Journal of Stomatology Oral and Maxillofacial Surgery最新文献

{"title":"The impact of heterodimeric G protein G12 family on proliferation, migration, and invasion in human oral squamous cell carcinoma cells","authors":"Tao-li Fang,&nbsp;Xiao-xia Ma,&nbsp;Sen Yang,&nbsp;Xue-hua Ma,&nbsp;Jiang Xu","doi":"10.1016/j.jormas.2025.102679","DOIUrl":"10.1016/j.jormas.2025.102679","url":null,"abstract":"<div><h3>Objective</h3><div>To characterize the expression of G12 subfamily members (GNA13 and GNA12) in oral squamous cell carcinoma (OSCC) and to evaluate their functional roles in regulating OSCC cell proliferation, migration and invasion.</div></div><div><h3>Methods</h3><div>Public bioinformatic resources were interrogated to profile GNA12 and GNA13 expression and associated functional pathways. Immunohistochemistry was performed on 102 OSCC and 48 adjacent non‑neoplastic tissue specimens, with correlation analyses against clinicopathological parameters and patient survival. Protein and transcript levels were validated in OSCC cell lines by Western blotting and RT‑qPCR. Loss‑of‑function studies using siRNA were followed by CCK‑8, colony formation, Transwell migration/invasion and wound‑healing assays to assess cellular phenotypes.</div></div><div><h3>Results</h3><div>Bioinformatic analyses showed significant upregulation of GNA13 and GNA12 in OSCC (<em>P</em> &lt; 0.001) and enrichment of Rho-mediated signalling pathways. Immunohistochemistry confirmed increased GNA13 and GNA12 expression in tumour tissues compared with adjacent mucosa (<em>P</em> &lt; 0.05). GNA13 expression correlated with tumour differentiation (<em>P</em> = 0.013) and nodal metastasis (<em>P</em> = 0.033), whereas GNA12 expression correlated with tumour differentiation (<em>P</em> = 0.010) and clinical stage (<em>P</em> = 0.027). Overexpression of both genes was associated with poorer overall survival (<em>P</em> &lt; 0.001). Elevated expression in OSCC cell lines was validated by Western blot and RT-qPCR. Functional assays demonstrated that siRNA-mediated knockdown of GNA13 or GNA12 significantly reduced cell viability, colony formation, migration and invasion compared with controls (<em>P</em> &lt; 0.05).</div></div><div><h3>Conclusion</h3><div>Elevated expressions of GNA13 and GNA12 in OSCC tumor tissues and cells are associated with poor patient prognosis. Targeted knockout of GNA13 and GNA12 effectively suppresses malignant behaviors of OSCC, including cell proliferation, migration abilities, and invasive potential. The G12 subfamily may represent a novel therapeutic target for OSCC treatment.</div></div>","PeriodicalId":55993,"journal":{"name":"Journal of Stomatology Oral and Maxillofacial Surgery","volume":"127 3","pages":"Article 102679"},"PeriodicalIF":2.0,"publicationDate":"2025-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145710486","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}

{"title":"The association between common NSAID use and early dental implant failure: A large-scale retrospective cohort study","authors":"Georgios S. Chatzopoulos ,&nbsp;Larry F. Wolff","doi":"10.1016/j.jormas.2025.102680","DOIUrl":"10.1016/j.jormas.2025.102680","url":null,"abstract":"<div><h3>Introduction</h3><div>The impact of NSAIDs on osseointegration remains controversial, with conflicting evidence from animal models and human clinical trials. The aim of the study was to investigate the association between the use of common Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) and the risk of early dental implant failure in a large, real-world patient cohort.</div></div><div><h3>Methods</h3><div>This retrospective cohort study utilized an EHR database of 12,943 patients receiving 49,997 implants. Patients were divided into an NSAID group (<em>n</em> = 3133) and a non-NSAID control group (<em>n</em> = 9810). The primary outcome was early implant failure, defined as implant removal within six months of placement. Multivariable logistic regression models were used to calculate Odds Ratios (ORs) for failure, adjusting for patient age, gender, history of diabetes, and history of osteoporosis. Analyses were conducted at both the implant and patient levels.</div></div><div><h3>Results</h3><div>Patients in the NSAID group were significantly older (62.8 vs. 58.7 years, <em>p</em> &lt; 0.0001) and had a higher prevalence of diabetes (22.0% vs. 16.7 %, <em>p</em> &lt; 0.0001) and osteoporosis (11.0 % vs. 7.0 %, <em>p</em> &lt; 0.0001). After adjusting for confounders, implant-level analysis showed that Ibuprofen use (OR 2.29; 95 % CI 1.48–3.55; <em>p</em> &lt; 0.0001) and Naproxen use (OR 2.65; 95 % CI 1.22–5.75; <em>p</em> = 0.0137) were significantly associated with increased odds of early failure. At the patient level, the association remained highly significant for Ibuprofen (OR 2.87; 95 % CI 1.83–4.51; <em>p</em> &lt; 0.0001), but not for Naproxen (<em>p</em> = 0.0689).</div></div><div><h3>Conclusion</h3><div>The use of Ibuprofen and, to a lesser extent, Naproxen, is associated with a significantly increased risk of early dental implant failure, independent of other patient risk factors. Clinicians should consider these findings when formulating post-operative analgesic plans, particularly for patients with complex medical histories.</div></div>","PeriodicalId":55993,"journal":{"name":"Journal of Stomatology Oral and Maxillofacial Surgery","volume":"127 3","pages":"Article 102680"},"PeriodicalIF":2.0,"publicationDate":"2025-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145710409","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}

{"title":"Oral and maxillofacial schwannoma (OMSCH): An institutional study of 102 patients","authors":"Lingli Huang ,&nbsp;Wenya Zhu ,&nbsp;Qicheng Ye ,&nbsp;Shengwen Liu ,&nbsp;Hao Lu ,&nbsp;Wenjun Yang ,&nbsp;Wanlin Xu","doi":"10.1016/j.jormas.2025.102678","DOIUrl":"10.1016/j.jormas.2025.102678","url":null,"abstract":"<div><h3>Background</h3><div>Oral and maxillofacial schwannoma (OMSCH) is a benign tumor originating from the Schwann cells of peripheral nerves in the oral and maxillofacial region, whose diagnosis and treatment remain challenging.</div></div><div><h3>Methods</h3><div>This retrospective study analyzed OMSCH cases treated at our institution from January 2020 to June 2022. Demographics, clinical features, diagnostic methods, surgical approaches, and postoperative pathology were comprehensively evaluated.</div></div><div><h3>Results</h3><div>A total of 102 patients with OMSCH were included, ranging from 8 to 86 years, with a notable female predominance. The parotid gland was the most frequent site of involvement, while tongue was the most commonly affected structure within the oral cavity. Seventy-one patients (69.6 %) had tumors exceeding 2 cm in size. Magnetic resonance imaging (MRI) exhibited the highest diagnostic accuracy (20/46, 43.5 %). Eighty-five patients (83.3 %) underwent complete surgical resection, with intracapsular enucleation primarily employed for facial nerve schwannomas. Postoperative histopathology revealed a characteristic biphasic pattern and prominent S100/SOX10 immunohistochemical staining. Postoperative complications included tongue deviation in one patient and facial paralysis in 17 patients (16.7 %). No recurrences were observed during follow-up (30–69 months).</div></div><div><h3>Conclusion</h3><div>OMSCH is a rare tumor with limited diagnostic accuracy. MRI remains the preferred diagnostic modality, and surgical intervention generally results in favorable outcomes.</div></div>","PeriodicalId":55993,"journal":{"name":"Journal of Stomatology Oral and Maxillofacial Surgery","volume":"127 3","pages":"Article 102678"},"PeriodicalIF":2.0,"publicationDate":"2025-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145702786","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}

{"title":"Nasal irrigation reduces radiation-induced rhinosinusitis in nasopharyngeal carcinoma treated with volumetric modulated arc therapy","authors":"Jiarong Li ,&nbsp;Yanchen Ji ,&nbsp;Zhining Yang ,&nbsp;Baihan Lin ,&nbsp;Ying Zhang ,&nbsp;Renxian Xie","doi":"10.1016/j.jormas.2025.102677","DOIUrl":"10.1016/j.jormas.2025.102677","url":null,"abstract":"<div><h3>Background</h3><div>Nasopharyngeal carcinoma (NPC), prevalent in Southeast Asia and Southern China, is commonly treated with radiotherapy (RT). Volumetric modulated arc therapy (VMAT) improves tumor control but radiation-induced rhinosinusitis (RIRS) remains a major complication. Nasal irrigation shows potential in mitigating mucosal damage, yet evidence in VMAT-treated NPC patients is limited. This study evaluates Nasal irrigation’s efficacy in reducing RIRS incidence in this population.</div></div><div><h3>Methods</h3><div>A retrospective cohort of 195 NPC patients treated with VMAT (2018–2021) was analyzed. Patients were divided into Nasal irrigation (<em>n</em> = 84) and non-Nasal irrigation (<em>n</em> = 111) groups. Baseline characteristics and dosimetric parameters (V20–V70, Dmean, Dmax) of the maxillary sinus were compared. Kaplan-Meier analysis and Cox regression models assessed Nasal irrigation’s impact on RIRS risk, with subgroup analyses stratified by sex, TNM stage, and treatment regimen.</div></div><div><h3>Results</h3><div>Kaplan-Meier analysis showed that the probability of developing RIRS was significantly higher in the group that did not undergo nasal irrigation compared with the NI group (<em>p</em> &lt; 0.001). Multivariate analysis confirmed NI reduced RIRS risk (adjusted HR=0.26, <em>p</em> &lt; 0.001), while allergic rhinitis increased risk (adjusted HR=6.56, <em>p</em> = 0.009). For maxillary sinusitis, NI remained protective (HR=0.29, <em>p</em> &lt; 0.001), and higher V70 dose (≥70 Gy) correlated with elevated risk (HR=1.10, <em>p</em> = 0.007). Subgroup analyses demonstrated consistent benefits across sex, T/N stage, and treatment groups (all interaction <em>p</em> &gt; 0.05).</div></div><div><h3>Conclusion</h3><div>NI reduces radiation-induced rhinosinusitis risk in VMAT-treated NPC patients, independent of baseline characteristics. Allergic rhinitis and high V70 doses independently worsen outcomes. These findings support NI as a simple, effective adjunct to improve post-radiotherapy quality of life.</div></div>","PeriodicalId":55993,"journal":{"name":"Journal of Stomatology Oral and Maxillofacial Surgery","volume":"127 3","pages":"Article 102677"},"PeriodicalIF":2.0,"publicationDate":"2025-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145702580","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}

{"title":"The causal link between socioeconomic status and oral cancer risk: Evidence from Mendelian Randomization and global burden of disease analysis (1990–2021)","authors":"Shiqi Li,&nbsp;Jinwei Wang,&nbsp;Xiaoshuai Wei,&nbsp;Zheng Liang","doi":"10.1016/j.jormas.2025.102673","DOIUrl":"10.1016/j.jormas.2025.102673","url":null,"abstract":"<div><h3>Objective</h3><div>Oral cancer shows significant disparities across economic levels and genders. We examine trends and determinants of oral cancer burden in regions with varying Social Development Index (SDI) levels using epidemiological data and Mendelian Randomization (MR).</div></div><div><h3>Methods</h3><div>Data from the 2021 Global Burden of Disease (GBD) dataset were analyzed across various SDI regions. Temporal trends were assessed using annual percentage change (EAPC), and risk factor attribution, decomposition analyses, and age-period-cohort models were conducted. MR were used to examine the causal relationship between economic factors and oral cancer incidence.</div></div><div><h3>Results</h3><div>Oral cancer burden is higher in males. High SDI regions have lower incidence, mortality, and DALYs compared to low SDI regions, with later onset and more pronounced gender differences. Tobacco and alcohol use are major risk factors in high SDI regions, while chewing tobacco predominates in low SDI areas. In low-SDI regions, population growth increases the risk; aging boosts incidence in high-SDI areas. MR analysis showed a negative causal relationship between educational attainment, household income, and oral cancer risk (<em>P</em> &lt; 0.05).</div></div><div><h3>Conclusion</h3><div>Improving socioeconomic factors, particularly education and income, may help prevent oral cancer. The burden is higher in low-SDI regions, among males, and among older people, indicating a need for targeted prevention.</div></div>","PeriodicalId":55993,"journal":{"name":"Journal of Stomatology Oral and Maxillofacial Surgery","volume":"127 3","pages":"Article 102673"},"PeriodicalIF":2.0,"publicationDate":"2025-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145679529","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}

{"title":"Finite element analysis of transnasal, zygomatic and pterygoid implants in the rehabilitation of the atrophic maxilla","authors":"Eren Togac,&nbsp;Ferhat Ayranci,&nbsp;Oguzhan Tapci","doi":"10.1016/j.jormas.2025.102674","DOIUrl":"10.1016/j.jormas.2025.102674","url":null,"abstract":"<div><h3>Aim</h3><div>This study aimed to evaluate the stress distribution generated by transnasal, zygomatic, and pterygoid implants on the implants and surrounding bone in atrophic maxilla models using finite element stress analysis</div></div><div><h3>Materials and methods</h3><div>Three atrophic maxilla models were designed. Model 1 included transnasal implants in regions 12 and 22 and zygomatic implants in regions 15 and 25. Model 2 consisted of four zygomatic implants in regions 12, 15, 22, and 25. Model 3 included transnasal implants in regions 12 and 22, zygomatic implants in regions 15 and 25, and pterygoid implants in regions 17 and 27. A vertical load of 150 N was applied separately to teeth 11 and 16 via a spherical food bolus model</div></div><div><h3>Results</h3><div>The highest Von Mises stress values on implants under both anterior and posterior loading were recorded in Model 1, whereas the lowest values were found in Model 3. For abutments, Model 2 exhibited the highest stress values, while Model 3 showed the lowest. In cortical bone, the highest stress values were observed in Model 2, whereas cancellous bone exhibited the highest stresses in Model 1. The lowest stress values in both bone types were consistently seen in Model 3</div></div><div><h3>Conclusion</h3><div>The combination of transnasal and zygomatic implants may serve as an alternative to the quad zygoma concept. However, incorporating pterygoid implants further reduces stress values and may provide biomechanical advantages in the rehabilitation of the atrophic maxilla.</div></div>","PeriodicalId":55993,"journal":{"name":"Journal of Stomatology Oral and Maxillofacial Surgery","volume":"127 3","pages":"Article 102674"},"PeriodicalIF":2.0,"publicationDate":"2025-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145679583","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}

{"title":"Deep neck infections caused by foreign bodies: Literature review","authors":"Hiroki Kimura ,&nbsp;Eiji Iwata ,&nbsp;Joe Iwanaga ,&nbsp;Chizuru Kobayashi ,&nbsp;Yuki Kunisada ,&nbsp;Norie Yoshioka ,&nbsp;Akira Tachibana ,&nbsp;Masaya Akashi ,&nbsp;Soichiro Ibaragi","doi":"10.1016/j.jormas.2025.102669","DOIUrl":"10.1016/j.jormas.2025.102669","url":null,"abstract":"<div><h3>Background</h3><div>Deep neck infections (DNIs) are potentially life-threatening diseases that are mainly caused by odontogenic and peritonsillar infections. Although DNI has also been reported to be caused by foreign bodies, no review articles exist to date.</div></div><div><h3>Methods</h3><div>A comprehensive literature search was conducted using PubMed for articles published between 2005 and 2025.</div></div><div><h3>Results</h3><div>A total of 131 relevant articles were identified. Frequently reported foreign bodies included injectable materials used in facial filler and fish bone. The latency to symptom onset varied widely, ranging from within 1 h after foreign body insertion to as long as 25 years, with substantial differences observed depending on the type of foreign body.</div></div><div><h3>Conclusion</h3><div>Although foreign bodies are rare causes of DNIs, various type of foreign bodies have been reported. Recognizing the possibilities of DNIs caused by foreign bodies will help oral and maxillofacial surgeons to search for the cause rapidly and determine treatment plans and prevent recurrence.</div></div>","PeriodicalId":55993,"journal":{"name":"Journal of Stomatology Oral and Maxillofacial Surgery","volume":"127 3","pages":"Article 102669"},"PeriodicalIF":2.0,"publicationDate":"2025-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145625062","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}

{"title":"Disparity in operation decision in Maxillofacial surgery: Influence of gender and social status","authors":"Laure Franchomme,&nbsp;Aurore Loretti,&nbsp;Romain Nicot","doi":"10.1016/j.jormas.2025.102672","DOIUrl":"10.1016/j.jormas.2025.102672","url":null,"abstract":"","PeriodicalId":55993,"journal":{"name":"Journal of Stomatology Oral and Maxillofacial Surgery","volume":"127 3","pages":"Article 102672"},"PeriodicalIF":2.0,"publicationDate":"2025-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145643158","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}

{"title":"A three-dimensional comparison of the upper airway between patients with non-syndromic cleft lip and palate and skeletal class I individuals","authors":"Jiali Shi ,&nbsp;Ruofan Jin ,&nbsp;Nan Zhang ,&nbsp;Fei Liu ,&nbsp;Jinwei Qin ,&nbsp;Wei Hou ,&nbsp;Weina Zhou","doi":"10.1016/j.jormas.2025.102668","DOIUrl":"10.1016/j.jormas.2025.102668","url":null,"abstract":"<div><h3>Introduction</h3><div>To compare the upper airway dimensions between patients with non-syndromic cleft lip and palate (NSCLP) and skeletal class I control group using three-dimensional imaging.</div></div><div><h3>Methods</h3><div>Using a retrospective cohort study, the investigators enrolled a sample of patients from the Orthodontic Department of the Affiliated Stomatological Hospital of Nanjing Medical University during 2014 and 2018. The primary predictor variable was dentofacial skeleton (NSCLP vs. skeletal class I). The main outcome was three-dimensional upper airway morphology, which included volume, minimum cross-sectional area, height, and symmetry. Appropriate statistics were computed using <em>P</em> &lt; 0.05 as statistical significance.</div></div><div><h3>Results</h3><div>The study included 51 NSCLP patients and 53 class I controls, with comparable age and gender distribution. Three-dimensional analysis revealed significant morphological differences: compared to the class I group, NSCLP patients exhibited a larger nasopharyngeal volume (<em>p</em> &lt; 0.01) and a larger minimum cross-sectional area in the nasopharynx (<em>p</em> &lt; 0.05) and palatopharynx (<em>p</em> &lt; 0.01), but a reduced height of the upper airway (<em>p</em> &lt; 0.05) and palatopharyngeal airway (<em>p</em> &lt; 0.01). Furthermore, in unilateral NSCLP patients, the transverse diameters of the nasopharynx and palatopharynx were significantly smaller on the affected side compared to the normal side (<em>p</em> &lt; 0.05). While bilateral NSCLP and class I groups demonstrated symmetry at the nasopharyngeal and palatopharyngeal levels, both exhibited significant asymmetry at the glossopharyngeal segment (<em>p</em> &lt; 0.05).</div></div><div><h3>Conclusion</h3><div>Our findings conclusively define the specific three-dimensional differences in the NSCLP upper airway, which include an enlarged yet foreshortened nasopharynx and consistent lateral asymmetries. These structural nuances must be considered in the interdisciplinary management of cleft lip and palate to optimize functional and structural results.</div></div>","PeriodicalId":55993,"journal":{"name":"Journal of Stomatology Oral and Maxillofacial Surgery","volume":"127 3","pages":"Article 102668"},"PeriodicalIF":2.0,"publicationDate":"2025-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145643092","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}

{"title":"A scoping review of modifications of the transconjunctival approach for maxillofacial fracture management and proposal of evidence-based algorithm for incision selection","authors":"Amanjot Kaur ,&nbsp;Aparna Ganesan ,&nbsp;Karthik Sennimalai ,&nbsp;Kamalpreet Kaur","doi":"10.1016/j.jormas.2025.102670","DOIUrl":"10.1016/j.jormas.2025.102670","url":null,"abstract":"<div><h3>Background</h3><div>The transconjunctival (TC) approach is widely utilized for orbital fracture repair due to its superior cosmetic outcomes compared to cutaneous incisions. However, concerns about limited surgical exposure, prolonged operative times, and lower eyelid complications have prompted several modifications of this technique.</div></div><div><h3>Purpose</h3><div>This scoping review aimed to systematically map and analyze the various modifications of the transconjunctival (TC) approach used for orbital and adjacent midface (infraorbital rim and zygomaticomaxillary complex) fracture repair, focusing on technical descriptions, clinical outcomes, and complications.</div></div><div><h3>Study Selection</h3><div>A systematic search of electronic databases was performed following PRISMA-ScR guidelines to identify studies reporting modifications of the TC approach. Inclusion criteria encompassed clinical studies, retrospective analyses, and case reports or series that described surgical techniques and reported outcomes. Studies describing TC approach modifications for orbital, infraorbital rim, or zygomatic fractures were included. Studies without specific details on modifications or outcomes were excluded. Of the initially identified articles, 22 studies met the inclusion criteria after independent screening by two reviewers.</div></div><div><h3>Results</h3><div>Twenty-two studies describing TC approach modifications were included, describing eight major categories of TC modifications. Reported variations included lateral paracanthal extensions, sutureless TC incisions, cutaneous Y-modifications, extended TC approaches, stair-step incisions, modified lateral canthotomy and aesthetic variations, lateral skin extensions and canthal-sparing techniques. These techniques were designed to improve surgical access and minimise complications such as ectropion, entropion, and scleral show. Some modifications prioritized enhanced exposure, while others focused on reducing morbidity and optimizing aesthetic results. Due to the heterogeneity of study designs and outcome measures, quantitative synthesis was not performed.</div></div><div><h3>Conclusions and Relevance</h3><div>The TC approach continues to evolve through multiple technical refinements that balance exposure and aesthetics. Awareness of these variants enables surgeons to individualise incision choices based on fracture patterns and risk profiles. The current evidence is largely descriptive and lacks standardised outcome measures, which limits direct comparisons. Prospective, well-designed studies are needed to establish the optimal modification for specific clinical contexts.</div></div>","PeriodicalId":55993,"journal":{"name":"Journal of Stomatology Oral and Maxillofacial Surgery","volume":"127 3","pages":"Article 102670"},"PeriodicalIF":2.0,"publicationDate":"2025-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145643149","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}