Pub Date : 2026-06-01Epub Date: 2025-12-31DOI: 10.1016/j.jormas.2025.102702
Rodriguez-Saenz Alvaro , Diego Mauricio Rodriguez-Saenz , Juan Pablo López
Temporomandibular joint discopexy techniques performed by arthroscopy have undergone multiple modifications to reduce the learning curve. Multiple modifications have been made to the technique and instruments; however, discopexy remains challenging due to the difficulty in suture capture. The curved technique leaves the suture in a more comfortable position for capturing the suture with the forceps in a simple way, facilitating the procedure and reducing surgical times without the need for special equipment.
{"title":"Curved tip discopexy as a modification to enhance the suture grasping in TMJ arthroscopy","authors":"Rodriguez-Saenz Alvaro , Diego Mauricio Rodriguez-Saenz , Juan Pablo López","doi":"10.1016/j.jormas.2025.102702","DOIUrl":"10.1016/j.jormas.2025.102702","url":null,"abstract":"<div><div>Temporomandibular joint discopexy techniques performed by arthroscopy have undergone multiple modifications to reduce the learning curve. Multiple modifications have been made to the technique and instruments; however, discopexy remains challenging due to the difficulty in suture capture. The curved technique leaves the suture in a more comfortable position for capturing the suture with the forceps in a simple way, facilitating the procedure and reducing surgical times without the need for special equipment.</div></div>","PeriodicalId":55993,"journal":{"name":"Journal of Stomatology Oral and Maxillofacial Surgery","volume":"127 3","pages":"Article 102702"},"PeriodicalIF":2.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145893417","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The trigeminocardiac reflex is a clinically important autonomic response to trigeminal stimulation, particularly characterized by heart rate reduction; however, its behavior under local anesthesia is not well defined. This prospective clinical study investigated the impact of different local anesthesia techniques on the incidence and hemodynamic characteristics of the trigeminocardiac reflex (TCR) during mandibular nerve stimulation in awake patients.
Materials and Methods
Forty individuals undergoing surgical extraction of impacted mandibular teeth were enrolled. To minimize vasovagal influence, anxious patients were excluded. Group-1 received a Gow-Gates mandibular nerve block, whereas Group-2 received an inferior alveolar nerve block with supplementary buccal anesthesia. Heart rate (HR) and mean arterial blood pressure (MABP) were continuously monitored throughout local anesthesia administration and all surgical stages.
Results
TCR-compatible bradycardia occurred in 30% (12/40) of patients, most frequently during anesthetic injection and mucosal manipulation, including flap elevation, and suturing.A significantly higher incidence of the TCR was observed in Group 1.The maximum HR reduction recorded was 43.5%. The linear progression of stage-specific baseline MABP and HR values showed a significant decrease during curettage/irrigation and suturing.
Conclusion
These findings demonstrate that the TCR can occur during oral surgery performed under local anesthesia, typically at mild levels, and that the anesthesia technique influences its incidence. This study contributes to the current literature by evaluating the prophylactic potential of different local anesthesia techniques in oral surgery and by integrating anxiety assessment to enhance methodological robustness.
{"title":"Role of anesthetic techniques in trigeminocardiac reflex during oral surgery of the mandible under local anesthesia","authors":"Bedreddin Cavlı , Aykut Şaylığ , Şeyma Kale , Necmiye Şengel , Ziver Ergun Yücel","doi":"10.1016/j.jormas.2025.102704","DOIUrl":"10.1016/j.jormas.2025.102704","url":null,"abstract":"<div><h3>İntroduction</h3><div>The trigeminocardiac reflex is a clinically important autonomic response to trigeminal stimulation, particularly characterized by heart rate reduction; however, its behavior under local anesthesia is not well defined. This prospective clinical study investigated the impact of different local anesthesia techniques on the incidence and hemodynamic characteristics of the trigeminocardiac reflex (TCR) during mandibular nerve stimulation in awake patients.</div></div><div><h3>Materials and Methods</h3><div>Forty individuals undergoing surgical extraction of impacted mandibular teeth were enrolled. To minimize vasovagal influence, anxious patients were excluded. Group-1 received a Gow-Gates mandibular nerve block, whereas Group-2 received an inferior alveolar nerve block with supplementary buccal anesthesia. Heart rate (HR) and mean arterial blood pressure (MABP) were continuously monitored throughout local anesthesia administration and all surgical stages.</div></div><div><h3>Results</h3><div>TCR-compatible bradycardia occurred in 30% (12/40) of patients, most frequently during anesthetic injection and mucosal manipulation, including flap elevation, and suturing.A significantly higher incidence of the TCR was observed in Group 1.The maximum HR reduction recorded was 43.5%. The linear progression of stage-specific baseline MABP and HR values showed a significant decrease during curettage/irrigation and suturing.</div></div><div><h3>Conclusion</h3><div>These findings demonstrate that the TCR can occur during oral surgery performed under local anesthesia, typically at mild levels, and that the anesthesia technique influences its incidence. This study contributes to the current literature by evaluating the prophylactic potential of different local anesthesia techniques in oral surgery and by integrating anxiety assessment to enhance methodological robustness.</div></div>","PeriodicalId":55993,"journal":{"name":"Journal of Stomatology Oral and Maxillofacial Surgery","volume":"127 3","pages":"Article 102704"},"PeriodicalIF":2.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145893432","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-06-01Epub Date: 2026-01-15DOI: 10.1016/j.jormas.2026.102722
Anusree J, Easwaran Ramaswami, Sonali Kadam, Vijayalaxmi Nimma, Siddhi Rane
Background
Oral squamous cell carcinoma (OSCC) is an aggressive malignancy with high recurrence rates and limited survival benefits from conventional treatments. Immunotherapy has emerged as a promising therapeutic approach, but its role in OSCC remains to be clearly defined.
Objectives
To systematically review and synthesize available evidence on the use of immunotherapy in OSCC, focusing on treatment regimens, clinical outcomes, and adverse effects.
Methods
A systematic search of PubMed, MEDLINE, Web of Science, Cochrane Library, and Google Scholar was conducted for studies published between January 2000 and December 2024. Eligible studies were case reports or case series involving OSCC patients treated with immunotherapy. Data extraction and quality assessment were performed using Joanna Briggs Institute (JBI) critical appraisal tools.
Results
Seventeen studies comprising 20 individual OSCC cases were included. The most common tumor sites were the tongue (30%) and gingiva (30%), with 60% presenting at stage IV. Immunotherapy was used more often as adjuvant therapy (55%) than monotherapy (45%). Pembrolizumab (n = 7) and nivolumab (n = 5) were the most frequently administered agents. complete responses occurred in 50%, partial responses in 20% of cases and progressive disease in 15%. Adverse effects, reported in 75% of cases, ranged from mild dermatologic reactions to severe immune-mediated events.
Conclusions
Immunotherapy shows promising clinical activity in OSCC, particularly in combination with conventional treatments, but its optimal use requires further high-quality research.
背景：口腔鳞状细胞癌（OSCC）是一种侵袭性恶性肿瘤，复发率高，常规治疗的生存率有限。免疫疗法已成为一种很有前景的治疗方法，但其在OSCC中的作用仍有待明确界定。目的：系统地回顾和综合有关免疫治疗在OSCC中的应用的现有证据，重点关注治疗方案、临床结果和不良反应。方法：系统检索PubMed、MEDLINE、Web of Science、Cochrane Library和谷歌Scholar，检索2000年1月至2024年12月间发表的研究。符合条件的研究包括接受免疫治疗的OSCC患者的病例报告或病例系列。使用乔安娜布里格斯研究所（JBI）的关键评估工具进行数据提取和质量评估。结果：纳入17项研究，包括20例个体OSCC病例。最常见的肿瘤部位是舌头（30%）和牙龈（30%），其中60%出现在IV期。免疫治疗作为辅助治疗（55%）比单一治疗（45%）更常用。Pembrolizumab （n = 7）和nivolumab （n = 5）是最常用的药物。50%的病例出现完全缓解，20%的病例出现部分缓解，15%的病例出现疾病进展。75%的病例报告了不良反应，从轻微的皮肤反应到严重的免疫介导事件。结论：免疫治疗在OSCC中显示出良好的临床活性，特别是与常规治疗相结合，但其最佳使用需要进一步的高质量研究。
{"title":"Role of immunotherapy in the management of oral squamous cell carcinoma – A systematic review","authors":"Anusree J, Easwaran Ramaswami, Sonali Kadam, Vijayalaxmi Nimma, Siddhi Rane","doi":"10.1016/j.jormas.2026.102722","DOIUrl":"10.1016/j.jormas.2026.102722","url":null,"abstract":"<div><h3>Background</h3><div>Oral squamous cell carcinoma (OSCC) is an aggressive malignancy with high recurrence rates and limited survival benefits from conventional treatments. Immunotherapy has emerged as a promising therapeutic approach, but its role in OSCC remains to be clearly defined.</div></div><div><h3>Objectives</h3><div>To systematically review and synthesize available evidence on the use of immunotherapy in OSCC, focusing on treatment regimens, clinical outcomes, and adverse effects.</div></div><div><h3>Methods</h3><div>A systematic search of PubMed, MEDLINE, Web of Science, Cochrane Library, and Google Scholar was conducted for studies published between January 2000 and December 2024. Eligible studies were case reports or case series involving OSCC patients treated with immunotherapy. Data extraction and quality assessment were performed using Joanna Briggs Institute (JBI) critical appraisal tools.</div></div><div><h3>Results</h3><div>Seventeen studies comprising 20 individual OSCC cases were included. The most common tumor sites were the tongue (30%) and gingiva (30%), with 60% presenting at stage IV. Immunotherapy was used more often as adjuvant therapy (55%) than monotherapy (45%). Pembrolizumab (<em>n</em> = 7) and nivolumab (<em>n</em> = 5) were the most frequently administered agents. complete responses occurred in 50%, partial responses in 20% of cases and progressive disease in 15%. Adverse effects, reported in 75% of cases, ranged from mild dermatologic reactions to severe immune-mediated events.</div></div><div><h3>Conclusions</h3><div>Immunotherapy shows promising clinical activity in OSCC, particularly in combination with conventional treatments, but its optimal use requires further high-quality research.</div></div>","PeriodicalId":55993,"journal":{"name":"Journal of Stomatology Oral and Maxillofacial Surgery","volume":"127 3","pages":"Article 102722"},"PeriodicalIF":2.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145994604","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-06-01Epub Date: 2025-12-11DOI: 10.1016/j.jormas.2025.102681
Janaina B. Medina , Wallena Albuquerque-da-Cunha , Andrés Blanco-Carrión , Maria Paula Siqueira de Melo Peres , Karem L. Ortega , Juliana Bertoldi Franco
Introduction
Liver cirrhosis significantly compromises patients’ physical and psychological health, leading to a marked reduction in quality of life (QoL). In addition to systemic complications oral health problems are prevalent and may exacerbate malnutrition, risk of infection, and overall clinical deterioration. Oral health–related quality of life (OHRQoL) is increasingly recognized as a relevant outcome in cirrhosis, yet it remains unclear whether acute dental needs, such as tooth extractions, further deteriorate patients’ perceived burden. Poor oral health can be particularly critical in patients awaiting liver transplantation, who often require urgent dental interventions due to infection foci, frequently resulting in multiple tooth extractions. Assessing the impact of oral health on quality of life in this population is essential to support comprehensive pre-transplant care.
Material & Methods
A cross-sectional study was conducted with 267 participants, divided into three groups: SG1 (cirrhosis with need for tooth extractions), SG2 (cirrhosis without need for tooth extractions), and CG (controls without cirrhosis). OHRQoL was assessed using the Oral Health Impact Profile (OHIP-14) questionnaire. The 14 items were analyzed according to seven predefined dimensions and a three-factor model. Exploratory factor analysis was performed, and the internal consistency of each factor was assessed using Cronbach’s alpha. Group comparisons were conducted using the Kruskal-Wallis test, followed by Mann-Whitney and Dwass-Steel-Critchlow-Fligner post hoc tests.
Results
Factor analysis confirmed the theoretical three-factor model (KMO = 0.888), with satisfactory internal consistency (Cronbach’s α > 0.70 for all factors). Cirrhotic patients showed significantly worse OHRQoL than controls across all OHIP-14 factors (p < 0.001), particularly in the psychological and physical dimensions. No significant differences were found between SG1 and SG2 in overall OHIP-14 scores, although SG1 presented worse scores in specific dimensions such as physical pain and social disability. The need for tooth extractions did not significantly affect overall OHRQoL, which remained moderate in both cirrhotic groups.
Discussion
Patients with liver cirrhosis awaiting liver transplantation experience a moderate negative impact of oral health on quality of life, predominantly in psychological and physical dimensions. Although the need for tooth extractions was associated with specific dimension scores, it did not significantly influence overall OHRQoL, suggesting that systemic disease burden plays a major role in patient perception.
{"title":"“Impact of the need for dental extractions on oral health-related quality of life in patients with cirrhosis: A cross-sectional study”","authors":"Janaina B. Medina , Wallena Albuquerque-da-Cunha , Andrés Blanco-Carrión , Maria Paula Siqueira de Melo Peres , Karem L. Ortega , Juliana Bertoldi Franco","doi":"10.1016/j.jormas.2025.102681","DOIUrl":"10.1016/j.jormas.2025.102681","url":null,"abstract":"<div><h3>Introduction</h3><div>Liver cirrhosis significantly compromises patients’ physical and psychological health, leading to a marked reduction in quality of life (QoL). In addition to systemic complications oral health problems are prevalent and may exacerbate malnutrition, risk of infection, and overall clinical deterioration<strong>.</strong> Oral health–related quality of life (OHRQoL) is increasingly recognized as a relevant outcome in cirrhosis, yet it remains unclear whether acute dental needs, such as tooth extractions, further deteriorate patients’ perceived burden. Poor oral health can be particularly critical in patients awaiting liver transplantation, who often require urgent dental interventions due to infection foci, frequently resulting in multiple tooth extractions. Assessing the impact of oral health on quality of life in this population is essential to support comprehensive pre-transplant care.</div></div><div><h3>Material & Methods</h3><div>A cross-sectional study was conducted with 267 participants, divided into three groups: SG1 (cirrhosis with need for tooth extractions), SG2 (cirrhosis without need for tooth extractions), and CG (controls without cirrhosis). OHRQoL was assessed using the Oral Health Impact Profile (OHIP-14) questionnaire. The 14 items were analyzed according to seven predefined dimensions and a three-factor model. Exploratory factor analysis was performed, and the internal consistency of each factor was assessed using Cronbach’s alpha. Group comparisons were conducted using the Kruskal-Wallis test, followed by Mann-Whitney and Dwass-Steel-Critchlow-Fligner post hoc tests.</div></div><div><h3>Results</h3><div>Factor analysis confirmed the theoretical three-factor model (KMO = 0.888), with satisfactory internal consistency (Cronbach’s α > 0.70 for all factors). Cirrhotic patients showed significantly worse OHRQoL than controls across all OHIP-14 factors (<em>p</em> < 0.001), particularly in the psychological and physical dimensions. No significant differences were found between SG1 and SG2 in overall OHIP-14 scores, although SG1 presented worse scores in specific dimensions such as physical pain and social disability. The need for tooth extractions did not significantly affect overall OHRQoL, which remained moderate in both cirrhotic groups.</div></div><div><h3>Discussion</h3><div>Patients with liver cirrhosis awaiting liver transplantation experience a moderate negative impact of oral health on quality of life, predominantly in psychological and physical dimensions. Although the need for tooth extractions was associated with specific dimension scores, it did not significantly influence overall OHRQoL, suggesting that systemic disease burden plays a major role in patient perception.</div></div>","PeriodicalId":55993,"journal":{"name":"Journal of Stomatology Oral and Maxillofacial Surgery","volume":"127 3","pages":"Article 102681"},"PeriodicalIF":2.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145751971","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-06-01Epub Date: 2025-12-26DOI: 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":"2026-06-01","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}
Pub Date : 2026-06-01Epub Date: 2025-12-26DOI: 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。
{"title":"Cold atmospheric plasma (CAP) shows strain-dependence against Candida albicans growth on titanium","authors":"Ntombizodwa P. Zwane , Isak J. van der Walt , Steve A.S. Olorunju , Euphemia Sekati , Adam Shnier , Deran Reddy","doi":"10.1016/j.jormas.2025.102698","DOIUrl":"10.1016/j.jormas.2025.102698","url":null,"abstract":"<div><h3>Objective</h3><div><strong>:</strong> This study assessed the effect of cold atmospheric plasma (CAP) using argon and oxygen on Candida albicans biofilm growth on titanium.</div></div><div><h3>Methods</h3><div><strong>:</strong> 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) (<em>n</em> = 8 for colony forming culture method, <em>n</em> = 8 for biofilm forming method) and resistant (ATCC 10,231) strain Positive Control (PC) (<em>n</em> = 8 for colony forming culture method, <em>n</em> = 8 for biofilm forming method) were tested. Negative Control (NC) was used, which involved plasma-untreated titanium plates (<em>n</em> = 2 for colony-forming culture method, <em>n</em> = 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.</div></div><div><h3>Results</h3><div><strong>:</strong> 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 (<em>p</em> = 0.011). Biofilm formation differed significantly between TG and PC (<em>p</em> = 0.014).</div></div><div><h3>Conclusion</h3><div><strong>:</strong> 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.</div></div>","PeriodicalId":55993,"journal":{"name":"Journal of Stomatology Oral and Maxillofacial Surgery","volume":"127 3","pages":"Article 102698"},"PeriodicalIF":2.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145851904","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-06-01Epub Date: 2025-11-24DOI: 10.1016/j.jormas.2025.102663
Thinzar Zaw , Shaohua Song , Aung Phyo Thu , Hsu Yin Min , Minsi Li , Zhong Wu , Xuanping Huang
This study aimed to evaluate maxillary bone and dento-alveolar changes in cleft lip and palate patients after total maxillary distraction osteogenesis (TMDO) and anterior maxillary segmental distraction osteogenesis (AMSDO).
The retrospective study included 18 cleft lip and palate patients who underwent either with TMDO or AMSDO. CBCT scans of individuals were obtained and measured at predistraction (T1), post distraction (T2). Linear and angular measurements of maxillary bone and dento-alveolar bone were performed using three-dimensional reconstruction images. For intragroup comparisons, a paired t-test or Wilcoxon signed-rank test was used. For intergroup comparisons, an independent t-test or Mann-Whitney U test was used, with the Bonferroni correction applied.
In sagittal plane, sella-nasion-point A angles (SNA) and overjet increased significantly after distraction osteogenesis in both groups, but greater value was found in TMDO group. Palatal length (ANS-PNS) was significantly increased more in AMSDO group compared to TMDO group. In the vertical plane, Nasion-ptm-point A angles (N-ptm-A) and overbite increased significantly in TMDO, but not in AMSDO. In the axial plane, there was a greater increase of posterior arch width and a decrease in anterior arch width in AMSDO but difference was not statistically significant.
TMDO is optimal for comprehensive profile correction, while AMSDO is ideal for increasing arch length. The distractor's angulation directly controls the magnitude of arch lengthening and vertical elongation.
{"title":"Maxillary bone and dento-alveolar changes in cleft lip and palate patients: Total maxillary distraction osteogenesis versus anterior maxillary segmental distraction osteogenesis","authors":"Thinzar Zaw , Shaohua Song , Aung Phyo Thu , Hsu Yin Min , Minsi Li , Zhong Wu , Xuanping Huang","doi":"10.1016/j.jormas.2025.102663","DOIUrl":"10.1016/j.jormas.2025.102663","url":null,"abstract":"<div><div>This study aimed to evaluate maxillary bone and dento-alveolar changes in cleft lip and palate patients after total maxillary distraction osteogenesis (TMDO) and anterior maxillary segmental distraction osteogenesis (AMSDO).</div><div>The retrospective study included 18 cleft lip and palate patients who underwent either with TMDO or AMSDO. CBCT scans of individuals were obtained and measured at predistraction (T1), post distraction (T2). Linear and angular measurements of maxillary bone and dento-alveolar bone were performed using three-dimensional reconstruction images. For intragroup comparisons, a paired <em>t</em>-test or Wilcoxon signed-rank test was used. For intergroup comparisons, an independent <em>t</em>-test or Mann-Whitney U test was used, with the Bonferroni correction applied.</div><div>In sagittal plane, sella-nasion-point A angles (SNA) and overjet increased significantly after distraction osteogenesis in both groups, but greater value was found in TMDO group. Palatal length (ANS-PNS) was significantly increased more in AMSDO group compared to TMDO group. In the vertical plane, Nasion-ptm-point A angles (N-ptm-A) and overbite increased significantly in TMDO, but not in AMSDO. In the axial plane, there was a greater increase of posterior arch width and a decrease in anterior arch width in AMSDO but difference was not statistically significant.</div><div>TMDO is optimal for comprehensive profile correction, while AMSDO is ideal for increasing arch length. The distractor's angulation directly controls the magnitude of arch lengthening and vertical elongation.</div></div>","PeriodicalId":55993,"journal":{"name":"Journal of Stomatology Oral and Maxillofacial Surgery","volume":"127 3","pages":"Article 102663"},"PeriodicalIF":2.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145643188","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-06-01Epub Date: 2025-12-30DOI: 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.
{"title":"Magnitude and predictors of psychological burden of care among informal caregivers of Noma survivors","authors":"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","doi":"10.1016/j.jormas.2025.102699","DOIUrl":"10.1016/j.jormas.2025.102699","url":null,"abstract":"<div><h3>Background</h3><div>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.</div></div><div><h3>Materials and methods</h3><div>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<strong>.</strong> Caregiver burden was assessed using the Zarit Burden Interview (ZBI)<strong>.</strong> 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 <em>p</em> < 0.05.</div></div><div><h3>Results</h3><div>The mean age of the caregivers was 38.0 years (SD ± 10.1)<strong>;</strong> most were female (84.8%)<strong>,</strong> married (87.0%)<strong>,</strong> 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 (<em>p</em> = 0.0170) and being a parent (<em>p</em> = 0.011) were associated with higher caregiver burden; female sex remained the only independent predictor of high caregiver burden <strong>(</strong><em>p</em> = 0.019)<strong>.</strong></div></div><div><h3>Conclusion</h3><div>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.</div></div>","PeriodicalId":55993,"journal":{"name":"Journal of Stomatology Oral and Maxillofacial Surgery","volume":"127 3","pages":"Article 102699"},"PeriodicalIF":2.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145890589","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-06-01Epub Date: 2026-01-14DOI: 10.1016/j.jormas.2026.102718
Stefania Troise , Federica Calabria , Raffaele Spinelli , Silvia De Masi , Sara Tramontano , Vincenzo Abbate , Paola Bonavolontà , Giovanni Salzano , Gianluca Renato De Fazio , Antonio Romano , Luigi Angelo Vaira , Giuseppe Consorti , Carlos Navarro Cuellar , Giovanni Dell'Aversana Orabona
Background
Orbital floor fractures are among the most frequent facial injuries, and precise reconstruction is essential to prevent both functional and aesthetic complications. Virtual Surgical Planning (VSP) combined with pre-shaped titanium mesh has transformed orbital reconstruction. This study aimed to evaluate whether VSP-assisted surgery with pre-modeled mesh provides greater accuracy and reduced operative times compared with conventional intraoperative mesh shaping.
Methods
A case–control study was performed on 52 patients treated at the “Federico II” University Hospital of Naples for large pure orbital floor fractures. Twenty-four patients (Group A) underwent VSP-assisted reconstruction using a preformed titanium mesh, while twenty-eight patients (Group B) received conventional intraoperative mesh modeling. Operative time, postoperative diplopia, infraorbital sensory disturbance, mesh malposition, screw loosening, and infection were compared in the two groups. Clinical and radiological follow-up was conducted at 12 months.
Results
Median operative time was significantly shorter in Group A compared with Group B (55 min [IQR 50–65] vs. 110 min [IQR 98–125]; p < 0.001). Persistent diplopia occurred in 4 % of patients in Group A and 28.6 % in Group B (p = 0.028). Implant malposition was observed exclusively in Group B (25 % vs. 0 %; p = 0.011). Other postoperative complications, including infraorbital nerve alterations, eyelid malposition, wound dehiscence, screw loss, and infection, were more frequent in Group B but did not reach statistical significance. No cases of postoperative ocular motility limitation or iatrogenic fracture were observed in either group.
Conclusions
VSP with pre-modeled titanium mesh significantly reduces operative time and postoperative complications, enhancing reconstructive precision and outcomes in orbital floor fracture management. This virtual protocol is useful for reducing the costs and waiting times of custom-made implants, manufactured by external companies.
背景：眶底骨折是最常见的面部损伤之一，精确的重建是防止功能和美学并发症的必要条件。虚拟手术计划（VSP）结合预成形钛网改造眼眶重建。本研究旨在评估与传统的术中补片成形相比，使用预建模补片的vsp辅助手术是否提供更高的准确性和更少的手术时间。方法：对那不勒斯“Federico II”大学医院收治的52例单纯眶底大骨折患者进行病例对照研究。24例患者（A组）采用预成型钛网进行vsp辅助重建，28例患者（B组）采用常规术中补片建模。比较两组手术时间、术后复视、眶下感觉障碍、补片错位、螺钉松动、感染情况。12个月后进行临床及影像学随访。结果：A组中位手术时间明显短于B组（55分钟[IQR 50-65] vs 110分钟[IQR 98-125]； p < 0.001）。A组持续复视发生率为4%，B组为28.6% （p = 0.028）。B组仅出现种植体错位（25% vs. 0%; p = 0.011）。B组术后其他并发症眶下神经改变、眼睑错位、创面裂开、螺钉脱落、感染发生率较高，但无统计学意义。两组均无术后眼动受限或医源性骨折发生。结论：预模钛网VSP可显著减少手术时间和术后并发症，提高眶底骨折重建精度和治疗效果。这种虚拟协议有助于减少由外部公司制造的定制植入物的成本和等待时间。
{"title":"Virtual surgical planning and 3D custom-made implants in the management of orbital floor fractures: A case control study","authors":"Stefania Troise , Federica Calabria , Raffaele Spinelli , Silvia De Masi , Sara Tramontano , Vincenzo Abbate , Paola Bonavolontà , Giovanni Salzano , Gianluca Renato De Fazio , Antonio Romano , Luigi Angelo Vaira , Giuseppe Consorti , Carlos Navarro Cuellar , Giovanni Dell'Aversana Orabona","doi":"10.1016/j.jormas.2026.102718","DOIUrl":"10.1016/j.jormas.2026.102718","url":null,"abstract":"<div><h3>Background</h3><div>Orbital floor fractures are among the most frequent facial injuries, and precise reconstruction is essential to prevent both functional and aesthetic complications. Virtual Surgical Planning (VSP) combined with pre-shaped titanium mesh has transformed orbital reconstruction. This study aimed to evaluate whether VSP-assisted surgery with pre-modeled mesh provides greater accuracy and reduced operative times compared with conventional intraoperative mesh shaping.</div></div><div><h3>Methods</h3><div>A case–control study was performed on 52 patients treated at the “Federico II” University Hospital of Naples for large pure orbital floor fractures. Twenty-four patients (Group A) underwent VSP-assisted reconstruction using a preformed titanium mesh, while twenty-eight patients (Group B) received conventional intraoperative mesh modeling. Operative time, postoperative diplopia, infraorbital sensory disturbance, mesh malposition, screw loosening, and infection were compared in the two groups. Clinical and radiological follow-up was conducted at 12 months.</div></div><div><h3>Results</h3><div>Median operative time was significantly shorter in Group A compared with Group B (55 min [IQR 50–65] vs. 110 min [IQR 98–125]; <em>p</em> < 0.001). Persistent diplopia occurred in 4 % of patients in Group A and 28.6 % in Group B (<em>p</em> = 0.028). Implant malposition was observed exclusively in Group B (25 % vs. 0 %; <em>p</em> = 0.011). Other postoperative complications, including infraorbital nerve alterations, eyelid malposition, wound dehiscence, screw loss, and infection, were more frequent in Group B but did not reach statistical significance. No cases of postoperative ocular motility limitation or iatrogenic fracture were observed in either group.</div></div><div><h3>Conclusions</h3><div>VSP with pre-modeled titanium mesh significantly reduces operative time and postoperative complications, enhancing reconstructive precision and outcomes in orbital floor fracture management. This virtual protocol is useful for reducing the costs and waiting times of custom-made implants, manufactured by external companies.</div></div>","PeriodicalId":55993,"journal":{"name":"Journal of Stomatology Oral and Maxillofacial Surgery","volume":"127 3","pages":"Article 102718"},"PeriodicalIF":2.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145992049","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-06-01Epub Date: 2025-12-05DOI: 10.1016/j.jormas.2025.102677
Jiarong Li , Yanchen Ji , Zhining Yang , Baihan Lin , Ying Zhang , Renxian Xie
Background
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.
Methods
A retrospective cohort of 195 NPC patients treated with VMAT (2018–2021) was analyzed. Patients were divided into Nasal irrigation (n = 84) and non-Nasal irrigation (n = 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.
Results
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 (p < 0.001). Multivariate analysis confirmed NI reduced RIRS risk (adjusted HR=0.26, p < 0.001), while allergic rhinitis increased risk (adjusted HR=6.56, p = 0.009). For maxillary sinusitis, NI remained protective (HR=0.29, p < 0.001), and higher V70 dose (≥70 Gy) correlated with elevated risk (HR=1.10, p = 0.007). Subgroup analyses demonstrated consistent benefits across sex, T/N stage, and treatment groups (all interaction p > 0.05).
Conclusion
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.
背景：鼻咽癌（NPC）常见于东南亚和中国南部，通常采用放疗（RT）治疗。体积调节弧线治疗（VMAT）改善肿瘤控制，但放射性鼻窦炎（RIRS）仍然是主要并发症。鼻冲洗显示出减轻粘膜损伤的潜力，但在vmat治疗的鼻咽癌患者中的证据有限。本研究评估鼻腔冲洗在降低该人群中RIRS发病率方面的疗效。方法：回顾性分析195例接受VMAT治疗的鼻咽癌患者（2018-2021）。患者分为鼻冲洗组（84例）和非鼻冲洗组（111例）。比较上颌窦的基线特征和剂量学参数（V20-V70、Dmean、Dmax）。Kaplan-Meier分析和Cox回归模型评估了鼻腔冲洗对RIRS风险的影响，并按性别、TNM分期和治疗方案进行了亚组分析。结果：Kaplan-Meier分析显示，未进行鼻冲洗组发生RIRS的概率明显高于NI组（p < 0.001）。多因素分析证实，NI降低了RIRS风险（调整HR=0.26, p < 0.001），而变应性鼻炎增加了RIRS风险（调整HR=6.56, p =0.009）。对于上颌鼻窦炎，NI仍然具有保护作用（HR=0.29, p < 0.001），较高的V70剂量（≥70 Gy）与风险升高相关（HR=1.10, p =0.007）。亚组分析显示，跨性别、T/N分期和治疗组均有一致的益处（所有相互作用p < 0.05）。结论：NI降低了vmat治疗的鼻咽癌患者放射性鼻窦炎的风险，与基线特征无关。变应性鼻炎和高剂量V70单独加重预后。这些发现支持NI作为一种简单、有效的辅助手段来改善放疗后的生活质量。
{"title":"Nasal irrigation reduces radiation-induced rhinosinusitis in nasopharyngeal carcinoma treated with volumetric modulated arc therapy","authors":"Jiarong Li , Yanchen Ji , Zhining Yang , Baihan Lin , Ying Zhang , 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> < 0.001). Multivariate analysis confirmed NI reduced RIRS risk (adjusted HR=0.26, <em>p</em> < 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> < 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> > 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":"2026-06-01","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}
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