Journal of Stomatology Oral and Maxillofacial Surgery最新文献

Objective: The effectiveness of exercise therapy in temporomandibular disorders treatment has been proven, but the heterogeneity of the data and the lack of analysis of subgroup data are noted as shortcomings. Therefore, this study aimed to investigate the effectiveness of a home exercise program in individuals with temporomandibular joint disc displacement with reduction (DDWR).

Methods: Forty participants diagnosed with DDWR were included in the study. The participants were divided into two groups: a study group and a control group. The study group received a home exercise program and patient education. The control group only received patient education. All participants were assessed at the beginning of the study and after completing the four-week program. Participants' mandibular range of motion was measured with a caliper, and their pain intensity was measured with a numerical pain scale. The Mandibular Impairment Questionnaire was used to assess mandibular function.

Results: The mean age of the participants (F:38, M:2) was 33. The home exercise group had statistically significant improvements in all parameters after treatment (p<0.05). In the patient education group, decreases in pain intensity during rest and activity (p=0.004, p=0.012), increases in right lateral deviation (p=0.026), and improvements in mandibular functional capacity (p=0.019). were statistically significant after treatment. When examining the differences between the groups, greater improvements were observed in all parameters except resting pain intensity in the exercise group (p<0.05).

Conclusion: A home exercise program for individuals with DDWR is effective in reducing pain intensity, increasing mandibular range of motion, and improving mandibular function.

Background: The persistent tympanic foramen (PTF) is a rare anatomical variation of the temporal bone and is of diagnostic significance due to its proximity to the temporomandibular joint (TMJ). Despite the widespread use of cone-beam computed tomography (CBCT), studies evaluating the prevalence and morphometric characteristics of PTF, as well as the distribution of anatomical variations and degenerative changes in adjacent temporomandibular structures in the TMJ, are limited.

Objetives: To evaluate the presence, location, and dimensions of the PTF on CBCT images of patients with temporomandibular joint disorders (TMD) and healthy control subjects, to investigate and compare the distribution of anatomical variations in temporomandibular structures and degenerative changes in the TMJ in the presence and absence of PTF.

Study design: CBCT images of 230 individuals with TMD and 238 healthy controls were analyzed. For all participants, the presence, location, and diameter (mm) of the PTF, condylar morphology, as well as the presence and type of articular eminence pneumatization (AEP) and glenoid fossa pneumatization (GFP) were assessed and recorded. Additionally, in individuals with TMD, the type of pathology was recorded.

Results: The frequency of PTF in the TMD group (37.8%) was found to be significantly higher than in the control group (23.5%) (p <0.001). In the TMD group, the frequency of PTF was higher in females. The most commonly observed condylar morphology in both individuals with and without PTF was the convex type (41.8%). The frequency of erosion was found to be significantly higher in individuals with PTF compared to those without PTF (p=0,046). PTF influenced the distribution of AEP (p=0.007); however, no significant relationship was found between the distribution of GFP and the presence of PTF (p=0.889).

Conclusions: The presence of PTF in approximately one-third of TMD patients and its close proximity to the TMJ are important in particularly invasive prosedures targeting the TMJ, and its presence should be evaluated by surgeons during the treatment planning phase.

Eagle Syndrome refers to an elongation of the styloid process or a calcification of the stylohyoid ligament mainly resulting in pain in the orofacial region. The treatment of Eagle syndrome includes conservative treatment or surgical removal of the styloid process. Two different surgical approaches have been described in the literature: the transoral and transcervical approaches. Both have their limitations and specific intraoperative risks. With the advent and the expanding utilization of new technologies, transoral robotic surgery has emerged as a promising minimally invasive approach for the treatment of Eagle syndrome. Herein we describe our method of styloidectomy via the transoral robotic surgery tonsil sparing approach.

Background: Bio-Oss® is a bovine-derived bone substitute frequently used in jawbone augmentation. Postoperative infections of bone grafts pose clinical challenges and may compromise graft survival. This study examines the impact of cold atmospheric plasma (CAP) treatment on Enterococcus faecalis-contaminated Bio-Oss® and evaluates possible changes in surface chemistry relevant to graft performance.

Methods: Bio-Oss® spongiosa blocks were sectioned, sterilized, and contaminated with E. faecalis for five days. Specimens were divided into four groups: untreated control and 5-, 10-, and 15-minute CAP treatments using the KinPen Med device (Neoplas Med, Germany), operated with high-purity argon gas (5 L/min) at 5 W output, with a nozzle-to-surface distance of approximately 10 mm. Bacterial load was quantified by colony-forming units (CFU), and surface characteristics were evaluated using scanning electron microscopy (SEM) and X-ray photoelectron spectroscopy (XPS).

Results: CFU analysis showed no statistically significant difference between the control and CAP-treated groups (one-way ANOVA, p = 0.79). SEM images confirmed the presence of bacteria on all specimens, regardless of treatment duration. XPS revealed reduced carboxyl group content and increased oxygen levels on CAP-treated samples (15 min) compared to untreated Bio-Oss®. The findings indicate that CAP altered the surface chemistry of the material but did not effectively reduce bacterial contamination under the tested parameters.

Conclusion: CAP treatment did not result in a significant bacterial reduction on E. faecalis-infected Bio-Oss®. The limited effectiveness may be related to the porous architecture of the material and plasma quenching in the liquid phase. However, observed surface modifications could influence wettability and cell interactions. These findings are restricted to the ex vivo model used, and further research with positive disinfection controls, mixed bacterial biofilms, and optimized plasma parameters is required before clinical application.

Autologous tooth transplantation is a treatment modality in which a donor tooth is transplanted into an extracted or surgically prepared alveolar socket of the same individual, thereby restoring a missing tooth. However, due to its high technical sensitivity, the clinical application of this procedure remains limited. Surgeons often encounter challenges in determining the optimal positioning and occlusion of the donor during surgery, which can result in excessive preparation of the alveolar bone and necessitate numerous crown adjustments. The aim of this study is to introduce a novel design 3D printed template that can assist in accurately placing donor teeth and simplify bonding procedures. It proposes that by utilizing 3D printed donor models combined with a 3D printed template, it is possible to reduce extra-oral time during autologous tooth transplantation, enhance preoperative evaluation and treatment accuracy, ensure optimal fit between donor and recipient alveolar sockets more effectively, minimize root absorption of transplanted teeth, promote post-transplantation healing processes as well as improve success rates and survival rates. In this paper, two cases involving autologous tooth transplantation guided by newly designed auxiliary positioning guides and adhesive guides are reported. The missing first or second molars were replaced with fully developed third molars with satisfactory one-year follow-up outcomes.

Objective: The primary aim of this study was to assess longitudinal radiographic changes in medication-related osteonecrosis of the jaw (MRONJ) using the expanded Composite Radiographic Index (eCRI) and to determine their associations with clinical disease severity and treatment outcomes. Secondary objectives included identifying individual radiographic parameters most strongly associated with clinical staging.

Materials and methods: In this single-center retrospective cohort study, MRONJ patients were monitored using cone-beam computed tomography (CBCT). Clinical severity was assessed using a seven-subclass scoring system (K0-K6), summarized as the Clinical Score (CS). Radiographic changes were evaluated using the eCRI. Statistical analyses included linear mixed-effects modeling to account for longitudinal data, Spearman's rank correlation for clinical-radiographic associations, and multivariate linear regression to identify factors associated with outcomes. Significance was set at p < 0.05.

Results: A total of 102 CBCT scans from 28 patients were analyzed over a mean follow-up of 17.2 ± 10.7 months. Linear mixed-effects models revealed that lytic changes (p = 0.002) and sequestration (p = 0.034) were significantly associated with advanced AAOMS stages. The combined presence of lytic changes and sequestration showed a significant positive correlation with higher Clinical Scores (p = 0.013). Conversely, no significant associations were found for sclerosis or periosteal reaction (p > 0.05). Multivariate analysis identified baseline eCRI as the only factor independently associated with radiographic outcome (p < 0.001).

Conclusion: The eCRI effectively captures longitudinal radiographic alterations in MRONJ. No statistically significant association between sclerosis or periosteal reaction and prognostic outcomes was observed in this cohort, although the limited sample size may have reduced statistical power. In contrast, the coexistence of lytic changes and sequestration served as a robust indicator of clinical severity. Persistence of these findings may reflect a tendency toward prolonged disease activity and may justify closer reassessment during follow-up. Integrating radiographic findings with clinical assessment may enhance accuracy in monitoring progression and support individualized treatment planning.

The study aimed to analyze the relationship between psoriasis (Ps) and radiomorphometric measurements of the mandibular bone. Forty one Ps patients (sixteen males and 25 females) and 39 controls (fourteen males and 25 females) were included in the study. Bone density (BD), fractal dimension (FD), mandibular cortical width (MCW), and mandibular cortical index (MCI) values were calculated on the radiographs. No significant differences were found between the mean FD, MCW values, and MCI distributions between the two groups (p > 0.05). The most purulent state of the mandibular cortex, C3, was observed 2.7 times more frequently in Ps patients relative to the control group. The MCW value was 45.93 mm in the control group and 42.22 mm in the group with Ps patients. Although no significant differences were observed between Ps patients and healthy subjects in bone parameters, porosity evaluations revealed that Ps patients were more prone to having thin and porous mandibular cortex structures.

Background: Virtual reality (VR)-based simulation has emerged as a technology-driven approach to improve procedural training in dentistry and oral healthcare. By enabling repeated, risk-free practice with objective feedback, VR simulation may enhance psychomotor control, procedural accuracy, and clinical readiness. However, the extent to which VR training translates into measurable performance advantages over conventional training remains uncertain. This systematic review aimed to evaluate the clinical impact of VR-based simulation on procedural skill acquisition in dental training, based exclusively on randomized controlled trials (RCTs).

Methods: Following PRISMA 2020 guidelines (PROSPERO ID: CRD420251161065), a comprehensive search was conducted in PubMed, ScienceDirect, and the Cochrane Library (January 2000-September 2025). Eligible studies included RCTs comparing VR-based interventions with traditional teaching among dental students. Data were extracted on participants, intervention type, outcomes, and study quality. The Cochrane Risk of Bias 2.0 tool was used to assess methodological quality.

Results: The included RCTs encompassed approximately 2,100 dental students across 19 countries. Domains included operative dentistry (n = 13), endodontics (n = 5), implantology/oral surgery (n = 4), prosthodontics (n = 2), orthodontics (n = 2), pediatric dentistry (n = 2), radiology (n = 2), multidisciplinary skills (n = 2), and single studies in periodontology, local anesthesia, and dental materials. Overall, 26 of 35 RCTs (74.3%) demonstrated statistically significant improvement in at least one prespecified educational or performance outcome compared with conventional instruction. Benefits were most consistently observed in early-stage psychomotor development, spatial understanding, and learner engagement. However, conventional simulation occasionally demonstrates superior performance in complex or transfer-based procedural tasks. Most studies presented some concerns regarding allocation concealment or reporting transparency, although objective outcome measurement reduced major bias risk.

Conclusion: VR-based simulation represents effective adjunctive tools in dental education, particularly within blended training models. While evidence supports their role in early skill acquisition and spatial training, they should complement rather than fully replace conventional simulation for advanced procedural competency.

Objective: To evaluate the incidence and mortality rates of oral cancer (OC) in China and to project the disease burden for the next 15 years, utilizing data from the Chinese Cancer Registry Annual Report (2004-2018).

Methods: National data of OC [ICD 10 codes C01-C06] were obtained from aforementioned report from 2004 to 2018. Using Joinpoint Regression Software to calculate the Estimated Annual Percent Change (EAPCs) and their corresponding 95% confidence intervals (CI) to assess the trends in incidence and mortality rates. Decomposition analysis assessed the contributions of demographic and epidemiological factors to the evolving burden of OC. Age-standardized rates (ASR) for OC incidence (ASIR) and mortality (ASMR) were projected for the next 15 years using a Bayesian Age-Period-cohort model integrated nested Laplace approximation (INLA).

Results: From 2004 to 2018, the number of OC cases, deaths, ASR of incidence, and mortality increased in China. During the study period, the ASIR of OC remained stable with EAPCs of 0.55% (95% CI: -0.28 to 1.38) and ASMR increased with EAPCs of 6.01% (95% CI: 3.56 to 8.52). The ASIR and ASMR for males exhibited an upward trend. Specifically, the age group with the fastest increasing incidence and mortality of OC in both sexes was 30-34 years and 35-39 years, respectively. Population aging accounted for 57.17% of the increase in OC cases and 55.66% of the increase in OC deaths. According to the forecast, by 2033, the ASIR and ASMR of OC in males aged 15 and older are expected to rise to 3.53 and 1.52 per 100,000, respectively, while the ASIR for females is expected to remain stable at 0.99 per 100,000, with the ASMR anticipated to increase slightly to 0.80 per 100,000.

Conclusion: From 2004 to 2018, the overall ASMR of OC in China was on the rise, and the overall ASIR showed a stable trend, while the ASIR of male displayed an increasing trend. The prevention and control of OC is a serious task, and the current prevention strategy should be reoriented to prevent the increase of OC cases.

Purpose: The early and accurate diagnosis of sarcomatous lesions holds significant importance for improving patient outcomes. This study aims to analyze the spiral CT imaging characteristics of osteosarcoma, chondrosarcoma, and Ewing sarcoma in the maxillofacial bones.

Methods: The CT imaging features of patients with osteosarcoma, chondrosarcoma, or Ewing sarcoma were retrospectively identified and statistically analyzed.

Results: A total of 163 patients were recruited, including 139 cases with osteosarcoma, 11 with chondrosarcoma, and 13 with Ewing sarcoma. The median ages of three lesions were 39, 54, and 14 years respectively (Kruskal-Wallis test). Osteosarcoma cases included 54 lesions in the maxilla, 83 in the mandible and 2 involving both. Chondrosarcoma lesions involved the maxilla in 3, the mandible in 3, and the temporomandibular joint region in 5 cases. Ewing sarcoma cases included 3 lesions in the maxilla and 10 in the mandible. Tumor size differed among three tumor types. The bone destruction patterns (osteoblastic, osteolytic and mixed) showed no significant differences among tumor types. However, χ² test showed significant differences in the tumor matrix mineralization among three tumors: osteosarcoma predominantly exhibited spiculated (33.1%) and irregular plaque-like (39.6%); chondrosarcoma did not show tumor bone in 36.4% of cases; while Ewing sarcoma demonstrated spiculated tumor bone in 38.5% of cases. Characteristic widening of the periodontal ligament space was more frequently seen in osteosarcoma cases (59.5%, χ² test) than that in chondrosarcoma (20%) or Ewing sarcoma (27.3%).

Conclusion: CT imaging manifestations hold certain value in the diagnosis and differentiation of sarcomatous lesions in maxillofacial bones.