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Oral and Maxillofacial Surgery: Recent Advances and Future Directions

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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: closed (30 June 2025) | Viewed by 9256

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Special Issue Editors

Dr. Tomasz Gredes

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Guest Editor

1. Department of Orthodontics, Technische Universität Dresden, Carl Gustav Carus Campus, Fetscherstr. 74, 01307 Dresden, Germany
2. Department of Orthodontics and Temporomandibular Disorders, Poznan University of Medical Sciences, Bukowska 70, 60-812 Poznan, Poland
Interests: orthodontics; oral health; regenerative medicine
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Dr. Ute Ulrike Botzenhart

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Guest Editor

1. Department of Orthodontics, Carl Gustav Carus, TU Dresden, Dresden, Germany
2. Department of Orthodontics and Temporomandibular Disorders, University of Medical Sciences, Poznań, Poland
Interests: oral surgery; maxillofacial surgery; orthodontics; distraction osteogenesis; oral health; digitalization
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

We invite you to participate in this Special Issue of JCM “Oral and Maxillofacial Surgery: Recent Advances and Future Directions”.

Oral and maxillofacial surgery has often been underrepresented in global healthcare, but plays a critical role in reducing global health inequalities caused by the impact of oral and craniofacial diseases.

Improved or new therapy concepts are being developed worldwide that integrate the most modern technologies. Digitalization has also found its way into medicine and dentistry as part of therapeutic measures and offers a variety of new opportunities to improve the quality of diagnostics and therapy.

Especially in surgery and orthodontics, new possibilities are opening up for the better planning and implementation of combination therapy for dental and skeletal deviations and craniofacial anomalies. From 3D surgery simulation to the 3D printing of templates, splints or osteosynthetic materials, new processes and the use of artificial intelligence offer impressive possibilities. With individually manufactured scaffolds or appliances, therapies can now be planned individually for each patient.

The combination of tried-and-tested techniques in the field of oral and maxillofacial surgery and new innovations in interdisciplinary therapy will be the topic of this Special Issue. Both theoretical approaches and practical experiences will be exchanged and presented here. Manuscripts on the presentation of clinical applications, use of new therapeutic methods and treatment of complex cases are also very welcome.

We look forward to receiving your submissions to this Special Issue.

Dr. Tomasz Gredes
Dr. Ute Ulrike Botzenhart
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 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

orthodontics
dentofacial orthopedics
bone regeneration
oral health
dentistry
digital technologies
virtual care

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Published Papers (7 papers)

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10 pages, 188 KiB

Open AccessArticle

Complications of Intravenous Midazolam–Fentanyl Sedation in Children and Adults Undergoing Oral Surgery: A Retrospective Study

by Margaux Nys, Melisa Garip, Ruxandra Coropciuc, Jan Meeus, Paul Legrand and Constantinus Politis

J. Clin. Med. 2025, 14(12), 4096; https://doi.org/10.3390/jcm14124096 - 10 Jun 2025

Viewed by 290

Abstract

Objective: This study examines the incidence and predictors of complications following intravenous (IV) sedation in children and adults. Methods: A retrospective analysis of 1463 surgical procedures under IV sedation was conducted at the University Hospitals of Leuven (2018–2022). Patients aged 10–91 years were divided into pediatric (10–16 years, n = 731) and adult (17–91 years, n = 732) groups. Data were analyzed using multiple regression models (p < 0.05). Results: Side effects occurred more often during recovery (children: 20.1%, adults: 9.4%) than intraoperatively (children: 4.8%, adults: 2.7%). The most common side effects were nausea (children: 10.5%, adults: 8.4%) and prolonged sedation (children: 6.0%, adults: 1.8%). Younger children had higher risks of intraoperative side effects (p = 0.02), hypotension (p < 0.001), and longer recovery (p < 0.001). Ketamine increased nausea risk in children (p = 0.02). Females had a higher risk of prolonged sedation (p = 0.03) and nausea (p = 0.01). Older adults had fewer recovery-related side effects (p = 0.03) and shorter recovery times (p = 0.05). Conclusions: IV sedation is a safe alternative to general anesthesia in oral surgery when properly monitored. However, nausea and prolonged sedation remain concerns, particularly in younger children and females. Prophylactic anti-emetics and cautious Ketamine use may help mitigate risks. Full article

(This article belongs to the Special Issue Oral and Maxillofacial Surgery: Recent Advances and Future Directions)

22 pages, 11077 KiB

Open AccessArticle

Stress and Displacement Dynamics in Surgically Assisted Rapid Maxillary Expansion: A Comprehensive Finite Element Analysis of Various Osteotomy Techniques

by Müjde Gürsu and Mehmet Barış Şimşek

J. Clin. Med. 2025, 14(2), 449; https://doi.org/10.3390/jcm14020449 - 12 Jan 2025

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Abstract

Objectives: This study aimed to compare the effects of surgically assisted rapid palatal expansion (SARPE) techniques and their combinations on the stresses (von Mises, maximum principal, and minimum principal) and displacements that occur in the maxilla, facial bones, and maxillary teeth using three-dimensional finite element analysis (FEA). Methods: SARPE was simulated using seven different osteotomy techniques. The FEA models were simulated with a combination of various osteotomies, including midpalatal and lateral osteotomies, lateral osteotomy with a step, and separation of the pterygomaxillary junction. For each osteotomy variant, the instantaneous displacements and stresses resulting from forces applied by a 1 mm expansion of a tooth-borne appliance were evaluated. Results: Midpalatal osteotomy increased lateral displacement in the alveolar bone margins and intermaxillary suture while significantly reducing stresses around the intermaxillary suture. The addition of a pterygomaxillary osteotomy to the midpalatal and lateral osteotomies effectively reduced stresses in the posterior maxilla and cranial structures while enhancing lateral displacement. Although lateral osteotomy significantly reduced stresses in the midface, its effect on maxillary expansion was limited. Stepped lateral osteotomy had minimal effects on transverse displacement and stress reduction. Conclusions: Increasing the number of osteotomies reduced stress levels in the maxilla while enhancing lateral displacement. These results highlight the importance of selecting the most appropriate osteotomy technique to achieve optimal outcomes. Full article

(This article belongs to the Special Issue Oral and Maxillofacial Surgery: Recent Advances and Future Directions)

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14 pages, 5381 KiB

Open AccessArticle

Diagnostic Utility of the “Air Sign” as a Radiological Indicator for Mandibular Body and Angle Fractures

by Weronika Michalik, Joanna Kuczera, Jakub Bargiel, Krzysztof Gąsiorowski, Tomasz Marecik, Paweł Szczurowski, Grażyna Wyszyńska-Pawelec and Michał Gontarz

J. Clin. Med. 2024, 13(20), 6288; https://doi.org/10.3390/jcm13206288 - 21 Oct 2024

Cited by 1 | Viewed by 1344

Abstract

Background: To plan optimal treatment, obtain satisfactory outcomes, and avoid undesirable clinical errors, surgeons need to have efficient tools for providing a complete and prompt diagnosis. The aim of this study was to establish the sensitivity, specificity, positive and negative predictive values, false positive rate, and false negative rate of the “air sign” (AS) within soft tissues as an indirect radiological indicator of mandibular body and angle fractures. Methods: A retrospective analysis of preoperative computed tomography (CT) and cone beam computed tomography (CBCT) scans was performed on patients with mandibular fractures within a three-year period. Two fracture types were analyzed: open and closed fractures. Results: Forty-three patients with a total of 71 mandibular fractures were included in the study. The mean age of the patients was 35 years, and the majority were male (83.7%). The sensitivity of the AS was 92.2%, specificity = 90.0%, positive predictive value = 95.9%, negative predictive value = 81.8%, false positive rate = 10.0%, and false negative rate = 7.8%. Higher values were observed for open fractures compared to closed fractures. Conclusions: The sensitivity and specificity of AS are lower than those of OPG, CT, and CBCT. However, AS offers an important additional radiological indicator that can effectively reduce the risk of misdiagnosing mandibular body and angle fractures. Full article

(This article belongs to the Special Issue Oral and Maxillofacial Surgery: Recent Advances and Future Directions)

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12 pages, 2821 KiB

Open AccessArticle

The Impact of Standing Electric Scooters on Maxillofacial Fractures: An Italian Multi-Centric Epidemiological Study

by Giovanni Salzano, Francesco Maffia, Luigi Angelo Vaira, Roberta Fusco, Massimo Albanese, Salvatore Crimi, Marco Cucurullo, Fabio Maglitto, Claudia Maugeri, Marzia Petrocelli, Francesca Pitino, Paolo Priore, Fabio Roccia, Alessandro Tel, Anna Maria Baietti, Alberto Bianchi, Federico Biglioli, Chiara Copelli, Giacomo De Riu, Pier Francesco Nocini, Guglielmo Ramieri, Massimo Robiony, Valentino Valentini and Luigi Califano Show full author list Hide full author list

J. Clin. Med. 2024, 13(17), 5195; https://doi.org/10.3390/jcm13175195 - 2 Sep 2024

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Abstract

Objectives: This study aimed to determine the impact of standing electric scooters on maxillofacial on the Italian territory. Methods: The authors analyzed the epidemiology of the injuries to define electric mobility’s impact on maxillofacial surgery practice. For this retrospective cohort study, data were collected by unifying the standing e-scooter-related fractures database from 10 Italian maxillofacial surgery departments. The reference period considered was from January 2020 to December 2023. The main data considered included age, gender, type of access, time slot of admission, type of admission, alcohol level, helmet use, dynamics of the accident, and area of the fracture. Results: A total of 79 patients were enrolled. The average age of the participants was approximately 31 years. The blood alcohol level was found to be above the Italian norm in 15 cases (19%). Only one patient wore a helmet. The most affected facial third was the middle one with 36 cases (45.5%), followed by the lower one (31, 39.3%). The most recurrent patterns were fractures of the orbito-malar-zygomatic complex (15, 19%), followed by multifocal (bifocal, trifocal) fractures of the mandible (14, 17.5%). Conclusions: This study demonstrated how maxillofacial fractures related to the use of electric scooters are associated with complex patterns, associated with a high rate of post-surgical aftermaths. Full article

(This article belongs to the Special Issue Oral and Maxillofacial Surgery: Recent Advances and Future Directions)

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14 pages, 1909 KiB

Open AccessOpinion

Open Mouth Posture Syndrome (OMPS): Classification

by Can-Florian Keleş, David Morais, Anand Marya, Omar Fawzi Chawshli, Adith Venugopal and Ute Ulrike Botzenhart

J. Clin. Med. 2025, 14(10), 3586; https://doi.org/10.3390/jcm14103586 - 21 May 2025

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Abstract

Objectives: This narrative review aims to redefine Open Mouth Posture Syndrome (OMPS) as a multifactorial condition with overlapping symptoms and a cyclical pathophysiology. A novel classification system for OMPS subtypes is proposed to standardize research approaches and enhance clinical understanding. Methods: An interdisciplinary literature review was conducted, focusing on structural, functional, and adaptive mechanisms underlying OMPS. Subtype definitions were refined based on recent findings. Results: OMPS is categorized into five subtypes: Obstructive, Habitual, Anatomical, Sleep-Disordered Breathing, and Tongue-Related Pathologies. These subtypes share interconnected etiologies and manifestations, contributing to a feedback loop that complicates diagnosis and management. Conclusions: This classification system lays the foundation for future research and clinical protocols, emphasizing the need for a systematic approach to understanding OMPS. Full article

(This article belongs to the Special Issue Oral and Maxillofacial Surgery: Recent Advances and Future Directions)

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17 pages, 1826 KiB

Open AccessSystematic Review

TMJ Replacement in Degenerative Disease: A Systematic Review

by Víctor Ravelo, Erick Vargas, Henry García Guevara, Roberto Sacco, Pablo Navarro and Sergio Olate

J. Clin. Med. 2025, 14(2), 580; https://doi.org/10.3390/jcm14020580 - 17 Jan 2025

Cited by 3 | Viewed by 1507

Abstract

Objectives: This study aims to describe and analyze the indications and clinical results of total TMJ replacement in participants with degenerative and/or inflammatory joint diseases, defining patient and intervention conditions. Methods: A systematic review was conducted according to the Cochrane Handbook for Systematic Reviews of Intervention and reported according to the PRISMA Items update. The search strategy was from 1997 to July 2024 in Pubmed, Embase, Scopus, and Web of Science. A search for gray literature was conducted in the databases Google Scholar and Open Access Theses and Dissertations (OATD), and there were no limitations on the language or study design. We incorporated studies involving human patients over 15 years of age with degenerative and/or inflammatory joint conditions who underwent joint prosthesis replacement, either concurrently or separately from orthognathic surgery, as an initial intervention or after prosthesis installation. Participants with a postoperative follow-up of 12 months or longer were included. A risk of bias analysis was performed for non-randomized studies using the ROBINS-I tool, and GRADE profiler (GRADEpro) software was used to assess the quality of evidence and synthesize the data. Results: All the selected studies performed postoperative follow-up with quantitative and qualitative parameters; 10 performed a follow-up of 2 to 5 years. The indication for joint prosthesis replacement due to system failure was only 4.07%. Concerning diagnoses, 579 presented degenerative and/or inflammatory joint diseases, with osteoarthritis being the most frequent, followed by osteoarthrosis, juvenile idiopathic arthritis, and rheumatoid arthritis. The maximum mouth opening of the participants with TMJ disease presented an average of 24.32 ± 5.8 mm with a range of 18 to 36.4 mm. Of the 579 participants, the studies mention that they presented a soft to liquid diet and pain associated with decreased mandibular functionality. Conclusions: A total of 76.18% of the participants presented a range of moderate to severe pain associated with a decrease in functionality and, after joint replacement, all participants mentioned a decrease in pain or absence of pain, a change in diet by incorporating solid foods, and an increase in opening with an average of 40.74 ± 3.1 mm. Total joint replacement shows favorable long-term results. It is not possible to identify the best time to perform joint replacement surgery, considering the time since diagnosis of the disease, the time since the start of non-surgical treatment, or the number of previous surgeries. Full article

(This article belongs to the Special Issue Oral and Maxillofacial Surgery: Recent Advances and Future Directions)

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13 pages, 2371 KiB

Open AccessSystematic Review

Umbilical and Placental Derivatives in Temporomandibular Joint Treatment: A Systematic Review

by Karolina Lubecka, Maciej Chęciński, Kamila Chęcińska, Filip Bliźniak, Tomasz Wach, Mariusz Szuta, Dariusz Chlubek and Maciej Sikora

J. Clin. Med. 2024, 13(23), 7002; https://doi.org/10.3390/jcm13237002 - 21 Nov 2024

Viewed by 1650

Abstract

Objectives: This review aimed to gather and summarize the existing information on the clinical application of allogeneic umbilical and placental derivatives in the treatment of temporomandibular joint disorders. Methods: Research on the impact of the use of umbilical and placental derivatives on reducing pain and improving mobility in the temporomandibular joint was included in the article. Medical databases, including ACM, BASE, Cochrane, Scopus, Google Scholar, ClinicalTrials.gov, and PubMed, were searched. The final search was conducted on 20 October 2024. Results: Out of the 43 records found, 5 were considered eligible for further analysis and showed that the use of placental and umbilical derivatives has the greatest potential in the treatment of ankylosis. The intra-articular administration of these tissues into the TMJ brings beneficial results, but they are similar to other, parallel methods, such as PRP or corticosteroids. Conclusions: The studies discussed may guide researchers in expanding clinical trials, particularly by including more patients with TMDs, and have promising potential in ankylotic disorders, where amniotic membrane use has shown clear benefits. Full article

(This article belongs to the Special Issue Oral and Maxillofacial Surgery: Recent Advances and Future Directions)

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