Journal of Stomatology Oral and Maxillofacial Surgery最新文献_第3页

Role of anesthetic techniques in trigeminocardiac reflex during oral surgery of the mandible under local anesthesia 局部麻醉下下颌骨口腔手术中麻醉技术对三叉心反射的影响。

IF 2 3区医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE

Journal of Stomatology Oral and Maxillofacial Surgery

Pub Date : 2025-12-31 DOI: 10.1016/j.jormas.2025.102704

Bedreddin Cavlı , Aykut Şaylığ , Şeyma Kale , Necmiye Şengel , Ziver Ergun Yücel

İntroduction

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.

İNTRODUCTION：三叉心反射是临床上对三叉神经刺激的重要自主神经反应，特别是以心率降低为特征；然而，其在局部麻醉下的行为尚不明确。本前瞻性临床研究探讨了不同局麻技术对清醒患者下颌神经刺激时三叉心反射（TCR）发生率和血流动力学特征的影响。材料与方法：选取40例手术拔除下颌阻生牙的患者为研究对象。为尽量减少对血管迷走神经的影响，排除焦虑患者。组1采用Gow-Gates下颌神经阻滞，组2采用下牙槽神经阻滞并辅以颊部麻醉。心率（HR）和平均动脉血压（MABP）在局麻给药期间和所有手术阶段持续监测。结果：30%（12/40）的患者发生tcr相容性心动过缓，最常见于麻醉注射和粘膜操作，包括皮瓣抬高和缝合。第1组TCR发生率明显增高。记录的最大人力资源减少为43.5%。分期特异性基线MABP和HR值的线性进展显示在刮除/冲洗和缝合期间显著降低。结论：这些研究结果表明，局部麻醉下进行口腔手术时，TCR可发生，通常为轻度，麻醉技术影响其发生率。本研究通过评估口腔手术中不同局部麻醉技术的预防潜力，并通过整合焦虑评估来提高方法的稳健性，从而对现有文献做出贡献。

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引用次数: 0

VEGF mRNA expression as a powerful independent predictor for recurrence in ameloblastoma: Integrating molecular profiling with surgical outcome analysis VEGF mRNA表达作为成釉细胞瘤复发的一个强大的独立预测因子：整合分子分析和手术结果分析。

IF 2 3区医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE

Journal of Stomatology Oral and Maxillofacial Surgery

Pub Date : 2025-12-31 DOI: 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.

目的：探讨血管内皮生长因子（VEGF） mRNA表达作为预测成釉细胞瘤（AM）复发的独立生物标志物，并评估其指导手术策略的潜力。方法：回顾性队列研究纳入了200例于2021年1月至2023年12月接受首次手术的原发性AM患者。将患者分为刮除组（n = 77）和扩大切除组（n = 123）。采用RT-qPCR定量检测肿瘤囊壁中VEGF mRNA的相对表达量。采用Kaplan-Meier分析和Cox回归分析无复发生存期（RFS）及危险因素。比较两组围手术期结局及并发症。采用Cox比例风险回归模型进行单因素和多因素分析。结果：复发组VEGF mRNA表达量（4.66±1.42）明显高于非复发组（3.24±2.02,P < 0.001）。ROC曲线分析发现，预测复发的最佳VEGF截止值为4.88 （AUC = 0.694）。这种分子分层揭示了一个深刻的差异：vegf -高组的2年RFS（77.4%）明显低于vegf -低组（94.9%,P < 0.001）。延长切除的2年RFS高于刮除（96.0% vs. 79.5%），结论：高VEGF mRNA表达是AM复发的一个强大的、独立的生物标志物，其预后影响超过手术选择。术前VEGF评估具有指导个体化手术计划和优化随访策略的重要潜力。

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引用次数: 0

Magnitude and predictors of psychological burden of care among informal caregivers of Noma survivors Noma生存者非正式照护者心理照护负担之大小与预测因子。

IF 2 3区医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE

Journal of Stomatology Oral and Maxillofacial Surgery

Pub Date : 2025-12-30 DOI: 10.1016/j.jormas.2025.102699

A.I. Yakubu , M. Bala , R.O. Braimah , A. Bello , A. Abubakar , A.T. Bakare , H.T. Ismail , I. Abdulfattah , I.O. Bruno , B.A. Sulaiman , J. Sarki , I.A. Hadi , Z. Umar , A.S. Inuwa , A.Y. Abbas , M.I. Gidado , A.A. Bioku , A. Abdullahi , U. Abdullahi , A.O. Taiwo

Background

Cancrum Oris is a devastating gangrenous lesion of the orofacial regions that primarily affects the undernourished children, with consequent disfigurement of the face. Noma places a considerable social, psychological, emotional, and financial burden on their informal caregivers. However, this burden on caregivers remains largely understudied. This research aimed to assess the level and predictors of caregiver psychological burden among informal caregivers of Noma patients in Northwestern Nigeria.

Materials and methods

This was a cross-sectional study conducted among 92 informal caregivers of Noma survivors attending Noma Children’s Hospital in Sokoto, who were recruited via a universal sampling method over two years. Caregiver burden was assessed using the Zarit Burden Interview (ZBI). Data were analyzed using SPSS version 25, with Chi-square tests employed to determine associations and logistic regression used to identify predictors. Statistical significance was set at p < 0.05.

Results

The mean age of the caregivers was 38.0 years (SD ± 10.1); most were female (84.8%), married (87.0%), and parents of the survivor. The caregivers experienced a mild-to-moderate burden in 47.8% of cases, a moderate-to-severe burden in 47.8%, and a severe burden in 4.4%. Being female (p = 0.0170) and being a parent (p = 0.011) were associated with higher caregiver burden; female sex remained the only independent predictor of high caregiver burden (p = 0.019).

Conclusion

Informal caregivers of Noma survivors experience considerable psychological burden, particularly female caregivers and parents of patients. Targeted psychosocial support is necessary to alleviate caregiver strain and enhance care outcomes.

背景：口癌是一种破坏性的口腔面部坏疽性病变，主要影响营养不良的儿童，导致面部畸形。坏疽性口炎给非正规照顾者带来了相当大的社会、心理、情感和经济负担。然而，对照顾者的这种负担的研究在很大程度上仍未得到充分研究。本研究旨在评估尼日利亚西北部Noma患者非正式照护者的心理负担水平及其预测因素。材料和方法：这是一项横断面研究，在索科托Noma儿童医院的92名Noma幸存者的非正式护理人员中进行，他们通过通用抽样方法在两年内招募。使用Zarit负担访谈（ZBI）评估照顾者负担。数据分析使用SPSS版本25，使用卡方检验确定关联，使用逻辑回归确定预测因子。p < 0.05为差异有统计学意义。结果：护理人员平均年龄38.0岁（SD±10.1）；大多数是女性（84.8%）、已婚（87.0%）和幸存者的父母。47.8%的护理人员有轻度至中度负担，47.8%的护理人员有中度至重度负担，4.4%的护理人员有重度负担。女性（p = 0.0170）和为人父母（p = 0.011）与较高的照顾者负担相关；女性仍然是高照顾者负担的唯一独立预测因子（p = 0.019）。结论：Noma幸存者的非正式照护者，尤其是女性照护者和患者父母，承受着相当大的心理负担。有针对性的社会心理支持对于减轻照护者压力和提高照护效果是必要的。

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引用次数: 0

Is it time to reconsider chronic electromagnetic field exposure as a possible risk factor in oral cancer? 是时候重新考虑慢性电磁场暴露作为口腔癌可能的危险因素了吗？

IF 2 3区医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE

Journal of Stomatology Oral and Maxillofacial Surgery

Pub Date : 2025-12-30 DOI: 10.1016/j.jormas.2025.102703

Nitya Krishnasamy , Hema Shree K

Introduction

Oral squamous cell carcinoma (OSCC) is a major global health burden, traditionally associated with tobacco, alcohol, and betel quid. In recent years, however, cases have emerged among individuals without these classic risk factors. Chronic exposure to electromagnetic fields (EMFs) from mobile phones and wireless devices has been classified as possibly carcinogenic, yet its potential role in oral carcinogenesis has not been systematically studied.

Technical Note

This article highlights the biological plausibility that prolonged, localized EMF exposure may contribute to DNA damage, oxidative stress, and epigenetic modifications in oral epithelial tissues. Evidence from pilot cytogenetic studies, in vitro models, and limited epidemiological data observed increased micronucleus frequency and altered cellular stress responses in buccal mucosal cells of long-term mobile phone users. While direct causal data in OSCC remain absent, these findings suggest that EMFs could act alone or in synergy with established carcinogens.

Discussion

The technical note underscores the urgent need for in vitro, in vivo, and epidemiological studies to evaluate whether chronic EMF exposure contributes to oral carcinogenesis. Recognizing this hypothesis is not alarmist but rather a call for rigorous and unbiased investigation. If validated, such evidence could inform preventive guidelines and public health policy for emerging exposures.

口腔鳞状细胞癌（OSCC）是一个主要的全球健康负担，传统上与烟草、酒精和槟榔有关。然而，近年来，在没有这些典型危险因素的个体中出现了病例。长期暴露于来自移动电话和无线设备的电磁场（emf）已被归类为可能致癌，但其在口腔致癌中的潜在作用尚未得到系统研究。技术说明：这篇文章强调了长期的、局部的EMF暴露可能导致口腔上皮组织的DNA损伤、氧化应激和表观遗传修饰的生物学合理性。来自初步细胞遗传学研究、体外模型和有限流行病学数据的证据表明，长期使用手机的人口腔黏膜细胞微核频率增加，细胞应激反应改变。虽然在OSCC中没有直接的因果数据，但这些发现表明，电磁场可以单独作用，也可以与已知的致癌物协同作用。讨论：技术说明强调迫切需要进行体外、体内和流行病学研究，以评估慢性EMF暴露是否有助于口腔致癌。认识到这一假设并不是危言耸听，而是呼吁进行严格和公正的调查。如果得到证实，这些证据可以为新出现的暴露提供预防指南和公共卫生政策。

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引用次数: 0

Meta-analysis comparing the outcomes of immediate versus delayed implant placement under periodontitis conditions 荟萃分析比较牙周炎条件下立即与延迟种植体放置的结果。

IF 2 3区医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE

Journal of Stomatology Oral and Maxillofacial Surgery

Pub Date : 2025-12-26 DOI: 10.1016/j.jormas.2025.102697

Jiaqin Wang , Dingfa Gu , Fei Sun

Objective

This study aimed to compare the outcomes of immediate versus delayed implant placement in patients with periodontitis through a meta-analysis, evaluating differences in restorative outcomes, implant success rate and aesthetics.

Methods

A systematic search was conducted across multiple databases (PubMed, Embase, Cochrane Library, China National Knowledge Infrastructure) for relevant randomised controlled trials (RCTs). The inclusion criteria identified patients with severe periodontitis with residual alveolar bone height ≥4 mm post-extraction. Nine RCTs were included, analysing the postoperative probing depth (PD), modified sulcus bleeding index (mSBI), modified plaque index (mPLI), aesthetic outcomes and implant success rate.

Results

Postoperative PD: Immediate implantation had significantly higher PD scores than delayed implantation (mean difference [MD] = 0.32, 95% confidence interval [CI] = 0.21–0.43, p < 0.0001). Postoperative mSBI: Immediate implantation showed superior mSBI scores (MD = 0.29, 95% CI = 0.12–0.46, p = 0.001). Postoperative mPLI: Immediate implantation outperformed delayed implantation (MD = 0.61, 95% CI = 0.53–0.69, p < 0.0001). Aesthetic outcomes: Immediate implantation resulted in better aesthetic scores at 3, 6 and 12 months (3 months: MD = 1.80, p < 0.0001; 6 months: MD = 2.42, p = 0.03; 12 months: MD = 1.65, p = 0.04). Implant Success Rate: A significant difference was found in implant success rates between the groups (risk ratio = 1.74, 95% CI = 1.30–2.34, p = 0.0002).

Conclusion

Immediate implantation shows significant short-term benefits in patients with periodontitis, particularly in restorative outcomes and aesthetics. Although there is no significant difference in implant success rates, delayed implantation may aid in periodontal tissue recovery. The choice between the two strategies should be tailored to the patient's condition and clinical needs.

目的：本研究旨在通过荟萃分析比较牙周炎患者即刻与延迟种植的结果，评估修复结果、种植成功率和美观性的差异。方法：系统检索多个数据库（PubMed, Embase, Cochrane Library, China National Knowledge Infrastructure）中相关的随机对照试验（RCTs）。纳入标准为拔牙后牙槽骨残余高度≥4mm的严重牙周炎患者。纳入9项随机对照试验，分析术后探查深度（PD）、改良沟出血指数（mSBI）、改良斑块指数（mPLI）、美学结果和种植体成功率。结果：术后PD：即刻种植的PD评分明显高于延迟种植（平均差异[MD] = 0.32,95%可信区间[CI] = 0.21-0.43,p < 0.0001）。术后mSBI：即刻植入术mSBI评分较高（MD = 0.29,95% CI = 0.12-0.46,p = 0.001）。术后mPLI：即刻种植优于延迟种植（MD = 0.61,95% CI = 0.53-0.69,p < 0.0001）。审美结果:直接植入导致更好的审美得分在3、6和12个月(3个月:MD = 1.80,p < 0.0001; 6个月:MD = 2.42,p = 0.03;12个月:MD = 1.65,p = 0.04)。种植成功率：两组种植成功率差异有统计学意义（风险比 = 1.74,95% CI = 1.30-2.34,p = 0.0002）。结论：即刻种植对牙周炎患者有显著的短期效益，特别是在修复效果和美观方面。虽然种植成功率没有显著差异，但延迟种植可能有助于牙周组织的恢复。这两种策略之间的选择应根据患者的病情和临床需要而定。

{"title":"Meta-analysis comparing the outcomes of immediate versus delayed implant placement under periodontitis conditions","authors":"Jiaqin Wang , Dingfa Gu , Fei Sun","doi":"10.1016/j.jormas.2025.102697","DOIUrl":"10.1016/j.jormas.2025.102697","url":null,"abstract":"<div><h3>Objective</h3><div>This study aimed to compare the outcomes of immediate versus delayed implant placement in patients with periodontitis through a meta-analysis, evaluating differences in restorative outcomes, implant success rate and aesthetics.</div></div><div><h3>Methods</h3><div>A systematic search was conducted across multiple databases (PubMed, Embase, Cochrane Library, China National Knowledge Infrastructure) for relevant randomised controlled trials (RCTs). The inclusion criteria identified patients with severe periodontitis with residual alveolar bone height ≥4 mm post-extraction. Nine RCTs were included, analysing the postoperative probing depth (PD), modified sulcus bleeding index (mSBI), modified plaque index (mPLI), aesthetic outcomes and implant success rate.</div></div><div><h3>Results</h3><div>Postoperative PD: Immediate implantation had significantly higher PD scores than delayed implantation (mean difference [MD] = 0.32, 95% confidence interval [CI] = 0.21–0.43, <em>p</em> < 0.0001). Postoperative mSBI: Immediate implantation showed superior mSBI scores (MD = 0.29, 95% CI = 0.12–0.46, <em>p</em> = 0.001). Postoperative mPLI: Immediate implantation outperformed delayed implantation (MD = 0.61, 95% CI = 0.53–0.69, <em>p</em> < 0.0001). Aesthetic outcomes: Immediate implantation resulted in better aesthetic scores at 3, 6 and 12 months (3 months: MD = 1.80, <em>p</em> < 0.0001; 6 months: MD = 2.42, <em>p</em> = 0.03; 12 months: MD = 1.65, <em>p</em> = 0.04). Implant Success Rate: A significant difference was found in implant success rates between the groups (risk ratio = 1.74, 95% CI = 1.30–2.34, <em>p</em> = 0.0002).</div></div><div><h3>Conclusion</h3><div>Immediate implantation shows significant short-term benefits in patients with periodontitis, particularly in restorative outcomes and aesthetics. Although there is no significant difference in implant success rates, delayed implantation may aid in periodontal tissue recovery. The choice between the two strategies should be tailored to the patient's condition and clinical needs.</div></div>","PeriodicalId":55993,"journal":{"name":"Journal of Stomatology Oral and Maxillofacial Surgery","volume":"127 3","pages":"Article 102697"},"PeriodicalIF":2.0,"publicationDate":"2025-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145851814","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}

引用次数: 0

Cold atmospheric plasma (CAP) shows strain-dependence against Candida albicans growth on titanium 低温大气等离子体（CAP）对白色念珠菌在钛上的生长表现出菌株依赖性。

IF 2 3区医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE

Journal of Stomatology Oral and Maxillofacial Surgery

Pub Date : 2025-12-26 DOI: 10.1016/j.jormas.2025.102698

Ntombizodwa P. Zwane , Isak J. van der Walt , Steve A.S. Olorunju , Euphemia Sekati , Adam Shnier , Deran Reddy

Objective

: This study assessed the effect of cold atmospheric plasma (CAP) using argon and oxygen on Candida albicans biofilm growth on titanium.

Methods

: Titanium disks were treated with CAP at 10 and 20 min exposure using argon or oxygen plasma. Typical growth from an unspecified clinical Isolate Test Group (TG) (n = 8 for colony forming culture method, n = 8 for biofilm forming method) and resistant (ATCC 10,231) strain Positive Control (PC) (n = 8 for colony forming culture method, n = 8 for biofilm forming method) were tested. Negative Control (NC) was used, which involved plasma-untreated titanium plates (n = 2 for colony-forming culture method, n = 2 for biofilm-forming method). Colony-forming units (CFU) were counted, inactivation rates calculated, and biofilm quantified using optical density at 495 nm (OD495). ANOVA and two-sample tests were applied.

Results

: Oxygen plasma achieved 100% inactivation of TG, while argon plasma showed partial reduction. For resistant PC, oxygen plasma showed no effect, whereas argon achieved up to 99.5% inactivation. ANOVA revealed that group (TG vs PC) was the only significant factor (p = 0.011). Biofilm formation differed significantly between TG and PC (p = 0.014).

Conclusion

: CAP shows strain-specific antifungal activity against C. albicans. Oxygen plasma effectively inhibited TG but not resistant strains, while argon plasma partially reduced both. CAP may have potential as an adjunctive antifungal strategy.

目的：研究氩气和氧气冷常压等离子体（CAP）对白色念珠菌生物膜在钛上生长的影响。方法：用氩气或氧气等离子体对钛盘进行10min和20min的CAP处理。对未指定临床分离试验组（TG）（集落形成培养法n=8，生物膜形成法n=8）和耐药菌株（ATCC 10231）阳性对照（PC）（集落形成培养法n=8，生物膜形成法n=8）的典型生长进行了测试。阴性对照（NC）为未经等离子体处理的钛板（n=2为菌落形成培养法，n=2为生物膜形成法）。计算菌落形成单位（CFU），计算失活率，并使用光密度（OD495）对生物膜进行量化。采用方差分析和双样本检验。结果：氧等离子体100%灭活TG，氩等离子体部分还原TG。对于耐腐蚀PC，氧等离子体对其无影响，而氩气可达到99.5%的失活率。方差分析显示，组（TG vs PC）是唯一显著因素（p=0.011）。TG与PC的生物膜形成差异有统计学意义（p=0.014）。结论：CAP对白色念珠菌具有特异性抗真菌活性。氧等离子体对TG有抑制作用，但对抗性菌株无抑制作用，而氩等离子体对TG和抗性菌株均有部分抑制作用。CAP可能具有作为辅助抗真菌策略的潜力。

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引用次数: 0

Early postoperative occlusal intervention in patients with maxillofacial trauma and malocclusion: Impact on mandibular function recovery 颌面外伤和错颌术后早期咬合干预：对下颌功能恢复的影响。

IF 2 3区医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE

Journal of Stomatology Oral and Maxillofacial Surgery

Pub Date : 2025-12-26 DOI: 10.1016/j.jormas.2025.102696

Guanglian Yang, Linkai Deng

Objective

To evaluate the impact of early postoperative occlusal intervention on mandibular border movement and functional recovery in patients with maxillofacial trauma and malocclusion.

Methods

In this retrospective 1:1 matched study, 184 patients treated during December 2019 to December 2023 were allocated to intervention (n = 92) and control (n = 92) groups. Controls received conventional postoperative care. The intervention group received additional systematic occlusal intervention initiated within one week post-surgery, comprising intermaxillary traction, occlusal splint therapy, and targeted occlusal training. Outcomes assessed included the mandibular border movement index (MBMI), Visual Analogue Scale (VAS), pressure pain threshold (PPT), Jaw Functional Limitation Scale (JFLS), and Oral Health Impact Profile-5 (OHIP-5). Complications were also recorded.

Results

At 3 months, both groups showed significant improvement in all MBMI parameters (maximum mouth opening, protrusion, lateral excursions) and the composite score, with the intervention group demonstrating superior outcomes (P < 0.05). The intervention group also exhibited significantly greater reductions in VAS scores and greater increases in PPT (P < 0.05). Similarly, significantly greater improvements were observed in the intervention group for all JFLS domains (mastication, vertical mobility, emotional/verbal expression) and OHIP-5 items, along with their total scores (P < 0.05). The complication rate did not differ significantly between groups (P > 0.05).

Conclusion

Early systematic occlusal intervention effectively promotes mandibular border movement recovery, alleviates orofacial pain, and enhances jaw function and oral health-related quality of life in patients with maxillofacial trauma and malocclusion, without increasing complication risks, representing a safe and effective adjunctive treatment strategy.

目的：探讨术后早期咬合干预对颌面部外伤错颌患者下颌缘运动及功能恢复的影响。方法：在这项回顾性1:1匹配研究中，将2019年12月至2023年12月期间接受治疗的184例患者分为干预组（n = 92）和对照组（n = 92）。对照组接受常规术后护理。干预组在术后一周内开始进行系统的咬合干预，包括上颌间牵引、咬合夹板治疗和有针对性的咬合训练。评估的结果包括下颌边界运动指数（MBMI）、视觉模拟量表（VAS）、压痛阈值（PPT）、颌骨功能限制量表（JFLS）和口腔健康影响概况-5 （OHIP-5）。并发症也有记录。结果：3个月时，两组MBMI各项参数（最大开口、突出、侧偏移）及综合评分均有显著改善，干预组疗效更佳（P < 0.05）。干预组VAS评分降低显著高于对照组，PPT评分升高显著高于对照组（P < 0.05）。同样，干预组在JFLS各领域（咀嚼、垂直活动能力、情绪/言语表达）和OHIP-5项目及其总分均有显著性改善（P < 0.05）。两组间并发症发生率差异无统计学意义（P < 0.05）。结论：颌面外伤、错颌患者早期系统的咬合干预可有效促进下颌缘运动恢复，减轻口面疼痛，提高颌功能和口腔健康相关生活质量，且不增加并发症风险，是一种安全有效的辅助治疗策略。

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引用次数: 0

Clinicopathological analysis and survival outcomes of head and neck spindle cell carcinoma: A systematic review 头颈部梭形细胞癌的临床病理分析和生存结果：系统回顾。

IF 2 3区医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE

Journal of Stomatology Oral and Maxillofacial Surgery

Pub Date : 2025-12-24 DOI: 10.1016/j.jormas.2025.102695

Moisés Willian Aparecido Gonçalves , Iara Vieira Ferreira , Reydson Alcides de Lima-Souza , Guilherme Arruda Vieira , Marcelo Elias Schempf Cattan , Natália Vital Gonçalves , Carlos Takahiro Chone , Alfio José Tincani , Arthur Antolini-Tavares , Erika Said Abu Egal , Albina Altemani , Fernanda Viviane Mariano

Background

This systematic review aimed to summarize the clinicopathological characteristics, molecular profile, treatment, and outcomes of head and neck spindle cell carcinoma (HNSpCC).

Methods

A comprehensive search was performed in five databases and gray literature (December 2024). Associations between clinical variables were tested using Fisher’s exact and Chi-square tests, and survival was analyzed with the Kaplan-Meier method.

Results

Thirty-nine studies reporting 2,250 cases were included. HNSpCC primarily affects adult males, with the larynx being the most common site, followed by the oral cavity and oropharynx, often presenting as polypoid/exophytic tumors. Diagnosis requires careful use of immunohistochemistry, especially vimentin and epithelial markers. Genetic alterations included TP53, EGFR, ALK, and PIK3CA mutations. Surgery was the main treatment; however, local recurrences, regional and distant metastases were frequent. Survival outcomes were influenced by tumor site, stage, and recurrence. Oral cavity tumors showed the worst prognosis, while laryngeal tumors had comparatively better survival.

Conclusions

HNSpCC is an aggressive malignancy with poor outcomes, especially in advanced-stage and oral cavity cases.

背景：本系统综述旨在总结头颈部梭形细胞癌（HNSpCC）的临床病理特征、分子特征、治疗和预后。方法：综合检索5个数据库和灰色文献（2024年12月）。临床变量间的相关性采用Fisher精确检验和卡方检验，生存率采用Kaplan-Meier法分析。结果：纳入39项研究，报告2250例。HNSpCC主要影响成年男性，以喉部为最常见部位，其次是口腔和口咽部，常表现为息肉样/外生性肿瘤。诊断需要仔细使用免疫组织化学，特别是静脉蛋白和上皮标记物。遗传改变包括TP53、EGFR、ALK和PIK3CA突变。手术是主要的治疗方法；然而，局部复发，区域和远处转移是常见的。生存结果受肿瘤部位、分期和复发的影响。口腔肿瘤预后最差，喉部肿瘤生存率相对较好。结论：HNSpCC是一种预后较差的侵袭性恶性肿瘤，尤其是在晚期和口腔病例中。

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引用次数: 0

Speech outcomes following Le Fort I maxillary advancement in cleft lip and palate patients: A retrospective evaluation using the Borel-Maisonny classification 唇腭裂患者上颌推进后的言语效果：Borel-Maisonny分类的回顾性评价。

IF 2 3区医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE

Journal of Stomatology Oral and Maxillofacial Surgery

Pub Date : 2025-12-24 DOI: 10.1016/j.jormas.2025.102693

Benedikta Kamdem , Oumama El Ezzi , Sophie Fries , Laurent Medinger , Anthony S. de Buys Roessingh

Objective

To analyse the effect of maxillary advancement on speech in patients born with unilateral or bilateral cleft lip and palate (uCLP/bCLP).

Methods

Using the retrospective cohort study design, the investigators included children with uCLP or bCLP who underwent Le Fort I osteotomy for maxillary advancement between January 2013 and December 2023 at a Swiss university hospital. Predictor variables were cleft type (uCLP/bCLP) and amount of maxillary advancement measured on lateral cephalograms. The primary outcome was speech competency evaluated by two speech therapists using the Borel-Maisonny classification (A: velopharyngeal competence/excellent speech; B: borderline competence/good speech; C: incompetence/poor speech). Appropriate statistical analyses were performed, and P < 0.05 was considered statistically significant.

Results

Forty-three non-syndromic CLP patients (mean age 16.4 ± 1.5 years; 37 % female) were included. The mean maxillary advancement was 6.6 ± 2.3 mm. Of the 36 patients classified as A or B preoperatively, 34 showed no change, while two (5.6 %) deteriorated from A to B. All seven patients with preoperative category C remained unchanged. Neither cleft type nor the extent of maxillary advancement significantly influenced postoperative speech (p = 0.65 and p = 0.80, respectively).

Conclusion

Although limited by sample size, this study suggests that speech deterioration after maxillary advancement in CLP patients with preoperative category A or B is uncommon. Conversely, Le Fort I osteotomy does not appear to improve speech in patients with preoperative category C.

目的：分析先天性单侧或双侧唇腭裂（uCLP/bCLP）患者上颌前移对言语功能的影响。方法：采用回顾性队列研究设计，研究人员纳入2013年1月至2023年12月在瑞士大学医院接受Le Fort I截骨术进行上颌推进的uCLP或bCLP儿童。预测变量为裂唇类型（uCLP/bCLP）和侧位头颅x线片测量的上颌前移量。主要结果是由两名语言治疗师使用Borel-Maisonny分类（A：腭咽能力/出色的语言；B：边缘能力/良好的语言；C：无能/糟糕的语言）评估语言能力。进行相应的统计分析，P < 0.05为有统计学意义。结果：纳入43例非综合征性CLP患者（平均年龄16.4±1.5岁，女性占37%）。上颌平均前移6.6±2.3 mm。36例术前A、B级患者中，34例无变化，2例（5.6%）从A级恶化为B级。7例术前C级患者保持不变。腭裂类型和上颌前进程度对术后言语均无显著影响（p = 0.65,p = 0.80）。结论：尽管受样本量限制，本研究提示术前A或B级CLP患者上颌前移后言语功能恶化的情况并不常见。相反，Le Fort I型截骨术并不能改善术前C类患者的语言能力。

{"title":"Speech outcomes following Le Fort I maxillary advancement in cleft lip and palate patients: A retrospective evaluation using the Borel-Maisonny classification","authors":"Benedikta Kamdem , Oumama El Ezzi , Sophie Fries , Laurent Medinger , Anthony S. de Buys Roessingh","doi":"10.1016/j.jormas.2025.102693","DOIUrl":"10.1016/j.jormas.2025.102693","url":null,"abstract":"<div><h3>Objective</h3><div>To analyse the effect of maxillary advancement on speech in patients born with unilateral or bilateral cleft lip and palate (uCLP/bCLP).</div></div><div><h3>Methods</h3><div>Using the retrospective cohort study design, the investigators included children with uCLP or bCLP who underwent Le Fort I osteotomy for maxillary advancement between January 2013 and December 2023 at a Swiss university hospital. Predictor variables were cleft type (uCLP/bCLP) and amount of maxillary advancement measured on lateral cephalograms. The primary outcome was speech competency evaluated by two speech therapists using the Borel-Maisonny classification (A: velopharyngeal competence/excellent speech; B: borderline competence/good speech; C: incompetence/poor speech). Appropriate statistical analyses were performed, and <em>P</em> < 0.05 was considered statistically significant.</div></div><div><h3>Results</h3><div>Forty-three non-syndromic CLP patients (mean age 16.4 ± 1.5 years; 37 % female) were included. The mean maxillary advancement was 6.6 ± 2.3 mm. Of the 36 patients classified as A or B preoperatively, 34 showed no change, while two (5.6 %) deteriorated from A to B. All seven patients with preoperative category C remained unchanged. Neither cleft type nor the extent of maxillary advancement significantly influenced postoperative speech (<em>p</em> = 0.65 and <em>p</em> = 0.80, respectively).</div></div><div><h3>Conclusion</h3><div>Although limited by sample size, this study suggests that speech deterioration after maxillary advancement in CLP patients with preoperative category A or B is uncommon. Conversely, Le Fort I osteotomy does not appear to improve speech in patients with preoperative category C.</div></div>","PeriodicalId":55993,"journal":{"name":"Journal of Stomatology Oral and Maxillofacial Surgery","volume":"127 3","pages":"Article 102693"},"PeriodicalIF":2.0,"publicationDate":"2025-12-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145844241","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}

引用次数: 0

Maxillofacial ballistic injuries: A 13-year single-institution experience 颌面部弹道损伤：13年单一机构经验。

IF 2 3区医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE

Journal of Stomatology Oral and Maxillofacial Surgery

Pub Date : 2025-12-23 DOI: 10.1016/j.jormas.2025.102692

Sebastian Leander Stein , Boris Kos , Emil Dediol , Željko Orihovac

Introduction

Maxillofacial ballistic and pyrotechnic injuries represent complex reconstructive challenges due to severe bone and soft tissue loss, infection risk, and high demands for both function and aesthetics. Recent trends favour early, definitive reconstruction with vascularized tissue, but optimal timing and outcomes remain controversial.

Materials and Methods

Patients with ballistic or pyrotechnic facial injuries treated between 2010 and 2023 were retrospectively analysed. Data included mechanism of injury, anatomical and soft tissue regions involved, reconstructive approaches, complications, and long-term functional and aesthetic outcomes. Major reconstruction was performed with free or regional pectoralis major flaps, classified as early (first hospitalization) or delayed (secondary hospitalization). Complications were defined as events requiring surgical intervention. Functional status was additionally reported by a modified Head and Neck Functional Integrity Scale (HNC-FIT), and aesthetic satisfaction by Visual Analog Scale (VAS).

Results

All seventeen patients suffered combined bone and soft tissue injuries; 71% were suicide attempts. The majority had midfacial and mandibular fractures, often requiring complex reconstruction. Free flaps were frequently used, with the osteofasciocutaneous radial forearm free flap (ORFFF) and fibula free flap (FFF) being most common. Significant complications occurred in 58.8% of patients, mainly infections and osteosynthetic material exposure. Early major reconstruction was associated with fewer and later-occurring complications compared to delayed reconstruction. Patients with lateral defects achieved better HNC-FIT scores and higher VAS satisfaction than those with central defects.

Conclusion

Early, definitive reconstruction is associated with fewer complications and superior long-term outcomes. Bone defects were reconstructed with bony free flaps. For complex central facial regions local flaps are essential to preserve anatomical integrity and achieve satisfactory functional and aesthetic results. Other subunits frequently require tailored combinations of techniques along the reconstructive ladder to address complex defects effectively.

颌面部弹道和烟火伤是复杂的重建挑战，由于严重的骨和软组织损失，感染风险，以及对功能和美学的高要求。最近的趋势倾向于早期，明确重建血管化组织，但最佳时机和结果仍然存在争议。材料和方法：回顾性分析2010年至2023年间治疗的弹道或烟火面部损伤患者。数据包括损伤机制、受损伤的解剖和软组织区域、重建入路、并发症、长期功能和美学结果。采用游离或区域胸大肌皮瓣进行主要重建，分为早期（第一次住院）和延迟（第二次住院）。并发症被定义为需要手术干预的事件。此外，通过改进的头颈部功能完整性量表（HNC-FIT）报告功能状态，并通过视觉模拟量表（VAS）报告审美满意度。结果：17例患者均出现骨、软组织复合损伤；71%是自杀未遂。大多数患者有面中部和下颌骨骨折，通常需要复杂的重建。游离皮瓣的应用较多，以前臂桡骨筋膜皮游离皮瓣（ORFFF）和腓骨游离皮瓣（FFF）最为常见。58.8%的患者出现了严重的并发症，主要是感染和骨合成材料暴露。与延迟重建术相比，早期重建术的并发症更少，发生时间也更晚。外侧缺损患者的HNC-FIT评分和VAS满意度均高于中心缺损患者。结论：早期确定重建并发症少，远期预后好。采用骨游离皮瓣重建骨缺损。对于复杂的面部中央区域，局部皮瓣是必要的，以保持解剖完整性，并获得满意的功能和美学效果。其他子单元经常需要沿着重构阶梯的技术组合来有效地处理复杂的缺陷。

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引用次数: 0