Pub Date : 2026-01-08DOI: 10.1016/j.jormas.2026.102711
Milan Martinez Sanchez , Annelies Kerckhofs , Elke Van de Casteele , Lukas Vaes , Wouter De Vos
Key Clinical Message
Lacrimal sac squamous cell carcinoma is extremely rare, and treatment guidelines remain unclear. In select cases, wide en bloc resection combined with prosthetic rehabilitation may offer the best outcomes. This case report advocates a multidisciplinary, consensus-driven approach centered on patient outcomes, with the use of a 3D printed skull with the benefits of gaining insight and providing visualisation pre-operatively. In addition, we want to emphasise the importance of speed in diagnosis and treatment in this report, in order to ensure optimal care.
Summary
Lacrimal sac squamous cell carcinoma is a rare epithelial malignancy often misdiagnosed as chronic dacryocystitis, delaying treatment. This article reports a pT4bN2bM0 case in a 67-year-old man treated with wide en bloc resection, yielding clear margins (>6 mm) and found after 4 months from initial symptoms. A 3D-printed skull model aided preoperative visualization. Histology revealed lymphovascular invasion and broad nests of atypical squamous cells with dyskeratosis and necrosis, confirming lacrimal origin. Adjuvant chemoradiotherapy followed. At 21 months follow-up, no signs of local, regional, or distant recurrence were observed.
{"title":"Squamous cell carcinoma in the lacrimal sac presenting as proptosis: a case report","authors":"Milan Martinez Sanchez , Annelies Kerckhofs , Elke Van de Casteele , Lukas Vaes , Wouter De Vos","doi":"10.1016/j.jormas.2026.102711","DOIUrl":"10.1016/j.jormas.2026.102711","url":null,"abstract":"<div><h3>Key Clinical Message</h3><div>Lacrimal sac squamous cell carcinoma is extremely rare, and treatment guidelines remain unclear. In select cases, wide en bloc resection combined with prosthetic rehabilitation may offer the best outcomes. This case report advocates a multidisciplinary, consensus-driven approach centered on patient outcomes, with the use of a 3D printed skull with the benefits of gaining insight and providing visualisation pre-operatively. In addition, we want to emphasise the importance of speed in diagnosis and treatment in this report, in order to ensure optimal care.</div></div><div><h3>Summary</h3><div>Lacrimal sac squamous cell carcinoma is a rare epithelial malignancy often misdiagnosed as chronic dacryocystitis, delaying treatment. This article reports a pT4bN2bM0 case in a 67-year-old man treated with wide en bloc resection, yielding clear margins (>6 mm) and found after 4 months from initial symptoms. A 3D-printed skull model aided preoperative visualization. Histology revealed lymphovascular invasion and broad nests of atypical squamous cells with dyskeratosis and necrosis, confirming lacrimal origin. Adjuvant chemoradiotherapy followed. At 21 months follow-up, no signs of local, regional, or distant recurrence were observed.</div></div>","PeriodicalId":55993,"journal":{"name":"Journal of Stomatology Oral and Maxillofacial Surgery","volume":"127 3","pages":"Article 102711"},"PeriodicalIF":2.0,"publicationDate":"2026-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145949492","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-07DOI: 10.1016/j.jormas.2026.102710
Isabela Menezes Santos , Emily Vieira Machado , Dhelfeson Willya Douglas de Oliveira , Olga Dumont Flecha , Brender Leonan-Silva
Introduction
Bruxism is a repetitive jaw-muscle activity, involving teeth clenching, grinding, and mandibular bracing or thrusting, occurring during wakefulness or sleep. Its multifactorial etiology includes neurophysiological, psychosocial, and pharmacological factors. Increasing evidence suggests an association between serotonergic antidepressants—especially SSRIs and SNRIs—and the onset or worsening of bruxism. This study aims to assess bruxism prevalence among SSRI/SNRI users and explore its correlation with demographic, occupational, and psychosocial factors.
Material and methods
A retrospective cross-sectional analysis was conducted based on clinical records of patients treated at the Temporomandibular Disorders Clinic of the Federal University of the Jequitinhonha and Mucuri Valleys (Brazil) between 2013 and 2024. Bruxism diagnosis was based on self-report and clinical evidence of tooth wear. Because the database spans years predating the publication of the STAB consensus, standardized STAB-based diagnostic protocols could not be retrospectively applied. Data were analyzed using Pearson’s chi-square and logistic regression (α = 0.05).
Results
Among 583 patients evaluated, 400 (68.6%) presented signs of bruxism. Fifty-three (9.1%) were SSRI/SNRI users, of whom 43 (81.1%) exhibited bruxism. Logistic regression revealed that antidepressant users were 2.5 times more likely to present bruxism than non-users (OR = 2.52; 95% CI: 1.21–5.23; p = 0.014). Occupational stress, particularly among students, was also significantly associated (OR = 1.77; p = 0.004). Axis II–related symptoms (stress, anxiety, and depression) showed no statistical significance.
Discussion
The use of serotonergic antidepressants, especially SSRIs, was significantly associated with bruxism. These findings underscore the importance of considering psychopharmacological and psychosocial factors in the diagnostic and therapeutic management of bruxism.
{"title":"Prevalence of bruxism in users of selective serotonin reuptake inhibitors and serotonin–norepinephrine reuptake inhibitors: A retrospective cross-sectional study","authors":"Isabela Menezes Santos , Emily Vieira Machado , Dhelfeson Willya Douglas de Oliveira , Olga Dumont Flecha , Brender Leonan-Silva","doi":"10.1016/j.jormas.2026.102710","DOIUrl":"10.1016/j.jormas.2026.102710","url":null,"abstract":"<div><h3>Introduction</h3><div>Bruxism is a repetitive jaw-muscle activity, involving teeth clenching, grinding, and mandibular bracing or thrusting, occurring during wakefulness or sleep. Its multifactorial etiology includes neurophysiological, psychosocial, and pharmacological factors. Increasing evidence suggests an association between serotonergic antidepressants—especially SSRIs and SNRIs—and the onset or worsening of bruxism. This study aims to assess bruxism prevalence among SSRI/SNRI users and explore its correlation with demographic, occupational, and psychosocial factors.</div></div><div><h3>Material and methods</h3><div>A retrospective cross-sectional analysis was conducted based on clinical records of patients treated at the Temporomandibular Disorders Clinic of the Federal University of the Jequitinhonha and Mucuri Valleys (Brazil) between 2013 and 2024. Bruxism diagnosis was based on self-report and clinical evidence of tooth wear. Because the database spans years predating the publication of the STAB consensus, standardized STAB-based diagnostic protocols could not be retrospectively applied. Data were analyzed using Pearson’s chi-square and logistic regression (α = 0.05).</div></div><div><h3>Results</h3><div>Among 583 patients evaluated, 400 (68.6%) presented signs of bruxism. Fifty-three (9.1%) were SSRI/SNRI users, of whom 43 (81.1%) exhibited bruxism. Logistic regression revealed that antidepressant users were 2.5 times more likely to present bruxism than non-users (OR = 2.52; 95% CI: 1.21–5.23; <em>p</em> = 0.014). Occupational stress, particularly among students, was also significantly associated (OR = 1.77; <em>p</em> = 0.004). Axis II–related symptoms (stress, anxiety, and depression) showed no statistical significance.</div></div><div><h3>Discussion</h3><div>The use of serotonergic antidepressants, especially SSRIs, was significantly associated with bruxism. These findings underscore the importance of considering psychopharmacological and psychosocial factors in the diagnostic and therapeutic management of bruxism.</div></div>","PeriodicalId":55993,"journal":{"name":"Journal of Stomatology Oral and Maxillofacial Surgery","volume":"127 3","pages":"Article 102710"},"PeriodicalIF":2.0,"publicationDate":"2026-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145936223","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-03DOI: 10.1016/j.jormas.2025.102705
Wei Cao , PengFei Zhao , Zhang Zhao , YiMing Chen
Background
Mandibular defect reconstruction after tumor resection poses significant challenges in oral and maxillofacial surgery. The free fibula flap is widely used and effective for reconstructing such defects. Traditional manual segmentation and stabilization can lead to inaccuracies; while 3D-printed guides improve cutting precision, they often overlook the stabilization of bone segments. The conventional surgical template system consists of three separate guides: a tumor removal guide, a fibula cutting guide, and a reconstruction guide, which requires manual detachment and reshaping of fibula segments before reconstruction. In contrast, the spliced surgical template system integrates an additional fibula cutting frame and reconstruction frame. This allows the fibula cutting guides to transform directly into the reconstruction guide without detaching the segments, thereby simplifying the workflow and improving stabilization accuracy. This study evaluates a spliced surgical template system and compares its accuracy in stabilizing bone segments with that of conventional systems.
Patient and method
A retrospective cohort study was conducted for patients who underwent mandibular tumor resection and free fibula flap reconstruction at Shanghai Ninth People’s Hospital from 01/01/2022 to 31/03/2025. Patients were divided into two groups based on whether they used conventional or spliced surgical template systems. Preoperative virtual surgical planning was adapted to create 3D models, cutting guides, and reconstructing guides. Postoperative CT scans were also analyzed to assess reconstruction accuracy by measuring deviations in three dimensions.
Result
20 patients were included; 10 used the spliced surgical template system, and the rest used the conventional ones. The spliced system showed significantly more minor errors in reconstruction accuracy than the other. The offset was X-axis 0.31 [0.13, 0.97] mm, Y-axis 0.32 [0.11, 0.78] mm, and Z-axis 0.37 [0.06, 0.47] mm for the spliced system, versus 4.03 [0.61, 18.49] mm, 3.50 [0.66, 13.94] mm, and 3.14 [0.85, 7.25] mm for the conventional system, which were all statistically significant (p < 0.05).
Conclusion
The spliced surgical template system provides higher accuracy and stability in mandibular reconstruction with the free fibula flap. It reduces errors in the positioning of fibula segments, resulting in improved reconstruction precision and potentially contributing to better functional outcomes compared with conventional methods.
{"title":"Reconstruction of mandibular defects using free fibula flaps with a spliced surgical template system","authors":"Wei Cao , PengFei Zhao , Zhang Zhao , YiMing Chen","doi":"10.1016/j.jormas.2025.102705","DOIUrl":"10.1016/j.jormas.2025.102705","url":null,"abstract":"<div><h3>Background</h3><div>Mandibular defect reconstruction after tumor resection poses significant challenges in oral and maxillofacial surgery. The free fibula flap is widely used and effective for reconstructing such defects. Traditional manual segmentation and stabilization can lead to inaccuracies; while 3D-printed guides improve cutting precision, they often overlook the stabilization of bone segments. The conventional surgical template system consists of three separate guides: a tumor removal guide, a fibula cutting guide, and a reconstruction guide, which requires manual detachment and reshaping of fibula segments before reconstruction. In contrast, the spliced surgical template system integrates an additional fibula cutting frame and reconstruction frame. This allows the fibula cutting guides to transform directly into the reconstruction guide without detaching the segments, thereby simplifying the workflow and improving stabilization accuracy. This study evaluates a spliced surgical template system and compares its accuracy in stabilizing bone segments with that of conventional systems.</div></div><div><h3>Patient and method</h3><div>A retrospective cohort study was conducted for patients who underwent mandibular tumor resection and free fibula flap reconstruction at Shanghai Ninth People’s Hospital from 01/01/2022 to 31/03/2025. Patients were divided into two groups based on whether they used conventional or spliced surgical template systems. Preoperative virtual surgical planning was adapted to create 3D models, cutting guides, and reconstructing guides. Postoperative CT scans were also analyzed to assess reconstruction accuracy by measuring deviations in three dimensions.</div></div><div><h3>Result</h3><div>20 patients were included; 10 used the spliced surgical template system, and the rest used the conventional ones. The spliced system showed significantly more minor errors in reconstruction accuracy than the other. The offset was X-axis 0.31 [0.13, 0.97] mm, Y-axis 0.32 [0.11, 0.78] mm, and Z-axis 0.37 [0.06, 0.47] mm for the spliced system, versus 4.03 [0.61, 18.49] mm, 3.50 [0.66, 13.94] mm, and 3.14 [0.85, 7.25] mm for the conventional system, which were all statistically significant (<em>p</em> < 0.05).</div></div><div><h3>Conclusion</h3><div>The spliced surgical template system provides higher accuracy and stability in mandibular reconstruction with the free fibula flap. It reduces errors in the positioning of fibula segments, resulting in improved reconstruction precision and potentially contributing to better functional outcomes compared with conventional methods.</div></div>","PeriodicalId":55993,"journal":{"name":"Journal of Stomatology Oral and Maxillofacial Surgery","volume":"127 3","pages":"Article 102705"},"PeriodicalIF":2.0,"publicationDate":"2026-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145907385","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-02DOI: 10.1016/j.jormas.2025.102708
Yi-quan Chen , Hai-jun Wu
Background
Despite complete surgical resection, recurrence remains a substantial challenge in patients with early-stage oral squamous cell carcinoma (OSSC). Conventional TNM staging does not fully capture the biological heterogeneity underlying relapse. This study aimed to develop an individualized recurrence-prediction model integrating clinicopathologic, immune, and spatial factors, and to evaluate the potential mediating role of perineural invasion (PNI).
Methods
We retrospectively analyzed 451 patients with stage I–II OSCC treated at Xiangya Hospital between 2018 and 2025. Twenty-three clinical, pathological, and immunohistochemical variables were initially screened using LASSO regression. Independent predictors of recurrence were subsequently identified through multivariable Cox analysis. A nomogram was constructed based on the final Cox model and internally validated using Harrell’s C-index, time-dependent AUCs, and 1,000-bootstrap calibration. Risk stratification was performed using Kaplan–Meier curves, and mediation analysis was used to determine whether PNI mediated the effects of tumor grade, P53 status, and age on recurrence.
Results
Six independent predictors were incorporated into the final model: tumor grade, PNI, postoperative lymphocyte nadir, tumor-to-midline distance, pathological stage, and P53 status. The model demonstrated good discrimination (C-index = 0.79) and strong time-dependent predictive accuracy (AUCs: 0.819, 0.825, and 0.807 at 1, 3, and 5 years, respectively). Calibration curves showed excellent agreement between predicted and observed recurrence probabilities. Risk stratification based on the nomogram clearly separated patients into low- and high-risk groups (log-rank p < 0.001). Mediation analysis showed that PNI partially mediated the effects of tumor grade (proportion mediated = 29.6%) and P53 status (7.7%) on recurrence, whereas age exhibited no significant mediation through PNI.
Conclusions
This integrated prognostic model combines immune recovery, spatial invasion, and molecular features to accurately predict recurrence in early-stage OSCC. The partial mediation of tumor aggressiveness through PNI highlights a biological pathway linking tumor phenotype to recurrence risk. The proposed nomogram provides a clinically applicable tool for postoperative risk stratification and may assist in tailoring surveillance strategies and individualized adjuvant treatment decisions.
背景：尽管完全手术切除，早期口腔鳞状细胞癌（OSSC）患者的复发仍然是一个重大挑战。传统的TNM分期不能完全反映复发的生物学异质性。本研究旨在建立一个综合临床病理、免疫和空间因素的个体化复发预测模型，并评估围神经浸润（PNI）的潜在介导作用。方法：回顾性分析2018年至2025年在湘雅医院治疗的451例I-II期OSCC患者。最初使用LASSO回归筛选23个临床、病理和免疫组织化学变量。随后通过多变量Cox分析确定了复发的独立预测因素。基于最终Cox模型构建nomogram，并使用Harrell’s C-index、随时间变化的auc和1000 -bootstrap校准进行内部验证。采用Kaplan-Meier曲线进行风险分层，并采用中介分析确定PNI是否介导肿瘤分级、P53状态和年龄对复发的影响。结果：最终模型纳入了六个独立的预测因素：肿瘤分级、PNI、术后淋巴细胞最低点、肿瘤至中线距离、病理分期和P53状态。该模型具有良好的判别性（C-index = 0.79）和较强的时间依赖性预测精度（auc分别为0.819、0.825和0.807，分别为1、3和5年）。校正曲线在预测和观测的重复概率之间表现出良好的一致性。基于nomogram风险分层将患者明确分为低危组和高危组（log-rank p < 0.001）。中介分析显示PNI部分介导肿瘤分级（比例介导 = 29.6%）和P53状态（7.7%）对复发的影响，而年龄没有通过PNI发挥显著的中介作用。结论：该综合预后模型结合了免疫恢复、空间侵袭和分子特征，可准确预测早期OSCC的复发。通过PNI部分介导肿瘤侵袭性强调了将肿瘤表型与复发风险联系起来的生物学途径。所提出的nomogram为术后风险分层提供了一种临床应用的工具，并可能有助于定制监测策略和个性化的辅助治疗决策。
{"title":"Integrative prognostic modeling and mediation analysis of recurrence risk in extremely early-stage oral squamous cell carcinoma","authors":"Yi-quan Chen , Hai-jun Wu","doi":"10.1016/j.jormas.2025.102708","DOIUrl":"10.1016/j.jormas.2025.102708","url":null,"abstract":"<div><h3>Background</h3><div>Despite complete surgical resection, recurrence remains a substantial challenge in patients with early-stage oral squamous cell carcinoma (OSSC). Conventional TNM staging does not fully capture the biological heterogeneity underlying relapse. This study aimed to develop an individualized recurrence-prediction model integrating clinicopathologic, immune, and spatial factors, and to evaluate the potential mediating role of perineural invasion (PNI).</div></div><div><h3>Methods</h3><div>We retrospectively analyzed 451 patients with stage I–II OSCC treated at Xiangya Hospital between 2018 and 2025. Twenty-three clinical, pathological, and immunohistochemical variables were initially screened using LASSO regression. Independent predictors of recurrence were subsequently identified through multivariable Cox analysis. A nomogram was constructed based on the final Cox model and internally validated using Harrell’s C-index, time-dependent AUCs, and 1,000-bootstrap calibration. Risk stratification was performed using Kaplan–Meier curves, and mediation analysis was used to determine whether PNI mediated the effects of tumor grade, P53 status, and age on recurrence.</div></div><div><h3>Results</h3><div>Six independent predictors were incorporated into the final model: tumor grade, PNI, postoperative lymphocyte nadir, tumor-to-midline distance, pathological stage, and P53 status. The model demonstrated good discrimination (C-index = 0.79) and strong time-dependent predictive accuracy (AUCs: 0.819, 0.825, and 0.807 at 1, 3, and 5 years, respectively). Calibration curves showed excellent agreement between predicted and observed recurrence probabilities. Risk stratification based on the nomogram clearly separated patients into low- and high-risk groups (log-rank p < 0.001). Mediation analysis showed that PNI partially mediated the effects of tumor grade (proportion mediated = 29.6%) and P53 status (7.7%) on recurrence, whereas age exhibited no significant mediation through PNI.</div></div><div><h3>Conclusions</h3><div>This integrated prognostic model combines immune recovery, spatial invasion, and molecular features to accurately predict recurrence in early-stage OSCC. The partial mediation of tumor aggressiveness through PNI highlights a biological pathway linking tumor phenotype to recurrence risk. The proposed nomogram provides a clinically applicable tool for postoperative risk stratification and may assist in tailoring surveillance strategies and individualized adjuvant treatment decisions.</div></div>","PeriodicalId":55993,"journal":{"name":"Journal of Stomatology Oral and Maxillofacial Surgery","volume":"127 3","pages":"Article 102708"},"PeriodicalIF":2.0,"publicationDate":"2026-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145901675","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Accurate biomechanical characterization of asymptomatic TMJ function requires anatomically complete, subject-specific models, yet such validated finite element (FE) frameworks remain limited.
Objective
To introduce and technically evaluate a novel MRI-validated, kinematically -driven, anatomically complete, subject-specific 3D nonlinear FE TMJ framework, and to demonstrate its biomechanical responses in one asymptomatic subject and two Class II cases with mild and moderate anterior disc displacement during the four-finger mouth-opening test.
Methods
Three subject-specific TMJ models were constructed using CBCT for hard tissues and high-resolution MRI for soft tissues. A hybrid anatomical workflow integrating 3D Slicer, Blender, and ANSYS SpaceClaim enabled complete maxillofacial reconstruction. Nonlinear FE simulations (ANSYS Workbench) quantified stresses in the disc, condylar head, condylar neck, articular eminence, and glenoid fossa using validated material properties, frictional contacts, and physiological kinematic loading derived from motion-capture trajectories.
Results
MRI-based geometric and kinematic validation showed <5% error in disc rotational angle and condylar translation. In the asymptomatic subject, compressive stresses occurred in intermediate disc regions, with tensile stresses near anterior and posterior attachments. The mild displacement case showed elevated posterior disc and anterior condylar stresses, while the moderate case exhibited the highest disc, condylar head, and neck stresses 0.637 MPa and 1.40 MPa, respectively. Across all three individuals, maximum stresses occurred as the condyle advanced over the articular eminence.
Conclusion
This feasibility study introduces a validated, anatomically complete subject-specific FE TMJ model that captures rotation–translation in the asymptomatic case and restricted translation with elevated stresses in mild and moderate displacement, supporting future expansion.
{"title":"Development and biomechanical evaluation of subject-specific, anatomically complete 3D finite element models of the temporomandibular joint using the four-finger mouth-opening test","authors":"Ananta Jain , Rashmi Uddanwadikar , Sunita Shrivastav","doi":"10.1016/j.jormas.2025.102706","DOIUrl":"10.1016/j.jormas.2025.102706","url":null,"abstract":"<div><h3>Background</h3><div>Accurate biomechanical characterization of asymptomatic TMJ function requires anatomically complete, subject-specific models, yet such validated finite element (FE) frameworks remain limited.</div></div><div><h3>Objective</h3><div>To introduce and technically evaluate a novel MRI-validated, kinematically -driven, anatomically complete, subject-specific 3D nonlinear FE TMJ framework, and to demonstrate its biomechanical responses in one asymptomatic subject and two Class II cases with mild and moderate anterior disc displacement during the four-finger mouth-opening test.</div></div><div><h3>Methods</h3><div>Three subject-specific TMJ models were constructed using CBCT for hard tissues and high-resolution MRI for soft tissues. A hybrid anatomical workflow integrating 3D Slicer, Blender, and ANSYS SpaceClaim enabled complete maxillofacial reconstruction. Nonlinear FE simulations (ANSYS Workbench) quantified stresses in the disc, condylar head, condylar neck, articular eminence, and glenoid fossa using validated material properties, frictional contacts, and physiological kinematic loading derived from motion-capture trajectories.</div></div><div><h3>Results</h3><div>MRI-based geometric and kinematic validation showed <5% error in disc rotational angle and condylar translation. In the asymptomatic subject, compressive stresses occurred in intermediate disc regions, with tensile stresses near anterior and posterior attachments. The mild displacement case showed elevated posterior disc and anterior condylar stresses, while the moderate case exhibited the highest disc, condylar head, and neck stresses 0.637 MPa and 1.40 MPa, respectively. Across all three individuals, maximum stresses occurred as the condyle advanced over the articular eminence.</div></div><div><h3>Conclusion</h3><div>This feasibility study introduces a validated, anatomically complete subject-specific FE TMJ model that captures rotation–translation in the asymptomatic case and restricted translation with elevated stresses in mild and moderate displacement, supporting future expansion.</div></div>","PeriodicalId":55993,"journal":{"name":"Journal of Stomatology Oral and Maxillofacial Surgery","volume":"127 3","pages":"Article 102706"},"PeriodicalIF":2.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145896156","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Preserving an adequate residual mandibular height during marginal mandibulectomy is essential to reduce the risk of postoperative fracture while maintaining oncologic safety in patients with oral squamous cell carcinoma (OSCC).
Purpose
The aim of this study was to evaluate the oncologic outcomes of marginal mandibulectomy guided by the mental foramen and to assess its relevance as an anatomical landmark for osteotomy.
Material and methods
Patients treated for OSCC by marginal mandibulectomy with localization of the mental foramen between 2007 and 2022 were retrospectively included. The primary endpoint was bone resection margin status. Secondary endpoints included local recurrence-free survival, disease-free survival, and overall survival. An anatomical analysis of the mental foramen position relative to the inferior osteotomy line was performed using postoperative computed tomography.
Results
A total of 150 patients met all inclusion criteria. Clear bone margins (R0) were achieved in 98 % of cases. Bone invasion (pT4) was observed in 41.3 % of patients. At 5 years, local recurrence-free survival, disease-free survival, and overall survival were consistent with outcomes reported for selected OSCC treated by marginal mandibulectomy. No immediate postoperative mandibular fractures were observed. The inferior osteotomy line showed a consistent relationship with the mental foramen.
Conclusion
Marginal mandibulectomy guided by the mental foramen allows reproducible bone resection while achieving satisfactory oncologic outcomes. The mental foramen constitutes a reliable anatomical landmark for osteotomy in carefully selected patients with OSCC.
{"title":"The use of the mental foramen as a guide for marginal mandibulectomy in oral squamous cell carcinoma patients with tumor-free margins: experience of 15 years","authors":"Luz Walker , Matthias Schlund , Claire Majoufre , Justine Duvernay","doi":"10.1016/j.jormas.2025.102701","DOIUrl":"10.1016/j.jormas.2025.102701","url":null,"abstract":"<div><h3>Background</h3><div>Preserving an adequate residual mandibular height during marginal mandibulectomy is essential to reduce the risk of postoperative fracture while maintaining oncologic safety in patients with oral squamous cell carcinoma (OSCC).</div></div><div><h3>Purpose</h3><div>The aim of this study was to evaluate the oncologic outcomes of marginal mandibulectomy guided by the mental foramen and to assess its relevance as an anatomical landmark for osteotomy.</div></div><div><h3>Material and methods</h3><div>Patients treated for OSCC by marginal mandibulectomy with localization of the mental foramen between 2007 and 2022 were retrospectively included. The primary endpoint was bone resection margin status. Secondary endpoints included local recurrence-free survival, disease-free survival, and overall survival. An anatomical analysis of the mental foramen position relative to the inferior osteotomy line was performed using postoperative computed tomography.</div></div><div><h3>Results</h3><div>A total of 150 patients met all inclusion criteria. Clear bone margins (R0) were achieved in 98 % of cases. Bone invasion (pT4) was observed in 41.3 % of patients. At 5 years, local recurrence-free survival, disease-free survival, and overall survival were consistent with outcomes reported for selected OSCC treated by marginal mandibulectomy. No immediate postoperative mandibular fractures were observed. The inferior osteotomy line showed a consistent relationship with the mental foramen.</div></div><div><h3>Conclusion</h3><div>Marginal mandibulectomy guided by the mental foramen allows reproducible bone resection while achieving satisfactory oncologic outcomes. The mental foramen constitutes a reliable anatomical landmark for osteotomy in carefully selected patients with OSCC.</div></div>","PeriodicalId":55993,"journal":{"name":"Journal of Stomatology Oral and Maxillofacial Surgery","volume":"127 3","pages":"Article 102701"},"PeriodicalIF":2.0,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145896342","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-31DOI: 10.1016/j.jormas.2025.102707
Jiayi Chen
{"title":"Reflections on the use of ChatGPT in oral and maxillofacial surgery","authors":"Jiayi Chen","doi":"10.1016/j.jormas.2025.102707","DOIUrl":"10.1016/j.jormas.2025.102707","url":null,"abstract":"","PeriodicalId":55993,"journal":{"name":"Journal of Stomatology Oral and Maxillofacial Surgery","volume":"127 3","pages":"Article 102707"},"PeriodicalIF":2.0,"publicationDate":"2025-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145893508","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-31DOI: 10.1016/j.jormas.2025.102702
Rodriguez-Saenz Alvaro , Diego Mauricio Rodriguez-Saenz , Juan Pablo López
Temporomandibular joint discopexy techniques performed by arthroscopy have undergone multiple modifications to reduce the learning curve. Multiple modifications have been made to the technique and instruments; however, discopexy remains challenging due to the difficulty in suture capture. The curved technique leaves the suture in a more comfortable position for capturing the suture with the forceps in a simple way, facilitating the procedure and reducing surgical times without the need for special equipment.
{"title":"Curved tip discopexy as a modification to enhance the suture grasping in TMJ arthroscopy","authors":"Rodriguez-Saenz Alvaro , Diego Mauricio Rodriguez-Saenz , Juan Pablo López","doi":"10.1016/j.jormas.2025.102702","DOIUrl":"10.1016/j.jormas.2025.102702","url":null,"abstract":"<div><div>Temporomandibular joint discopexy techniques performed by arthroscopy have undergone multiple modifications to reduce the learning curve. Multiple modifications have been made to the technique and instruments; however, discopexy remains challenging due to the difficulty in suture capture. The curved technique leaves the suture in a more comfortable position for capturing the suture with the forceps in a simple way, facilitating the procedure and reducing surgical times without the need for special equipment.</div></div>","PeriodicalId":55993,"journal":{"name":"Journal of Stomatology Oral and Maxillofacial Surgery","volume":"127 3","pages":"Article 102702"},"PeriodicalIF":2.0,"publicationDate":"2025-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145893417","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The trigeminocardiac reflex is a clinically important autonomic response to trigeminal stimulation, particularly characterized by heart rate reduction; however, its behavior under local anesthesia is not well defined. This prospective clinical study investigated the impact of different local anesthesia techniques on the incidence and hemodynamic characteristics of the trigeminocardiac reflex (TCR) during mandibular nerve stimulation in awake patients.
Materials and Methods
Forty individuals undergoing surgical extraction of impacted mandibular teeth were enrolled. To minimize vasovagal influence, anxious patients were excluded. Group-1 received a Gow-Gates mandibular nerve block, whereas Group-2 received an inferior alveolar nerve block with supplementary buccal anesthesia. Heart rate (HR) and mean arterial blood pressure (MABP) were continuously monitored throughout local anesthesia administration and all surgical stages.
Results
TCR-compatible bradycardia occurred in 30% (12/40) of patients, most frequently during anesthetic injection and mucosal manipulation, including flap elevation, and suturing.A significantly higher incidence of the TCR was observed in Group 1.The maximum HR reduction recorded was 43.5%. The linear progression of stage-specific baseline MABP and HR values showed a significant decrease during curettage/irrigation and suturing.
Conclusion
These findings demonstrate that the TCR can occur during oral surgery performed under local anesthesia, typically at mild levels, and that the anesthesia technique influences its incidence. This study contributes to the current literature by evaluating the prophylactic potential of different local anesthesia techniques in oral surgery and by integrating anxiety assessment to enhance methodological robustness.
{"title":"Role of anesthetic techniques in trigeminocardiac reflex during oral surgery of the mandible under local anesthesia","authors":"Bedreddin Cavlı , Aykut Şaylığ , Şeyma Kale , Necmiye Şengel , Ziver Ergun Yücel","doi":"10.1016/j.jormas.2025.102704","DOIUrl":"10.1016/j.jormas.2025.102704","url":null,"abstract":"<div><h3>İntroduction</h3><div>The trigeminocardiac reflex is a clinically important autonomic response to trigeminal stimulation, particularly characterized by heart rate reduction; however, its behavior under local anesthesia is not well defined. This prospective clinical study investigated the impact of different local anesthesia techniques on the incidence and hemodynamic characteristics of the trigeminocardiac reflex (TCR) during mandibular nerve stimulation in awake patients.</div></div><div><h3>Materials and Methods</h3><div>Forty individuals undergoing surgical extraction of impacted mandibular teeth were enrolled. To minimize vasovagal influence, anxious patients were excluded. Group-1 received a Gow-Gates mandibular nerve block, whereas Group-2 received an inferior alveolar nerve block with supplementary buccal anesthesia. Heart rate (HR) and mean arterial blood pressure (MABP) were continuously monitored throughout local anesthesia administration and all surgical stages.</div></div><div><h3>Results</h3><div>TCR-compatible bradycardia occurred in 30% (12/40) of patients, most frequently during anesthetic injection and mucosal manipulation, including flap elevation, and suturing.A significantly higher incidence of the TCR was observed in Group 1.The maximum HR reduction recorded was 43.5%. The linear progression of stage-specific baseline MABP and HR values showed a significant decrease during curettage/irrigation and suturing.</div></div><div><h3>Conclusion</h3><div>These findings demonstrate that the TCR can occur during oral surgery performed under local anesthesia, typically at mild levels, and that the anesthesia technique influences its incidence. This study contributes to the current literature by evaluating the prophylactic potential of different local anesthesia techniques in oral surgery and by integrating anxiety assessment to enhance methodological robustness.</div></div>","PeriodicalId":55993,"journal":{"name":"Journal of Stomatology Oral and Maxillofacial Surgery","volume":"127 3","pages":"Article 102704"},"PeriodicalIF":2.0,"publicationDate":"2025-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145893432","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-31DOI: 10.1016/j.jormas.2025.102700
Yao Li , Ke Liu , Yifan Lu , Min Gan
Objective
To investigate vascular endothelial growth factor (VEGF) mRNA expression as an independent biomarker for predicting recurrence in ameloblastoma (AM), and to evaluate its potential for guiding surgical strategy.
Methods
A retrospective cohort study was conducted involving 200 patients with primary AM undergoing initial surgery during January 2021-December 2023. Patients were categorized into curettage (n = 77) and extended resection (n = 123) groups. Relative VEGF mRNA expression in the tumor cyst wall was quantified using RT-qPCR. Kaplan-Meier analysis and Cox regression were used to analyze recurrence-free survival (RFS) and risk factors. Perioperative outcomes and complications were compared between groups. Univariate and multivariate analyses were performed using Cox proportional hazards regression models.
Results
VEGF mRNA expression was significantly elevated in the recurrence group (4.66 ± 1.42) versus the non-recurrence group (3.24 ± 2.02, P < 0.001). ROC curve analysis identified an optimal VEGF cutoff value of 4.88 for predicting recurrence (AUC = 0.694). This molecular stratification revealed a profound disparity: the 2-year RFS was significantly lower in the VEGF-high group (77.4 %) compared to the VEGF-low group (94.9 %, P < 0.001). While extended resection provided a higher 2-year RFS than curettage (96.0 % vs. 79.5 %, P < 0.001), it incurred greater operative burden and complication risks. Crucially, multivariate analysis established high VEGF expression as the most powerful independent predictor of recurrence (HR = 45.15, P < 0.001), with a risk magnitude exceeding that of curettage (HR = 37.22, P < 0.001).
Conclusion
High VEGF mRNA expression is a powerful, independent biomarker for AM recurrence, with a prognostic impact surpassing surgical choice. Preoperative VEGF assessment holds significant potential for guiding individualized surgical planning and optimizing follow-up strategies.
{"title":"VEGF mRNA expression as a powerful independent predictor for recurrence in ameloblastoma: Integrating molecular profiling with surgical outcome analysis","authors":"Yao Li , Ke Liu , Yifan Lu , Min Gan","doi":"10.1016/j.jormas.2025.102700","DOIUrl":"10.1016/j.jormas.2025.102700","url":null,"abstract":"<div><h3>Objective</h3><div>To investigate vascular endothelial growth factor (VEGF) mRNA expression as an independent biomarker for predicting recurrence in ameloblastoma (AM), and to evaluate its potential for guiding surgical strategy.</div></div><div><h3>Methods</h3><div>A retrospective cohort study was conducted involving 200 patients with primary AM undergoing initial surgery during January 2021-December 2023. Patients were categorized into curettage (<em>n</em> = 77) and extended resection (<em>n</em> = 123) groups. Relative VEGF mRNA expression in the tumor cyst wall was quantified using RT-qPCR. Kaplan-Meier analysis and Cox regression were used to analyze recurrence-free survival (RFS) and risk factors. Perioperative outcomes and complications were compared between groups. Univariate and multivariate analyses were performed using Cox proportional hazards regression models.</div></div><div><h3>Results</h3><div>VEGF mRNA expression was significantly elevated in the recurrence group (4.66 ± 1.42) versus the non-recurrence group (3.24 ± 2.02, <em>P</em> < 0.001). ROC curve analysis identified an optimal VEGF cutoff value of 4.88 for predicting recurrence (AUC = 0.694). This molecular stratification revealed a profound disparity: the 2-year RFS was significantly lower in the VEGF-high group (77.4 %) compared to the VEGF-low group (94.9 %, <em>P</em> < 0.001). While extended resection provided a higher 2-year RFS than curettage (96.0 % vs. 79.5 %, <em>P</em> < 0.001), it incurred greater operative burden and complication risks. Crucially, multivariate analysis established high VEGF expression as the most powerful independent predictor of recurrence (HR = 45.15, <em>P</em> < 0.001), with a risk magnitude exceeding that of curettage (HR = 37.22, <em>P</em> < 0.001).</div></div><div><h3>Conclusion</h3><div>High VEGF mRNA expression is a powerful, independent biomarker for AM recurrence, with a prognostic impact surpassing surgical choice. Preoperative VEGF assessment holds significant potential for guiding individualized surgical planning and optimizing follow-up strategies.</div></div>","PeriodicalId":55993,"journal":{"name":"Journal of Stomatology Oral and Maxillofacial Surgery","volume":"127 3","pages":"Article 102700"},"PeriodicalIF":2.0,"publicationDate":"2025-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145893434","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"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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