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The anterior mandible is the most challenging anatomical site for performing periodontal plastic surgeries. Increased demands for optimal root coverage and esthetic outcomes contribute to the development of pedicle flap-based surgical solutions, in contrast to the predominantly used free gingival graft. The aims of this study were to (1) summarize the current literature to identify the most-used techniques, indications, and their efficacy, and (2) provide a decision table for surgeons to navigate through the selection of appropriate techniques. Four main approaches were identified: free gingival graft, lateral sliding, tunneling, and coronally advanced flap. The flap approaches are mostly combined with a connective tissue graft. The decision table considers the patient's chief complaint, local anatomical factors, and technique sensitivity. The table provides a framework for supporting an evidence-based selection of surgical techniques and for studying novel methods to achieve predictable root coverage in the anterior mandible. [ABSTRACT FROM AUTHOR]

Objective: Currently, there is no established treatment protocol to treat interdental papillary loss. This research aimed to evaluate the outcomes of interdental papillary reconstruction using minimally invasive surgery, with injectable hyaluronic acid gel. Method and materials: Seventeen patients were included, each with five sites of class 1 papillary recession (40 sites in the maxilla and 45 sites in the mandible). Subperiosteal tunneling was performed through a horizontal incision made apical to the base of the papilla without penetrating it. The free gingival sulcus was sealed by 000 retraction cord. A total of 0.2 to 0.6 mL hyaluronic acid was injected gradually. The incision was sutured with poly-glycolic sutures. Treated sites underwent clinical and digital evaluation at three follow-up time points (1 month, 3 months, and 6 months). Results: The interdental papillary defect height in the maxillary sites significantly reduced by 60%, 66%, and 42% at 1,3, and 6 months, respectively. In mandibular sites, the reduction was 54%, 55%, and 40% at the same follow-up time points. Regarding interdental papillary defect surface area in the maxilla, the reduction was 65%, 71%, and 45% at 1, 3, and 6 months. In the mandible, a reduction of 60%, 64%, and 48% was noticed at the same time points. Regarding patients' pain level score, during the day of surgery, 16 patients reported pain; the average pain score out of 10 was 3.94, and 11 patients (64.7%) needed to take analgesics. The pain generally subsided in the following days. At the day of treatment, 12 out of the 17 patients (70.6%) reported mild difficulty in speaking and eating. No complication, hypersensitivity, or allergy was noted in any patient. Conclusion: Subperiosteal tunneling with hyaluronic acid injection demonstrates clinical improvements in papilla height and papillary recession surface area reduction after 3 months of follow-up, with reduction in improvement after 6 months. Clinical significance: Adjunctive use of hyaluronic acid injection with minimally invasive surgery in interdental papillary management may improve clinical and esthetic outcomes. [ABSTRACT FROM AUTHOR]

Objective: Mucogingival surgery involving tissue grafts is commonly employed for cosmetic procedures like root coverage, and is increasingly applied in implant therapy to modulate peri-implant soft tissues and enhance implant survival. These procedures involve harvesting autologous connective or epithelial connective tissue, often from the palate or tuber maxillae. However, this can cause patient morbidity due to postoperative pain. Substitute materials, including animal-derived and xenografts, have been developed but lack qualities of autologous grafts. Method and materials: To address postoperative discomfort, a novel technique, named "palatal shield," using composite resin stabilized on adjacent teeth's palatal surface is proposed as an aid to donor site healing after mucogingival procedures. Two cases are reported where this technique was successfully applied. The first case involves a 53-year-old woman undergoing free gingival graft surgery for peri-implant treatment. The second case features a 58-year-old man receiving subepithelial connective tissue graft surgery for root sensitivity. Results: Ten days post surgery, both patients reported excellent postoperative comfort. The technique's effectiveness is highlighted in these cases, demonstrating its applicability in various surgical cases involving free gingival graft or connective tissue graft harvesting. Conclusion: The proposed "palatal shield" technique offers several advantages, including enhanced patient comfort, ease of application, and cost-effectiveness, making it a promising addition to mucogingival surgical procedures. [ABSTRACT FROM AUTHOR]

Vertical ridge augmentation in the anterior mandible is a technically delicate procedure that requires knowledge of some anatomical structures to reduce intra- and postoperative complications. Proper soft tissue management is one of the primary aspects to the success of these techniques, enabling tension-free primary wound closure and preventing membrane exposure. This cadaveric and clinical study provides an anatomical overview of the lingual portion of the anterior mandible. Moreover, there is a description of a novel surgical approach for release of the lingual flap that will help clinicians achieve primary closure without incurring intrasurgical complications. [ABSTRACT FROM AUTHOR]

This randomized controlled trial aimed to determine the clinical efficacy of xenogeneic collagen membrane (XCM) derived from porcine peritoneum in combination with a coronally advanced flap (CAF) in the management of gingival recession defects and to compare the outcomes to those of connective tissue grafts (CTGs). A total of 12 systemically healthy individuals presenting with 30 isolated/multiple Cairo RT 1/2 gingival recession defects in maxillary canines and premolars were randomly treated either with CAF + XCM or CAF + CTG. Recession height (RH), gingival biotype (GB), gingival thickness (GT), width of keratinized gingiva (WKG), and width of attached gingiva (WAG) were recorded at baseline and at 3, 6, and 12 months. Patient perceptions of pain and esthetics and the modified root coverage esthetic score (MRES) were also documented. From baseline to 12 months, both groups showed a significant reduction in mean RH (CAF + CTG: 2.73 ± 0.79 mm to 0.33 ± 0.61 mm; CAF + XCM: 2.73 ± 0.88 mm to 1.20 ± 0.77 mm). At 12 months, CAF + CTG sites had a mean root coverage percentage (MRC%) of 85.60% ± 28.74%, whereas CAF + XCM sites had an MRC% of 55.13% ± 31.22%. CAF + CTG-treated sites had significantly better outcomes, with a greater number of sites achieving complete root coverage (n = 11) and higher MRES scores than the porcine peritoneal membrane group (P < .05). [ABSTRACT FROM AUTHOR]

Successful rehabilitation of the anterior maxilla remains a challenge, primarily due to postextraction ridge collapse, which can lead to gingival recession and a nonesthetic appearance. The socket shield technique presents a viable alternative for immediate dental implant placement in the esthetic zone. This pilot study aimed to evaluate the survival, complication rates, and marginal bone loss around body-shift implants placed in fresh extraction sockets with the socket shield technique to replace maxillary incisors. After socket shield preparation, 14 hopeless incisors were extracted and immediately replaced by a body-shift implant (Inverta, Southern Implants) at baseline. Patients were followed up for 12 to 39 months (mean: 18.1 ± 8.2 months). The average age was 52.3 ± 16.9 years, and the survival rate was 100%. One socket shield presented minimal internal exposure that was successfully treated with a connective tissue graft. The mean PES score was 12.9 ± 1.2. Mean interproximal marginal bone loss was -0.4 ± 0.5 mm. Body-shift implants can be a promising alternative for immediate tooth replacement combined with the socket shield technique. The superior esthetic outcomes remained stable, suggesting that the extra space created by the narrow cervical portion of the implant is beneficial for preserving the alveolar bone and limiting internal shield exposure. [ABSTRACT FROM AUTHOR]

This study evaluated the clinical efficacy of the coronally advanced lingual flap (CALF) technique in terms of the extent of lingual and buccal flap advancement, the maintenance of primary wound closure, and safety in comparison to buccal flap advancement alone during horizontal ridge augmentation in the posterior mandible. A total of 14 patients were randomly allocated to two different groups: buccal flap advancement without the CALF technique (control), referred to as the NO-CALF group, and buccal flap advancement with the CALF technique (test), referred to as the CALF group. Wound healing was monitored weekly for the first 4 weeks, then at 2, 4, 6, and 9 months postoperatively for any sod tissue dehiscence (titanium mesh [TM] exposure) along the incision line. The extent of lingual and buccal flap advancement was measured, and any intraoperative and postoperative CALF-related complications were reported. The difference between groups was statistically significant (P < .0001) in terms of (1) TM exposure: 83.3% of cases in the NO-CALF group showed early Class П exposures, whereas the CALF group showed no exposure; (2) mean lingual flap advancement: 3.9 ± 1.1 mm and 14.4 ± 3.8 mm for the NO-CALF and CALF groups, respectively; and (3) mean buccal flap advancement: 15.8 ± 2.1 mm and 10.5 ± 1.4 mm for the NO-CALF and CALF groups, respectively. There were no reported complications related to the CALF technique. Tension-free primary wound closure was facilitated and maintained during the healing period by applying the CALF technique, which is a reliable technique to safely advance the lingual flap coronally. [ABSTRACT FROM AUTHOR]

Purpose: To examine the stresses caused by different All-on-4 surgical techniques—conventional, a combination of monocortical and bicortical, bicortical, and nasal floor elevation—on the implant and the surrounding bone using 3D finite element analysis (FEA). Materials and Methods: A 3D bone model of the atrophic maxilla was created based on CT imaging of the fully edentulous adult patient. All implants used in the models were 4 mm in diameter, and the length was 13 mm in the anterior and 15 mm in the posterior. Implants were applied to four different atrophic maxillary models with the All-on-4 technique: anterior and posterior monocortical implants in the first model, anterior monocortical and posterior bicortical in the second model, anterior and posterior bicortical in the third model, and anterior and posterior bicortical with nasal floor elevation in the fourth model. Eight linear analyses were performed by applying force from both vertical and 45-degree oblique directions to the four models prepared in our study. Results: When the cortical and cancellous bone around the anterior implants was examined, it was observed that the oblique and vertical loading conditions and the stresses around the implant were similar in all models. When the posterior implants were examined, model 1 (ie, anterior and posterior monocortical implants) showed the greatest oblique compression, vertical compression, and vertical tension forces. According to the Von Mises stress (VMS) analysis results for anterior and posterior implants, higher values were observed in model 1 compared to models 3 and 4 under oblique and vertical forces. It was observed that bicortical placement of the implants reduced the stresses on the bone and implant-abutment system but had no significant effect on the stress on the bar. Conclusions: According to the results of our study, in the All-on-4 technique, bicortical placement of the implants reduced the stresses on the bone and implant when the anatomical limitations allowed. In addition, nasal floor elevation can be applied in the atrophic maxilla in appropriate indications. [ABSTRACT FROM AUTHOR]

Currently, the incision design for periodontal and implant surgeries is mainly based on the surgeon's personal preference. The primary aim of this study is to review the intricate periodontal microvascular system and to illustrate the potential impact of commonly applied flap designs on the integrity of this system. A complete literature electronic search resulted in 37 relevant articles. The maxillary, facial, and lingual arteries supply the microvasculature system, including the supraperiosteal, intraligamental, and intraosseous arterioles. These arterioles have their own territories yet are extensively interconnected. The impact of common papilla management techniques are discussed, including tunneling; papilla base, incision, and preservation; and flap-releasing incisions. Flap design can impact reperfusion and blood inflow in the early healing phase, which eventually influences wound closure probability, healing speed, surgical predictability, tissue volume change, and postoperative morbidity. Future studies on the three-dimensional distribution of microvasculature and clinical impact of various flap designs on tissue reperfusion can lead to evidence-based incision selection and improved wound-healing outcomes. [ABSTRACT FROM AUTHOR]

This study clinically and histologically evaluated the outcome of a porcineapatite xenograft used to elevate the maxillary sinus floor in a severely atrophic ridge. A two-stage crestal window sinus elevation protocol was conducted in 24 patients with crestal bone ≤ 2 mm. Highly porous porcine carbonate apatite moistened with saline solution was placed in the elevated sinus cavity as the sole grafting material. Bone core biopsy samples were taken at 6, 9, and 12 months after sinus augmentation surgery (at implant placement). Treatment outcomes were assessed using microCT (μCT) and histologic analysis. Statistical analysis was performed using nonparametric Kruskal-Wallis test, followed by post-hoc Dunn multiple comparison test. At 6 months after implant placement, all implants achieved good primary stability (insertion torque ≥ 30 Ncm) and successfully osseointegrated. The residual graft amount (mean ± SE) was low (11.91% ± 1.99%) at 6 months and further decreased (6.11% ± 2.64%) by 12 months. On the contrary, the amount of new bone detected was 18.94% ± 4.08% at 6 months and was significantly (P < .05) increased (40.16% ± 5.27%) at 12 months. Histologic assessment revealed osteoclasts actively resorbing the graft as well as osteoblasts actively forming new bone. In the severely atrophic maxilla, the porcine-apatite xenograft promotes new bone formation while being slowly absorbed. Within the limited sample size, the porcine-apatite xenograft seems to be a good graft material for crestal window sinus augmentation. [ABSTRACT FROM AUTHOR]

The aim of this case series was to evaluate the clinical performance of a new volume-stable collagen matrix (VCMX) in combination with the modified coronally advanced tunnel technique (MCAT) for the treatment of gingival recessions. Thirteen patients with a total of 33 maxillary RT1 single and multiple gingival recessions were included in the study. Probing pocket depth (PPD), recession width (RECW), recession depth (REC), height of keratinized tissue (HKT), and gingival thickness (GT) were assessed at baseline and at the 12-month follow-up. Postoperative healing was uneventful in all cases without any complications. At 12 months, mean root coverage (MRC) was 92.88%, with complete root coverage (CRC) in 87.88% of treated sites. The present findings suggest that VCMX in combination with MCAT results in predictable coverage of maxillary RT1 gingival recessions. Further studies with larger sample sizes and control groups are needed to support these preliminary outcomes. [ABSTRACT FROM AUTHOR]

Objectives: Low bone density and lack of adequate vertical bone dimension as a result of maxillary sinus pneumatization present some of the most problematic cases for endosseous implant applications in posterior maxillary regions that hinder prosthetic rehabilitation. The overall objectives of the study were to assess the histologic, histomorphometric, and radiologic evaluation of biopsies gathered from maxillary sinuses that were grafted with three different bovine bone particles (Bio-Oss, Cerabone, and Ti-Oss) and analyze the volume of the bone graft and the quantity of new bone formation. Method and materials: Thirty-six patients with < 4 mm of residual ridge height unilaterally in the posterior maxilla were equally divided into three groups, each of which received different bovine bone particles for maxillary sinus augmentation. Six months later, biopsies were harvested for histologic and histomorphometric evaluations. Volumetric changes in maxillary sinus augmentation were analyzed at 1-week and 6-month time-points following maxillary sinus augmentation surgery. Results: Histomorphometric and histologic analysis revealed a significant difference between the Ti-Oss group compared with the Bio-Oss and Cerabone groups (P=.011). In terms of residual graft particlesand soft tissue, there were no significant differences between groups. 3D volumetric reductions between 1-week (baseline) and 6-month time-points recorded significant graft volume reduction in all groups (P < .05). Significantly greater bone resorption and lower new-bone formation were manifested in the Ti-Oss group in comparison to the other groups. Conclusions: Within the limits of thisstudy, histologic and radiologic results indicated that Bio-Oss and Cerabone could be used efficiently in sinus augmentation procedures, while further prospective studies are needed to evaluate the Ti-Oss material in maxillary sinus augmentation. [ABSTRACT FROM AUTHOR]

An 8-year-old male intact mixed breed dog was treated for a 3.7×3×3.6 cm grade 1 multilobular osteochondrosarcoma (MLO) arising from the dorsal aspect of the right coronoid process with a coronoidectomy, a zygomectomy, and a caudal maxillectomy. Ten months later, the dog presented for a swelling near the right angular process, which was presumed to be a locoregional recurrence. Blood work and initial staging tests (abdominal ultrasound) had mild abnormalities of no clinical concern/significance. The dog was hospitalized with a plan for computed tomographic (CT) scan of skull and chest the following day. Overnight, the swelling rapidly increased, and the dog became laterally recumbent, febrile, and hypotensive. Laboratory evaluation revealed hypoglycemia, elevated lactate, and elevated band neutrophils with moderate toxicity, most consistent with sepsis. The dog was stabilized with fluid resuscitation, intravenous (IV) antibiotics, IV dextrose, and pressor support. Once stabilized, a contrast CT scan was performed, which revealed evidence of an infected parotid gland sialocele. To our knowledge, this is the first veterinary case that describes sepsis secondary to an infected protracted parotid sialocele.

Orofacial clefts are among the most prevalent birth defects, with severe medical and psychosocial consequences. Cleft lip with or without cleft palate (CL ± P) and cleft palate only (CPO) affect on average nearly 1/700 births worldwide. The cause of most non-syndromic cases is unknown. Maternal factors and disorders are assumed to modify the risk of orofacial clefting. In the present study, we performed a systematic review and meta-analysis to analyze the effects of maternal underweight, obesity, hypertension, diabetes, as well as smoking, and alcohol consumption on the development of orofacial clefts. As CL ± CP and CPO have distinct pathogenetic backgrounds, these cleft subtypes were assessed separately. Altogether, 5,830 studies were identified and 64 of them met the inclusion and exclusion criteria. Obesity significantly elevated the odds of clefting (OR = 1.28, CI:1.08–1.51) (ORCL±CP = 1.23, CI:1.01–1.50; ORCPO = 1.31, CI:0.97–1.77). Maternal underweight also significantly increased the odds of clefting (OR = 1.21 CI:1.06–1.38). In mothers with type 1 diabetes, the odds of cleft development were significantly elevated (OR = 1,75, CI:1.45–2.12). Essential hypertension was also associated with higher odds of developing cleft (OR = 1.55, CI:1.18–2.03). Smoking during pregnancy significantly elevated the odds of cleft development (OR = 1.55, CI:1.34–1.79) (ORCL±CP = 1.58, CI:1.36–1.83; ORCPO = 1.50, CI:1.15–1.96). Passive smoking was even more damaging than active tobacco use, but alcohol consumption had no effect. In conclusion, this study clearly showed the importance of maintaining normal maternal body weight and emphasized the importance of hypertension and type 1 diabetes care in the first months of pregnancy. It also highlighted similarnegative effects of passive and active smoking, while alcohol consumption did not seem to be a significant risk factor for cleft development. However, there is a complete lack of available studies on the interactions of these factors, which is an essential direction for improving prevention. [ABSTRACT FROM AUTHOR]

To discuss the application value of Case-based Learning (CBL) combined with Bridge-In, Objective, Pre-assessment, Participatory Learning, Post-assessment, and Summary (BOPPPS) model into master students' program of oral and maxillofacial surgery. 38 master's students in oral and maxillofacial surgery at Y2 and Y3 from January 2022 to December 2022 are selected as the research objects. They are randomly assigned into two learning groups, namely the traditional LBL (Learn-based Learning) (19 participants) and CBL combined with BOPPPS mode (19 participants). Their theoretical knowledge was assessed after training and the modified Mini-Clinical Evaluation Exercise (Mini-CEX) scale was used to score their clinical thinking. At the same time, the Personal Teaching Efficiency and the Teachers' Sense of Teaching Efficiency (TSTE) were evaluated, and students' satisfaction with teaching outcomes was investigated. The basic theoretical knowledge, clinical case analysis and total scores of the experimental group were better than those of the control group, with statistically significant difference (P <0.05). Based on the evaluation of clinical speculative thinking by the modified Mini-CEX, it is found that except for the medical history writing level without statistically significant difference (P >0.05), the other four items and total scores in the experimental group were better than those in the control group, with statistically significant difference (P <0.05).The Personal Teaching Efficiency, TSTE and total scores were higher than those before adopting CBL combined with BOPPPS teaching mode, with statistically significant difference (P <0.05).The sampled master's students in experimental group believed that the new teaching method could improve students' ability to clinical speculative thinking, with statistically significant difference in all aspects (P <0.05).More participants in the experimental group suggested that the new teaching mode has increased learning pressure, but without statistically significant difference (P >0.05). CBL combined with BOPPPS teaching method can improve students' clinical critical thinking ability and help them adapt to the clinical rhythm. It is an effective measure to ensure teaching quality and is worthy of promotion. It is worthwhile to promote the application of CBL combined with BOPPPS mode into master's course of oral and maxillofacial surgery, which not only improve the basic theoretical knowledge and speculative thinking ability of master's students, but also improve the teaching efficiency. [ABSTRACT FROM AUTHOR]

Background: Recent advancements in dental implantology have significantly improved outcomes, with success rates of 90–95% over a 10-year period. Key improvements include enhanced preplanning processes, such as precise implant positioning, model selection, and optimal insertion depth. However, challenges remain, particularly in achieving correct spatial positioning and alignment of implants for optimal occlusion. These challenges are pronounced in patients with reduced bone substance or complex anthropometric features, where even minor misalignments can result in complications or defects. Methods: This paper introduces a vision-guided robotic system designed to improve spatial positioning accuracy during dental implant surgery. The system incorporates advanced force-feedback control to regulate the pressure applied to bone, minimizing the risk of bone damage. A preoperative CBCT scan, combined with real-time images from a robot-mounted camera, guides implant positioning. A personalized marker holder guide, developed from the initial CBCT scan, is used for patient–robot calibration. The robot-mounted camera provides continuous visual feedback of the oral cavity during surgery, enabling precise registration of the patient with the robotic system. Results: Initial experiments were conducted on a 3D-printed mandible using a personalized marker holder. Following successful patient–robot registration, the robotic system autonomously performed implant drilling. To evaluate the accuracy of the robotic-assisted procedure, further tests were conducted on 40 identical molds, followed by measurements of implant positioning. The results demonstrated improved positioning accuracy compared to the manual procedure. Conclusions: The vision-guided robotic system significantly enhances the spatial accuracy of dental implants compared to traditional manual methods. By integrating advanced force-feedback control and real-time visual guidance, the system addresses key challenges in implant positioning, particularly for patients with complex anatomical structures. These findings suggest that robotic-assisted implant surgery could offer a safer and more precise alternative to manual procedures, reducing the risk of implant misalignment and associated complications. [ABSTRACT FROM AUTHOR]

Objectives: To date, studies have only investigated the use of platelet-rich fibrin (PRF) after removal of third molars from the mandible or maxilla. Removal of the upper and lower third molars is typically combined into one session per side; therefore, this study aimed to investigate influence on PRF. Materials and methods: This prospective, single-blinded, randomized controlled, clinical trial (split-mouth design) included 25 patients. After third molar removal, the test group’s sockets were treated with solid PRF clots, whereas the control group’s sockets were conventionally treated. The primary outcome was swelling, which was measured digitally and analogously. Secondary outcomes included trismus, pus, hematoma, and clinical attachment loss (CAL) of the second molars on days 1, 3, 7, and 14. Patient-centered outcome measures and the consumption of painkillers and antibiotics were recorded on days 0–7. The t-test for paired samples, Wilcoxon test, and Chi-Square test were used for statistical analyses. Results: Swelling was significantly lower on day 14 in the test group (p < 0.05). No statistically significant differences were observed in pain, trismus, and CAL. In the test group, the number of painkillers taken and the number of days of intake were significantly lower (p < 0.05). Conclusions: PRF caused a reduction of painkiller consumption and in the days painkillers were needed. PRF significantly considerably reduced swelling after 14 days. Owing to the lack of differences in other parameters, the integration of PRF application into routine wisdom tooth removal is critical. Clinical relevance: PRF affects the long-term outcomes of third molar removal by reducing swelling and reducing as well as shortening painkiller consumption. Trial registration: clinicaltrials.gov (NCT05089812). [ABSTRACT FROM AUTHOR]

This article highlights social work practices for children with cleft lip and palate (CLP) and their families in a hospital. Embodiment is the main theoretical perspective used to analyse complex encounters between clients (children with CLP and their parents) and social workers in concrete interactive situations. It allows us to symmetrically reflect on how encounters between the bodies of clients, the social worker and medical professionals co-construct and redefine the social worker's identities. Three body-related identities emerge and coexist as the practice proceeds: a normal person with a normal life, a learner without embodied knowledge of a particular illness and a professional with both medical and social work authorities. These three dimensions show how mutual embodiment in contextualised interactions affects the social worker-client relationship. About implications for social work practice, we draw attention to the situated identities of social worker in a specific context, and explain how embodiment serves as a critical tool to improve our understanding of practitioners' dynamic identities through embodied reflexivity. [ABSTRACT FROM AUTHOR]

Objective: To determine whether blended learning results in better educational outcomes compared to traditional learning in the acquisition of oral surgery technical skills for 4th‐year undergraduate dental students. Materials and Methods: Seventy‐three students participated in this two‐arm parallel randomized controlled trial. Only students in the blended learning group had access to the online preparation platform for oral surgery practical work (PW) on a pig's jaw and to the debriefing. Kirkpatrick's four‐level model was used to assess the educational outcomes directly after (levels 1 and 2) and 6 months later, after the start of the students' clinical activity (levels 3 and 4). Results: For level 1, higher global satisfaction scores were found for students in the blended learning compared to the traditional learning group (p =.002). For level 2, blended learning resulted in an increase in knowledge score (p <.01), comparable to that observed in the traditional learning group. For level 3, students in the blended group made more progress in 6 months than those in the traditional group in terms of feeling able to assess and perform anaesthesia (p =.040) and surgical tooth extraction (p =.043). No difference in level 4 was found for the 6‐month clinical surgical activity between groups, but students in the blended group felt more able to assess and perform the surgical management of a failed extraction requiring bone removal (p =.044). Conclusion: Blended learning for oral surgery PW had a positive impact on three of the four Kirkpatrick levels (level 1, 3 and 4). Efforts should focus on the procedures that are perceived as the most difficult. [ABSTRACT FROM AUTHOR]

Evaluation of the quality of dental information produced by the ChatGPT artificial intelligence language model within the context of oral surgery, preventive dentistry, and oral cancer. This study adopted quantitative methods approach. The experts prepared 50 questions (including dimensions of, risk factors, preventive measures, diagnostic methods, and treatment options) that would be presented to ChatGPT, and its responses were rated for their accuracy, completeness, relevance, clarity or comprehensibility, and possible risks using a standardized rubric. To carry out the assessment of the responses by ChatGPT, a standardized scoring rubric was used. Evaluation process included feedback concerning the strengths, weaknesses, and potential areas of improvement in the responses provided by ChatGPT. While achieving the highest score for preventive dentistry at 4.3/5 and being able to communicate the complex information coherently, the tool showed lower accuracy for oral surgery and oral cancer, scoring 3.9/5 and 3.6/5, respectively, with several gaps for post-operative instructions, personalized risk assessments, and specialized diagnostic methods. Potential risks, such as a lack of individualized advice, were shown in 53% of the oral cancer and in 40% of the oral surgery. While showing promise in some domains, ChatGPT had important limitations in specialized areas that require nuanced expertise. The findings point to the need for professional supervision while using AI-generated information and ongoing evaluation as capabilities evolve, for the assurance of responsible implementation in the best interest of patient care. [ABSTRACT FROM AUTHOR]

Orthognathic surgery enables patients with severe jaw malocclusions to normalise their chewing function and, as such, to improve their quality of life. Over the last few years, digitalisation has been set in motion by intraoral scanners and the improvement of planning software in the field of oral and maxillofacial surgery. Previous studies based on plaster cast models showed that the virtual occlusion based on digitally scanned models can be comparable to conventional methods. This retrospective crossover study aimed to prove that the virtual occlusion finding with the IPS CaseDesigner® (version 2.3.5.2, KLS Martin, Tuttlingen, Germany) is accurate enough to use intraoral scans exclusively. A total of 23 orthognathic surgery patients receiving an intraoral scan for their treatment were included in this study. Two experienced maxillofacial surgeons haptically performed the occlusion finding on three-dimensional (3D) stereolithographic models using the fully digital pathway. One surgeon repeated the procedure a second time to evaluate intra-observer variability. The study aimed to show the difference between these two planning methods by upholding the surgical accuracy of less than 2 mm in translation and 2° in rotation. The conventional haptic occlusion was set as a reference throughout the whole study. The data were tested with a one-sample Wilcoxon test for the fit into the surgical accuracy. The difference between the virtual and conventional groups was significantly smaller than the surgical accuracy (all p < 0.001). Both translational movements (anterior/posterior (median 0.51 mm [0.28, 0.88]), left/right (median 0.46 mm [0.20, 0.87]), cranial/caudal (median 0.37 mm [0.11, 0.69])) and rotations (Roll (median 0.71° [0.29, 1.35]), Pitch (median 0.72° [0.29, 1.44]), Yaw (median 1.09° [0.33, 1.60])) were in the range of surgical accuracy (2 mm/2°). The most significant differences were found in the anterior/posterior translation (median 0.51 mm [0.28, 0.88]) and the Yaw rotation (median 1.09° [0.33, 1.60]). These results demonstrate that the entirely virtual workflow in orthognathic surgery, including intraoral scanning and the virtual semi-automatic occlusion finding, represents a reliable and state-of-the-art alternative to the conventional haptic method. [ABSTRACT FROM AUTHOR]

The objective of this work is to review the literature on the use of three-dimensional scaffolds obtained by printing for the regeneration of bone defects in the maxillofacial area. The research question asked was: what clinical experiences exist on the use of bone biomaterials manufactured by CAD/CAM in the maxillofacial area? Prospective and retrospective studies and randomized clinical trials in humans with reconstruction area in the maxillofacial and intraoral area were included. The articles had to obtain scaffolds for bone reconstruction that were designed by computer processing and printed in different materials. Clinical cases, case series, in vitro studies and those that were not performed in humans were excluded. Six clinical studies were selected that met the established inclusion criteria. The selected studies showed heterogeneity in their objectives, materials used and types of regenerated bone defects. A high survival rate was found for dental implants placed on 3D-printed scaffolds, with rates ranging from 94.3% to 98%. The materials used included polycaprolactone, coral-derived hydroxyapatite, biphasic calcium phosphate (BCP) and bioceramics. The use of CAD/CAM technology is seen as key for satisfying variations in the shapes and requirements of different fabrics and size variations between different individuals. Furthermore, the possibility of using the patient's own stem cells could revolutionize the way bone defects are currently treated in oral surgery. The results indicate a high survival rate of dental implants placed on 3D-printed scaffolds, suggesting the potential of this technology for bone regeneration in the maxillofacial mass. [ABSTRACT FROM AUTHOR]

The article describes interdisciplinary dentistry (ID) and how it can be applied to better care for pediatric patients. Topics discussed include the interdisciplinary dental treatment process, ID treatment plan, and University of Washington interdisciplinary dentistry example interdisciplinary problem list template.

Aim: To present a rare case of xanthogranuloma affecting the oral cavity of an adult man and to highlight the utility of ultrasound in demonstrating its sonographic features and guiding the surgical procedure. Materials and Methods: Description of a rare case of oral xanthogranuloma in an adult patient, with treatment performed using ultrasound. This tool provides safety as it functions as a real‐time imaging technique that can be utilized during surgeries without exposing the patient to radiation. Results: The case exhibited oral xanthogranuloma as a hypoechoic image with poorly defined borders. Conclusion: Ultrasound is an excellent tool for aiding diagnostic investigation and during surgical procedures, serving as a surgical guide that ensures accuracy and safety. Additionally, ultrasound is a portable, practical and accessible examination, proving to be indispensable in certain clinical and hospital settings. [ABSTRACT FROM AUTHOR]

Brugada syndrome is an inherited cardiovascular disorder, which can affect the rhythm of the heart. Dental treatment can often present as an obstacle for patients with Brugada syndrome as the use of local anaesthetic can have adverse effects on the electrical conduction system of the heart. Aim: The aim of this series is to discuss the aetiopathogenesis, presentation and management of Brugada syndrome and its relevance to dentistry and the dental team. Methods: The authors present a series of three Brugada syndrome patients who underwent dental intervention in a hospital setting. Results and Conclusion: The series highlighted the importance of multidisciplinary care for patients with Brugada syndrome. Liaising with other teams, such as cariologists and GMPs, allows a patient centred approach and better understanding of patient management. [ABSTRACT FROM AUTHOR]

Objective : To assess the effect of secondary alveolar bone grafting (SABG) on maxillary growth in patients with unilateral cleft lip or palate (UCL/P) Design : Systematic review and Meta-analysis Methods : Pubmed, Cochrane Library, Embase, Scopus, Web of Science and manual search was performed to assess the maxillary growth following SABG in UCL/P patients Patients and Participants: Non-syndromic patients with UCL/P Main Outcome Measure: Comparison of maxillary growth between patients with UCL/P who underwent SABG and UCL/P patients who had not undergone SABG or non-cleft control Results : 39 of the identified 233 articles were assessed for inclusion and exclusion criteria after duplicate removal and title and abstract reading. 7 articles (1 prospective, and 6 retrospective studies) were included in the qualitative analysis and 2 articles were subjected to quantitative analysis. Four studies had a low risk of bias and three studies had a moderate risk of bias. Meta-analysis revealed a significant reduction of SNA and no significant difference in ANB in the SABG group compared to the non-cleft control group(I2 = 0%). There was no significant difference in ANB between SABG and non-cleft control; however, results showed high heterogeneity(I2 = 83%). Meta-analysis of SNA and ANB showed no significant difference between SABG and the cleft control group; however, there was high heterogeneity. Conclusions : The studies showed a low to moderate risk of bias. SABG causes inhibition of maxillary growth in patients with cleft lip or palate when compared to patients with non-cleft control. Due to high heterogeneity, comparison to cleft control showed insufficient evidence. [ABSTRACT FROM AUTHOR]

Background: Autologous bone grafts are essential in reconstructive oral and maxillofacial surgery, and depending on the donor site, they can be associated with specific harvesting morbidities. One of the most commonly applied bone grafts is the iliac crest bone graft, irrespective of other grafts, which might be associated with an easier surgical procedure or the possibility of harvesting them under local anaesthesia. Objective of the study is the clinical evaluation of proximal tibia bone grafts regarding their eligibility for maxillofacial bone grafting. Methods: In this retrospective study, proximal tibia bone grafts were examined with regard to associated donor and recipient site morbidity and their suitability for alveolar ridge augmentation and rhinoplasty. Results: In total, 21 tibia grafts were included. Fifty-seven percent of the bone grafts were used for alveolar ridge reconstruction, and 43% were used for augmentative rhinoplasty. No significant complications occurred during or after harvesting, but in 14.3% of the patients, minor wound healing disorders were recorded at the donor site, and in 19% of the patients, they were recorded at the recipient site. Statistically, patient sex, age, nicotine and alcohol abuse and metabolic diseases had no significant influence on the complication rate. Graft harvesting under local anaesthesia and at summer temperatures was associated with significantly more complications at the harvesting site (p < 0.05). In cases of dental implant insertion into augmented sites, the implants (n = 31) were followed up for a median period of 40.5 months, during this time 86.7% of the implants survived. Conclusion: The proximal tibia is a suitable donor site for harvesting autologous bone grafts for alveolar ridge augmentation or rhinoplasty because the donor site morbidity is low, and in contrast to iliac crest bone grafts, they can be harvested under local anaesthesia, which might be advantageous for outpatient surgeries. [ABSTRACT FROM AUTHOR]

Objectives: The Functional Clear Aligner (FCA) is a novel orthodontic appliance designed for the treatment of Class II malocclusion with mandibular retrognathia in adolescents. The aim of this study was to investigate the biomechanical characteristics of the masticatory muscles, jawbone, and temporomandibular joint (TMJ) during mandibular advancement using either FCA or Class II elastics combined with clear aligner (Class II elastics) through finite element analysis. Materials and methods: A 3D finite element model of the 'muscle-jawbone-TMJ-appliance' system was constructed based on CBCT and MRI images of a boy with skeletal Class II malocclusion. Masticatory muscles included masseter, temporal, medial pterygoid, and lateral pterygoid muscles. The TMJ consists of the temporal bone's glenoid fossa, disc, and mandibular condyle. To observe the biomechanical characteristics of the muscles and TMJ during orthodontic appliance wearing and the retention phase, two different protocols were used: Model 1: The mandibular advancement using FCA; Model 2: The mandibular advancement using Class II elastics. Results: The FCA group produced greater and more coordinated masticatory muscle forces compared to the Class II elastics group. Temporal and masseter muscles exhibited the most pronounced variation in muscle strength during mandibular advancement. The FCA group exhibited greater TMJ region stress compared to the Class II elastics group. Interestingly, the stress on the articular discs in both models decreased over time. Tensile stresses were observed in both the condyle and the posterior region of the articular fossa. Conclusion: During skeletal Class II malocclusion treatment, masticatory muscle forces and stress on the TMJ were higher in the FCA group compared to the Class II elastics group. In both models, stress cushioning was provided by the articular disc. [ABSTRACT FROM AUTHOR]

Purpose: Although bone morphogenetic protein-2 (BMP-2) possesses potent osteoinductivity, there have been some concerns on the safety of BMP-2 and BMP-2-incorporated bone substitutes used for bone formation. On the other hand, BMP-2-loaded calcium phosphate cement (BMP-2@CPC) has been developed and used for bone regeneration in oral implantology. Therefore, this study aims to investigate this product's biocompatibility and clinical safety after being used in maxillofacial surgery. Materials and methods: A rat model was employed to assess the osteoinduction and biocompatibility of BMP-2@CPC. Further, a retrospective investigation was carried out: 110 patients who received BMP-2@CPC treatment after their maxillofacial surgery were recruited to describe relative adverse events. Results: In vivo, BMP-2@CPC showed a significantly higher mean bone volume density and osteoblasts volume density (15 ± 2% and 3 ± 1%)than those of the CPC group (p < 0.05) after being implanted in the dorsal area of rats. Regarding biocompatibility, the mean fibrous tissue volume density was significantly lower in the BMP-2@CPC group (20 ± 5% compared to 31 ± 6%, p = 0.026). The retrospective clinical study showed that only five mild/moderate adverse events were identified in four patients based on the medical records of 110 patients, including swelling, bony mass, and wound dehiscence. This adverse event occurrence was not affected by gender, age, the dose of filled materials, and operations in the study (p > 0.05). Conclusions: BMP-2-loaded CPC has osteoinductivity and more promising biocompatibility than pure CPC. However, its degradation is slower than CPC. The safety of BMP-2-loaded CPC with 0.5 or 1 mg BMP-2 is promising in oral maxillofacial surgery. Clinical implications: This study confirmed the promising safety of this BMP-2 incorporated CPC used in dental clinical practice, which can promote its reassuring application for dental implant placement in bone insufficient areas. [ABSTRACT FROM AUTHOR]

Background: Restoration of the mandibular region after segmental resection surgery is crucial for masticatory function and facial aesthetics. The precision of three‐dimensional printers has advanced in recent years, enabling the development of fully customized reconstruction plates. In recent years, three‐dimensional printing technology has been applied in the field of dental and oral surgery. Among these, the selective laser melting method has been developed. This case report was aimed at exploring the utility in restoring mandibular morphology. Cases: Patients diagnosed with medication‐related osteonecrosis of the jaw (MRONJ) in Oral and Maxillofacial Surgery at Kanazawa Medical University Hospital who underwent mandibular disarticulation and immediate completely customized reconstruction plate (COSMOFIX) were included. Case 1 involved a female in her 70s with MRONJ on the right side of the mandible. Case 2 involved a female who received bisphosphonates for extensive metastatic breast cancer, resulting in MRONJ affecting the bilateral mandible. Case 3 involved a woman who developed MRONJ on the right side of the mandible during alendronate treatment for osteoporosis. Completely customized reconstruction plates were used for reconstruction after segmental resections. Findings: The three patients adapted to the remaining bone. The reconstructed and preoperative mandibular morphologies were similar. Conclusions: In conclusion, the use of completely customized reconstruction plates obviates the need for bending and other adaptations, reduces surgical time, and improves postoperative aesthetics. Of significance, preparing completely customized reconstruction plate requires about 3 weeks; thus, careful case selection and scheduling are indispensable. [ABSTRACT FROM AUTHOR]

This clinical report describes how a decubital ulcer arose from the direct contact of the vestibular movable mucous membrane against mini‐implant balled‐type heads after the mini‐implant insertion in the edentulous atrophic mandible of a 78‐year‐old patient who was not wearing a conventional mandibular complete denture for more than 10 years. Due to severe alveolar ridge atrophy, mini‐implant insertion (2.0 mm wide) was an option without extensive surgical procedures. The patient signed the informed consent. A few days after the implant insertion, injury, inflammation, and induration of the vestibular movable mucous membrane were observed on the movable vestibular mucosa on the right side, opposing the mini‐implants. The cause of inflammation was attributed to increased perioral muscle tonus which pushed the movable mucosa onto the mini‐implant heads and caused mechanical trauma. During the period of edentulism, the perioral muscle tonus increased, directing the mucous membrane of the lips and cheeks against residual ridge to enable food comminution. To treat the persistent decubitus, a bulk of dental composite resin was placed around mini‐implant heads and light‐cured to protect the mucosa from further mechanical trauma, as the patient did not possess an old mandibular denture to cover the mini‐implant heads. Vestibuloplastic surgery (disinsertion of movable attachments and deepening of the vestibulum) was also done. After the surgery, a silicone splint, resembling an occlusal rim, was made to protect the mucous membrane, keep medicaments for faster epitalization in place, to decrease perioral muscle tonus before the new dentures' delivery, and to prevent movable tissue relapse. The custom impression, jaw relationship determination, and try‐in of the artificial teeth setup were made with sutures still in place. After the denture delivery and implant loading, the patient was instructed to sleep with the dentures to protect the movable mucous membrane. One year later, almost no peri‐implant marginal bone loss was observed, attached and peri‐implant mucosa were healthy, and the patient was delighted. [ABSTRACT FROM AUTHOR]

Background: Preoperative oral carbohydrate intake can improve the postoperative recovery of fasting patients in many kinds of surgeries; however, the effect of carbohydrates on patients undergoing daytime oral surgery is still unclear. This study was designed to evaluate the effect of preoperative oral carbohydrate intake on the quality of recovery of patients undergoing daytime oral surgery using the quality of recovery-15 (QoR-15) questionnaire. Methods: Ninety-two patients scheduled for daytime oral surgery were randomly allocated to the midnight fasting group (F group, n = 45) or the carbohydrate-Outfast loading group (O group, n = 47). Participants in the F group fasted from midnight the day before surgery. Patients in the O group also fasted but received the Outfast drink (4 ml/kg) 2–3 h before the induction of anesthesia. QoR-15 questionnaire, patient well-being, and satisfaction were assessed before anesthesia induction and 24 h after surgery. Perioperative blood glucose, postoperative exhaust time, and adverse events were also recorded. Results: The QoR-15 scores were significantly higher in the O group than in the F group preoperatively and postoperatively. Seven parameters representing patient well-being evaluated on a numeric rating scale (NRS, 0–10) were lower in the O group than in the F group postoperatively, except for the hunger and sleep quality scores. Patient satisfaction scores on a 5-point scale were higher in the O group than in the F group preoperatively and postoperatively. Meanwhile, the postoperative exhaust time was significantly shorter in the O group compared to the F group, while there were no significant differences in blood glucose concentrations between two groups. Conclusions: Preoperative oral carbohydrate intake could improve postoperative recovery quality, well-being, and satisfaction of patients undergoing daytime oral surgery 24 h after surgery, and may serve as a treatment option for patients undergoing daytime oral surgery. Trial registration: This trial was registered in the Chinese Clinical Trial Registry (ChiCTR2100053753) on 28/11/2021. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to evaluate the clinical efficacy of applying real-time dynamic navigation (RDN) in the extraction of deep horizontal mandibular impacted third molars, hypothesizing that RDN reduces surgical time and minimizes the risk of injury to adjacent anatomical structures. Methods: A prospective study was conducted on 160 patients aged between 18 and 37 years with deep horizontal impaction of the mandibular third molar. The participants were randomly assigned to either the experimental group (receiving RDN-assisted extractions) or the control group (undergoing traditional extraction methods). Preoperative planning utilized cone beam computed tomography (CBCT) and Mimics software for the accurate localization and segmentation of impacted teeth. Parametric data were analysed via an independent t test for intergroup comparisons, and significance was set to p < 0.05. Results: In the experimental group, an average of 11 ± 1 min was required for preoperative planning via RDN, which was not required in the control group. The setup of the navigation system took an average of 4 ± 1 min in the experimental group and 0 min in the control group. The experimental group demonstrated a significantly shorter average surgical time (22 ± 3 min) than did the control group (36 ± 3 min). The differences in the preoperative design time, surgical time, and complication rates between the two groups were statistically significant (p = 0.005). Additionally, the RDN group reported no complications related to adjacent tooth damage or nerve injury. Conclusion: The precision, safety, real-time guidance of RDN supports its use in complicated dental extractions, which would introduce a new era of oral and maxillofacial surgery. [ABSTRACT FROM AUTHOR]

Background: Patient demand for oral and maxillofacial telehealth services increased during COVID-19. To explore the potential for their continued use post-COVID-19, an assessment was conducted by examining the association between the clinical and socio-demographic characteristics of consultants and the perceived facilitators and barriers influencing their future intent. Methods: Practicing oral and maxillofacial consultants were recruited through purposive and snowball sampling methods. Data were collected through surveys and key informant interviews. Chi-square tests were used to determine whether consultants' clinical and socio-demographic characteristics and perceptions were associated with a willingness to use telehealth in the future. Coded interview transcripts were analyzed thematically to identify the main themes influencing their willingness. Results: Among the 42 respondents, 82% expressed a willingness to continue using telehealth services with the majority having at least 2 to 3 years (p = 0.028) of experience utilizing these services. The four main themes impacting consultants willingness include the accessibility of oral and maxillofacial healthcare, challenges addressing patient needs, the uncertainty of diagnostic accuracy and effectiveness as a post-operation observation tool. Conclusion: Most oral and maxillofacial consultants favored the routine use of telehealth services beyond COVID-19. Concern for patients' needs was a key determinant of their continued use. Co-designing strategies to eliminate barriers and unmet needs for consultants and patients may improve oral and maxillofacial telehealth uptake. [ABSTRACT FROM AUTHOR]

Background: In very rare cases, patients who have undergone surgery-first approach with intraoral vertical ramus osteotomy (IVRO) exhibit unusual downward movements of mandible even up to 1-year post surgery, which makes it difficult for orthodontists to stabilize the occlusion during the postoperative orthodontic period. The aim of this study was to identify factors affecting the unusual downward movement of the mandible 1-year after the surgery-first approach using IVRO, while focusing on cephalometric values. Methods: This retrospective cohort study sample was divided into two groups based on the amount of vertical movement of the B-point 1-year post surgery (Group S, predictable upward movement; Group U, unpredictable downward movement greater than 2 mm). To evaluate cephalometric changes between the two groups, cephalograms were obtained before surgery, 1 day after surgery, 1 month after surgery, and 1 year after surgery. The data were analyzed using the independent t-test, Mann–Whitney U test with Bonferroni correction, Pearson correlation analysis, and multiple regression analysis. Results: At the initial examination, Group U showed a shallower anterior overbite. The vertical surgical change in the B-point was statistically different between the two groups (p < 0.001), indicating that group U exhibited more upward movement of the mandible during surgery. Group U showed significant downward movement of the mandible 1 month after surgery, and this finding persisted until 1 year postoperatively. Clockwise rotation of the mandible was also observed. Surgical vertical movement of the B-point showed a strong correlation with postoperative vertical movement of mandible (r = -0.674; p < 0.001) along a linear relationship, indicating that the amount of postoperative vertical downward movement of the mandible increased as the amount of surgical upward movement of the B-point increased (R2 = 0.449; p < 0.001). Conclusions: This study revealed that unusual downward movement of the mandible after a surgery-first approach using IVRO is correlated with the amount of upward movement during the surgery. When planning surgery, in cases in which a significant upward movement of the mandible is anticipated, orthodontists should prepare for the possibility of subsequent unusual downward movement and a tendency for the anterior overjet to decrease during the postoperative orthodontic period. [ABSTRACT FROM AUTHOR]

Buccal fat pads are biconvex adipose tissue bags that are uniquely found on both sides of the human face along the anterior border of the masseter muscles. Buccal fat pads are important determinants of facial appearance, facilitating gliding movements of facial masticatory and mimetic muscles. Buccal fad pad flaps are used for the repair of oral defects and as a rich and easily accessible source of mesenchymal stem cells. Here, we introduce the buccal fat pad anatomy and morphology and report its functions and applications for oral reconstructive surgery and for harvesting mesenchymal stem cells for clinical use. Future frontiers of buccal fat pad research are discussed. It is concluded that many biological and molecular aspects still need to be elucidated for the optimal application of buccal fat pad tissue in regenerative medicine. [ABSTRACT FROM AUTHOR]

Background: The use of microvascular grafts is the gold standard in oral and maxillofacial surgery for the reconstruction of soft tissue and bony and combined defects. Graft loss is one of the most serious complications in the field of reconstructive surgery. A comprehensive analysis of factors influencing this is, therefore, essential. Methods: This hypothesis-generating study analyzed 251 patient cases of oral and maxillofacial surgery at the University Hospital Düsseldorf from 2016 to 2020 regarding patient- and therapy-specific parameters for their impact on graft survival. Results: Statistically significant influencing factors were found among the 80 parameters examined: treatment with antiplatelet medication and a BMI ≥ 24.5 at the time of surgery had a positive influence on graft survival, while existing diabetes mellitus, atrial fibrillation, tracheostomy, and a longer operation time had a statistically relevant negative influence. Conclusions: This work demonstrates the relevance of patient-specific risk stratification and the need for further research to develop a valid risk profile. Identifying high-risk patients with medium-sized defects, where alternatives to microvascular reconstruction are available, appears to be crucial for the clinical outcome. [ABSTRACT FROM AUTHOR]

Bone grafting in oral and maxillofacial surgery has evolved significantly due to developments in materials science, offering innovative alternatives for the repair of bone defects. A few grafts are currently used in clinical settings, including autografts, xenografts, and allografts. However, despite their benefits, they have some challenges, such as limited availability, the possibility of disease transmission, and lack of personalization for the defect. Synthetic bone grafts have gained attention since they have the potential to overcome these limitations. Moreover, new technologies like nanotechnology, 3D printing, and 3D bioprinting have allowed the incorporation of molecules or substances within grafts to aid in bone repair. The addition of different moieties, such as growth factors, stem cells, and nanomaterials, has been reported to help mimic the natural bone healing process more closely, promoting faster and more complete regeneration. In this regard, this review explores the currently available bone grafts, the possibility of incorporating substances and molecules into their composition to accelerate and improve bone regeneration, and advanced graft manufacturing techniques. Furthermore, the presented current clinical applications and success stories for novel bone grafts emphasize the future potential of synthetic grafts and biomaterial innovations in improving patient outcomes in oral and maxillofacial surgery. [ABSTRACT FROM AUTHOR]

Introduction: Since its establishment in 1999, the journal of Clinical Implant Dentistry and Related Research (CIDRR) has consistently disseminated notable clinical and translational research within the domain of oral implantology. As the journal approaches its milestone 25th anniversary, this study endeavors to systematically delineate the publication trends, level of evidence, and bibliometric indices characterizing the initial quarter‐century of CIDRR's scholarly activity. Notably, the investigation adopts a contemporary methodology by incorporating Altmetric analysis, thereby enriching the evaluation with an assessment of the broader societal and online impact of the published research. Methods: A comprehensive search was performed in SCOPUS and PubMed to access the bibliographic data of all articles published in the journal from 1999 to 2024. Additionally, Altmetric database was used to obtain social media attention scores (AAS). Journal's overall performance via impact factor and quartile range was assessed. Most cited papers were identified and the most prolific authors, institutions and countries and the collaboration networks among those were assessed. The level of evidence of all articles was determined based on Oxford level of evidence scale. All articles were categorized based on their major topic in the field of implant dentistry. Results: Throughout its first 25 years of activity, CIDRR published 1912 articles with an annual growth rate of 2.67% and consistently being ranked at Q1 quartile in "Dentistry (miscellaneous)" and "Oral Surgery" journal categories. When clinical studies are considered, level I and II evidence constituted 22.82% and 11.82% of all articles, respectively. Sweden, the USA, and Italy as well as Göteborgs Universitet, Sahlgrenska Akademin. and Malmö Högskola were the most prolific countries and institutions respectively. "Implant system/design/characteristics," "Bone Augmentation," and "Implant Prosthesis" were the top most investigated topics. Conclusions: The examination of the journal's initial 25 years highlighted that CIDRR has surpassed similar dental research journals in publishing a greater number of high‐level evidence articles. It also showcased diverse country‐ and author‐collaboration networks. However, the journal's social media presence is still evolving. This article, presenting a comprehensive overview of the journal's scientometric and bibliographic activities, serves as a valuable reference for researchers, clinicians, and stakeholders, offering insights into both traditional and contemporary perspectives. [ABSTRACT FROM AUTHOR]

Objective: To describe the use of transoral robotic surgery (TORS) in conjunction with intraoperative localization techniques for removal of challenging upper aerodigestive tract (UADT) foreign bodies. Methods: Three cases were taken to the operating room for removal of UADT foreign bodies. Two of these cases had previously undergone failed surgery(s). TORS was performed in all 3 cases and intraoperative localization was used in 2 cases. Results: All foreign bodies were successfully removed. Conclusion: This case series is the largest-to-date on UADT foreign body removals using TORS. Additionally, the novel use of intraoperative localization techniques in conjunction with TORS is described. Such an approach can facilitate the identification of difficult-to-identify foreign bodies, as well as potentially decreasing operative time, number of operations, and associated morbidity. [ABSTRACT FROM AUTHOR]

Purpose: Benefits of prophylactic platelet (PLT) transfusion before dentoalveolar surgery are unclear. This study investigated the effect of prophylactic PLT transfusions on the incidence of postoperative bleeding (POB) in patients with thrombocytopenia and a PLT count ≤ 75*109/L. Methods: The cohort in this retrospective study comprised 83 patients with thrombocytopenia ≤ 75*109/L who had undergone dentoalveolar surgery. Exclusion criteria were other coagulation deficiencies or medications that would affect hemostasis. In all, 144 teeth had been removed. POB events were extracted and compared between the group that had received prophylactic PLT transfusion before dentoalveolar surgery and the group that had not. Results: POB events were observed in 5 of 83 patients (6.0%) who had a median PLT count of 35*109/L before any transfusion. The group with no postoperative bleeding (NPOB) had a median PLT count of 34*109/L. Two (4.2%) of the 48 patients who had received prophylactic PLT transfusions before dentoalveolar surgery developed POB. Three (8.6%) of the 35 patients who had not received a transfusion experienced POB. The difference between these two groups was not significant (p = 0.646). When two or more teeth were removed in the same session, a significantly higher incidence of POB was observed (p = 0.042). Conclusions: Our data indicate that prophylactic PLT transfusions in thrombocytopenic patients with PLT counts ≤ 75*109/L do not reduce the incidence of POB after dentoalveolar surgery. However, caution is warranted when extracting multiple teeth in the same surgical session since we found this to be significantly associated with an increased risk of POB. [ABSTRACT FROM AUTHOR]

PPS space tumors are extremely rare, accounting for 0.5% of head and neck neoplasms. Trans-oral, Trans-cervical, Trans-parotid, Trans-cervical-trans-mandibular, and infratemporal are various surgical approaches that have been described for PPS tumors. Of late, with the advent of robotic surgery, Trans Oral Robotic Surgery (TORS) for PPS tumors is being increasingly advocated with promising results. To establish both efficacy and safety of Trans Oral Robotic Surgery, Five cases of pleomorphic adenoma of parapharyngeal space with sizes varying between 2.5 cm to 7.5 cm were evaluated and removed using Trans oral robotic approach using the Da Vinci system. Three were removed in toto and two in piecemeal fashion. There was capsule breach in 2 cases, no major complication was reported in any of the cases. Transoral Robotic Approach for PPS tumors can provide the much-required bridge between Transcervical and Trans mandibular Oral Approach. It provides a better direct approach. Carefully selected patients with well encapsulated tumors are more amenable to this approach. [ABSTRACT FROM AUTHOR]

Objective: This meta-analysis aims to investigate the long-term survival rates of dental implants over a 20-year period, providing a practical guide for clinicians while identifying potential areas for future research. Materials and methods: Data were sourced from recent publications, focusing exclusively on screw-shaped titanium implants with a rough surface. Both retrospective and prospective studies were included to ensure an adequate sample size. A systematic electronic literature search was conducted in the databases: MEDLINE (PubMed), Cochrane, and Web of Science. The risk of bias for all studies was analyzed using a tool by Hoy et al. Results: Three prospective studies (n = 237 implants) revealed a mean implant survival rate of 92% (95% CI: 82% to 97%), decreasing to 78% (95% CI: 74%-82%) after imputation (n = 422 implants). A total of five retrospective studies (n = 1440 implants) showed a survival rate of 88% (95% CI: 78%-94%). Implant failure causes were multifactorial. Conclusion: This review consolidates 20-year dental implant survival data, reflecting a remarkable 4 out of 5 implants success rate. It emphasizes the need for long-term follow-up care, addressing multifactorial implant failure. Prioritizing quality standards is crucial to prevent overestimating treatment effectiveness due to potential statistical errors. While dental implantology boasts reliable therapies, there is still room for improvement, and additional high-quality studies are needed, particularly to evaluate implant success. Clinical relevance: Never before have the implant survival over 20 years been systematically analyzed in a meta-analysis. Although a long-term survival can be expected, follow-up is essential and shouldn't end after insertion or even after 10 years. [ABSTRACT FROM AUTHOR]

This study aims to investigate the association of time to oral and maxillofacial surgery after Covid-19 infection with the risk of postoperative complications in a population from China. In the current study, a total of 1342 consecutive patients underwent general anesthesia (GA) in the maxillofacial district of the Chinese Oral and Maxillofacial COVID Collaborative, which consists of 27 teaching hospitals. Pulmonary, cardiovascular and thrombotic complications were monitored for 1 month after GA surgery (GAS) and their incidence was reported for the first 30 days. Post-operative complications were observed in 4 of 1076 cases (0.37%) who had suffered from mild Omicron infection and in none of the controls. Results from the Quasi-Poisson multivariate regression models showed that Omicron infection was not associated with increased post-operative complications compared to controls. Among the infected patients, delays of >4 but not >6 weeks were associated with lower OR of complications (0.08, 95% CI 0.01–0.78 and 0.06, 95% CI 0.01–1.80, respectively). Findings of this study suggest that delaying surgery for a period of 4–6 weeks following infection can provide a protective effect. [ABSTRACT FROM AUTHOR]

This study aimed to determine the accuracy of large language models (LLMs) in answering oral and maxillofacial surgery (OMS) multiple choice questions. A total of 259 questions from the university's question bank were answered by the LLMs (GPT-3.5, GPT-4, Llama 2, Gemini, and Copilot). The scores per category as well as the total score out of 259 were recorded and evaluated, with the passing score set at 50%. The mean overall score amongst all LLMs was 62.5%. GPT-4 performed the best (76.8%, 95% confidence interval (CI) 71.4–82.2%), followed by Copilot (72.6%, 95% CI 67.2–78.0%), GPT-3.5 (62.2%, 95% CI 56.4–68.0%), Gemini (58.7%, 95% CI 52.9–64.5%), and Llama 2 (42.5%, 95% CI 37.1–48.6%). There was a statistically significant difference between the scores of the five LLMs overall (χ2 = 79.9, df = 4, P < 0.001) and within all categories except 'basic sciences' (P = 0.129), 'dentoalveolar and implant surgery' (P = 0.052), and 'oral medicine/pathology/radiology' (P = 0.801). The LLMs performed best in 'basic sciences' (68.9%) and poorest in 'pharmacology' (45.9%). The LLMs can be used as adjuncts in teaching, but should not be used for clinical decision-making until the models are further developed and validated. [ABSTRACT FROM AUTHOR]

Hashtags on Instagram help users globally search for posts to their liking. This study aimed to determine who posts the most popular oral and maxillofacial surgery (OMS) hashtags on Instagram and to evaluate the impact of educational content. The posts were analyzed for the type of post and differences between content creators when posting OMS-related content. This cross-sectional study evaluated OMS content categorized by 36 hashtags. The top 9 posts with each hashtag were evaluated based on the type of content creator, if it was a video or picture, and if it was educational or for marketing purposes. 6 million posts existed among 36 hashtags. Regarding the categories of person/organization posting the content (US or non-US oral and maxillofacial surgeon, residency program, patient, and 'other'), the top posts (N = 295) were posted by 'other' and the least by 'residency program'. Among the posts by non-US oral and maxillofacial surgeons, there was 3.8-fold more marketing content, while among the posts by US oral and maxillofacial surgeons, there was 2-fold more educational content. Educational posts achieved the highest engagement in terms of 'likes'. This study highlights how oral and maxillofacial surgeons can educate the general population and expand their reach. [ABSTRACT FROM AUTHOR]

Since 2023, ChatGPT has been leading a research boom in large language models. Research on the applications of large language models in various fields is also being explored. The aim of this study was to explore the use of ChatGPT/GPT-4 for post-surgery patient follow-up after oral surgery. Thirty questions that are the most commonly asked or may be encountered during follow-up and in daily practice were collected to test ChatGPT/GPT-4′s responses. A standard prompt was used for each question. The responses given by ChatGPT/GPT-4 were evaluated by three experienced oral and maxillofacial surgeons to assess the suitability of this technology for clinical follow-up, based on the accuracy of medical knowledge and rationality of the advice in ChatGPT/GPT-4′s responses. ChatGPT/GPT-4 achieved full marks in terms of both the accuracy of its medical knowledge and the rationality of its recommendations. Additionally, ChatGPT/GPT-4 was able to accurately sense patient emotions and provide them with reassurance. In conclusion, ChatGPT/GPT-4 could be used for patient follow-up after oral surgeries, but this should be done with careful consideration of the technology's current limitations and under the guidance of healthcare professionals. [ABSTRACT FROM AUTHOR]

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Introduction: This study is designed to outline the likely patterns of treatment modalities based on patient demographics and mechanism of injury in eastern region of India (industrial area). Objective: To evaluate the various treatment patterns in eastern region of India and for better understanding of providing patient care. Materials and Methods: We conducted a retrospective study by collecting data from the records of the patients who reported at our institution from 2018 to 2020. The types of the major procedures done at the department were classified based on the type and the area of the trauma. The data were tabulated using Excel sheet and projected in percentages. Later with statistical analysis by one-way ANOVA, the different groups were compared with SPSS version 20.0. Results: The total number of patients observed were 197. The gender distribution was M/F = 1.31:1. Comminuted mandibular fracture had the highest incidence with RTA (road traffic accident) being the most prevalent etiology, whereas no significant difference was found between the types of procedures performed and demography of the patients. Conclusion: Being a dominant industrial area (Jharkhand), it can be concluded that facial trauma is seen predominant in this part of eastern India due to road traffic accidents with heavy, high-speed vehicles and lack of awareness in using protective safety accessories. This study helped us evaluate the various major surgical procedures performed in the department of Oral and Maxillofacial Surgery. Such data would also act as an educational tool for trainees and for enhancing multidisciplinary meets. [ABSTRACT FROM AUTHOR]

Platelet-rich fibrin (PRF) is a novel approach to tissue regeneration is emerging as a valuable tool to enhance healing in numerous dental and oral surgery procedures. The aim of present study is to evaluate the efficacy of Platelet Rich Fibrin on soft tissue healing in the experimental group in contrast to the control group and to compare the rate of soft tissue healing between the two groups and to assess the presence or absence of infection. 30 patients (15 patients each as case and control smokers) following tooth extraction. The patients were split into two groups, 15 patients in each Group A: Experimental group: Immediately after extraction, PRF was placed and wound secured with sutures. Group B: Control group: Immediately following extraction, the wound was secured with sutures. Follow up was done on day 3, day 7 and day 15. Both the groups showed statistically significant healing over time (days 3 through 15). Healing on days 3 and 7, between both the groups was not statistically significant and showed no difference. However, on day 15, the healing in the case group was much better. In conclusion, this study has shown the efficacy of PRF in wound healing following tooth extraction in smokers. We can safely conclude that PRF is a healing biomaterial which can be employed safely. [ABSTRACT FROM AUTHOR]