The Evolution of the "Head and Neck" Section: Annals of Plastic Surgery Embraces "Craniomaxillofacial Surgery".

Odontogenic maxillofacial space infections are life-threatening conditions that result from untreated dental problems, in which bacteria infect the facial fascial spaces from the affected teeth and supporting tissues. Despite their clinical severity, epidemiological data from sub-Saharan Africa and Ethiopia remain limited. Understanding their prevalence and associated factors is essential for effective management and prevention. To determine the prevalence and associated factors of odontogenic maxillofacial space infection among adult patients (aged > 18 years) admitted to the Oral and Maxillofacial Surgery Unit at Hawassa University Comprehensive Specialized Hospital over 3 years (2023-2025). A retrospective cross-sectional study using patients' medical records was conducted among patients admitted to the Oral and Maxillofacial Surgery between January 2023 and December 2025. Of these cases, 419 were deemed eligible according to predefined inclusion and exclusion criteria, and data were systematically extracted from the records. For a case to be included, there was a need to have clinical or radiographic evidence that the subject was infected and had pus drainage upon incision and drainage. Data were entered into Epi-Data 4.6, and data analysis was carried out using SPSS Version 26.0 (Windows 10). Descriptive statistics, such as frequencies and percentages, and logistic regression analysis were done. p < 0.05 was considered statistically significant. This study included 419 patient charts; 50 patients had confirmed odontogenic maxillofacial space infection. The prevalence of odontogenic maxillofacial space infection was 12.0% (95% CI: 9.0%-15.0%) among admitted patients. On multivariate analysis, rural residence (AOR = 2.70, 95% CI: 1.35-5.40), hypertension (AOR = 2.40; 95% CI: 1.15-5.00), diabetes mellitus (AOR = 3.10, 95% CI: 1.45-6.60), and delay in healthcare seeking (AOR = 4.00, 95% CI: 1.95-8.20) were independently associated. The prevalence of odontogenic maxillofacial space infections was relatively high among admitted patients in this tertiary hospital. Rural residence, hypertension, diabetes mellitus, and delay in healthcare seeking are associated with the infection. Strengthening early diagnosis and treatment of dental infections, improving access to oral health services, and encouraging timely healthcare-seeking behaviour helps reduce the burden of odontogenic maxillofacial space infections.

The primary aim of this study was to compare the overall satisfaction and quality of life (QoL) up to 5 years after treatment in patients who underwent root canal treatment (RCT), re-treatment (re-RCT), or single tooth implant (STI) placement in the anterior zone. The secondary aim was to analyze factors influencing decision-making and patients' fear levels. This cross-sectional study entailed face-to-face personal interviews performed 5 years after treatment. The procedures were performed in private practice by two experienced dentists, specialists in Endodontics and Oral Surgery and Implantology, respectively. The Chi-squared test was used to evaluate the differences in treatment decision-making. Factors influencing treatment decisions were compared using the Kruskal-Wallis test, while ANOVA was employed to assess Oral Health Impact Profile (OHIP)-14 scores and overall satisfaction. Significance was set at p < 0.05. Most patients reported that decisions were made jointly with their dentist, with no differences among groups (p > 0.05). Esthetics were the most influential factor in decision-making (p < 0.05). No differences were found in overall satisfaction among the groups (p > 0.05). STI treatment induced the highest perceived fear and pain scores (p < 0.05). Significant differences were found in some domains of the OHIP-14 in the STI group compared with the RCT and re-RCT groups (p < 0.05). No differences were found between the RCT and re-RCT groups (p > 0.05). Endodontic treatments (RCT and re-RCT) yielded high patient QoL and satisfaction levels comparable to STI, while resulting in lower social disability, psychological discomfort, and physical disability. Esthetics were the most influential determinant across all procedures. In addition, STI resulted in significantly higher perceived fear and pain levels compared with endodontic procedures. The present study's findings underscore the importance of personalized, patient-centered approaches in dental practice to enhance long-term patient satisfaction and outcomes.

Pre-anaesthetic assessment is essential for identifying perioperative risk and optimising patient safety. Digital alternatives, including video consultation and structured electronic health record (EHR) review, may improve efficiency, but comparative evidence regarding postoperative safety remains limited. We hypothesise that digital pre-anaesthetic assessment modalities will be associated with low rates of major postoperative complications in selected low-risk patients. This protocol describes a single-centre study with retrospective data collection including adult patients scheduled for elective otorhinolaryngologic, oral or maxillofacial surgery at Copenhagen University Hospital-Rigshospitalet, Copenhagen, Denmark. Patients underwent preoperative assessment using one of three modalities: in-person consultation (2019-2020), EHR review (2021-2022) or video consultation (2024-2025). The primary outcome is a composite of major postoperative complications within 30 days, including all-cause mortality, admission to the intensive care unit, bleeding requiring transfusion, infection requiring antibiotics, or hospital readmission. Secondary outcomes include number of days spent hospitalised within 30 days after surgery, changes in anaesthesia plan, airway management modifications, delay in surgical start time, intubation attempts and same-day cancellations. Associations between assessment modality and dichotomous outcomes will be examined using multivariable generalised linear models with a log-link function, adjusted for prespecified covariates. Sensitivity analyses will include inverse probability weighting and win ratio analysis. This single-centre cohort study will examine whether digital pre-anaesthetic assessment strategies, such as video consultation and EHR review, are associated with differences in major postoperative complications compared with in-person assessment. The findings may inform the implementation of patient-centred, resource-efficient preoperative assessment strategies within the Danish healthcare system and similar international settings.

Dental Pain in Emergency Department Patients: Utilizing Point-of-Care Ultrasound for Dental Abscess Detection.

This scoping review aimed to comprehensively map the available evidence on the migration of fixation hardware and skeletal growth aberrations caused by craniomaxillofacial (CMF) osteosynthesis in the paediatric population. A systematic search was made in PubMed, Embase, Cochrane Library, Scopus, and Web of Science based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR). Search terms were tailored to captures studies addressing growth restriction and hardware migration associated with CMF fixation in children. A total of 762 articles were identified. 10 clinical studies and 23 animal studies were eligible. Due to the nature of the studies found, only a descriptive analysis was performed. Out of 183 children, 76% of them (mean age 10.6 months) underwent CMF fixation for management of craniosynostosis. 24.6% of these patients experienced hardware migration, exclusively in the calvaria. The temporal, parietal & frontal regions were the most frequent sites for migration, with the majority of fixation being titanium plates and screws (54.1%). Most transcranial migrations were asymptomatic (77.8%) and surgical intervention was performed in 28.8% of these affected children. Amongst the animal studies, intracranial hardware migration was reported in only 2 studies. Growth restriction was observed when CMF fixation involved cranial sutures or midfacial sites (16 studies), whereas mandibular growth remained unaffected (5 studies). Overall, the evidence regarding the long-term impact of titanium-based fixation on paediatric CMF growth and transcranial migration of hardware remains limited. This is largely attributed to the retrospective nature of available clinical studies and heterogeneity of animal models. Well-designed longitudinal studies are needed to provide more robust evidence to inform clinical practice. Nevertheless, this review consolidates current findings, highlights existing knowledge gaps and underscores the need for the development of bioresorbable fixation systems in paediatric CMF surgery.

Quaternized chitosan nanofibers: Bioabsorbable mucoadhesive dressings with haemostatic, antimicrobial, and antioxidant properties for oral surgery.

Jawbone defects following cystectomy for cysts of the jaw may cause postoperative complications such as pathological fractures and secondary infections. Therefore, different bone-grafting procedures have been developed. Novel cotton-like bone graft material composed of β-tricalcium phosphate, poly-L-lactic acid, and polyglycolic acid (β-TCP/PLLA/PGA) has handling properties, three-dimensional shapeability, and bone forming ability, and has potential clinical utility for bone formation. However, no studies have evaluated the clinical outcomes of the novel β-TCP/PLLA/PGA in patients of oral and maxillofacial surgery. Thus, we evaluated the usefulness of β-TCP/PLLA/PGA in bone formation within jawbone defects following cystectomy. : 28 patients (19 males and 9 females; mean age: 47.5 years) who visited the Department of Oral and Maxillofacial Surgery, Shimane University Hospital, between November 2022 and April 2024 were included. They underwent cystectomy for cysts of the jaw (maxilla or mandible) and were grafted with β-TCP/PLLA/PGA. All excised cyst were submitted for histopathological examination. Patient demographics, clinical data, and computed tomography (CT) images were retrospectively evaluated to assess the defect dimensions, CT values, and bone continuity of the jawbone defects. Data on postoperative complications were obtained from medical records. Among the 28 cystic lesions (6 maxillary and 22 mandibular jaw cases), 27 were odontogenic cysts (26 odontogenic cysts and 1 orthokeratinized odontogenic cyst), and 1 was a non-odontogenic cyst (nasopalatine duct cyst). Both long- and short-axis lengths of the jawbone defect revealed a significant decrease at 6 months postoperatively compared with the preoperative and 1-month postoperative values. The CT values were significantly increased from 1 month to 6 months postoperatively (P<0.05). At 6 months postoperatively, 39.3% of the patients achieved full bone continuity. No serious adverse events were observed. β-TCP/PLLA/PGA demonstrated excellent handling characteristics and clinical safety as a novel cotton-like bone graft material for jawbone defects following cystectomy.

Platelet-rich fibrin (PRF), a second-generation platelet concentrate, has emerged as a promising autologous biomaterial in regenerative medicine. Unlike platelet-rich plasma (PRP), PRF is prepared without anticoagulants or biochemical additives, allowing natural platelet activation and fibrin polymerization. This process generates a three-dimensional fibrin matrix containing concentrated platelets, leukocytes, cytokines, and growth factors that collectively support tissue regeneration. Owing to these regenerative properties, PRF has been increasingly applied in oral and maxillofacial surgery. Despite its widespread clinical use, the precise biological mechanisms underlying PRF-mediated bone regeneration remain incompletely understood. PRF functions not only as a reservoir for growth factors, but also as a dynamic immunomodulatory scaffold that regulates inflammation, angiogenesis, cellular migration, and osteogenic differentiation. Recent evidence further suggests that leukocytes, fibrin architecture, cytokine networks, and osteoimmunological interactions within PRF play critical roles in coordinating tissue regeneration. This scoping review aims to summarize the current understanding of the biological mechanisms and regenerative potential of PRF in bone healing and oral and maxillofacial reconstruction. Particular emphasis is placed on the interplay between growth factor release, fibrin matrix structure, immune modulation, and cellular signaling pathways involved in osteogenesis. Furthermore, recent advances, limitations, and future perspectives regarding PRF optimization and clinical applications are discussed.

A Two-Piece Fixation Device for Reliable Nasotracheal Intubation in Oral and Maxillofacial Surgery.

Antiseptic management in oral surgery remains heterogeneous, with no standardised, procedure-specific protocols guiding the perioperative use of agents such as chlorhexidine (CHX) or cetylpyridinium chloride (CPC). This consensus document aims to integrate the best available evidence with structured expert judgement to generate evidence-based clinical practice guidelines for the use of oral antiseptics across dentoalveolar and implant surgical scenarios. A structured two-round expert consensus process was employed, combining a systematic literature search of PubMed/MEDLINE with a structured expert panel discussion conducted in December 2025. Seven oral surgeons and implantologists from four leading Spanish universities participated. Consensus was organised around five thematic blocks regarding the use of oral antiseptics: indications and safety, preoperative preparation, postoperative care, management of complications, and future research priorities. Following independent duplicate screening, 69 studies were included in the qualitative synthesis. CHX 0.12-0.2% (in monotherapy or in combination with CPC) was established as the reference perioperative antiseptic, with evidence supporting its efficacy in reducing postoperative complications (RR=0.66; 95% CI 0.55 to 0.80). A risk-stratified postoperative protocol was formulated, incorporating gel, rinse, and spray formulations adapted to individual patient profiles. Povidone-iodine and CPC were identified as evidence-supported alternatives. Complication-specific recommendations were generated for wound dehiscence, alveolar osteitis, and localised postoperative infection, ranging from conservative antiseptic irrigation and intra-alveolar gel application to escalating surgical and systemic antibiotic management based on severity. All recommendations were explicitly classified as evidence-based, expert consensus-derived, or a combination, reflecting the variable quality of supporting data across clinical scenarios. CHX constitutes the gold standard oral antiseptic for perioperative use in oral surgery. The expert panel recommends CHX+CPC combination formulations (e.g., 0.12% CHX+0.05% CPC) as an alternative perioperative antiseptic option, offering comparable antimicrobial efficacy with an improved tolerability profile relative to CHX monotherapy. Individualised, risk-stratified protocols, which account for procedural complexity, patient comorbidities, and antiseptic tolerability, are recommended to optimise clinical outcomes while minimising adverse effects.

Systematic safety approaches, remain largely unevaluated in dental implantology. This prospective interventional study aimed to evaluate the impact of a structured surgical safety checklist on clinical incidents and organizational efficiency in dental implant surgery. A before-and-after study design was implemented at a high-volume center, documenting 124 consecutive dental implant surgeries (61 without, 63 with checklist) using a previously by Kupka et al. developed safety checklist. The primary endpoint was the occurrence of incidents divided into clinical deviations and workflow disruptions; the secondary endpoint was procedure duration. Checklist implementation resulted in a statistically significant reduction in mean surgery duration. Mean operative time decreased from 75.4min (SD 31.9) to 60.3min (SD 31.4), representing a median decrease: 15.0min (p < 0.01). The rate of surgeries with at least one incident decreased from 36.1% (22/61) to 23.8% (15/63), which was not statistically significant (p = 0.170). However, clinical deviations dropped significantly from 13.1% to 0.0% (p = 0.003). To our knowledge, this is the first study investigating checklist effects on incidents and operating time in implant dentistry, and the largest case number in oral surgery. Introducing a surgical checklist significantly improved efficiency by reducing procedure duration. While the reduction in overall incidents was not statistically significant, the elimination of clinical deviations suggests a safety benefit. Structured checklists might be a valuable tool to enhance patient safety and operational workflow in elective implant surgery.

Adding beta-tricalcium phosphate ceramic to additive manufactured 3D porous Ti6Al4V scaffolds enhances osteogenic activity of human mesenchymal stromal cells in vitro.

To systematically identify research trends, collaborative patterns, thematic developments and emerging areas of interest in the field of robotic surgery for the treatment of obstructive sleep apnoea (OSA) worldwide, thereby providing an evidence-based foundation for optimising clinical decision-making and formulating research strategies. Using the Web of Science Core Collection database, we retrieved relevant literature on robotic surgery for the treatment of OSA from 2003 to 2026. After deduplication and screening, the data were imported into software such as CiteSpace 7.0 and Origin 2021. We conducted bibliometric and visualisation analyses from multiple dimensions, including publication trends, collaboration networks among countries, institutions and authors, co-occurrence clustering and outlier detection of keywords, and outlier detection of co-cited publications. A total of 167 valid studies were included. The accumulation of domain knowledge exhibited an exponential growth trend (R² = 0.9826), evolving through three distinct phases: an embryonic phase (2003-2011), a rapid growth phase (2012-2016) and a fluctuating stabilisation phase (2017-2026). At the national level, an unbalanced pattern emerged with the United States (63 papers) and Italy (35 papers) as dual cores; the United Kingdom exhibited the highest intermediary centrality (0.69), playing a pivotal linking role in global knowledge flows; at the institutional level, the University of Michigan system and Imperial College London served as core institutions; At the author level, Vicini C and Cammaroto G serve as dual cores, with a network density of 0.3162, forming a highly cohesive niche academic community. Keyword clustering identified nine themes, which can be categorised into four major research dimensions: core procedures (oral robotic surgery, base of tongue and lingual tonsil surgery), precise assessment (drug-induced sleep endoscopy), functional prognosis (voice quality, vital signs monitoring), and cross-applications in head and neck oncology. Detection of prominent terms indicates that the research paradigm is shifting from the early phase of technical feasibility verification and procedural expansion towards a stage of precise integrated perioperative management, characterised by the terms 'management' and 'obstructive sleep apnoea'. Citation analysis reveals that the series of papers published by Vicini C between 2010 and 2014 constitute the core knowledge base of the field, whilst recent high-impact publications by Baptista PM, Lechien JR and others indicate that the current research frontier has shifted towards individualised surgical selection, functional prognosis assessment and multidisciplinary management. The focus of research into robotic surgery for OSA is gradually shifting from proof-of-concept studies towards precision treatment. Future research will concentrate on transoral robotic surgery assisted by artificial intelligence and augmented reality navigation; the expansion of indications to include children and special populations; multi-level combined airway reconstruction; comparative efficacy studies between robotic surgery and neurostimulation techniques; and health economic evaluations based on real-world evidence. This study systematically maps the knowledge landscape and evolutionary trajectory of this field, providing a directional reference for subsequent clinical translation, the optimisation of international collaboration networks, and multidisciplinary cooperation.

Impacted mandibular third molars present a common challenge in oral surgery, often associated with postoperative complications such as delayed healing and periodontal defects; therefore, optimizing adjunctive therapies is clinically important. In this study, we aimed to evaluate the efficacy of platelet-rich fibrin (PRF) and preoperative azithromycin in modulating inflammation and enhancing wound healing following surgical extraction of impacted mandibular third molars. In this prospective clinical study, healthy subjects aged 18-50 years were randomly assigned to three groups: a control group receiving standard postoperative amoxicillin therapy, a PRF group receiving PRF with standard therapy, and a PRF-plus-azithromycin group receiving PRF, standard therapy, and a single preoperative dose of azithromycin. Clinical parameters were assessed and cytomorphometric analysis was performed preoperatively and postoperatively. Clinical parameters generally improved over time in all groups (p < 0.001). Differences between groups were observed for interincisal distance, Landry Index, and pain scores, with a trend toward more favorable outcomes in the combined-therapy group. Cytomorphometric analysis revealed cellular alterations in the control group, relative stability in the PRF group, and intermediate changes in the combined-therapy group. Within the limitations of this study, the combination of PRF and preoperative azithromycin showed potential benefits in several postoperative outcomes. However, given the study design and sample characteristics, these findings should be considered preliminary and require confirmation in larger prospective studies before definitive clinical recommendations can be made.

Improving healing after surgical extraction of partially impacted lower third molar by modification of three sided flap: a clinical pilot study.

Bone healing in osteoporotic bone represents a significant clinical challenge in oral and maxillofacial surgery. The aim of this experimental study was to evaluate the effects of melatonin and vitamin E supplementation on bone healing following alloplastic graft application in cranial bone defects created under osteoporotic conditions. A total of 35 male Wistar rats were randomly allocated into five groups. Experimental osteoporosis was induced by retinoic acid administration. Following osteoporosis induction, critical-sized cranial bone defects were created in the parietal bone. Except for the negative control group, all defects were filled with an alloplastic bone graft. Melatonin and/or vitamin E were administered systemically to the experimental groups. At the end of the experimental period, bone healing was evaluated histologically. No bone healing was observed in the negative control group, whereas mild to moderate new bone formation was detected in the graft control group. The melatonin-treated group demonstrated pronounced and high-grade bone formation. In contrast, the vitamin E-treated group did not show a significant improvement in bone healing compared to the graft control group. The findings of this experimental study suggest that melatonin may have a supportive effect on bone healing following alloplastic grafting in osteoporotic bone defects. Vitamin E, either alone or in combination with melatonin, did not provide an additional benefit in terms of bone regeneration. These results provide preclinical evidence to guide the selection of biological adjunctive agents in osteoporotic bone healing.

Evaluating the performance of general vs retrieval-augmented generation large language models on oral and maxillofacial surgery board examinations.

This report describes a case in which a removable partial mandibular denture made of polycarbonate resin was fabricated using a computer-aided design and manufacturing (CAD/CAM) system for a patient with microstomia and trismus caused by scar contracture in the maxillofacial region after multiple tumor resections and reconstructive surgeries. The patient was an 82-year-old woman with a history of multiple oral cancer surgeries and radiotherapy. She presented with a markedly narrow oral aperture circumference (145 mm) and had no prior experience with dentures. Given the difficulty of applying conventional impression techniques in this case, impressions were obtained using unilateral stock trays and split custom trays. The denture base and artificial teeth were milled from a polycarbonate disk into a single-piece structure to create a denture with no microgaps. One month after insertion, the patient's Oral Health Impact Profile-54 score improved from 36 to 6, masticatory efficiency increased from 84 mg/dL to 131 mg/dL, and the facial scale score improved from 13/20 to 7/20. Furthermore, the smooth denture surface minimized denture plaque adhesion, aiding oral hygiene maintenance. In addition to the low water absorption and high smoothness of polycarbonate resin, integrated design achieved using CAD/CAM contributes to the prevention of denture stomatitis and oral candidiasis.

Background: Suture materials employed in oral surgery vary with respect to their structure, absorbability, coating, handling characteristics, and propensity for plaque retention and tissue reaction. These attributes may impact early wound stability and signs of postoperative inflammation. Objective: To compare four widely utilized oral surgery suture materials with respect to clinician-rated intraoperative performance and early postoperative clinical response. Methods: A total of forty patients requiring oral surgical procedures involving suturing were incorporated into a four-arm pilot comparative study. Four types of suture materials were assessed: absorbable monofilament Monocryl 4-0, non-absorbable braided polyester Ethibond Excel 4-0, absorbable antibacterial-coated braided polyglactin 910 Vicryl Plus 4-0, and braided silk 4-0. Follow-up evaluations were conducted at days 3, 7, and 14. Sutures were removed on day 7, including those that are absorbable. The operator rated smoothness, handling, and resistance during placement on a 0-10 scale. Clinical scores for edema, gingival inflammation, perilesional plaque, and suppuration were documented at follow-up. Results: Monocryl demonstrated the highest mean smoothness score (8.47 ± 0.85) and clinician-rated resistance score (8.92 ± 0.74). Silk exhibited the lowest scores in smoothness (5.60 ± 1.10) and resistance (5.21 ± 0.97), while attaining the highest handling score (7.82 ± 0.95). Early clinical assessments indicated increased edema and inflammation associated with silk at 3 days; conversely, Vicryl Plus showed comparatively low inflammatory scores and low perilesional plaque scores at day 3 and lower scores than silk during follow-up. Suppuration was infrequent across all groups. Conclusions: Within the limitations of this pilot dataset, synthetic sutures appeared to provide more favorable intraoperative performance than braided silk, while antibacterial-coated Vicryl Plus showed favorable early clinical scores. The findings should be interpreted cautiously because of the small sample size, incomplete reporting of allocation and ethics procedures, unclear scoring definitions, and absence of microbiological analysis. Larger randomized clinical studies with standardized clinical and microbiological outcomes are required before definitive recommendations can be made.