Objective To compare industrial plasticine-assisted physical model reconstruction with virtual surgical planning (VSP) for preoperative planning of comminuted Le Fort I maxillary fractures. Methods This single-centre retrospective cohort study included patients with comminuted Le Fort I fractures, defined as at least three segments, who underwent open reduction and internal fixation between June 2024 and June 2025. Patients were classified by routine planning workflow. Primary outcomes were hands-on planning time and root mean square (RMS) deviation. Secondary outcomes were infection, nonunion and occlusal disorder. Results Thirty-three patients were included: 15 in the physical model group and 18 in the VSP group. Hands-on planning time was shorter in the physical model group (8.87 ± 3.10 vs 15.85 ± 5.39 min; mean difference, -6.98 min; 95% confidence interval [CI], -10.06 to -3.91; P < 0.001). RMS deviation did not differ significantly (1.16 ± 0.14 vs 1.21 ± 0.10 mm; mean difference, -0.04 mm; 95% CI, -0.14 to 0.05; P = 0.32). Adjusted analyses were consistent. No infection or nonunion occurred. Occlusal disorder occurred in 2 patients (13.3%) and 4 patients (22.2%), respectively (P = 0.66). Conclusions Industrial plasticine-assisted physical model reconstruction was associated with shorter hands-on planning time than VSP, with no statistically significant differences in RMS deviation or recorded short-term postoperative outcomes. Clinical significance: For comminuted Le Fort I fractures requiring restoration of dental arch form and occlusion, this workflow may be a practical adjunct to digital planning.

Background/Objectives: Functional outcomes after digitally planned mandibular fracture repair remain incompletely characterized. This study estimated the 12-month frequency of clinician-recorded temporomandibular disorder (TMD) and examined its associations with condylar injury and clinical findings documented at 3 months. Methods: This single-center retrospective cohort included patients treated between September 2021 and June 2023. Of 139 patients eligible after criterion review, 18 (12.9%) lacked an observed 12-month outcome and 121 were analyzed. The endpoint was the treating-team clinical diagnosis after structured symptom review and examination; preserved records did not support full Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) Axis I decision rules, subtype assignment, or Axis II instruments. Associations with condylar involvement were estimated using modified-Poisson regression with robust variance; the adjusted model included age, sex, and displacement grade. Associations with 3-month findings were exploratory and multiplicity-controlled. Results: Thirty-three of 121 patients had clinician-recorded TMD at 12 months (27.3%; 95% confidence interval [CI], 20.1-35.8%). TMD occurred in 27 of 47 patients with condylar involvement (57.4%) and 6 of 74 without it (8.1%; risk ratio [RR], 7.09; 95% CI, 3.17-15.86). The adjusted RR was 6.87 (95% CI, 3.06-15.41), with similar results when displacement grade was categorical. Malocclusion, TMJ clicking, TMJ pain, abnormal opening pattern, limited mouth opening, and unilateral chewing at 3 months remained associated after correction (all q ≤ 0.003). Conclusions: Clinician-recorded TMD was concentrated among patients with condylar injury. Associations with early functional abnormalities may reflect persistence or recurrence because several findings overlap with the later endpoint. These data support closer functional surveillance but do not establish causality, independent prediction, or the comparative effectiveness of digital planning.

Maxillofacial fractures require reconstruction of a functional craniofacial unit rather than isolated realignment of fractured bone. Stable occlusion, mandibular movement, temporomandibular joint position, facial contour, and fixation-device adaptation should be considered as interdependent treatment targets. Digital workflows incorporating CT or CBCT reconstruction, virtual surgical planning, CAD/CAM, 3-dimensional printing, patient-specific implants or plates, and navigation have improved visualization and surgical transfer. However, comminution, bilateral injury, loss of anatomic references, dental arch disruption, limited mouth opening, metal artifacts, and labor-intensive segmentation still restrict efficiency and reproducibility. This narrative review summarizes artificial intelligence applications across the occlusion-oriented digital reconstruction chain, including image screening, craniofacial and dental segmentation, tooth numbering, model repair, 3-dimensional shape completion, planning assistance, intraoperative registration, and postoperative deviation analysis. The literature was reviewed with emphasis on clinical task, evidence maturity, implementation risk, and translational feasibility. To make the clinical hierarchy explicit, AI applications were classified as near-term supervised clinical support, intermediate translational tools, exploratory research applications, or not ready for routine clinical use. Current evidence supports AI most strongly as supervised decision support for fracture triage, preliminary jaw and tooth segmentation, planning preparation, and postoperative measurement. A representative clinical workflow scenario is included to illustrate how these tasks can be integrated into surgeon-led planning without converting AI outputs into autonomous surgical decisions. Shape completion, automated reduction, fixation design, and real-time intraoperative feedback remain promising early translational applications but require stricter validation before broad clinical deployment. Future translation should prioritize multicenter annotated data sets, external validation, uncertainty reporting, auditable human-in-the-loop workflows, and outcome measures that link radiographic accuracy with occlusal contact, masticatory efficiency, temporomandibular function, patient-reported outcomes, and cost-effectiveness.

Objective To verify the accuracy of a digital workflow for occlusal relationship reduction in patients with maxillofacial fractures via cone beam computed tomograhy/ computerized tomography (CBCT/CT). Methods We collected CBCT/CT data and oral scan data from both general patients and fracture patients and established digital models. The differences between the oral scan model and the CBCT/CT digital model were compared. 3D-printed dental models were made for general patients, and comparisons were made matching the dental model with the original occlusion. Differences among the postoperative CT digital models of fracture patients, the virtual reconstruction models, and the model surgery reconstructed models were compared. Results A total of 20 general patients and 27 fracture patients participated in this study. The average error for the segmented CBCT/CT modelling group was 122.90±26.94 μm, whereas the average error for the nonsegmented CBCT/CT modelling group was 84.50±9.21 μm, with a significant difference between the two groups (t = 6.364, P < 0.01). The error in the occlusal relationship between the 3D-printed models and the patient's actual occlusion was 18.35±2.20 μm. The average error for the virtual reconstruction group was 438.89±155.55 μm, whereas it was 857.09±116.55 μm for the model surgery reconstruction group, with a significant difference between the two groups (t = 11.180, P < 0.01). Conclusion CBCT/CT-based digital dental models can be created with high accuracy. Using 3D-printed models and intercuspal occlusion guidance, the original occlusal relationship can be restored. Compared with model surgery, virtual fracture reconstruction offers superior accuracy. Clinical significance This study demonstrates the feasibility of accurate digital occlusal restoration in fracture patients, providing a new approach for maxillofacial fracture management.

Restoration of the occlusal relationship is the key point in the treatment of maxillofacial fractures. Poor restoration of the occlusal relationship seriously impacts oral function as well as physical and mental health. This study combines virtual surgical technology with model surgery, uses computed tomography data to establish a maxillofacial bone model, and performs a virtual reduction of fractures. The upper and lower dentition models after reconstruction were intercepted and 3-dimensional printed. After the occlusal relationship was reconstructed by the prosthodontist using the model, an occlusal reduction guide was designed and manufactured based on the reconstructed occlusal relationship to accurately reduce the occlusal relationship in patients with maxillofacial fractures. This study proposes an occlusal guide design process for maxillofacial fractures and optimizes the traditional model surgical process to provide a convenient surgical strategy. This study provides new ideas for the design of personalized surgical guides for maxillofacial fractures.

Objective: To study the incidence and related risk factors for new-onset temporomandibular joint disorder after mandibular surgery to provide clinical guidance. Materials and methods: The medical records of patients who underwent open reduction and internal fixation formandibular fractures between September 2020 andJune 2023 were retrospectively analysed, and their personal information and the incidence and pathogenic factors of temporomandibular joint disorder before surgery were recorded. Patients were followed up at 3 months, 6 months, and 1 year after surgery to investigate the incidence and pathogenic factors of postoperative temporomandibular joint disorder. Results: A total of 121 patients were included in this study, 33 of whomdeveloped temporomandibular joint disorder, accounting for 27.27% of the study population, and 88 patients who did not develop temporomandibular joint disorder, accounting for 72.73% of the study population. Univariate analysis revealed significant differences in abnormal occlusion and healing rates, unilateral chewing rates, and deep overbite of the anterior teeth rates (P <0.05). There was no significantdifference in age, sex, fracture area, cause of trauma, infection rate, bruxism rate, empty chewing rate, or postoperative anxiety rate between the two groups (P >0.05). Binary logisticregression analysis revealed that abnormal occlusion and healing (OR=0.044) and unilateral chewing (OR=0.142) may be risk factors for new-onset temporomandibular joint disorder after maxillofacial fracture surgery. Conclusion: During the follow-up period, long-term postoperative occlusal habits should be established, and attention should be given the patients’ postoperative psychological state. Accurate digital reconstruction of the occlusal relationship is needed fortreating mandibular fractures.

Background Third molar (M3) extraction is a common surgery in oral and maxillofacial surgery, and composite wound dressings such as hydroxybutyl chitosan (HBC) may improve postoperative sequala following M3 removal. Purpose The study purpose was to measure and compare differences in pain, swelling, trismus, wound healing, and quality of life (QOL) between the HBC and the control sides in patients undergoing M3 removal. Study Design, Setting, Sample This study is a double-blind, split-mouth, randomized clinical trial. Patients who required M3 removal between June 2022 and May 2023 were included. Exclusion criteria included seafood allergies, smoking, poor oral hygiene, and systemic diseases. Predictor Variable The predictor variable was the socket treatment technique. Subjects were randomly assigned to the HBC or control (physiological saline) side. Main Outcome Variable The primary outcome variables, including pain assessed by visual analog scale, swelling, and maximal incisional opening, were measured on the first, third, and seventh postoperative days. The secondary outcome variables included QOL and wound healing score measured on the third and seventh days after surgery. Covariates The covariates included age, sex, and operation time. Analyses The Shapiro‒Wilk test was used to evaluate the normality of the data distribution. The paired t test or Wilcoxon signed-rank test was adopted. Statistical significance was set at P < .05. Results The study included 60 patients (mean age: 25.81 ± 4.91; 23 (38%) males, 37 (62%) females). A statistically significant difference in the level of pain (HBC: 37.58 ± 4.39 mm, control: 47.00 ± 4.33 mm, day 1, P < .001; 21.88 ± 3.25 mm, 35.95 ± 1.57 mm, day 3, P < .001), maximal incisional opening (23.92 ± 1.38 mm, 18.22 ± 1.82 mm, day 1, P < .001; 30.00 ± 1.61 mm, 23.78 ± 1.70 mm, day 3, P < .001), and swelling (6.86 ± 0.70 mm, 7.15 ± 0.80 mm, day 3, P = .006) was detected after surgery. A statistically significant difference in QOL was detected (HBC: 13.70 ± 1.65, control: 18.60 ± 2.14, day 3, P < .001). Conclusion and Relevance The application of HBC hydrogels to wounds after impacted mandibular M3 extraction reduces postoperative sequalae, promotes wound healing and improves postoperative QOL.

ObjectiveThe margin status of oral squamous cell carcinoma patients is considered to be predictive of recurrence and long-term survival. Therefore, precise intraoperative margin assessment is crucial. This study investigated the feasibility of using near-infrared fluorescence imaging technology to guide margin design in oral squamous cell carcinoma patients.MethodsIn this retrospective study, indocyanine green solution was intravenously injected preoperatively into patients. Intraoperatively, the surgical area was illuminated using a near-infrared fluorescence imaging system, which caused the lesion to fluoresce in the surgical area. Surgery was performed with the assistance of fluorescence imaging. The fluorescence intensity of the lesion area and surrounding normal tissue was recorded during surgery. Intraoperative margins were sent for rapid pathology, and postoperative margin pathology results were documented.ResultsSixteen patients were included in this study (7 males, 9 females), with an average age of 65.65 ± 12.37 years. Preoperative biopsy and postoperative pathology confirmed oral squamous cell carcinoma in all patients. No cancer cells were found in the margin pathology results. The average fluorescence intensity of the lesion area was 214 ± 4.70, and that of the surrounding normal tissue was 104.63 ± 3.14. There was no significant difference in the fluorescence intensity values of the lesion areas among all patients (F=0.38, P>0.05). There was a significant difference in fluorescence intensity between the lesion area and surrounding normal tissue (t=33.76, P<0.05).ConclusionNear-infrared fluorescence imaging technology can aid in real-time imaging differentiation of lesion areas based on differences in fluorescence intensity during surgery. The use of this technology can assist surgeons in assessing the safety margin and reliably guide surgery.

Abstract Objective Restoration of the occlusal relationship is critical in the treatment of maxillofacial fractures. Poor restoration of the occlusal relationship has a serious impact on the patient's oral function and physical and mental health. Materials and Methods This study is based on computer-aided design and manufacturing and aimed to use computed tomography (CT) data to establish a maxillofacial bone model and perform virtual reduction of such fractures. The upper and lower dentition models were established and reconstructed via 3D printing. After the occlusal relationship was determined by the prosthodontist using the model, the occlusal relationship was obtained through an oral three-dimensional scanner. Based on the reconstructed occlusal relationship, an occlusal reduction guide plate was designed and manufactured to precisely reduce the occlusal relationship in patients with maxillofacial fractures. Results This study proposes a design process for occlusal guides for maxillofacial fractures that optimizes the traditional surgical processes and enhances surgical convenience. Conclusion This study presents new ideas for the design of personalized surgical guides for maxillofacial fractures. Clinical Relevance: The application of the occlusal guide can assist the surgeon to accurately reset the occlusal relationship and fix the occlusal relationship, which can significantly improve the operation efficiency.

Objectives: In the field of computer-assisted surgery, 3D printing technology and computer-aided navigation (CAN) technology have led to advances in craniofacial surgery. However, the application of these two techniques in maxillofacial fractures is mostly limited to unilateral zygomatic bone and zygomatic arch fractures, and few studies have investigated their use for multiple maxillofacial fractures. This study summarizes the combined application of 3D printing technology and CAN for complex maxillofacial fractures to guide clinical practice. Materials and methods: Twenty-six patients with multiple maxillofacial fractures from 09/2017 to 03/2021 were retrospectively studied and divided according to surgical method into an experimental group (navigation-aided surgery combined with a 3D-printed guide) and a control group (navigation-aided surgery only). The surgical time was compared between the groups, and posttreatment computed tomography and follow-up visits were conducted at 1 week and 3 months, respectively, to compare the quality of treatment in terms of infection, occlusal disorder, restricted mouth opening, midline displacement, and bilateral asymmetry. Results: According to our results, the combined use of CAN and 3D printing significantly improved the treatment results of double-sided maxillofacial fractures (rs = 0.448, P < 0.05). The surgical time of the experimental group was significantly shorter than that of the control group (Z = -2.083, P < 0.05). Conclusions: This study broadens our understanding of the treatment of multiple maxillofacial fractures. The combined use of 3D printing technology and CAN effectively shortened the operation time and achieved a better therapeutic effect. (c) 2023 Asian Surgical Association and Taiwan Robotic Surgery Association. Publishing services by Elsevier B.V. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

Background: Ambulatory surgery and single-visit surgery are becoming increasingly accepted and practiced. Materials and methods: The clinical data of patients undergoing ambulatory surgery were collected, and infor-mation on their chief complaint and basic information was specifically included. Follow-up phone calls were conducted 1 and 3 days, 1 and 2 weeks, and 1 month after treatment. Information on their recovery and well-being was collected. Results: A total of 427 patients (males: 224, females: 203, average age: 23.07 +/- 11 years) were recruited for this study. A total of 43.55% of the patients chose ambulatory surgery. A total of 62.9% of them selected it for convenience, while 43.55% selected it for pain reduction. The top three diseases treated by ambulatory sur-gery were impacted teeth (56.7%), jaw cyst (14.75%) and supernumerary teeth (10.07%). Postoperative com-plications occurred in 248 of the 427 patients, with an incidence rate of 58.08%. The complication that occurred most frequently was postoperative pain (56.44%). Complications frequently occurred on Day 3 after the operation and resolved after 2 weeks. Conclusion: After being diagnosed, ambulatory surgery is an effective mode of treatment for oral and maxillo-facial diseases. Oral hygiene, professional postoperative follow-up visits and rigorous anesthesia evaluation are very important for ambulatory surgery for oral and maxillofacial diseases.(c) 2022 Elsevier Masson SAS. All rights reserved.

目的 研究和讨论种植体相关危险因素在早、晚期失败中的影响差异,以指导种植的术前准备与术后维护,提高种植体留存率.方法 收集2011年1月至2018年12月期间,在合肥市口腔医院行种植修复的7334名患者中种植体失败的177例病例,按失败时间分为早期失败组和晚期失败组,分别统计可能影响患者种植体失败的相关危险因素,分析两组数据间的差异.结果 种植体早期失败与晚期失败在性别、植入部位、种植体尺寸及是否使用骨替代材料等因素上的差异有统计学意义.女性患者、前牙区、植入骨替代材料更易发生早期失败,男性患者、后牙区更易发生晚期失败.结论 完善的术前评估与危险因素的预防性治疗可有效降低种植体的早期失败率.术后定期随访、控制风险因素、及时的种植体维护性治疗可有效的预防种植体的晚期失败.

[目的]探讨口腔门诊学龄前儿童牙科畏惧症(children's dental fear,CDF)的发生状况及影响因素.[方法]随机抽取于儿童口腔科就诊的3～6岁学龄前儿童411例,采用学龄前儿童牙科畏惧调查问卷和口腔健康调查表进行调查,并采用儿童畏惧调查表-牙科分量表(the children's fear survey-dental subscale,CFS-DS)评估儿童牙科畏惧程度,通过单因素和多因素Logistics回归分析学龄前儿童CDF影响因素.[结果]本次共发放问卷423份,回收有效问卷411份,有效回收率为411/423,学龄前儿童牙科畏惧症发生率占56.0％.单因素分析发现有CDF者与无CDF者在年龄、主要抚养人、家庭结构、家庭人均月收入、CDF处理方式、日常口腔健康宣教、长期服药史、初次就诊经历、父母口腔健康知识得分及父母牙科畏惧方面的差异均有统计学意义(P＜0.05);而学龄前儿童乳牙龋则与CDF无关(P＞0.05).Logistic多元回归分析结果显示学龄前儿童CDF影响因素有主要抚养人、家庭人均月收入、父母口腔健康知识得分及父母牙科畏惧.[结论]学龄前儿童牙科畏惧症由主要抚养人、家庭人均月收入、父母口腔健康知识得分及父母牙科畏惧等多方因素综合作用所致,需要患儿、家长及医护人员共同努力来降低其发病率.