行对专业培训影响的看法。方法在全国范围内设计问卷，评估颌面外科住院医师的手术活动、对手术培训的影响以及对其未来的感知影响。结果收集所有正在培训的颌面外科住院医师的结果。32人中有3人报告手术活动减少了90-100%，11人报告减少了75%，12人报告减少了50%，6人报告减少了25%。大多数住院医生表示需要考虑延长培训时间。替代培训工具，如虚拟活动和模拟培训应被视为正式补充住院医师计划。结论：我们发现所有受训者的手术活动明显减少，并且一致关注他们的培训进展。

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引用次数: 0

Lower face widening in mandibular osteotomies: Is the increase in osseous and cutaneous bigonial distance correlated with mandibular advancement? 下颌骨截骨术中下脸变宽：骨性和皮肤双颊距离的增加是否与下颌骨前进相关？

IF 2.1 2区医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE

Journal of Cranio-Maxillofacial Surgery

Pub Date : 2025-12-01 DOI: 10.1016/j.jcms.2025.09.016

Guillaume Santoni , Thomas Schouman , Jean-Baptiste Caruhel

Mandibular osteotomies are known to widen the mandibular angles by increasing the bigonial distance (BGD). Previous studies have highlighted the relationship between the extent of mandibular movement and the increase in BGD, both for cutaneous bigonial distance (CBGD) and osseous bigonial distance (OBGD). However, the relationship between changes in OBGD, CBGD and mandibular advancement remains to be fully established.

The aim of this study was to compare changes in OBGD and CBGD using adapted three-dimensional examination techniques in patients who underwent mandibular osteotomies. Preoperative and postoperative computed tomography scans and stereophotogrammetry were used to measure mandibular advancement, OBGD and CBGD before and after surgery.

Of the 77 patients included, 93.5 % underwent bilateral sagittal split osteotomy, and 79.2 % had received patient-specific guided surgery. Of these, 53 patients had mandibular advancement and 24 underwent mandibular setback. In all cases, a significant increase in both OBGD and CBGD was found after surgery. The extent of mandibular advancement was significantly associated with a greater increase in both OBGD and CBGD.

众所周知，下颌截骨术通过增加双侧距离（BGD）来扩大下颌角。先前的研究强调了下颌运动程度与BGD增加之间的关系，包括皮肤双牙距离（CBGD）和骨双牙距离（OBGD）。然而，OBGD、CBGD的变化与下颌前移之间的关系仍有待完全确定。本研究的目的是比较使用适应的三维检查技术在接受下颌截骨术的患者中OBGD和CBGD的变化。术前和术后采用计算机断层扫描和立体摄影测量术测量术前和术后下颌推进、OBGD和CBGD。在纳入的77例患者中，93.5%的患者接受了双侧矢状面劈开截骨术，79.2%的患者接受了特定的指导手术。其中，53例患者下颌骨前进，24例患者下颌骨后退。在所有病例中，手术后发现OBGD和CBGD均显著增加。下颌前移的程度与OBGD和CBGD的增加显著相关。

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引用次数: 0

Prelacrimal recess morphology in unilateral cleft lip and palate: A cone-beam computed tomography study with surgical implications 单侧唇腭裂的泪前隐窝形态：具有外科意义的锥束计算机断层扫描研究。

IF 2.1 2区医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE

Journal of Cranio-Maxillofacial Surgery

Pub Date : 2025-12-01 DOI: 10.1016/j.jcms.2025.10.004

Yunus Çetiner , Duygu Çelik Özen , Şuayip Burak Duman

Cleft lip and palate(CLP) is a deformity that affects the anatomical structure of the nose and the maxillary sinus(MS). In the management of MS pathologies, the prelacrimal recess approach(PLRA), a minimally invasive technique within endoscopic sinus surgery, holds significant importance. This study aims to evaluate the morphometric characteristics of the nasolacrimal duct(NLD) and the prelacrimal recess(PLR), as well as the feasibility of the prelacrimal recess approach(PLRA), in patients with unilateral cleft lip and palate(UCLP) using cone-beam computed tomography(CBCT). CBCT images of both the cleft and non-cleft sides of 60 patients with UCLP were retrospectively analyzed. Morphometric measurements related to the anatomy of the NLD and the PLR were performed and statistically compared.In these patients, the mediolateral diameter of the NLD was found to be significantly narrower on the cleft side(5.10 ± 1.29 mm) compared to the non-cleft side(5.74 ± 1.28 mm)(p = 0.03). The mediolateral thickness of the PLR was also significantly thinner on the cleft side(1.89 ± 1.46 mm) than on the non-cleft side(2.91 ± 1.95 mm)(p = 0.01). However, no significant difference was observed in the anteroposterior length of the PLR between the cleft side(5.08 ± 2.54 mm) and the non-cleft side(4.64 ± 2.67 mm)(p = 0.35).The prelacrimal recess and nasolacrimal canal on the cleft side may be affected in patients with UCLP. CBCT serves as a valuable tool in identifying these anatomical variations, which are frequently associated with congenital deformities such as UCLP and should be carefully considered during surgical planning.

唇腭裂（CLP）是一种影响鼻和上颌窦解剖结构的畸形。在多发性硬化病理的治疗中，泪前隐窝入路（PLRA）是内镜鼻窦手术中的一种微创技术，具有重要意义。本研究旨在评估单侧唇腭裂（UCLP）患者鼻泪管（NLD）和泪前隐窝（PLR）的形态学特征，以及泪前隐窝入路（PLRA）的可行性。回顾性分析60例UCLP患者的裂侧和非裂侧CBCT图像。对NLD和PLR的解剖结构进行形态学测量并进行统计学比较。在这些患者中，发现裂唇侧NLD的内外侧直径（5.10±1.29 mm）明显小于非裂唇侧（5.74±1.28 mm）（p = 0.03）。裂唇侧PLR的中外侧厚度（1.89±1.46 mm）明显小于非裂唇侧（2.91±1.95 mm）（p = 0.01）。而腭裂侧和非腭裂侧PLR的前后长度（5.08±2.54 mm）与非腭裂侧（4.64±2.67 mm）差异无统计学意义（p = 0.35）。裂唇患者的泪前隐窝和鼻泪管可能受到影响。CBCT是识别这些解剖变异的有价值的工具，这些变异通常与先天性畸形（如UCLP）有关，在手术计划时应仔细考虑。

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引用次数: 0

Bioprinting for craniofacial reconstruction: A review of advancements, clinical use, and challenges 生物打印用于颅面重建：进展，临床应用和挑战的回顾。

IF 2.1 2区医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE

Journal of Cranio-Maxillofacial Surgery

Pub Date : 2025-12-01 DOI: 10.1016/j.jcms.2025.10.010

Niayesh Najafi, Kevin Babakhan Vartanian, Tony Eskandar, Kevin Ghookas, Edgmin Rostomian, Devendra K. Agrawal

Craniofacial reconstructive surgery faces significant challenges due to complex anatomy, intricate vascularization requirements, and the limitations of traditional grafts. Recent advancements in three-dimensional (3D) bioprinting technology present a promising paradigm shift, offering precise, patient-specific solutions for repairing critical zygomatic, orbital, nasal, and mandibular defects. This review systematically examines the latest breakthroughs in bioprinting methods, including extrusion-based, laser-assisted, stereolithography, magnetic bioprinting, spheroid rapid printing, and artificial intelligence integration. Through detailed analysis of clinical applications, we highlight successful case studies demonstrating enhanced surgical outcomes and patient satisfaction, particularly in complex zygomatic reconstructions and delicate orbital floor repairs. Furthermore, we explore the novel bioink formulations, emphasizing hydrogel composites and biofunctional materials optimized for craniofacial tissue regeneration, while addressing persistent technical and biological challenges such as vascularization, immune compatibility, and regulatory hurdles. Finally, we outline strategic pathways for advancing clinical translation, advocating for interdisciplinary collaboration, standardization, and innovative integration of artificial intelligence-driven optimization to accelerate the adoption of bio-printed constructs into clinical practice. Overall, 3D bioprinting represents a transformative frontier in craniofacial reconstruction, poised to significantly improve patient outcomes and reshape surgical approaches to complex head and neck defects.

由于复杂的解剖结构、复杂的血管化要求和传统移植物的局限性，颅面重建手术面临着巨大的挑战。三维（3D）生物打印技术的最新进展呈现出一种有希望的范式转变，为修复颧骨、眶、鼻和下颌的关键缺陷提供了精确的、针对患者的解决方案。本文系统地综述了生物打印技术的最新突破，包括基于挤压的生物打印、激光辅助的生物打印、立体光刻、磁性生物打印、球体快速打印和人工智能集成。通过对临床应用的详细分析，我们强调了成功的案例研究，证明了手术效果和患者满意度的提高，特别是在复杂的颧骨重建和精细的眶底修复中。此外，我们探索新的生物链接配方，强调水凝胶复合材料和生物功能材料优化颅面组织再生，同时解决持续的技术和生物学挑战，如血管化，免疫相容性和监管障碍。最后，我们概述了推进临床翻译的战略途径，倡导跨学科合作，标准化和人工智能驱动优化的创新整合，以加速生物打印构建物进入临床实践。总的来说，3D生物打印代表了颅面重建的变革前沿，有望显著改善患者的治疗效果，重塑复杂头颈部缺陷的手术方法。

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引用次数: 0

Identifying the optimal facial midsagittal plane: Harmonizing soft-tissue and skeletal references for precise incisor positioning in virtual surgery 识别最佳面部正中矢状面：协调虚拟手术中精确门牙定位的软组织和骨骼参考。

IF 2.1 2区医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE

Journal of Cranio-Maxillofacial Surgery

Pub Date : 2025-12-01 DOI: 10.1016/j.jcms.2025.11.007

Jinseong Park , Dohyoung Kim , Hyung-Kyu Noh

In virtual orthognathic surgery, accurate upper incisor positioning relative to the facial soft-tissue midsagittal plane is essential. However, the optimal method for constructing this plane and its relationship to the skeletal midsagittal plane remain unclear. This study aimed to identify the optimal facial soft-tissue midsagittal plane and to establish clinical guidelines for reconciling soft-tissue and skeletal planes in virtual surgery. The study analyzed pretreatment records of 60 patients with skeletal Class III malocclusion (symmetric and asymmetric). Outcomes included root-mean-squared (RMS) distance and incisor deviation measurements to assess plane accuracy and alignment across various planes between groups. The Ex-Ex.midEn plane—defined by bilateral exocanthions and the midpoint of endocanthions—showed the lowest RMS distance in both groups, approximating the optimized plane. In the asymmetric group, incisor deviations varied significantly across plane types, with midEn-midTr-SubN < Ba-Na-ANS < Ex-Ex.midEn < FH⊥Ba-Na (mean difference ∼1 mm between pairs). Therefore, the Ex-Ex.midEn plane closely approximates the optimized midsagittal plane and is compatible with both Ba-Na-ANS and FH⊥Ba-Na within a 1 mm margin. Clinicians are advised to initially position the incisor using the skeletal midsagittal plane and adjust the resultant maxilla-mandibular complex position only if the discrepancy with the soft-tissue midsagittal plane exceeds 2 mm.

在虚拟正颌手术中，准确的上切牙相对于面部软组织正中矢状面定位是必不可少的。然而，构建该平面的最佳方法及其与骨骼中矢状面之间的关系尚不清楚。本研究旨在确定最佳的面部软组织正中矢状面，并建立虚拟手术中协调软组织和骨骼平面的临床指南。本研究分析了60例骨骼III类错颌畸形（对称型和非对称型）的预处理记录。结果包括根均方（RMS）距离和切牙偏差测量，以评估两组间不同平面的平面精度和对齐。Ex-Ex。中位面（由双侧外包膜和内包膜中点定义）两组的RMS距离最低，接近优化平面。在不对称组中，切牙偏差在平面类型上有显著差异，中间-中间-中间- subn

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引用次数: 0

Relations between local bone density from computed tomography and bone regeneration in alveolar cleft repair 牙槽骨裂修复术中局部骨密度与骨再生的关系。

IF 2.1 2区医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE

Journal of Cranio-Maxillofacial Surgery

Pub Date : 2025-12-01 DOI: 10.1016/j.jcms.2025.09.013

Guang Zhang , Siqi Wei , Qingqing Li , Tianyi Gu , Yongqian Wang

Numerous factors influence postoperative bone regeneration with autologous iliac bone grafting in alveolar cleft repair. However, few studies have reported the relationship between preoperative local bone quality and postoperative bone regeneration. Local bone density (BD) was determined according to the gray value in preoperative computed tomography (CT) images with 3D reconstruction technique. Postoperative bone formation volume (BFV) and preoperative bone defect volume (BDV) were obtained after 3D reconstruction, fitting alignment, and Boolean operation based on preoperative and postoperative CT images. The bone formation rate (BFR) was subsequently calculated (BFV/BDV). 12 patients were included in this retrospective study. The mean BD was 658.34 ± 73.40 HU, the mean BFV was 404.89 ± 164.93 mm³ and the mean BFR was 46.1 ± 12.18 % after a follow-up of at least 6 months. Pearson correlation analysis showed that there was a significant positive correlation between the BFV and the BD (r = 0.7815, p = 0.0027), and the BFR and the BD were also significantly positively correlated (r = 0.6533, p = 0.0213). In conclusion, Postoperative BFV and BFR in patients with alveolar cleft who underwent autogenous iliac bone grafting were positively correlated with BD of recipient site.

影响牙槽裂自体髂骨移植术后骨再生的因素很多。然而，很少有研究报道术前局部骨质量与术后骨再生的关系。采用三维重建技术根据术前CT图像灰度值确定局部骨密度（BD）。术后骨形成体积（BFV）和术前骨缺损体积（BDV）根据术前、术后CT图像进行三维重建、拟合对齐、布尔运算后得到。计算骨形成率（BFR）（BFV/BDV）。本回顾性研究纳入了12例患者。随访至少6个月后，平均BD为658.34±73.40 HU，平均BFV为404.89±164.93 mm3，平均BFR为46.1±12.18%。Pearson相关分析显示BFV与BD呈显著正相关（r = 0.7815, p = 0.0027）， BFR与BD也呈显著正相关（r = 0.6533, p = 0.0213）。综上所述，牙槽沟裂行自体髂骨移植术患者术后BFV和BFR与受体部位BD呈正相关。

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引用次数: 0

Incidence, risk factors and prevention of surgical site infections following orthognathic surgery: a retrospective analysis of 736 surgical procedures over a 5-year period in a French tertiary center 正颌手术后手术部位感染的发生率、危险因素和预防：对法国某三级医疗中心5年来736例手术的回顾性分析

IF 2.1 2区医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE

Journal of Cranio-Maxillofacial Surgery

Pub Date : 2025-12-01 DOI: 10.1016/j.jcms.2025.10.005

Moussa Bazia , Soline Bobet , Sophie Dugast , Pierre Corre , Alice Prevost , Hélios Bertin

Surgical site infection (SSI) remains a common complication following orthognathic surgery, with no consensus on optimal antibiotic prophylaxis and a lack of comprehensive risk factors. This study aims to determine the incidence of SSI after orthognathic surgery and identify independent risk factors. We conducted a retrospective cohort study of 736 procedures performed in our department between January 2019 and January 2024. Demographic data, comorbidities, data on surgical procedure, and antibiotic regimens were extracted from patients' records. SSI was defined as any documented infection occurred within 12 months postoperatively. Correlations between SSI and suggested risk factors were assessed using univariable and multivariable logistic regression. Among 736 procedures performed in 699 patients, 37 (5.0 %) SSI occurred. Multivariable analysis showed that extended postoperative antibiotics reduced SSI odds by 82 % (adjusted OR = 0.18; 95 % CI [0.07–0.45]; p < 0.001). Bilateral sagittal split osteotomy (BSSO) performed alone increased SSI risk threefold (adjusted OR = 2.64; 95 % CI [1.25–5.59]; p = 0.011). Outpatient procedures were significantly associated with a lower risk of SSI (adjusted OR = 0.21; 95 % CI [0.05–0.91]; p = 0.038). Tailored postoperative antibiotic prophylaxis is pivotal in reducing SSI after orthognathic surgery.

手术部位感染（SSI）仍然是正颌手术后常见的并发症，关于最佳抗生素预防和缺乏综合危险因素尚无共识。本研究旨在确定正颌手术后SSI的发生率，并确定独立危险因素。我们对2019年1月至2024年1月在我科进行的736例手术进行了回顾性队列研究。从患者记录中提取人口统计数据、合并症、外科手术数据和抗生素方案。SSI定义为术后12个月内发生的任何有记录的感染。使用单变量和多变量逻辑回归评估SSI与建议危险因素之间的相关性。在699例患者的736例手术中，37例（5.0%）发生SSI。多变量分析显示，术后延长使用抗生素可使SSI发生率降低82%(调整后OR = 0.18; 95% CI [0.07-0.45]

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