The past forty-three years of dental implantology literature. A global mapping and scientometric analysis.

PURPOSE: The aim of this research is to make a scientometric analysis of the dental implantology literature and to present the results in a more understandable way to the reader by visualizing them with maps. METHODS: The dental implantology literature was accessed through the Web of Science database. Scientometric data was obtained with Citespace 6.1 software, co-citation, clustering analysis, citation burst, and mapping analyzes were performed. Scimago Graphica software was used for additional visualizations. RESULTS: A total of 35,704 articles were included in the analysis. There were 88,616 authors, 72,333 institutes, 142 countries/regions, and 3,265 journals contributing to the dental implantology literature. The United States was first with 7,334 publications and 225,868 citations. The literature between 1980 and 2023 was divided into 19 different clusters, and the literature between 2000 and 2023 was divided into 16 different clusters. CONCLUSIONS: Key themes in the field include the use of autogenous bone, advancements in implant surface technology, and the use of platform switching and intraoral scanners. Emerging topics of interest include esthetic considerations in the treatment of the anterior region, stress distribution, the use of zirconia, and the impact of implant treatment on oral health-related quality of life. With similar scientometric analysis studies to be done in the future, the progress of the literature can be followed on the basis of evidence.

Two Cases of COVID-Related Osteonecrosis of the Jaws: A New and Worrying Entity Is Emerging.

Many people were affected by COVID-19 in its severe form. Some intercurrences are still emerging. We here report two cases of COVID-related osteonecrosis of the jaws (CRONJ). Two retrospective cases were admitted into Imam Reza Hospital, Mashhad, Iran with suspected CRONJ. One patient escaped from hospital while the other showed a positive result after our proposed treatment. A new aftermath to COVID-19 infections is emerging. Maxillofacial and orthopedic surgeons should be aware of this situation. CRONJ should be on the suspect list in patients with COVID-19. Measures that are useful in the treatment carried out, as well as some measures recommended in the literature, were discussed. Surgical treatment of CRONJ appears to be an effective alternative, especially in the more aggressive cases.

Frontal facial analysis of female celebrity attractiveness standards through artificial intelligence.

The contemporary significance of celebrities' facial aesthetics underscores their heightened importance in shaping attractiveness standards. This retrospective study aimed to investigate the impact of patterns on aesthetic canons in the profile views of female celebrities, using artificial intelligence. The study sought to compare different races and propose standards for attractive faces. In this retrospective cohort study, a Python-based algorithm was used to analyze frontal patterns and evaluate their influence on aesthetic norms in publicly accessible images of female global celebrities. Ten ideal angular or proportional measures were gathered from the literature, and were trained to serve as a benchmark for the analysis of facial attractiveness. Demographic characteristics were described statistically. A one-way ANOVA test was employed to assess data distribution. Differences in means between groups were evaluated using nonparametric independent-sample tests, with statistical significance set at < 0.05. The study involved facial analyses for 115 female celebrities. It revealed variations in facial features among races. The mean golden ratio differed, with African and Asian individuals showing lower ratios. Symmetry varied, with Latin and Caucasian faces considered the most symmetrical. The zygomatic-to-mandibular width ratio was similar across races, with a ratio close to 80% being associated with more attractive faces. Differences in nose-to-mouth ratio, lips, alar base width, and chin angle were noted among race groups. The study concluded that, regardless of race, an attractive female face is characterized by specific ratios and angles. Facial symmetry, though desirable, is not strictly necessary. Irrespective of race background, an appealing female face is characterized by a zygomatic-to-mandibular width ratio nearing 80%, a mid-facial third that is slightly larger than the lower third, and a distinctive chin angle of approximately 138°, contributing to a trapezoidal facial shape. The findings contribute valuable insights into attractiveness standards and the impact of frontal patterns on aesthetic canons in female celebrities.

The butterfly effect in oral and maxillofacial surgery: Understanding and applying chaos theory and complex systems principles.

The present paper provides a historical context for chaos theory, originating in the 1960s with Edward Norton Lorenz's efforts to predict weather patterns. It introduces chaos theory, fractal geometry, nonlinear dynamics, and the butterfly effect, highlighting their exploration of complex systems. The authors aim to bridge the gap between chaos theory and oral and maxillofacial surgery (OMFS) through a literature review, exploring its applications and emphasizing the prevention of minor deviations in OMFS to avoid significant consequences. A comprehensive literature review was conducted on PubMed, Web of Science, and Google Scholar databases. The selection process adhered to the PRISMA-ScR guidelines and Leiden Manifesto principles. Articles focusing on chaos theory principles in health sciences, published in the last two decades, were included. The review encompassed 37 articles after screening 386 works. It revealed applications in outcome variation, surgical planning, simulations, decision-making, and emerging technologies. Potential applications include predicting infections, malignancies, dental fractures, and improving decision-making through disease prediction systems. Emerging technologies, despite criticisms, indicate advancements in AI integration, contributing to enhanced diagnostic accuracy and personalized treatment strategies. Chaos theory, a distinct scientific framework, holds potential to revolutionize OMFS. Its integration with advanced techniques promises personalized, less traumatic surgeries and improved patient care. The interdisciplinary synergy of chaos theory and emerging technologies presents a future in which OMFS practices become more efficient, less traumatic, and achieve a level of precision never seen before.

Emerging Trends in Virtual Surgical Planning for Orthognathic Surgery: A Global Overview of Research and Publication Patterns.

PURPOSE: Anticipating trends and pursuing innovative ideas are imperative for the advancement of science. The objective of this study was to conduct a bibliometric analysis of 3-dimensional virtual simulation in orthognathic surgery, explore its implications for clinical practice, and identify future publication trends through digital tools. METHODS: This study employed a retrospective bibliometric analysis using data obtained from the Web of Science database. The search strategy focused on articles related to orthognathic surgery and virtual simulation techniques. RStudio and bibliometrix tools were used to data mining. The independent variables retrieved from digital analysis were the emerging themes related to virtual planning in orthognathic surgery. The trends that we identified were facial esthetics, digital workflow, personalized treatments, and complex cases. The primary outcome variable was the number of publications dedicated to virtual simulation in orthognathic surgery, along with secondary outcomes such as citation rates, language of publication, country of origin, institutional affiliations, and emerging research themes. Covariates included variables related to publication characteristics, author affiliations, and geographic distribution of publications. Publication analyses over time involved descriptive statistics, regression analysis, Pearson correlation tests, and graphical representation techniques. Statistical significance was set at a 95% confidence interval (P value < .05). RESULTS: A comprehensive analysis of 987 articles reveals the impact of included authors, with a mean h-index of 62 (SD = 18.4). The analysis further illuminates a discernible upward trend in publications on this subject, showcasing a linear pattern with a notable R2 value of 0.88 (P = .021). English remains the predominant language of publication, accounting for 97.97% of articles, while contributions hailed from a diverse spectrum of 56 countries. Interestingly, a moderate correlation emerges between publication numbers and gross domestic product per capita (r = 0.30, P = .044) and total area (r = 0.30, P = .032), whereas a more substantial correlation is evident with total population (r = 0.61, P = .034). Notably, the most cited article amassed 254 citations. Furthermore, a Pearson correlation coefficient of 0.97 underscores the correlation between citation density and the year of publication. CONCLUSION: The bibliometric indicators provided insights for evaluating research productivity and the quality of research output. Emerging themes included facial esthetics, 3-dimensional printing, and the utilization of custom-made templates and implants. This study holds relevance for maxillofacial surgeons, academics, and researchers alike.

Haptic devices as an educational approach for oral and maxillofacial surgical procedures.

OBJECTIVE: Developing the skills of a proficient surgeon with a deep understanding of force requires extensive training and repetitive practice. Traditionally, dental students and surgical trainees observed and participated in procedures using models, animals, or cadavers under expert supervision before performing the procedures independently. To address these challenges, interactive simulators with visuo-haptic features have been introduced in surgical training, providing visual and tactile feedback that replicates the sense of touch through applied forces, vibrations, or motions. STUDY DESIGN: Two independent reviewers employed a specific search strategy to explore online databases such as PubMed, Scopus, and Web of Science (WoS). This strategy included keywords such as "haptic device," "education," "oral surgery," "surgery," and "maxillofacial surgery." All types of studies related to maxillofacial surgery, except for case reports, reviews, and eBooks, were considered for inclusion. RESULTS: A total of 22 articles meeting the screening criteria were identified. The use of haptic devices for training dental students in oral surgery, anesthesia, as well as oral and maxillofacial trainees and surgeons in various surgical procedures, was evaluated. CONCLUSION: Incorporating tactile devices into the training of residents and maxillofacial surgeons offers numerous advantages, including improved technical skills and enhanced patient safety.

The online attention analysis on orthognathic surgery research.

OBJECTIVES: Altmetrics is one of the fields of bibliometrics that seeks to assess the impact and interest of a given subject through Internet users. The aim of this study is to make an altmetric analysis of the orthognathic surgery literature. METHODS: A literature search was conducted using Dimensions app up to December 2023. A list of the 100 most mentioned articles on the topic was compiled. A Google Trends search was performed with same strategy to visualize important data regarding internet search. Charts and tables were created using Microsoft Excel and VOSviewer software to allow bibliometric visualization. RESULTS: There was a very poor correlation between the number of mentions and the number of citations (r = 0.0202). Most articles discussed on technical innovations associated to orthognathic surgery, majority related to virtual planning (n = 26). Other topics considered interesting to internet readers were complications (n = 18), surgical technique (n = 14), and psychological aspects/quality of life (n = 13). CONCLUSION: Online interest in orthognathic surgery closely aligns with the level of academic interest but is also influenced by factors such as location and economic status. The internet is a powerful tool for disseminating scientific research to a broad audience, making it more accessible and engaging than traditional academic channels.

Shaping the 4D frontier in maxillofacial surgery with faceMesh evolution.

OBJECTIVES: This work aims to introduce a Python-based algorithm and delve into the recent paradigm shift in Maxillofacial Surgery propelled by technological advancement. The provided code exemplifies the utilization of the MediaPipe library, created by Google in C++, with an additional Python interface available as a binding. TECHNICAL NOTE: The advent of FaceMesh coupled with artificial intelligence (AI), has brought about a transformative wave in contemporary maxillofacial surgery. This cutting-edge deep neural network, seamlessly integrated with Virtual Surgical Planning (VSP), offers surgeons precise 4D facial mapping capabilities. It accurately identifies facial landmarks, tailoring surgical interventions to individual patients, and streamlining the overall surgical procedure. CONCLUSION: FaceMesh emerges as a revolutionary tool in modern maxillofacial surgery. This deep neural network empowers surgeons with detailed insights into facial morphology, aiding in personalized interventions and optimizing surgical outcomes. The real-time assessment of facial dynamics contributes to improved aesthetic and functional results, particularly in complex cases like facial asymmetries or reconstructions. Additionally, FaceMesh has the potential for early detection of medical conditions and disease prediction, further enhancing patient care. Ongoing refinement and validation are essential to address limitations and ensure the reliability and effectiveness of FaceMesh in clinical settings.

Postoperative nausea and vomiting in orthognathic surgery: systematic review and meta-analysis.

PURPOSE: Postoperative nausea and vomiting (PONV) is a frequently reported adverse event following orthognathic surgery. The aim of this work is to conduct a systematic review of the literature on the subject, and to discuss the role of maxillofacial surgeons and the steps that can be taken to prevent or control PONV in orthognathic surgery. METHODS: A systematic review was conducted according to the PRISMA guidelines, using the search strategy: (orthognathic AND (nausea OR vomiting)). The authors searched PubMed, Embase, Dimensions, Web of Science and Google Scholar databases, without any language restrictions. RevMan 5.4 was used to create a risk of bias graph and a forest plot. RESULTS: The included articles were classified as having a low risk of bias, despite the limited literature on the subject. Various measures have been reported to be beneficial in preventing or managing PONV, such as the use of dexamethasone, antiemetic drugs, gastric aspiration, and anesthetic blocks. Effective bleeding control and faster surgeries can also be helpful. CONCLUSIONS: Throat packs have not been found to be effective in preventing PONV. Although no definitive protocol has been established in the literature, the Enhanced Recovery After Surgery (ERAS) protocol could be a useful approach. Overall, a multimodal approach may be taken to prevent PONV, and further research is needed to establish definitive protocols.

Advanced Techniques in Upper Blepharoplasty: Cauterization + Plication for Enhanced Surgical Outcomes.

Blepharoplasty is a commonly performed cosmetic surgery worldwide to address the excess skin and fat on the upper eyelids. The purpose of this paper is to present a surgical variation on blepharoplasty, achieving more pleasant outcomes. This paper describes the cauterization + plication technique, which involves using a cauterizing tool to remove excess skin and fat from the upper eyelid before using sutures to create a crease. It provides valuable insights into the advantages and limitations of this technique, drawing on relevant literature and clinical experience. Muscle cauterization and plication technique is an upgrade from the traditional technique, producing more esthetically pleasing results. This study highlights the importance of understanding the different techniques available for blepharoplasty to achieve the best possible outcomes for patients.

A global landscape analysis of the impact, trends, and dissemination in oral and maxillofacial surgery research.

OBJECTIVE: This study aims to comprehensively analyze the global landscape of oral and maxillofacial surgery (OMFS) literature through bibliometrics. The research focuses on evaluating publication trends, influential topics, and the impact of scholarly works within the field. METHODS: Following the principles of the Leiden Manifesto, a literature search was conducted using the Web of Science database, encompassing seven OMFS journals. A total of 18,218 publications were analyzed, with indicators such as publication language, geographic location, specialty, year, citation, and authorship examined. Statistical analyses, including Pearson correlation tests and angular coefficient calculations, were performed in RStudio. RESULTS: The study revealed a strong upward trend in publications related to orthognathic surgery, trauma, and infections. Geographic analysis indicated a dominance of European and Asian contributions, with the USA leading in overall publications. The impact of self-citations was explored, emphasizing nuanced perspectives on their role in scholarly impact metrics. The data provided insights into the scholarly impact of OMFS publications, including the H-index, number of citations, and citing articles. CONCLUSION: The findings underscored potential global discrepancies in OMFS research, both geographically and in terms of topics covered. The study discussed the influence of language and journal impact on citation counts, emphasizing the role of English publications. Specific topics, such as trauma and infections, exhibited high scholarly interest and citation rates. Recommendations were made to encourage submissions on specific topics, such as cosmetic surgery and pathology, to enhance the diversity of OMFS literature. The study aims to foster international collaboration and leverage bibliometrics for evidence-based decision-making, educational strategies, and advancements in the dynamic field of oral and maxillofacial surgery.

Assessment of Benign Paroxysmal Positional Vertigo (BPPV) Incidence Following Closed Sinus Lift and Ridge Splitting Surgeries: A Cohort Study.

Background: With a notable increase in demand for implant placement in atrophic cases, this study aimed to evaluate the occurrence of benign paroxysmal positional vertigo (BPPV) following closed sinus lift and ridge splitting surgeries. Materials and Methods: Healthy patients requiring posterior maxillary closed sinus lift or ridge split surgeries at Mashhad Dental School from September 2021 to September 2022 were enrolled in this cohort study. A single surgeon performed all surgeries under standard protocols. The intervention groups consisted of closed sinus lift and ridge splitting procedures. The primary outcome variable was BPPV, and the Dix-Hallpike maneuver was used before and after the operation to diagnose BPPV. The data were statistically analyzed using SPSS 23, and the significance level was set at 0.05. Results: A total of 112 patients (51 women and 61 men) with a mean age of 48.4 ± 9.5 years participated in the study. The average BMI was 21.5 ± 2.4, and the mean duration of surgery was 31.9 ± 6.6 min. Of the patients, 10.7, 36.6, 27.7, 12.5, and 1.8% presented with hypertension, headache, dizziness, nausea, and BPPV, respectively. Two patients (3.1%) in the closed sinus lift group were diagnosed with BPPV, whereas no patients in the ridge split group were diagnosed. However, there was no significant difference (P = 0.509). No statistically significant difference in the occurrence of certain symptoms between two groups was found. There was a significant association between certain health conditions and the onset of BPPV. Conclusion: The study suggests closed sinus lift surgery may have a higher risk of BPPV than ridge split surgery, but further studies with larger sample are needed to confirm this association.

Optimizing drug regimens and supplementation in orthognathic surgery: A comprehensive and practical guide.

OBJECTIVE: This study aimed to comprehensively review the literature and provide a practical guide for optimizing drug regimens and supplementation related to orthognathic surgery. METHODS: The authors conducted a thorough review of the existing literature, following the PRISMA-ScR guidelines. Various types of studies except case reports and reviews were included. The study applied specific inclusion criteria, focusing on perioperative and/or postoperative drugs, medications, or supplementation related to orthognathic surgery. RESULTS: This guide included 78 studies on various medications in orthognathic surgery. It encompasses clinical trials, cohort studies, cross-sectional studies, prospective and retrospective studies. The topics covered include antibiotics, analgesics, corticosteroids, antiemetics, hemostatic agents, local anesthetics, herbal medicine, and botulinum toxin. Pain and edema control involved specific medications, while local anesthesia utilized ropivacaine and bupivacaine. The guide also discusses mineral and vitamin supplementation. The effectiveness of hemostatic agents and antiemetics was highlighted. CONCLUSION: Pain management, reduced swelling, enhanced wound healing, and faster recovery are among the advantages. In addition to the standard drugs and medications, the inclusion of vitamin and mineral supplements, tranexamic acid, postoperative anesthetic blocks, and preemptive antiemetics is anticipated to offer various benefits in orthognathic surgery, despite the limited available evidence.

Exploring the relationship between the number of systematic reviews and quality of evidence: an orthognathic surgery-based study.

OBJECTIVE: We analyzed the quality and quantity of systematic reviews (SRs) of orthognathic surgery, the most frequently published topic in maxillofacial surgery. STUDY DESIGN: We searched the PubMed database for SRs of orthognathic surgery with no restriction on the language of publication date. We assessed the certainty of evidence presented according to the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocol and the Leiden Manifesto using the Grading of Recommendations Assessment, Development, and Evaluation approach. We analyzed the data using descriptive statistics, Pearson´s correlation test, and linear regression. RESULTS: Of the 171 SRs evaluated, approximately one fifth presented evidence with a high level of certainty. The number of orthognathic surgery SRs has been increasing, and many SRs were published after very similar topics had already been published. There is no relationship between the impact factor and the certainty of evidence. CONCLUSIONS: An excessive number of SRs of orthognathic surgery are published, and many SRs are superfluous, simply reporting previous findings. Clinicians should not base treatment decisions solely on the evidence presented in SRs, and journal editors and reviewers should evaluate these SRs more critically, particularly when they address topics that have already been covered in the literature.

Treatment Options of Maxillofacial Fractures in Iran: A Comprehensive Systematic Review.

Background: The aim of this study was to systematically review the literature on the treatment options of maxillofacial fractures in Iran, complementing a previous article regarding causes and the overall prevalence. Methods: A systematic search of PubMed, Cochrane Library, Web of Science (WS) and Google Scholar (GS) electronic databases was conducted to identify the relevant articles published up to January 2023. Studies reporting the treatment option of maxillofacial fractures in Iran were included in the analysis. MOOSE guidelines were adopted for the current systematic review. No data or language restriction were applied. Risk of bias across the articles was assessed. Results: This systematic review included 13 articles with a total of 19,147 treated patients for maxillofacial fractures. ORIF was the most common type of treatment, but complications occurred in approximately 5% of cases. Mandible fractures were not statistically more treated by ORIF than closed reduction or conservative treatment, and no type of treatment was considered statistically preferable depending on the anatomical region affected by Iranian maxillofacial surgeons. The included studies were considered to have a low risk of bias, but many were not clear in reporting cross-referenced data regarding the type of treatment, which could be considered a major flaw. Conclusion: Overall, this study provides valuable insights into the types of treatment used for maxillofacial fractures by Iranian surgeons and highlights the importance of clear reporting of data in research articles.

What is the Most Prevalent Type of Third Molar Impaction in Patients with Pericoronitis?

Background: Pericoronitis is a common pathological condition related to mandibular third molar teeth (wisdom teeth). It is an inflammation of the soft tissue surrounding the crown of an erupted or partially erupted tooth that causes pain and discomfort. We aimed to investigate the relation between third molar impaction types and pericoronitis. Methods: This cross-sectional study assessed 60 patients referred to the Oral and Maxillofacial Surgery Department of Mashhad Dental School, Mashhad University of Medical Sciences, Mashhad, Iran in 2022 for totally and partially impacted mandibular third molar tooth surgery with pericoronitis. Their demographic data, including age and gender, was recorded. The impacted tooth's side and the symptoms of pericoronitis were identified using clinical examination and panoramic radiography imaging, based on the Pell & Gregory criteria and Peterson's classification. Third-molar tooth surgery was performed according to standard protocol. Patients' data were recorded and were analyzed using Excel 2019 and SPSS ver 21. Results: The prevalence of pericoronitis symptoms in women was higher than in men (P< 0.001). The Class B type of third molar teeth impaction had a relation with the majority of pericoronitis cases (P< 0.001). Pericoronitis and systemic symptoms were more likely to occur in Class II than in Class I type of third molar teeth impaction (P< 0.001). The most frequent kind of impaction linked to pericoronitis and systemic symptoms such as malaise was mesio-angular (P< 0.001). The symptoms of pericoronitis were substantially correlated with smoking (P< 0.001). Conclusion: Class B, Class II, and mesio-angular types of third molar impaction are linked with a higher risk of pericoronitis. This information might help in the early diagnosis and management of pericoronitis in patients with impacted third molar teeth.

Science mapping analysis of maxillofacial reconstruction over the last four decades.

PURPOSE: This paper aims to provide a bibliometric analysis of the maxillofacial reconstruction literature over 40 years and to compare the data with previous studies. METHODS: A bibliographical search for oral and maxillofacial surgery literature in maxillofacial reconstruction was conducted on Wef of Science. A graphic representation of authorship and keywords was created with VOSviewer. Mendeley and Microsoft Excel were used for tabulation and data visualization. Some statistical tests were performed with a 95 % confidence interval, which was considered significant. RESULTS: A total of 7417 articles from specialized journals were included in the study. These articles received 138,493 citations from 63,390 other studies, with an average citation count of 18.67, and a very high H-index. A total of 2375 specific keywords were analyzed, covering a wide range of topics, with two noteworthy MeSH keywords that have recently gained prominence. A total of 33 journals were included in the study, with a mean Impact Factor of 2.404, indicating a relatively high influence in the subject area. CONCLUSION: The high h-index reflects abundant and high-quality literature on maxillofacial reconstruction, with the United States leading in publication quantity. Emerging topics in maxillofacial reconstruction were discussed. These areas shape the discipline, driving advancements and offering opportunities for researchers and clinicians to contribute to progress and improve patient outcomes.

The importance of written informed consent in facial cosmetic surgery litigation.

It is the aim of the study to discuss litigation related to facial cosmetic surgery with a particular focus on written consent, in order to prevent unfortunate outcomes for the surgeon and patient alike. A 10-year online search for facial cosmetic surgery litigation in Brazil was conducted from 2012 to 2022. Statistical analyzes were performed using RStudio, and the results were considered significant with a 95% confidence interval. A total of 992 litigations were identified through the search. Of these, 122 articles met our inclusion criteria. The number of legal disputes on this subject has been increasing for years. Female patients are more prone to litigation. Financial damage ranged from $75 to $500,000 (mean: $59,536). Many of the lawsuits that had appropriate written consent have had a favorable outcome for the defendant. The primary specialty was the most common plastic surgery (67%), followed by maxillofacial surgery (9%). Surgeons engaged in facial cosmetic surgery should protect themselves legally from litigation. Written consent significantly reduces both litigation losses and financial damage. Some details on the preparation of this consent form have been discussed.