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

CEACAM1 regulates autophagy in oral squamous cell carcinoma through the PPAR signaling pathway CEACAM1通过PPAR信号通路调控口腔鳞状细胞癌的自噬。

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

Journal of Stomatology Oral and Maxillofacial Surgery

Pub Date : 2026-06-01 Epub Date: 2025-12-05 DOI: 10.1016/j.jormas.2025.102676

Sai Ma, Zhonghua Wang, Chao Li, Zhenli Liu, Xuan Zhang

Background

Oral squamous cell carcinoma (OSCC), as one of the most common malignant tumors in the head and neck region, has a complex and diverse pathogenesis. An increasing number of studies indicate that cellular autophagy plays a significant role in the occurrence, development, and treatment of tumors. However, the specific mechanisms of autophagy in oral squamous cell carcinoma are not yet fully understood.

Methods

This study is based on the oral squamous cell carcinoma dataset GSE222673, and has conducted a gene set enrichment analysis (GSEA) on the whole genome, aiming to find potential enriched pathways among non-differentially expressed genes. Weighted gene co-expression network analysis (WGCNA) was used to identify key modules and determine the key hub genes within the modules. The experimental part employed Western Blot to verify the expression changes and functional roles of core molecules in OSCC cells.

Results

GSEA indicates that non-differentially expressed genes are enriched in mitochondrial autophagy, PPAR, Toll-like receptor, and MTOR signaling pathways. WGCNA identified 3794 hub genes, including the CEACAM1 gene. Further Western Blot experiments indicate that in OSCC cells, the CEACAM1 gene has a negative regulatory effect on the PPAR signaling pathway, and changes in its expression levels affect the upregulation or downregulation of key molecules PPAR, ILK, and PDK1. Furthermore, the overexpression of the CEACAM1 gene can promote the expression of autophagy-related molecules such as PINK1, Parkin, LC3I, LC3II, and mitochondrial fusion-related proteins OPA1, MFN2, as well as mitochondrial biogenesis-related proteins NRF1, TFAM in OSCC cells. The overexpression of the CEACAM1 gene inhibits the expression of mitochondrial fission-related proteins and promotes the expression of apoptosis-related proteins.

Conclusions

CEACAM1 regulates the PPAR signaling pathway key molecules, affecting OSCC cell autophagy, mitochondrial balance, and apoptosis.

背景：口腔鳞状细胞癌（Oral squamous cell carcinoma， OSCC）是头颈部最常见的恶性肿瘤之一，其发病机制复杂多样。越来越多的研究表明，细胞自噬在肿瘤的发生、发展和治疗中起着重要的作用。然而，自噬在口腔鳞状细胞癌中的具体机制尚不完全清楚。方法：本研究基于口腔鳞状细胞癌数据集GSE222673，对全基因组进行基因集富集分析（GSEA），旨在寻找非差异表达基因中潜在的富集途径。加权基因共表达网络分析（WGCNA）用于识别关键模块，并确定模块内的关键枢纽基因。实验部分采用Western Blot验证核心分子在OSCC细胞中的表达变化及功能作用。结果：GSEA显示非差异表达基因在线粒体自噬、PPAR、toll样受体和MTOR信号通路中富集。WGCNA鉴定出3794个枢纽基因，包括CEACAM1基因。进一步的Western Blot实验表明，在OSCC细胞中，CEACAM1基因对PPAR信号通路具有负调控作用，其表达水平的变化影响关键分子PPAR、ILK和PDK1的上调或下调。此外，CEACAM1基因的过表达可以促进自噬相关分子如PINK1、Parkin、LC3I、LC3II，以及线粒体融合相关蛋白OPA1、MFN2，以及线粒体生物发生相关蛋白NRF1、TFAM的表达。CEACAM1基因的过表达抑制线粒体分裂相关蛋白的表达，促进凋亡相关蛋白的表达。结论：CEACAM1调控PPAR信号通路关键分子，影响OSCC细胞自噬、线粒体平衡和凋亡。

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引用次数: 0

Chatbot content analysis of patient information on orthodontic tooth extractions 聊天机器人内容分析正畸拔牙患者信息。

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

Journal of Stomatology Oral and Maxillofacial Surgery

Pub Date : 2026-06-01 Epub Date: 2025-12-08 DOI: 10.1016/j.jormas.2025.102675

Şule Gökmen , Ebru Yurdakurban , Kübra Gülnur Topsakal , Gökhan Serhat Duran

Introduction

This study aims to evaluate the quality, accuracy, readability, and understandability of patient information provided by various Artificial intelligence (AI)-based chatbots regarding orthodontic tooth extractions

Materials and methods

Two researchers created a list of questions for patients to ask the chatbots. The questions were categorized into ‘Pre-extraction’ and ‘Post-extraction’, with 20 questions in each category. Four different criteria were used to evaluate the chatbot responses to 40 questions: the Global Quality Scale (GQS), the Simple Measure of Gobbledygook (SMOG), and the Understandability and Accuracy Index. Jamovi (The Jamovi Project, 2022, version 2.3; Sydney, Australia) software was used for all statistical analyses.

Results

The highest mean values were observed in Claude 3.5 sonnet for GQS, Readability, and Accuracy Index. In terms of readability, as measured by the SMOG index, all three AI-based chatbots required a college-level education for comprehension. In the 'Pre-extraction' and 'Post-extraction' sections, Claude 3.5 Sonnet demonstrated the highest mean values for the GQS, readability, and accuracy indices. In terms of Understandability subcriteria 1 and 2, statistically significant differences were observed among the three chatbots, primarily due to the variation between Gemini and Claude 3.5 Sonnet.

Conclusion

AI-based chatbots with a variety of features have generally provided answers of high quality, reliability, and difficult readability to questions. Although the medical information related to orthodontic tooth extraction supplied by chatbots is of higher quality, it is recommended that individuals consult their healthcare professionals on this issue.

本研究旨在评估各种基于人工智能（AI）的聊天机器人提供的关于正畸拔牙的患者信息的质量、准确性、可读性和可理解性。材料和方法：两位研究人员创建了患者向聊天机器人提问的问题列表。这些问题被分为“提取前”和“提取后”，每个类别有20个问题。研究人员使用了四种不同的标准来评估聊天机器人对40个问题的回答：全球质量量表（GQS）、官样文章简单衡量量表（SMOG）以及可理解性和准确性指数。所有统计分析均使用Jamovi （The Jamovi Project, 2022, version 2.3; Sydney, Australia）软件。结果：Claude 3.5十四行诗GQS、可读性和准确性指数的平均值最高。在可读性方面，根据烟雾指数的衡量，这三个基于人工智能的聊天机器人都需要大学水平的教育才能理解。在“预提取”和“提取后”部分，Claude 3.5 Sonnet在GQS、可读性和准确性指标上显示出最高的平均值。在可理解性子标准1和2方面，三种聊天机器人之间存在统计学上的显著差异，主要是由于Gemini和Claude 3.5 Sonnet之间的差异。结论：基于人工智能的聊天机器人具有多种功能，通常能够提供高质量、可靠、难读的问题答案。虽然聊天机器人提供的与正畸拔牙相关的医疗信息质量更高，但建议个人在这个问题上咨询他们的医疗保健专业人员。

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引用次数: 0

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 颏孔为指导无瘤缘口腔鳞状细胞癌患者下颌骨边缘切除术：15年的经验。

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

Journal of Stomatology Oral and Maxillofacial Surgery

Pub Date : 2026-06-01 Epub Date: 2026-01-01 DOI: 10.1016/j.jormas.2025.102701

Luz Walker , Matthias Schlund , Claire Majoufre , Justine Duvernay

Background

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.

背景：对于口腔鳞状细胞癌（OSCC）患者，在下颌边缘切除术中保留足够的下颌高度对于降低术后骨折风险和维持肿瘤安全至关重要。目的：本研究的目的是评估颏孔引导下颌骨边缘切除术的肿瘤学结果，并评估其作为截骨术的解剖学标志的相关性。材料和方法：回顾性分析2007年至2022年间接受下颌边缘切除术并颏孔定位治疗OSCC的患者。主要终点是骨切除边缘状态。次要终点包括局部无复发生存期、无病生存期和总生存期。使用术后计算机断层扫描对相对于下截骨线的颏孔位置进行解剖分析。结果：共有150例患者符合所有纳入标准。98%的病例骨缘清晰（R0）。41.3%的患者出现骨侵犯（pT4）。5年时，局部无复发生存期、无疾病生存期和总生存期与经下颌边缘切除术治疗的选择性OSCC报告的结果一致。术后未见下颌骨骨折。下截骨线与颏孔的关系一致。结论：颏孔引导下的下颌骨边缘切除术可获得满意的肿瘤治疗效果。在精心挑选的OSCC患者中，颏孔构成了可靠的截骨解剖学标志。

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引用次数: 0

Enhancing AI-driven diagnostics for supernumerary teeth: data consistency and dataset balance 增强人工智能驱动的多余牙齿诊断：数据一致性和数据集平衡。

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

Journal of Stomatology Oral and Maxillofacial Surgery

Pub Date : 2026-06-01 Epub Date: 2025-11-26 DOI: 10.1016/j.jormas.2025.102671

Weihao Cheng , Hangyu Zhu

引用次数: 0

Comment on: “Refractory oral manifestations of Crohn's disease” 点评：“克罗恩病的难治性口腔表现”。

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

Journal of Stomatology Oral and Maxillofacial Surgery

Pub Date : 2026-06-01 Epub Date: 2025-11-22 DOI: 10.1016/j.jormas.2025.102664

Lucas Alves da Mota Santana , Carlos Eduardo Palanch Repeke , Rajiv Gandhi Gopalsamy , Juliana Batista Melo da Fonte , Lysandro Pinto Borges

引用次数: 0

Prevalence of bruxism in users of selective serotonin reuptake inhibitors and serotonin–norepinephrine reuptake inhibitors: A retrospective cross-sectional study 选择性5 -羟色胺再摄取抑制剂和5 -羟色胺-去甲肾上腺素再摄取抑制剂使用者磨牙症的患病率：一项回顾性横断面研究。

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

Journal of Stomatology Oral and Maxillofacial Surgery

Pub Date : 2026-06-01 Epub Date: 2026-01-07 DOI: 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.

磨牙症是在清醒或睡眠时发生的一种重复性颚肌活动，包括咬牙、磨牙、下颌支撑或推牙。其多因素病因包括神经生理、社会心理和药理学因素。越来越多的证据表明，血清素类抗抑郁药——尤其是SSRIs和snris——与磨牙症的发病或恶化有关。本研究旨在评估磨牙症在SSRI/SNRI使用者中的患病率，并探讨其与人口统计学、职业和社会心理因素的相关性。材料和方法：回顾性横断面分析2013 - 2024年在巴西联邦大学XXXXXXXXXX颞下颌疾病诊所治疗的患者的临床记录。磨牙症的诊断是基于自我报告和牙齿磨损的临床证据。由于该数据库涵盖了STAB共识发表之前的数年，因此标准化的基于STAB的诊断方案无法回顾性应用。数据分析采用Pearson卡方和logistic回归（α = 0.05）。结果：583例患者中，400例（68.6%）出现磨牙症状。SSRI/SNRI使用者53例（9.1%），其中磨牙43例（81.1%）。Logistic回归显示，抗抑郁药服用者出现磨牙的可能性是非服用者的2.5倍（OR = 2.52;95% CI: 1.21-5.23; p = 0.014）。职业压力，尤其是学生，也显著相关（OR = 1.77;p = 0.004）。轴ii相关症状（压力、焦虑和抑郁）无统计学意义。讨论：5 -羟色胺类抗抑郁药的使用，尤其是SSRIs类抗抑郁药，与磨牙症显著相关。这些发现强调了在磨牙症的诊断和治疗管理中考虑精神药理学和社会心理因素的重要性。

{"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":"2026-06-01","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}

引用次数: 0

Deep neck infections caused by foreign bodies: Literature review 异物引起的深颈部感染：文献综述

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

Journal of Stomatology Oral and Maxillofacial Surgery

Pub Date : 2026-06-01 Epub Date: 2025-11-27 DOI: 10.1016/j.jormas.2025.102669

Hiroki Kimura , Eiji Iwata , Joe Iwanaga , Chizuru Kobayashi , Yuki Kunisada , Norie Yoshioka , Akira Tachibana , Masaya Akashi , Soichiro Ibaragi

Background

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.

Methods

A comprehensive literature search was conducted using PubMed for articles published between 2005 and 2025.

Results

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.

Conclusion

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.

深颈部感染（DNIs）是一种潜在的危及生命的疾病，主要由牙源性和牙周感染引起。尽管也有报道称DNI是由外国机构引起的，但迄今为止尚无评论文章。方法利用PubMed对2005 ~ 2025年间发表的文献进行综合检索。结果共鉴定出相关文献131篇。经常报道的异物包括用于面部填充物和鱼骨的注射材料。症状发作的潜伏期差异很大，从异物插入后1小时到长达25年不等，根据异物的类型有很大差异。结论虽然异物是引起DNIs的罕见原因，但各种类型的异物均有报道。认识到由异物引起的DNIs的可能性将有助于口腔颌面外科医生迅速寻找病因，确定治疗方案并防止复发。

{"title":"Deep neck infections caused by foreign bodies: Literature review","authors":"Hiroki Kimura , Eiji Iwata , Joe Iwanaga , Chizuru Kobayashi , Yuki Kunisada , Norie Yoshioka , Akira Tachibana , Masaya Akashi , 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":"2026-06-01","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}

引用次数: 0

Reflections on the use of ChatGPT in oral and maxillofacial surgery ChatGPT在口腔颌面外科应用的思考。

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

Journal of Stomatology Oral and Maxillofacial Surgery

Pub Date : 2026-06-01 Epub Date: 2025-12-31 DOI: 10.1016/j.jormas.2025.102707

Jiayi Chen

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 : 2026-06-01 Epub 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

Total lower lip and chin replantation following a trampoline accident: Rescue surgery with intensive leech therapy 蹦床事故后儿童全下唇及下巴再植一例：强化水蛭治疗的抢救手术。

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

Journal of Stomatology Oral and Maxillofacial Surgery

Pub Date : 2026-06-01 Epub Date: 2026-01-07 DOI: 10.1016/j.jormas.2026.102709

V Sounthakith , A Schweitzer-Chaput , A Picard , J Prebot , A Galland , C Neiva-Vaz , RH Khonsari

Lip amputations in children may require urgent microsurgical management. Here we report a salvage procedure with partial survival following lower lip and chin replantation after a trampoline accident. Total amputation was managed with inferior labial artery anastomosis; however, venous drainage was not reestablished, necessitating leech therapy. Despite arterial revisions, 75 % of the lip and 25 % of the chin were lost by post-operative day 14. Reconstruction with a combined right Karapandzic flap and left Camille Bernard flap was performed one month later, supplemented by mesotherapy and nanofat injections. The outcome was marked by residual microstomia. These injuries are rare in children, often caused by dog bites. Venous anastomosis is frequently unfeasible, with leech therapy critical for drainage. When replantation is partially successful, reconstruction may involve local flaps or free tissue transfers. Microsurgical expertise, access to leech therapy and close collaboration with intensivists are essential for optimizing outcomes.

儿童唇部截肢可能需要紧急显微外科治疗。在此，我们报告一个在蹦床事故后下唇和下巴再植后部分存活的抢救手术。全截肢采用唇下动脉吻合术；然而，静脉引流没有恢复，需要水蛭治疗。尽管动脉修复，术后第14天75%的嘴唇和25%的下巴都消失了。1个月后行右侧Karapandzic皮瓣和左侧Camille Bernard皮瓣联合重建，并辅以化疗和纳米脂肪注射。结果以残留的小口畸形为标志。这些伤害在儿童中很少见，通常是由狗咬伤引起的。静脉吻合通常不可行，水蛭疗法对引流至关重要。当再植部分成功时，重建可能涉及局部皮瓣或游离组织转移。显微外科专业知识、获得水蛭疗法以及与重症医师密切合作对于优化结果至关重要。

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引用次数: 0