Seoung-Won Cho

Background/Objectives: Occlusal splints are widely used for temporomandibular disorders (TMDs), but direct evidence comparing ready-made soft splints with customized hard stabilization splints remains limited. This exploratory randomized study compared the short-term clinical outcomes of a ready-made soft splint and a digitally fabricated, customized 3D-printed hard stabilization splint, representing two distinct fabrication and delivery workflows. Methods: Seventy adults with TMDs were randomized 1:1 to a customized hard splint fabricated using intraoral scanning and digital light processing 3D printing or to a ready-made soft splint (n = 35 per group); 68 completed follow-up. Modified Helkimo index scores were assessed at baseline (T0), 4 weeks (T1), and 12 weeks (T2). Results: Scores decreased significantly from baseline in both groups at T1 and T2 (all p < 0.001). No statistically significant between-group difference was detected in change from baseline to T1 (Hodges–Lehmann median difference, hard minus soft = 0.00; 95% CI, −1.00 to 1.00; p = 0.573) or T2 (−1.00; 95% CI, −2.00 to 0.00; p = 0.209). Conclusions: No statistically significant difference in short-term clinical improvement was detected between the two splint groups. This finding should not be interpreted as evidence of equivalence or non-inferiority. Ready-made soft splints may have a limited, hypothesis-generating role as a short-term conservative or bridging option for selected patients, but adequately powered, prospectively registered non-inferiority trials are needed to define their clinical role. Trial Registration: CRIS KCT0012318 (retrospectively registered).

This randomized controlled clinical trial compared a conventional combined screw- and cement-retained prosthesis (CSCRP) workflow (control group) with a fully digital cementless screw-retained prosthesis (CL-SRP) system (test group) for single posterior implant restorations. A total of 40 implants in 35 patients were allocated to either workflow. Clinical procedure times, prosthetic accuracy, peri-implant soft tissue changes, and marginal bone loss (MBL) were assessed. The test group demonstrated significantly shorter total prosthetic time (p < 0.001) and impression-taking time (p < 0.001) compared with the control group. Prosthetic adjustment time (p = 0.211) and adjustment volume (p = 0.474) did not differ significantly. Gingival shape changes were likewise not statistically significant (p = 0.966). MBL was significantly lower in the test group (p < 0.05). From a prosthetic standpoint, both workflows yielded clinically acceptable outcomes; however, the digital CL-SRP approach improved procedural efficiency and early peri-implant bone preservation without compromising prosthetic quality. This trial had inherent limitations, including a short follow-up duration, a relatively small sample size, combined test conditions, and restriction to single posterior implants. Therefore, further long-term studies are warranted to confirm durability and broader clinical applicability.

Objectives: This review aimed to evaluate the role of ChatGPT in original research articles within the field of oral and maxillofacial surgery (OMS), focusing on its applications, limitations, and future directions. Methods: A literature search was conducted in PubMed using predefined search terms and Boolean operators to identify original research articles utilizing ChatGPT published up to October 2024. The selection process involved screening studies based on their relevance to OMS and ChatGPT applications, with 26 articles meeting the final inclusion criteria. Results: ChatGPT has been applied in various OMS-related domains, including clinical decision support in real and virtual scenarios, patient and practitioner education, scientific writing and referencing, and its ability to answer licensing exam questions. As a clinical decision support tool, ChatGPT demonstrated moderate accuracy (approximately 70–80%). It showed moderate to high accuracy (up to 90%) in providing patient guidance and information. However, its reliability remains inconsistent across different applications, necessitating further evaluation. Conclusions: While ChatGPT presents potential benefits in OMS, particularly in supporting clinical decisions and improving access to medical information, it should not be regarded as a substitute for clinicians and must be used as an adjunct tool. Further validation studies and technological refinements are required to enhance its reliability and effectiveness in clinical and research settings.

During extraction surgery, the inferior alveolar nerve (IAN) can occasionally be observed in the extraction socket of the mandibular third molar (M3). The purpose of this study was to investigate and compare the incidence of IAN injury in groups with and without intraoperative IAN exposure during surgical extraction of M3, and to identify additional risk factors for the IAN injury in addition to the IAN exposure. A total of 288 cases in 240 patients, who underwent surgical extraction of M3 by a single surgeon, were divided into the exposed group (n = 69) and the unexposed group (n = 219). The surgeon recorded the information regarding the procedure when the clinical observation of IAN exposure was made during the surgery. The incidence of IAN injury after the extraction surgery was significantly higher in the exposed group than in the unexposed group (4.3% versus 0%, p < 0.05). Paresthesia was recognized in three cases of the exposed group, but it showed complete recovery within three postoperative months. No case of permanent paresthesia was detected in both groups. According to the logistic regression, the only significant risk factor of IAN injury in the exposed group was the increase of age (OR 1.108, p < 0.05). Intraoperative IAN exposure during surgical extraction of M3 may show a higher incidence of IAN injury than the case without IAN exposure, representing an incidence of 4.3%. Even if the paresthesia associated with IAN exposure occurs, it is likely to be a temporary injury, and this risk may increase with age.

Medication-related osteonecrosis of the jaw (MRONJ) is one of the most interesting diseases in the field of maxillofacial surgery. In addition to bisphosphonates, the use of antiresorptive and antiangiogenic agents is known to be the leading cause. However, the exact pathogenesis of MRONJ has not been established, and various hypotheses have been proposed, such as oxidative stress-related theory. As a result, a definitive treatment protocol for MRONJ has not been identified, while various therapeutic approaches are applied to manage patients with MRONJ. Although the surgical approach to treat osteomyelitis of the jaw has been proven to be most effective, there are limitations, such as recurrence and delayed healing. Many studies and clinical trials are being conducted to develop another effective therapeutic modality. The use of some materials, including platelet concentrates and bone morphogenetic proteins, showed a positive effect on MRONJ. Among them, teriparatide is currently the most promising material, and it has shown encouraging results when applied to patients with MRONJ. Furthermore, cell therapy using mesenchymal stem cells showed promising results, and it can be the new therapeutic approach for the treatment of MRONJ. This review presents various treatment methods for MRONJ and their limitations while investigating newly developed and researched molecular and cellular therapeutic approaches along with a literature review.

Objective: Orthognathic surgery (OGS) is a surgical intervention that corrects dentofacial deformities through the movement of maxillary and mandibular segments to achieve adequate masticatory function, joint health, and facial harmony. However, some patients present with occlusal discrepancies, condylar sag, and/or temporomandibular disorders after OGS. Various methods have been employed to solve these problems after surgery. This study aimed to evaluate the effectiveness of early screw removal in patients with occlusal discrepancies after OGS using three-dimensional cone-beam computed tomography (CBCT). Methods: In 44 patients with dentofacial deformities, patient-customized OGSs with customized plates were performed to correct facial deformities using customized guides with computer-aided surgical simulation. Of the 44 patients, eight patients complained of occlusal discrepancies and temporomandibular disorders after OGS. These eight patients underwent screw removal under local anesthesia around four weeks. The temporomandibular joint spaces at three time points (pre-surgical, post-surgical, and after screw removal) in the sagittal and coronal planes were compared using CBCT. Results: Eight patients showed an increase in joint space on CBCT images immediately after surgery (T1), but after early screw removal (T2), these spaces almost returned to their pre-surgical state, and the temporomandibular joint problem disappeared. Conclusions: The removal of screws located in the distal segment under local anesthesia between three and four weeks post-surgically may be a treatment option for patients with post-OGS occlusal discrepancies, condylar sag, and/or temporomandibular disorder.

Objective: Digital twins of adult Korean females were created as a tool to evaluate and compare the sagittal relationship between the maxillary central incisors and the forehead before and after orthodontic treatment. Methods: Digital twins were reconstructed for a total of 50 adult female patients using facial scans and cone-beam computed tomography (CBCT) images. The anteroposterior position of the maxillary central incisor and the forehead inclination were measured. Results: The control group presented a mean of 6.7 mm for the sagittal position and 17.5° for forehead inclination. The study group showed a mean of 9.3 mm for the sagittal position and 13.6° for forehead inclination. Most Korean females seeking orthodontic treatment had their maxillary central incisor anterior to the glabella. In contrast, fewer Korean females who completed their orthodontic treatments had their maxillary central incisor anterior to the glabella. Furthermore, patients who had completed the orthodontic treatment were more likely to have the maxillary central incisor between the forehead facial axis and glabella. Conclusion: The use of digital twins for three-dimensional (3D) analysis of the profile implies a high clinical significance. In addition, as the facial profile of Koreans is different from that of Caucasians, careful consideration should be made when setting treatment goals for the anteroposterior position of the maxillary central incisors.

The purpose of this study was to devise a classification and lateral window design method based on implants and to evaluate whether these classifications and methods are applicable to clinical practice. When applying the maxillary sinus elevation technique using the lateral window, possible situations were classified into four: (A) two or more sites for implants are required for maxillary sinus augmentation, (B) a single implant is required when there are no adjacent teeth, (C) a single implant is required when one adjacent tooth is present at the mesial or distal area, and (D) a single implant is required when both mesial and distal adjacent teeth are present. In order to verify whether this classification can be used in all situations, 76 patients who underwent maxillary sinus elevation with a lateral window were selected and investigated. Of them, 47 (62%) were included in Group A, 9 (12%) in Group B, 8 (11%) in Group C, and 12 (15%) in Group D. Lateral window designing in the lateral approach of sinus augmentation can be classified into four clinical situations. There were no unclassified cases. This classification and window positioning method can be applied to most cases.

Clinical application of osteofixation materials is essential in performing maxillofacial surgeries requiring rigid fixation of bone such as trauma surgery, orthognathic surgery, and skeletal reconstruction. In addition to the use of titanium plates and screws, clinical applications and attempts using bioabsorbable materials for osteofixation surgery are increasing with demands to avoid secondary surgery for the removal of plates and screws. Synthetic polymeric plates and screws were developed, reaching satisfactory physical properties comparable to those made with titanium. Although these polymeric materials are actively used in clinical practice, there remain some limitations to be improved. Due to questionable physical strength and cumbersome molding procedures, interests in resorbable metal materials for osteofixation emerged. Magnesium (Mg) gained attention again in the last decade as a new metallic alternative, and numerous animal studies to evaluate the possibility of clinical application of Mg-based materials are being conducted. Thanks to these researches and studies, vascular application of Mg-based biomaterials was successful; however, further studies are required for the clinical application of Mg-based biomaterials for osteofixation, especially in the facial skeleton. The review provides an overview of bioabsorbable osteofixation materials in maxillofacial bone surgery from polymer to Mg.

Facemasks using tooth-borne anchorages have been used primarily for the treatment of Class III malocclusion with maxillary undergrowth. However, when using a tooth as an anchorage, if the stability of the tooth used as an anchor is weak, the anchoring function may fail as the tooth tilts. Meanwhile, the use of skeletal anchorages such as implants, mini-implants, and mini-plates has been claimed to minimize the side effects of using dental anchorage. This case report describes the treatment of a six-year-old male patient with Class III malocclusion, presenting maxillary undergrowth and mandibular prognathism. Due to the mobility of the anchoring primary teeth, a device using dental anchorage was replaced with that using customized skeletal anchorage for the treatment. Customized guides and miniplates for the surgery were fabricated in advance through a computer-assisted system, in order to avoid possible damage to the adjacent tooth buds. The customized plates were accurately and passively placed on the intended part, showing the desired outcome.