International journal of oral and maxillofacial surgery最新文献

This report describes a case of peripheral ameloblastoma of the mandible with metastasis to a cervical lymph node. The clinicopathological characteristics of both the primary and metastatic tumours are presented. In addition, a comprehensive review of the literature pertaining to this rare phenomenon was performed, covering the past 50 years. A 76-year-old male, who had undergone successful surgical resection of a right mandibular peripheral ameloblastoma 10 years earlier, presented with metastatic lesions in a cervical lymph node. Both the primary lesion and the metastatic specimen were re-examined using haematoxylin-eosin staining and immunohistochemical methods. Pathological examination revealed that both the primary and metastatic lesions were cytologically benign. The literature search identified 207 articles, among which 59 reported cases of ameloblastoma with metastasis. All reported cases involved intraosseous ameloblastoma, with the exception of one case of peripheral ameloblastoma reported in 1987. The diagnosis in such cases is often challenging due to the presence of multiple lesions. Both haematogenous and lymphatic metastases may occur, particularly in cases with multiple local recurrences and surgical interventions. In summary, metastatic ameloblastoma is very rare, and peripheral ameloblastoma with lymph node metastasis is even more uncommon, especially after successful surgery for the primary lesion.

There is a well-documented relationship between the monoclonal antibody (MAB) denosumab and medication-related osteonecrosis of the jaw (MRONJ). However, the association between other MABs and MRONJ remains unclear. A systematic search was conducted across MEDLINE, Embase, and Web of Science to identify articles describing cases of MRONJ associated with the use of MABs excluding denosumab. The Joanna Briggs Institute (JBI) critical appraisal checklist for case reports and case series was used to critically appraise all included studies. Demographics, clinical presentation, risk factors, MRONJ staging as per the American Association of Oral and Maxillofacial Surgeons (2014), treatment modalities, and outcomes were extracted and analysed. A total of 2324 articles were identified and screened, of which 30, describing 32 cases of MRONJ, met the inclusion criteria. In most cases, MRONJ presented at an advanced stage (stage 2 or 3), and it was often precipitated by dental extractions. Bevacizumab was the most common MAB linked to MRONJ, followed by other MABs including infliximab, pembrolizumab, adalimumab, and rituximab. This review demonstrated a broad spectrum of MABs associated with MRONJ and highlights the need for enhanced preventive measures, early diagnosis, and effective management strategies.

Device failures during critical medical procedures can jeopardize treatment outcomes. This report documents the innovative use of 3D scanning and resin 3D printing to fabricate a modified screwdriver to achieve effective activation of bilateral mandibular external multi-vector distraction devices on a patient undergoing counterclockwise craniofacial distraction osteogenesis. The modified screwdriver served as a rescue device, as the external midface device obstructed activation of the mandibular external distractors with the manufacturer-supplied activation screwdriver. By designing and fabricating a custom screwdriver, successful device activation and treatment continuation were ensured.

Nevoid basal cell carcinoma syndrome (NBCCS) is a rare autosomal dominant hereditary condition associated with developmental abnormalities and tumourigenesis with a prevalence rate of 1:60,000. The objective of this study was to identify NBCCS in patients diagnosed with odontogenic keratocysts (OKC) at Nair Hospital Dental College in Mumbai, India, and to compare the findings with those from Indian and international studies. Archived institutional data on OKC cases from the years 2009-2024 were analysed for NBCCS based on the criteria established by Kimonis et al. in 1997. Of the 231 cases of OKC identified, 39 (16.9%) met the diagnostic criteria for NBCCS; 27 were male and 12 were female (age range 8-55 years). Major criteria observed were OKC, palmar/plantar pits, rib anomalies, calcification of the falx cerebri, basal cell carcinomas, and a positive family history. Minor criteria included ocular hypertelorism, frontal bossing, macrocephaly, multiple pigmented nevi, syndactyly, Sprengel deformities, ovarian fibromas, and vertebral anomaly. Synophrys was found in 76.9% of cases. Analysis of criteria across countries suggests that NBCCS features in India may vary due to genetic or geographical factors The high prevalence of synophrys in this study suggests its inclusion as a new diagnostic criterion for NBCCS.

Extended reality (XR) technologies, including augmented reality (AR), mixed reality (MR), and virtual reality (VR), are increasingly transforming surgical disciplines. Oral and maxillofacial surgery, given the anatomical complexity and precision required, is particularly suited to benefit from these innovations. The aim of this scoping review was to map the clinical applications of XR in oral and maxillofacial surgery and compare the most commonly used commercial headsets. A comprehensive literature search was performed across the PubMed, Scopus, and Web of Science databases, covering studies published between January 2018 and June 2025. The PRISMA-ScR guidelines were followed. Overall, 759 records were identified in the database and subsequent citation search, of which 90 met the predefined inclusion criteria. The studies were categorized based on the type of application: training, preoperative planning, virtual surgical planning (VSP), and intraoperative guidance. The analysis revealed that AR and MR are predominantly employed in intraoperative procedures, enhancing surgical navigation and precision. In contrast, fully immersive VR is primarily employed in training, preoperative simulation, and VSP, while its adoption in the postoperative phase remains a promising area for future exploration. XR technologies hold significant potential in oral and maxillofacial surgery and are evolving rapidly and diversifying in their applications. Further research and regulatory validation are needed to support clinical integration and evaluate long-term outcomes.

The aim of this study was to analyse the spontaneous changes in ramal inclination following mandibular setback surgery in patients with asymmetric prognathism. The stability of these changes and their impact on the condylar head position and joint space were evaluated. Fifty-three condyles were included and categorized into deviated side (D) and non-deviated side (ND) groups. Data were collected from cone beam computed tomography scans obtained preoperatively (Pre), immediately postoperative (Post), and at 6 months postoperative (6 m). The raw files were analysed using 3D software. On the deviated side, the condylar heads shifted significantly laterally and rotated inward (yaw) during surgery. On the non-deviated side, they shifted inferiorly and rotated outward (roll). These intraoperative rotations (ramal yaw, ramal roll) were maintained throughout the remodelling period (P = 0.001 and P = 0.006, respectively). Spontaneous rotation of the ramus helped resolve the imbalance in ramal inclination between the deviated and non-deviated sides. It did not significantly affect condylar head volume or joint space (Pre-6 m, P > 0.05). These findings suggest that intentional adjustment of the ramal inclination may be a feasible approach to compensate for imbalances in yawing and rolling in patients with deviated mandibular prognathism.

In sagittal split osteotomy (SSO), unaesthetic notching of the lower mandibular border can occur postoperatively, particularly after significant advancements. This single-centre, prospective study evaluated whether applying calcium phosphate paste to prevent these defects increases the risk of surgical site infection. A total of 234 patients who underwent mandibular lengthening at the European Face Centre in Brussels between 2017 and 2022 were included. The predictor variable was the use of calcium phosphate paste at the lower mandibular border, while the primary outcome was the incidence of infective complications at the SSO site. Secondary outcomes included hardware removal and intraoperative complications. Minimum follow-up was 6 months. Fourteen patients (6.0%) developed an SSO-site infection. T-test and logistic regression analysis showed a significant difference in infection at the SSO site between the calcium phosphate group (n = 8, 11.3%) and control group (n = 6, 3.7%) (odds ratio 3.3, 95% confidence interval 1.1-9.9, P = 0.032). Although the higher infection risk remained significant after adjusting for age and sex, it lost significance when adjusted for amount of mandibular advancement. The study findings support the use of calcium phosphate paste due to its long-term benefits in mitigating jawline notching, outweighing the manageable infection risk.

Evaluating masticatory behaviour before and after surgical orthodontic treatment is crucial for successful postoperative oral rehabilitation of patients with jaw deformities. In this study, masticatory function was evaluated by measuring masticatory behaviour quantitatively in patients with jaw deformities before and after surgical orthodontic treatment. The untreated group included 42 patients with jaw deformities. The post-treatment group included 55 patients whose jaw deformities had been corrected surgically at least 1 year previously. The control group included 53 adults with individual normal occlusion. Masticatory behaviour was measured using a Bitescan device, and the occlusal contact area and maximum occlusal force were measured using Dental Prescale II system. The post-treatment group had the longest eating time (P = 0.008 compared to the control group). There was no significant difference in the right-left imbalance among the groups (P = 0.078). Both occlusal contact area and maximum occlusal force of the untreated group and post-treatment group were significantly lower than those of the control group (all P < 0.001). This study revealed that postoperative masticatory behaviour was not sufficiently improved, suggesting the possibility of insufficient adaptation to postoperative occlusion, a state of recovery of masticatory muscles, and a reliance on habitual masticatory behaviour.

This retrospective cohort study was performed to investigate the long-term skeletal, dental, and aesthetic stability, and patient satisfaction, following mandibular advancement with bilateral sagittal split osteotomy (BSSO) in skeletal Class II malocclusion patients. The follow-up period ranged from 6 to 19 years (mean 11.9 years), longer than in many previous studies. Twenty-nine patients (18 female, 11 male) who underwent mandibular advancement with rigid internal fixation between 2004 and 2017 were included. Lateral cephalometric radiographs from four time points were analysed: pre-surgery (T1), post-surgery (T2), 6-12 months post-surgery (T3), and long-term follow-up (T4). Patient satisfaction with the treatment outcome was assessed using the Orthognathic Quality of Life Questionnaire (OQLQ, Swedish version). The mean mandibular advancement was 5.53 ± 1.91 mm. Long-term follow-up revealed stable skeletal and dental outcomes, with no significant relapse in SNB, ANB, overjet, or overbite between T3 and T4. Soft tissue changes (T3-T4) for lower lip to E-line distance (mean -3.86 mm to -4.74 mm) and N'-Sn-Pog' angle (mean 159.91-162.11°) were statistically significant (P < 0.001) but not clinically relevant. Neurosensory disturbances were present in 21 patients after the surgery (72%), and these persisted in 13 at long-term follow-up (45%). Despite this, OQLQ scores indicated high patient satisfaction (mean 12.6, range 0-70), with minimal functional problems and improved oral health-related quality of life. These findings demonstrate the long-term skeletal and dental stability of BSSO with rigid fixation, as well as its effectiveness in achieving high patient satisfaction in the correction of skeletal Class II malocclusion.

In the management of oral squamous cell carcinoma (OSCC), neck dissection is essential for achieving loco-regional control. The submandibular gland (SMG) is frequently removed during this procedure, which may result in xerostomia and negatively affect postoperative quality of life. Although preservation of SMG could be beneficial, its oncological safety in OSCC remains uncertain. This retrospective, cross-sectional, multicentre study aimed to determine the prevalence of SMG involvement in OSCC, identify associated risk factors, and evaluate its impact on survival. Clinical and pathological data of OSCC patients diagnosed between 2000 and 2021 were analysed. Patients who did not undergo neck dissection, received neoadjuvant therapy, or had incomplete records were excluded. Data were obtained from the Malaysian Oral Cancer Database and Tissue Bank System. Survival outcomes were analysed using Kaplan-Meier estimates and log-rank tests. Among 223 included patients, SMG involvement was uncommon (n = 7, 3.1%). Most affected cases involved buccal mucosa OSCC and presented with advanced disease (cTNM stage IVa). SMG involvement was significantly associated with level Ib lymph node metastasis (P < 0.001) and extranodal extension (P = 0.013). No significant association was observed between SMG involvement and overall or disease-free survival. SMG preservation appears feasible in selected OSCC patients.