Journal of Stomatology Oral and Maxillofacial Surgery最新文献_第7页

An in vitro evaluation of photothermal effect of gold nanoparticles on oral squamous cell carcinoma 金纳米颗粒对口腔鳞状细胞癌光热作用的体外评价。

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

Journal of Stomatology Oral and Maxillofacial Surgery

Pub Date : 2025-11-16 DOI: 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.

目的：口腔鳞状细胞癌（Oral squamous cell carcinoma， OSCC）是发生在头颈部的主要癌症类型，生存率较低。金纳米颗粒（GNPs）由于其光热特性，有望成为一种替代癌症治疗方法。本研究研究了GNPs对口腔癌细胞的体外影响，通过分析激光照射和不照射时Caspase-8、细胞色素C和C- myc的表达水平，重点研究了GNPs对口腔癌细胞的光热影响。方法：研究分为四组：对照组，不进行治疗；治疗组，多柔比星（DOX）、GNSCs和GNSCs激光照射。通过荧光染色检测细胞死亡方式，ELISA检测细胞色素c和Caspase-8表达，PCR检测C-Myc癌基因表达。结果：研究发现，与单独GNSCs相比，激光照射GNSCs可显著增加口腔癌细胞的凋亡。DOX处理通过提高细胞色素C和Caspase-8的表达来降低细胞活力和增加凋亡。虽然GNSCs单独使用无显著影响，但GNSCs与激光照射联合使用可提高Caspase-8水平。DOX和GNSCs均能抑制C-Myc的表达，其中DOX更有效。结论：GNSCs光热疗法联合激光治疗通过增强Caspase-8活性和降低C- myc表达诱导细胞凋亡，有望替代化疗和放疗，尽管在促进细胞色素C释放和抑制C- myc方面不如DOX有效。

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引用次数: 0

Multivector gracilis muscle transfer for smile reanimation in long-standing facial paralysis: Simultaneous upper and lower lip construction 多向量股薄肌移植治疗长期面瘫患者恢复微笑：同时构建上下唇。

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

Journal of Stomatology Oral and Maxillofacial Surgery

Pub Date : 2025-11-16 DOI: 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.

背景：传统的股薄肌移植面部修复术能有效地恢复口腔连接偏移，但往往不能纠正下唇不对称，导致全牙微笑受损和口腔周围功能障碍。本研究评估了一种多矢量股薄肌转移术，旨在同时使上下嘴唇恢复活力。方法：我们回顾性分析了29例长期单侧面瘫患者，这些患者在2020年至2024年间接受了多矢量股薄肌转移。股薄肌被剪裁成一个分叉的结构，卡瓦固定在口腔连合处、上唇和下唇。使用Emotrics软件对客观结果进行量化。采用Terzis和Noah评分法评估微笑对称性和肌肉功能。采用面部临床评估（FaCE）量表评估患者报告的生活质量。结果：平均随访时间为1.76±0.95年。所有患者在休息时以及闭嘴和张开嘴微笑时均表现出明显的口腔周围对称性改善。患侧与未患侧牙面不对称明显减少。Terzis和Noah平均评分从1.07 ± 0.26提高到3.83 ± 0.60，FaCE总分从41.7 （IQR 34.6-48.8）提高到61.7 （IQR 57.5-70.4）。结论：这种多矢量叉状股薄肌设计可以一次修复上下唇，改善动态微笑修复的功能和美学效果。

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引用次数: 0

Delineating the regulatory axis of miR-20a, STAT3, and IL-6 in oral squamous cell carcinoma 描述miR-20a、STAT3和IL-6在口腔鳞状细胞癌中的调控轴

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

Journal of Stomatology Oral and Maxillofacial Surgery

Pub Date : 2025-11-14 DOI: 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.

目的：研究miR-20a及其基础水平在OSCC组织中STAT3/IL-6通路中的调节作用，并评估miR-20a和STAT3的伴随作用，特别是miR-20a对STAT3在OSCC进展中的抑制作用。材料与方法：63例OSCC患者的活检标本。使用TRIzol进行RNA分离，生成cDNA进行实时定量PCR，分析配对OSCC和邻近非癌组织中miR-20a、STAT3和IL-6的水平。western blot检测正常和癌组织中STAT3和IL-6蛋白的表达。数据转移到Microsoft Excel中，使用GraphPad Prism进行统计分析，包括t检验和方差分析（p < 0.05）。探讨miR-20a、STAT3和IL-6表达与肿瘤分级和组织学分期的临床病理相关性。结果：在OSCC组织中，STAT3和IL-6 mRNA及蛋白的表达明显高于相应的非肿瘤组织，miR-20a mRNA的表达明显低于相应的非肿瘤组织。分析发现，OSCC组织样本中miR-20a、STAT3、IL-6的表达水平差异有统计学意义（p < 0.0001）。两者呈反比关系：随着肿瘤分级和临床分期的增加，miR-20a水平降低，STAT3和IL-6的表达也发生变化。结论：本研究显示OSCC组织样本中STAT3和IL-6显著上调，miR-20a显著下调，提示miR-20a可能具有抑瘤作用。临床意义：miR-20a表达与STAT3、IL-6水平呈负相关，随肿瘤进展而下降，在STAT3/IL-6通路调控中起关键作用。观察到的miR-20a的特征表明其在OSCC诊断和靶向治疗中的潜在应用。miR-20a与STAT3之间的拮抗作用强调了基于mir -20的替代和免疫治疗在个性化治疗策略中的价值。此外，miR-20a、STAT3和IL-6的表达谱可能作为早期诊断和治疗干预的潜在指标。

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引用次数: 0

Non-surgical management of Ameloblastoma: A proof of concept study exploring the immunohistochemical expression of immune checkpoint Programmed Death Ligand- 1 in Ameloblastoma 成釉细胞瘤的非手术治疗：一项探讨免疫检查点程序性死亡配体- 1在成釉细胞瘤中免疫组织化学表达的概念验证研究。

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

Journal of Stomatology Oral and Maxillofacial Surgery

Pub Date : 2025-11-14 DOI: 10.1016/j.jormas.2025.102656

Revathi Krishna , Aadithya B. Urs , Jeyaseelan Augustine , Priya Kumar

Objectives

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.

目的：成釉细胞瘤（AM）是最常见的牙源性肿瘤。非手术和保守治疗方法越来越受欢迎，传统的治疗方法包括宽边缘的节段性颌骨切除术。本研究旨在评估AM与正常牙滤泡（DF）中免疫检查点程序性死亡配体-1 （PDL-1）的免疫组织化学表达。方法：用PDL-1抗体对回顾性检索的组织块进行AM （n=25）和DF （n=12）的免疫组化染色。计算PDL-1总阳性评分（TPS）、染色强度评分和H评分。经统计学比较，p值≤0.05被认为是显著的。结果：在TPS评分方面，我们观察到AM中PDL-1的表达（80%）比DF（58.4%）有统计学意义上的增加(结论：本研究强调了AM中免疫检查点改变的证据，AM是一种良性但侵袭性的牙源性肿瘤。初步结果鼓励在牙源性肿瘤免疫治疗领域进行更多的研究。

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引用次数: 0

Rood & Shehab’s radiographic features associated with inferior alveolar nerve paraesthesia: A pooled analysis of 15,000 cases Rood & Shehab的放射学特征与下肺泡神经感觉异常相关：一项15000例病例的汇总分析。

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

Journal of Stomatology Oral and Maxillofacial Surgery

Pub Date : 2025-11-12 DOI: 10.1016/j.jormas.2025.102648

Jonas Hue

引用次数: 0

Cranial base and midfacial morphology in pfeiffer syndrome: A 3D quantitative analysis Pfeiffer综合征的颅底和面中形态：三维定量分析。

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

Journal of Stomatology Oral and Maxillofacial Surgery

Pub Date : 2025-11-11 DOI: 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.

Pfeiffer综合征以颅缝闭合、面中部发育不全和严重眼球突出为特征，手术治疗复杂，复发风险高。尽管最近外科技术和多学科治疗取得了进展，但颅面形态和生长模式的证据仍然有限。本研究旨在全面分析Pfeiffer综合征患者的颅底和面中形态及生长模式。材料和方法：回顾性分析2015年11月1日至2023年12月31日期间12例Pfeiffer综合征患者和10例年龄匹配的对照者的CT扫描。使用高质量的三维形态测量分析，测量各种颅底和中脸标志。数据分析采用Mann-Whitney U检验比较偏差。结果：该研究揭示了显著的颅面畸形的普伊弗综合征，特别是在第一年的生活。颅中窝缩短，有颅底后凸倾向。涉及体和翼状板的蝶骨畸形在正前方、矢状面和横向上生长受限。上颌骨、颧骨和钢板长度缩短。眶底和颧骨的后缩比中脸的其他部位多。讨论：蝶骨的发育异常对面部中部的整体形态和功能有巨大的影响。上颌-颧-眶复合畸形的特点是局部发育不全，而不是发育不全。早期和精确的手术干预和改进的手术方法对改善预后至关重要。

{"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}

引用次数: 0

Dynamic finite element analysis of stress distribution in edentulous fixed restorations: Effects of different implant configurations and framework materials 无牙固定修复体应力分布的动态有限元分析：不同种植体结构和框架材料的影响。

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

Journal of Stomatology Oral and Maxillofacial Surgery

Pub Date : 2025-11-10 DOI: 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.

目的：不同种植体结构和框架材料在无牙颌固定修复中的生物力学效应尚未明确量化。此外，在功能动加载条件下的应力分布特征需要进一步明确。本研究采用动态有限元分析（FEA）评估种植体结构和框架材料对下颌固定修复体应力分布的影响。材料与方法：重建无牙下颌骨和骨架三维模型。建立了三种种植体构型（All-on-4、All-on-6、All-on-6短种植体）。这些构型与钛、氧化锆、聚醚醚酮（PEEK）和碳纤维增强聚醚醚酮（CFR-PEEK）四种框架材料组合，组成12个实验组。采用动态加载周期（0.875 s），在600 N双侧后牙（每牙100 N）载荷下，分阶段进行垂直和斜向加载。对比分析了骨组织、种植体和框架的von Mises应力（VMS）分布以及框架在不同加载阶段的变形。结果：在动态载荷下，记录到的最小应力分布为：皮质骨All-on-6+Zirconia，松质骨All-on-6-short+Zirconia，种植体All-on-6-short+CFR-PEEK，框架All-on-6+PEEK。All-on-6+氧化锆的骨架变形最小。结论：在动态载荷下，与四种植体设计相比，六种植体配置显著降低了骨、种植体和框架的VMS。与All-on-6相比，All-on-6-short在斜荷载作用下更容易出现应力集中。All-on-4框架的应力和变形主要集中在后悬臂区，而All-on-6和All-on-6-short则利用多支结构将应力分布在前侧。此外，倾斜载荷显著增加了系统应力。氧化锆降低骨应力和抑制框架变形，而PEEK减轻框架和种植体的内应力。

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引用次数: 0

Clinical outcomes of minimally invasive bone grafting integrated with concentrated growth factor for periodontitis 微创植骨联合浓缩生长因子治疗牙周炎的临床效果。

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

Journal of Stomatology Oral and Maxillofacial Surgery

Pub Date : 2025-11-10 DOI: 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.

目的：牙周炎是一种以牙周组织进行性破坏为特征的常见慢性炎症性疾病，牙槽骨缺损对临床治疗提出了重大挑战。本研究旨在探讨微创植骨联合浓缩生长因子治疗牙周炎的临床疗效。方法：将78例牙周炎合并骨缺损患者随机分为对照组（采用引导组织再生联合植骨治疗）和试验组（采用引导组织再生联合微创植骨+ CGF治疗）。比较术前、术后1天、3天、7天的术后疼痛、术后7天的黏膜愈合情况、探探深度（PD）、临床附着水平（CAL）、牙龈退缩深度（GRD）、出血指数（BI）、牙龈指数（GI）、牙槽骨缺损深度（术后6个月），通过锥形束计算机断层扫描（CBCT）检测术后3、6个月种植体新骨厚度和密度的变化。并比较两组植入术成功率及术后并发症。结果：实验组3、7 d疼痛评分较低（P < 0.05），黏膜愈合较好（P < 0.05）， 6个月牙周指标PD、CAL、GRD、BI、GI较好（P < 0.05）。CBCT显示实验组骨厚/骨密度高于对照组（P < 0.05）。试验组并发症发生率较对照组低（P < 0.05），两组植入成功率差异无统计学意义（P < 0.05）。结论：微创植骨联合GTR + CGF可改善牙周炎合并骨缺损患者的牙周状况，获得良好的骨再生效果，减少术后并发症。

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引用次数: 0

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 大型语言模型能进行临床记忆吗？chatgpt - 40、Claude和Gemini在口腔颌面疾病病例提问诊断推理中的比较评价。

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

Journal of Stomatology Oral and Maxillofacial Surgery

Pub Date : 2025-11-08 DOI: 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.

前言：本研究旨在评估大型语言模型（LLMs）是否可以模拟口腔颌面外科医生的临床记忆过程和诊断推理。材料与方法：模拟上颌窦疾病、根尖周围病变、口面疼痛和神经性疼痛综合征、牙源性囊肿和肿瘤、颞下颌关节疾病5个诊断类别25例真实临床病例。三位法学硕士（ChatGPT 40， Claude 4和Gemini 2.5）每人只提供患者的主诉，并指示他们问多达10个连续的问题以得出诊断。一位独立评估师以100分制对模型的表现进行评分，每增加一个问题就扣除10分。采用Kruskal-Wallis和Bonferroni事后检验进行统计比较。结果：各模型间差异无统计学意义（p = 0.431）。Gemini的平均诊断评分最高（43.6±40.71），其次是chatgpt - 40（37.2±36.8）和Claude（31.6±33.0）。中困难病例诊断准确率最高（p = 0.021），困难病例诊断准确率显著降低（p = 0.016）。结论：大型语言模型显示了使用有限信息进行结构化记忆和得出有临床意义的诊断结论的能力。虽然在模型之间没有观察到显著差异，但双子座获得了最高的总体平均分。这些发现表明llm具有作为诊断推理的补充工具和作为口腔颌面外科模拟教育资源的潜力。

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引用次数: 0

Effect of multidisciplinary ERAS-based nursing model on postoperative recovery in patients undergoing radical resection for oral cancer 多学科erass护理模式对口腔癌根治术后康复的影响。

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

Journal of Stomatology Oral and Maxillofacial Surgery

Pub Date : 2025-11-07 DOI: 10.1016/j.jormas.2025.102643

Xin Lin , Yi Wang , Yue Deng , Yan Mao , Yu Pu , Ying Chen

Objective

To evaluate the efficacy of multidisciplinary enhanced recovery after surgery (ERAS)-based nursing model in patients undergoing radical oral cancer resection and its impact on postoperative recovery.

Methods

A total of 288 patients undergoing radical oral cancer resection during December 2023-August 2025 were randomized to ERAS (n = 144) or control group (n = 144). Outcome measures included time to first feeding, length of hospital stay (LOS), complications, pain (Visual Analog Scale, VAS), inflammatory cytokines [interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α)], and quality of life (QoL) [36-Item Short Form Health Survey (SF-36), Functional Assessment of Cancer Therapy-General (FACT-G), Satisfaction With Life Scale (SWLS)]. Subgroup analyses were based on age, tumor stage, and preoperative nutrition.

Results

At day 7, RAS significantly reduced time to first feeding (17.93 ± 1.13 h vs. 26.56 ± 1.23 h) and LOS (8.35 ± 0.62 d vs. 12.18 ± 0.55 d; P < 0.001). ERAS also lowered VAS scores, IL-6, and TNF-α, while elevated SF-36, FACT-G, and SWLS scores (P < 0.001). Complications decreased in the ERAS group for infection (0.7 % vs. 27.8 %) and dysphagia (20.1 % vs. 67.4 %; P < 0.001). The ERAS group showed superior QoL trajectories and reduced adverse outcome risks (RR < 1, 95 % CI excluding 1). Subgroups with greatest benefit included age ≥ 60 years, malnutrition, and early-stage disease (interaction P < 0.05).

Conclusion

Multidisciplinary ERAS-based nursing accelerates recovery, reduces complications, and improves QoL post oral cancer surgery, with enhanced efficacy in elderly, malnourished, and early-stage patients.

目的：评价以ERAS为基础的多学科强化术后恢复护理模式在口腔癌根治性手术中的疗效及对术后恢复的影响。方法：将2023年12月~ 2025年8月行根治性口腔癌切除术的288例患者随机分为ERAS组（n = 144）和对照组（n = 144）。结果测量包括首次进食时间、住院时间（LOS）、并发症、疼痛（视觉模拟量表，VAS）、炎症因子[白细胞介素-6 （IL-6）、肿瘤坏死因子-α (TNF-α)]和生活质量（QoL）[36项简短健康调查（SF-36）、肿瘤治疗功能评估（FACT-G）、生活满意度量表（SWLS）]。亚组分析基于年龄、肿瘤分期和术前营养状况。结果：在第7天，RAS显著缩短了首次饲喂时间（17.93±1.13 h比26.56±1.23 h）和LOS（8.35±0.62 d比12.18±0.55 d, P < 0.001）。ERAS还降低了VAS评分、IL-6和TNF-α，同时升高了SF-36、FACT-G和SWLS评分（P < 0.001）。ERAS组感染（0.7% vs. 27.8%）和吞咽困难（20.1% vs. 67.4%; P < 0.001）并发症减少。ERAS组表现出更好的生活质量轨迹和更低的不良结局风险（RR < 1, 95% CI（排除1））。获益最大的亚组包括年龄≥60岁、营养不良和早期疾病（相互作用P < 0.05）。结论：多学科erass护理促进口腔癌术后康复，减少并发症，改善生活质量，对老年、营养不良、早期患者疗效显著。

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