Journal of Stomatology Oral and Maxillofacial Surgery最新文献

Two years after the first evaluation of ChatGPT (GPT-3.5) for medical scientific writing, this short communication reassesses its capabilities using the GPT-5 model. Under the same experimental protocol as in 2023, GPT-5 generated a coherent and factually accurate article, integrating verified references and a structured IMRaD format, with human oversight but without post-generation textual rewriting. The model demonstrated significant progress in factual reliability, reasoning, and technical architecture, reflecting the shift from static language prediction to retrieval-augmented reasoning. However, despite these advances, large language models remain dependent on human expertise for validation, ethical interpretation, and scientific judgment. The results highlight the potential of AI as a valuable assistant in medical writing, while reaffirming that authorship, responsibility, and critical analysis must remain human.

Background: Robotic neck dissection has emerged as a minimally invasive alternative to conventional open surgery, providing enhanced surgical precision, reduced morbidity, and improved cosmetic outcomes. Advances in technology and refinement of surgical techniques have broadened the applicability of robotic approaches in head and neck oncology. This study aims to describe a novel robotic approach for neck dissection and assess its technical feasibility, safety, and short-term perioperative outcomes.

Materials and methods: Patients with early-stage oral cavity squamous cell carcinoma who did not require neck access for flap reconstruction were selected for the procedure. A bilateral infraclavicular approach for robotic neck dissection (BIRD) was performed with the Intuitive da Vinci Xi Surgical System. Outcomes assessed included lymph node yield, as well as intraoperative and postoperative complications.

Results: Three patients underwent the BIRD procedure. All underwent selective neck dissection (levels I-IV) without a visible cervical scar. Lymph node yield ranged from 24 to 39, with a mean of 30. Intraoperative blood loss ranged from 150 to 225 ml (mean 183 ml). No major intraoperative complications, including vascular injury, chyle leak, conversion to open surgery, or re-exploration, were observed. Drain output was <25 ml per 24 hours by postoperative day 4 in all patients. Postoperative assessment revealed normal function of the spinal accessory, hypoglossal, and marginal mandibular nerves in all cases.

Conclusion: BIRD is a technically feasible approach for prophylactic neck dissection in early-stage oral cavity squamous cell carcinoma. It respects established oncologic principles in terms of lymph node yield, and is associated with acceptable short-term functional and cosmetic outcomes.

Background: Oral squamous cell carcinoma (OSCC) is the sixth most common type of cancer worldwide. Its diagnosis and treatment rely on pathological section analysis. However, the pathological diagnosis process is time-consuming, complicated, and may lead to errors due to human subjective factors. Therefore, the development of Automated and accurate auxiliary diagnostic tools based on deep learning are crucial.

Methods: This study proposed a novel deep learning model RRGNet, which was improved based on the RegNet architecture. By introducing the Ghost module and the residual channel attention module in the final stage of the model, and adopting strategies such as label smoothing, Mixup data augmentation, and SWALR learning rate adjustment, the feature extraction efficiency and computational cost were significantly optimized. The model was trained on a three-category dataset including OSCC and two types of vitiligo lesions, and the performance was compared with mainstream deep learning models such as GhostNet, HRNet, RegNet, ResNet50, and ViT .

Results: The experimental results show that the RRGNet model has an accuracy of 79.49% on the test set and an AUC value of more than 0.85, which is better than all the comparison models. At the same time, the number of parameters of RRGNet is significantly lower than that of other models, showing excellent computational efficiency and generalization ability. In addition, activation heat map analysis shows that the model can accurately focus on the lesion area and has strong clinical interpretability.

Conclusion: The RRGNet model performed well in the three-classification task of OSCC pathological images, providing pathologists with an efficient and reliable auxiliary diagnostic tool. This study provides technical support for the early detection and precise treatment of OSCC. In the future, the universality of the model will be further verified on multi-center data, and a practical application system will be developed to promote clinical translation.

Autoimmune and autoinflammatory diseases, though traditionally considered distinct, share overlapping pathogenic mechanisms that complicate diagnosis and management, particularly in joint involvement. Psoriasis-especially when associated with inflammatory joint manifestations-and familial Mediterranean fever (FMF) exemplify this overlap. Temporomandibular joint (TMJ) involvement is well recognized in connective tissue diseases; however, its presentation in such overlapping clinical states remains underreported and poorly understood. To the best of our knowledge, we present the first documented case of TMJ fibrous ankylosis in a patient with coexisting psoriasis and FMF. A 40-year-old female developed right TMJ fibrous ankylosis, confirmed by clinical examination and imaging. Despite multiple arthrocentesis procedures and conservative treatments, she experienced progressive limitation in mouth opening, ultimately requiring open joint surgery and arthroplasty. This rare case underscores the importance of considering TMJ involvement in patients with systemic inflammatory diseases and highlights the diagnostic and therapeutic challenges encountered when autoimmune and autoinflammatory conditions overlap.

Background: Non-syndromic cleft lip and palate (NSCLP) is one of the most common congenital craniofacial anomalies. This study aims to systematically evaluate the developmental trends and research frontiers in NSCLP research using bibliometric analysis.

Methods: NSCLP-related articles published in English between January 1982 and February 2025 were retrieved from the Web of Science Core Collection database. VOSviewer, CiteSpace, and R package "bibliometrix" were used to evaluate publication trends, citation patterns, collaborative networks, and keyword evolution.

Results: A total of 1,068 eligible articles were analyzed. The United States (254 articles, 11,488 citations) was the most productive countries, with the University of Iowa being the most active institution. Mary L. Marazita (H-index 25) was the most influential researchers. Keyword analysis revealed five distinct research clusters: genetic mechanisms, clinical phenotypes, epidemiological factors, genetic susceptibility, and developmental biology. Keyword burst analysis indicated that "prevalence" continues to exhibit a burst trend in 2025, with a link strength of 8.46.

Conclusion: This study employs bibliometric analysis to comprehensively map the landscape and developmental trajectory of NSCLP research, highlighting its key areas spanning basic mechanisms, clinical medicine, and epidemiology. The findings suggest that future research priorities are likely to remain focused on the epidemiological aspects of the disease.

Introduction: Dentin is a potential bone graft substitute given that it shares compositional similarity with bone. It remains unknown regarding the mechanism of demineralization levels affecting its osteogenic efficacy in bone regeneration. This study evaluated the osteogenic effects of partially demineralized dentin block (PDDB) and non-demineralized dentin block (NDDB) in alveolar ridge augmentation.

Material and methods: In vitro, human bone marrow mesenchymal stem cells (hBMSCs) were cultured on dentin blocks demineralized with 2 % nitric acid for 0-60 min. ALP activity and osteogenic gene expression were detected by ALP staining and RT-qPCR, respectively. In vivo, six beagles underwent bilateral alveolar ridge splitting technique (ARST) with PDDB or NDDB. Histology was analyzed by hematoxylin-eosin staining, Masson's trichrome staining and immunohistochemistry. Micro-CT examination and Toluidine blue staining were performed 3 months after implant placement.

Results: In vitro, there were significantly increased ALP activity and expression of osteogenic genes in hBMSCs with dentin blocks with 10-min demineralization (all P < 0.05). In vivo, there was no statistical difference in ridge width gain between groups (P > 0.05). However, the PDDB group exhibited superior bone regeneration based on histological analysis. Furthermore, the PDDB group showed significantly higher RUNX2 and OCN expression, and more vigorous bone regeneration at the implant-dentin graft interface. Additionally, no significant inter-group differences were observed in bone microstructure and quantitative parameters (all P > 0.05).

Conclusion: Dentin blocks are feasible for ARST ridge augmentation, which can boost implant osseointegration. PDDB can further enhance their osteogenic efficacy, offering a favorable option for alveolar bone regeneration clinically.

Objectives: Postoperative pulmonary complications (PPCs) are common after major head and neck cancer surgery. This trial evaluated whether adding daily lung ultrasonography (LUS) to the current diagnostic strategy (clinical evaluation with on-demand chest X-ray [CXR]) improves PPC detection.

Methods: In this randomized controlled trial, 196 adults at intermediate/high risk for PPCs undergoing head and neck cancer surgery with free-flap reconstruction were assigned to the current strategy alone or a routine strategy (daily LUS plus current strategy). The primary outcome was the detection rate of clinically relevant PPCs.

Results: The routine strategy identified significantly more clinically relevant PPCs than the current strategy (92.3% vs. 66.7%, p = 0.035) with higher diagnostic accuracy (AUC: 91.9% vs. 80.4%, p = 0.035). Detection occurred earlier with the routine strategy (median postoperative day 2 vs. 3, p = 0.042). No significant differences were observed in hospital stay or mortality.

Conclusions: Incorporating daily LUS into postoperative care enhances the detection of PPCs in patients on general wards after head and neck cancer surgery, without significantly altering short-term clinical outcomes.

Introduction: Pathological fractures of the mandible, often secondary to intraosseous lesions or post-enucleation bone loss, pose significant structural and clinical concerns. While miniplate fixation is routinely used for reinforcement, its mechanical reliability lacks standardized assessment. This study employs finite element analysis to model stress distribution across various mandibular defect scenarios, quantify the biomechanical performance of miniplates, and evaluate postoperative stability in structurally compromised regions.

Methods: This study involved 3D reconstruction of mandibular bone models from CT scans, followed by finite element analysis using ANSYS and LS-DYNA software. Cortical and trabecular structures were modeled with region-specific parameters, and Champy-style mini-plates with screws were applied to simulate post-enucleation reinforcement. Various defect scenarios were evaluated under 350 N occlusal loading, with boundary conditions ensuring model stability. A total of 16 simulations assessed stress distribution and mechanical performance.

Results: Titanium plate application reduced principal stresses in all models. In Model 3, maximum and minimum stresses (565 MPa and 472 MPa) decreased to 204 MPa and 105 MPa with force applied from the healthy side. With plate application, maximum stress decreased from 142 MPa to 37 MPa in Model 1, from 150 MPa to 66 MPa in Model 2, from 565 MPa to 74 MPa in Model 3, and from 140 MPa to 66 MPa in Model 4.

Conclusion: Miniplates can effectively reduce stress in mandibular defects post surgery, but their success depends on defect type, cortical bone quality, and anatomical factors. Unicortical defects carry lower fracture risk, and accurate screw placement is critical. In select cases, conservative management with dietary precautions may be sufficient. These results support individualized treatment planning and highlight the need for further clinical validation.