In patients with unilateral cleft lip, alveolus, and palate (U-CLAP), wide clefts negatively affect facial aesthetics, alveolar alignment, and speech. Although various presurgical orthopedic devices have been used, none reliably achieve substantial cleft narrowing. This study introduces the Super-Passive Alveolar Correcting Equipment (SPACE), a molar-supported passive plate that significantly reduces cleft width, narrowing the mean alveolar gap to 1.87 mm before surgery (n = 83). SPACE enabled a one-stage repair - lip repair, gingivoperiosteoplasty, and palatoplasty - performed at approximately 6 months of age. All patients underwent the one-stage procedure, with no oronasal fistulas observed. Among them, 56 complete U-CLAP patients were assessed using six linear measurements from dental casts obtained at the initial visit, before surgery, and at 1 year. Five-year outcomes included evaluations of maxillofacial growth (via lateral cephalometry), need for secondary alveolar bone grafting (SBG), and speech development. At age 5, cephalometric values were comparable between the SPACE one-stage (SOG) and the conventional Hotz multistage groups (HMG), except for U1-NF. The SBG avoidance rate with the SOG was 38.6 %. Malarticulation occurred in 14.6 % of the SOG patients, versus 42.2 % for the HMG. SPACE provides reliable presurgical cleft narrowing and facilitates a simplified one-stage protocol with favorable mid-term outcomes.
在单侧唇腭裂（U-CLAP）患者中，宽裂对面部美观、牙槽排列和言语产生负面影响。虽然使用了各种手术前矫形装置，但没有一种能可靠地实现实质性的腭裂狭窄。本研究介绍了超被动牙槽矫正设备（SPACE），这是一种臼齿支持的被动板，可显着减少裂宽，将术前平均牙槽间隙缩小至1.87 mm （n = 83）。SPACE可以在大约6个月大的时候进行一期修复——唇修复、牙龈骨膜成形术和腭成形术。所有患者均接受一期手术，未观察到口鼻瘘。其中，56例完整的U-CLAP患者在首次就诊、术前和1年时使用牙模进行了6项线性测量。5年的结果包括评估颌面部生长（通过侧位测量），需要二次牙槽骨移植（SBG）和语言发育。在5岁时，除U1-NF外，SPACE一期组（SOG）和传统Hotz多期组（HMG）的头颅测量值具有可比性。SOG对SBG的回避率为38.6%。SOG患者中有14.6%出现了关节失调，而HMG患者中有42.2%。SPACE提供了可靠的术前腭裂狭窄，简化了一期手术方案，中期预后良好。
{"title":"Super-Passive Alveolar Correcting Equipment (SPACE): a novel presurgical cleft device with 5-year outcomes following one-stage repair.","authors":"Akihiko Oyama, Emi Funayama, Toru Okamoto, Takahiiro Miura, Yuki Sasaki, Noriko Nishizawa, Satoko Imai, Taku Maeda, Kosuke Ishikawa, Masahiro Hojo, Yuhei Yamamoto","doi":"10.1016/j.jcms.2025.12.001","DOIUrl":"https://doi.org/10.1016/j.jcms.2025.12.001","url":null,"abstract":"<p><p>In patients with unilateral cleft lip, alveolus, and palate (U-CLAP), wide clefts negatively affect facial aesthetics, alveolar alignment, and speech. Although various presurgical orthopedic devices have been used, none reliably achieve substantial cleft narrowing. This study introduces the Super-Passive Alveolar Correcting Equipment (SPACE), a molar-supported passive plate that significantly reduces cleft width, narrowing the mean alveolar gap to 1.87 mm before surgery (n = 83). SPACE enabled a one-stage repair - lip repair, gingivoperiosteoplasty, and palatoplasty - performed at approximately 6 months of age. All patients underwent the one-stage procedure, with no oronasal fistulas observed. Among them, 56 complete U-CLAP patients were assessed using six linear measurements from dental casts obtained at the initial visit, before surgery, and at 1 year. Five-year outcomes included evaluations of maxillofacial growth (via lateral cephalometry), need for secondary alveolar bone grafting (SBG), and speech development. At age 5, cephalometric values were comparable between the SPACE one-stage (SOG) and the conventional Hotz multistage groups (HMG), except for U1-NF. The SBG avoidance rate with the SOG was 38.6 %. Malarticulation occurred in 14.6 % of the SOG patients, versus 42.2 % for the HMG. SPACE provides reliable presurgical cleft narrowing and facilitates a simplified one-stage protocol with favorable mid-term outcomes.</p>","PeriodicalId":54851,"journal":{"name":"Journal of Cranio-Maxillofacial Surgery","volume":" ","pages":"104422"},"PeriodicalIF":2.1,"publicationDate":"2026-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145946848","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}
Aim: Conservative treatment of pediatric condyle fractures remains the generally accepted norm even today. However, longterm results of conservatively treated displaced pediatric condyle fractures often display adverse effects on the affected temporomandibular joint (TMJ), and also on the growing facial skeleton. We analyzed results of surgical treatment in pediatric intraarticular condyle fractures.
Patients and methods: Children with displaced intraarticular condyle fractures were treated surgically, with open reduction and internal fixation (ORIF). The articular disc was addressed in each case. Postoperatively, patients were controlled at 1 week, 1 month, 3-6 months, and yearly thereafter. Facial symmetry, maximal mouth opening (MMO), maximal lateropulsions, lateral chin deflection, TMJ pain, condylar translation, palpable pathological phenomena, occlusion and postoperative scars were assessed clinically. Fracture healing, condylar height, shape and growth were assessed radiologically. Possible surgical complications were also noted.
Results: From 2016 through 2022, 14 children with 19 displaced intraarticular condyle fractures were treated surgically, of whom 11 children with 16 fractures enrolled in the survey. In all the fractures, the TMJ was opened, and all the fractures save one reduced and fixed. In 5 fractures (31 %), the articular disc was displaced and ruptured, and was reduced and sutured. The age range was 4-12 years (average 9.7 years). Follow up time was 2-8 years (average 5.1 years). All of the patients maintained proper occlusion and MMO. Only one patient with ORIF developed mild facial asymmetry, limited condylar translation, and limited contralateral lateropulsion of the mandible. In the patient where only exploration was performed, the condyle grew angulated (20O anteromedially) and its translation is slightly limited. In all the other patients, symmetrical growth and TMJ mobility were achieved. None of the patients presented with chewing difficulties or joint pain. There were 2 cases of postoperative facial nerve weakness, both of which completely resolved in 2 and 4 weeks. In 1 patient, the lag screw was removed after 2 months because of protrusion into the joint space. In another, a reoperation was performed 2 days after the initial surgery due to fragment malposition. No other intra- or postoperative complications were noted.
Conclusion: Surgical treatment of displaced intraarticular pediatric condylar fractures restores skeletal and soft-tissue anatomy and thereby enables unaltered TMJ function and symmetrical growth of the condyles and the entire facial skeleton.
{"title":"Surgical treatment of displaced intraarticular pediatric condyle fractures.","authors":"Aleš Vesnaver, Vojko Didanovič, Anže Birk, Tadej Dovšak","doi":"10.1016/j.jcms.2025.104428","DOIUrl":"https://doi.org/10.1016/j.jcms.2025.104428","url":null,"abstract":"<p><strong>Aim: </strong>Conservative treatment of pediatric condyle fractures remains the generally accepted norm even today. However, longterm results of conservatively treated displaced pediatric condyle fractures often display adverse effects on the affected temporomandibular joint (TMJ), and also on the growing facial skeleton. We analyzed results of surgical treatment in pediatric intraarticular condyle fractures.</p><p><strong>Patients and methods: </strong>Children with displaced intraarticular condyle fractures were treated surgically, with open reduction and internal fixation (ORIF). The articular disc was addressed in each case. Postoperatively, patients were controlled at 1 week, 1 month, 3-6 months, and yearly thereafter. Facial symmetry, maximal mouth opening (MMO), maximal lateropulsions, lateral chin deflection, TMJ pain, condylar translation, palpable pathological phenomena, occlusion and postoperative scars were assessed clinically. Fracture healing, condylar height, shape and growth were assessed radiologically. Possible surgical complications were also noted.</p><p><strong>Results: </strong>From 2016 through 2022, 14 children with 19 displaced intraarticular condyle fractures were treated surgically, of whom 11 children with 16 fractures enrolled in the survey. In all the fractures, the TMJ was opened, and all the fractures save one reduced and fixed. In 5 fractures (31 %), the articular disc was displaced and ruptured, and was reduced and sutured. The age range was 4-12 years (average 9.7 years). Follow up time was 2-8 years (average 5.1 years). All of the patients maintained proper occlusion and MMO. Only one patient with ORIF developed mild facial asymmetry, limited condylar translation, and limited contralateral lateropulsion of the mandible. In the patient where only exploration was performed, the condyle grew angulated (20<sup>O</sup> anteromedially) and its translation is slightly limited. In all the other patients, symmetrical growth and TMJ mobility were achieved. None of the patients presented with chewing difficulties or joint pain. There were 2 cases of postoperative facial nerve weakness, both of which completely resolved in 2 and 4 weeks. In 1 patient, the lag screw was removed after 2 months because of protrusion into the joint space. In another, a reoperation was performed 2 days after the initial surgery due to fragment malposition. No other intra- or postoperative complications were noted.</p><p><strong>Conclusion: </strong>Surgical treatment of displaced intraarticular pediatric condylar fractures restores skeletal and soft-tissue anatomy and thereby enables unaltered TMJ function and symmetrical growth of the condyles and the entire facial skeleton.</p>","PeriodicalId":54851,"journal":{"name":"Journal of Cranio-Maxillofacial Surgery","volume":" ","pages":"104428"},"PeriodicalIF":2.1,"publicationDate":"2026-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145919259","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 : 2026-01-01Epub Date: 2025-12-18DOI: 10.1016/j.jcms.2025.11.017
Yuxin Liu , Hongzhi Quan
Background
Oral submucous fibrosis (OSF) has a high propensity for malignant transformation, and oral squamous cell carcinoma (OSCC) associated with OSF exhibits different clinical and pathological features compared to non-OSF-related OSCC. It aimed to investigate the expression characteristics of peripheral blood interleukins (ILs) in patients with OSF-related OSCC and their relationship with clinical and pathological features.
Methods
A total of 219 OSCC patients were included and divided into OSF group (OG, n = 115) and non-OSF group (nOG, n = 104). Additionally, 119 healthy volunteers were recruited through community health screening as the healthy control group (HCG). Clinical and pathological data were collected, and ILs in peripheral blood were measured. The levels of IL-11 in peripheral blood of OSF-related OSCC patients with different pathological features were compared.
Results
Compared to the nOG and HCG, the OG exhibited a lower proportion of individuals aged ≥65 years, a higher proportion of males, and significantly elevated levels of IL-2 and IL-11. Additionally, compared to the nOG, the OG demonstrated lower recurrence and mortality rates, as well as a higher proportion of oral tumors and well-differentiated pathological features (P < 0.05). The area under the curve (AUC) for diagnosing OSF-related OSCC based on the levels of IL-2, IL-4, IL-10, and IL-11 in peripheral blood were 0.671, 0.593, 0.570, and 0.725, respectively. IL-11 levels were correlated with the degree of differentiation, lymph node metastasis (LNM), clinical staging, prognosis, and 5-year survival status in patients with OSF-related OSCC (P < 0.05).
Conclusion
Elevated IL-11 in peripheral blood of patients with OSF-related OSCC are closely associated with clinical and pathological features.
背景：口腔粘膜下纤维化（OSF）具有较高的恶性转化倾向，与OSF相关的口腔鳞状细胞癌（OSCC）与非OSF相关的OSCC相比，表现出不同的临床和病理特征。目的探讨osf相关性OSCC患者外周血白细胞介素（il）的表达特征及其与临床病理特征的关系。方法：219例OSCC患者分为OSF组（OG, n = 115）和非OSF组（nOG, n = 104）。此外，通过社区健康筛查招募119名健康志愿者作为健康对照组（HCG）。收集临床及病理资料，测定外周血il。比较不同病理特征osf相关性OSCC患者外周血IL-11水平。结果：与nOG和HCG相比，OG年龄≥65岁的个体比例较低，男性比例较高，IL-2和IL-11水平显著升高。此外，与nOG相比，OG表现出更低的复发率和死亡率，以及更高的口腔肿瘤比例和分化良好的病理特征(P结论：osf相关性OSCC患者外周血IL-11升高与临床和病理特征密切相关。
{"title":"IL-11 as a potential diagnostic and prognostic biomarker in oral submucous fibrosis-related oral squamous cell carcinoma: A single-center exploratory study","authors":"Yuxin Liu , Hongzhi Quan","doi":"10.1016/j.jcms.2025.11.017","DOIUrl":"10.1016/j.jcms.2025.11.017","url":null,"abstract":"<div><h3>Background</h3><div>Oral submucous fibrosis (OSF) has a high propensity for malignant transformation, and oral squamous cell carcinoma (OSCC) associated with OSF exhibits different clinical and pathological features compared to non-OSF-related OSCC. It aimed to investigate the expression characteristics of peripheral blood interleukins (ILs) in patients with OSF-related OSCC and their relationship with clinical and pathological features.</div></div><div><h3>Methods</h3><div>A total of 219 OSCC patients were included and divided into OSF group (OG, n = 115) and non-OSF group (nOG, n = 104). Additionally, 119 healthy volunteers were recruited through community health screening as the healthy control group (HCG). Clinical and pathological data were collected, and ILs in peripheral blood were measured. The levels of IL-11 in peripheral blood of OSF-related OSCC patients with different pathological features were compared.</div></div><div><h3>Results</h3><div>Compared to the nOG and HCG, the OG exhibited a lower proportion of individuals aged ≥65 years, a higher proportion of males, and significantly elevated levels of IL-2 and IL-11. Additionally, compared to the nOG, the OG demonstrated lower recurrence and mortality rates, as well as a higher proportion of oral tumors and well-differentiated pathological features (<em>P <</em> 0.05). The area under the curve (AUC) for diagnosing OSF-related OSCC based on the levels of IL-2, IL-4, IL-10, and IL-11 in peripheral blood were 0.671, 0.593, 0.570, and 0.725, respectively. IL-11 levels were correlated with the degree of differentiation, lymph node metastasis (LNM), clinical staging, prognosis, and 5-year survival status in patients with OSF-related OSCC (<em>P <</em> 0.05).</div></div><div><h3>Conclusion</h3><div>Elevated IL-11 in peripheral blood of patients with OSF-related OSCC are closely associated with clinical and pathological features.</div></div>","PeriodicalId":54851,"journal":{"name":"Journal of Cranio-Maxillofacial Surgery","volume":"54 1","pages":"Article 104414"},"PeriodicalIF":2.1,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145806361","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 : 2026-01-01Epub Date: 2025-11-29DOI: 10.1016/j.jcms.2025.11.013
Simin Li , Xiong Zhang , Faping Sun , Shaonan Hu , Deborah Kreher , Gerhard Schmalz , Hui Xiao
Head and neck cancers (HNCs) affect approximately 650,000 individuals annually worldwide, with cisplatin, docetaxel, and fluorouracil serving as cornerstone agents in the widely employed Taxane [docetaxel], Platinum [cisplatin], and Fluorouracil (TPF) regimen; however, despite their demonstrated survival benefits, a comprehensive comparative pharmacovigilance analysis quantifying the distinctive safety profiles and adverse drug reaction (ADR) burdens of these agents remains absent from the literature. This study aimed to conduct a systematic pharmacovigilance analysis using the EudraVigilance database to quantify drug-specific safety signals and characterize comparative toxicity profiles of cisplatin, docetaxel, and fluorouracil through rigorous disproportionality methodologies. Analysis of 244,769 ADR reports revealed markedly distinct toxicity profiles: cisplatin demonstrated the highest death reporting rate (0.56 %) and exhibited disproportionately elevated associations with renal and urinary disorders (ROR: 5.96, 95 % CI: 5.57–6.37) and ear and labyrinth disorders (ROR: 10.80, 95 % CI: 9.35–12.47), with nephrotoxicity, ototoxicity, neutropenia (4.19 %), and myelosuppression (4.07 %) representing its characteristic profile. Docetaxel revealed an extraordinary psychiatric burden previously underappreciated in clinical trials, showing a 20.67-fold increased signal for psychiatric disorders (95 % CI: 19.20–22.26) and 34.28-fold association with adverse social circumstances (95 % CI: 27.69–42.44), with alopecia (12.99 %), psychological trauma (5.82 %), and emotional distress (4.03 %) constituting the most common adverse reactions, alongside prominent skin and subcutaneous tissue disorders (18.55 %). Fluorouracil demonstrated distinctive cardiovascular toxicities including coronary arteriospasm and cardiogenic shock (ROR: 1.71, 95 % CI: 1.46–2.01), the highest bone marrow suppression rate (5.73 %), and extensive gastrointestinal manifestations including ischemic colitis and hemorrhagic diarrhea. Additionally, 116 common ADR signals were identified across all three agents, predominantly hematological toxicities distributed across 18 System Organ Classes (SOCs). These quantified safety signals provide clinically actionable intelligence for evidence-based risk stratification, enabling personalized treatment selection based on patient-specific vulnerability profiles, proactive implementation of targeted toxicity mitigation strategies including renal protection for cisplatin recipients, psychological support for docetaxel-treated patients, and cardiac monitoring for fluorouracil administration, ultimately transforming empirical clinical practice into precision pharmacovigilance for optimized therapeutic outcomes in HNC management.
{"title":"Beyond the common ground: Unmasking unique toxicity signatures of cisplatin, docetaxel, and fluorouracil with implications for head and neck cancer treatment","authors":"Simin Li , Xiong Zhang , Faping Sun , Shaonan Hu , Deborah Kreher , Gerhard Schmalz , Hui Xiao","doi":"10.1016/j.jcms.2025.11.013","DOIUrl":"10.1016/j.jcms.2025.11.013","url":null,"abstract":"<div><div>Head and neck cancers (HNCs) affect approximately 650,000 individuals annually worldwide, with cisplatin, docetaxel, and fluorouracil serving as cornerstone agents in the widely employed Taxane [docetaxel], Platinum [cisplatin], and Fluorouracil (TPF) regimen; however, despite their demonstrated survival benefits, a comprehensive comparative pharmacovigilance analysis quantifying the distinctive safety profiles and adverse drug reaction (ADR) burdens of these agents remains absent from the literature. This study aimed to conduct a systematic pharmacovigilance analysis using the EudraVigilance database to quantify drug-specific safety signals and characterize comparative toxicity profiles of cisplatin, docetaxel, and fluorouracil through rigorous disproportionality methodologies. Analysis of 244,769 ADR reports revealed markedly distinct toxicity profiles: cisplatin demonstrated the highest death reporting rate (0.56 %) and exhibited disproportionately elevated associations with renal and urinary disorders (ROR: 5.96, 95 % CI: 5.57–6.37) and ear and labyrinth disorders (ROR: 10.80, 95 % CI: 9.35–12.47), with nephrotoxicity, ototoxicity, neutropenia (4.19 %), and myelosuppression (4.07 %) representing its characteristic profile. Docetaxel revealed an extraordinary psychiatric burden previously underappreciated in clinical trials, showing a 20.67-fold increased signal for psychiatric disorders (95 % CI: 19.20–22.26) and 34.28-fold association with adverse social circumstances (95 % CI: 27.69–42.44), with alopecia (12.99 %), psychological trauma (5.82 %), and emotional distress (4.03 %) constituting the most common adverse reactions, alongside prominent skin and subcutaneous tissue disorders (18.55 %). Fluorouracil demonstrated distinctive cardiovascular toxicities including coronary arteriospasm and cardiogenic shock (ROR: 1.71, 95 % CI: 1.46–2.01), the highest bone marrow suppression rate (5.73 %), and extensive gastrointestinal manifestations including ischemic colitis and hemorrhagic diarrhea. Additionally, 116 common ADR signals were identified across all three agents, predominantly hematological toxicities distributed across 18 System Organ Classes (SOCs). These quantified safety signals provide clinically actionable intelligence for evidence-based risk stratification, enabling personalized treatment selection based on patient-specific vulnerability profiles, proactive implementation of targeted toxicity mitigation strategies including renal protection for cisplatin recipients, psychological support for docetaxel-treated patients, and cardiac monitoring for fluorouracil administration, ultimately transforming empirical clinical practice into precision pharmacovigilance for optimized therapeutic outcomes in HNC management.</div></div>","PeriodicalId":54851,"journal":{"name":"Journal of Cranio-Maxillofacial Surgery","volume":"54 1","pages":"Article 104410"},"PeriodicalIF":2.1,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145650081","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 : 2026-01-01Epub Date: 2025-12-18DOI: 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 : 2026-01-01Epub Date: 2025-12-18DOI: 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 : 2026-01-01Epub 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":"2026-01-01","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}
Pub Date : 2026-01-01Epub Date: 2025-11-19DOI: 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 : 2026-01-01Epub Date: 2025-12-18DOI: 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}
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