International Journal of Oral and Maxillofacial Surgery
Efficacy of intra-arterial chemoradiotherapy via the superficial temporal artery for squamous cell carcinoma of the maxillary gingiva: a retrospective study of 34 patients with T3/4 disease
Yamazaki M, Masubuchi T, Fushimi C et al. · 2026 Oct
Study Type:
Retrospective single-centre case series (n=34)
Key Question:
Is weekly intra-arterial cisplatin via the superficial temporal artery with concurrent radiotherapy effective and tolerable for T3/T4 maxillary gingival SCC?
Key Findings:
- Complete response in 91.2% (31/34), partial response in 8.8% (3/34).
- 3-year rates: overall survival 77.1%, progression-free survival 61.6%, local progression-free survival 93.9%.
- Grade 3 mucositis 58.8%, grade 3 dermatitis 20.6%, grade 3/4 neutropenia 11.8%, grade 3 anaemia 5.9%. Cisplatin was neutralised with IV sodium thiosulfate.
Clinical Relevance:
This offers a potential organ-preserving alternative to maxillectomy for advanced disease, though the technique (STA catheterisation with thiosulfate neutralisation) is not standard in the UK and would require interventional radiology expertise.
Limitations:
Small, uncontrolled retrospective series with no comparator (e.g. surgery or IV chemoradiotherapy), and a 3-year PFS of 61.6% despite excellent local control suggests regional or distant failure remains a problem.
International Journal of Oral and Maxillofacial Surgery
Clinico-radiological correlation of MRI findings in patients with temporomandibular joint disc perforation
Akçay Köprücü S, Uzun T, Atasoy Sındıraç A et al. · 2026 Sep 21
Study Type:
Retrospective cross-sectional imaging study (single centre, 282 patients, 564 TMJs)
Key Question:
How does MRI-detected TMJ disc perforation relate to disc position, joint morphology, effusion, marrow signal change and pain?
Key Findings:
- Perforation was present in 129/564 TMJs (22.9%); affected patients were older (P = 0.004), with no sex association.
- 79.1% of perforated joints showed normal disc position, whereas displacement (with or without reduction) predominated in non-perforated joints (P < 0.001). Disc configuration and condylar morphology also differed by perforation status (P < 0.001).
- Effusion (P = 0.78) and marrow signal change (P = 0.68) were not associated with perforation; VAS pain was lower in perforated joints (P = 0.043).
Clinical Relevance:
Perforation on MRI may represent a late, relatively quiescent stage rather than a pain generator, so imaging findings should not alone drive escalation to arthrocentesis or surgery in NHS TMD pathways.
Limitations:
Retrospective, cross-sectional design prevents inference about temporal progression, and the abstract gives no effect sizes, details of MRI reader reliability, or control for confounders such as age.
International Journal of Oral and Maxillofacial Surgery
Upper airway and sleep quality changes after bimaxillary orthognathic surgery: influence of posterior nasal spine displacement in skeletal class III malocclusion
Kaewja T, Sonsuwan N, Powcharoen W et al. · 2026 Sep 22
Study Type:
Ambispective cohort study (n = 33)
Key Question:
Does 3D displacement of the posterior nasal spine (PNS) during bimaxillary surgery for skeletal class III malocclusion affect upper airway volume and sleep quality?
Key Findings:
- Mean PNS displacement was 3.71 mm anteriorly and 2.12 mm superiorly. Nasopharyngeal volume fell by a mean of 555 mm³ (~7%), and each millimetre of superior PNS displacement was associated with a 453 mm³ reduction (P = 0.001).
- Oropharyngeal, hypopharyngeal and total airway volumes did not change significantly.
- Objective sleep parameters (level III polysomnography) showed no clinically significant deterioration, and Pittsburgh Sleep Quality Index scores improved (P = 0.040).
Clinical Relevance:
Reassures surgeons planning posterior maxillary impaction in class III patients without significant preoperative OSA that nasopharyngeal narrowing is unlikely to compromise sleep, which is useful for UK surgical planning and consent discussions.
Limitations:
Small sample, short follow-up and use of a level III screening polysomnography device limit confidence that no sleep-disordered breathing was missed.
International Journal of Oral and Maxillofacial Surgery
Short- and long-term outcomes of photodynamic therapy in oral potentially malignant disorders
Liu XY, Guo QY, Wang Q et al. · 2026 Sep 22
Study Type:
Retrospective single-arm cohort study with propensity-matched historical/concurrent control comparison (design details not fully specified in abstract).
Key Question:
Does 5-ALA photodynamic therapy produce durable response and reduce malignant transformation in oral potentially malignant disorders (OPMDs)?
Key Findings:
- Short-term: 36.2% complete response, 92.6% overall response (n=94). Better response with smaller lesions (<2 cm², P=0.002), single lesions, no baseline pain, and topical incubation ≥2.5 h (P=0.002).
- Median follow-up 38 months: cumulative recurrence 33.0% at 1 year, 42.6% at 2 years; malignant transformation 1.1%, 10.6% and 25.5% at 1, 2 and 5 years. Hyperglycaemia and no initial response predicted transformation.
- After matching (84 pairs), controls transformed faster (P=0.041), most clearly in high-risk sites (P=0.001).
Clinical Relevance:
PDT is a non-surgical option for field or multifocal OPMDs, but the 25.5% five-year transformation rate supports continued long-term surveillance in NHS follow-up pathways.
Limitations:
Non-randomised design with an unclear control group and no effect-size estimate for the transformation benefit, so confounding and selection bias remain likely.
International Journal of Oral and Maxillofacial Surgery
Two-portal arthroscopic subtotal meniscectomy for temporomandibular joint disc perforation
Sánchez-Moreno RJ, Muñoz-Guerra M, Labrador-Carrillo R · 2026 Sep 22
Study Type:
Technical note (surgical technique description); no patient cohort, outcome data, or comparator reported in the abstract.
Key Question:
Can non-repairable TMJ disc perforation be managed by arthroscopic subtotal meniscectomy using a simplified two-portal approach rather than open discectomy?
Key Findings:
- Technique uses a standard posterolateral viewing portal and a single anterolateral working portal.
- Disc is released sequentially with radiofrequency, and fragments are removed with grasping forceps through the same cannula under continuous visualisation, aiming to limit capsular trauma.
- A thin medial or posteromedial remnant may remain; the authors consider this functionally irrelevant. No clinical outcomes (pain, mouth opening, complications) are given in the abstract.
Clinical Relevance:
Offers a potentially less invasive alternative to open discectomy for advanced internal derangement, relevant to units with TMJ arthroscopy capability, though NHS provision of TMJ arthroscopy is variable.
Limitations:
The abstract presents feasibility only, with no outcome data, follow-up, or comparison with open discectomy, so efficacy and safety remain unestablished.
International Journal of Oral and Maxillofacial Surgery
Salvage surgery for recurrent oral cavity squamous cell carcinoma: patient selection, reconstructive strategy, and a multidisciplinary decision framework
Caruso DP, Fernandes RP · 2026 Sep 22
Study Type:
Narrative review with an expert-informed decision framework (not a systematic review; no stated search methodology).
Key Question:
How should patients with recurrent oral cavity SCC be selected for salvage surgery, and how should reconstruction and adjuvant therapy be planned in a previously treated field?
Key Findings:
- Loco-regional recurrence affects up to 50% of advanced-stage OCSCC; pooled 5-year overall survival after salvage surgery is approximately 40%.
- A four-gate framework is proposed: oncological resectability, prognostic stratification (disease-free interval, prior treatment intensity, recurrence stage, performance status), reconstructive feasibility (including recipient vessels and flap choice in irradiated tissue), and adjuvant sequencing (re-irradiation, systemic therapy).
- Patients are grouped into favourable, intermediate and unfavourable salvage-risk categories to structure MDT discussion. The abstract gives no category-specific outcomes.
Clinical Relevance:
Offers a structured approach for UK head and neck MDTs, where salvage candidacy decisions are often inconsistent and no validated tools exist.
Limitations:
The framework is expert-derived and unvalidated, with no reported outcome data supporting the risk categories.
International Journal of Oral and Maxillofacial Surgery
Nodular fasciitis of the oral cavity presenting with periodic fever: a case report and literature review
Zhu Y, Lin Z, Liao G et al. · 2026 Sep 22
Study Type:
Single case report with literature review.
Key Question:
Can nodular fasciitis of the oral cavity present with systemic features such as periodic fever, and how should it be distinguished from malignancy?
Key Findings:
- A 55-year-old man presented with a rapidly growing 4×5 cm pedunculated, ulcerated buccal mass and low-grade afternoon fever. The mass enlarged further after biopsy.
- Histopathology confirmed nodular fasciitis. Local resection led to resolution of the fever, with no recurrence at 3 months.
- The authors describe this as the first reported NF case with periodic fever, suggesting an inflammatory component. The abstract gives no findings from the literature review.
Clinical Relevance:
NF should remain on the differential for rapidly growing oral mucosal masses, including those with fever and post-biopsy enlargement, to avoid unnecessarily radical surgery for presumed malignancy.
Limitations:
A single case with only 3 months' follow-up cannot establish a causal link between NF and fever, and no fever work-up (e.g., inflammatory markers, infection screen) is reported in the abstract.
International Journal of Oral and Maxillofacial Surgery
Outcomes of mandibular reconstruction using conventional plates vs patient-specific implants
Matsuzaki Y, Watabe Y, Shigematsu S et al. · 2026 Sep 24
Study Type:
Retrospective single-centre cohort study (n=39; 21 PSI vs 18 conventional plates), 8-year period.
Key Question:
Do patient-specific implants (PSI) improve perioperative outcomes versus conventional bent reconstruction plates in mandibular reconstruction for oral cancer using soft-tissue free flaps without bone?
Key Findings:
- PSI group had significantly shorter operative time (P = 0.0002) and lower intraoperative blood loss (P = 0.0039); absolute values not given in the abstract.
- Plate-related infection: 0/21 with PSI vs 3/18 with conventional plates (no P value reported).
- Median follow-up was 1322 days (range 91–3225); all patients had anterolateral thigh flap reconstruction.
Clinical Relevance:
Offers some support for PSI in bone-free (plate-and-soft-tissue) mandibular reconstruction, relevant to UK units weighing PSI cost and lead time against theatre efficiency, particularly in patients unsuitable for composite bone flaps.
Limitations:
Small retrospective non-randomised series with likely selection and temporal bias (and unequal follow-up between groups), so the findings should be viewed as hypothesis-generating rather than definitive.
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