Journal of Stomatology Oral and Maxillofacial Surgery最新文献_第4页

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

Comment on “Periauricular incision vs. Modified Blair incision in parotidectomy: A systematic review and meta-analysis of randomized controlled trials” “耳廓周围切口与改良Blair切口行腮腺切除术：随机对照试验的系统回顾和荟萃分析”。

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

Journal of Stomatology Oral and Maxillofacial Surgery

Pub Date : 2025-12-18 DOI: 10.1016/j.jormas.2025.102683

Erdem Köroğlu

引用次数: 0

Association of Toll-like receptors 3, 4, 9 expression with clinicopathological features in oral squamous cell carcinoma toll样受体3,4,9表达与口腔鳞状细胞癌临床病理特征的关系

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

Journal of Stomatology Oral and Maxillofacial Surgery

Pub Date : 2025-12-18 DOI: 10.1016/j.jormas.2025.102688

Melih Solhan , Betül Öğüt , Melike Urgancı , İsmet Bayramoğlu

Introduction

This study aimed to evaluate the expression levels of Toll-like receptor 3, 4, and 9 in oral cavity squamous cell carcinoma (SCC) and their associations with clinicopathological parameters.

Material and methods

Fifty-three patients diagnosed with oral cavity SCC between 2010 and 2015 were retrospectively analyzed. Immunohistochemical staining for TLR-3, TLR-4, and TLR-9 was performed on formalin-fixed, paraffin-embedded tumor tissues. Expression was assessed based on staining intensity, staining status and percentage of positive tumor cells (prevalence). Associations with tumor stage (T, N, TNM), depth of invasion (DOI), lymphovascular invasion (LVI), perineural invasion (PNI), extranodal extension (ENE), histological grade, recurrence, and survival status were evaluated statistically.

Results

No statistically significant correlations were found between TLR-3, TLR-4, or TLR-9 expression and any of the examined clinicopathological features (p > 0.05). Although an increasing trend in DOI was observed with stronger TLR-3 and TLR-4 staining, the results were not statistically significant.

Discussion

This study did not establish a clear prognostic role for TLR-3, TLR-4, or TLR-9 in oral cavity SCC. However, the findings highlight the biological complexity of TLR-mediated pathways in cancer. Further large-scale, multi-institutional studies are necessary to better understand the clinical relevance of TLRs in oral carcinogenesis.

本研究旨在评估toll样受体3、4和9在口腔鳞状细胞癌（SCC）中的表达水平及其与临床病理参数的关系。材料与方法：回顾性分析2010 ~ 2015年53例口腔鳞状细胞癌患者的临床资料。对福尔马林固定、石蜡包埋的肿瘤组织进行TLR-3、TLR-4和TLR-9的免疫组化染色。根据染色强度、染色状态和阳性肿瘤细胞百分比（患病率）评估表达。统计评价肿瘤分期（T、N、TNM）、浸润深度（DOI）、淋巴血管浸润（LVI）、神经周围浸润（PNI）、结外延伸（ENE）、组织学分级、复发和生存状况的相关性。结果：TLR-3、TLR-4、TLR-9的表达与所检查的任何临床病理特征均无统计学意义（p < 0.05）。虽然随着TLR-3和TLR-4染色的增强，DOI有增加的趋势，但结果无统计学意义。讨论：本研究并未明确TLR-3、TLR-4或TLR-9在口腔鳞状细胞癌中的预后作用。然而，这些发现强调了tlr介导的癌症通路的生物学复杂性。为了更好地了解tlr在口腔癌变中的临床意义，需要进一步的大规模、多机构研究。

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引用次数: 0

An oral microbiome from 1929: Paleoproteomic study of a toothbrush belonging to Georges Clemenceau (1841–1929). 1929年口腔微生物组：乔治·克列孟梭（1841-1929）牙刷的古蛋白质组学研究。

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

Journal of Stomatology Oral and Maxillofacial Surgery

Pub Date : 2025-12-18 DOI: 10.1016/j.jormas.2025.102691

P Charlier , L Lentignac , J Armengaud

引用次数: 0

Orthognathic surgery in instability of the TMJ using surgical guides and customized plates: 3 case reports 使用手术指南和定制钢板治疗TMJ不稳定的正颌手术：3例报告。

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

Journal of Stomatology Oral and Maxillofacial Surgery

Pub Date : 2025-12-18 DOI: 10.1016/j.jormas.2025.102689

Kiatanant Boonsiriseth , Nutnicha Naknual , Chedtha Puncreobutr , Sukkarn Themkumkwun

Purpose

Patients with facial deformities and temporomandibular joint (TMJ) instability present unique challenges in orthognathic surgery (OGS). This report presents three complex cases of syndromic or post-traumatic deformities treated with virtual surgical planning (VSP), surgical guides, and customized fixation plates.

Methods

Three patients with syndromic or post-traumatic deformities and TMJ instability underwent OGS. Planning was performed using Dolphin Imaging software. Surgical guides and patient-specific plates were designed with CAD software and fabricated via selective laser melting. Surgical workflows incorporated bone- and tooth-borne guides, with fixation achieved using customized titanium plates. Postoperative accuracy was evaluated by superimposing pre- and postoperative computed tomography (CT) scans.

Results

Superimposition analysis revealed maximum surface deviations of less than 2 mm in all patients, with the maxilla demonstrating superior accuracy (<1 mm). Clinically, all patients showed improved facial symmetry, occlusion, and profile. The use of surgical guides and customized plates enhanced intraoperative precision and reduced the risk of root and nerve injury.

Conclusion

Guided surgery with customized fixation improve surgical accuracy and outcomes in patients with complex deformities and TMJ instability. These results support the application of surgical guides and customized plates in challenging orthognathic cases.

目的：面部畸形和颞下颌关节（TMJ）不稳定的患者在正颌手术（OGS）中提出了独特的挑战。本文报告了三例复杂的综合征或创伤后畸形的治疗，采用虚拟手术计划（VSP），手术指南，和定制的固定板。方法：对3例综合征性或创伤后畸形伴颞下颌关节不稳定的患者行OGS。使用Dolphin Imaging软件进行计划。用CAD软件设计手术导板和患者专用板，并通过选择性激光熔化制作。手术工作流程包括骨和牙齿导向，使用定制的钛板实现固定。通过叠加术前和术后计算机断层扫描（CT）来评估术后准确性。结果：叠加分析显示，所有患者的最大表面偏差均小于2mm，上颌精度较高(结论：在复杂畸形和TMJ不稳定患者中，引导手术采用定制固定可提高手术精度和疗效。这些结果支持在具有挑战性的正颌病例中应用外科导板和定制钢板。

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引用次数: 0

Ameloblastoma in Chongqing children and adolescents: a review of 16 cases 重庆儿童青少年成釉细胞瘤16例报告。

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

Journal of Stomatology Oral and Maxillofacial Surgery

Pub Date : 2025-12-18 DOI: 10.1016/j.jormas.2025.102687

Ying Xu, Xiao-Juan Fu, Li Xiang, Wan-Shan Li

Background

Ameloblastoma is a benign tumor of odontogenic epithelial origin, characterized by local aggression and a high recurrence rate in adults. Although rare in children, it accounts for 10 to 15 % of all ameloblastoma cases. However, a consensus on the clinicopathological features and treatment protocols for this condition remains lacking.

Purpose

This study aims to summarize the clinicopathological characteristics of ameloblastoma in pediatric patients within the oral and maxillofacial regions.

Methods

Clinical, radiological, and histological data from sixteen pediatric patients who underwent surgical curettage followed by pathological diagnosis of ameloblastoma were retrospectively analyzed.

Results

The cohort comprised 11 males and 5 females, yielding a male-to-female ratio of 2.1:1. Patient age at diagnosis ranged from 2 to 13 years (mean age: 7.6 years). Lesions were located in the maxilla in two cases and the mandible in fourteen. Within the mandible, lesions were predominantly found in the posterior teeth region (7 cases, 50.0 %), followed by the mandibular angle (3 cases, 21.43 %), the angle and ramus (1 case, 7.14 %), the ramus (1 case, 7.14 %), the midline of the mandible (1 case, 7.14 %), and the anterior mandible (1 case, 7.14 %). Painless swelling was the most common symptom, observed in 9 of 16 patients (56.25 %). All patients were treated surgically. Radiological findings revealed unilocular lesions in 14 cases, while 2 cases exhibited multilocular lesions. Histologically, 14 cases presented with the solid type, and 2 cases with the unicystic type. Postoperative follow-up ranged from 1 to 81 months, with one recurrence.

Conclusions

The recurrence rate of ameloblastoma in children is relatively low. Unicystic ameloblastoma is more prevalent in this population. Simple surgical curettage typically results in a favorable prognosis with minimal recurrence. Early and accurate recognition of the disease’s clinical, radiological, and histological features is critical in reducing misdiagnosis.

背景：成釉细胞瘤是一种牙源性上皮性良性肿瘤，在成人中具有局部侵袭性和高复发率。虽然在儿童中很少见，但它占所有成釉细胞瘤病例的10%至15%。然而，对这种情况的临床病理特征和治疗方案仍然缺乏共识。目的：总结口腔颌面部儿童成釉细胞瘤的临床病理特点。方法：回顾性分析16例手术刮除后病理诊断为成釉细胞瘤的患儿的临床、影像学和组织学资料。结果：该队列包括11名男性和5名女性，男女比例为2.1:1。诊断时患者年龄从2岁到12岁不等（平均年龄：7.6岁）。病变位于上颌骨2例，下颌骨14例。下颌骨内病变以后牙区为主（7例，50.0%），其次为下颌角（3例，21.43%）、牙角及支（1例，7.14%）、支（1例，7.14%）、下颌中线（1例，7.14%）、前颌骨（1例，7.14%）。无痛性肿胀是最常见的症状，16例患者中有9例（56.25%）出现无痛性肿胀。所有患者均行手术治疗。影像学表现为单眼病变14例，多房病变2例。组织学表现为实型14例，单囊型2例。术后随访1 ~ 81个月，复发1例。结论：儿童成釉细胞瘤的复发率较低。单囊性成釉细胞瘤在这一人群中更为普遍。简单的手术刮除通常预后良好，复发最小。早期和准确识别疾病的临床、放射学和组织学特征是减少误诊的关键。

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引用次数: 0

The impact of fracture fragment displacement on sensory function recovery of the inferior alveolar nerve in mandibular angle fractures 骨折碎片移位对下颌角骨折下牙槽神经感觉功能恢复的影响。

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

Journal of Stomatology Oral and Maxillofacial Surgery

Pub Date : 2025-12-18 DOI: 10.1016/j.jormas.2025.102684

Zhihui Huang

Objective

To investigate the correlation between the initial, three-dimensionally quantified displacement of mandibular angle fractures and the prognosis of inferior alveolar nerve (IAN) sensory function recovery following open reduction and internal fixation (ORIF).

Methods

This retrospective cohort study included patients with unilateral mandibular angle fractures treated with ORIF between March 2022 and August 2025. Preoperative cone-beam computed tomography (CBCT) was used to measure the maximum 3-dimensional (3D) displacement of the fracture fragments. Patients were stratified into three groups based on displacement: mild (<2 mm), moderate (2–5 mm), and severe (>5 mm). IAN sensory function was systematically evaluated through objective tests (light touch, two-point discrimination, and pinprick) and subjective tests (Visual Analog Scale) at preoperative, 1 week, 1 month, 3 months, 6 months, and 12 months follow-ups. Multivariate logistic regression was used to identify independent predictors for complete sensory recovery.

Results

A total of 128 patients were included: 45 in the mild, 52 in the moderate, and 31 in the severe displacement groups. The incidence of preoperative IAN sensory deficit was significantly higher in the severe group (67.7%) compared to the moderate (34.6%) and mild (11.1%) groups (p < 0.001). At the 12-month follow-up, the complete recovery rates were 91.1%, 63.5%, and 22.6% for the mild, moderate, and severe groups, respectively (P < 0.001). Multivariable logistic regression identified severe displacement (OR = 0.09, 95% CI: 0.03–0.29), moderate displacement (OR = 0.28, 95% CI: 0.11–0.71), and age>40 years (OR = 0.41, 95% CI: 0.18–0.93) as independent negative predictors for complete sensory recovery.

Conclusion

The initial 3D displacement of mandibular angle fractures is a significant predictor of IAN injury severity and postoperative sensory recovery. Preoperative quantitative assessment using CBCT may aid in personalized prognosis, patient counseling, and surgical planning.

目的：探讨下颌角骨折初始、三维量化位移与切开复位内固定（ORIF）后下牙槽神经（IAN）感觉功能恢复预后的相关性。方法：本回顾性队列研究纳入了2022年3月至2025年8月间接受ORIF治疗的单侧下颌角骨折患者。术前使用锥形束计算机断层扫描（CBCT）测量骨折碎片的最大三维（3D）位移。根据移位程度将患者分为三组：轻度（5毫米）。在术前、1周、1个月、3个月、6个月和12个月随访时，通过客观测试（轻触、两点辨别和针刺）和主观测试（视觉模拟量表）系统评估IAN感觉功能。多变量逻辑回归用于识别完全感觉恢复的独立预测因子。结果：共纳入128例患者：轻度移位组45例，中度移位组52例，重度移位组31例。术前IAN感觉缺陷发生率在重度组（67.7%）明显高于中度组（34.6%）和轻度组（11.1%）(p40年（OR = 0.41,95% CI: 0.18-0.93）作为感觉完全恢复的独立负向预测因子。结论：下颌角骨折的初始三维位移是预测IAN损伤严重程度和术后感觉恢复的重要指标。术前使用CBCT定量评估可能有助于个性化预后、患者咨询和手术计划。

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引用次数: 0

Success rate of dental implants in HIV patients: an overview of systematic reviews HIV患者种植牙的成功率：系统综述。

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

Journal of Stomatology Oral and Maxillofacial Surgery

Pub Date : 2025-12-18 DOI: 10.1016/j.jormas.2025.102685

Ana Waleska Pessôa Barros de AGUIAR , Pedro Henrique da Hora SALES , Marco MELETI , Alessandra Albuquerque Tavares CARVALHO , Paolo VESCOV , Jair Carneiro LEÃO

Aims: To identify whether individuals with positive serology for HIV have a higher risk of losing the dental implant for this treatment. Methods and results: This study was conducted according to PRISMA guidelines and registered in the international prospective registry of systematic reviews, PROSPERO. The databases consulted were MEDLINE via PubMed, Scopus, DARE Cochrane, LILACS, Base, and Google Scholar. The search descriptors: “HIV,” “dental implants” and “AIDS” were used. To assess methodological quality, the AMSTAR 2 tool was used, and the entire process was reviewed in pairs, in addition, a third evaluator was consulted in case of disagreement. Four systematic reviews were included, encompassing 1239 implants in 450 patients with positive serology for HIV. Success rate of the dental implants was 94.72%, with a standard deviation of 0.455%. Three were classified as critically low-quality and one as moderate-quality. Conclusion: Similar implant survival rates were observed in HIV-negative patients. Therefore, the disease itself does not appear to have a significant influence on osseointegration. New controlled studies with low bias and high methodological quality are needed to ensure rehabilitation with dental implants with greater predictability and safety for HIV individuals.

目的：确定艾滋病毒血清学阳性的个体是否有更高的风险失去种植体进行这种治疗。方法和结果：本研究按照PRISMA指南进行，并在国际前瞻性系统评价注册中心PROSPERO注册。参考的数据库包括MEDLINE、PubMed、Scopus、DARE Cochrane、LILACS、Base和谷歌Scholar。搜索描述符是：“HIV”、“植牙”和“艾滋病”。为了评估方法的质量，使用了AMSTAR 2工具，对整个过程进行了成对的审查，此外，如果有分歧，还咨询了第三个评估者。纳入了四项系统评价，包括450例HIV血清学阳性患者的1,239例植入物。种植体成功率为94.72%，标准差为0.455%。其中三个被归类为极低质量，一个被归类为中等质量。结论：hiv阴性患者种植体存活率相近。因此，疾病本身似乎对骨整合没有显著影响。需要新的低偏倚和高方法学质量的对照研究，以确保对艾滋病毒个体具有更大的可预测性和安全性的牙种植体康复。

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引用次数: 0

Design and application of Tai Chi modification of the contralateral submental flap 太极改良对侧颏下皮瓣的设计与应用。

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

Journal of Stomatology Oral and Maxillofacial Surgery

Pub Date : 2025-12-18 DOI: 10.1016/j.jormas.2025.102690

Lin Wang , Dongpo Li , Fengzhi Liu , Haijun Zhao , Xiurong Chen , Shuangyi Wang

Background

Tai Chi flap began as a novel design for a radial forearm flap. There have been no reports of submental island Tai Chi flap. This study aims to investigate the feasibility of the Tai Chi modification of the submental flap in the repair of tongue cancer-related defects.

Methods

This project was designed as a retrospective cohort study. Clinical data of patients who underwent contralateral Tai Chi modification of the submental flap repair after tongue cancer resection at our institution from April 2024 to April 2025 were retrospectively analyzed.

Results

The cohort consisted of 4 patients (3 males and 1 female). No significant postoperative flap necrosis was seen, with only 1 case of tip bruising. In terms of tension in the donor area, the patients self-reported no significant tension in the neck, and no incision cracking was seen after suture removal on the 7th postoperative day. The patient's tongue function recovered well after surgery.

Conclusions

The submental island Tai Chi modification of the submental flap reconstructs tongue cancer defects with good postoperative functional recovery. And with low neck tension, the neck suture can be removed earlier.

背景：太极拳皮瓣最初是前臂桡骨皮瓣的一种新颖设计。目前还没有关于岛下太极瓣的报道。本研究旨在探讨太极修饰颏下皮瓣修复舌癌相关缺损的可行性。方法：本研究采用回顾性队列研究。回顾性分析我院2024年4月至2025年4月舌癌切除术后行对侧太极改良颏下皮瓣修复术患者的临床资料。结果：该队列包括4例患者（男3例，女1例）。术后皮瓣未见明显坏死，仅有1例鼻尖挫伤。供区张力方面，患者自述颈部无明显张力，术后第7天拆线后未见切口开裂。手术后病人的舌头功能恢复得很好。结论：颏下岛式太极改良颏下皮瓣重建舌癌缺损，术后功能恢复良好。且颈部张力低，可较早拆除颈部缝线。

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引用次数: 0

Advancing AI-driven clinical anamnesis: Insights from a comparative evaluation of large language models in oral and maxillofacial diagnosis 推进人工智能驱动的临床记忆：来自口腔颌面部诊断中大型语言模型比较评估的见解。

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

Journal of Stomatology Oral and Maxillofacial Surgery

Pub Date : 2025-12-18 DOI: 10.1016/j.jormas.2025.102682

Weihao Cheng

引用次数: 0