Pub Date : 2025-11-19DOI: 10.1016/j.jormas.2025.102662
Solène Chanteux , Cyril Debortoli , Frédérique Bally-Genet , Barbara Lerhe , Charles Savoldelli
Background
Clear aligners are increasingly integrated into orthognathic surgery workflows. However, the lack of rigid intraoperative anchorage limits their use to mild or moderate cases, as aligners alone cannot ensure stable intermaxillary fixation.
Objective
To describe a simplified, reproducible, and cost-effective technique using a customized cobalt–chromium surgical archwire that enables stable intermaxillary fixation in patients treated with clear aligners.
Technical note
A 47-year-old woman with skeletal Class III malocclusion underwent bimaxillary orthognathic surgery under aligner treatment. A CAD-designed cobalt–chromium archwire with interdental posts was bonded using a conventional three-step adhesive protocol. The procedure required approximately 25 min and allowed precise intraoperative traction without detachment or deformation. The optional use of a silicone positioning key improved bonding accuracy and reproducibility.
Conclusion
This technique provides rigid and evenly distributed anchorage without removing aligner attachments or adding brackets or screws. By enabling stable intra- and postoperative fixation, it removes a key limitation of aligner-based surgical planning. This expands the applicability of clear aligners to more complex orthognathic cases, such as segmental osteotomies or asymmetrical corrections, and improves the integration of aligners into modern surgical workflows.
{"title":"Simplifying intermaxillary fixation in orthognathic surgery using customized surgical archwire with clear aligners: a technical note and exemplifying case","authors":"Solène Chanteux , Cyril Debortoli , Frédérique Bally-Genet , Barbara Lerhe , Charles Savoldelli","doi":"10.1016/j.jormas.2025.102662","DOIUrl":"10.1016/j.jormas.2025.102662","url":null,"abstract":"<div><h3>Background</h3><div>Clear aligners are increasingly integrated into orthognathic surgery workflows. However, the lack of rigid intraoperative anchorage limits their use to mild or moderate cases, as aligners alone cannot ensure stable intermaxillary fixation.</div></div><div><h3>Objective</h3><div>To describe a simplified, reproducible, and cost-effective technique using a customized cobalt–chromium surgical archwire that enables stable intermaxillary fixation in patients treated with clear aligners.</div></div><div><h3>Technical note</h3><div>A 47-year-old woman with skeletal Class III malocclusion underwent bimaxillary orthognathic surgery under aligner treatment. A CAD-designed cobalt–chromium archwire with interdental posts was bonded using a conventional three-step adhesive protocol. The procedure required approximately 25 min and allowed precise intraoperative traction without detachment or deformation. The optional use of a silicone positioning key improved bonding accuracy and reproducibility.</div></div><div><h3>Conclusion</h3><div>This technique provides rigid and evenly distributed anchorage without removing aligner attachments or adding brackets or screws. By enabling stable intra- and postoperative fixation, it removes a key limitation of aligner-based surgical planning. This expands the applicability of clear aligners to more complex orthognathic cases, such as segmental osteotomies or asymmetrical corrections, and improves the integration of aligners into modern surgical workflows.</div></div>","PeriodicalId":55993,"journal":{"name":"Journal of Stomatology Oral and Maxillofacial Surgery","volume":"127 2","pages":"Article 102662"},"PeriodicalIF":2.0,"publicationDate":"2025-11-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145566300","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 : 2025-11-16DOI: 10.1016/j.jormas.2025.102659
Sara Mohamed Ali , Mohamed Hossam Eldin Elmallahy , Amira Mohamed Gamal Eldeen , Seham Ahmed Abdel Ghani
Objectives
Oral squamous cell carcinoma (OSCC) is the leading type of cancer found in the head and neck area with a low survival rate. Gold nanoparticles (GNPs) show promise as an alternative cancer treatment due to their photothermal properties. The study investigated the in vitro effects of GNPs on oral cancer cells, focusing on their photothermal impact by analyzing the expression levels of Caspase-8, Cytochrome C, and C-Myc, both with and without laser application.
Methods
The study included four groups: a control group with no treatment, and three treatment groups, doxorubicin (DOX), GNSCs, and GNSCs with laser exposure. Key parameters were measured, including the mode of cell death via fluorescence staining, Cytochrome-C and Caspase-8 expression using ELISA, and C-Myc oncogene expression through PCR.
Results
The study found that GNSCs with laser exposure significantly increased apoptosis in oral cancer cells compared to GNSCs alone. DOX treatment reduced cell viability and increased apoptosis by elevating Cytochrome C and Caspase-8 expression. While GNSCs alone had no significant effect, combining GNSCs with laser exposure enhanced Caspase-8 levels. Both DOX and GNSCs with laser suppressed C-Myc expression, with DOX being more effective.
Conclusion
Photothermal therapy using GNSCs combined with laser treatment shows promise as an alternative to chemotherapy and radiotherapy by inducing apoptosis through enhanced Caspase-8 activity and reduced C-Myc expression, although it is less effective than DOX in promoting Cytochrome C release and suppressing C-Myc.
{"title":"An in vitro evaluation of photothermal effect of gold nanoparticles on oral squamous cell carcinoma","authors":"Sara Mohamed Ali , Mohamed Hossam Eldin Elmallahy , Amira Mohamed Gamal Eldeen , Seham Ahmed Abdel Ghani","doi":"10.1016/j.jormas.2025.102659","DOIUrl":"10.1016/j.jormas.2025.102659","url":null,"abstract":"<div><h3>Objectives</h3><div>Oral squamous cell carcinoma (OSCC) is the leading type of cancer found in the head and neck area with a low survival rate. Gold nanoparticles (GNPs) show promise as an alternative cancer treatment due to their photothermal properties. The study investigated the in vitro effects of GNPs on oral cancer cells, focusing on their photothermal impact by analyzing the expression levels of Caspase-8, Cytochrome C, and C-Myc, both with and without laser application.</div></div><div><h3>Methods</h3><div>The study included four groups: a control group with no treatment, and three treatment groups, doxorubicin (DOX), GNSCs, and GNSCs with laser exposure. Key parameters were measured, including the mode of cell death via fluorescence staining, Cytochrome-C and Caspase-8 expression using ELISA, and C-Myc oncogene expression through PCR.</div></div><div><h3>Results</h3><div>The study found that GNSCs with laser exposure significantly increased apoptosis in oral cancer cells compared to GNSCs alone. DOX treatment reduced cell viability and increased apoptosis by elevating Cytochrome C and Caspase-8 expression. While GNSCs alone had no significant effect, combining GNSCs with laser exposure enhanced Caspase-8 levels. Both DOX and GNSCs with laser suppressed C-Myc expression, with DOX being more effective.</div></div><div><h3>Conclusion</h3><div>Photothermal therapy using GNSCs combined with laser treatment shows promise as an alternative to chemotherapy and radiotherapy by inducing apoptosis through enhanced Caspase-8 activity and reduced C-Myc expression, although it is less effective than DOX in promoting Cytochrome C release and suppressing C-Myc.</div></div>","PeriodicalId":55993,"journal":{"name":"Journal of Stomatology Oral and Maxillofacial Surgery","volume":"127 2","pages":"Article 102659"},"PeriodicalIF":2.0,"publicationDate":"2025-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145551873","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 : 2025-11-16DOI: 10.1016/j.jormas.2025.102658
Pingping Liu, Ning Ma, Yong Tang, Sen Chen, Yilong Guo, Zhe Yang, Yangqun Li
Background
Traditional facial reanimation with gracilis muscle transfer effectively restores oral commissure excursion but often fails to correct lower lip asymmetry, resulting in compromised full-dental smiles and perioral dysfunction. This study evaluated a multivector gracilis transfer designed to simultaneously reanimate both the upper and lower lips.
Methods
We retrospectively analyzed 29 patients with long-standing unilateral facial paralysis who underwent multivector gracilis free muscle transfer between 2020 and 2024. The gracilis was tailored into a forked configuration, with slips anchored to the oral commissure, upper lip, and lower lip. Objective outcomes were quantified using Emotrics software. Smile symmetry and muscle function were evaluated with the Terzis and Noah grading scale. Patient-reported quality of life was assessed using the Facial Clinimetric Evaluation (FaCE) scale.
Results
The mean follow-up was 1.76 ± 0.95 years. All patients demonstrated significant improvements in perioral symmetry at rest and during both closed- and open-mouth smiling. The dental show asymmetry between affected and unaffected sides was significantly reduced. The mean Terzis and Noah score increased from 1.07 ± 0.26 to 3.83 ± 0.60, and overall FaCE scores improved from 41.7 (IQR 34.6–48.8) to 61.7 (IQR 57.5–70.4). Complications included one hematoma and three flap bulkiness
Conclusion
This multivector forked gracilis design enables one-stage reanimation of both the upper and lower lips, improving functional and aesthetic outcomes in dynamic smile restoration.
{"title":"Multivector gracilis muscle transfer for smile reanimation in long-standing facial paralysis: Simultaneous upper and lower lip construction","authors":"Pingping Liu, Ning Ma, Yong Tang, Sen Chen, Yilong Guo, Zhe Yang, Yangqun Li","doi":"10.1016/j.jormas.2025.102658","DOIUrl":"10.1016/j.jormas.2025.102658","url":null,"abstract":"<div><h3>Background</h3><div>Traditional facial reanimation with gracilis muscle transfer effectively restores oral commissure excursion but often fails to correct lower lip asymmetry, resulting in compromised full-dental smiles and perioral dysfunction. This study evaluated a multivector gracilis transfer designed to simultaneously reanimate both the upper and lower lips.</div></div><div><h3>Methods</h3><div>We retrospectively analyzed 29 patients with long-standing unilateral facial paralysis who underwent multivector gracilis free muscle transfer between 2020 and 2024. The gracilis was tailored into a forked configuration, with slips anchored to the oral commissure, upper lip, and lower lip. Objective outcomes were quantified using Emotrics software. Smile symmetry and muscle function were evaluated with the Terzis and Noah grading scale. Patient-reported quality of life was assessed using the Facial Clinimetric Evaluation (FaCE) scale.</div></div><div><h3>Results</h3><div>The mean follow-up was 1.76 ± 0.95 years. All patients demonstrated significant improvements in perioral symmetry at rest and during both closed- and open-mouth smiling. The dental show asymmetry between affected and unaffected sides was significantly reduced. The mean Terzis and Noah score increased from 1.07 ± 0.26 to 3.83 ± 0.60, and overall FaCE scores improved from 41.7 (IQR 34.6–48.8) to 61.7 (IQR 57.5–70.4). Complications included one hematoma and three flap bulkiness</div></div><div><h3>Conclusion</h3><div>This multivector forked gracilis design enables one-stage reanimation of both the upper and lower lips, improving functional and aesthetic outcomes in dynamic smile restoration.</div></div>","PeriodicalId":55993,"journal":{"name":"Journal of Stomatology Oral and Maxillofacial Surgery","volume":"127 2","pages":"Article 102658"},"PeriodicalIF":2.0,"publicationDate":"2025-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145551883","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 : 2025-11-14DOI: 10.1016/j.jormas.2025.102646
Priya Thomas , Abilasha Ramasubramanian , Durairaj Sekar
Aim
To investigate the regulatory role of miR-20a and its basal levels in the STAT3/IL-6 pathway in OSCC tissues, and assessing the concomitant role of miR-20a and STAT3, particularly the miR-20a’s inhibitory role on STAT3 in OSCC progression.
Materials & methods
Biopsied specimens were obtained from 63 OSCC individuals. RNA isolation was performed using TRIzol, and cDNA was generated for quantitative real-time PCR to analyze miR-20a, STAT3, and IL-6 levels across paired OSCC and adjacent noncancerous tissues. The protein expression of STAT3 and IL-6 were evaluated using western blot in both normal and OSCC samples. Data were transferred to Microsoft Excel, and statistical analyses, including t-tests and ANOVA (p < 0.05), were conducted using GraphPad Prism. Clinicopathological correlation between miR-20a, STAT3, and IL-6 expression with tumor grade and histological staging were also explored.
Results
In OSCC tissues, STAT3 and IL-6 mRNA and protein expressions were significantly higher, while miR-20a mRNA expression was significantly lower compared to corresponding nontumorous tissue. Analysis revealed that OSCC tissue samples exhibited marked difference in the levels of miR-20a, STAT3, and IL-6 expression, with very high statistical significance (p < 0.0001). An inverse relationship was noted: as miR-20a levels decreased with increasing tumor grade and clinical stage, STAT3 and IL-6 expressions varied.
Conclusion
This study shows significant upregulation of STAT3 and IL-6 and downregulation of miR-20a in OSCC tissues samples suggesting miR-20a’s potential as a tumor suppressor.
Clinical significance
miR-20a expression inversely correlates with STAT3 and IL-6 levels, declining with tumor progression and playing a key part in regulating the STAT3/IL-6 pathway. The observed characteristics of miR-20a indicate its potential application in OSCC diagnostics and targeted therapeutics. The antagonism between miR-20a and STAT3 emphasizes the value of miR-20a-based replacement and immunotherapy in personalized treatment strategies. Additionally, the expression profiles of miR-20a, STAT3, and IL-6 may function as potential indicators for early diagnosis and therapeutic intervention.
{"title":"Delineating the regulatory axis of miR-20a, STAT3, and IL-6 in oral squamous cell carcinoma","authors":"Priya Thomas , Abilasha Ramasubramanian , Durairaj Sekar","doi":"10.1016/j.jormas.2025.102646","DOIUrl":"10.1016/j.jormas.2025.102646","url":null,"abstract":"<div><h3>Aim</h3><div>To investigate the regulatory role of miR-20a and its basal levels in the STAT3/IL-6 pathway in OSCC tissues, and assessing the concomitant role of miR-20a and STAT3, particularly the miR-20a’s inhibitory role on STAT3 in OSCC progression.</div></div><div><h3>Materials & methods</h3><div>Biopsied specimens were obtained from 63 OSCC individuals. RNA isolation was performed using TRIzol, and cDNA was generated for quantitative real-time PCR to analyze miR-20a, STAT3, and IL-6 levels across paired OSCC and adjacent noncancerous tissues. The protein expression of STAT3 and IL-6 were evaluated using western blot in both normal and OSCC samples. Data were transferred to Microsoft Excel, and statistical analyses, including <em>t</em>-tests and ANOVA (<em>p</em> < 0.05), were conducted using GraphPad Prism. Clinicopathological correlation between miR-20a, STAT3, and IL-6 expression with tumor grade and histological staging were also explored.</div></div><div><h3>Results</h3><div>In OSCC tissues, STAT3 and IL-6 mRNA and protein expressions were significantly higher, while miR-20a mRNA expression was significantly lower compared to corresponding nontumorous tissue. Analysis revealed that OSCC tissue samples exhibited marked difference in the levels of miR-20a, STAT3, and IL-6 expression, with very high statistical significance (<em>p</em> < 0.0001). An inverse relationship was noted: as miR-20a levels decreased with increasing tumor grade and clinical stage, STAT3 and IL-6 expressions varied.</div></div><div><h3>Conclusion</h3><div>This study shows significant upregulation of STAT3 and IL-6 and downregulation of miR-20a in OSCC tissues samples suggesting miR-20a’s potential as a tumor suppressor.</div></div><div><h3>Clinical significance</h3><div>miR-20a expression inversely correlates with STAT3 and IL-6 levels, declining with tumor progression and playing a key part in regulating the STAT3/IL-6 pathway. The observed characteristics of miR-20a indicate its potential application in OSCC diagnostics and targeted therapeutics. The antagonism between miR-20a and STAT3 emphasizes the value of miR-20a-based replacement and immunotherapy in personalized treatment strategies. Additionally, the expression profiles of miR-20a, STAT3, and IL-6 may function as potential indicators for early diagnosis and therapeutic intervention.</div></div>","PeriodicalId":55993,"journal":{"name":"Journal of Stomatology Oral and Maxillofacial Surgery","volume":"127 2","pages":"Article 102646"},"PeriodicalIF":2.0,"publicationDate":"2025-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145534988","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}
Ameloblastoma (AM) is the most common odontogenic tumour. Non-surgical and conservative treatment approaches are rising in popularity which traditionally involve segmental jaw resection with wide margins. The current study aims to assess the immunohistochemical expression of immune checkpoint Programmed death ligand – 1 (PDL-1) in AM when compared to normal dental follicle (DF).
Methods
Immunohistochemical staining of AM (n = 25) and DF (n = 12) using PDL-1 antibody was performed on tissue blocks retrieved retrospectively from the archives. The PDL-1 Total Positive Score (TPS), staining intensity score and H score were calculated. These were statistically compared and p value ≤ 0.05 was considered significant.
Results
We observed statistically significant increase in the expression of PDL-1 in AM (80 %) when compared to DF (58.4 %) in terms of TPS score (p < 0.001), H score (p = 0.022) and staining intensity (p < 0.001). PDL-1 positivity was seen in both peripheral and central odontogenic epithelial tumour cells with increased staining in the stellate reticulum like areas.
Conclusions
This study highlights the evidence of immune checkpoint alteration in AM which is a benign but aggressive odontogenic neoplasm. The preliminary results encourage more research in the terrain of immunotherapy for odontogenic neoplasms.
{"title":"Non-surgical management of Ameloblastoma: A proof of concept study exploring the immunohistochemical expression of immune checkpoint Programmed Death Ligand- 1 in Ameloblastoma","authors":"Revathi Krishna , Aadithya B. Urs , Jeyaseelan Augustine , Priya Kumar","doi":"10.1016/j.jormas.2025.102656","DOIUrl":"10.1016/j.jormas.2025.102656","url":null,"abstract":"<div><h3>Objectives</h3><div>Ameloblastoma (AM) is the most common odontogenic tumour. Non-surgical and conservative treatment approaches are rising in popularity which traditionally involve segmental jaw resection with wide margins. The current study aims to assess the immunohistochemical expression of immune checkpoint Programmed death ligand – 1 (PDL-1) in AM when compared to normal dental follicle (DF).</div></div><div><h3>Methods</h3><div>Immunohistochemical staining of AM (<em>n</em> = 25) and DF (<em>n</em> = 12) using PDL-1 antibody was performed on tissue blocks retrieved retrospectively from the archives. The PDL-1 Total Positive Score (TPS), staining intensity score and H score were calculated. These were statistically compared and p value ≤ 0.05 was considered significant.</div></div><div><h3>Results</h3><div>We observed statistically significant increase in the expression of PDL-1 in AM (80 %) when compared to DF (58.4 %) in terms of TPS score (<em>p</em> < 0.001), H score (<em>p</em> = 0.022) and staining intensity (<em>p</em> < 0.001). PDL-1 positivity was seen in both peripheral and central odontogenic epithelial tumour cells with increased staining in the stellate reticulum like areas.</div></div><div><h3>Conclusions</h3><div>This study highlights the evidence of immune checkpoint alteration in AM which is a benign but aggressive odontogenic neoplasm. The preliminary results encourage more research in the terrain of immunotherapy for odontogenic neoplasms.</div></div>","PeriodicalId":55993,"journal":{"name":"Journal of Stomatology Oral and Maxillofacial Surgery","volume":"127 2","pages":"Article 102656"},"PeriodicalIF":2.0,"publicationDate":"2025-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145535011","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 : 2025-11-12DOI: 10.1016/j.jormas.2025.102648
Jonas Hue
{"title":"Rood & Shehab’s radiographic features associated with inferior alveolar nerve paraesthesia: A pooled analysis of 15,000 cases","authors":"Jonas Hue","doi":"10.1016/j.jormas.2025.102648","DOIUrl":"10.1016/j.jormas.2025.102648","url":null,"abstract":"","PeriodicalId":55993,"journal":{"name":"Journal of Stomatology Oral and Maxillofacial Surgery","volume":"127 2","pages":"Article 102648"},"PeriodicalIF":2.0,"publicationDate":"2025-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145524931","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 : 2025-11-11DOI: 10.1016/j.jormas.2025.102649
Lantian Zheng , Norli Anida Abdullah , Norlisah Mohd Ramli , Firdaus Hariri
Introduction
Pfeiffer syndrome is characterized by craniosynostosis, midfacial hypoplasia, and severe ocular proptosis, with complex surgical management and a high risk of relapse. Despite recent advances in surgical techniques and multidisciplinary care, evidence on the craniofacial morphology and growth patterns remains limited. This study aims to provide a comprehensive analysis of cranial base and midfacial morphology and growth pattern in patients with Pfeiffer syndrome.
Material and methods
Twelve CT scans from patients with Pfeiffer syndrome and ten age-matched controls were retrospectively accessed for research purposes between 01/11/2015 and 31/12/ 2023. Using high-quality 3D morphometric analyses, various cranial base and midface landmarks were measured. The data were analyzed using Mann-Whitney U test to compare the deviations.
Results
The study revealed significant craniofacial deformities in Pfeiffer syndrome, particularly within the first year of life. There was a shortening in the middle cranial fossa and a tendency towards cranial base kyphosis. The deformity of sphenoid bone involved in body and pterygoid plates exhibited restricted growth in anteroposterior, sagittal, and transverse directions. The lengths of the maxilla, zygoma and plate were shortened. There was more retrusion in the orbital floor and zygoma compared to the rest of the midface.
Discussion
The developmental abnormalities of the sphenoid bone have a massive impact on the overall midfacial morphology and function. The maxilla-zygomatic-orbit complex deformities are characterized by localized underdevelopment rather than uniform growth deficiency. Early and precise surgical interventions and improved surgical methods are crucial for better prognosis.
{"title":"Cranial base and midfacial morphology in pfeiffer syndrome: A 3D quantitative analysis","authors":"Lantian Zheng , Norli Anida Abdullah , Norlisah Mohd Ramli , Firdaus Hariri","doi":"10.1016/j.jormas.2025.102649","DOIUrl":"10.1016/j.jormas.2025.102649","url":null,"abstract":"<div><h3>Introduction</h3><div>Pfeiffer syndrome is characterized by craniosynostosis, midfacial hypoplasia, and severe ocular proptosis, with complex surgical management and a high risk of relapse. Despite recent advances in surgical techniques and multidisciplinary care, evidence on the craniofacial morphology and growth patterns remains limited. This study aims to provide a comprehensive analysis of cranial base and midfacial morphology and growth pattern in patients with Pfeiffer syndrome.</div></div><div><h3>Material and methods</h3><div>Twelve CT scans from patients with Pfeiffer syndrome and ten age-matched controls were retrospectively accessed for research purposes between 01/11/2015 and 31/12/ 2023. Using high-quality 3D morphometric analyses, various cranial base and midface landmarks were measured. The data were analyzed using Mann-Whitney U test to compare the deviations.</div></div><div><h3>Results</h3><div>The study revealed significant craniofacial deformities in Pfeiffer syndrome, particularly within the first year of life. There was a shortening in the middle cranial fossa and a tendency towards cranial base kyphosis. The deformity of sphenoid bone involved in body and pterygoid plates exhibited restricted growth in anteroposterior, sagittal, and transverse directions. The lengths of the maxilla, zygoma and plate were shortened. There was more retrusion in the orbital floor and zygoma compared to the rest of the midface.</div></div><div><h3>Discussion</h3><div>The developmental abnormalities of the sphenoid bone have a massive impact on the overall midfacial morphology and function. The maxilla-zygomatic-orbit complex deformities are characterized by localized underdevelopment rather than uniform growth deficiency. Early and precise surgical interventions and improved surgical methods are crucial for better prognosis.</div></div>","PeriodicalId":55993,"journal":{"name":"Journal of Stomatology Oral and Maxillofacial Surgery","volume":"127 1","pages":"Article 102649"},"PeriodicalIF":2.0,"publicationDate":"2025-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145514979","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 : 2025-11-10DOI: 10.1016/j.jormas.2025.102647
Yue Lan , Baohui Su
Aim
The biomechanical effects of different implant configurations and framework materials in fixed restorations for edentulous jaws have not been clearly quantified. Furthermore, the characteristics of stress distribution under functional dynamic loading conditions require further clarification. This study utilized dynamic finite element analysis (FEA) to evaluate the effects of implant configurations and framework materials on stress distribution in mandibular fixed restorations.
Material and methods
Three-dimensional models of edentulous mandibles and frameworks were reconstructed. And three implant configurations (All-on-4, All-on-6, and All-on-6 with short implants) were established. These configurations were combined with four framework materials: titanium, zirconia, polyetheretherketone (PEEK), and carbon fiber-reinforced polyetheretherketone (CFR-PEEK) to form 12 experimental groups. A dynamic loading cycle (0.875 s) was applied, consisting of staged vertical and oblique loads under 600 N bilateral posterior loading (100 N per tooth). Comparative analyses were conducted on the Von Mises stress (VMS) distribution in bone tissue, implants, and frameworks, as well as the deformation of frameworks across different loading stages.
Results
Under dynamic loading, the minimum stress distributions were recorded as follows: All-on-6+Zirconia for cortical bone, All-on-6-short+Zirconia for cancellous bone, All-on-6-short+CFR-PEEK for implants, and All-on-6+PEEK for frameworks. The minimum framework deformation was observed in All-on-6+Zirconia.
Conclusions
Under dynamic loading, the six-implant configurations significantly reduced VMS in bone, implants, and frameworks compared to the four-implant design. Compared to All-on-6, All-on-6-short was more prone to stress concentration under oblique loading. Stress and deformation in the All-on-4 framework primarily concentrated in the posterior cantilever area, Whereas All-on-6 and All-on-6-short utilized multisupport structure to distribute stress anteriorly. Furthermore, oblique loading significantly increased system stress. Zirconia reduced bone stress and suppressed framework deformation, while PEEK alleviated internal stress within frameworks and implants.
{"title":"Dynamic finite element analysis of stress distribution in edentulous fixed restorations: Effects of different implant configurations and framework materials","authors":"Yue Lan , Baohui Su","doi":"10.1016/j.jormas.2025.102647","DOIUrl":"10.1016/j.jormas.2025.102647","url":null,"abstract":"<div><h3>Aim</h3><div>The biomechanical effects of different implant configurations and framework materials in fixed restorations for edentulous jaws have not been clearly quantified. Furthermore, the characteristics of stress distribution under functional dynamic loading conditions require further clarification. This study utilized dynamic finite element analysis (FEA) to evaluate the effects of implant configurations and framework materials on stress distribution in mandibular fixed restorations.</div></div><div><h3>Material and methods</h3><div>Three-dimensional models of edentulous mandibles and frameworks were reconstructed. And three implant configurations (All-on-4, All-on-6, and All-on-6 with short implants) were established. These configurations were combined with four framework materials: titanium, zirconia, polyetheretherketone (PEEK), and carbon fiber-reinforced polyetheretherketone (CFR-PEEK) to form 12 experimental groups. A dynamic loading cycle (0.875 s) was applied, consisting of staged vertical and oblique loads under 600 N bilateral posterior loading (100 N per tooth). Comparative analyses were conducted on the Von Mises stress (VMS) distribution in bone tissue, implants, and frameworks, as well as the deformation of frameworks across different loading stages.</div></div><div><h3>Results</h3><div>Under dynamic loading, the minimum stress distributions were recorded as follows: All-on-6+Zirconia for cortical bone, All-on-6-short+Zirconia for cancellous bone, All-on-6-short+CFR-PEEK for implants, and All-on-6+PEEK for frameworks. The minimum framework deformation was observed in All-on-6+Zirconia.</div></div><div><h3>Conclusions</h3><div>Under dynamic loading, the six-implant configurations significantly reduced VMS in bone, implants, and frameworks compared to the four-implant design. Compared to All-on-6, All-on-6-short was more prone to stress concentration under oblique loading. Stress and deformation in the All-on-4 framework primarily concentrated in the posterior cantilever area, Whereas All-on-6 and All-on-6-short utilized multisupport structure to distribute stress anteriorly. Furthermore, oblique loading significantly increased system stress. Zirconia reduced bone stress and suppressed framework deformation, while PEEK alleviated internal stress within frameworks and implants.</div></div>","PeriodicalId":55993,"journal":{"name":"Journal of Stomatology Oral and Maxillofacial Surgery","volume":"127 1","pages":"Article 102647"},"PeriodicalIF":2.0,"publicationDate":"2025-11-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145508176","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 : 2025-11-10DOI: 10.1016/j.jormas.2025.102645
Yi Gan , Xudong Su , Rong Yuan
Objective
Periodontitis is a prevalent chronic inflammatory disease characterized by progressive destruction of periodontal tissues, with alveolar bone defects posing significant challenges for clinical treatment. This research aimed to ascertain the clinical efficacy of minimally invasive bone grafting combined with concentrated growth factor (CGF) for treating periodontitis.
Methods
Seventy-eight patients with periodontitis and bone defects were randomized into the control group (received guided tissue regeneration (GTR) combined with bone grafting treatment) and the test group (received GTR combined with minimally invasive bone grafting and CGF treatment). Postoperative pain at 1 day, 3 days, and 7 days postoperatively, mucosal healing at 7 days postoperatively, probing depth (PD), clinical attachment level (CAL), gingival recession depth (GRD), bleeding index (BI), gingival index (GI), and the alveolar bone defect depth preoperatively and at 6 months postoperatively were compared, changes in implant new bone thickness and density at 3 and 6 months postoperatively were tested by cone-beam computed tomography (CBCT), and implantation success rate and postoperative complications were compared.
Results
The test group exhibited lower pain scores at 3 and 7 days (P < 0.05), improved mucosal healing (P < 0.05), and superior periodontal indicators (PD, CAL, GRD, BI, GI) at 6 months (P < 0.05). CBCT revealed greater bone thickness/density in the test group (P < 0.05). Complication rates were lower in the test group (P < 0.05), with no significant difference in implantation success (P > 0.05).
Conclusion
Minimally invasive bone grafting combined GTR with CGF improves periodontal conditions in patients with periodontitis complicated by bone defects, achieves good bone regeneration results, and reduces postoperative complications.
{"title":"Clinical outcomes of minimally invasive bone grafting integrated with concentrated growth factor for periodontitis","authors":"Yi Gan , Xudong Su , Rong Yuan","doi":"10.1016/j.jormas.2025.102645","DOIUrl":"10.1016/j.jormas.2025.102645","url":null,"abstract":"<div><h3>Objective</h3><div>Periodontitis is a prevalent chronic inflammatory disease characterized by progressive destruction of periodontal tissues, with alveolar bone defects posing significant challenges for clinical treatment. This research aimed to ascertain the clinical efficacy of minimally invasive bone grafting combined with concentrated growth factor (CGF) for treating periodontitis.</div></div><div><h3>Methods</h3><div>Seventy-eight patients with periodontitis and bone defects were randomized into the control group (received guided tissue regeneration (GTR) combined with bone grafting treatment) and the test group (received GTR combined with minimally invasive bone grafting and CGF treatment). Postoperative pain at 1 day, 3 days, and 7 days postoperatively, mucosal healing at 7 days postoperatively, probing depth (PD), clinical attachment level (CAL), gingival recession depth (GRD), bleeding index (BI), gingival index (GI), and the alveolar bone defect depth preoperatively and at 6 months postoperatively were compared, changes in implant new bone thickness and density at 3 and 6 months postoperatively were tested by cone-beam computed tomography (CBCT), and implantation success rate and postoperative complications were compared.</div></div><div><h3>Results</h3><div>The test group exhibited lower pain scores at 3 and 7 days (<em>P</em> < 0.05), improved mucosal healing (<em>P</em> < 0.05), and superior periodontal indicators (PD, CAL, GRD, BI, GI) at 6 months (<em>P</em> < 0.05). CBCT revealed greater bone thickness/density in the test group (<em>P</em> < 0.05). Complication rates were lower in the test group (<em>P</em> < 0.05), with no significant difference in implantation success (<em>P</em> > 0.05).</div></div><div><h3>Conclusion</h3><div>Minimally invasive bone grafting combined GTR with CGF improves periodontal conditions in patients with periodontitis complicated by bone defects, achieves good bone regeneration results, and reduces postoperative complications.</div></div>","PeriodicalId":55993,"journal":{"name":"Journal of Stomatology Oral and Maxillofacial Surgery","volume":"127 3","pages":"Article 102645"},"PeriodicalIF":2.0,"publicationDate":"2025-11-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145508151","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 : 2025-11-08DOI: 10.1016/j.jormas.2025.102644
Birkan Eyup Yilmaz , Furkan Ozbey , Busra Nur Gokkurt Yilmaz , Hasan Akpinar
Introduction
This study aimed to evaluate whether large language models (LLMs) can emulate the clinical anamnesis process and diagnostic reasoning of oral and maxillofacial surgeons.
Materials and methods
Twenty-five real clinical cases from five diagnostic categories maxillary sinus diseases, periapical pathologies, orofacial pain disorders and neuropathic pain syndromes, odontogenic cysts and tumors, and temporomandibular joint disorders were simulated. Three LLMs (ChatGPT 4o, Claude 4, and Gemini 2.5) were each provided only the patient’s chief complaint and instructed to ask up to ten sequential questions to reach a diagnosis. One independent evaluators scored model performances on a 100 point scale, deducting 10 points for each additional question asked. Statistical comparisons were conducted using Kruskal–Wallis and Bonferroni post-hoc tests.
Results
No statistically significant difference was found among the models (p = 0.431). Gemini achieved the highest mean diagnostic score (43.6 ± 40.71), followed by ChatGPT-4o (37.2 ± 36.8) and Claude (31.6 ± 33.0). Diagnostic accuracy was highest in moderately difficult cases (p = 0.021) and markedly decreased in difficult ones (p = 0.016).
Conclusion
LLMs demonstrated the ability to perform structured anamnesis and reach clinically meaningful diagnostic conclusions using limited information. Although no significant difference was observed among the models, Gemini achieved the highest overall mean score. These findings indicate that LLMs hold potential as complementary tools for diagnostic reasoning and as simulation-based educational resources in oral and maxillofacial surgery.
{"title":"Can large language models perform clinical anamnesis? Comparative evaluation of ChatGPT, Claude, and Gemini in diagnostic reasoning through case-based questioning in oral and maxillofacial disorders","authors":"Birkan Eyup Yilmaz , Furkan Ozbey , Busra Nur Gokkurt Yilmaz , Hasan Akpinar","doi":"10.1016/j.jormas.2025.102644","DOIUrl":"10.1016/j.jormas.2025.102644","url":null,"abstract":"<div><h3>Introduction</h3><div>This study aimed to evaluate whether large language models (LLMs) can emulate the clinical anamnesis process and diagnostic reasoning of oral and maxillofacial surgeons.</div></div><div><h3>Materials and methods</h3><div>Twenty-five real clinical cases from five diagnostic categories maxillary sinus diseases, periapical pathologies, orofacial pain disorders and neuropathic pain syndromes, odontogenic cysts and tumors, and temporomandibular joint disorders were simulated. Three LLMs (ChatGPT 4o, Claude 4, and Gemini 2.5) were each provided only the patient’s chief complaint and instructed to ask up to ten sequential questions to reach a diagnosis. One independent evaluators scored model performances on a 100 point scale, deducting 10 points for each additional question asked. Statistical comparisons were conducted using Kruskal–Wallis and Bonferroni post-hoc tests.</div></div><div><h3>Results</h3><div>No statistically significant difference was found among the models (<em>p</em> = 0.431). Gemini achieved the highest mean diagnostic score (43.6 ± 40.71), followed by ChatGPT-4o (37.2 ± 36.8) and Claude (31.6 ± 33.0). Diagnostic accuracy was highest in moderately difficult cases (<em>p</em> = 0.021) and markedly decreased in difficult ones (<em>p</em> = 0.016).</div></div><div><h3>Conclusion</h3><div>LLMs demonstrated the ability to perform structured anamnesis and reach clinically meaningful diagnostic conclusions using limited information. Although no significant difference was observed among the models, Gemini achieved the highest overall mean score. These findings indicate that LLMs hold potential as complementary tools for diagnostic reasoning and as simulation-based educational resources in oral and maxillofacial surgery.</div></div>","PeriodicalId":55993,"journal":{"name":"Journal of Stomatology Oral and Maxillofacial Surgery","volume":"127 2","pages":"Article 102644"},"PeriodicalIF":2.0,"publicationDate":"2025-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145490756","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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