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Oral squamous cell carcinoma (OSCC) is amongst the most common malignancies, with an estimated incidence of 377,000 and 177,000 deaths worldwide. The interval between the onset of symptoms and the start of adequate treatment is directly related to tumor stage and 5-year-survival rates of patients. Early detection is therefore crucial for efficient cancer therapy. This study aims to detect OSCC on clinical photographs (CP) automatically. 1406 CP(s) were manually annotated and labeled as a reference. A deep-learning approach based on Swin-Transformer was trained and validated on 1265 CP(s). Subsequently, the trained algorithm was applied to a test set consisting of 141 CP(s). The classification accuracy and the area-under-the-curve (AUC) were calculated. The proposed method achieved a classification accuracy of 0.986 and an AUC of 0.99 for classifying OSCC on clinical photographs. Deep learning-based assistance of clinicians may raise the rate of early detection of oral cancer and hence the survival rate and quality of life of patients.

Objective. The aim of this paper is to review different surface modifications of dental implants and their effect on osseointegration. Common marketed as well as experimental surface modifications are discussed. Discussion. The major challenge for contemporary dental implantologists is to provide oral rehabilitation to patients with healthy bone conditions asking for rapid loading protocols or to patients with quantitatively or qualitatively compromised bone. These charging conditions require advances in implant surface design. The elucidation of bone healing physiology has driven investigators to engineer implant surfaces that closely mimic natural bone characteristics. This paper provides a comprehensive overview of surface modifications that beneficially alter the topography, hydrophilicity, and outer coating of dental implants in order to enhance osseointegration in healthy as well as in compromised bone. In the first part, this paper discusses dental implants that have been successfully used for a number of years focusing on sandblasting, acid-etching, and hydrophilic surface textures. Hereafter, new techniques like Discrete Crystalline Deposition, laser ablation, and surface coatings with proteins, drugs, or growth factors are presented. Conclusion. Major advancements have been made in developing novel surfaces of dental implants. These innovations set the stage for rehabilitating patients with high success and predictable survival rates even in challenging conditions.

Mandibular fractures are among the most frequent facial traumas in oral and maxillofacial surgery, accounting for 57% of cases. An accurate diagnosis and appropriate treatment plan are vital in achieving optimal re-establishment of occlusion, function and facial aesthetics. This study aims to detect mandibular fractures on panoramic radiographs (PR) automatically. 1624 PR with fractures were manually annotated and labelled as a reference. A deep learning approach based on Faster R-CNN and Swin-Transformer was trained and validated on 1640 PR with and without fractures. Subsequently, the trained algorithm was applied to a test set consisting of 149 PR with and 171 PR without fractures. The detection accuracy and the area-under-the-curve (AUC) were calculated. The proposed method achieved an F1 score of 0.947 and an AUC of 0.977. Deep learning-based assistance of clinicians may reduce the misdiagnosis and hence the severe complications.

Postoperative complications following mandibular fracture treatment vary from local wound infections to severe conditions including osteomyelitis and impaired fracture healing. Several risk factors have been associated with the development healing disorders, including fracture localisation, treatment modality and substance abuse. However, limited research on the sex-specific influence of these complications exists. A total of about 300,000 female and male patients with mandibular fractures were examined in two cohorts. After matching for confounders (age, nicotine and alcohol dependence, malnutrition, overweight, anaemia, diabetes, osteoporosis and vitamin D deficiency), two cohorts were compared with propensity-score-matched patients according to outcomes (osteomyelitis, pseudoarthrosis and disruption of the wound) within 1 year after fracture. There were significant differences between female and male patients regarding the occurrence of osteomyelitis (odds ratio [OR] [95% confidence interval]: 0.621 [0.563; 0.686]) and disruption of the wound (OR [95% confidence interval]: 0.703 [0.632; 0.782]). Surprisingly, matching for the expected confounders did not change the results substantially. Sex plays a dominant role in determining the risk stratification for postoperative osteomyelitis and disruption of the wound, after accounting for other potential confounding factors. Additional research is needed to understand the underlying mechanisms and to develop sex-specific strategies to prevent these complications.

Osseous non-union following free flap reconstruction of segmental mandibular defects can prolong patients’ dental rehabilitation. Various plating systems have been developed to optimize biomechanical fixation, but healing may be retarded. Quantifying intersegmental micromovements could help monitor healing but remains challenging. This study investigates a novel method to visualize segmental movements during healing using a fluoroscopy-based approach. To track segment movements, tantalum beads were implanted intraoperatively in the osseous flap and native mandibular segments. Additionally, single-plane fluoroscopic imaging was performed to assess bead position at maximum mouth opening and intercuspation. Bead positions were merged as three-dimensional objects. Intersegmental movements were quantified using model-based roentgen stereophotogrammetry (mbRSA). Exemplarily, preliminary images were collected from one patient. Fluoroscopic imaging with mbRSA effectively displayed movements and allowed quantification. Translation and rotation were assessed between the native mandible and the flap during maximum mouth opening and intercuspation. For the first time, our analyses demonstrate the feasibility of quantifying segment mobility during healing. This first in men study illustrates the feasibility of the method to monitor intersegmental movements in cases of maxillofacial reconstructions. Further research involving larger patient cohorts is necessary to identify relevant thresholds and differentiate from those that result in lack of healing.

Background Obstructive sleep apnea (OSA) is a common sleep-related breathing disorder linked to substantial cardiovascular, pulmonary and metabolic morbidity. Recent observations have raised the question that OSA may also contribute to cancer development. This study aimed to evaluate the association between OSA and the 5-year incidence of cancer, cardiometabolic, pulmonary and metabolic disorders in a large real-world hospitalized population. Methods A retrospective analysis of the TriNetX research database was conducted. Two cohorts of 1,524,190 adults with and without OSA, matched for age and sex, were analyzed for incident cancer, chronic ischemic heart disease, chronic obstructive pulmonary disease (COPD), asthma, overweight/obesity, and diabetes mellitus. Risk estimates, risk differences, risk ratios (RR), and odds ratios were calculated; cancer risk was additionally analyzed using Kaplan–Meier curves and log-rank tests. Significance was indicated by p  < 0.05. Results OSA was associated with significantly higher 5-year incidences of all predefined outcomes, including cancer (RR 1.40), chronic ischemic heart disease (RR 1.36), COPD (RR 1.64), asthma (RR 1.96), diabetes mellitus (RR 1.51), and overweight/obesity (RR 2.70) ( p  < 0.001). Conclusions In this large real-world analysis, OSA was associated with increased 5-year risks of incident cancer and major cardiovascular, pulmonary, and metabolic diseases. The magnitude of cancer risk was comparable to that of non-malignant chronic conditions, supporting the concept of OSA as a systemic disorder characterized by multisystem morbidity.

Rosacea is often considered a cosmetic problem but is known to be associated with a variety of comorbidities. To identify such risks, we generated two age- and sex-matched real-world cohorts of 122,444 patients each with and without rosacea. In contrast to earlier studies, we found significant associations with malignant melanoma (OR 6.02, 95% CI 5.76–6.32). This association does not exist for an Asian sub-cohort, which could explain previous inconclusive or conflicting reports. Several strongly associated comorbidities like visual disturbances (ICD-10: H53–H54; OR 4.80, 4.68–4.92), metabolic disorders (E73–E79; OR 3.17, 3.11–3.22), joint problems (M25; OR 4.16, 4.08–4.25) and type 2 diabetes (E11; OR 1.62, 1.58–1.65) should be watched as a risk for rosacea patients. Rosacea is associated with some comorbidities and ethnicity may be a risk factor in melanoma development. The retrospective nature of this study and the sole use of ICD-10 code based filtering calls for future validation of our findings. Additionally, confounding factors such as skin type and previous UV exposure should be included in future studies.

Purpose For the new generation of mandibular reconstruction, patient-specific mandible reconstruction plates (PSMPs) have been developed which are milled from titanium after preoperative computer planning using CAD/CAM procedures. Resection margins and plate position are determined by surgical guides. In addition, length and shape of the plate and the number and angulation of the screw holes can be planned. Methods 30 patients received such PSMP. Indication ranged from stabilization osteosynthesis, single alloplastic stand-alone reconstruction to microvascular reconstructions. Time for planning, fit of surgical guides and plates, pre-/postoperative occlusion, radiological position of the temporo mandibular joint and complications were recorded.Results The median time for online planning was 35 min. The results concerning fit and handling of the PSMP and the surgical guides were mainly very positive. In six cases, the plan had to be adapted to the intraoperative clinical needs. The postoperative position of the condyles in the temporo mandibular fossae was regular in 28 cases. The evaluation of the occlusion was not representative due to not clearly identifiable occlusion in 2/3 of the cases. Nevertheless, complications like postoperative extraoral plate exposure, infection, graft and flap necrosis or difficulties to position the guides or the plate during surgery occurred.Conclusions Mandibular reconstruction with PSMP offers a broad range of opportunities and benefits compared with standard procedures and can be recommended for all kind of mandibular reconstructions. It is not yet foreseeable whether PSMP will in future become routine clinical practice for mandibular reconstruction or will be confined to selected isolated cases.

Periapical radiolucencies, which can be detected on panoramic radiographs, are one of the most common radiographic findings in dentistry and have a differential diagnosis including infections, granuloma, cysts and tumors. In this study, we seek to investigate the ability with which 24 oral and maxillofacial (OMF) surgeons assess the presence of periapical lucencies on panoramic radiographs, and we compare these findings to the performance of a predictive deep learning algorithm that we have developed using a curated data set of 2902 de-identified panoramic radiographs. The mean diagnostic positive predictive value (PPV) of OMF surgeons based on their assessment of panoramic radiographic images was 0.69 (±0.13), indicating that dentists on average falsely diagnose 31% of cases as radiolucencies. However, the mean diagnostic true positive rate (TPR) was 0.51 (±0.14), indicating that on average 49% of all radiolucencies were missed. We demonstrate that the deep learning algorithm achieves a better performance than 14 of 24 OMF surgeons within the cohort, exhibiting an average precision of 0.60 (±0.04), and an F1 score of 0.58 (±0.04) corresponding to a PPV of 0.67 (±0.05) and TPR of 0.51 (±0.05). The algorithm, trained on limited data and evaluated on clinically validated ground truth, has potential to assist OMF surgeons in detecting periapical lucencies on panoramic radiographs.

Facial Vascularized Composite Allotransplantation (fVCA) restores form and function for patients with severe facial disfigurements, yet multi-center outcome data remain scarce. We accessed the Organ Procurement and Transplantation Network (OPTN) database from 2008 to 2024 to identify all full- or partial-face fVCA recipients, excluding patients under 18 years and those with physiologically impossible BMIs. Of 25 identified patients, 16 (64%) met inclusion criteria (69% male; mean age 43 ± 14 years). Recipients experienced a median of 5 [IQR 0.0–10] acute rejection episodes, which correlated with inotrope use during donor procurement (p = 0.033). On average, patients were hospitalized 2.4 ± 1.8 times, with arginine vasopressin (AVP) administration linked to fewer hospitalizations (p = 0.035). Seven recipients (44%) experienced complications, and extended-criteria donor (ECD) status was associated with higher complication rates (p = 0.049). These findings underscore the promise of fVCA to address complex facial defects while identifying key risk factors—particularly inotrope use and ECD status, while AVP administration may mitigate hospital stays. Further studies with larger cohorts are warranted to refine perioperative strategies, improve outcomes, and expand the clinical utility of fVCA.