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Oral and Maxillofacial Surgery: Current Progress and Future Directions

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A Special Issue of Journal of Clinical Medicine (ISSN 2077-0383) belonging to the section "Dentistry, Oral Surgery and Oral Medicine".

Deadline for manuscript submissions: 20 November 2026 | Viewed by 4595

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Editors

Dr. Fabio Maglitto

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Maxillofacial Surgery Unit, Department of Neurosciences, Reproductive and Odontostomatological Sciences, University of Naples Federico II, 80131 Naples, Italy
Interests: oral and maxillofacial surgery; plastic surgery; otolaryngology; oral desease
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Dr. Giovanni Salzano

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Head and Neck Section, Department of Neurosciences, Reproductive and Odontostomatological Science, Federico II University of Naples, 80131 Naples, Italy
Interests: oral and maxillofacial surgery; plastic surgery; otolaryngology
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Oral and maxillofacial surgery (OMFS) is a rapidly evolving specialty that integrates medicine and advanced surgical techniques to diagnose and treat diseases affecting the face, jaws, and oral cavity. Recent progress in the field has been driven by technological innovation, improved biomaterials, and a growing emphasis on patient-centered care.

One of the most significant advancements is the adoption of digital technologies. Virtual surgical planning, computer-assisted surgery, and three-dimensional (3D) printing have transformed preoperative assessment and intraoperative precision. These tools allow surgeons to create patient-specific models, guides, and implants, leading to more predictable outcomes in reconstructive and orthognathic procedures. Additionally, minimally invasive techniques, including endoscopic and robotic-assisted surgery, have reduced operative morbidity, shortened recovery times, and improved esthetic results. Another area of progress is implantology and regenerative medicine. Innovations in implant design, surface modification, and guided placement have increased the success rates of dental implants. At the same time, tissue engineering and stem cell research are opening new possibilities for bone and soft tissue regeneration, offering alternatives to traditional grafting methods. These biologically driven approaches are particularly important in managing complex defects caused by trauma, congenital anomalies, or tumor resection.

Artificial intelligence (AI) is also playing an increasingly important role. AI-driven systems can enhance diagnostic accuracy, assist in radiographic interpretation, and support personalized treatment planning. Machine learning models are being developed to predict surgical outcomes and optimize workflows, improving efficiency and reducing human error. Furthermore, emerging technologies such as augmented and virtual reality are being explored for surgical training and intraoperative guidance. In oncology, advancements in early detection, targeted therapies, and reconstructive techniques have improved survival rates and quality of life for patients with oral cancers. Similarly, progress in temporomandibular joint (TMJ) disorders and facial nerve repair has expanded treatment options and functional outcomes.

Looking ahead, the future of OMFS lies in precision medicine and interdisciplinary collaboration. Personalized treatment approaches based on genetic, molecular, and microbiological data are expected to become more common. The integration of immunotherapy in head and neck cancer management and the continued development of biomaterials and smart implants will further enhance therapeutic outcomes.

Despite these advancements, challenges remain, including the high cost of technology, the need for specialized training, and ensuring equitable access to care. Nevertheless, ongoing research and innovation continue to push the boundaries of the field.

In conclusion, oral and maxillofacial surgery is undergoing a paradigm shift characterized by digitalization, biologically driven therapies, and AI integration. These developments promise safer, more efficient, and highly personalized treatments, shaping a future where patient outcomes and quality of life are significantly improved.

The purpose of this Special Issue on “Oral and Maxillofacial Surgery: Current Progress and Future Directions” is to provide a comprehensive platform for the dissemination of cutting-edge research, innovative techniques, and critical insights shaping the evolution of oral and maxillofacial surgery (OMFS). As a dynamic and interdisciplinary specialty, OMFS continues to advance through the integration of emerging technologies, novel biomaterials, and evidence-based clinical practices. This Special Issue aims to capture these developments and highlight their implications for both current practice and future innovation.

We seek to bring together contributions that explore recent progress in areas such as digital surgery, including virtual planning, computer-assisted procedures, and three-dimensional (3D) printing; minimally invasive and robotic-assisted techniques; and advances in implantology and regenerative medicine. Particular emphasis will be placed on research addressing tissue engineering, stem cell applications, and biomaterial innovations that are transforming reconstructive and restorative outcomes.

In addition, this Special Issue aims to examine the growing role of artificial intelligence, machine learning, and data-driven approaches in diagnosis, treatment planning, and surgical precision. Submissions focusing on augmented and virtual reality in intraoperative navigation are also encouraged, as these technologies are reshaping clinical practice.

Topics of interest for publication include, but are not limited to, the following:

Orthognathic surgery, surgical treatment/correction of dental and maxillofacial malformations;
Head and neck cosmetic surgery;
Oral cancer;
Reconstructive surgery;
Management of oral diseases;
New methods and techniques in oral and maxillofacial surgery;
Oral and maxillofacial soft and hard tissue trauma and reconstruction techniques;
Drug-related osteonecrosis of the jaw;
New diagnostic and therapeutic tools for the management of potentially malignant diseases of the oral cavity;
Temporomandibular joint (TMJ) disorders.

Dr. Fabio Maglitto
Dr. Giovanni Salzano
Guest Editors

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Keywords

oral and maxillofacial surgery
digital planning
head and neck surgery
reconstructive surgery
implant–prosthetic rehabilitation
oral diseases
regenerative dentistry
AI

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Published Papers (6 papers)

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Research

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15 pages, 4433 KB

Open AccessArticle

Advanced Visualization of Peroneal Artery Perforators Prior to Autologous Transplantation in Head and Neck Surgery by Dual-Energy CTA and Semiautomatic Vessel Unfolding

by Marco Wiesmueller, Konstantin Hellwig, Maximilian Hinsen, Markus Kopp, Claudius Sebastian Mathy, Tobias Moest, Marco Kesting, Michael Uder and Matthias Stefan May

J. Clin. Med. 2026, 15(14), 5698; https://doi.org/10.3390/jcm15145698 - 21 Jul 2026

Viewed by 430

Abstract

Background/Objectives: Accurate visualization of peroneal perforator vessels prior to autologous transplantation of osteomyocutaneous fibular flap is essential for surgical success. Our aim was to improve and simplify pre-surgical diagnostics of peroneal perforators using a dedicated dual-energy Computed Tomography Angiography (CTA) protocol and semiautomatic Vessel Unfolding Reconstruction algorithm (VUR). Methods: CTA of both lower legs was performed in 22 patients using dual-energy acquisitions from a third-generation dual-source CT scanner and a high iodine flux (7 mL/s, 350 mg/mL). Low-energy virtual monoenergetic reconstructions (40 keV) were automatically reconstructed from the scanner and used for centerline labeling of the peroneal arteries and their perforators on a post-processing console using a dedicated vascular workflow. Separate segmentation and curved multiplanar reconstructions (MPRs) of each identified peroneal perforator vessel were regarded as the gold standard. Traditional visualization techniques of the entire volume like thin-slice maximum intensity projections (MIPs) or the volume rendering technique (VRT) were compared to a new VUR algorithm that aimed to adjust the visualization plane to the course of the vessels. The identified numbers and lengths of the perforator arteries were compared between curved MPRs, thin-slice MIPs in oblique coronal orientation, posterior-view VRT and coronal VUR of each lower leg. Results: The VUR algorithm was feasible in all patients and the same quantity of peroneal perforator vessels could be detected in comparison to the gold standard. The mean number of perforator vessels per lower leg was 2.6. Mean perforator length in VUR was slightly shorter by 1.6% and did not significantly differ from curved MPRs (p = 0.54), whereas length values from oblique coronal MIP and VRT reconstructions were significantly shorter (both p < 0.001). Conclusions: The combination of virtual monoenergetic reconstructions and the VUR algorithm enables comprehensive and precise depiction of small peroneal perforator vessels prior to autologous fibular flap transplantation, representing a diagnostic tool comparable to traditional visualization methods. Full article

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

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Review

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19 pages, 650 KB

Open AccessReview

Dextrose Injections Across Temporomandibular Joint Mobility Disorders: A Scoping Review

by Julia Kasprzycka, Maciej Chęciński, Justyna Wilk, Wojciech Macek, Maja Kosińska, Amelia Hoppe, Oliwia Jagiełło, Karolina Grzybowska-Kowalczyk, Tomasz Horodniczy, Zuzanna Baniak, Izabella Chyży, Kamila Chęcińska and Maciej Sikora

J. Clin. Med. 2026, 15(17), 6708; https://doi.org/10.3390/jcm15176708 - 29 Aug 2026

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Abstract

Background/Objectives: Temporomandibular joint (TMJ) mobility disorders encompass opposing clinical problems, ranging from hypermobility, subluxation, and recurrent dislocation to restricted mandibular mobility caused by disc displacement without reduction (DDwoR). Dextrose-based injections have been investigated in both settings, although their therapeutic objectives may differ. This scoping review mapped the clinical indications, injection protocols, outcomes, safety findings, and evidence gaps. Methods: PubMed/MEDLINE, Europe PMC, and BASE were searched from inception through 14 June 2026. Study selection and data charting were conducted independently by two reviewers, and primary studies underwent design-specific JBI appraisal. Results: Eighteen reports were included: 14 reports describing 13 primary clinical studies (two reports were companion publications from the same randomized pilot cohort) and four systematic reviews used for evidence mapping. Among the primary studies, twelve addressed excessive TMJ mobility, and one evaluated DDwoR with limited mouth opening. In hypermobility and recurrent dislocation, within-group reductions in pain, excessive mouth opening, and recurrence were commonly reported, but superiority over placebo or active comparators was inconsistent. In DDwoR, 5% dextrose was associated with improvements in pain, mouth opening, and chewing function, although the evidence was limited by the small sample. No serious adverse events were reported. Conclusions: Substantial heterogeneity precluded quantitative synthesis and prevented identification of an optimal protocol. Indication-specific, adequately powered randomized trials with standardized outcomes and longer follow-up are required. Full article

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

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14 pages, 5791 KB

Open AccessReview

Anatomical References for the Study of 3D Facial Photographs: A Scoping Review and Proposed Preliminary Framework for Comprehensive Facial Evaluation

by Gonzalo Muñoz, Leonardo Brito, Josefa Alarcon-Apablaza, Antônio Carlos de Oliveira Ruellas, Victor Ravelo and Sergio Olate

J. Clin. Med. 2026, 15(15), 6091; https://doi.org/10.3390/jcm15156091 - 5 Aug 2026

Viewed by 395

Abstract

Background/Objectives: Facial deformities compromise craniofacial aesthetics and functionality. Maxillofacial surgery and orthodontics require meticulous planning utilizing tomography and clinical photography. Although tomography provides precise information about bony structures, it has limitations in evaluating soft tissues. Three-dimensional photography emerges as a complementary alternative; however, there is limited information regarding morphological facial analysis in three dimensional (3D) images. Methods: A scoping review was conducted according to PRISMA-ScR guidelines and the Joanna Briggs Institute methodological framework. The MEDLINE (PubMed), Scopus, SciELO, and Web of Science databases were searched for studies published between 2017 and 2025 evaluating the use of 3D facial photography in orthodontics, orthognathic surgery, maxillofacial surgery, and related craniofacial applications. Two independent reviewers performed study selection and data extraction, with disagreements resolved by a third reviewer. Anatomical landmarks and facial measurements were descriptively synthesized according to facial regions and measurement type. Results: Out of 79 initially identified articles, 18 observational studies examining 3D facial photographs were included. Consequently, the “3D FullFace A” tool was developed, incorporating 13 midline points and 12 bilateral points, enabling 18 linear and 28 angular measurements for comprehensive facial analysis. Conclusions: Available evidence suggests that 3D facial photography is a promising tool for orthognathic surgical planning. Key advances identified include reliable stereophotogrammetric landmark identification, quantification of soft-tissue changes following orthognathic and orthodontic treatment, and characterization of facial asymmetry and proportionality. Full article

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

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21 pages, 851 KB

Open AccessReview

Peri- and Intraarticular Injections with Isolable Treatment Effects in Recurrent Mandibular Dislocation: A Mapping Review of the Current Evidence

by Amelia Hoppe, Maciej Chęciński, Wojciech Macek, Maja Kosińska, Karolina Grzybowska-Kowalczyk, Tomasz Horodniczy, Julia Kasprzycka, Oliwia Jagiełło, Zuzanna Baniak, Kamila Chęcińska and Maciej Sikora

J. Clin. Med. 2026, 15(14), 5589; https://doi.org/10.3390/jcm15145589 - 16 Jul 2026

Viewed by 404

Abstract

Background/Objectives: Recurrent temporomandibular joint dislocation is associated with repeated dislocation episodes, pain, impaired jaw function, and psychosocial burden. Injectable intra- and periarticular therapies have been proposed as minimally invasive methods of improving joint stability, but the available evidence is heterogeneous and frequently involves adjunctive procedures. This mapping review aimed to characterize injectable treatments whose effects could be assessed independently from simultaneous non-injectable interventions. Methods: PubMed (MEDLINE), Europe PMC, and BASE were searched from inception to 7 April 2026. Reference lists of included studies and relevant reviews were also screened. Studies reporting clinical outcomes of injectable intra- or periarticular treatments for recurrent mandibular dislocation were eligible when the effect of the injectable component could be evaluated independently. Study selection, data charting, and critical appraisal were performed using predefined methods. Results: Five primary clinical studies and eight secondary mapping or reference-checking sources were included. The primary studies evaluated autologous blood injection, dextrose prolotherapy, and sodium morrhuate or other sclerosing-agent injections. Most studies reported reductions in recurrent dislocation or subluxation and improvements in joint stability. Some also reported improvements in maximal mouth opening, clicking, pain, or other clinical outcomes. However, the evidence was limited by small sample sizes, heterogeneous protocols, variable injection sites, and limited comparative data. Conclusions: The available literature on injectable therapies for recurrent mandibular dislocation is limited and heterogeneous. Although included studies generally reported favorable outcomes, the evidence does not permit conclusions regarding the comparative effectiveness or superiority of any specific injectable modality. Full article

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

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18 pages, 1556 KB

Open AccessReview

Decision-Making in Unilateral Progressive Condylar Growth of the Mandible: Biological Insights and the Role of Proportional Condylectomy

by Sergio Olate, Victor Ravelo, Marcelo Parra and Majeed Rana

J. Clin. Med. 2026, 15(12), 4654; https://doi.org/10.3390/jcm15124654 - 16 Jun 2026

Cited by 1 | Viewed by 441

Abstract

Background: Unilateral progressive condylar growth (UPCG) represents a complex clinical condition characterized by abnormal enlargement of the mandibular condyle, leading to progressive facial asymmetry and functional impairment. Objectives: The aim of this review is to analyze the biological, clinical, and therapeutic factors guiding condylectomy, assess the current role and scope of proportional condylectomy, and propose an algorithm to guide its indication in patients with UPCG. Methods: A narrative review was conducted to analyze the biological, clinical, and therapeutic factors involved in the indication for condylectomy in patients with progressive unilateral condylar growth. Studies including patients diagnosed with unilateral condylar hyperplasia or condylar osteochondroma who underwent surgical treatment were considered to evaluate clinical indications, timing of intervention, and outcomes. Special attention was given to the concept of proportional condylectomy. Results: Current evidence indicates that early intervention may control disease progression, reduce the severity of residual deformity, and minimize the need for secondary orthognathic surgery. The integration of clinical findings, three-dimensional imaging, and patient-specific factors is essential for appropriate treatment planning. Conclusions: Based on these considerations, a structured clinical algorithm is proposed to guide decision-making in patients with unilateral progressive condylar growth. This approach supports individualized treatment strategies aimed at optimizing functional and esthetic outcomes. Full article

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

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Other

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22 pages, 1725 KB

Open AccessSystematic Review

Donor-Site Morbidity Following Radial Forearm Free Flap Harvest for Head and Neck Reconstruction: A Systematic Review and Meta-Analysis

by Fabio Maglitto, Giovanni Salzano, Eutilia Manzo, Serena Trotta, Luigi Angelo Vaira, Marzia Petrocelli, Stefania Troise and Giovanni Dell’Aversana Orabona

J. Clin. Med. 2026, 15(17), 6513; https://doi.org/10.3390/jcm15176513 - 23 Aug 2026

Viewed by 205

Abstract

Background: The radial forearm free flap (RFFF) remains one of the most reliable and widely adopted reconstructive options for head and neck defects because of its consistent vascular anatomy, long pedicle, and excellent tissue pliability. Nevertheless, donor-site morbidity continues to represent its principal drawback and may negatively affect postoperative recovery, upper-limb function, and patient satisfaction. Although numerous surgical modifications and donor-site reconstruction techniques have been proposed to reduce morbidity, the available evidence remains fragmented and heterogeneous. This systematic review and meta-analysis aimed to quantify the incidence of the principal donor-site complications following RFFF harvest and critically evaluate the current evidence regarding strategies to minimize donor-site morbidity. Methods: This systematic review and meta-analysis was conducted according to the PRISMA 2020 statement and prospectively registered in PROSPERO (CRD420261423543). PubMed/MEDLINE, Embase, and Scopus were systematically searched from inception to June 2026. Clinical studies reporting donor-site outcomes after RFFF harvest for head and neck reconstruction were eligible. Primary outcomes were tendon exposure and skin graft loss/failure. Random-effects meta-analyses were performed to estimate pooled incidence rates. Secondary complications, functional outcomes, and patient-reported outcome measures were synthesized qualitatively. Methodological quality and certainty of evidence were assessed using the Joanna Briggs Institute critical appraisal tools and the GRADE framework. Results: Twenty-two studies met the inclusion criteria for qualitative synthesis. Fourteen studies were included in the meta-analysis of tendon exposure and twelve in the meta-analysis of graft loss/failure. The pooled incidence of tendon exposure was 8% (95% CI, 7–11%; I² = 0%), whereas the pooled incidence of graft loss/failure was 11% (95% CI, 7–16%; I² = 67.1%). Delayed wound healing, infection, sensory disturbances, scar-related morbidity, and functional impairment were reported inconsistently across studies, precluding quantitative synthesis. Available studies generally reported limited long-term functional impairment, although substantial heterogeneity in assessment methods and follow-up precluded quantitative synthesis. Overall certainty of evidence was rated as low. Conclusions: Donor-site morbidity following RFFF harvest remains clinically relevant despite the excellent reconstructive reliability of the flap. Approximately one in twelve patients experiences tendon exposure and one in ten experiences graft loss or failure. Current evidence does not support the superiority of any specific donor-site reconstruction technique. Future high-quality prospective comparative studies adopting standardized outcome definitions and validated patient-reported measures are required to optimize donor-site management and improve reconstructive decision-making. Full article

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

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