Journal of Cranio-Maxillofacial Surgery最新文献_第8页

Pro-apoptotic effects of 5-fluorouracil on ameloblastoma in vitro: Exploring the potential of topical 5-FU ointment in adjunctive therapy 5-氟尿嘧啶对体外成釉细胞瘤的促凋亡作用：探索外用5-FU软膏辅助治疗的潜力。

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.2025.09.009

Zhengrui Zhu , Jie Wang , Jing-Rui Yi , Yinfu Che , Qiwen Man

Objective

This study aimed to evaluate the pro-apoptotic effects of 5-fluorouracil (5-FU) on ameloblastoma (AM) through in vitro experiments and to explore its potential as a topical adjunctive therapy following surgery.

Methods

Primary AM cells and freshly resected tumor tissues were treated with 5 μM 5-FU for 48 h. Apoptotic changes were assessed via transmission electron microscopy (TEM), TUNEL staining, and flow cytometry. Cell proliferation and viability were evaluated using EdU incorporation and CCK-8 assays. Transcriptomic profiling and Gene Ontology (GO) enrichment analyses were conducted to investigate underlying mechanisms.

Results

5-FU treatment markedly induced apoptosis in AM tissues and cells. TEM revealed abundant apoptotic bodies, with a mean count 2.01-fold higher than controls (p < 0.05). TUNEL staining demonstrated a 2.66-fold increase in apoptotic area (p < 0.01). Flow cytometry showed a 4.70-fold rise in early apoptotic cells (Annexin V⁺/PI⁻) and a 25.5 % decrease in viable cells (Annexin V⁻/PI⁻) (p < 0.01 and p < 0.05, respectively). EdU incorporation decreased by 35.0 %, and CCK-8 assays indicated a 34.5 % reduction in cell viability (p < 0.01). Transcriptomic analysis revealed downregulation of cell cycle-related genes (CCNB1, CCNB2) and enrichment of pathways involved in cell cycle arrest and apoptosis.

Conclusion

5-FU effectively induces apoptosis and inhibits proliferation in AM cells, likely through disruption of cell cycle progression. These findings support the potential use of topical 5-FU as an adjunctive pharmacologic strategy in the post-surgical management of ameloblastoma.

目的：本研究旨在通过体外实验评估5-氟尿嘧啶（5-FU）对成釉细胞瘤（AM）的促凋亡作用，并探讨其作为手术后局部辅助治疗的潜力。方法：用5 μM - 5- fu处理原代AM细胞和新鲜切除的肿瘤组织48 h，通过透射电镜（TEM）、TUNEL染色和流式细胞术观察细胞凋亡的变化。用EdU掺入和CCK-8测定细胞增殖和活力。转录组学分析和基因本体（GO）富集分析探讨了潜在的机制。结果：5-FU显著诱导AM组织和细胞凋亡。透射电镜显示大量凋亡小体，平均计数比对照组高2.01倍（p +/PI-），活细胞（Annexin V-/PI-）减少25.5% (p结论：5-FU可能通过破坏细胞周期进程有效诱导AM细胞凋亡和抑制增殖。这些发现支持了局部使用5-FU作为成釉细胞瘤术后治疗的辅助药理学策略。

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引用次数: 0

Surgical treatment of frontal sinus fractures: a retrospective evaluation of 116 cases 额窦骨折的外科治疗116例回顾性分析。

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.2025.10.011

Michael Maurer , Katharina Ritzinger , Maximilian Gottsauner , Amer Haj , Karl-Michael Schebesch , Thomas Kühnel , Torsten Reichert , Tobias Ettl

There are various treatment options for frontal sinus fractures. They mainly depend on whether the anterior or posterior table and the frontal sinus outflow tract (FSOT) are affected. Our study retrospectively assessed the surgical management of 116 frontal sinus fractures in terms of the different surgical treatment options as well as the resulting complications. In our cohort, all cases of displaced anterior table fractures (n = 73) were treated by open reduction and fixation (ORIF). In cases of posterior table fractures (n = 43), cranialization, obliteration, sinus preserving measures, or no treatment were carried out. Pyomucocele was the most common complication, occurring in 8.6 % of cases. It was significantly more frequent with dislocation of the posterior table without treatment (p = 0.003). Cerebrospinal fluid (CSF) leakage was especially observed in combined anterior and posterior table fractures (p = 0.012) and in cases of accompanying centrolateral midfacial fractures (p < 0.001). Poor aesthetic outcome was significantly more frequent with concomitant nasoethmoidal fracture (p < 0.001). CSF leakage and cosmetic defects seem to depend mainly on the severity of the trauma and the accompanying injuries. Reconstruction of the posterior wall and sealing it with autologous grafts appears to be an effective method of preventing CSF leakage and pyomucocele in most cases.

额窦骨折有多种治疗方案。主要取决于前、后表及额窦流出道（FSOT）是否受到影响。我们的研究回顾性地评估了116例额窦骨折的外科治疗方法，包括不同的手术治疗方案以及由此产生的并发症。在我们的队列中，所有移位的前台骨折病例（n = 73）均采用切开复位固定（ORIF）治疗。对于43例后台骨折患者，采用开颅、封堵、鼻窦保留措施或不进行治疗。脓囊性囊肿是最常见的并发症，发生率为8.6%。未经治疗的后表脱位更常见（p = 0.003）。脑脊液（CSF）渗漏尤其见于前后台合并骨折（p = 0.012）和伴发中外侧面中骨折（p = 0.012）

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引用次数: 0

Machine learning approach to predict surgical site infection in head and neck squamous cell carcinoma patients after free flap reconstruction 机器学习方法预测头颈部鳞状细胞癌患者游离皮瓣重建后手术部位感染。

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.2025.09.010

Hanchen Zhou , Chuning Luo , Qiaoshi Xu , Chong Wang , Bo Li , Delong Li , Huan Liu , Hao Wang , Chang Liu , Jingrui Li , Teng Ma , Fen Liu , Zhien Feng

Head and neck squamous cell carcinoma (HNSCC) patients undergoing free flap reconstruction face a high risk of surgical site infection (SSI). Logistic regression (LR) models for SSI prediction are limited by linear assumptions, while machine learning (ML) approaches like random forest (RF) may offer superior performance by handling complex clinical data. This study aimed to identify SSI risk factors and compare the predictive performance of LR and RF models. This retrospective study included 442 HNSCC patients. Two predictive models were constructed based on LR and RF methods, respectively. The predictive performance of two models was assessed based on area under the receiver operator characteristic curves, calibration curve, and decision curve analysis (DCA). SHapley Additive exPlanations (SHAP) was applied in the RF model to analyze the impact of features on prediction results. The RF model outperformed LR, achieving higher accuracy, sensitivity, specificity, and AUC. Calibration curves indicated superior alignment of RF predictions with observed outcomes. DCA revealed higher net benefits for RF across a wide probability threshold range. SHAP analysis identified PNI, operation time, and NLR as top predictors. Novel systemic markers (PNI, NLR) and clinical factors are critical for risk stratification.

头颈部鳞状细胞癌（HNSCC）患者接受游离皮瓣重建面临手术部位感染（SSI）的高风险。用于SSI预测的逻辑回归（LR）模型受到线性假设的限制，而随机森林（RF）等机器学习（ML）方法可能通过处理复杂的临床数据提供卓越的性能。本研究旨在确定SSI的危险因素，并比较LR和RF模型的预测性能。本回顾性研究纳入了442例HNSCC患者。分别基于LR和RF方法构建了两个预测模型。基于接收算子特征曲线下面积、校准曲线和决策曲线分析（DCA）对两种模型的预测性能进行了评估。RF模型采用SHapley加性解释（SHAP）分析特征对预测结果的影响。RF模型优于LR，具有更高的准确性、灵敏度、特异性和AUC。校准曲线显示RF预测与观察结果非常吻合。DCA显示，在较宽的概率阈值范围内，射频的净收益更高。SHAP分析确定PNI、手术时间和NLR是最重要的预测因子。新的系统标志物（PNI， NLR）和临床因素是危险分层的关键。

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引用次数: 0

Extensive surgical therapy for oral cancer and the impact on a patient's social life and ability to cope with everyday stress: three-year results 口腔癌的广泛手术治疗及其对患者社交生活和应对日常压力能力的影响：三年的结果。

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.2025.10.013

Johannes Spille , Astrid Dempfle , Anne Susann Bachmann , Katrin Hertrampf

Extensive tumour resection remains the gold standard in the treatment of oral cancer. However, this can lead to severe functional and psychosocial complications. The study aimed to evaluate the social life and everyday stress in a long-term cohort of patients with oral cancer and who required surgical intervention over a period of three years. Patients undergoing surgery for malignant oral tumours in the Department of Maxillofacial Surgery at the University Hospital of Schleswig-Holstein in Kiel, Germany, participated in the study from August 2016 to July 2021. The questionnaires “Perceived Stress Scale” (PSS), “Social Interaction Anxiety Scale” (SIAS), and “The Berlin Social Support Scales” (BSSS) were evaluated in a three-year follow-up. A total of 136 patients participated in the study (age range = 42–86 years). Levels of perceived stress, anxiety, and support changed only slightly over the three years after surgery. Significantly more anxiety in social interaction situations was reported by women (p = 0.002) and by younger patients (p = 0.046). On the other hand, subscales of the BSSS showed that women and younger patients also reported more “perceived available support” (p = 0.02 for gender and p = 0.03 for age) and “support seeking” (p = 0.05 for gender and p = 0.02 for age). Head and neck cancer surgery can lead to significant and long-lasting psychosocial stress, which can remain high for years. Medical staff should consider this aspect in tumour follow-up care and provide psychosocial support to these patients.

广泛的肿瘤切除仍然是口腔癌治疗的金标准。然而，这可能导致严重的功能和社会心理并发症。该研究旨在评估长期口腔癌患者的社会生活和日常压力，这些患者在三年内需要手术干预。2016年8月至2021年7月，在德国基尔石勒苏益格-荷尔斯泰因大学医院颌面外科接受口腔恶性肿瘤手术的患者参与了这项研究。采用“感知压力量表”（PSS）、“社会互动焦虑量表”（SIAS）和“柏林社会支持量表”（BSSS）进行3年随访。共有136例患者参与了这项研究（年龄范围42-86岁）。在手术后的三年中，感知到的压力、焦虑和支持水平只有轻微的变化。在社交情境中，女性患者（p = 0.002）和年轻患者（p = 0.046）报告了更多的焦虑。另一方面，BSSS的子量表显示，女性和年轻患者也报告更多的“感知可用支持”（性别p = 0.02，年龄p = 0.03）和“寻求支持”（性别p = 0.05，年龄p = 0.02）。头颈癌手术可能会导致严重而持久的心理社会压力，这种压力可能会持续数年。医务人员在肿瘤后续护理中应考虑到这一点，并为这些患者提供社会心理支持。

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引用次数: 0

Comparing the importance of implant customization vs. usage of a fibular graft using a novel mandibular implant for improved reconstruction: a finite element study 比较定制种植体与使用新型下颌种植体改善重建的腓骨移植的重要性：一项有限元研究。

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.2025.11.001

Samrat Sagar , B. Ravi , Darshan S. Shah

This study proposes and analyses a novel standard conformal implant (SCI) design, combining the benefits of standard implants (SI) and custom implants (CI) for mandibular defect reconstruction. Using finite element analysis, the performance of all three implant types was compared during unilateral clenching tasks, both with and without fibular graft. The analysis focused on stress and strain distribution in implants and fixation screws.

Without fibular graft, CI exhibited lower maximum stress compared to SI and SCI. Reconstruction with fibular graft significantly reduced stress and strain values across all implants, suggesting a lower probability of implant fracture and screw loosening. While SCI seemed promising, reconstruction with SI also resulted in the stress values within failure limits of the implant and screw material and strain values within the threshold for bone resorption, suggesting that implant choice may be less critical with graft support.

The study concluded that fibular grafts play a more crucial role in mandibular reconstruction compared to implant customization. However, the custom implant could be a suitable option for patients unable to receive fibular grafts due to comorbidities. Further improvements in the computational model and experimental validation are needed to assess the clinical viability and long-term performance of the implants.

本研究提出并分析了一种新的标准适形种植体（SCI）设计，结合了标准种植体（SI）和定制种植体（CI）用于下颌缺损重建的优点。采用有限元分析，比较了所有三种种植体类型在单侧握紧任务时的性能，包括有和没有腓骨移植。重点分析了种植体和固定螺钉的应力应变分布。没有腓骨移植，相比于SI和SCI， CI表现出更低的最大应力。腓骨重建显著降低了所有假体的应力和应变值，表明假体骨折和螺钉松动的可能性较低。虽然脊髓损伤似乎很有希望，但用SI重建也会导致植入物和螺钉材料的应力值在失效范围内，应变值在骨吸收阈值内，这表明在移植物支持下，植入物的选择可能不那么重要。该研究得出结论，与定制种植体相比，腓骨移植物在下颌骨重建中起着更重要的作用。然而，对于由于合并症而无法接受腓骨移植的患者，定制种植体可能是一个合适的选择。需要进一步改进计算模型和实验验证来评估植入物的临床生存能力和长期性能。

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引用次数: 0

Groningen TMJ total joint replacement prosthesis: 3 to 7-year follow-up on surgical and patient reported outcomes 格罗宁根TMJ全关节置换假体：手术和患者报告结果的3至7年随访。

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.2025.09.008

Bram B.J. Merema , Nico B. van Bakelen , Carrol P. Saridin , Joep Kraeima , Fred K.L. Spijkervet

A prosthetic total joint replacement (TJR) may be indicated for patients who suffer from severe dysfunction or resorption of the temporomandibular joint (TMJ). Currently, the patient-specific or custom TMJ-TJR prosthesis options are plentiful. However, there is a lack of thorough (long term) follow-up studies.

The aim of this prospective study was to assess the 3 to 7-year follow-up outcomes of the patient-specific Groningen temporomandibular joint total joint replacement (G-TMJ-TJR) prosthesis (Xilloc Medical®, Geleen, the Netherlands). Longitudinal assessments of surgical outcomes, changes in maximum interincisal opening (MIO), laterotrusion, protrusion and patient reported outcomes (PROMs) on functional mandibular impairment (MFIQ) and pain (VAS) were studied. These outcomes were collected preoperatively, and 6, 12 and 24 months postoperatively for all included patients, while MIO, VAS pain and MFIQ were reported till up to 60 months postoperatively.

Fourteen patients (13 female, 1 male) who had received a patient-specific G-TMJ-TJR, with a minimum follow-up period of 24 months, were included. The average age at implantation was 53.7 (sd 11.3) years.

A patient-specific G-TMJ-TJR prosthesis was successfully implanted in all 14 patients without any mechanical failures or adverse effects during the minimum 2-year follow-up (mean 57 months) period. All G-TMJ-TJR devices were accurately implanted according to the 3D-VSP. There were no post-operative infections but temporary weakness of a facial nerve branch was reported by two patients. The median MIO increased from 19.5 to 30.0 mm, while the median VAS pain (R: 0–10) score reduced from 7.2 to 0.9 cm. The median MFIQ (R: 0–68) diminished from 47.0 to 9. Pain was relieved by the G-TMJ-TJR prosthesis in all but one patient with chronic pain. Protrusion and laterotrusion to both sides increased, indicating more freedom of movement in the operated joint and resulting in a more natural jaw movement.

This study shows considerable functional improvement compared to a prior follow up of a former G-TMJ-TJR study. This indicates that thorough 3D planning, subsequent patient-specific modelling, and accurate guided placement of the G-TMJ-TJR improves clinical outcomes significantly.

假体全关节置换术（TJR）可能适用于患有严重功能障碍或颞下颌关节（TMJ）吸收的患者。目前，患者专用或定制的TMJ-TJR假体选择很多。然而，缺乏彻底的（长期）随访研究。这项前瞻性研究的目的是评估患者特异性Groningen颞下颌关节全关节置换术（G-TMJ-TJR）假体（Xilloc Medical®，Geleen, Netherlands）的3至7年随访结果。研究了手术结果的纵向评估，最大内开度（MIO）的变化，侧突，突出和患者报告的下颌功能性损伤（MFIQ）和疼痛（VAS）的预后（PROMs）。收集所有患者的术前、术后6个月、12个月和24个月的这些结果，同时报告MIO、VAS疼痛和MFIQ直到术后60个月。14例患者（13名女性，1名男性）接受了针对患者的G-TMJ-TJR，随访时间至少为24个月。平均着床年龄为53.7岁（sd 11.3）。在至少2年（平均57个月）的随访期间，14例患者均成功植入了患者特异性G-TMJ-TJR假体，无机械故障或不良反应。所有G-TMJ-TJR装置均按照3D-VSP准确植入。术后无感染，但有2例患者出现面神经分支暂时性无力。中位MIO从19.5 mm增加到30.0 mm，中位VAS疼痛评分（R: 0-10）从7.2 cm减少到0.9 cm。中位MFIQ （R: 0-68）从47.0降至9。除1例慢性疼痛患者外，G-TMJ-TJR假体均能缓解疼痛。两侧的前突和侧突增加，表明手术关节活动更自由，下颌运动更自然。与先前的G-TMJ-TJR研究相比，该研究显示了相当大的功能改善。这表明，彻底的3D规划、随后的患者特异性建模以及G-TMJ-TJR的精确引导放置可显著改善临床结果。

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引用次数: 0

Accuracy of 3D simulation in soft tissue change after orthognathic surgery in class III malocclusion: Influence of different vertical facial patterns III类错颌正颌手术后软组织变化三维模拟的准确性：不同垂直面部模式的影响

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.2025.09.012

Carol Yi-Hsuan Chen , Tong Xi , Ellen Wen-Ching Ko , Shih-Ying Tsao

This study aimed to evaluate the accuracy of 3D soft tissue prediction with Simplant O&O software in skeletal Class III patients who received double-jaw orthognathic surgery (OGS). The influences of different vertical facial patterns on the accuracy of surgical prediction were also assessed.

Sixty consecutive skeletal class III patients treated with bimaxillary surgery and orthodontic treatment were included. Patients were divided into the high-angle (HA) group and low-angle (LA) group according to the mandibular plane angle. Cone-beam computerized tomographs were acquired before surgery and after debonding. All patients received 3D virtual surgical planning. The accuracy of soft tissue prediction was calculated in terms of 3D regional soft tissue changes between the preoperative simulation and debonding. Independent t-test, chi-square test were used to test for intergroup differences, in combination with. Pearson correlation, Spearman correlation and multiple logistic regression.

3D soft tissue simulation in Class III patients provided an overall clinical acceptable accuracy (mean error <2.0 mm). However, the chin area is less predictable (mean simulation error 1.63 ± 1.64 mm and 1.47 ± 1.21 mm in HA and LA group respectively). The predicted anterior movement of soft tissue in the cheek and lower lip regions were often underestimated. Although the simulation accuracy between the high-angle group and low-angle groups were generally comparable, the upper lip region prediction showed a higher accuracy in the high-angle group compared to the low-angle group. In conclusion, the accuracy of 3D soft tissue prediction should be viewed carefully, and further validation is recommended to fully understand its clinical utility in optimizing surgical outcomes.

本研究旨在评估Simplant O&O软件对接受双颌正颌手术（OGS）的骨骼III类患者三维软组织预测的准确性。不同的垂直面部模式对手术预测准确性的影响也进行了评估。本研究包括60例连续接受双颌手术和正畸治疗的骨骼III类患者。根据下颌平面角度将患者分为高角度组（HA）和低角度组（LA）。手术前和脱粘后进行锥形束计算机断层扫描。所有患者均接受三维虚拟手术计划。根据术前模拟与脱粘之间的三维区域软组织变化来计算软组织预测的准确性。组间差异采用独立t检验、卡方检验，并结合。Pearson相关、Spearman相关及多元logistic回归。III类患者的三维软组织模拟提供了总体临床可接受的准确性（平均误差）

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引用次数: 0

Artificial intelligence in joint face–skeletal prediction for orthognathic procedures: A systematic review 人工智能在正颌手术面部骨骼预测中的应用：系统综述。

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.2025.11.002

Xiaozhe Wang , Jiahao Chen , Qianhan Zheng , Ting Kang , Gengyu Hu , Mengqi Zhou , Huogen Wang , Weifang Zhang , Xuepeng Chen

Objective

This systematic review aimed to produce an overview of the development of AI in joint skeletal–soft tissue prediction after orthognathic surgery, and to assess its accuracy comprehensively.

Materials and methods

Following PRISMA guidelines, a systematic search was conducted in PubMed, Web of Science, IEEE Xplore, EMBASE, and Scopus (as of July 20, 2025). The initial search yielded 885 records, with eight studies meeting the inclusion criteria. The PICOS principle was applied to focus on AI models’ joint predictive ability and their clinical validation. QUADAS-2 and JBI tools were used to assess bias, and GRADE was applied to evaluate outcome certainty.

Results

The included AI models significantly enhanced prediction accuracy through innovations like CPSA, P2P-Conv, and DGCFP. Surface bias errors in critical areas were reduced, and clinical acceptance rates increased. However, challenges remain, including insufficient modeling of anatomical details, high sample homogeneity, and lack of standardized assessments.

Conclusion

AI-driven joint predictive modeling shows great potential for improving surgical accuracy and efficiency. Future work should focus on creating multicenter, cross-ethnic datasets, exploring hybrid architectures, and conducting prospective clinical validation to enhance generalizability. Establishing uniform evaluation standards, improving model interpretability, and enhancing ethical and privacy frameworks are also crucial for clinical translation.

Clinical relevance

Based on model evaluations, AI-based orthognathic prediction shows region-dependent accuracy: highest for the chin (genioplasty), followed by the mandibular body, and partial for the maxillary nasal base. Current models lack precision for lip aesthetics and 3D rotational displacement, but offer high value for rapid chin–mandible continuity predictions.

目的：本系统综述了人工智能在正颌手术后关节骨骼-软组织预测中的发展概况，并对其准确性进行了全面评价。材料和方法：遵循PRISMA指南，在PubMed， Web of Science, IEEE explore， EMBASE和Scopus（截至2025年7月20日）中进行了系统搜索。最初的检索产生了885条记录，其中8项研究符合纳入标准。应用PICOS原理，重点研究人工智能模型的联合预测能力及其临床验证。使用QUADAS-2和JBI工具评估偏倚，使用GRADE评估结果确定性。结果：纳入的人工智能模型通过CPSA、P2P-Conv和DGCFP等创新显著提高了预测精度。减少了关键部位的表面偏置误差，提高了临床接受率。然而，挑战仍然存在，包括解剖细节建模不足，样本同质性高，缺乏标准化评估。结论：人工智能驱动的关节预测建模在提高手术精度和效率方面具有很大的潜力。未来的工作应侧重于创建多中心、跨种族的数据集，探索混合架构，并进行前瞻性临床验证，以增强可泛化性。建立统一的评估标准，提高模型的可解释性，加强伦理和隐私框架对临床翻译也至关重要。临床相关性：基于模型评估，基于人工智能的正颌预测显示出区域依赖的准确性：下颌（颏成形术）最高，其次是下颌体，上颌鼻基部分。目前的模型在唇美学和三维旋转位移方面缺乏精度，但在快速预测下颌连续性方面具有很高的价值。

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引用次数: 0

Open reduction and internal fixation with disc reduction for pediatric condylar fractures: three-dimensional CT evaluation and follow-up results 儿童髁突骨折切开复位内固定配合椎间盘复位：三维CT评价及随访结果。

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.2025.11.009

Jieyun Zhao , Chuan Lu , Huimin Zhu , Xiaoli Zhang , Hengxiang Sun , Xin Nie , Chi Yang , Dongmei He

Purpose

To evaluate the efficacy of open reduction and internal fixation (ORIF) with disc reduction for pediatric condylar fractures (CFs) and assess mandibular growth outcomes using three-dimensional (3D) CT measurement.

Materials and methods

Patients under 18 years with CF who underwent ORIF with disc reduction were recruited in the study. CT data including pre-operation, post-operation and at least 1 year follow-up were measured by ProPlan CMF 3.0 software for mandibular ramus height, mandibular body length, chin deviation and retrusion. Complications including bone resorption, fixation failure, temporomandibular joint ankylosis (TMJA), etc. were recorded.

Results

18 patients with 25 condylar fractures were included in the study. There were 6 males and 12 females with the mean age of 13.44 years (SD 2.87). 40 % (n = 10) of them were intracapsular condylar fractures, 52 % (n = 13) were condylar neck fractures and 8 % (n = 2) were subcondylar fractures. After ORIF, the mandibular ramus height was restored 4.53 mm (SD 2.89). Chin deviation was corrected 3.87 mm (SD 2.29) and chin retrusion was improved 3.29 mm (SD 2.88). After an average follow-up of 26.39 months (SD 13.19), the ramus grew 2.48 mm (SD 3.87) with no progressing jaw deformity. There were no complications such as hardware failure and ankylosis.

Conclusions

ORIF with disc reduction is effective for the treatment of pediatric CFs with regard to restoration of mandibular ramus height and prevention of progressive jaw deformity, bone resorption and ankylosis.

目的：评价切开复位内固定（ORIF）联合椎间盘复位治疗小儿髁突骨折（CFs）的疗效，并利用三维（3D） CT测量评估下颌骨生长情况。材料和方法：研究招募了18岁以下的CF患者，他们接受ORIF合并椎间盘复位。术前、术后及随访至少1年的CT资料采用ProPlan CMF 3.0软件测量下颌支高、下颌体长、下颌偏移、后缩情况。并发症包括骨吸收、固定失败、颞下颌关节强直（TMJA）等。结果：18例25例髁突骨折纳入研究。男性6例，女性12例，平均年龄13.44岁（SD 2.87）。其中，髁囊内骨折占40% (n = 10)，髁颈骨折占52% (n = 13)，髁下骨折占8% （n = 2）。ORIF术后下颌支高度恢复4.53 mm （SD 2.89）。下颌偏移矫正3.87 mm (SD 2.29)，下颌后缩改善3.29 mm （SD 2.88）。平均随访26.39个月（SD 13.19），支长2.48 mm (SD 3.87)，无进展性颌骨畸形。无硬件故障、强直等并发症。结论：ORIF联合椎间盘复位在恢复下颌支高度、防止进行性颌骨畸形、骨吸收和强直方面是治疗小儿慢性脊髓炎的有效方法。

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引用次数: 0

Design and application of submental island "kiss flap" 颏下岛“吻瓣”的设计与应用。

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.2025.09.014

Lin Wang , Meng Wang , Fengzhi Liu , Dongpo Li , Yubo Wei , Shuangyi Wang , Xiurong Chen

This study aimed to investigate the clinical effects of the kiss flap and the conventional submental island flap for reconstruction after tongue cancer resection. From March 2023 to March 2025, 60 patients with T2–T4 tongue cancer underwent surgical resection. Of these, 16 patients underwent kiss flap reconstruction, and 44 underwent conventional submental island flap reconstruction. The patients were divided into two groups (kiss flap group and conventional flap group) using a double-blind method. The recovery times for speech, swallowing, tongue movement, and donor site complications were evaluated at the 6-month follow-up. SPSS 26.0 software was used for statistical analysis. There was no significant difference in speech intelligibility between the two groups (clarity: p = 0.717; acceptability: p = 0.823). However, the recovery of swallowing function in the kiss flap group was significantly better than that in the conventional flap group (MTF grade good: p = 0.021; acceptable: p = 0.002). Regarding tension at the donor site, the tension of the kiss flap was significantly lower than that of the conventional flap. Kiss flap repair provides tissue volume to the tongue and preserves its movement, speech intelligibility, and swallowing ability. The limitations of this study, including the unbalanced sample size and short follow-up period, along with the need for long-term aesthetic and functional assessments, are acknowledged and discussed in detail. The kiss flap needs further improvement to reduce complications and enhance patients’ quality of life. This study lays a foundation for such further improvement.

摘要本研究旨在探讨舌癌切除后吻骨瓣与传统颏下岛状皮瓣重建的临床效果。从2023年3月至2025年3月，60例T2-T4舌癌患者行手术切除。其中16例患者行吻瓣重建术，44例行常规颏下岛状皮瓣重建术。采用双盲法将患者分为两组（吻瓣组和常规瓣组）。随访6个月，观察两组患者言语、吞咽、舌动及供区并发症的恢复时间。采用SPSS 26.0软件进行统计分析。两组的语音可理解性无显著差异（清晰度：p = 0.717；可接受性：p = 0.823）。但吻接皮瓣组吞咽功能恢复明显优于常规皮瓣组（MTF分级良好：p = 0.021；可接受：p = 0.002）。在供区张力方面，吻合器瓣的张力明显低于常规皮瓣。舌瓣修复提供舌头的组织体积，并保持其运动，言语清晰度和吞咽能力。本文承认并详细讨论了本研究的局限性，包括样本量不平衡和随访时间短，以及需要长期的美学和功能评估。吻合器瓣需要进一步改进，以减少并发症，提高患者的生活质量。本研究为进一步完善奠定了基础。

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