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Children
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Pediatric Oral and Facial Surgery: Advances and Future Challenges
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Pediatric Oral and Facial Surgery: Advances and Future Challenges

A special issue of Children (ISSN 2227-9067). This special issue belongs to the section "Pediatric Dentistry & Oral Medicine".

Deadline for manuscript submissions: 1 June 2026 | Viewed by 1520

Special Issue Editors

Dr. Rocío Trinidad Velázquez-Cayón

E-Mail Website
Guest Editor
1. Oral Medicine and Phototherapy Research Group—OMEP, Faculty of Health Sciences, Department of Dentistry, Fernando Pessoa Canary Islands University, 35450 Gran Canaria, Spain
2. Centro Universitario San Isidoro, Pablo de Olavide University, 41092 Seville, Spain
Interests: oral health; oral surgery
Dr. Alberto Garcia-Perla-Garcia

E-Mail Website
Guest Editor
1. Department of Surgery, University of Seville, Seville, Spain
2. Oral and Maxillofacial Surgeon, Department of Oral and Maxillofacial Surgery, “Virgen del Rocio” University Hospital, Seville, Spain
Interests: oral surgery; implantology; orthognathic surgery

Special Issue Information

Dear Colleagues,

This Special Issue aims to explore current challenges, innovations, and future directions in pediatric oral and facial surgery. We welcome the submission of cutting-edge research on surgical techniques, craniofacial conditions, digital technologies, perioperative care, the psychosocial aspects of pediatric surgical care, and multidisciplinary treatment with physiotherapy in pre- and postoperative care in pediatric oral and facial surgery, especially studies addressing clinical impact and translational relevance.

We welcome the submission of original research articles, reviews, and case reports that offer novel insights or comprehensive overviews of emerging trends in pediatric oral and facial surgery.

If you are interested in submitting to this Special Issue, please feel free to contact me. I would also appreciate it if you could share this invitation with colleagues who may wish to contribute.

Dr. Rocío Trinidad Velázquez-Cayón
Dr. Alberto Garcia-Perla-Garcia
Guest Editors

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 250 words) can be sent to the Editorial Office for assessment.

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. Children is an international peer-reviewed open access monthly 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 2400 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

  • pediatric surgery
  • craniofacial disorders
  • digital health technologies
  • perioperative care
  • maxillofacial physiotherapy
  • psychosocial pediatric surgical care
  • new technologies

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Further information on MDPI's Special Issue policies can be found here.

Published Papers (2 papers)

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Research

19 pages, 4568 KB  
Article
Role of Computer-Assisted Surgery in the Management of Pediatric Orbital Tumors: Insights from a Leading Referral Center
by Elena Gomez Garcia, Maria Granados, Javier M. Saceda, Maria N. Moreno, Jorge Zamorano, Jose L. Cebrian and Susana Noval
Children 2025, 12(12), 1649; https://doi.org/10.3390/children12121649 - 4 Dec 2025
Viewed by 420
Abstract
Background/Objectives: Pediatric orbital tumors are rare and complex, requiring multidisciplinary care at specialized centers. Contemporary treatment paradigms emphasize centralized care delivery through experienced multidisciplinary teams to optimize patient outcomes. Recent advances in surgical planning technologies and intraoperative navigation systems have substantially enhanced surgical [...] Read more.
Background/Objectives: Pediatric orbital tumors are rare and complex, requiring multidisciplinary care at specialized centers. Contemporary treatment paradigms emphasize centralized care delivery through experienced multidisciplinary teams to optimize patient outcomes. Recent advances in surgical planning technologies and intraoperative navigation systems have substantially enhanced surgical safety through improvement in tumor resection and reconstruction and reduction in complications, including recurrence of the lesion. Computed-aided surgical technologies enable precise virtual planning, minimally invasive approaches and more precise reconstruction methods when necessary by mean of patient-specific cutting guides, premolded orbital plates or individual patient solutions (IPS) prosthesis. Three-dimensional biomodelling visualizes tumor architecture and aids localization while preserving neurovascular structures, and real-time neuronavigation improves safety and efficacy. Methods: We conducted a retrospective analysis of 98 pediatric patients with orbital tumors treated between 2014 and 2025 at a tertiary center to evaluate the use of computed-assisted surgical technologies and the indications for treatment. Inclusion criteria comprised all cases where computer-assisted techniques were employed. Patients were classified into two groups: Group 1—intraconal or extensive periorbital lesions with eye-sparing intent treated via craniofacial approaches; Group 2—periorbital tumors with orbital wall involvement, to analyze the use of the different technologies. Data collected included tumor age, type, location, technology used, adjunctive treatments, and postoperative outcomes. Results: Twelve patients underwent computer-assisted surgery. Technologies employed over the last six years included intraoperative navigation, 3D planning with/without tumor segmentation, orbital-wall reconstruction by mirroring, IPS or titanium mesh bending, and preoperative biomodelling. Patients were grouped by tumor location and treatment goals: Group 1—intraorbital lesions (primarily intraconal or 270–360° involvement), including one case of orbital encephalocele treated transcranially; Group 2—periorbital tumors with orbital-wall destruction, treated mainly via midfacial approaches. Intraoperative navigation was used in 10/12 cases (8/11 with tumor segmentation); in 3 cases with ill-defined margins, navigation localized residual tumor. Virtual surgery predominated in Group 2 (4 patients) and one in Group 1, combined with cutting guides for margins and Individual Prosthetic Solutions (IPS) prosthesis fitting (two patients: titanium and PEEK). In two cases, virtual plans were performed, STL models printed, and premolded titanium meshes used. No complications related to tumor persistence or orbital disturbance were observed. Conclusions: Advanced surgical technologies substantially enhance safety, efficiency, and outcomes in pediatric orbital tumors. Technology-assisted approaches represent a paradigm shift in this complex field. Additional studies are needed to establish evidence-based protocols for systematic integration of technology in pediatric orbital tumor management. Full article
(This article belongs to the Special Issue Pediatric Oral and Facial Surgery: Advances and Future Challenges)
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16 pages, 1106 KB  
Article
Diagnostic Accuracy and Clinical Impact of Handheld Point-of-Care Ultrasound in Pediatric Odontogenic Infections: A Prospective Cohort Study
by Hanna Frid, Amir Bilder, Ahmad Hija and Omri Emodi
Children 2025, 12(10), 1392; https://doi.org/10.3390/children12101392 - 15 Oct 2025
Viewed by 753
Abstract
Background: Pediatric odontogenic infections pose significant diagnostic challenges, particularly in distinguishing between cellulitis and abscess. Accurate differentiation is crucial for guiding appropriate management—antibiotics alone for cellulitis versus surgical incision and drainage (I&D) for an abscess—but can be difficult without specialized expertise or advanced [...] Read more.
Background: Pediatric odontogenic infections pose significant diagnostic challenges, particularly in distinguishing between cellulitis and abscess. Accurate differentiation is crucial for guiding appropriate management—antibiotics alone for cellulitis versus surgical incision and drainage (I&D) for an abscess—but can be difficult without specialized expertise or advanced imaging. Objective: We aimed to evaluate the diagnostic accuracy of handheld point-of-care ultrasound (POCUS; Philips Lumify), utilized by non-specialist clinicians, in differentiating cellulitis from abscess in pediatric odontogenic infections. A secondary objective was to assess its impact on reducing hospital admissions and emergency department (ED) burden. Methods: This prospective cohort study involved 111 pediatric patients (aged 1–17 years) presenting with maxillofacial odontogenic infections to a tertiary care academic medical center. Following clinical evaluations, handheld POCUS assessments were performed by trained non-specialist clinicians. Findings from I&D or clinical resolution with antibiotics served as the reference standard. Ninety cases were included in the final diagnostic accuracy analysis after 21 exclusions. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and diagnostic accuracy with 95% confidence intervals (CIs) were calculated. Hospital admission trends were compared before (2017–2021) and after POCUS implementation (January 2022–April 2025). Interpretation should consider potential verification bias from the asymmetric reference standard (I&D for abscess vs. clinical resolution for cellulitis). Results: Handheld POCUS exhibited a sensitivity of 72.97% (95% CI: 57.02–84.60%), specificity of 73.58% (95% CI: 60.42–83.56%), PPV of 65.85% (95% CI: 50.55–78.44%), NPV of 79.59% (95% CI: 66.36–88.52%), and overall accuracy of 73.33% (95% CI: 63.38–81.38%). Following POCUS implementation, the annualized hospital admission rate for pediatric facial odontogenic infections decreased from 60.0 to 19.5 admissions/year; rate ratio (RR) = 0.33 (95% CI: 0.25–0.42), p < 0.001 (Poisson regression with log-offset for period length). Conclusions: Handheld POCUS, operated by non-specialist clinicians after a defined training protocol, was associated with a lower annualized admission rate and demonstrated moderate diagnostic accuracy. Its adoption was associated with a notable reduction in hospitalizations, suggesting its potential for alleviating ED overcrowding, reducing healthcare costs, and minimizing pediatric stress. Wider adoption, supported by standardized training, could enhance healthcare efficiency and quality in managing this common pediatric condition. Full article
(This article belongs to the Special Issue Pediatric Oral and Facial Surgery: Advances and Future Challenges)
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