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Current Perspectives and Future Directions in Oral and Maxillofacial Surgery
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Current Perspectives and Future Directions in Oral and Maxillofacial Surgery

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Dentistry, Oral Surgery and Oral Medicine".

Deadline for manuscript submissions: 25 January 2025 | Viewed by 6720

Special Issue Editor

Dr. Oreste Iocca

E-Mail Website
Guest Editor
Division of Maxillofacial Surgery, Città Della Salute e Della Scienza Hospital, University of Torino, 10125 Torino, Italy
Interests: head and neck oncology; microvascular reconstruction; orthognathic surgery; implant surgery

Special Issue Information

Dear Colleagues,

It is a pleasure to announce our new Special Issue, "Current Perspectives and Future Directions in Oral and Maxillofacial Surgery".

The field of oral and maxillofacial surgery is constantly evolving thanks to technological advancements, basic research discoveries, and the development and validation of novel treatment strategies. Digitally assisted treatment planning and execution, three-dimensional printing, novel surgical approaches for facial nerve reanimation, and new prognostic indicators in oral cancer are just a few of the advances that have been developed, refined, and integrated into everyday clinical practice for surgeons around the world in the last two decades.

At the same time, exciting new research topics still in their infancy will likely shape the future of our specialty, from the adoption of immunotherapy in head and neck cancer to the use of machine learning algorithms for various clinical uses and the potential application of radiomics to enhance the imaging-based diagnosis and treatment planning. Researchers in the field of maxillofacial surgery subspecialties aim to enhance the level of care delivered to patients through high-quality research and to foster the application of evidence-based treatments.

To this end, we invite contributions from researchers, clinicians, and experts across the discipline of oral and maxillofacial surgery sharing their insights and experiences.

Dr. Oreste Iocca
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • head and neck cancer
  • maxillofacial trauma
  • orthognathic surgery
  • implantology
  • temporomandibular joint
  • facial plastic surgery
  • reconstructive surgery
  • oncology

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Published Papers (6 papers)

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Research

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17 pages, 15192 KiB  
Article
Personalized Temporomandibular Joint Total Alloplastic Replacement as a Solution to Help Patients with Non-Osteosynthesizable Comminuted Mandibular Head Fractures
by Paulina Pruszyńska, Marcin Kozakiewicz, Piotr Szymor and Tomasz Wach
J. Clin. Med. 2024, 13(17), 5257; https://doi.org/10.3390/jcm13175257 - 5 Sep 2024
Viewed by 615
Abstract
Background: Treatment methods for mandibular head fractures are controversial, although effective techniques for open reduction and rigid fixation (ORIF) have been known since the late 1990s. Notably, some forms of posttraumatic comminution of the mandibular head can be reduced or fixed. Methods [...] Read more.
Background: Treatment methods for mandibular head fractures are controversial, although effective techniques for open reduction and rigid fixation (ORIF) have been known since the late 1990s. Notably, some forms of posttraumatic comminution of the mandibular head can be reduced or fixed. Methods: This study presents a personalized treatment to cure patients with nonreduced comminuted fractures of the mandibular head: total temporomandibular joint alloplastic replacement (18 patients). The reference group included patients who underwent ORIF (11 patients). Results: Personalized alloplastic joint replacements resulted in a more stable mandibular ramus after three months compared with ORIF. Conclusions: The authors recommend not performing osteosynthesis when the height of the mandibular ramus cannot be stably restored or when periosteal elevation from most of the mandibular head is necessary for ORIF. Personalized TMJ replacement should be considered in such patients. Personalized medicine allows patients to maintain a normal mandibular ramus height for a long period of time. Full article
(This article belongs to the Special Issue Current Perspectives and Future Directions in Oral and Maxillofacial Surgery)
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17 pages, 2061 KiB  
Article
Molecular Genetic Analysis of Perioperative Colonization by Infection-Related Microorganisms in Patients Receiving Intraoral Microvascular Grafts
by Henriette Louise Moellmann, Katharina Kommer, Nadia Karnatz, Klaus Pfeffer, Birgit Henrich and Majeed Rana
J. Clin. Med. 2024, 13(14), 4103; https://doi.org/10.3390/jcm13144103 - 13 Jul 2024
Viewed by 1004
Abstract
Background/Objectives: In oral and maxillofacial surgery, the reconstruction of defects often involves the transfer of skin tissue into the oral cavity utilizing microvascular grafts. This study investigates postoperative changes in microbial colonization following intraoral microvascular transplantation, as well as potential influencing factors. [...] Read more.
Background/Objectives: In oral and maxillofacial surgery, the reconstruction of defects often involves the transfer of skin tissue into the oral cavity utilizing microvascular grafts. This study investigates postoperative changes in microbial colonization following intraoral microvascular transplantation, as well as potential influencing factors. Methods: In 37 patients undergoing intraoral reconstructions, pre- and postoperative swabs were taken from the donor and recipient regions to quantify the seven selected marker bacteria using TaqMan PCRs. Patient-specific factors and clinical data were also recorded. Results: The infection-associated Acinetobacter baumannii tended to decrease postoperatively, while the infectious pathogens Pseudomonas aeruginosa, Enterococcus faecalis and the family of Enterobacteriaceae showed a postoperative increase without being directly associated with a clinical infection. Streptococcus mitis showed a significant postoperative decrease on buccal mucosa and increase on the graft surface (oral dysbiosis) and was significantly reduced or displaced by other bacteria (e.g., Mycoplasma salivarium, positive selection) when treated with ampicillin/sulbactam. Conclusions: The cutaneous microbiome of the graft adapts to the local intraoral environment. Postoperative shifts in oral bacterial colonization and an increase in infection-relevant bacteria were observed. These perioperative changes in colonization are also influenced by the administration of ampicillin/sulbactam. Consequently, single doses of antibiotics appear to be more beneficial compared to longer-term preventive use. Full article
(This article belongs to the Special Issue Current Perspectives and Future Directions in Oral and Maxillofacial Surgery)
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Review

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11 pages, 1613 KiB  
Review
Reconstructive Surgery of the Head and Neck in Organ Transplant Recipients: A Case Report and a Review of the Literature
by Andrea Rampi, Lara Valentina Comini, Andrea Galli, Bright Oworae Howardson, Alberto Tettamanti, Paolo Luparello, Gabriele Redaelli, Davide Di Santo and Stefano Bondi
J. Clin. Med. 2024, 13(16), 4790; https://doi.org/10.3390/jcm13164790 - 14 Aug 2024
Cited by 1 | Viewed by 931
Abstract
The number of solid organ transplant recipients (SOTRs) is growing as a consequence of an increase in transplantations and longer survival; these patients, thus, frequently suffer various comorbidities and are subjected to the detrimental effects of immunosuppressive agents, which expose them to a [...] Read more.
The number of solid organ transplant recipients (SOTRs) is growing as a consequence of an increase in transplantations and longer survival; these patients, thus, frequently suffer various comorbidities and are subjected to the detrimental effects of immunosuppressive agents, which expose them to a higher risk of developing malignancies. These drugs also complicate the surgical treatment of neoplasms, as they can hinder wound healing, especially when associated with other unfavorable factors (e.g., previous radiotherapy, diabetes, etc.). We herein present our experience with a 74-year-old SOTR who underwent a radical extended parotidectomy and reconstruction with a submental island flap for a persistent cutaneous squamous carcinoma after radiotherapy; his complicated clinical course was characterized by incredibly slow wound healing. The current literature was reviewed to provide a succinct overview of the main difficulties of head and neck surgery in SOTRs. In particular, the immunosuppressive regimen can be tapered considering the individual risk and other elements should be carefully assessed, possibly prior to surgery, to prevent cumulative harm. New developments, including intraoperative monitoring of flap vascularization through indocyanine green fluorescence video-angiography and the prophylactic application of negative pressure wound therapy, when feasible, may be particularly beneficial for high-risk patients. Full article
(This article belongs to the Special Issue Current Perspectives and Future Directions in Oral and Maxillofacial Surgery)
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Other

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13 pages, 1391 KiB  
Systematic Review
Oral Reconstruction with Locoregional Flaps after Cancer Ablation: A Systematic Review of the Literature
by Remo Accorona, Domenico Di Furia, Alice Cremasco, Luca Gazzini, Niccolò Mevio, Francesco Pilolli, Andrea Achena, Haissan Iftikhar, Shadi Awny, Giorgio Luigi Ormellese, Alberto Giulio Dragonetti and Armando De Virgilio
J. Clin. Med. 2024, 13(14), 4181; https://doi.org/10.3390/jcm13144181 - 17 Jul 2024
Viewed by 1088
Abstract
Introduction: The planning of oral reconstruction after tumor resection is a pivotal point for head and neck surgeons. It is mandatory to consider two aspects: the size of the surgical defect and the complexity of the oral cavity as an anatomical region. [...] Read more.
Introduction: The planning of oral reconstruction after tumor resection is a pivotal point for head and neck surgeons. It is mandatory to consider two aspects: the size of the surgical defect and the complexity of the oral cavity as an anatomical region. We offer a review of the literature that focuses on four types of locoregional flaps that can be profitably used for such reconstruction: infrahyoid (IF), nasolabial (NF), platysma (PF), and submental (SF). Methods: The study was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. This systematic review was carried out according to the PICOS acronym through a comprehensive electronic search on PubMed/MEDLINE, Cochrane Library, and Google Scholar databases. For each selected article, we extrapolated eight main parameters, of which all mean values were compared through an ANOVA test. The dimensions of the oral defects were referred to as “small” (<7 cm2), “medium” (7–50 cm2), or “large” (>50 cm2). Results: A total of 139 articles were selected with a total of 5898 patients. The mean ages for each type of flap were not statistically significant (p = 0.30, p > 0.05). Seven sublocations of oral defects were reported: The most common was the tongue (2003 [34.0%] patients), followed by the floor of the mouth (1786 [30.4%]), buccal mucosa (981 [16.6%]), cheek (422 [7.2%]), hard palate (302 [5.1%]), alveolar ridge (217 [3.7%]), and retromolar trigone (187 [3.2%]). The defects were mainly medium-sized (4507 [76.4%] patients), and fewer were small-sized (1056 [17.9%]) or large-sized (335 [5.7%]). Complications were noted, the most frequent of which was flap necrosis, seen in 0.57% of cases. The functional and esthetical results were mainly positive. Conclusions: Locoregional flaps represent a good alternative in medium-sized defects as well as a fairly good alternative in small- and large-sized defects when other options are ruled out. Full article
(This article belongs to the Special Issue Current Perspectives and Future Directions in Oral and Maxillofacial Surgery)
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16 pages, 1250 KiB  
Systematic Review
Temporomandibular Joint Injections and Lavage: An Overview of Reviews
by Natalia Turosz, Kamila Chęcińska, Maciej Chęciński, Karolina Lubecka, Filip Bliźniak, Dariusz Chlubek, Tomasz Olszowski and Maciej Sikora
J. Clin. Med. 2024, 13(10), 2855; https://doi.org/10.3390/jcm13102855 - 12 May 2024
Cited by 5 | Viewed by 1114
Abstract
Objectives: This overview was conducted following the Preferred Reporting Items for Overviews of Reviews guidelines and aimed to collect and compare the results of systematic reviews on temporomandibular joint injection treatment. Methods: Systematic reviews of randomized clinical trials on temporomandibular disorders treated with [...] Read more.
Objectives: This overview was conducted following the Preferred Reporting Items for Overviews of Reviews guidelines and aimed to collect and compare the results of systematic reviews on temporomandibular joint injection treatment. Methods: Systematic reviews of randomized clinical trials on temporomandibular disorders treated with lavage or intra-articular administrations were qualified for syntheses. The final searches were conducted on 27 February 2024, without time frame restrictions. Results: Of the 232 identified records, 42 systematic reviews were selected. The most evidence-based conclusions call into question the clinical differences between many therapeutic approaches, including the following: (1) injectable selection for the treatment of pain and hypomobility; (2) the method of performing arthrocentesis; (3) the use of imaging when rinsing the TMJ cavity; (4) the supplementation of the extracapsular administration of unprocessed blood with intracapsular deposition in the treatment of TMJ hypermobility. Conclusions: Systematic reviews based solely on randomized clinical trials proved the following differences: (1) in painful temporomandibular hypomobility, a better therapeutic effect is observed with arthrocentesis followed by I-PRF administration compared to lavage alone; (2) in painful temporomandibular hypomobility, inferior- or double-compartment injection leads to better results than superior-compartment injection; (3) in temporomandibular joint recurrent dislocation, hypertonic dextrose administration is superior to placebo, although (4) unprocessed blood has a better effect than hypertonic dextrose. PROSPERO registration number: CRD42024496142. Full article
(This article belongs to the Special Issue Current Perspectives and Future Directions in Oral and Maxillofacial Surgery)
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12 pages, 506 KiB  
Systematic Review
Enhancing Cranio-Maxillofacial Fracture Care in Low- and Middle-Income Countries: A Systematic Review
by Christian Deininger, Florian Wichlas, Marco Necchi, Amelie Deluca, Susanne Deininger, Klemens Trieb, Herbert Tempfer, Lukas Kriechbaumer and Andreas Traweger
J. Clin. Med. 2024, 13(8), 2437; https://doi.org/10.3390/jcm13082437 - 22 Apr 2024
Viewed by 1087
Abstract
Background: Cranio-maxillofacial (CMF) injuries represent a significant challenge in low- and middle-income countries (LMICs), exacerbated by inadequate infrastructure, resources, and training. This systematic review aims to evaluate the current strategies and solutions proposed in the literature to improve CMF fracture care in [...] Read more.
Background: Cranio-maxillofacial (CMF) injuries represent a significant challenge in low- and middle-income countries (LMICs), exacerbated by inadequate infrastructure, resources, and training. This systematic review aims to evaluate the current strategies and solutions proposed in the literature to improve CMF fracture care in LMICs, focusing on education, patient transfer, and off-label solutions. Methods: A comprehensive literature search was conducted using PubMed/Medline from January 2000 to June 2023. Studies were selected based on the Preferred Reporting Items for Systematic Review and Meta-analysis Statement (PRISMA). Solutions were categorized into three main areas: education (digital and on-site teaching, fellowships abroad), patient transfer to specialized clinics, and off-label/non-operative solutions. Results: Twenty-three articles were included in the review, revealing a consensus on the necessity for enhanced education and training for local surgeons as the cornerstone for sustainable improvements in CMF care in LMICs. Digital platforms and on-site teaching were identified as key methods for delivering educational content. Furthermore, patient transfer to specialized national clinics and innovative off-label techniques were discussed as immediate solutions to provide quality care despite resource constraints. Conclusions: Effective CMF fracture care in LMICs requires a multifaceted approach, prioritizing the education and training of local healthcare professionals, facilitated patient transfer to specialized centers, and the adoption of off-label solutions to leverage available resources. Collaborative efforts between international organizations, local healthcare providers, and educational institutions are essential to implement these solutions effectively and improve patient outcomes in LMICs. Full article
(This article belongs to the Special Issue Current Perspectives and Future Directions in Oral and Maxillofacial Surgery)
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