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Purpose: To assess the clinical utility of the 3D 4K exoscope for reconstructive head and neck surgery. Methods: This retrospective study analyzed surgical details and complications with the use of the 3D 4K exoscope for microvascular reconstruction at a high-volume Department of Oral and Maxillofacial Surgery, compared to the use of a 2D microscope. Patients with oral cancer undergoing microvascular reconstruction were categorized into two cohorts based on the intraoperative use of the 3D 4K exoscope (Orbeye™, Olympus, Tokyo, Japan) or a conventional microscope (ZEISS S8 – OPMI Vario, Carl Zeiss AG, Oberkochen, Germany; Leica M680, Leica Mikrosysteme Vertrieb GmbH, Wetzlar, Germany) during a six-month study period, respectively. Outcomes were also compared between two time periods of the exoscope use to assess the learning curve over time. Results: The exoscope was applied for microvascular anastomosis in 55 surgical cases (cohort 1), and the conventional microscope was employed in 56 cases (cohort 2). The rates of postoperative complications within 14 days following the use of the exoscope were 14.5% (N = 8), compared to 16.1% (N = 9) in cohort 2. Analysis over time demonstrated a learning curve with the exoscope, reflected in a decrease in postoperative complications within 14 days from 22.7 to 9.1%. Conclusion: The three-dimensional camera system provides excellent and reliable intraoperative visualization in reconstructive head and neck surgery. Transitioning to this new technology did not lead to an increase in intra- or postoperative complications, but the successful implementation requires some experience with the device. [ABSTRACT FROM AUTHOR]

Objective: The purpose of this study has been to analyze retrospectively the clinical records of patients admitted to a single Maxillofacial Surgery center in Northern Italy, evaluating the epidemiological differences during the different phases of the SARS-CoV-2 pandemic. Materials and Methods: The retrospective study included patients who had undergone surgery for facial bone fractures at the between February 23, 2020, and February 23, 2022. According to the date of admission, all the data were stratified into four chronological periods representing the four different phases of the SARS-CoV-2 pandemic in Italy in terms of restriction: pre-pandemic, first wave, partial restrictions and post-pandemic groups. Finally, any differences in epidemiological data between the groups were analyzed. Results: A total of 155 patients were included. The causes of admission of the pre-pandemic group demonstrated a statistically significant difference compared with the first wave group, whereas there were no differences between the pre-pandemic and the other two groups. The first wave group reported statistically significant differences in terms of the fracture etiology also with the partial restrictions and post-pandemic groups. Conclusions: During the COVID-19 pandemic, there were profound changes in the epidemiology of fractures influenced by the restrictive measures implemented by the government. At the end of the pandemic, the epidemiology of fractures returned to the same as in the pre-pandemic period. [ABSTRACT FROM AUTHOR]

Purpose: This qualitative study explored the health needs of patients after undergoing bariatric surgery. The study specifically aimed to describe the unique physical, emotional, and social challenges patients face following surgery in order to inform the development of future obesity treatment programs. Methods: A 90-min focus group was conducted using a semi-structured interview guide. Bariatric surgery patients were enrolled using purposive sampling. The mean number of months since surgery was 20.2 (SD 10.8). The mean age of participants was 53.3 (SD 9.8) years. The focus group was both audio and video recorded, transcribed, and analyzed using topic and analytical coding. Results: Three main themes emerged revealing postoperative needs for (1) assistance with physical changes and reduced barriers to exercise, (2) reinforcement for healthy eating behaviors, and (3) emotional support from peers, family, and community. Conclusions: Findings suggest that rehabilitation following bariatric surgery is complex in nature and patients may benefit from both pre- and post-surgery programs that address their unique needs. Weight maintenance and sustaining healthy behavior change post-surgery requires ongoing personal and professional assistance. Interventions should emphasize healthy eating practices, include practical exercise suggestions, and offer social and emotional support. [ABSTRACT FROM AUTHOR]

Objective: This narrative review aims to explore the current applications and future prospects of AI within the subfields of oral and maxillofacial surgery (OMS), emphasizing its potential benefits and anticipated challenges. Methods: A detailed review of the literature was conducted to evaluate the role of AI in oral and maxillofacial surgery. All domains within OMS were reviewed with a focus on diagnostic, therapeutic and prognostic interventions. Results: AI has been successfully integrated into surgical specialties to enhance clinical outcomes. In OMS, AI demonstrates potential to improve clinical and administrative workflows in both ambulatory and hospital-based settings. Notable applications include more accurate risk prediction, minimally invasive surgical techniques, and optimized postoperative management. Conclusion: OMS stands to benefit enormously from the integration of AI. However, significant roadblocks, such as ethical concerns, data security, and integration challenges, must be addressed to ensure effective adoption. Further research and innovation are needed to fully realize the potential of AI in this specialty. [ABSTRACT FROM AUTHOR]

Phytonanoparticles have emerged as a promising class of biomaterials for enhancing bone regeneration and osseointegration, offering unique advantages in biocompatibility, multifunctionality, and sustainability. This comprehensive review explores the synthesis, characterization, and applications of phytonanoparticles in bone tissue engineering. The green synthesis approach, utilizing plant extracts as reducing and stabilizing agents, yields nanoparticles with intrinsic bioactive properties that can synergistically promote osteogenesis. We examine the mechanisms by which phytonanoparticles, particularly those derived from gold, silver, and zinc oxide, influence key molecular pathways in osteogenesis, including RUNX2 and Osterix signaling. The review discusses advanced strategies in phyto-nanoparticle design, such as surface functionalization and stimuli-responsive release mechanisms, which enhance their efficacy in bone regeneration applications. Preclinical studies demonstrating improved osteoblast proliferation, differentiation, and mineralization are critically analyzed, along with emerging clinical data. Despite promising results, scalability, standardization, and regulatory approval challenges persist. The review also addresses the economic and environmental implications of phyto-nanoparticle production. Looking ahead, we identify key research directions, including developing personalized therapies, combination approaches with stem cells or gene delivery, and long-term safety assessments. By harnessing the power of plant-derived nanomaterials, phytonanoparticles represent an innovative approach to addressing the complex challenges of bone regeneration, with potential applications spanning dental, orthopedic, and maxillofacial surgery. [ABSTRACT FROM AUTHOR]

Oropharyngeal and orthognathic surgeries cause more postoperative pain than simple dental procedures. The lack of detailed pain pattern analysis after dental surgeries makes pain management challenging. We assessed postoperative pain patterns in patients undergoing various dental surgeries, categorized based on changing pain levels, and identified the most frequent surgical procedures within each pain pattern cluster. Patients aged 18 years and older undergoing elective oral and maxillofacial surgeries under general anesthesia and hospitalized for > 36 h were included. Exclusion criteria were COPD, head injury, adverse drug reactions, substance misuse, severe metabolic disorders, infections, or psychiatric conditions. We retrospectively analyzed previously collected postoperative visual analog scale (VAS) data at 0, 6, 12, 24, and 36 h postoperatively from 790 patients undergoing various dental surgeries under general anesthesia using k-means clustering to identify pain patterns. Surgery type, duration, and patient-controlled analgesia were analyzed for three pain clusters. Cluster 1 had high prolonged initial pain (VAS 7.43 ± 1.62), mostly involving extensive oropharyngeal cancer surgeries. Cluster 2 experienced moderate pain initially (VAS 5.95 ± 1.44), steadily declining, typically involving orthognathic surgeries. Cluster 3 reported moderate initial pain (VAS 5.21 ± 1.49) that decreased rapidly. Extensive procedures were common in Cluster 1, whereas simpler excisions were prevalent in Cluster 3. Postoperative pain varies significantly according to the extent and invasiveness of surgery. Identifying specific pain trajectories based on detailed surgical assessments can enhance preemptive pain management and aid clinicians in predicting and managing postoperative pain. [ABSTRACT FROM AUTHOR]

Background/Objectives: Mandibular gingival squamous cell carcinoma (SCC) is the second most common oral cancer after tongue cancer. As these carcinomas often invade the mandible early, accurately defining the resection extent is important. This report highlights the use of preoperative virtual surgery data, computer-aided design and manufacturing (CAD/CAM) technology, surgical guidance, and extended reality (XR) support in achieving highly accurate marginal mandibulectomy without recurrence or metastasis. Methods: CT imaging data obtained a month before surgery were imported into Materialize Mimics and Materialize Magics (Materialize, Leuven, Belgium, Ver22.0) CAD/CAM software and used to design an osteotomy guide. An STL file was generated, and the guide was fabricated using a 3D printer (Objet 260 Connex; Stratasys Ltd., Eden Prairie, MN, USA) prior to the operation. An XR application, installed on a HoloLens (Microsoft, WA, USA) head-mounted display, projected a hologram onto the surgical field. Results: The rapid intraoperative diagnostic tests were negative, and histopathology confirmed SCC without vascular or perineural invasion. No complications, including occlusal or feeding problems and sensory abnormalities, were observed. Postoperative imaging 3 years later showed no recurrence. Conclusions: Combining CAD/CAM and XR techniques for mandibulectomy may improve surgical accuracy and safety in oral and maxillofacial surgeries, whereas in-house 3D printing aids in managing tumor progression. [ABSTRACT FROM AUTHOR]

Objective: The authors examined the effect of previously described facial proportions and facial asymmetry on the perception of beauty and attractiveness. The optimal values of four different facial ratios and the optimal degree of asymmetry were examined. Methods: In this study, 10 faces were adjusted to reference values and -5%, -2.5%, +2.5%, and +5% deformations were created. Participants were asked to select via online survey the most and least attractive face between 5 photographs of the same person with different facial ratio values. Finally, split-face imaging was used to generate right and left-symmetrical images. These images along with the original images were questioned to determine the most and least attractive. Results: The most attractive face was closer to the reference ratio, whereas the least attractive face was most distant from the reference. Both left and right symmetrical faces were considered less attractive than natural asymmetrical faces. Conclusion: Standardized "golden" ratios are effective reference points for the perception of facial attractiveness although deviation from these proportions does not always imply that a face will not be perceived as attractive, as some degree of asymmetry also contributes to facial attractiveness and beauty. [ABSTRACT FROM AUTHOR]

In the United States, Oral and Maxillofacial Surgery (OMS) is a specialty of dentistry that focuses on the management of injuries, diseases, and defects of the head, neck, face, and jaws. The present manuscript is an article on education and training of OMS residents in the United States. It a lso briefly describes the scope of practice of the specialty. The manuscript also sheds light upon the less practiced areas such as research and business administration aspects of the specialty. The authors also discuss gender and racial distribution of OMS residents. Descriptive information was obtained from the literature and official organization websites. Lastly, owing to the background and the arduous training required, OMS is a specialty of its own kind. It is a combination of both medical and dental sciences, with surgical and anesthesia training, and is unique in the field of medicine and dentistry. OMS play a unique role in the bridge between medicine and dentistry. Continuing education and advocacy in the hospitals, institutions, and society are crucial for increased awareness of the scope of OMS to further our specialty. [ABSTRACT FROM AUTHOR]

This article reviews the human and veterinary literature regarding liposome encapsulated bupivacaine use in dentistry and oral and maxillofacial surgery. The purpose of this review is to present available information on this local anesthetic in a manner that will allow veterinary dentists and oral and maxillofacial surgeons to use evidence-based information when considering incorporating liposomal bupivacaine into their practice. The twelve human clinical studies and three veterinary reports that met the literature search criteria do not support the use of liposomal bupivacaine in veterinary dentistry and oral and maxillofacial surgery. [ABSTRACT FROM AUTHOR]

This review explores the recent advancements and ongoing challenges in regenerating alveolar bone, which is essential for dental implants and periodontal health. It examines traditional techniques like guided bone regeneration and bone grafting, alongside newer methods such as stem cell therapy, gene therapy, and 3D bioprinting. Each approach is considered for its strengths in supporting bone growth and integration, especially in cases where complex bone defects make regeneration difficult. This review also looks at different biomaterials, from bioactive scaffolds to nanomaterials, assessing how well they encourage cell growth and healing. Personalized treatments, like customized 3D-printed scaffolds, show promise in enhancing bone formation and tissue compatibility. Additionally, signaling molecules, like bone morphogenetic proteins, play a crucial role in guiding the process of bone formation and remodeling. Despite these advances, challenges remain—particularly with severe bone loss and with refining biomaterials for more reliable, long-term outcomes. This review proposes combining advanced materials, regenerative technologies, and personalized approaches to achieve more effective and consistent outcomes in oral and maxillofacial surgery. [ABSTRACT FROM AUTHOR]

Maxillofacial reconstruction surgery involves restoring bones or skeletal structures in areas such as the mouth, jaw, and face using bones like the iliac crest and fibula. This surgery requires a high level of difficulty and precision, necessitating extensive practice and accurate 3D model simulations. However, due to limitations in training environments, opportunities for sufficient practice are restricted, and the precision of simulations may be compromised by the limitations of existing tools. To address these challenges, this paper proposes a maxillofacial reconstruction surgery simulator utilizing virtual reality technology. The proposed method allows users to explore a virtual space through a head-mounted display, where they can visualize, navigate, and manipulate bone models (move and rotate) using the joystick and buttons of a controller, as well as perform resection operations. Additionally, to verify the effectiveness of the simulator, performance evaluation is conducted through frame per second and resource usage analysis, usability testing is performed via questionnaires with dental students, and accuracy validation is carried out for the reconstruction models. The results of each evaluation method are analyzed to confirm the utility and potential of the proposed simulator. [ABSTRACT FROM AUTHOR]

Background/Aim: This study aimed to investigate age- and sex-related morphological variations of the mandibular condyle, sigmoid notch, and coronoid process in a mid-sized German population using panoramic radiographs. Patients and Methods: A total of 150 participants (89 males, 61 females) aged between 18 and 80 years were included. Participants were divided by age and sex. Panoramic radiographs were obtained, and the right and left condylar processes, sigmoid notches, and coronoid processes were evaluated for shape variations. Results: Age-related differences were found in the mandibular condyles, with younger individuals exhibiting round-shaped condyles more frequently, while older participants showed a higher prevalence of flat-shaped condyles (p<0.001). Sex-related differences included females displaying more diamond-shaped condyles (p=0.033) and triangular-shaped coronoid processes (p=0.004), whereas males exhibited more round condylar processes. Conclusion: This study highlights significant age- and sex-related morphological variations in the mandibular condyles, sigmoid notches, and coronoid processes. These findings have important clinical implications for the diagnosis and treatment of temporomandibular joint disorders and maxillofacial surgery. Understanding these variations can improve diagnostic accuracy and surgical outcomes in patient-specific care. [ABSTRACT FROM AUTHOR]

Background/Objectives: The burden of scoliosis care extends beyond treatment costs and includes missed school for patients and lost income for parents. Chronic absenteeism, defined as more than 18 days of missed school, can have a significant impact on a child's educational progression, but missed school and work due to scoliosis treatment are not well quantified in the literature. This study investigates absenteeism among scoliosis patients and their caregivers. Methods: We conducted a retrospective comparative study of survey results based on surgery timing and surgery type. Patients and caregivers presenting for clinic visits for scoliosis treatment at a single large tertiary care center from 2014 to 2022 were queried. Results: We collected 2772 surveys from 1104 unique patients. Of these, 223 surveys from 132 patients were within one year of surgery: 140 post-fusion surveys, 71 post-nonfusion surveys, and 11 post-halo/multistage surgery surveys. A total of 2280 surveys were from 1022 nonoperatively treated patients. School absenteeism was significantly higher for surgeries during the school year compared to summer in both the fusion and nonfusion groups, though work absenteeism showed no significant differences. Halo/multistage surgery patients had the highest rates of absenteeism. Conclusions: This study highlights the impacts of scoliosis surgery timing and type on absenteeism among patients and their caregivers. Surgery during summer breaks reduces school absenteeism and academic disruption. Halo/multistage surgery patients face the greatest risk of chronic absenteeism from school, indicating a need for targeted interventions. Optimized surgical timing and planning can help families navigate the educational and financial challenges of scoliosis treatment. [ABSTRACT FROM AUTHOR]

ABSTRACT: The treatment of odontogenic keratocysts (OKCs) continues to be a contentious issue in oral and maxillofacial surgery. Despite extensive research and systematic reviews, no definitive protocol or consensus has been established. This case series investigates how OKCs can be treated through a thorough approach combining preoperative investigation – fine needle aspiration cytology (FNAC) – to confirm the diagnosis of OKC, followed by treatment of the combined surgical approach of enucleation, peripheral ostectomy, and chemical cauterization using modified Carnoy's solution under local or general anesthesia. This study demonstrates how well this multimodal therapy method works in lowering the chances of recurrence and reaching the best results. [ABSTRACT FROM AUTHOR]

ABSTRACT: Introduction: Bilateral sagittal split osteotomy (BSSO) is the most performed orthognathic surgery for mandibular dentofacial abnormalities. The most common complication is the neurosensory deficit. The current study was aimed at determining the incidence of inferior alveolar nerve neurosensory deficit (NSD) following BSSO surgery, and in assessing intra-operative nerve encounter status and possible relation to NSD. Materials and Methods: The pilot study was conducted in the Oral and maxillofacial surgery department, KIMS Dental college and hospital, Amalapuram, Andhra Pradesh. The sample of thirty subjects were selected from the patients undergoing BSSO surgeries from April 2022- July 2023, as according to the inclusion and exclusion criteria. Patients were followed up for six months postoperatively. The evaluation was done preoperatively and postoperatively (1week, 1 month, 3 months, 6months) using subjective and objective methods. NSD was assessed by both subjective (Five-point scale) and objective (2-point discrimination, pin pressure, and thermal discrimination) tests. Statistical Analysis: Descriptive statistics were used. Results: Post-osteotomy, the inferior alveolar nerve was in the distal fragment in 36 (60%) of the sites, 14 (22%) on the proximal fragment and needed dissection, 10 (18%) not seen post osteotomy, and nil (0%) got transected. The incidence of prolonged NSD was highest seen in the proximal fragment needing dissection. The neurosensory deficit after BSSO was 21.5% in post-six-month follow-up. Conclusion: The incidence of transient neurosensory deficit of the inferior alveolar nerve after BSSO surgeries is inevitable. Prolonged NSD is due to nerve manipulation depending on the nerve status intra-operatively. [ABSTRACT FROM AUTHOR]

Oral and maxillofacial surgery (OMS) is a field that straddles knowledge and clinical experience from both medical and dental specialties. In the small island nation of Singapore, the rapidly and constantly changing needs of its diverse and aging population, as well as changes in the mindsets of both students and educators have led to many developments in the local OMS program. Tied to the only dental school in the country, the curriculum of the training program has kept up with the changes in the demographics and attitudes of the local patient pool, which comprises a multicultural population with both traditional and modern mindsets. Since its inception, the training program has also shifted away from the traditional apprenticeship model of surgical specialties to include more integrated and modular learning with a heavy emphasis on evidence-based medicine, simulation training workshops, and more focus on digital planning and other technological advancements. This review explores the current scope of training and practice in the Singapore landscape, and how it has evolved and been tailored to meet the needs of its patients and future clinicians. [ABSTRACT FROM AUTHOR]

Adult spinal deformity (ASD) commonly affects older adults, with up to 68% prevalence in those over 60, and is often complicated by osteoporosis, which reduces bone mineral density (BMD) and increases surgical risks. Osteoporotic patients undergoing ASD surgery face higher risks of complications like hardware failure, pseudoarthrosis, and proximal junctional kyphosis (PJK). Medical management with antiresorptive medications (e.g., bisphosphonates, SERMs, and denosumab) and anabolic agents (e.g., teriparatide, abaloparatide, and romosozumab) can improve BMD and reduce complications. While bisphosphonates reduce fracture risk, teriparatide and newer agents like romosozumab show promise in increasing bone density and improving fusion rates. Surgical adaptations such as consideration of age-adjusted alignment, fusion level selection, cement augmentation, and the use of expandable screws or tethers enhance surgical outcomes in osteoporotic patients. Specifically, expandable screws and cement augmentation have been shown to improve fixation stability. However, further research is needed to evaluate the effectiveness of these treatments, specifically in osteoporotic ASD patients. [ABSTRACT FROM AUTHOR]

(1) Background: Necrotizing fasciitis is known as a severe condition with a high risk of mortality, placing it among the most feared infections. In most cases, it has a polymicrobial etiology (type 1), requiring complex treatment that is continuously adapted to the evolving microbiological status. The facial localization of the disease is rare, fulminant progressing, and is often life-threatening. (2) Methods: We present the case of a patient with multiple comorbidities who, following trauma to the nasal dorsum, developed a wound with a rapid and severe progression to extensive bilateral periorbital necrosis. This was accompanied by a dramatic deterioration in their general condition, a polymicrobial biological status, and fluctuating progression despite instituted treatment (both medical and surgical). (3) Results: The patient required multiple surgical interventions by multidisciplinary teams (plastic surgery; ear, nose, and throat specialist (ENT); maxillofacial surgery; and ophthalmology), experiencing periods of a severe, life-threatening general condition, necessitating prolonged orotracheal intubation. Wounds with fluctuating progression, extensive skin necrosis, and significant post-excisional soft tissue defects required skin graft coverage. The result meant a saved life and functional and aesthetic sequelae at the level of the face. (4) Conclusions: Necrotizing fasciitis of the face is a rare and severe disease that must be recognized early and treated appropriately by a multidisciplinary team to save the patient's life and minimize the resulting functional and aesthetic sequelae. [ABSTRACT FROM AUTHOR]

Introduction: Sufficient volume of bone is of prime importance for successful osseointegration of dental implants. The mandibular ramus acts as a good source of cortical bone graft with fewer complications compared to harvesting from the mandibular symphysis or body. Aim: To evaluate the maximum extent and different dimensions of cortical bone graft that can be harvested from the ascending ramus of the mandible while maintaining a safe zone from anatomical vital structures by using Cone Beam Computed Tomography (CBCT). Materials and Methods: A retrospective analytical study was carried out in the Department of Oral and Maxillofacial Surgery, Guru Nanak Institute of Dental Sciences and Research, Kolkata, West Bengal, India from February 2021 to September 2022. CBCTs of 30 patients were used to study 55 sites of the ascending ramus of the mandible. The CBCTs were collected from the institutional archive. The studies were done using NewTom Viewer (NNT) viewer software. The dimensions measured in the present study included length, height, thickness, surface area and volume of the bone graft. Each dimension was compared among genders, sides and different age groups (18-29 years, 30-45 years and >45 years). Statistical Package for Social Sciences (SPSS) version 22.0 was used for statistical analysis. Continuous variables (Mean, Median and Standard Deviation) were compared using Mann-Whitney U test or Kruskal Wallis Test as appropriate. Results: Among 55 sites, 25 (45.5%) were from female candidates and 30 (54.5%) were from males. A total of 56.4% (n=31) of the sites were from the right side and 24 (43.6%) were from the left side. The sites were divided into three age groups: 18-29 years 18 (32.7%), 30-44 years 24 (43.6%) and ≥45 years 13 (23.6%). The mean length of cortical bone graft that can be harvested from the mandibular ramus was found to be 14.49±2.66 mm, whereas the mean height and thickness were 6.40±2.07 mm and 3.04±0.61 mm, respectively. The mean surface area was found to be 308.88±75.37 sq mm, whereas the volume was 272.15±92.02 cu mm. Statistically significant differences were found for surface area and volume between genders, with males having greater dimensions than females. Conclusion: The mandibular ramus can be an excellent option for harvesting cortical bone grafts for alveolar ridge augmentation procedures. The maximum dimensions of the ramus bone graft observed in the present study will help surgeons decide whether to harvest the ramus graft according to the size of the defect present. [ABSTRACT FROM AUTHOR]

This study is envisioned to assess the structural changes the muscles undergo beneath the submucosal tissues and whether these changes necessitate a novel strategy from the existing conventional modality in the treatment of oral submucous fibrosis (OSMF) medically through a systematic literature survey. Literature search was performed electronically using Medline, EMBASE and CENTRAL databases to identify published literature until the end of April 2024 in dental, oral and maxillofacial surgery, plastic surgery and otolaryngology journals containing the terms "oral submucous fibrosis", "muscles of mastication", "muscles of facial expression", "histopathologic study", "ultrasonographic study", "CT", "MRI" in either their titles, abstracts, and keywords with only English being the preferred language. The data was extracted from the selected articles and prudently studied to gather and compile the data. Descriptive data from all the carefully chosen articles were selected and analysed. Seven studies met the inclusion criteria. It was observed that the masseter muscle was the first to be involved in the disease process of OSMF among the muscles of mastication and facial expression. It was observed that the anterior temporalis and orbicularis oris muscles remained unaffected. However, the buccinator muscle which lies in utmost vicinity is not evaluated in the included studies. The degree of muscle degeneration and the degree of disease progression were directly related to the duration of the habit. The restricted mouth opening noticed in OSMF is not only governed by the subepithelial fibrosis but also on the extent of muscle degeneration. The changes the surrounding muscles undergo could be a manifestation of the disease, atrophy as a sequalae to the limited functional activity of the muscles which is brought about by fibrosis or it could be an essential part of the disease itself. [ABSTRACT FROM AUTHOR]

The purpose of this study was to do a retrospective analysis about patients with zygomatic arch who were treated at the department of Maxillofacial Surgery, Regional University Hospital of Ancona, Italy, between 2007 and 2021. Patients were evaluated based on various parameters including age, sex, aetiology, symptoms, comorbidity, clinical findings, zygomatic arch fracture type, other facial fractures, treatment, waiting time before the operation, complications and sequelae. In the period described we recorded 103 zygomatic arch fractures. Of the patients, 64 were male (65,92%) and 39 were female (34,08%). The average age of the patients was 47,02 years (ranging from 8 to 93 years). The leading cause of these fractures was sports-related injury (n = 24; 23,30%), and isolated zygomatic arch fractures were the most frequent (63,1%). The most common clinical signs and symptoms were, pain, depression of the facial profile, difficulty in chewing, limitation of the buccal opening, difficulty in protrusion movements and mandibular lateralization. 93% of patients underwent surgery under local anesthesia, almost exclusively patients undergoing an open approach to internal fixation. The successful and effective management of zygomatic arch fractures requires a solid understanding of its anatomy, pathophysiology and related biomechanical structures and forces. The continuous research in epidemiology, aetiology, materials and techniques will further refine our treatments which are nowadays more and more customized according to the type of trauma. [ABSTRACT FROM AUTHOR]

The article in the journal "Dental Traumatology" discusses the importance of public health policies, regenerative endodontics, autotransplantation, computer-aided autotransplantation, tooth apexification, fragment reattachment, maxillofacial trauma in pediatric populations, restoration techniques for endodontically treated teeth, mouthguards in sports, social media's role in disseminating knowledge about dental trauma, and the integration of artificial intelligence in dental care. The text emphasizes the need for evidence-based practices, continued research, and advancements in dental trauma management to enhance patient outcomes and improve long-term dental health. The authors highlight the significance of accurate information dissemination, standardized treatment protocols, and the potential benefits of innovative techniques in dental care. [Extracted from the article]

Background: Odontogenic infections are common and self-limiting in most cases, but, they can lead to severe consequences and considerable morbidity and can even be fetal in spite of modern medical therapy. Patients and Methods: Retrospective study included data of pregnant patients with deep fascial space infections, done in Oral & Maxillofacial Surgery Department, Faculty of Dentistry. Alexandria University, and Oral & Maxillofacial Surgery Department, King Fahd Specialist Hospital, Burayda, Qassim, Saudi Arabia, from June2017 to Dec2022. Data were analyzed to study incidence, etiology, pattern, treatment modalities, outcomes, complications, and effects on pregnancy. Results: Thirty-eight pregnant patients, with a mean age of 30.8 ± 6.21 years, were included. The mean age of pregnancy was 24.5 ± 4.3 weeks. Diabetes mellitus was identified in seven cases (18.42%) and combined with hypertension in one case (2.63%) and with valvular heart disease in another one. The commonest affected single space was the submandibular space that occurred in six cases (15.8%). Canine space was the second single commonly involved one which occurred in five patients (13.2%). Complications occurred in 11 patients. Unesthetic scar occurred in three patients (7.9%). Trismus was observed in two patients (5.3%). Recurrent abscess was found in one case. Complications affecting the developing fetus and considered the most serious occurred in four patients: two cases of preterm labor and two cases of abortion. Conclusion: These infections may lead to serious outcomes and may have irreversible effects on the pregnancy and the developing fetus. Urgent intervention with multidisciplinary team to provide adequate care. [ABSTRACT FROM AUTHOR]

Analysis of skeletal, cephalometric, and volumetric changes and occlusion during long-term follow-up was performed for two patients who underwent bimaxillary facial transplantation (FT). The study material consisted of the follow-up data of two bimaxillary composite FT performed in Helsinki University Hospital, one in 2016 and the other in 2018. Serial three-dimensional computed tomography scans obtained during follow-up (6 years for patient 1, 4 years for patient 2) were analyzed. The position of the maxilla remained stable in both patients. At 4 and 6 years, the changes in the anterior maxilla were ≤1 mm, while the anterior mandible had moved 2.6–4 mm anteriorly and the mandibular midline 0.4–3.7 mm to the left side. Patient 1 underwent re-osteosynthesis 4 months after transplantation due to mandibular non-union. Patient 2 had a sagittal mandibular osteotomy at 15 months after FT due to lateral crossbite and tension created by temporomandibular joint rotation. Thereafter both patients had a stable occlusion. A continuous bone volume reduction in the mandible was noticed in both patients (6% and 9% reduction of the transplanted volume). The volume of the transplanted maxilla decreased during the early postoperative period but increased back to the original transplanted volume during the follow-up. [ABSTRACT FROM AUTHOR]

After nasal bone fractures, fractures of the mandible are the most frequently encountered injuries of the facial skeleton. Accurate identification of fracture locations is critical for effectively managing these injuries. To address this need, JawFracNet, an innovative artificial intelligence method, has been developed to enable automated detection of mandibular fractures in cone-beam computed tomography (CBCT) scans. JawFracNet employs a 3-stage neural network model that processes 3-dimensional patches from a CBCT scan. Stage 1 predicts a segmentation mask of the mandible in a patch, which is subsequently used in stage 2 to predict a segmentation of the fractures and in stage 3 to classify whether the patch contains any fracture. The final output of JawFracNet is the fracture segmentation of the entire scan, obtained by aggregating and unifying voxel-level and patch-level predictions. A total of 164 CBCT scans without mandibular fractures and 171 CBCT scans with mandibular fractures were included in this study. Evaluation of JawFracNet demonstrated a precision of 0.978 and a sensitivity of 0.956 in detecting mandibular fractures. The current study proposes the first benchmark for mandibular fracture detection in CBCT scans. Straightforward replication is promoted by publicly sharing the code and providing access to JawFracNet on grand-challenge.org. [ABSTRACT FROM AUTHOR]

A positive patient experience and person-centred care is at the forefront of all healthcare services and is linked to improved health outcomes. Patient satisfaction surveys are used widely to measure patient experiences and satisfaction with hospitals and can help to evaluate and improve services. This article presents a service evaluation from the patient perspective of their perioperative experience in a neuro-theatre suite of one hospital in Scotland. A patient questionnaire was used to evaluate factors that impact on the patient experience, including service quality, staff/patient interaction, comfort and needs, fears and concerns and information provision. A total of 97 responses to the questionnaire were received and findings showed 98.8% overall satisfaction with the care. Continuous evaluation of services is vital to understanding patient satisfaction with services provided by nurses, thus helping to improve the services. The gap in literature highlights the importance of continuing to use this tool within the perioperative neuro-theatre setting. [ABSTRACT FROM AUTHOR]

Background and Objectives: Third molar (wisdom tooth) extraction is one of the most common surgical procedures in oral and maxillofacial surgery. Traditional rotary instruments and burs have long been the standard tools for this procedure. However, recent advancements in surgical techniques, such as piezoelectric surgery, have gained popularity due to their purported advantages in terms of precision, safety, and postoperative outcomes. This systematic review aims to evaluate the efficacy, safety, and clinical outcomes of third molar surgery performed using burs versus piezoelectric surgery. Materials and Methods: This systematic review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A comprehensive literature search was performed using the PubMed, Scopus, Web of Science, and Cochrane databases to identify relevant studies published up until October 2024. Randomized controlled trials (RCTs), clinical trials, and comparative studies assessing third molar surgery using either burs or piezoelectric instruments were included. The primary outcomes evaluated were surgical time, postoperative pain, swelling, nerve damage, and healing time. The data extraction and quality assessment were performed independently by two reviewers using standardized tools, and any discrepancies were resolved by a third reviewer. Results: A total of five studies met the inclusion criteria, and the meta-analysis revealed that piezoelectric surgery resulted in significantly lower postoperative pain and swelling compared to traditional bur techniques (p < 0.05). Additionally, the incidence of nerve injury was lower in the piezoelectric group, though the difference was not statistically significant. Surgical time was found to be longer with piezoelectric devices, but this was offset by improved healing outcomes and patient comfort. Conclusions: Piezoelectric surgery offers a less traumatic alternative to traditional burs for third molar extraction, with reduced postoperative morbidity and enhanced patient outcomes. Although the longer surgical duration may be a drawback, the overall benefits, particularly in terms of pain management and tissue preservation, support the adoption of piezoelectric techniques in clinical practice. Further high-quality randomized trials are recommended to strengthen the evidence base for these findings. [ABSTRACT FROM AUTHOR]

Background and Objectives: Functional rehabilitation in patients with hemimandibulectomy remains a challenge no matter what method of reconstruction is chosen by physicians. In this paper, we aim to evaluate the feasibility of an acceptable occlusal restoration in patients who have undergone hemimanidublectomy without the reestablishment of mandibular continuity. Materials and Methods: Data were collected retrospectively on 10 patients with varying degrees of mandible resection. The greatest challenge in the restoration of an acceptable occlusion form is the natural latero-deviation that occurs in patients whose mandibular continuity was not restored. This causes an unbalanced and uncoordinated occlusal plane. Based on our research, this deviation is highly dependent on three main factors: the presence of teeth (which allow for a proprioceptive stimulus that counteracts the deviation), the extension of the defect and the presence or lack of the coronoid process. Results: Based on the presence of dental elements or lack thereof, patients were either rehabilitated with implant-supported dentures or removable partial dentures. Although the gold standard of care for these patients remains the restoration of mandible continuity through use of bone grafts, an acceptable rehabilitation of occlusion and therefore function may be acquired in non-grafted patients. Conclusions: Both physicians and patients must manage their expectations carefully and be eager to find a compromise to provide the best possible solution given the challenges of the premises. [ABSTRACT FROM AUTHOR]

This study aimed to compare the angular, platform, and apical deviation of zygoma implants placed with the aid of a dynamic navigation (DN) device compared with the implants placed freehand. Eight cadaver heads were used for the study. Preoperative cone beam computerized tomography (CBCT) scans were made for the heads, and an implant-planning software was used to plan zygoma implants bilaterally in each scanned head. A total of 16 zygoma implants were placed using each surgical technique. Postimplant CBCT scans were merged with the preoperative plan to evaluate and compare the accuracy of the implants using each technique. Angular and linear deviations of the implants were measured and compared. The effect of implant length and position on the deviation was also investigated. The results showed a mean angular deviation of 2.44° ± 1.10° for implants placed using DN compared with 6.63° ± 4.81° for implants placed freehand. The mean apical deviation for implants placed using DN and for implants placed freehand was 2.14 ± 1.02 mm and 3.80 ± 2.49 mm, respectively. Finally, the mean platform deviation for implants placed using DN and for implants placed freehand was 1.66 ± 0.9 mm and 2.81 ± 2.1 mm, respectively. The analysis showed a significant difference between the two techniques in angular and apical deviation (p =.001 and.029, respectively). Zygoma implants placed with a DN device resulted in less apical and angular deviation than implants placed freehand. [ABSTRACT FROM AUTHOR]

Background: Most tertiary-care teaching institutes in low and middle-income nations lack dedicated oral and maxillofacial surgery (OMFS) units in the emergency trauma centers. Consequently, most facial fractures need to be managed in the otolaryngology and head-neck surgery (ORL-HNS) setup. Objectives: To present a study on a series of patients with facial fractures attending the emergency and outpatient departments of ORL-HNS in a tertiary-care teaching institute in India that lacked the facility of OMFS in its emergency trauma center. Methodology: For the patients included in the study, a general protocol for managing polytrauma was followed. Patients with concomitant intracavitary and long bone injuries were excluded. Those with facial fractures that essentially required OMFS expertise were referred to dedicated maxillofacial centers. The most common presentation was pain/tenderness, followed by peri-orbital ecchymosis and trismus. Orbital symptoms were associated with orbital floor and zygomatico-maxillary complex fractures. Diagnosis and surgical planning were made following high-resolution computed tomography scan. Except for nasal bones, all the fractures were managed by open reduction and fixation. Results: The mean age of the 26 patients included in the series was 32.88 years (range 7–55 years) with a male preponderance of 2.7:1. The fractures involved orbital floor (n = 3), frontal bone (n = 2), mandible (n = 4), zygomatico-maxillary complex (n = 14), and nasal bone (n = 3). Road traffic accidents were the commonest etiology. Management of the respective facial bone fractures was done following the standard care of surgical practice. Conclusions: For their expertise in functionally and esthetically appropriate repair, a dedicated OMFS unit is desirable for managing facial fractures. The present series shares the experience of managing such fractures by the ORL-HNS team in the absence of an OMFS facility in the emergency trauma center, highlighting the importance of a multidisciplinary approach in the care delivery system. [ABSTRACT FROM AUTHOR]

Introduction: The postgraduates (PGs) training of maxillofacial surgery today needs an innovative teaching method. This is especially for increasing scope of the speciality, the need of speciality to team up with other medical specialities and gaining the surgical competency immediately after training. Interprofessional education (IPE) is one additional teaching method. It is an important pedagogical approach for preparing health professions students to provide patient care in a collaborative team environment. Aim: To assess improvement of resident's knowledge of and attitude towards the multidisciplinary approach to facial trauma management using Interprofessional Education module (IPE) Objectives: 1. To assess gain in knowledge of residents and 2. To assess the change in attitude of residents. Method: A prospective interventional study with 30 postgraduates participants from three disciplines underwent the IPE module planned. The assessment was done by MCQ pre- & post-questionnaire and structured viva voce for knowledge gain. For change in attitude, the attitude towards healthcare teams (ATHCT) questionnaire (prepost) was used. The descriptive statistics was used. Conclusion: IPE module is an effective clinical and service-based quality improvement education mode for postgraduates. There is definite gain in knowledge and improvement in attitude of residents. [ABSTRACT FROM AUTHOR]

Study Design: Prospective pre-post study. Objective: Maxillofacial trauma presenting to the emergency department (ED) are often accompanied with complex concomitant injuries, thereby making thorough diagnosis and treatment plan quite an exacting task owing to the demanding conditions of the ED. The use of a structured maxillofacial trauma template helps in documenting the injuries comprehensively, aids in treatment planning, avoids medical negligence thereby improving the quality of care given to the patient. The study introduced a structured maxillofacial trauma template to improve the quality of the ED documentation. Methods: A total of 220 patients were evaluated for the quality of their ED documentation from September 2023 till February 2024. The group A included 110 patients where complete medical documentation was done routinely on a blank A4 sized paper, group B included 110 patients where the documentation was done using the structured oral and maxillofacial trauma template. The ED notes were thoroughly evaluated by the 2 independent authors for record completeness and documentation rate of history and examination findings. Results: The introduction of trauma template demonstrated a significant improvement of 18.95 % in record completeness. Significant improvement was seen in documentation rate among the covariates like place of injury, time of evaluation, primary care given, wound classification, dento-alveolar injury, ophthalmic evaluation, nerve injury evaluation, comorbidities with P =.001, and referral with P =.03. The ophthalmic evaluation showed significant improvement among covariates (loss of visual acuity, reflexes, diplopia, enophthalmos, subconjunctival haemorrhage, chemosis, periorbital oedema, periorbital ecchymosis, ocular dystopia) with P =.001, and extraocular muscle restriction with P =.004. Conclusions: The study demonstrated that the use of a structured oral and maxillofacial trauma template can significantly improve the quality of the ED documentation and contributes to better patient care in the ED. [ABSTRACT FROM AUTHOR]

Study Design: This paper presents a case series analysis of 5 patients with Luhr class III mandible fractures treated using virtual surgical planning (VSP) and patient-specific implants (PSI) between October 2020 and February 2023. The study focuses on evaluating the effectiveness of VSP and PSI in managing complex mandibular fractures, particularly in edentulous patients. Objective: The primary objective is to assess the outcomes of using VSP and PSI for reconstructive surgery in patients with Luhr class III mandible fractures. The study aims to determine the accuracy of these techniques in fracture reduction and their impact on surgical complications and overall patient outcomes. Methods: The methodology involves a detailed preoperative planning process using VSP to design customized implants tailored to the specific anatomical needs of each patient. The study tracks the surgical procedures, implant placements, and postoperative outcomes, comparing the preoperative plans with the actual surgical results to evaluate accuracy and effectiveness. Results: The results indicate successful fracture reduction in all 5 patients, with a high degree of accuracy in implant placement and alignment compared to the preoperative virtual plans. The study highlights the benefits of VSP and PSI, including precise screw placement and enhanced potential for prosthetic rehabilitation. Despite the higher costs, the outcomes suggest significant advantages in terms of surgical precision and patient recovery. Conclusions: The use of VSP and PSI in the treatment of Luhr class III mandible fractures provides a tailored approach that enhances surgical accuracy and patient outcomes. While acknowledging the increased costs, the findings support the value of these advanced techniques in managing complex edentulous mandible fractures, advocating for their consideration in similar cases to improve surgical results and patient care. The study adds to the growing evidence of the benefits of VSP and PSI in reconstructive maxillofacial surgery. [ABSTRACT FROM AUTHOR]

Study Design: N/A. Objective: This study investigated the different ways of orbital floor reconstruction with special focus on reconstruction materials, imaging modalities (intra-/ post-operative), 3D printing and navigation. Methods: The heads of all governmental-run or associated cranio-maxillofacial surgery units in Switzerland, Austria and Germany were asked in person or received an email link for an online survey with 12 questions. Results: The return rate was 57%. The most often selected number of reconstructions was between 10 and 50 per year. Resorbable polydioxanone (PDS) foils (41%) and titanium mesh (18 %) were most often used to reconstruct the orbital floor. 31% use 3D Navigation intraoperative. Post-operative imaging was most often performed with CBCT (34.5%) in patients without complications, whereas CT scans were most often performed (63.3%) in patients with persisting complications. In total, 27% stated that they never use preformed orbital plates, and the remaining units use them more or less regularly. 48% have access to a 3D printer and 75% of the respondents use patient specific implants. Conclusions: The majority of the participating units prefer to use resorbable material for the reconstruction of the orbital floor defects. 3D printing facilities are not available in the majority of units, but it can be expected that the number of units with 3D printing facilities will rise in the near future. [ABSTRACT FROM AUTHOR]

Study Design: This study explores the workflow of in-house computer-aided design/manufacturing (CAD/CAM) in head and neck oncologic surgery, focusing on 3D printing of biomodels and cutting guides. Objective: We aim to describe a validated workflow for an in-house 3D Printing Department within a level III University Hospital of the Spanish Public Health System using free software. Methods: Our study outlines a cost-effective and time-efficient workflow utilizing free software for 3D printing. We assess the feasibility of establishing an in-house department compared to outsourcing to the biomedical industry. Results: The study demonstrates that creating an in-house 3D Printing Department in a hospital setting is a viable option. We discuss the advantages, including cost savings and reduced lead times, as well as the limitations of this approach. Conclusions: In conclusion, establishing an in-house 3D Printing Department has the potential to significantly streamline complex head and neck oncologic surgery procedures. This approach can enhance accessibility to advanced CAD/CAM, making them more efficient and cost-effective within the healthcare system. [ABSTRACT FROM AUTHOR]

Purpose: This study aims to compare the outcomes of suture-less and multiple suture closure methods on postoperative pain, swelling, and trismus, and associated complications. Materials and methods: This prospective, randomized clinical trial was conducted at the Department of Oral & Maxillofacial Surgery, Goa Dental College & Hospital. Inclusion criteria encompassed subjects aged between 17 and 55 years, classified as American Society of Anaesthesiologists (ASA) I, with asymptomatic impacted third molars falling within the moderately difficult impaction range (Pederson's difficulty index: 5–7). Study excluded individuals classified as ASA II, III, or IV, those with known or suspected allergies to the anaesthetic solution, immunocompromised patients, and individuals taking medications that could affect healing. Pregnant or lactating females and those with a history of bleeding disorders were also excluded. Wound closure methods were compared: Group A underwent primary closure with silk sutures, while Group B had suture-less closure. Subjects were allocated to the specific groups using a simple randomization method. This involved using a lottery-based random sequence to assign each participant to either Group A or Group B. Pain intensity, facial swelling, and trismus were key outcomes. Secondary outcomes included lingual nerve sensation and postoperative complications. Demographics factors, surgical details, radiographic and perioperative data, and physiological parameters were considered. Non-parametric tests and parametric test (repeated measure ANOVA) were employed. Statistical significance was set at P < 0.05. Results: Among 101 participants, both closure techniques exhibited similar outcomes in pain, swelling, and lingual nerve function. However, suture-less closure resulted in significantly less trismus and fewer cases of delayed wound healing. Conclusions: Suture-less method after surgical removal of third molar may reduce trismus compared to multiple sutures. While pain, swelling, and lingual nerve function management were comparable. [ABSTRACT FROM AUTHOR]

With increasing age and edentulism, numerous esthetic changes occur to the perioral region. The upper lips lose definition, flatten, and lengthen, the cupid's bow is lost, and the oral commissures descend. The nasolabial folds deepen, marionette lines become prominent, vertical rhytids around the lips form, and chin rhytids form. Chronic exposure to UVA radiation from the sun can lead to photodamage, characterized by wrinkles, lentigines, actinic keratoses, and other pigment changes. In addition, edentulism leads tojaw atrophy, which often compromises soft tissue support. Removable dentures, the conventional treatment to restore missing teeth, not only replace teeth, but also provide support to the lips via the labial flange. Implant-supported Axed prostheses are a very popular option to restore completely edentulous arches; these prostheses are flangeless, providing no bulk to the lips. Addressing changes in the perioral region due to aging and edentulism requires a combination of treatments, with each addressing different issues. Onabotulinum toxin A can be used to treat dynamic perioral and chin rhytids, and upturn the corners of the mouth. Hyaluronic acid filler can be used to treat deep nasolabial folds, marionette lines, and re-volumize the lips. Chemical peels can treat photodamaged skin, static rhytids, and other dermatologic pathologies. The subnasal lip lift, developed by Cardoso and Sperli in 1971, has become an increasingly common technique used to rejuvenate the upper lip in elderly and edentulous patients. This case report describes an elderly patient who was treated with a combination of subnasal lip lift, hyaluronic acid filler, onabotulinum toxin A, and chemical peel to achieve superior perioral esthetics. This case highlights the synergy of each procedure when done in combination to achieve highly effective results. [ABSTRACT FROM AUTHOR]

Abstract Identifying high-risk patients for developing postoperative delirium (POD) is essential for optimizing the medical field’s human and financial resources through specialty-relevant geriatric assessments that can aid in establishing prehabilitation strategies. This study aims to identify geriatric screening tools to predict preoperative delirium and explore the high-risk elderly patients undergoing oral maxillofacial surgery. A comprehensive geriatric assessment encompassing 23 instruments was used to evaluate inpatients undergoing surgery under general anaesthesia, preoperatively and postoperatively. Selective intraoperative and postoperative variables were also assessed for their relation to POD occurrence. This prospective study included 90 patients (mean age 79.0 years) from August 2022 to August 2023. The POD rate in this cohort was (8.9% n = 8). The Clock-Drawing Test (CDT) was significantly associated with POD occurrence (p = 0.005). Significant associations were found between POD occurrence and operation type (p = 0.018), duration (p = 0.026), length of stay ( p = 0.002), and postoperative hemoglobin levels (p = 0.027). This study highlights the importance of comprehensive geriatric assessments in predicting POD in elderly patients. Future research should build on these findings to enhance preoperative care strategies and improve outcomes. Trial registration: German Register of Clinical Studies, DRKSID DRKS00028614.

During maxillofacial surgery, the precise placement of surgical tools is crucial for accurate implant placement. Particularly if multiple implants are needed, e.g., after cancerous bone removal, visual landmarks might not be obtainable. To this end, we propose a vision-based tracking approach with deep learning. Our markerless tracking approach is based on video streams from two cameras for tracking a mandible phantom. We study, to what extent vision-based localization using deep learning is feasible. For real-time 6D pose estimation we propose a Siamese network with a ResNet-18 subnetwork. We acquire a large training dataset with a robot and evaluate the tracking accuracy on partially occluded images. Thereby, we mimic visual information that is accessible during clinical interventions. We report a mean position error of 1.33 ± 1.14mm and a rotation error of 0.86 ± 0.71 deg for partially occluded images. Overall we present a promising tracking approach that is marker-free and robust toward image artifacts.

Background: Three-dimensional (3D) printing produces objects by adding layers of material rather than mechanically reducing material. This production technology has several advantages and has been used in various medical fields to, for instance, improve the planning of complicated operations, customize medical devices, and enhance medical education. However, few existing studies focus on the adoption and the aspects that could influence or hinder the adoption of 3D printing. Objective: To describe the state of 3D printing in Sweden, explore the perceived effects of using 3D printing, and identify barriers to its adoption. Methods: A qualitative study with respondents from seven life science regions (i.e., healthcare regions with university hospitals) in Sweden. Semi-structured interviews were employed, involving 19 interviews, including one group interview. The respondents were key informants in terms of 3D printing adoption. Data collection occurred between April and May 2022 and then between February and May 2023. Thematic analysis was applied to identify patterns and themes. Results: All seven regions in Sweden used 3D printing, but none had an official adoption strategy. The most common applications were surgical planning and guides in clinical areas such as dentistry, orthopedics, and oral and maxillofacial surgery. Perceived effects of 3D printing included improved surgery, innovation, resource efficiency, and educational benefits. Barriers to adoption were categorized into organization, environment, and technology. Organizational barriers, such as high costs and lack of central decisions, were most prominent. Environmental barriers included a complex regulatory framework, uncertainty, and difficulty in interpreting regulations. Technological barriers were less frequent. Conclusions: The study highlights the widespread use of 3D printing in Swedish healthcare, primarily in surgical planning. Perceived benefits included improved surgical precision, innovation, resource efficiency, and educational enhancements. Barriers, especially organizational and regulatory challenges, play a significant role in hindering widespread adoption. Policymakers need comprehensive guidance on 3D printing adoption, considering the expensive nature of technology investments. Future studies could explore adoption in specific clinical fields and investigate adoption in non-life science regions within and outside Sweden. [ABSTRACT FROM AUTHOR]