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A special issue of Diagnostics (ISSN 2075-4418). This special issue belongs to the section "Clinical Diagnosis and Prognosis".

Deadline for manuscript submissions: closed (31 March 2026) | Viewed by 4662

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Special Issue Editors

Dr. Dimitris Tatsis

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Guest Editor

Fourth Surgical Department, Faculty of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
Interests: oral pathology; oral implantology; oral diseases; maxillofacial surgery; implant dentistry
Special Issues, Collections and Topics in MDPI journals

Dr. Alexandros Louizakis

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Guest Editor Assistant

Department of Oral & Maxillofacial Surgery, Aristotle University of Thessaloniki, Specialized Cancer Treatment and Reconstruction Centre, General Hospital of Thessaloniki “George Papanikolaou”, 57010 Thessaloniki, Greece
Interests: oral and maxillofacial surgery; plastic surgery; ENT; head and neck surgery; tracheotomy; skull base surgery; endoscopic surgery

Special Issue Information

Dear Colleagues,

The Special Issue titled “Diagnosis and Management in Oral and Maxillofacial Surgery” aims to highlight recent advancements in the diagnosis, evaluation, and management of conditions affecting the head and neck region. This collection aims to present innovative diagnostic methodologies, including artificial intelligence-assisted imaging, molecular diagnostics, and 3D visualization techniques, that enhance accuracy in detecting pathologies such as maxillofacial trauma, temporomandibular disorders, oral malignancies, and congenital disorders. Furthermore, this issue will cover innovative management strategies ranging from minimally invasive procedures to complex reconstructive techniques utilizing patient-specific implants, 3D printing, and virtual surgical planning. Emphasis will be placed on integrating interdisciplinary approaches, including regenerative medicine and advanced biomaterials, to optimize functional and esthetic outcomes.

By bringing together expertise from various subspecialties, this Special Issue aims to provide a comprehensive perspective on how modern diagnostics and tailored management strategies improve patient care in oral and maxillofacial surgery.

Dr. Dimitris Tatsis
Guest Editor

Dr. Alexandros Louizakis
Guest Editor Assistant

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. Diagnostics 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

oral and maxillofacial surgery
artificial intelligence in surgery
virtual surgical planning
3D printing and patient-specific implants
oral cancer diagnosis
temporomandibular disorders
regenerative medicine in OMFS
advanced biomaterials for reconstruction
new technologies in head and neck surgery

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Published Papers (8 papers)

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Research

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11 pages, 574 KB

Open AccessArticle

Evaluation of the Impact of Different Skeletal Orthodontic Anomalies on Condylar Asymmetry Using Cone-Beam Computed Tomography

by Muhammet Bahattin Bingul, Seda Kotan, Saadet Cinarsoy Cigerim and Mevlude Yuce Polat

Diagnostics 2026, 16(5), 812; https://doi.org/10.3390/diagnostics16050812 - 9 Mar 2026

Viewed by 387

Abstract

Background/Objectives: This study aims to evaluate mandibular condylar asymmetry in individuals with different types of skeletal malocclusions using a three-dimensional imaging technique, and to determine the relationship between these anomalies and condylar asymmetry. Methods: The study included 100 individuals who visited the Department of Orthodontics Faculty of Dentistry between 2015 and 2020 and underwent Cone-Beam Computed Tomography (CBCT) imaging for various reasons. The evaluation of condylar asymmetry was performed using the Habets method, and measurements were carried out with the NemoCeph V.2017 software. Participants were categorized into skeletal Class I (2–4°), Class II (>4°), and Class III based on their ANB angles. For statistical analysis, frequency distribution, the Kruskal–Wallis H test, and Spearman’s correlation coefficient were used. Results: No statistically significant relationship was found between gender and skeletal classifications (p > 0.05). In terms of age, the mean age of individuals in the Class III group was significantly lower than that of those in the Class II group (p < 0.05). A weak positive correlation was observed between condylar and ramal indices in the overall sample (p = 0.029); however, this correlation was found to be moderate and statistically significant only within the Class III group (p = 0.002). Conclusions: The presence of a significant relationship between condylar and ramal asymmetries in individuals with Class III malocclusion indicates an increased risk of developing facial asymmetry if left untreated. These findings underscore the importance of skeletal malocclusions in influencing condylar morphology. Full article

(This article belongs to the Special Issue Diagnosis and Management in Oral and Maxillofacial Surgery)

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17 pages, 3194 KB

Open AccessArticle

Recurrent Phosphoglyceride Crystal Deposition Disease in the Mandible Mimicked a Malignant Tumor: Insights from a Clinical Case Report and Literature Review

by Jumpei Shirakawa, Motoo Ito, Takuya Matsuzaki, Mitsuko Iguchi, Kie Nakatani, Eri Sasabe, Yukio Yoshioka, Tetsuya Yamamoto and Kenji Yamagata

Diagnostics 2026, 16(4), 567; https://doi.org/10.3390/diagnostics16040567 - 13 Feb 2026

Viewed by 429

Abstract

Background and Clinical Significance: Phosphoglyceride crystal deposition disease (PCDD) is an extremely rare condition characterized by the deposition of phosphoglyceride crystals, occasionally forming tumor like lesions that present significant diagnostic challenges. Here, we report, to our knowledge, the first documented recurrent case of PCDD confined to the mandible, which clinically and radiologically mimicked a malignant bone tumor. Case Presentation: An 80-year-old female patient presented with a progressively enlarging mandibular mass, and imaging studies demonstrated an osteolytic lesion with cortical bone destruction and marked fluorodeoxyglucose uptake on positron emission tomography-computed tomography, raising a strong suspicion of malignancy. Histopathological examination revealed foreign-body granulomatous inflammation with characteristic crystal deposition, and the diagnosis of PCDD was definitively established through the combined use of gold hydroxamic acid staining, Raman spectroscopy, and ultrastructural analysis. Although surgical excision with curettage was initially achieved, local recurrence was observed 6 years later, indicating the potential for long-term disease persistence. In addition, a comprehensive literature review conducted in accordance with the PRISMA guidelines was performed to summarize previously reported cases of PCDD, with particular attention to anatomical distribution, radiological characteristics, recurrence patterns, and proposed pathogenic mechanisms. The review confirmed the extreme rarity of mandibular involvement and demonstrated that recurrence can occur apparently even after surgical treatment. Conclusions: This case underscores the importance of a multimodal diagnostic strategy integrating imaging, histopathology, and spectroscopic analyses for the accurate identification of PCDD and highlights the necessity of histopathological confirmation to prevent unnecessary aggressive treatment. Full article

(This article belongs to the Special Issue Diagnosis and Management in Oral and Maxillofacial Surgery)

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16 pages, 805 KB

Open AccessArticle

Neck Management in Malignant Parotid Tumors: A Retrospective Analysis of Elective Neck Dissection Indications and Outcomes

by Andrea Battisti, Giulio Pagnani, Giulia Scivoletto, Marco Della Monaca, Matteo Fatiga, Andrea Cassoni and Valentino Valentini

Diagnostics 2025, 15(24), 3194; https://doi.org/10.3390/diagnostics15243194 - 14 Dec 2025

Viewed by 659

Abstract

Background/Objectives: Management of the clinically negative neck in malignant parotid tumors remains controversial. We aimed to identify clinicopathologic predictors of nodal involvement and to evaluate whether elective neck dissection (END) improves disease-free survival (DFS) versus observation in cN0 patients. Methods: We performed a retrospective cohort study of adults undergoing surgery for malignant parotid tumors at a single tertiary center (2013–2023) with ≥24 months of follow-up. Collected variables included demographics, tumor T category and histologic grade (AJCC 8th), parotidectomy type, neck management [END vs. therapeutic neck dissection (TND) vs. observation], lymph node yield, and outcomes. Associations were tested with Fisher’s exact tests; disease-free survival (DFS) was analyzed using Kaplan–Meier curves, log-rank tests and an exploratory multivariable Cox proportional hazards model. Results: Seventy-four patients were included (mean age 54.3 years; 12.2% preoperative facial nerve impairment). Parotidectomy was partial (41.9%), total (31.1%), radical (21.6%), or extended (5.4%). Neck dissection was performed in 40.5% (END 23.0%; TND 17.6%). Overall pathologic nodal positivity (pN+) was 18.9%. T3–T4 tumors had greater odds of nodal metastasis than T1–T2 (OR 10.58; p < 0.05). Among cN0 patients, occult metastasis was 17.6%; notably, all high-grade cN0 tumors that underwent END were pN+. Intraparotid nodal metastases occurred in 28.6% and always co-occurred with cervical metastases. DFS did not differ significantly between cN0 patients managed with END versus observation (log-rank p > 0.05). Patients with pN0 had superior DFS versus pN+ (p < 0.05). Lymph node yield groupings (0–17 vs. 18–40 vs. >40) were not associated with recurrences. In the exploratory multivariable Cox model, high/intermediate-grade and T3-T4 tumors and nodal positivity were associated with reduced DFS. Conclusions: Higher T category and high/intermediate grade strongly predict nodal involvement, and pN+ status portends worse DFS. Although END did not show a DFS advantage over observation in cN0 patients, the 17.6% occult metastasis rate—especially in high-grade disease—and the linkage between intraparotid and cervical metastases support a risk-adapted END strategy and intraoperative assessment of intraparotid nodes to guide neck management. Full article

(This article belongs to the Special Issue Diagnosis and Management in Oral and Maxillofacial Surgery)

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13 pages, 687 KB

Open AccessArticle

Development of a Prognostic Model for Oral Cancer by Incorporating Novel Nodal Parameters Beyond Conventional TNM Staging

by Ping-Chia Cheng, Chih-Ming Chang, Li-Jen Liao, Po-Wen Cheng and Wu-Chia Lo

Diagnostics 2025, 15(24), 3133; https://doi.org/10.3390/diagnostics15243133 - 9 Dec 2025

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Abstract

Background: Oral cancer is a major global health burden with heterogeneous survival outcomes. This study aimed to identify clinicopathological factors, particularly lymph node-related parameters, associated with prognosis in patients with oral cancer and to construct a survival model for predicting overall survival (OS). Methods: A total of 174 patients with oral cancer who underwent surgery between January 2018 and November 2021 were retrospectively analyzed. Clinicopathological variables, including age, gender, body mass index (BMI), pathological T, N and overall stage, tumor subsite, perineural invasion (PNI), lymphovascular invasion (LVI), surgical margin status, lymph node yield (LNY), lymph node metastases (LNM), and lymph node ratio (LNR), were evaluated. Univariate and multivariate Cox regression analyses were performed to identify independent prognostic factors for OS and disease-specific survival (DSS). Results: Univariate analysis showed that older age, lower BMI, advanced pathological stage, presence of PNI or LVI, positive/close margins, LNY < 15, LNM ≥ 3, and LNR ≥ 0.0454 were significantly associated with poorer OS. Multivariate analysis identified age ≥ 63 years, pathological stage 3–4, LNY < 15, LNM ≥ 3, and LNR ≥ 0.0454 as independent predictors of OS. LNR ≥ 0.0454 was the only independent predictor of DSS. A survival model incorporating age, pathological stage, LNY, LNM, and LNR demonstrated good discriminatory ability for OS. Conclusions: Multiple independent prognostic factors for oral cancer survival were identified. The proposed survival model provides a practical tool for risk stratification and may assist personalized treatment planning, with particular emphasis on lymph node-related parameters. Full article

(This article belongs to the Special Issue Diagnosis and Management in Oral and Maxillofacial Surgery)

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11 pages, 777 KB

Open AccessArticle

Nasolacrimal Canal Topography in Relation to the Maxillary Position: CBCT Insights into Le Fort Osteotomy and Fixation Safety

by Mehmet Emre Yurttutan, Merve Berika Kadıoğlu, Mahzun Yıldız, Ömer Faruk Kocamaz, Meyra Durmaz, Mehmet Alp Eriş and Anıl Kamal

Diagnostics 2025, 15(23), 3008; https://doi.org/10.3390/diagnostics15233008 - 26 Nov 2025

Cited by 3 | Viewed by 719

Abstract

Background/Objectives: Le Fort I osteotomy is a widely performed surgical procedure for correcting maxillary deformities, but it carries the risk of rare complications, including nasolacrimal duct (NLD) injury. This study evaluated the anatomical relationship between the nasolacrimal canal (NLC) and the maxilla across different skeletal patterns via cone-beam computed tomography (CBCT) to define safer zones for fixation during orthognathic surgery. Methods: This retrospective study included 76 patients (152 canals) scheduled for orthognathic surgery. The participants were classified into retrognathic, orthognathic, and prognathic groups based on SNA values. Four linear distances were measured on sagittal CBCT sections: from the superior (SL), middle (ML), and inferior (IL) points of the NLD to the anterior maxillary border and from the canine apex to the inferior NLC point (IC). A total of 608 measurements were analyzed via ANOVA, the Kruskal–Wallis test, and post hoc tests, with significance set at p < 0.05. Results: The ML distance was significantly greater in the prognathic group than in the retrognathic and orthognathic groups (p < 0.001). The IL distance was significantly shorter in retrognathic individuals (p < 0.001). No significant differences were found in SL (p = 0.063) or IC (p = 0.141) among the groups. Conclusions: The proximity of the NLC to the maxilla varies according to the skeletal pattern. The retrognathic maxilla results in shorter IL distances, suggesting increased risk during fixation, whereas the prognathic maxilla results in greater ML distances. Preoperative CBCT-based individualized evaluation is recommended to optimize fixation and reduce NLD injury risk in Le Fort I osteotomy. Full article

(This article belongs to the Special Issue Diagnosis and Management in Oral and Maxillofacial Surgery)

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Review

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13 pages, 1016 KB

Open AccessReview

Molecular and Microenvironmental Mechanisms of Malignant Transformation in Benign Salivary Gland Tumors: Implications for Oral Squamous Cell Carcinoma

by Panagiotis Giasimakopoulos, Danai Mylona, Aggelos Diafas, Ioannis Stamoulopoulos and Konstantinos Markou

Diagnostics 2026, 16(6), 898; https://doi.org/10.3390/diagnostics16060898 - 18 Mar 2026

Viewed by 359

Abstract

Malignant transformation of benign salivary gland tumors represents a critical biological process that provides valuable insights into head and neck carcinogenesis, with potential implications for oral squamous cell carcinoma (OSCC). Understanding the molecular, epigenetic, and microenvironmental mechanisms underlying this transition is essential for improving early diagnosis, risk stratification, and personalized management strategies. This study presents a comprehensive narrative review of the current literature focusing on benign salivary gland tumors with malignant potential, particularly pleomorphic adenoma and carcinoma ex pleomorphic adenoma, emphasizing molecular alterations, angiogenesis, and tumor microenvironment dynamics. A structured literature search was conducted across major biomedical databases, including PubMed and Scopus, selecting studies that addressed genetic rearrangements, epigenetic modifications, histopathological features, and clinical connections of malignant transformation. The findings highlight recurrent genetic alterations such as PLAG1 and HMGA2 rearrangements, TP53 mutations, and ERBB2 overexpression, along with epigenetic dysregulation through CpG island hypermethylation. Enhanced angiogenesis, marked by increased expression of CD105 and vascular endothelial growth factor, as well as a “cold” immune microenvironment, emerged as key contributors to tumor progression. These mechanisms demonstrate significant overlap with pathways implicated in OSCC development. Benign salivary gland tumors represent a valuable model for studying malignant transformation in head and neck oncology. Interpreting shared molecular and microenvironmental pathways may facilitate the identification of novel biomarkers and support the development of personalized diagnostic and therapeutic approaches for OSCC. Full article

(This article belongs to the Special Issue Diagnosis and Management in Oral and Maxillofacial Surgery)

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Other

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10 pages, 4606 KB

Open AccessCase Report

Surgical Retrieval of a Broken Local Anesthetic Needle in the Pterygomandibular Space Using CBCT and C-Arm Guidance

by Alexandru Nemțoi, Sorin Axinte, Ana Nemțoi and Vlad Covrig

Diagnostics 2026, 16(6), 902; https://doi.org/10.3390/diagnostics16060902 - 18 Mar 2026

Viewed by 298

Abstract

Background and Clinical Significance: Needle fracture during inferior alveolar nerve block is a rare complication, but it can nevertheless result in serious complications, especially when the fragment migrates into deep anatomical spaces like the pterygomandibular region. Accurate localization and safe retrieval are vital in preventing infection, chronic pain, neurovascular injury, and long-term functional impairment. Case Presentation: We present a case of a 27-year-old patient who had a fractured needle fragment from a local anesthetic procedure retained in the left pterygomandibular space. Cone beam computed tomography (CBCT) was carried out to verify the presence of the metallic foreign body and to define its exact three-dimensional position in relation to adjacent bone and soft tissue landmarks. The approach was transoral, and the surgery was done under general anesthesia. During the surgery C-arm fluoroscopy was used to help guide localization and retrieval, along with the help of radiopaque reference markers to assist in determining the trajectory. The fragment was removed without any issue. After the surgery, the patient’s condition improved well, and he showed no signs of functional deficits. Conclusions: The management of broken needle fragments in the pterygomandibular space can be safely and effectively done using a combination of preoperative CBCT and intraoperative C-arm guidance. This technique allows for exact location determination, minimizes unnecessary dissection of the tissue, and will make the surgery safer in complicated areas. Full article

(This article belongs to the Special Issue Diagnosis and Management in Oral and Maxillofacial Surgery)

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25 pages, 2072 KB

Open AccessSystematic Review

Mid-Term Outcomes, Biological Responses and Complications of Dental Implants in Maxillomandibular Reconstruction with Free Bone Flaps: A Systematic Review and Meta-Analysis

by Siqi Qiu, Kuo Feng Hung and Feng Wang

Diagnostics 2026, 16(3), 435; https://doi.org/10.3390/diagnostics16030435 - 1 Feb 2026

Viewed by 439

Abstract

Background/Objectives: Maxillofacial reconstruction with a vascularized free bone flap for facial contour restoration serves as a foundation for dentition rehabilitation. Although state-of-the-art studies have reported promising results with implant-supported prostheses in such cases, evidence for dental implant prognosis remains insufficient. This study aims to synthesize the mid-term clinical outcomes of implants placed in vascularized free bone flaps, taking into account the biological responses and associated complications. Methods: Studies with a minimal 3-year follow-up, no less than 10 patients, and reporting implant survival/success rate were included. Literature published from 2000 to 2025 was collected from PubMed, Embase, and Scopus. Meta-analyses were performed to pool the implant survival and success rates for the entire cohort, the biological complication rates, the odds ratio for radiotherapy, and the pooled implant failure rates associated with radiotherapy. Parameters related to biological prognosis were collected. ROBINS-E and NOS scale were used to assess the risk of bias. Results: Of the 949 records identified, 14 retrospective and 2 cohort studies were included, yielding a total of 1165 dental implants placed in free bone flaps. On the implant level, meta-analysis demonstrated a pooled implant survival rate of 97.9% (95% CI: 0.922–0.994, I² = 64.4%) and a pooled implant success rate of 88.1% (95% CI: 0.803–0.931, I² = 68.3%). The pooled biological complication rate was 8.6% (95% CI: 0.052–0.138; I² = 69.5%). Among patients who underwent radiotherapy, the pooled implant failure rate was 13.7% (95% CI: 0.087–0.210; I² = 0.0%; p = 0.4702) with an odds ratio of 3.086 (I² = 66.5%) for radiotherapy-associated implant failure. Conclusions: Implant-related outcomes in these complex cases are generally acceptable, with high survival, moderately high success rates and overall stable biological response. Additionally, radiotherapy adds to the risk of implant failure on implant level. However, the statistical heterogeneity and inconsistent definitions of biological outcomes in the literature suggest that caution is warranted when planning implant therapy in these cases. Further studies with long-term follow-up, focused on peri-implant tissue conditions and adopting more stratified study designs to minimize confounding factors, are needed. Full article

(This article belongs to the Special Issue Diagnosis and Management in Oral and Maxillofacial Surgery)

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