Pub Date : 2026-01-01Epub Date: 2025-11-10DOI: 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.
{"title":"A systematic review of prognostic factors and anatomical variability in surgically managed T4b oral squamous cell carcinoma: implications for future classification","authors":"Munir J. Abukhder , M. Shihabul Hassan , Omar Mubarak , Karl F. Payne , Axel Sahovaler , Clare Schilling","doi":"10.1016/j.bjoms.2025.10.280","DOIUrl":"10.1016/j.bjoms.2025.10.280","url":null,"abstract":"<div><div>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.</div></div>","PeriodicalId":55318,"journal":{"name":"British Journal of Oral & Maxillofacial Surgery","volume":"64 1","pages":"Pages 5-13"},"PeriodicalIF":1.9,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145589784","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"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: 2025-11-12DOI: 10.1016/j.bjoms.2025.11.001
A. Kanatas
{"title":"The BAOMS Mouth Cancer Awareness Week – 30 years supporting the campaign and saving lives","authors":"A. Kanatas","doi":"10.1016/j.bjoms.2025.11.001","DOIUrl":"10.1016/j.bjoms.2025.11.001","url":null,"abstract":"","PeriodicalId":55318,"journal":{"name":"British Journal of Oral & Maxillofacial Surgery","volume":"64 1","pages":"Pages 3-4"},"PeriodicalIF":1.9,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145642793","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"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: 2025-09-23DOI: 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.
{"title":"Comparison of large language models in oral and maxillofacial surgery","authors":"Ricardo Grillo , Alexandre Hugo Llanos , Claudio Costa , Fernando Melhem-Elias","doi":"10.1016/j.bjoms.2025.08.015","DOIUrl":"10.1016/j.bjoms.2025.08.015","url":null,"abstract":"<div><div>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.</div></div>","PeriodicalId":55318,"journal":{"name":"British Journal of Oral & Maxillofacial Surgery","volume":"64 1","pages":"Pages 43-49"},"PeriodicalIF":1.9,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145276670","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"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: 2025-06-27DOI: 10.1016/j.bjoms.2025.06.005
J. Pallot , L. Dovgalski , P. Evans , K. Shah , M.A. Kittur
{"title":"Custom-made fibular cradle plate to optimise bone positioning for implant placement, restore maxillary contour, and preserve pedicle length in reconstruction of the maxilla","authors":"J. Pallot , L. Dovgalski , P. Evans , K. Shah , M.A. Kittur","doi":"10.1016/j.bjoms.2025.06.005","DOIUrl":"10.1016/j.bjoms.2025.06.005","url":null,"abstract":"","PeriodicalId":55318,"journal":{"name":"British Journal of Oral & Maxillofacial Surgery","volume":"64 1","pages":"Pages 77-80"},"PeriodicalIF":1.9,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144796203","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"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: 2025-10-22DOI: 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.
{"title":"HPOCUS versus CBCT as a follow-up modality for patients with zygomatic arch fractures","authors":"Andrei Krasovsky , Ahmad Hija , Tal Capucha , Ron Elzami , Amir Bilder , Omri Emodi","doi":"10.1016/j.bjoms.2025.09.321","DOIUrl":"10.1016/j.bjoms.2025.09.321","url":null,"abstract":"<div><div>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.</div></div>","PeriodicalId":55318,"journal":{"name":"British Journal of Oral & Maxillofacial Surgery","volume":"64 1","pages":"Pages 56-60"},"PeriodicalIF":1.9,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145507823","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"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: 2025-10-10DOI: 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.
{"title":"Comparison between clinical and punch biopsy diagnosis of suspected head and neck skin cancer","authors":"Luke Butler , Sian Williams , Krishna Gumparthy , Ashwin Kerai , Simon N. Rogers","doi":"10.1016/j.bjoms.2025.09.318","DOIUrl":"10.1016/j.bjoms.2025.09.318","url":null,"abstract":"<div><div>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.</div></div>","PeriodicalId":55318,"journal":{"name":"British Journal of Oral & Maxillofacial Surgery","volume":"64 1","pages":"Pages 50-55"},"PeriodicalIF":1.9,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145427185","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"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: 2025-10-25DOI: 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。
{"title":"Pedicled flaps in the reconstruction of medication-related osteonecrosis and osteoradionecrosis of the jaws: a systematic review and meta-analysis","authors":"Agata J. Baczynska , Zekiye Karagozlu , Umar Rehman , Alexandra Mackenzie , Mohammad S. Sarwar , Peter A. Brennan","doi":"10.1016/j.bjoms.2025.10.002","DOIUrl":"10.1016/j.bjoms.2025.10.002","url":null,"abstract":"<div><div>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.</div></div>","PeriodicalId":55318,"journal":{"name":"British Journal of Oral & Maxillofacial Surgery","volume":"64 1","pages":"Pages 14-23"},"PeriodicalIF":1.9,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145642760","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"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: 2025-09-03DOI: 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）
{"title":"Online patient information on temporomandibular disorders provided by UK NHS hospitals: assessment and improvement of readability standards using AI-chatbots","authors":"Shireen S. Gohari , Agata J. Baczynska , Valentin Weber , Mohammad S. Sarwar , Umar Rehman , Peter A. Brennan","doi":"10.1016/j.bjoms.2025.08.008","DOIUrl":"10.1016/j.bjoms.2025.08.008","url":null,"abstract":"<div><div>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.</div></div>","PeriodicalId":55318,"journal":{"name":"British Journal of Oral & Maxillofacial Surgery","volume":"64 1","pages":"Pages 66-71"},"PeriodicalIF":1.9,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145208482","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"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: 2025-11-10DOI: 10.1016/j.bjoms.2025.10.283
Poramate Pitak-Arnnop
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