British Journal of Oral & Maxillofacial Surgery最新文献

英文中文

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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引用次数: 0

HPOCUS versus CBCT as a follow-up modality for patients with zygomatic arch fractures HPOCUS与CBCT作为颧弓骨折患者的随访方式。

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.2025.09.321

Andrei Krasovsky , Ahmad Hija , Tal Capucha , Ron Elzami , Amir Bilder , Omri Emodi

Handheld point-of-care ultrasound (HPOCUS) is a rapidly growing technology with an expanding range of medical applications. A new method to compare two-dimensional (2D) HPOCUS accuracy with three-dimensional (3D) cone-beam computed tomography (CBCT) was devised. Ten patients who had completed long-term follow up after surgical intervention to correct displaced zygomatic arch (ZA) fractures were included. The outer cortical outline of the 2D ZA was identified using HPOCUS and superimposed on to a 3D CBCT segmentation. A pointwise analysis of 100 discrete paired points was used to calculate the distance discrepancy between curves representing the ZA outlines derived from HPOCUS and CBCT. The mean (SD) distance between all patients’ US and CBCT curves was 0.141 (0.087) mm. Given the minimal spatial discrepancy between the modalities, we recommend HPOCUS as the gold standard, first-line imaging follow-up modality for patients with ZA fractures.

手持式即时超声（HPOCUS）是一项快速发展的技术，其医疗应用范围不断扩大。提出了一种比较二维（2D） HPOCUS与三维（3D）锥束计算机断层扫描（CBCT）精度的新方法。10例患者在手术干预后完成了长期随访，以纠正移位的颧弓（ZA）骨折。使用HPOCUS识别2D ZA的皮质外轮廓，并将其叠加到3D CBCT分割上。对100个离散成对点进行逐点分析，计算HPOCUS和CBCT得到的ZA轮廓曲线之间的距离差异。所有患者的US和CBCT曲线之间的平均（SD）距离为0.141 (0.087)mm。鉴于模式之间的空间差异最小，我们推荐HPOCUS作为ZA骨折患者的金标准，一线影像学随访模式。

引用次数: 0

Pedicled flaps in the reconstruction of medication-related osteonecrosis and osteoradionecrosis of the jaws: a systematic review and meta-analysis 带蒂皮瓣在颌骨药物相关性骨坏死和放射性骨坏死重建中的应用：系统综述和荟萃分析。

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.2025.10.002

Agata J. Baczynska , Zekiye Karagozlu , Umar Rehman , Alexandra Mackenzie , Mohammad S. Sarwar , Peter A. Brennan

Medication-related osteonecrosis (MRONJ) and osteoradionecrosis (ORN) present a significant reconstructive challenge. Assessing the suitability of pedicled flap (PF) reconstruction in the context of a compromised tissue bed is essential for effective surgical management. This systematic review evaluates the outcomes of PF reconstruction in MRONJ and ORN. PubMed, Ovid (MEDLINE ALL, Embase), and Cochrane CENTRAL were searched for outcomes of PF reconstruction from inception through to November 2024. A total of 48 studies met inclusion criteria (32 MRONJ, 16 ORN). Analysis included 575 patients (MRONJ: n = 478; ORN: n = 97) receiving 607 flaps (MRONJ: n = 509; ORN: n = 98). The pooled success rate was 90% (95% CI: 87% to 92%) for MRONJ and 98% (95% CI: 94 to 100%) for ORN. Both conditions showed an 18% pooled complication rate (MRONJ: 95% CI, 14% to 23%; ORN: 95% CI: 11% to 28%). In MRONJ, buccal fat pad flap was most common (n = 189, 37.13%), while submental island flap with mylohyoid muscle showed the highest success rate (94%, 95% CI: 67% to 99%). There were significant differences in complication rates across flap types (p < 0.0001), with the mylohyoid flap showing the lowest rate (9%, 95% CI: 2% to 36%). For ORN, pectoralis major musculofascial flap was most common (n = 36, 36.73%). Pedicled flaps demonstrate high success rates (>90%) in MRONJ and ORN reconstruction, supporting their use as a reliable option in compromised tissue beds. Flap selection should be individualised based on defect characteristics and patient factors. Further research is needed to better define indications and optimise patient selection.

药物相关性骨坏死（MRONJ）和放射性骨坏死（ORN）是一个重大的重建挑战。在组织床受损的情况下，评估带蒂皮瓣（PF）重建的适用性对于有效的外科治疗至关重要。本系统综述评估了MRONJ和ORN中PF重建的结果。检索PubMed， Ovid （MEDLINE ALL, Embase）和Cochrane CENTRAL从成立到2024年11月的PF重建结果。共有48项研究符合纳入标准（32项MRONJ， 16项ORN）。分析包括575例患者（MRONJ: n = 478; ORN: n = 97）接受607个皮瓣（MRONJ: n = 509; ORN: n = 98）。MRONJ的总成功率为90% (95% CI: 87% ~ 92%)， ORN的总成功率为98% （95% CI: 94 ~ 100%）。两种情况的合并并发症发生率均为18% （MRONJ: 95% CI， 14%至23%；ORN: 95% CI: 11%至28%）。MRONJ中以颊脂肪垫瓣最为常见（n = 189, 37.13%），而带髓舌骨肌的颏下岛状瓣成功率最高（94%,95% CI: 67% ~ 99%）。在MRONJ和ORN重建中，不同皮瓣类型的并发症发生率有显著差异（p > 90%），支持它们作为受损组织床的可靠选择。皮瓣的选择应根据缺损特征和患者因素进行个体化。需要进一步的研究来更好地确定适应症和优化患者选择。

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引用次数: 0

Online patient information on temporomandibular disorders provided by UK NHS hospitals: assessment and improvement of readability standards using AI-chatbots 英国NHS医院提供的颞下颌疾病在线患者信息：使用人工智能聊天机器人评估和改进可读性标准。

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.2025.08.008

Shireen S. Gohari , Agata J. Baczynska , Valentin Weber , Mohammad S. Sarwar , Umar Rehman , Peter A. Brennan

Temporomandibular disorders (TMD) are complex conditions that burden patients and healthcare systems. Disparities in health literacy may hinder patient comprehension of online educational materials, potentially influencing outcomes. Artificial intelligence (AI)-driven chatbots offer a promising solution to improve the readability of patient information materials. We assessed the readability of available online materials on TMD in the United Kingdom (UK) and evaluate the ability of three AI-chatbots to improve readability. A search was done of all UK public hospital websites with Oral and Maxillofacial Surgery (OMFS) or Ear, Nose, and Throat (ENT) units for TMD-related patient information. Readability was assessed using five standard scoring systems. Three AI-chatbots (ChatGPT, Claude, and Google Gemini) were used to revise the content to an 11-year-old (sixth-grade) reading level. A total of 31 out of 122 of UK hospital Trusts provided online TMD materials. Of these, 12/31 and 1/31 met the target readability according to the Flesch-Kincaid Grade Level (FKGL), and the Gunning Fog Index/Coleman-Liau Index (GFI/CLI), respectively, with mean (SD) readability at 64.68 (6.79) for Flesch Reading Ease Score (FRES). After AI modification by Gemini, 96.8% met the target readability per FKGL, 54.8% per GFI, and 29.0% per CLI. Gemini improved the mean (SD) score significantly to 82.59 (5.73) (p < 0.001) for FRES, meeting the target readability level. Online patient information on TMD exceeds the recommended Year Six (sixth grade in the US) reading level. AI chatbots, particularly Gemini, can significantly enhance the readability of these materials, enabling them to meet health literacy standards according to certain readability tools.

颞下颌疾病（TMD）是一种复杂的疾病，给患者和医疗保健系统带来了负担。健康素养的差异可能会阻碍患者对在线教育材料的理解，从而可能影响结果。人工智能（AI）驱动的聊天机器人为提高患者信息材料的可读性提供了一个很有前途的解决方案。我们评估了英国TMD上可用在线材料的可读性，并评估了三种人工智能聊天机器人提高可读性的能力。我们搜索了英国所有有口腔颌面外科（OMFS）或耳鼻喉科（ENT）的公立医院网站，以获取与tmd相关的患者信息。使用五种标准评分系统评估可读性。使用三个人工智能聊天机器人（ChatGPT， Claude和谷歌Gemini）将内容修改为11岁（六年级）的阅读水平。在122家英国医院信托基金中，共有31家提供在线TMD材料。其中12/31和1/31分别达到了Flesch- kincaid Grade Level （FKGL）和Gunning Fog Index/Coleman-Liau Index （GFI/CLI）的目标可读性，Flesch Reading Ease Score （FRES）的平均（SD）可读性为64.68（6.79）。Gemini人工智能修改后，96.8%的FKGL、54.8%的GFI和29.0%的CLI达到了目标可读性。双子组的平均（SD）评分显著提高至82.59分（5.73分）

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引用次数: 0

Comment on “Ghost-writing in oral and maxillofacial literature: Facilitator of progress or ethical erosion?” 评《口腔颌面文学中的代笔：是进步的推动者还是道德的侵蚀？》

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.2025.10.283

Poramate Pitak-Arnnop

引用次数: 0

The Verona suture for tip definition in aesthetic rhinoplasty 维罗纳缝线在鼻尖整形术中的应用。

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.2025.10.249

Paolo Verona , Kleidy Pabón , Christian Alanuca , Natalia Cardona , Steven Rodríguez

引用次数: 0

In reply to the Letter to the Editor regarding Ghost-writing in oral and maxillofacial literature: Facilitator of progress or ethical erosion?” 答《致编辑关于口腔颌面文学代写的信：是进步的推动者还是道德的侵蚀？》

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.2025.10.284

Anuj Jain, Yash Merchant

引用次数: 0

Late complication of cosmetic injectable treatments presenting to oral and maxillofacial surgeons: soft tissue filler granulomas 口腔颌面外科整形注射治疗晚期并发症：软组织填充物肉芽肿。

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.2025.07.014

James Olding, Stavroula Stavropoulou-Tatla, Danyal Awal, Ashraf Messiha

Hospital-based clinicians have seen a progressive increase in complications following cosmetic treatments. A challenging late complication of soft tissue filler treatments is granuloma formation. Oral and maxillofacial surgeons have a key role in the discussion around this delayed-onset complication. We present a case of trismus arising from intramasseteric granulomas following soft-tissue filler injections. Collaboration between surgeons and aesthetic medicine clinicians is crucial to preventing and managing complications from treatments which remain largely unregulated.

医院的临床医生已经看到了美容治疗后并发症的逐渐增加。软组织填充物治疗的晚期并发症是肉芽肿的形成。口腔颌面外科医生在讨论这种迟发性并发症时起着关键作用。我们报告一例由软组织填充物注射后的肠内肉芽肿引起的咬合。外科医生和美容医学临床医生之间的合作对于预防和管理治疗并发症至关重要，这些并发症在很大程度上仍然不受监管。

引用次数: 0

Exploring oral and maxillofacial dental core trainees’ perceptions of preparedness for practice after a high-fidelity simulation course to teach emergencies 探讨口腔颌面牙核心学员在高保真急救模拟课程后对实习准备的认知。

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.2025.08.006

Miss Alice Cameron , Adam Matthew Holden

Many dental core trainees (DCT) feel unprepared to manage unwell patients and emergent situations. Simulation-based education (SBE) is a widely used educational intervention that can facilitate learning without compromising patient safety, and increase preparedness for emergencies. To supplement the predominantly positivist relevant literature, this study endeavoured to answer a research gap through in-depth, meaningful enquiry. The aim was to explore the perceptions of preparedness for practice of oral and maxillofacial surgery (OMFS) DCTs following a one-day, high-fidelity SBE course. The construct under study was preparedness for practice. The study was grounded in the conceptual frameworks of social cognitive theory, constructivist principles, and experiential learning theory. DCTs who had attended an SBE course underwent semi-structured interviews. Thematic analysis of the data generated four main themes: realism; safe learning environment; community of practice; and DCT as a unique experience. The results outlined the importance of physical and psychological fidelity within the SBE design, debrief facilitated by experienced, multidisciplinary faculty, and incorporation of learning through peer-observation, as important SBE features to advance DCT learning and subsequent preparedness. The conclusions reflected participants’ positivity about SBE as an educational technique to increase their preparedness. Overall, the findings illustrate a wide range of benefits from SBE in this context, the concepts of which other educationalists could consider adopting as a medical education strategy to improve DCTs’ preparedness for OMFS.

许多牙科核心培训生（DCT）对管理身体不适的病人和紧急情况感到措手不及。基于模拟的教育（SBE）是一种广泛使用的教育干预措施，它可以在不损害患者安全的情况下促进学习，并增强对紧急情况的准备。为了补充以实证主义为主的相关文献，本研究试图通过深入、有意义的调查来回答研究空白。目的是探讨在为期一天的高保真SBE课程后，对口腔颌面外科（OMFS） dct实践准备的看法。所研究的结构是为实践做准备。本研究以社会认知理论、建构主义原则和经验学习理论为概念框架。参加过SBE课程的dct接受了半结构化访谈。专题分析产生的数据主要有四个主题：现实主义；安全的学习环境；实践共同体；而DCT是一种独特的体验。结果概述了生理和心理上的忠诚在SBE设计中的重要性，由经验丰富的多学科教师进行汇报，并通过同伴观察结合学习，作为重要的SBE特征，以促进DCT学习和随后的准备。这些结论反映了参与者对SBE作为一种提高他们准备程度的教育技术的积极态度。总的来说，研究结果表明，在这种情况下，SBE有广泛的好处，其他教育工作者可以考虑将这些概念作为一种医学教育策略，以提高dct对OMFS的准备。

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In reply to the Letter to the Editor regarding "Ghost-writing in oral and maxillofacial literature: facilitator of progress or ethical erosion?" 关于“口腔颌面文学中的代写：进步的推动者还是道德的侵蚀？”致编辑的回复

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

British Journal of Oral & Maxillofacial Surgery

Pub Date : 2025-12-24 DOI: 10.1016/j.bjoms.2025.11.010

Anuj Jain, Yash Merchant

引用次数: 0

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