The aim of this study was to quantify the contribution of contralateral coronoidectomy to intraoperative mouth opening in patients with severe unilateral temporomandibular joint (TMJ) ankylosis by measuring the incremental gain achieved after each surgical step. Seven consecutive patients (six Sawhney type IV and one type III) underwent gap arthroplasty followed sequentially by ipsilateral and contralateral coronoidectomy. Mouth opening was measured intraoperatively after each surgical step and at 1-year follow-up. Statistical analysis was performed using the Friedman test for repeated measures and the Wilcoxon signed-rank test for paired comparisons. Median preoperative mouth opening was 0 mm (IQR 0-0), increasing to 20 mm (IQR 5-22) after gap arthroplasty, 28 mm (IQR 25-30) after ipsilateral coronoidectomy, and 45 mm (IQR 40-46) after contralateral coronoidectomy. Overall differences between surgical stages were significant (p < 0.001). Contralateral coronoidectomy provided a median additional gain of 17 mm (p = 0.022), with further improvement observed in every patient. At 1-year follow-up, median mouth opening was 43 mm (IQR 42-45), with no recurrence or major complications. These findings provide quantitative evidence supporting the contribution of contralateral coronoidectomy to achieving functional mouth opening during the surgical management of severe unilateral TMJ ankylosis.
OBJECTIVE:Warthin tumour most often arises in the parotid gland. Parapharyngeal space (PPS) involvement is uncommon and usually represents extension from the deep lobe, although apparently separate extraparotid lesions have been described. We report synchronous bilateral prestyloid PPS Warthin tumours with no demonstrable radiological or intraoperative continuity with either parotid gland and review the relevant literature. CASE PRESENTATION:A 59-year-old man undergoing staging for tongue squamous cell carcinoma (SCC) was found incidentally to have bilateral prestyloid PPS masses on contrast-enhanced computed tomography. Neither lesion was clinically apparent or symptomatic. Each was separated from the corresponding deep parotid lobe by a preserved circumferential fat plane. The patient underwent hemiglossectomy, selective neck dissection and transcervical excision of both PPS lesions during the same operation. Histopathological examination confirmed completely encapsulated Warthin tumours with adjacent benign serous salivary gland tissue and no residual lymph node architecture. The PPS tumours were synchronous but anatomically and histopathologically unrelated to the tongue SCC. CONCLUSION:The distinctive feature of this case is the synchronous bilateral occurrence of PPS Warthin tumours with bilateral radiological and operative separation from the parotid glands. The findings are compatible with, but do not conclusively establish, origin from heterotopic salivary tissue. Recognition of this pattern may improve the assessment of prestyloid PPS masses and facilitate surgical planning.
OBJECTIVES:To prospectively evaluate the transversal surgical accuracy and one-year stability of segmented Le Fort I osteotomy using a validated three-dimensional (3D) voxel-based assessment protocol. METHODS:In this prospective single-center study, patients undergoing two-piece or three-piece segmented Le Fort I osteotomy for transverse maxillary deficiency were included. Virtual surgical planning was performed using computer-aided design/ manufacturing (CAD/CAM) workflows. Cone-beam computed tomography (CBCT) scans were acquired preoperatively, one week, 6 months and one year postoperatively. The primary outcome was one-year dental transverse relapse, analyzed as a continuous variable. Skeletal transverse width was measured between the greater palatine foramina, and dental width between the maxillary first molars. Segment-specific surgical accuracy and postoperative stability of the lateral maxillary segments were quantified using a validated 3D voxel-based registration protocol across six degrees of freedom. Clinically relevant instability was defined as a transverse relapse of ≥2 mm. Multivariate regression analysis was used to identify predictors of relapse. RESULTS:Twenty-seven patients (14 two-piece, 13 three-piece) were included. Mean skeletal transverse expansion was 3.75 mm, whereas mean dental expansion was 1.55 mm. At one year, mean skeletal and dental relapse were 0.79 mm and 0.72 mm, respectively. Dental relapse (≥2 mm) occurred in 22.2% of patients, while skeletal relapse (≥2mm) was observed in 18.2%. Logistic regression demonstrated that greater planned dental expansion significantly increased the risk of dental relapse, with each additional millimeter increasing the odds by 28%. A data-derived Youden threshold of approximately 3.5 mm showed moderate discrimination (specificity 0.81; sensitivity 0.67) but requires external validation. Postoperative roll-related stability changes were associated with dental relapse. CONCLUSIONS:Segmented Le Fort I osteotomy provides predictable skeletal transverse expansion with acceptable one-year stability in this prospective cohort. Dental transverse expansion is more susceptible to relapse than skeletal widening, and greater planned dental expansion increased the risk of clinically relevant dental relapse. Segment-specific 3D assessment suggests that postoperative rotational control, particularly roll stability of the lateral segments, may be relevant for transverse stability.
BACKGROUND:Patient-reported outcomes are central to rhinoplasty evaluation, but evidence from Kurdish and Middle Eastern populations remains limited. This study evaluated retrospectively reported nasal satisfaction, patient-perceived function, participant-reported postoperative complications, and exploratory associations with the reported 1-year outcome after primary rhinoplasty. METHODS:This retrospective questionnaire-based observational study included 400 patients who had undergone primary rhinoplasty at least 12 months earlier. During one survey, participants retrospectively rated their nose on a 1-10 visual analogue scale (VAS) for three reference periods: before surgery, at the time of surgery, and 1 year after surgery. Item-level questions assessed appearance, breathing, confidence, comments from others, and willingness to undergo rhinoplasty again. Complication status was derived from a single participant-reported field permitting one primary response and was not clinically adjudicated. Differences among the three recalled VAS ratings were analyzed using generalized estimating equations with patient clustering. An expanded multivariable linear regression modeled the recalled 1-year VAS score, and an exploratory logistic regression examined unwillingness to repeat surgery. RESULTS:The sample was predominantly female (298/400, 74.5%), with a mean age of 24.64 ± 5.40 years. Mean retrospectively reported VAS ratings were 4.84 ± 2.55 before surgery, 7.05 ± 2.20 at the time of surgery, and 7.65 ± 2.33 at 1 year. Compared with the recalled preoperative rating, adjusted mean differences were 2.21 points (95% CI 1.92 to 2.51) at the time of surgery and 2.81 points (95% CI 2.49 to 3.12) at 1 year (both Holm-adjusted p<0.001). At 1 year, 333 patients (83.2%) had a good-to-excellent global outcome, 302 (75.5%) reported easy breathing, and 74 (18.5%) were definitely willing to undergo rhinoplasty again. A primary participant-reported postoperative complication was recorded by 160 patients (40.0%). In the expanded model (n=399), age, recalled preoperative VAS, education, and participant-reported complication status were associated with the recalled 1-year VAS; the model explained 26.0% of outcome variance (adjusted R²=0.211). In exploratory analysis, participant-reported complication status was associated with greater adjusted odds of not being definitely willing to repeat surgery (OR=2.15, 95% CI 1.18 to 3.93). CONCLUSIONS:Participants rated the surgical and 1-year states more favorably than the recalled preoperative state. Because all three ratings were obtained retrospectively in one survey, they should not be interpreted as prospectively observed change. Within the limitations of a single-category, non-adjudicated participant-reported complication measure, complication status was associated with lower recalled 1-year satisfaction and greater odds of not being definitely willing to undergo the procedure again. These associations are exploratory and should not be interpreted causally.
Fracture of a zygomatic implant is an uncommon but clinically challenging complication. Conventional management generally involves implant removal or alternative anchorage strategies, both of which may require extensive surgery, increase patient morbidity, and compromise an existing implant-supported rehabilitation.This technical report describes the development, biomechanical validation, and first clinical application of a novel prosthetic rescue device for the conservative management of cervical fractures of zygomatic implants while preserving the osseointegrated apical segment.A customized Grade V titanium device incorporating an internal threaded connection and supplementary self-tapping fixation screws was specifically designed to restore the fractured implant. Biomechanical performance was assessed by dynamic fatigue testing according to ISO 14801. The device was subsequently used in a 60-year-old woman presenting with a cervical fracture of a zygomatic implant. Placement was performed using a surgical guide, and the device was secured with an insertion torque of approximately 20 Ncm.Fatigue testing demonstrated mechanical resistance exceeding five million loading cycles under a maximum load of 129 N. At the 24-month follow-up, the patient remained free of mechanical or biological complications, with stable clinical and radiographic findings and successful maintenance of the implant-supported prosthetic rehabilitation.This case suggests that the proposed prosthetic rescue device may represent a minimally invasive alternative to implant removal in carefully selected cases of cervical fracture of zygomatic implants with a stable osseointegrated apical segment. Further clinical studies are required to confirm the reproducibility, long-term mechanical performance, and clinical predictability of this approach.
Purpose To retrospectively assess the effect of interim prostheses on bone healing, postoperative complications, and graft success in sites undergoing bone regeneration. Material and Methods This monocentric retrospective study included 100 patients who underwent 138 bone regeneration procedures between 2018 and 2025. Patients were divided into a control group without interim prostheses (n = 49) and a prosthesis group (n = 51). The prosthesis group was further described according to prosthesis type in exploratory subgroup analyses. Demographics, surgical, radiographic, and clinical data were collected. Bone gain, bone loss, and postoperative complications were compared using chi-square, Fisher’s exact test, ANOVA, and logistic regression, as appropriate. Results A total of 138 bone regeneration procedures were analyzed. Bone augmentation and bone loss after healing were similar in patients with and without interim prostheses (p > 0.05). Postoperative complications, including hematoma, swelling, bleeding, edema, and ecchymosis, did not differ significantly between groups. Theoretical bone gain (5.5 ± 3.2 mm vs. 6.2 ± 4.1 mm; p = 0.3), actual bone gain (4.4 ± 3.2 mm vs. 4.6 ± 3.5 mm; p = 0.7), and bone loss (1.31 ± 1.27 mm vs. 1.59 ± 1.66 mm; p = 0.3) were comparable between groups. Exploratory subgroup analyses suggested differences in theoretical bone gain according to prosthesis type (p = 0.026), but no robust difference was demonstrated for actual bone gain, bone loss, or complications. Conclusions In this retrospective cohort, carefully adjusted interim prostheses did not appear to adversely affect bone healing or graft success. These findings should be interpreted cautiously because of selection bias, surgical heterogeneity, and limited subgroup sample sizes. Prospective studies are needed to confirm these observations and refine clinical recommendations.
BACKGROUND:Perineural invasion (PNI) is a recognised histopathological feature of salivary gland carcinoma (SGC), but its independent prognostic value across different survival endpoints has not been quantified. This study was performed to evaluate the association between PNI and multiple survival outcomes. METHODS:A comprehensive search was conducted in 4 different databases. Studies reporting multivariable-adjusted hazard ratios (HRs) for the association between PNI and prognosis in patients with SGC were eligible. Pooled HRs with 95% confidence intervals (CIs) were calculated using random-effects models. Subgroup, sensitivity, and publication bias analyses were performed to improve the robustness. RESULTS:Twenty-two studies were included in this analysis. PNI was independently associated with worse overall survival (OS) (HR 2.75, 95% CI 1.83-4.12; I² = 54.8%), disease-free survival (DFS) (HR 2.48, 95% CI 1.75-3.52; I² = 48.4%), disease-specific survival (HR 1.70, 95% CI 1.11-2.60; I² = 0%), and local control (LC) (HR 1.84, 95% CI 1.38-2.45; I² = 36.1%). Subgroup and leave-one-out sensitivity analyses identified the sources of heterogeneity of the OS, DFS and LC estimates. Begg's test suggested possible publication bias in DFS estimate. CONCLUSIONS:These findings suggest that PNI is an independent adverse prognostic factor in SGC across multiple survival endpoints. Its presence should be routinely reported and considered in risk stratification, although whether it should guide adjuvant-treatment intensity requires prospective evaluation.
Extracranial trigeminal schwannomas are rare benign nerve sheath tumors whose management remains challenging due to anatomical complexity and limited high-quality evidence. This systematic review characterized their clinical presentation, anatomical distribution, and treatment outcomes, and assessed the availability of radiotherapy data for purely extracranial lesions. The review followed PRISMA 2020 guidelines and was registered in PROSPERO (CRD420251276199). PubMed, Scopus, and Web of Science were searched from inception to January 2026; eligible studies were analyzed with respect to clinical features, anatomical location, treatment strategies, and outcomes. Twenty-five studies encompassing 65 patients were included, using the operational definition of purely extracranial disease applied in this review (lying entirely distal to the trigeminal ganglion and Meckel's cave without a dural-based or intracranial component). Surgery, mainly gross-total or near-total resection, was the most frequently reported strategy. As an exploratory, post hoc complement to the qualitative synthesis, and after excluding a non-decomposable, group-level-only cohort of 13 patients from the sensory-disturbance denominator, pooled proportions showed symptom or pain improvement in 97.8% of evaluable patients (44/45; 95% CI 88.4-99.6%), new or worsened postoperative sensory disturbance in 17.3% (9/52; 95% CI 9.4-29.7%), and recurrence in 1.6% (1/61; 95% CI 0.3-8.7%); these should be read as descriptive summaries of a heterogeneous literature rather than precise incidence estimates. Evidence derives exclusively from small, heterogeneous case reports and case series at moderate-to-high risk of bias, and no study provided extractable radiotherapy-specific outcomes for purely extracranial lesions. Comparative treatment effectiveness therefore remains unestablished, and this evidence gap highlights the need for standardized, multicenter reporting.
Mandibular reconstruction in oncologic surgery using free bone flaps allows restoration of facial symmetry, preservation of key orofacial functions, and facilitation of adjuvant treatments. Despite these advances, dental rehabilitation remains challenging. Implant-supported prostheses seem to improve functional outcomes compared with conventional removable prostheses; however, there is still no consensus regarding optimal implantation strategies. This technical note proposes a structured, implant-oriented decision-making framework for mandibular reconstruction using free fibula flaps. It integrates key components, including three-dimensional bone positioning, soft tissue management, and guided implant placement within a prosthetically driven planning approach. The framework aims to standardize the integration of implant planning into the reconstructive workflow, from virtual planning to surgical execution. By providing a pragmatic and reproducible strategy, this work contributes to improving the predictability of prosthetic rehabilitation while maintaining oncologic safety standards.
OBJECTIVE:To compare the quality and readability of responses from five generative artificial intelligence chatbot platforms to clinician-oriented questions on open temporomandibular joint (TMJ) surgery against guideline-based reference answers. MATERIAL AND METHODS:Forty questions across eight domains were submitted on 16 July 2026 to ChatGPT (GPT-5.5), Claude (Opus 4.8), Gemini (3.1 Pro), Grok (4) and Perplexity (Pro), each via its paid tier at default settings (200 responses). Two blinded oral and maxillofacial surgeons applied the Quality Analysis of Medical Artificial Intelligence (QAMAI) tool, the Global Quality Score (GQS) and a five-point overall quality rating using a priori key elements and written anchors. Readability was assessed with the Flesch-Kincaid Grade Level (FKGL) and Flesch Reading Ease Score (FRES); platforms were compared with the Friedman test and Bonferroni-corrected Wilcoxon post-hoc tests; inter-rater reliability used intraclass correlation coefficients (ICC). RESULTS:Inter-rater reliability was good to excellent (average-measure ICC 0.93-0.99). All outcomes except clarity differed among platforms (P < .001). Perplexity achieved the highest QAMAI total (27.5 ± 1.4; Kendall's W = 0.75), largely through retrieval-based source provision; excluding this domain, Claude, Perplexity and Gemini converged. Claude had the highest GQS (4.5 ± 0.6), Gemini the highest overall rating (4.3 ± 0.7); Grok scored lowest. Claude and Gemini were least readable (median FKGL 22.7 and 26.1; FRES -11.6 and -7.5). Length did not explain scores within platforms. CONCLUSIONS:Performance varied substantially across platforms and dimensions; no platform optimized all outcomes. These findings describe informational quality, not clinical safety or decision-making, and support specialist verification before clinical use.
This retrospective study aimed to evaluate the long-term neurosensory function of the inferior alveolar nerve (IAN) following bilateral sagittal split osteotomy (BSSO) using both subjective and objective methods, and to determine the incidence of persistent neurosensory disturbances (NSD). A total of 102 patients who underwent BSSO between 2013 and 2024 and were reassessed at least 12 months postoperatively were included. Neurosensory function was assessed using a questionnaire-based visual analog scale (VAS) and objective tests, primarily the pin-prick test. Persistent NSD was defined as a patient-reported sensory disturbance within the IAN distribution area (lower lip and chin) that remained present for ≥12 months after BSSO. Patients were categorized according to the presence and side of sensory alteration, and statistical analysis was performed using the Fisher-Freeman-Halton exact test (p < 0.05). Persistent NSD at ≥12 months was observed in 5 of 102 patients (4.9%). Within the total cohort, unilateral and bilateral postoperative sensory changes were reported by 36.2% and 30.4% of patients, respectively. The most commonly reported symptoms were hypoesthesia (35.3%) and paresthesia (32.4%), which were predominantly mild in severity. Patient-reported sensory symptoms most commonly lasted up to 6 months. Functional impairment was limited, and most patients reported minimal discomfort. Patient satisfaction (89.2%) and recommendation rates (82.4%) were high. Although neurosensory disturbances were common in the early postoperative period after BSSO, they were generally mild, with patient-reported symptoms most commonly lasting up to 6 months, while persistent deficits beyond 1 year were uncommon. Patient-reported outcomes and objective sensory testing may provide complementary information regarding different aspects of postoperative neurosensory function.
BACKGROUND:Preoperative identification of Warthin tumor (WT) can inform surgical planning and patient counseling. This study aimed to develop and externally validate a simple clinical prediction model based on routinely available preoperative variables. METHODS:This two-center retrospective study included 230 patients in the development cohort and 245 in the external validation cohort. Nine routinely available preoperative variables were assessed using LASSO-penalized logistic regression with stratified five-fold cross-validation. Model performance was evaluated using discrimination, calibration, overall prediction error, 1,000-resample bootstrap internal validation, decision curve analysis, and clinical impact curves. RESULTS:Among 475 patients, 81 (17.1%) had histopathologically confirmed WT. The final model included age (OR = 1.037, 95% CI: 1.008-1.067), male sex (OR = 3.828, 95% CI: 1.146-12.783), and smoking history (OR = 3.591, 95% CI: 1.550-8.316). The AUC was 0.791 (95% CI: 0.721-0.862) in the development cohort and 0.868 (95% CI: 0.816-0.919) in external validation. After bootstrap correction, the AUC was 0.785, the calibration intercept was -0.048, the calibration slope was 0.942, the Brier score was 0.129, and Emax was 0.088. In the external cohort, the calibration intercept and slope were 0.379 and 1.503, respectively; the Brier score was 0.101 and Emax was 0.139. Decision curve analysis suggested potential net benefit across selected threshold ranges. CONCLUSIONS:A model based on age, sex, and smoking history showed useful preoperative discrimination between WT and other parotid tumors. The web-based dynamic nomogram may support initial assessment and patient counseling, although further prospective and geographically diverse validation is needed.
Reconstruction of extensive oncologic scalp defects is challenging in older patients who are poor candidates for flap surgery. We report an 87-year-old woman who underwent wide excision of a 14 × 11 cm basal cell carcinoma, resulting in a 16 × 13 cm full-thickness scalp defect with partial calvarial exposure. The anterior wound was covered with a human acellular dermal matrix and the posterior wound with a bilayer collagen-glycosaminoglycan dermal regeneration template. After formation of a vascularised neodermis, the defect was resurfaced with a cultured autologous skin equivalent; a second application treated residual uncovered areas. Both scaffolds integrated. A localised Enterobacter cloacae infection resolved with susceptibility-guided oral levofloxacin. Progressive epithelialisation achieved complete, durable coverage with an acceptable contour and no further complications at 9 months. This staged strategy avoided flap surgery and extensive donor-site morbidity.
Objectives This study aimed to systematically analyze the online discourse surrounding dangerous facial aesthetic trends, with particular focus on the "looksmaxxing" phenomenon and its associated practices. Methods This study employed a cross-sectional design. Quantitative data were collected using Brand24 social listening tools, Google Trends analysis, and Instagram engagement metrics. Search strategies combined keywords including "DIY cosmetic procedures," "self-injection," "bonesmashing," "mewing," "DIY chemical peels," and "looksmaxxing." Inclusion criteria comprised non-medically supervised facial aesthetic procedures inspired by social media and popular content promoting specific facial aesthetic trends. Engagement metrics (likes, shares, comments, views) were compared using Mann-Whitney and Kruskal-Wallis tests with Dunn's post-hoc tests and Bonferroni correction. Following quantitative analysis, a qualitative thematic analysis was conducted on a purposive sample of the 100 most-engaged posts promoting looksmaxxing practices. Results Over the 12-month period, the term "bonesmashing" generated 2,518 total mentions, with social media reach estimated at 32 million and total interactions reaching 2,477,227 over three months. YouTube dominated the discourse (43.7%), followed by TikTok (17.4%). Sentiment analysis revealed 65% neutral mentions, 18% negative, and 17% positive, with joy (33%) as the predominant emotion. Tutorial content received higher engagement than non-tutorial posts (W=9, p=0.0978). Gender analysis demonstrated an overwhelming male predominance in #bonesmashing content (approximately 98% male), compared to #mewing (74% male; χ²=8.31, p<0.01). Google Trends showed a 5,000% increase in searches for "bonesmashing" compared to the previous year. Qualitative thematic analysis of the 100 most-engaged posts identified four dominant narratives: (1) self-improvement as empowerment; (2) pseudoscientific legitimacy; (3) community belonging and mutual validation; and (4) risk minimization and normalization. Conclusions The data demonstrate that looksmaxxing practices constitute a significant online phenomenon with substantial reach and engagement, particularly among young men. The prevalence of positive and neutral sentiment, combined with high engagement with tutorial content, suggests that dangerous practices are being normalized within online communities through sophisticated discursive strategies that employ pseudoscientific language and community validation.
BACKGROUND:Adjunctive surgical procedures may be performed simultaneously with Le Fort I osteotomy (LF1) to ensure adequate paranasal augmentation. AIMS:The objective of this systematic review is to integrate current knowledge on concurrent local surgical methods to supplement LF1 to enhance paranasal volume. RESULTS:Twenty-two studies involving 463 patients were reviewed. Four subgroups of local surgical adjuncts were identified. Subgroup 1 (9 studies, 245 patients) consisted of high and quadrangular Le Fort I modifications. This subgroup had the most robust evidence in terms of paranasal volume augmentation and stability. Subgroup 2 (6 studies, 83 patients) consisted of pedicled buccal fat pad (BFP) and free intra-oral autogenous bone block grafts. While the two types of grafts were shown to be useful in paranasal augmentation, there are insufficient long-term studies to demonstrate their stability. The third subgroup (4 studies, 103 patients) had no reported complications and showed good stability, but the amount of augmentation was modest. The last subgroup (3 studies, 32 patients) had the weakest degree of evidence. CONCLUSION:All four types of surgical adjuncts demonstrated clinical benefit based on subjective outcome assessments. However, given the predominance of low-level evidence, firm conclusions regarding efficacy cannot be drawn. When compared, subgroup 1 showed the best evidence whereas subgroup 4 showed the least. Subgroup 2 lacked evidence in stability while subgroup 3 showed limited amount of paranasal augmentation.
PURPOSE:To evaluate the association, agreement, and reproducibility of contrast-enhanced computed tomography (CT)-derived depth of invasion (rDOI) compared with pathological depth of invasion (pDOI) in lip squamous cell carcinoma. MATERIAL AND METHODS:This retrospective single-center study included 51 patients who underwent preoperative contrast-enhanced CT between January 2010 and April 2024. Two observers independently measured rDOI, tumor thickness, and maximum tumor diameter twice. Pathological measurements served as the reference standard. Correlation, Bland-Altman agreement, mean absolute error, classification performance at pDOI thresholds of >5 mm and >10 mm, and intraobserver and interobserver reproducibility were assessed. RESULTS:Mean pDOI was 6.48 ± 4.67 mm; mean rDOI was 5.87 ± 4.11 mm for observer 1 and 6.77 ± 4.64 mm for observer 2. rDOI correlated significantly with pDOI (r = 0.685 and 0.781; both p < 0.001). Mean CT-pathology biases were -0.61 and 0.29 mm, but the 95% limits of agreement were wide. Mean absolute errors were 3.08 and 2.75 mm. Classification accuracy was 72.9% at the >5-mm threshold and 83.3% at the >10-mm threshold for both observers, although sensitivity varied at >10 mm. Interobserver reproducibility was excellent for DOI, tumor thickness, and maximum tumor diameter. CONCLUSION:CT-derived DOI was reproducible in measurable lip squamous cell carcinomas but was not interchangeable with pDOI. It should be used as an adjunctive preoperative estimate rather than as a stand-alone basis for DOI-based staging or surgical management.
PURPOSE:This study aimed to evaluate the factors associated with the treatment duration of dentigerous cysts in pediatric patients who underwent decompression as the primary treatment approach. METHODS:This retrospective cohort study included patients aged 5-13 years who presented to the Faculty of Dentistry, Marmara University, with a diagnosis of dentigerous cyst. All cystic lesions were treated with decompression. The associations between demographic, lesion-related, and tooth-related factors and the treatment duration were evaluated. RESULTS:A total of 51 patients, including 29 females and 22 males, with a mean age of 8.94 ± 1.76 years, were included in this study. The mean treatment duration was 8.63 ± 6.45 months. Initial cyst volume was significantly associated with treatment duration in the univariable analysis (p = 0.010), whereas the number of teeth associated with the cyst was the only independently significant factor in the multivariable model (p = 0.008). Age, sex, affected jaw, cortical expansion, cortical perforation, tooth location, tooth orientation, buccolingual position, mesiodistal position, impaction depth, and root development were not significantly associated with treatment duration (p > 0.05). CONCLUSIONS:The number of teeth associated with the cyst was independently associated with treatment duration, whereas initial cyst volume was significant only in the univariable analysis. These findings suggest that the extent of tooth involvement may help estimate the anticipated duration of decompression treatment.
PURPOSE:The purpose of this study was to evaluate the incidence and determinants of complications following orthognathic surgery, with particular emphasis on factors influencing complication severity. MATERIALS AND METHODS:This retrospective single-center cohort study included patients who underwent orthognathic surgery between 2016 and 2025. Independent variables included skeletal pattern, surgical movement (<10 mm vs ≥10 mm), type of surgery, fixation method, planning approach, and demographic factors. The primary outcome was perioperative complications, additionally categorized as minor, moderate, or major. Multivariable logistic regression identified independent predictors of complications, and ordinal logistic regression assessed factors associated with increasing complication severity. RESULTS:The sample included 243 patients (mean age 23.4 ± 5.3 years); 152 (62.6%) were female. Complications occurred in 43 patients (17.7%). In multivariable analysis, Class III deformity demonstrated lower odds of complications compared with Class II (OR: 0.33; p = 0.035). Surgical movement ≥10 mm and double-jaw surgery were associated with higher complication rates in univariable analysis but not after adjustment. No significant association was observed for fixation type or planning method. In severity analysis, skeletal classification remained a significant predictor of increasing complication severity. Movements ≥10 mm were associated with a higher frequency of major complications (9.2%vs 0.6%; RR: 14.3; p = 0.001). CONCLUSION:Complication risk in orthognathic surgery is influenced by both procedural and biomechanical factors. Larger surgical movements may increase the risk of major complications despite similar overall complication rates.
