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Innovations in Maxillofacial Surgery
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Innovations in 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 June 2025 | Viewed by 1598

Special Issue Editors

Prof. Dr. Carlos Navarro-Cuéllar

E-Mail Website
Guest Editor
1. Oral and Maxillofacial Surgery Department, Gregorio Marañón General University Hospital, Madrid, Spain
2. School of Medicine, Universidad Complutense de Madrid, Madrid, Spain
Interests: head and neck oncology; microsurgery; head and neck reconstruction; dental implants; free flaps; orthognatic surgery; dental implants in oncologic patients; surgical treatment of sleep apnea
Special Issues, Collections and Topics in MDPI journals
Prof. Dr. José Luis Cebríán-Carretero

E-Mail Website
Guest Editor
Oral and Maxillofacial Surgery Department, University Hospital La Paz, Universidad Autónoma de Madrid, 28046 Madrid, Spain
Interests: oral and maxillofacial surgery; dental implants; orthognathic surgery; oral cancer; facial reconstruction; facial trauma; dental bone regeneration
Special Issues, Collections and Topics in MDPI journals
Dr. Ignacio Navarro Cuéllar

E-Mail Website
Guest Editor
Oral and Maxillofacial Surgery Department, Gregorio Marañón General University Hospital, Madrid, Spain
Interests: oral and maxillofacial surgery; oral and maxillofacial pathology; orthognathic surgery; oral implantology; head and neck oncology; head and neck reconstruction

Special Issue Information

Dear Colleagues,

As maxillofacial surgery continues to advance, the integration of innovative techniques and technologies is reshaping the future of patient care. To showcase these developments, we invite researchers, clinicians, and surgeons to submit original articles, reviews, and case reports for our upcoming issue on “Innovations in Maxillofacial Surgery”.

This Special Edition will focus on the latest advances and emerging technologies in the field. We are particularly interested in manuscripts covering a wide range of topics, including but not limited to the following:

  • Advanced surgical techniques: innovative approaches to facial trauma, reconstruction, orthognathic surgery, and aesthetic procedures.
  • Digital surgery and 3D technologies: the role of virtual planning, computer-aided design, and 3D printing in enhancing surgical precision and outcomes.
  • Regenerative medicine: new materials and biological therapies for bone regeneration and soft tissue healing.
  • Oncology and reconstruction: advances in the surgical management of maxillofacial tumors and novel reconstruction techniques.
  • Sleep apnea and orthognathic surgery: surgical interventions in obstructive sleep apnea, with a focus on orthognathic surgery and airway improvement.
  • Minimally invasive surgery: the exploration of new tools and techniques that reduce patient morbidity and recovery time.

Prof. Dr. Carlos Navarro-Cuéllar
Prof. Dr. José Luis Cebríán-Carretero
Dr. Ignacio Navarro Cuéllar
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

  • orthognathic surgery
  • sleep apnea
  • 3D technologies
  • regenerative medicine
  • reconstructive surgery
  • facial trauma
  • minimally invasive surgery
  • oncology

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

Published Papers (3 papers)

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14 pages, 2851 KiB  
Article
Guided Frontal Sinus Osteotomy: A Pilot Study of a Digital Protocol for “In-House” Manufacturing Surgical Cutting Guides
by Antonio Romano, Stefania Troise, Raffaele Spinelli, Vincenzo Abbate and Giovanni Dell’Aversana Orabona
J. Clin. Med. 2025, 14(9), 3141; https://doi.org/10.3390/jcm14093141 - 1 May 2025
Viewed by 254
Abstract
Objective: Frontal sinus surgery is still challenging for surgeons; the frontal osteotomy with the preparation of a frontal bone flap to access the sinus is usually hand-crafted by experienced surgeons. The objective of our study is to present a fully digital protocol for [...] Read more.
Objective: Frontal sinus surgery is still challenging for surgeons; the frontal osteotomy with the preparation of a frontal bone flap to access the sinus is usually hand-crafted by experienced surgeons. The objective of our study is to present a fully digital protocol for the manufacturing of “in-house” surgical cutting guides, customized to the patient’s anatomy, to perform precise frontal sinus osteotomy, showing the costs, times, and intraoperative complications reduction. Materials and Methods: A prospective study was conducted on 12 patients with complex pathologies involving the frontal sinus who underwent frontal sinus osteotomy in the Maxillofacial Surgery Unit of the Federico II University of Naples, from January 2021 to April 2025, considering the last surgery in November 2023. The same digital protocol to manufacture the surgical cutting guide was used for all the 12 patients. The first step was to upload the preoperative CT images in DICOM format to the software Mimics Medical to perform a rapid segmentation of the skull region of interest to create a 3D object and to identify the frontal sinus margins and the osteotomy lines. The second step was to realize the surgical cutting guide, incorporating the design of titanium plates to fix onto the skull in order to make a precise osteotomy. The final digital step was to export the cutting guide 3D object in the software “Formlab-Form 3B” to print the model with a specific resin. The model was then used during the surgery to perform the precise frontal osteotomy by piezo surgery. The clinical outcomes, in terms of complications and recurrences, were then recorded. Results: In all the patients, no intraoperative complications occurred; the median follow-up was 31.7 months and at one year of follow-up only one patient experienced a recurrence. The mean operative time was about 4 h, with a frontal osteotomy time of about 23 min. Digital protocol time was about 4 h while printing times were between 2 and 4 h. Conclusions: This “in-house” protocol seems to demonstrate that the use of intraoperative templates for the realization of the frontal sinus osteotomy reduces preoperative and intraoperative costs and times, reducing the risk of intraoperative complications, and also allows less experienced surgeons to perform the procedure safely. Obviously, this study is to be considered a “pilot study”, and other studies with large cohorts of patients will have to confirm these promising results. Full article
(This article belongs to the Special Issue Innovations in Maxillofacial Surgery)
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11 pages, 5228 KiB  
Article
Continuous Measurement of Radial Free Forearm Flap Tissue Perfusion for Flap Monitoring After Microvascular Head and Neck Reconstruction—Systemic Blood Pressure as a Potential Confounder in the Early Postoperative Period
by Mark Ooms, Philipp Winnand, Marius Heitzer, Nils Vohl, Anna Bock, Johannes Bickenbach, Frank Hölzle and Ali Modabber
J. Clin. Med. 2025, 14(8), 2561; https://doi.org/10.3390/jcm14082561 - 8 Apr 2025
Viewed by 305
Abstract
Background: Continuous measurement of flap tissue perfusion in the context of postoperative flap monitoring after microvascular head and neck reconstruction may be confounded by alterations in systemic blood pressure, particularly when using predefined absolute thresholds for the detection of vascular flap compromise. This [...] Read more.
Background: Continuous measurement of flap tissue perfusion in the context of postoperative flap monitoring after microvascular head and neck reconstruction may be confounded by alterations in systemic blood pressure, particularly when using predefined absolute thresholds for the detection of vascular flap compromise. This study aimed to investigate the relationship between radial free forearm flap (RFFF) tissue perfusion and systemic blood pressure following head and neck reconstruction. Methods: The study included 14 patients reconstructed with an RFFF in the head and neck region between 2020 and 2022. Eight hours of postoperatively recorded flap tissue perfusion, determined with an attached surface probe at a 3 mm tissue depth with the Oxygen-2-See (O2C) analysis system, in terms of blood flow and hemoglobin oxygen saturation, and systemic blood pressure, determined as absolute and relative values (difference between measured and preoperative values), in terms of systolic blood pressure (SBP), diastolic blood pressure (DBP), and mean arterial blood pressure (MBP), were analyzed for correlations. Results: Blood flow and hemoglobin oxygen saturation were generally indifferent between the hourly measurement intervals. Blood flow was correlated with relative DBP and MBP values (0.191, p < 0.001; and 0.213, p < 0.001). These correlations persisted upon controlling for norepinephrine, propofol, or sulfentanyl (all p < 0.001). Conclusions: Early postoperative RFFF tissue perfusion measured with attached surface probes for the O2C analysis system remains constant but correlates with systemic blood pressure in terms of blood flow and relative blood pressure values. This highlights the importance of maintaining constant systemic blood pressure during RFFF tissue perfusion measurement for postoperative flap monitoring. Full article
(This article belongs to the Special Issue Innovations in Maxillofacial Surgery)
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15 pages, 5390 KiB  
Technical Note
Concomitant Unilateral/Bilateral Temporomandibular Joint Reconstruction and Maxillomandibular Advancement for Temporomandibular Joint Pathologies and Obstructive Sleep Apnea: Technical Note and Case Report
by Jean-Pierre T.F. Ho, Ning Zhou, Cornelis Klop, Nadeem R. Saeed and Jan de Lange
J. Clin. Med. 2025, 14(5), 1719; https://doi.org/10.3390/jcm14051719 - 4 Mar 2025
Viewed by 700
Abstract
Background: Patients with a triad of severe temporomandibular joint (TMJ) pathologies, obstructive sleep apnea (OSA), and dentofacial deformities often experience significant functional and aesthetic impairments. A combination of total TMJ reconstruction and maxillomandibular advancement (MMA) has emerged as a promising treatment option, which [...] Read more.
Background: Patients with a triad of severe temporomandibular joint (TMJ) pathologies, obstructive sleep apnea (OSA), and dentofacial deformities often experience significant functional and aesthetic impairments. A combination of total TMJ reconstruction and maxillomandibular advancement (MMA) has emerged as a promising treatment option, which can address the complexity of these conditions simultaneously. Methods: This paper presents a practical protocol for TMJ reconstruction using patient-specific alloplastic total joint prosthesis in conjunction with additional splintless osteotomies. This approach integrates the recent advancements in virtual surgical planning (VSP), custom TMJ prostheses, and three-dimensional (3D) custom osteotomy guide and implant manufacturing, allowing for precise anatomical correction and enhanced treatment outcomes. Three patients were treated with the present protocol. Postoperative assessments mainly included maximum inter-incisal opening, apnea–hypopnea index (AHI), and patient satisfaction with facial aesthetics. Results: All surgeries were performed without complications. The follow-up period ranged from 7 to 12 months. For the two patients with TMJ ankylosis, the postoperative maximum inter-incisal opening (MIO) increased from 3–5 to 35 mm and from 12 to 32 mm, respectively. Additionally, all three cases demonstrated that the protocol could significantly decrease AHI (with improvements of 57.5, 49, and 66.4 events/h, respectively) and achieve satisfactory aesthetics. Conclusions: These findings suggest that this protocol is a viable option for addressing complex cases involving severe TMJ pathologies, OSA, and dentofacial deformities. Future studies with larger cohorts and long-term follow-up are needed to further validate these findings. Full article
(This article belongs to the Special Issue Innovations in Maxillofacial Surgery)
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