British Journal of Oral & Maxillofacial Surgery最新文献

英文中文

Are resorbable plating systems comparable to conventional titanium plating in paediatric maxillofacial trauma patients? A systematic review and meta-analysis. 在儿童颌面外伤患者中，可吸收镀钛系统是否与传统镀钛系统相比较？系统回顾和荟萃分析。

IF 1.9 4区医学 Q3 DENTISTRY, ORAL SURGERY & MEDICINE

British Journal of Oral & Maxillofacial Surgery

Pub Date : 2026-01-07 DOI: 10.1016/j.bjoms.2026.01.001

Sibgutulah Rashid, Vyakhya Akhileshkumar Gupta, Shivendra Choudhary, Khan Sabera Kalimuddin, Deepika Deepika, Rudra Deo Kumar

This systematic review and meta-analysis evaluated the effectiveness of resorbable versus titanium plating systems in the management of paediatric maxillofacial fractures. A comprehensive search of PubMed, Embase, Scopus, and specialty journals up to December 2024 identified six retrospective studies published between 2010 and 2024, involving 1,584 patients aged ≤18 years. Both resorbable and titanium systems provided satisfactory fracture stability and healing. Titanium fixation was consistently associated with higher complication rates, ranging from 8%-12% whereas resorbable systems demonstrated rates of 0%-11%, mostly minor complications. Titanium fixation was frequently associated with hardware removal, with reported rates ranging from 15%-95%, reflecting both complication-related and protocol-driven removals, whereas none of the resorbable systems required secondary surgery for hardware removal. Meta-analysis demonstrated a non-significant reduction in complication odds with resorbables compared with titanium (odds ratio 0.42; 95% confidence interval 0.12 to 1.48; p = 0.18; I² = 52%). These findings indicate that resorbable plating systems offer comparable stability to titanium, with fewer complications and the significant advantage of eliminating the need for removal. Titanium remains the preferred option for load-bearing mandibular fractures due to its superior mechanical strength, while resorbables appear effective for non-load-bearing and growth-sensitive sites. Further prospective trials with long-term follow up are required to confirm their impact on craniofacial growth and cost-effectiveness.

本系统综述和荟萃分析评估了可吸收系统与钛电镀系统在小儿颌面骨折治疗中的有效性。通过对PubMed、Embase、Scopus和专业期刊的全面检索，截至2024年12月，确定了2010年至2024年间发表的6项回顾性研究，涉及1584名年龄≤18岁的患者。可吸收系统和钛系统都提供了令人满意的骨折稳定性和愈合。钛固定始终与较高的并发症发生率相关，范围为8%-12%，而可吸收系统的发生率为0%-11%，主要是轻微并发症。钛固定经常与硬体取出相关，报道的发生率在15%-95%之间，反映了并发症相关和协议驱动的取出，而所有可吸收系统都不需要二次手术来取出硬体。荟萃分析显示，与钛相比，可吸收物的并发症发生率无显著降低（优势比0.42；95%可信区间0.12 ~ 1.48;p = 0.18; I2 = 52%）。这些发现表明，可吸收电镀系统具有与钛相当的稳定性，并发症更少，并且无需移除。钛由于其优越的机械强度，仍然是承重下颌骨骨折的首选材料，而可吸收材料似乎对非承重和生长敏感部位有效。需要进一步的长期随访的前瞻性试验来确认它们对颅面生长的影响和成本效益。

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引用次数: 0

Association between orthognathic surgery and temporomandibular disorder in dentofacial disharmony patients: a systematic review and meta-analysis 牙面不和谐患者正颌手术与颞下颌紊乱的关系：系统回顾和荟萃分析。

IF 1.9 4区医学 Q3 DENTISTRY, ORAL SURGERY & MEDICINE

British Journal of Oral & Maxillofacial Surgery

Pub Date : 2026-01-01 DOI: 10.1016/j.bjoms.2025.09.316

Chenxinzi Lin, Jingyuan Zhang, Minsheng Zheng, Chongjie Zhu, Chi Zhang, Qilong Wan

This systematic review and meta-analysis aimed to evaluate the association between orthognathic surgery and temporomandibular disorder (TMD) symptoms in patients with dentofacial disharmony (DFD) during different postoperative time periods. The study protocol was prospectively registered on PROSPERO (CRD42024609472). PubMed, Embase, CENTRAL, SIGLE, CNKI, WANFANG, and VIPC databases were searched from 2000 to 2025 for studies assessing the efficacy of orthognathic surgery in DFD patients, focusing on changes in TMD symptoms during different postoperative time periods. Random-effects meta-analysis was utilised to pool risk ratios (RR) and mean differences (MD) with 95% confidence intervals (CI) calculated. This review included 21 studies comprising 2070 participants. There was a reduction in TMD signs during different postoperative time periods but no significant intergroup differences (p = 0.68). Temporomandibular joint (TMJ) pain (RR 0.57, 95% CI 0.35 to 0.93, p = 0.02) and TMJ clicking status (RR 0.31, 95% CI 0.14 to 0.68, p = 0.004) were significantly alleviated at six months postoperatively. However, when compared with six months, a significant recurrence of symptoms was noted at one or two years postoperatively. Notably, the intergroup difference concerning TMJ clicking (p = 0.04) was more significant than it was for TMJ pain (p = 0.64) during different postoperative time periods. Furthermore, maximal mouth opening (MMO) gradually increased over time. Orthognathic surgery primarily aims to correct DFD, and after improving the occlusion there is a possibility that TMD symptoms may subsequently improve. However, certain symptoms may recur to varying degrees during different postoperative periods. Further research is necessary to expand the sample size and investigate the different effects of various factors such as type of DFD, surgical procedure, condylar resorption, and articular disc condition, on the alleviation of TMD symptoms.

本系统综述和荟萃分析旨在评估牙面不和谐（DFD）患者术后不同时期正颌手术与颞下颌紊乱（TMD）症状之间的关系。该研究方案在PROSPERO上前瞻性注册（CRD42024609472）。检索PubMed、Embase、CENTRAL、SIGLE、CNKI、万方和VIPC数据库，从2000年到2025年评估DFD患者正颌手术疗效的研究，重点关注术后不同时间段TMD症状的变化。随机效应荟萃分析用于汇总风险比（RR）和平均差异（MD），并计算95%置信区间（CI）。本综述包括21项研究，包括2070名参与者。术后不同时间段TMD症状减少，但组间差异无统计学意义（p = 0.68）。术后6个月颞下颌关节（TMJ）疼痛（RR 0.57, 95% CI 0.35 ~ 0.93, p = 0.02）和TMJ叩响状态（RR 0.31, 95% CI 0.14 ~ 0.68, p = 0.004）明显减轻。然而，与6个月相比，术后1年或2年症状明显复发。值得注意的是，在术后不同时间段，TMJ咔哒声组间差异（p = 0.04）大于TMJ疼痛组间差异（p = 0.64）。最大开口（MMO）随时间逐渐增加。正颌手术的主要目的是矫正DFD，改善咬合后，TMD症状可能随之改善。然而，某些症状可能在术后不同时期不同程度地复发。需要进一步的研究来扩大样本量，并调查各种因素如DFD类型、手术方式、髁突吸收和关节盘状况对缓解TMD症状的不同影响。

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引用次数: 0

Training groups / Instructions to Authors 培训小组/对作者的指导

IF 1.9 4区医学 Q3 DENTISTRY, ORAL SURGERY & MEDICINE

British Journal of Oral & Maxillofacial Surgery

Pub Date : 2026-01-01 DOI: 10.1016/S0266-4356(25)00917-9

引用次数: 0

A systematic review of prognostic factors and anatomical variability in surgically managed T4b oral squamous cell carcinoma: implications for future classification 对手术治疗的T4b口腔鳞状细胞癌的预后因素和解剖变异的系统回顾：对未来分类的影响。

IF 1.9 4区医学 Q3 DENTISTRY, ORAL SURGERY & MEDICINE

British Journal of Oral & Maxillofacial Surgery

Pub Date : 2026-01-01 DOI: 10.1016/j.bjoms.2025.10.280

Munir J. Abukhder , M. Shihabul Hassan , Omar Mubarak , Karl F. Payne , Axel Sahovaler , Clare Schilling

T4b oral squamous cell carcinoma (OSCC) is a broad umbrella term for advanced oral cancers. Recent evidence points towards a subset of T4b tumours invading the masticator space (MS) that may be amenable to complete resection. Our aim was to evaluate the current evidence and present and discuss the arguments for and against re-classification. A systematic review was conducted of articles published between January 2000 and February 2025 to summarise prognostic factors that influence survival outcomes in MS T4b OSCC patients. Ten studies met the inclusion criteria. Only two reported statistically significant worse outcomes for supra-notch disease. Other established negative prognostic factors common to all OSCC subsites, such as pathological variables or nodal involvement, did not separate T4b disease into survival subgroups. Although several studies highlight the significance of vertical extension in T4b disease relative to the sigmoid notch, the data remain heterogeneous. Future research should adopt a unified system for classifying tumour extension before considering a subclassification of resectable cases, as current evidence is insufficient to justify changes to the staging criteria.

T4b口腔鳞状细胞癌（OSCC）是晚期口腔癌的总称。最近的证据表明，侵袭咀嚼间隙（MS）的T4b肿瘤亚群可能可以完全切除。我们的目的是评估现有的证据，提出并讨论支持和反对重新分类的论点。对2000年1月至2025年2月间发表的文章进行了系统回顾，总结了影响MS T4b OSCC患者生存结果的预后因素。10项研究符合纳入标准。只有两个报告了统计上显著的超notch疾病更差的结果。所有OSCC亚位点共有的其他已确定的不良预后因素，如病理变量或淋巴结受累，并没有将T4b疾病划分为生存亚组。虽然有几项研究强调了相对于乙状结肠切迹，垂直延伸在T4b疾病中的重要性，但数据仍然不一致。在考虑可切除病例的亚分类之前，未来的研究应采用统一的肿瘤扩展分类系统，因为目前的证据不足以证明改变分期标准是合理的。

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引用次数: 0

Treatment options for radiation-induced xerostomia in patients with head and neck cancer: a systematic review and meta-analysis 头颈癌患者放射性口干症的治疗选择：系统回顾和荟萃分析。

IF 1.9 4区医学 Q3 DENTISTRY, ORAL SURGERY & MEDICINE

British Journal of Oral & Maxillofacial Surgery

Pub Date : 2026-01-01 DOI: 10.1016/j.bjoms.2025.10.003

Oadi N. Shrateh , Ashna Habib , Hammad Ur Rehman Shamsi , Kanwal Ashok Kumar , Belal Mohammad Mousa Omar , Ahmad Mansour , Mahmoud Mohsen , Ali M. Hamad , Manish Mair , Bindy Sahota

Radiation-induced xerostomia is a frequent and debilitating complication in patients undergoing radiotherapy for head and neck cancer. This study aimed to compare the effectiveness of available treatment modalities in preventing or managing radiation-induced xerostomia and associated complications in head and neck cancer patients. A detailed search of PubMed and Google Scholar was conducted. Only randomised controlled trials (RCTs) involving radiotherapy-treated head and neck cancer patients were included. The interventions that were analysed encompassed pharmacological agents (for example, pilocarpine, and amifostine), antioxidants, herbal formulations, acupuncture, low-level laser therapy (LLLT), and regenerative approaches. Primary outcomes included severity of xerostomia, rates of salivary flow, mucositis, oral pain, dysphagia, and fatigue. Thirty-one randomised clinical trials met the inclusion criteria. Pooled analysis showed no significant reduction in severity of xerostomia at weeks 3, 4, or 6, or 6 months. Stimulated salivary flow did not significantly improve (mean difference (MD): 0.22; p = 0.15), while unstimulated salivary flow showed a significant benefit (MD: 0.13; 95% CI: 0.09 to 0.17; p < 0.00001). A significant reduction in the severity of oral pain was also noted (MD: −2.25; p < 0.0001). No significant differences were found for the incidence or duration of mucositis, dysphagia, or fatigue. Considerable heterogeneity was observed across the studies and no single intervention demonstrated consistent efficacy in managing radiation-induced xerostomia. Some therapies have shown promise in improving unstimulated salivary flow and reducing oral pain; however, the overall evidence remains inconclusive. To address this persistent clinical challenge, future trials should adopt standardised outcome measures, assess combination therapies, and investigate novel regenerative strategies.

辐射诱发的口干是头颈癌放疗患者中一种常见且衰弱的并发症。本研究旨在比较现有治疗方式在预防或处理头颈癌患者放射性口干及相关并发症方面的有效性。对PubMed和b谷歌Scholar进行了详细的搜索。仅纳入随机对照试验（rct），涉及放疗治疗的头颈癌患者。分析的干预措施包括药理学药物（例如，匹罗卡品和氨磷汀）、抗氧化剂、草药配方、针灸、低水平激光治疗（LLLT）和再生方法。主要结局包括口干的严重程度、唾液流率、粘膜炎、口腔疼痛、吞咽困难和疲劳。31项随机临床试验符合纳入标准。综合分析显示，在第3、4、6或6个月时，口干症的严重程度没有显著降低。受刺激的唾液流量没有显著改善(平均差值（MD）： 0.22；p = 0.15)，而未受刺激的唾液流量显示出显著的益处(MD: 0.13; 95% CI: 0.09至0.17;p

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引用次数: 0

Thanks to Reviewers 感谢审稿人

IF 1.9 4区医学 Q3 DENTISTRY, ORAL SURGERY & MEDICINE

British Journal of Oral & Maxillofacial Surgery

Pub Date : 2026-01-01 DOI: 10.1016/S0266-4356(25)00928-3

引用次数: 0

Comparison of large language models in oral and maxillofacial surgery 大语言模型在口腔颌面外科中的比较。

IF 1.9 4区医学 Q3 DENTISTRY, ORAL SURGERY & MEDICINE

British Journal of Oral & Maxillofacial Surgery

Pub Date : 2026-01-01 DOI: 10.1016/j.bjoms.2025.08.015

Ricardo Grillo , Alexandre Hugo Llanos , Claudio Costa , Fernando Melhem-Elias

This study evaluates the performance of six large language models (LLMs) in generating content relevant to oral and maxillofacial surgery (OMFS), focusing on their ability to provide accurate, comprehensive, and relevant information across five specific tasks. Each LLM was assessed based on its responses to five prompts: (1) postoperative instructions for third molar surgery; (2) a list of best-selling books on orthognathic surgery; (3) the most cited articles in OMFS; (4) novel ideas for systematic reviews; and (5) emerging trends in OMFS. Responses were scored for relevance, comprehensiveness, and accuracy using predefined criteria. Statistical analysis was performed using the Kruskal-Wallis test to compare tool performance. The LLMs performed similarly overall, with varying strengths and weaknesses. For postoperative instructions, they all provided comparable recommendations, though Perplexity underperformed. In identifying best-selling books, Gemini and Perplexity excelled, while ChatGPT and Copilot struggled with retrieving highly cited articles. Copilot and Claude were more effective in suggesting novel systematic review topics, while ChatGPT, Claude, Copilot, and DeepSeek identified emerging trends most accurately. LLMs demonstrate significant potential in supporting OMFS-related tasks, but their performance varies depending on the specific application. While they excel at synthesising existing information and identifying trends, limitations in accuracy and occasional hallucinations highlight the need for human oversight. These findings underscore the importance of integrating artificial intelligence (AI) as a supplementary tool in clinical, academic, and research settings, ensuring its use complements, rather than replaces, human expertise.

本研究评估了六个大型语言模型（llm）在生成口腔颌面外科（OMFS）相关内容方面的表现，重点关注它们在五个特定任务中提供准确、全面和相关信息的能力。每个LLM根据其对五个提示的反应进行评估：(1)第三磨牙手术的术后指示；（二）有关正颌外科的畅销书一览表；(3) OMFS中被引次数最多的文章；(4)系统评价的新颖思路；(5) OMFS的新趋势。使用预定义的标准对回答的相关性、全面性和准确性进行评分。采用Kruskal-Wallis检验进行统计分析，比较刀具性能。法学硕士的总体表现相似，只是优势和劣势各不相同。对于术后指导，他们都提供了类似的建议，尽管Perplexity表现不佳。在识别畅销书方面，Gemini和Perplexity表现出色，而ChatGPT和Copilot在检索高引用文章方面表现不佳。Copilot和Claude在提出新颖的系统评论主题方面更有效，而ChatGPT、Claude、Copilot和DeepSeek对新兴趋势的识别最为准确。llm在支持与omfs相关的任务方面显示出巨大的潜力，但是它们的性能取决于特定的应用程序。虽然它们擅长综合现有信息和识别趋势，但准确性的局限性和偶尔出现的幻觉凸显了人类监督的必要性。这些发现强调了将人工智能（AI）作为临床、学术和研究环境中的补充工具的重要性，确保其使用是对人类专业知识的补充，而不是取代。

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引用次数: 0

The BAOMS Mouth Cancer Awareness Week – 30 years supporting the campaign and saving lives BAOMS口腔癌宣传周- 30年来支持运动和拯救生命。

IF 1.9 4区医学 Q3 DENTISTRY, ORAL SURGERY & MEDICINE

British Journal of Oral & Maxillofacial Surgery

Pub Date : 2026-01-01 DOI: 10.1016/j.bjoms.2025.11.001

A. Kanatas

引用次数: 0

Custom-made fibular cradle plate to optimise bone positioning for implant placement, restore maxillary contour, and preserve pedicle length in reconstruction of the maxilla 定制的腓骨摇篮板，用于优化种植体放置的骨定位，恢复上颌轮廓，并在上颌重建中保留蒂长度。

IF 1.9 4区医学 Q3 DENTISTRY, ORAL SURGERY & MEDICINE

British Journal of Oral & Maxillofacial Surgery

Pub Date : 2026-01-01 DOI: 10.1016/j.bjoms.2025.06.005

J. Pallot , L. Dovgalski , P. Evans , K. Shah , M.A. Kittur

引用次数: 0

Comparison between clinical and punch biopsy diagnosis of suspected head and neck skin cancer 疑似头颈部皮肤癌临床与穿刺活检诊断的比较。

IF 1.9 4区医学 Q3 DENTISTRY, ORAL SURGERY & MEDICINE

British Journal of Oral & Maxillofacial Surgery

Pub Date : 2026-01-01 DOI: 10.1016/j.bjoms.2025.09.318

Luke Butler , Sian Williams , Krishna Gumparthy , Ashwin Kerai , Simon N. Rogers

Skin cancer, particularly non-melanoma skin cancer (NMSC), represents a significant healthcare burden globally. Correct clinical diagnosis can be challenging with patients being misdiagnosed and having unnecessary surgery or delays in treatment. Punch biopsies offer a minimally invasive method to establish the diagnosis prior to treatment. This study correlates clinical appearance with histological diagnosis post punch biopsy and reflects on its value in the patient pathway. This single-unit study evaluated 200 consecutive punch biopsies of 137 suspected NMSC patients. Data were analysed for demographic factors, clinical appearances, histopathological results, subsequent management, and time between these events. The clinical diagnoses were 124 basal cell carcinoma (BCC), 36 squamous cell carcinoma (SCC), one lentigo maligna, one Merkel cell tumour, and 38 benign lesions. Overall clinical diagnosis and punch biopsy histology were the same in 86 cases (43%). In 89 of 162 NMSC cases (55.6%) the punch biopsy diagnosis avoided further surgery. In 10 cases (5%) it was necessary to expedite surgical intervention where SCC or BCC were unexpectedly diagnosed. Correct clinical diagnosis for BCC and SCC was 41.9% and 30.6%, respectively, underscoring the importance of histological confirmation in cases where clinical diagnosis is uncertain. Twenty-five punch biopsies were for dermatology referrals, and concordance was 12 (48%). Punch biopsy did not delay treatment as time from clinical assessment to biopsy result was mean (SD) 19.1 (16.3) days. This study highlights that the benefit of punch biopsies, which helped clarify the diagnosis for both the patient and surgeon, improved diagnostic accuracy, and avoided inappropriate use of theatre time with associated patient burden and morbidity.

皮肤癌，特别是非黑色素瘤皮肤癌（NMSC），是全球重大的医疗负担。正确的临床诊断可能具有挑战性，因为患者会被误诊，进行不必要的手术或延误治疗。穿孔活检提供了一种微创的方法来确定治疗前的诊断。本研究将临床表现与穿刺活检后的组织学诊断联系起来，并反映其在患者路径中的价值。这项单单元研究评估了137例疑似NMSC患者的200个连续穿孔活检。对数据进行人口统计学因素、临床表现、组织病理学结果、后续处理和这些事件之间的时间间隔的分析。临床诊断为基底细胞癌124例，鳞状细胞癌36例，lentigo恶性肿瘤1例，Merkel细胞瘤1例，良性病变38例。86例（43%）患者的临床诊断与穿刺活检组织学相同。162例NMSC病例中89例（55.6%）穿刺活检诊断避免了进一步手术。在10例（5%）中，当意外诊断出SCC或BCC时，需要加快手术干预。BCC和SCC的临床正确诊断率分别为41.9%和30.6%，强调了在临床诊断不确定的病例中组织学证实的重要性。25例穿孔活检用于皮肤科转诊，一致性为12例（48%）。从临床评估到活检结果的平均时间（SD）为19.1（16.3）天，Punch活检没有延迟治疗。本研究强调了穿孔活检的好处，它有助于明确患者和外科医生的诊断，提高了诊断的准确性，并避免了与患者负担和发病率相关的不当使用住院时间。

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