Journal of Stomatology Oral and Maxillofacial Surgery最新文献

Background: Oral squamous cell carcinoma (OSCC) ranks on position 14 in global cancer analysis and makes up to 38 % of all head and neck squamous cell carcinomas. While surgery is accepted as first-line treatment of early tumors, the reconstructive approach is not standardized. Therefore, we evaluated the concept of ablative tumor removal and microvascular reconstruction in terms of oncological safety and surgical morbidity for early OSCCs.

Methods: 262 patients received ablative tumor surgery with neck dissection together with microvascular reconstruction between 2010 and 2020. General clinical data was analyzed descriptively with regard to surgery time, duration of tracheotomy and hospitalization.

Results: Estimated 5-year overall and progression-free survival was 85 % and 77 % respectively with no significant difference between stage I or II cancer patients. Tracheotomy was performed in 131 patients (50 %). 19 patients (7.3 %) were temporarily dependent to a gastric feeding tube. Flap loss occurred in 9 patients (3.4 %).

Discussion: In a standardized setting, mean surgery time could be reduced constantly. We propose consistent tumor ablation, combined with elective neck dissection and microvascular reconstruction in early oral squamous cell carcinoma. The presented concept leads to excellent oncological and functional results with acceptable morbidity and short surgery times.

Purpose: The tongue is a complex organ that can provide insight into oral and systemic conditions. A variety of disorders, such as geographic tongue, hairy tongue, fissured tongue, macroglossia, microglossia, and others, can be observed. The objective of this cross-sectional study, conducted on a cohort of dental patients, was to examine the prevalence of tongue disorders and their relationship with factors such as demographic data, oral hygiene practices, history of systemic diseases, and bad habits.

Method: The tongues of 772 dental outpatients, comprising 355 males and 417 females, were examined in detail, and the factors associated with tongue disorders were noted.

Results: The prevalence of tongue disorders was 32.6 %. The remaining tongue disorders were as follows: fissured tongue (12.1 %), macroglossia (7.1 %), geographic tongue (3.4 %), hairy tongue (3.6 %), coated tongue (3.4 %), median rhomboid glossitis (0.5 %), ankyloglossia (0.4 %), glossitis (0.4 %), and microglossia (0.1 %). The most prevalent tongue disorder observed in the study cohort was fissured tongue, while both bifid tongue and idiopathic burning tongue syndrome were absent. The prevalence of macroglossia, fissured tongue, and hairy tongue was significantly higher in males than in females (p < 0.05, p < 0.05, p < 0.05, p < 0.005, respectively). A statistically significant difference was observed in the frequency of macroglossia, furred tongue, hairy tongue, and glossitis between age groups.

Conclusion: The findings of this study identified the most common tongue disorders and their relationship with factors such as systemic history, demographic factors, oral hygiene care, bad habits, and systemic diseases. The significance of tongue appearance in providing insight into the systemic and oral condition of the patient has once again been demonstrated.

The dentigerous cyst is defined as a pathological cavity whose origin is produced by developmental alterations. Most usual treatment is the enucleation of the cyst with the extraction of the tooth. The current approach tends to preserve the tooth. The aim of this study was to determine the total and partial success of the conservative treatment of the dentigerous cyst in terms of eruption of the associated permanent tooth. Pub-Med, Scopus and the Cochrane Central Register of Controlled Trials were searched from January 2012 to December 2023, including patients aged 18 years old or less with a dentigerous cyst associated with a repositionable permanent tooth in the arch. 118 articles were found and 24 were included in full text. 40 cases were reported in the mandible (83 %) and 8 in the maxilla (17 %). 29 cases of marsupialization were included (60 %), 17 of enucleation (36 %) and 2 of decompression (4 %). The percentage of teeth that erupted spontaneously, either completely or partially, after marsupialization, enucleation and decompression was 83 %, 59 % and 100 % respectively. No recurrences have been described in any case. This study highlights that the conservative treatment was a predictable procedure with a total success of 83 % by marsupialization and 100 % after decompression.

Introduction: Murins were used for microsurgical training but in the literature, only a few papers reported about murin combination of flaps and fewer about osteocutaneous ones. We proposed a rat model of a combined osteocutaneous flap in which the pedicle axis is intentionally lengthened.

Technical note: From June to August 2020, one corpse and eight living Albinos Wistar rats were dissected. The 4th vertebra was harvested with its vessels and transferred to the groin with end-to-side anastomosis to the femoral vessels. Surviving rats were dissected to explore the combined osteocutaneous flap. Only two rats survived until second dissection. Transfixiant arterial and veinous stitches were observed in failed procedures. Caudal pedicles and epigastric pedicles were permeable in surviving animal with bleeding of the vertebra body surface.

Discussion: Perspective of simultaneous vertebral free flap and bone graft could build up a potential rat model of comparison with a prelaminar flap.

Objective: The purpose of this study is to evaluate the performance of Scholar GPT in answering technical questions in the field of oral and maxillofacial surgery and to conduct a comparative analysis with the results of a previous study that assessed the performance of ChatGPT.

Materials and methods: Scholar GPT was accessed via ChatGPT (www.chatgpt.com) on March 20, 2024. A total of 60 technical questions (15 each on impacted teeth, dental implants, temporomandibular joint disorders, and orthognathic surgery) from our previous study were used. Scholar GPT's responses were evaluated using a modified Global Quality Scale (GQS). The questions were randomized before scoring using an online randomizer (www.randomizer.org). A single researcher performed the evaluations at three different times, three weeks apart, with each evaluation preceded by a new randomization. In cases of score discrepancies, a fourth evaluation was conducted to determine the final score.

Results: Scholar GPT performed well across all technical questions, with an average GQS score of 4.48 (SD=0.93). Comparatively, ChatGPT's average GQS score in previous study was 3.1 (SD=1.492). The Wilcoxon Signed-Rank Test indicated a statistically significant higher average score for Scholar GPT compared to ChatGPT (Mean Difference = 2.00, SE = 0.163, p < 0.001). The Kruskal-Wallis Test showed no statistically significant differences among the topic groups (χ² = 0.799, df = 3, p = 0.850, ε² = 0.0135).

Conclusion: Scholar GPT demonstrated a generally high performance in technical questions within oral and maxillofacial surgery and produced more consistent and higher-quality responses compared to ChatGPT. The findings suggest that GPT models based on academic databases can provide more accurate and reliable information. Additionally, developing a specialized GPT model for oral and maxillofacial surgery could ensure higher quality and consistency in artificial intelligence-generated information.

In cranio-cervico-facial reconstructive surgery, it is accepted that the use of free flaps is the treatment of choice. The multiple antecedents can place the surgeon in situations of vascular deserts. The aim of our study is to report and analyse our experience of the use of temporal vessels in primary and secondary reconstructive surgery. A retrospective study was conducted between 01/01/2010 and 31/03/2023. Patients who underwent cranio-cervico-facial reconstruction using free flaps, with use of the superficial temporal pedicle as the recipient site for the vascular anastomosis were included. Early and late complication and failure rates were analysed according to type of reconstruction, location and risk factors for free flap failure. A total of 94 patients underwent craniocervical-facial reconstruction using a free flap anastomosed to the superficial temporal pedicle (in primary or secondary situations). Ten patients underwent reconstruction of the upper third, 58 the middle third and 26 the lower third. With an overall complication rate of 28.7% (21.3% minor complications and 7.4% major complications). Our study proves the reliability of the superficial temporal pedicle, both in the primary situation (with a success rate of 93.9%) and in the secondary situation (with a success rate of 89.3%), as well as its versatility whatever the cranio-cervico-facial level to be reconstructed. This study demonstrates the value of preserving the superficial temporal pedicle in craniofacial reconstruction surgery. This is because it is a preferred recipient site for reconstructions of the upper and middle thirds in the primary situation or in the event of recourse.

Background: The natural growth of the mandible in craniofacial microsomia (CFM) remains a topic of considerable debate. This study aims to characterize the mandibular architecture and its natural growth in children with type IIA CFM using functional unit analysis.

Materials and methods: 16 sets CT data of 8 unoperated children with unilateral IIA CFM with an interval ranging from 2 to 6 years (3.4±1.5 years,AVR±SD)were collected. The baseline skeletal units' discrepancy in size, annual growth, and angular measurements were analyzed.

Results: The condylar, coronoid, and body units were smaller (reaching 63%, 79%, and 90% of the unaffected side, respectively) while the angular unit was larger on the affected side. The condylar unit on the affected side grew slower than the unaffected side, at about 60% of its rate, and other units showed no statistically significant bilateral differences. The backward rotation angle of the affected body unit (BUA) increased from T1 to T2.

Conclusion: This preliminary study suggests that the condyle unit is the center of mandible deformity in type IIA CFM and exhibits insufficient growth relative to the unaffected side . Meanwhile, the hemi-mandible on the affected side rotated posteriorly during growth, thus worsening spatial relation. Future studies with larger sample sizes that incorporate clinical assessments are needed to elucidate the progression of CFM.

Objective: Reliable metrics are needed to measure the impact of academic publications in order to fully understand and evaluate the contributions of articles published in the field of oral and maxillofacial surgery(OMFS). The aim was to identify and analyze the top 100 articles each year, with the highest Field-Weighted Citation Impact(FWCI) and citation counts, in the field of OMFS over the past decade, totaling 1,000 articles.

Materials and methods: The research was conducted on April 20, 2024, using the Scopus database. It identified the top 100 articles each year with the highest FWCI from the top six journals with the highest metric scores in OMFS, totaling 1,000 articles. The citation counts of these publications in Google Scholar were also recorded. The predictor variable was the articles. The primary outcome variable was the FWCI value, while the secondary outcome variable was the number of citations. The covariates were the journals in which the articles were published, the publication year, the type of document, the type of access policy, and the subject of the research.

Results: There was a weak positive correlation between FWCI and citation count(rho = 0.083, P = .009). All covariates significantly affected FWCI(P < .005), while all but access policy significantly affected citation count(P = .167). The highest average FWCI(6.31 ± 5.51) was observed in the Journal of Stomatology, Oral and Maxillofacial Surgery(JSOMS), and the highest citation count was found in the Journal of Oral and Maxillofacial Surgery(JOMS)(61.5 ± 126.4). Orthognathic Surgery and Dentofacial Deformities were the scientific fields with the most publications(14 %). COVID-19 and Artificial Intelligence had the highest FWCI(8.65 ± 10.98 and 7.68 ± 6.42, respectively). MRONJ had the highest average citation count(88.6 ± 254).

Conclusion: This study demonstrates that using both FWCI and citation count metrics can more accurately assess the impact of academic publications in the field of OMFS. These findings can serve as a guide for future research and contribute to strategic decisions aimed at improving clinical practices and patient care.

Introduction: The aim of this study was to conduct a three-dimensional analysis of the effects on mentolabial soft tissues of three different orthognathic surgery protocols: bimaxillary surgery without genioplasty, bimaxillary surgery with conventional or minimally invasive genioplasty (MIS).

Materials and methods: Pre-operative and post-operative CBCT were superimposed to quantify and ascertain the direction of mandibular movements, and soft tissue were analyzed to evaluate the hard to soft tissue ratio. Data from 97 consecutive patients were evaluated: 30 conventional genioplasty, 36 MIS and 31 no genioplasty.

Results: The impact of the surgical movements on the overlying soft tissues can be consider with stronger correlation in the group No Genioplasty in the whole mentolabial region, stronger correlation in labial and pogonion region in the MIS group and no stronger correlation in the conventional group.

Conclusions: Sutures in the mentolabial region directly interfere with the postoperative impact of orthognathic surgery on soft tissues in mentolabial area, in both the vertical and horizontal directions. A smaller incision - consequently involving less detachment of soft tissues in the region - may promote a lower risk of chin ptosis, in addition to greater suspension of the musculature.