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20 September 2025, Volume 23 Issue 5 Previous Issue   

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Expert Consensus

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Expert consensus on clinical nutrition management of chyle leakage in neck dissection of patients with oral and maxillofacial malignant tumors Huang Qiuyu, Wang Shuai, He Yue, Zheng Jiawei, Peng Xin, Liu Bing, Li Yi, Wang Anxun, Liu Xiqiang, Chen Chuanjun, Bi Xiaoqin, Yang Yue, Wu Hongmei, Ye Yanbin, Xiao Wei, Chen Yunmei, Zhao Fang, Li Yan'e, Zhou Tao, He Xingfang, Wang Cheng, Ye Jingjing, Wang Xiaoling, Chen Chaogang, Hou Jinsong 2025, 23 (5):  425-433.  doi: 10.19438/j.cjoms.2025.05.001 Abstract ( 43 )   PDF (1249KB) ( 67 )   The treatment of chyle leakage primarily relies on conservative approaches, with clinical nutrition management being a crucial component that significantly contributes to the rapid recovery of chyle leakage patients. Currently, the clinical nutrition management strategies for chyle leakage following neck dissection in patients with oral and maxillofacial malignant tumors vary across different medical institutions, and there is a lack of widely accepted and standardized management procedures. To standardize the clinical nutrition management of chyle leakage after neck dissection in patients with oral and maxillofacial malignant tumors, promote rapid recovery, and improve health outcomes, our team developed the expert consensus on clinical nutrition management of chyle leakage in neck dissection of patients with oral and maxillofacial malignant tumors. The consensus was developed based on the best available literature and the collective opinions of multidisciplinary experts from 21 medical colleges and affiliated hospitals in China. The consensus not only focused on clinical nutrition management, but also provided essential information on the etiology of chyle leakage. Additionally, it covered intraoperative prevention, diagnosis, monitoring of complications, conventional conservative treatment, and surgical treatment as necessary. References | Related Articles | Metrics

Original Articles

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Study on the regulation and mechanism of kaempferol-3-O-arabinoside on osteogenic differentiation of bone marrow mesenchymal stem cells Zhang Haoze, Ren Haining, Zhu Qinghai, Wang Chenxing, Ye Jinhai 2025, 23 (5):  434-441.  doi: 10.19438/j.cjoms.2025.05.002 Abstract ( 24 )   PDF (1749KB) ( 15 )   PURPOSE: To study the effect of kaempferol-3-O-arabinoside(KA) on osteogenic differentiation and epidermal growth factor receptor(EGFR), mitogen-activated protein kinase(MAPK) pathway by stimulating bone marrow mesenchymal stem cells (BMSCs). METHODS: BMSCs were isolated from the extraction sockets of impacted teeth in healthy young males, cultured until passage 3, and then treated with different concentrations of KA. CCK-8 assay was used to determine cell proliferation activity. Alkaline phosphatase (ALP) and alizarin red S (ARS) staining were employed to detect the changes in osteogenic capacity of BMSCs after KA treatment, and ImageJ software was used to analyze ALP activity. Real-time quantitative reverse transcription PCR (RT-qPCR) and Western blot were used to detect the changes in the gene and protein expressions of osteogenic differentiation-related genes including Runt-related transcription factor 2 (RUNX2), type I collagen (COL1), and osteopontin (OPN). Network pharmacology was adopted to analyze the main action targets and potential related signaling pathways of KA. BMSCs were treated with 5 μmol/L EGFR inhibitor gefitinib, 10 μmol/L MEK1/2 inhibitor U0126, and 10 μmol/L p38 inhibitor SB203580 to inhibit the main signaling molecules of the MAPK signaling pathway, and then RT-qPCR and Western blot were used to detect the changes in the osteogenic capacity of BMSCs. RESULTS: The results of CCK-8 showed that 80 and 160 μmol/L KA significantly affected the activity of BMSCs, and 10, 20 and 40 μmol/L KA were used for further experiments. The results of ALP and ARS staining indicated that 10 μmol/L KA had the best osteogenic induction effect. The results of RT-qPCR and Western blot showed that KA at 10 μmol/L had the best effect on the expression of mRNA and protein related to osteogenesis. The results of prediction analysis suggested that KA might promote osteogenic differentiation of BMSCs through EGFR- MAPK pathway. Western blot results showed that BMSCs activated MAPK signaling pathway after KA treatment, and the osteogenic promotion effect of BMSCs was decreased after treatment with MAPK signaling pathway-related inhibitors. CONCLUSIONS: Certain concentration of KA can stimulate and regulate BMSCs, activate EGFR-MAPK-RUNX2 signaling pathway and promote osteogenic differentiation. References | Related Articles | Metrics

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Comparative biomechanical analysis of stress distribution in cylindrical, conical implants for maxillary anterior teeth under different occlusal conditions Guo Wendi, Wang Xing 2025, 23 (5):  442-449.  doi: 10.19438/j.cjoms.2025.05.003 Abstract ( 18 )   PDF (1982KB) ( 22 )   PURPOSE: Through three-dimensional finite element analysis, this study explores the differences in stress distribution between cylindrical and conical implants used for restoring maxillary central incisors under three occlusion types (edge-to-edge, normal and deep overbite), aiming to provide a biomechanical basis for the selection of clinical treatment plans. METHODS: Three-dimensional maxillary models of the anterior region were constructed using CBCT data from healthy volunteers. Cylindrical and conical implant prototypes were designed in SolidWorks 2024. Finite element analysis (FEA) was performed in ANSYS Workbench 2020 R2 to simulate stress distribution patterns in implants, crowns, and surrounding bone tissues under the three occlusal conditions. RESULTS: Both implant types exhibited peak von Mises stresses concentrated at the abutment neck region, with cortical bone stress localized at the cervical area. Cylindrical implants demonstrated highest stress values under edge-to-edge occlusion (implant: 583.47 MPa, crown: 248.96 MPa, cortical bone: 697.42 MPa). Deep overbite caused significant crown stress elevation (341.25 MPa). Conical implants showed optimal stress distribution under normal occlusion (implant: 313.53 MPa, crown: 90.13 MPa, cortical bone: 154.47 MPa), though their cancellous bone stress stability was superior to cylindrical implants in deep overbite. Overall, conical implants demonstrated better stress distribution capability under normal occlusion, while cylindrical implants exhibited higher crown fracture risk in deep overbite scenarios. CONCLUSIONS: Implant geometry and occlusal type significantly influence biomechanical performance. The conical implant's root-analog design effectively reduces cervical bone interface stress under normal occlusion, making it preferable for aesthetic zone restorations. Cylindrical implants, despite their simpler structure, require cautious selection and occlusal adjustment in deep overbite cases. Clinical protocols should implement individualized implantation strategies based on occlusal classification to optimize long-term prognosis. References | Related Articles | Metrics

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Application of geostatics on the extraction of high-risk mandibular third molars : a prospective randomized controlled study on inferior alveolar nerve function Kuang Shijun, Liu Xiangqi, Wu Jiashun, Feng Ximei, Yang Xin 2025, 23 (5):  450-456.  doi: 10.19438/j.cjoms.2025.05.004 Abstract ( 23 )   PDF (1828KB) ( 25 )   PURPOSE: To evaluate the effect of geostatics on inferior alveolar nerve (IAN) function after extraction of high-risk mandibular third molars (M3Ms), and to provide a clinical reference for reducing IAN injury risk. METHODS: A prospective single-blind randomized controlled trial was conducted, including 270 high-risk M3Ms from 263 patients. The M3Ms were randomly divided into two groups (135 M3Ms each): the experimental group (extracted via geostatics) and the control group (extracted via traditional mechanical methods). One week after operation, the stitches were removed during the follow-up visit. The occurrence of IAN injury in both groups was recorded, and the differences between the groups and between genders were analyzed. RESULTS: There were no significant differences in age, gender, Pell-Gregory classification and Winter classification of M3Ms between the two groups (P>0.05). The incidence of IAN injury was 11.1% (15/135) in the control group and 3.0% (4/135) in the experimental group, with significant difference (P=0.009). Stratified analysis by gender showed that the incidence of IAN injury was 1.7% (2/121) in males and 11.4% (17/149) in females, with significant difference (P=0.002). CONCLUSIONS: Geostatics can effectively reduce the incidence of IAN injury after high-risk M3M extraction, providing a new technical approach for clinical IAN protection. More attention should be paid to IAN protection in female patients during high-risk M3M extraction. References | Related Articles | Metrics

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Relationship between masticatory electromyographic activity and disk displacement in patients with unilateral anterior temporomandibular joint displacement Zhu Yan, Li Minhan, He Jiaying, Wang Bian, Yang Chi, Ma Zhigui 2025, 23 (5):  457-462.  doi: 10.19438/j.cjoms.2025.05.005 Abstract ( 18 )   PDF (686KB) ( 12 )   PURPOSE: To investigate the changes in the electromyographic activity of the temporalis and occlusal muscles in patients with unilateral anterior displacement (UADD) of the temporomandibular joint (TMJ) compared with those with normal TMJ disc-condylar relationship. METHODS: A total of 136 patients who underwent TMJ magnetic resonance imaging and needle electromyography (nEMG) examinations at Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine from January 2021 to February 2024 were selected. Among them, there were 74 cases with normal bilateral TMJ disc-condylar relationship (control group), and 62 patients diagnosed with UADD by TMJ magnetic resonance imaging (UADD group). The indicators such as the amplitude and duration of motor unit potential (MUP) in the two groups of patients were compared, and the correlation analysis between UADD and abnormal electromyographic activity of the masticatory muscles was conducted. RESULTS: The occurrence of abnormal electromyographic activities of the masseter muscle and temporal muscle was both related to the anterior displacement of the temporomandibular joint disc(P<0.001), and the more severe the TMJ lesion grade was, the greater the possibility of disorder in the masseter muscle and temporal muscle. The amplitude and wave length of the masseter muscle on the affected side in the UADD group were significantly higher than those in the control group(P<0.05), and the trend of wave length extension was consistent with the abnormal amplitude, suggesting that the neurogenic activity of the masseter muscle on the affected side in the UADD group was abnormally enhanced. However, in the UADD group, the amplitude(P=0.096) and wave length(P=0.079) of the temporal muscle on the affected side did not significantly deviate from the control group, but the abnormal direction was consistent with that of the masseter muscle. CONCLUSIONS: There is a high correlation between unilateral anterior displacement of the temporomandibular joint and abnormal masticatory electromyographic activity. Clinically, for patients with masticatory muscle electromyographic disorders, attention should be paid to the possibility of potential risks of unilateral anterior displacement of the temporomandibular joint disc. References | Related Articles | Metrics

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Retrospective study of delayed tracheal extubation after oral and maxillofacial free flap transplantation surgery Yu Lianpin, Huang Shengyun, Liu Junjie, Zhang Weidong, Zheng Peihui, Hou Yali 2025, 23 (5):  463-468.  doi: 10.19438/j.cjoms.2025.05.006 Abstract ( 22 )   PDF (701KB) ( 20 )   PURPOSE: To evaluate the clinical efficacy of delayed tracheal extubation in oral and maxillofacial tumor resection with simultaneous vascularized free tissue flap transplantation and reconstruction. METHODS: Retrospective review was conducted on 257 patients treated by the same surgical team in Shandong Provincial Hospital between January 2019 and May 2024 for oral and maxillofacial tumor resection combined with vascularized free tissue flap transplantation. Clinical data of patients were collected, postoperative complications were analyzed, and the factors that might affect the postoperative catheter duration of patients were statistically analyzed by using R 4.3.3 software. RESULTS: All 257 patients underwent nasal tracheal intubation under general anesthesia. All postoperative patients with nasotracheal tube were transferred to the intensive care unit(ICU) instead of prophylactic tracheotomy. The nasotracheal tube was delay extubated when the risk of airway obstruction was relieved. A total of 251 patients (97.67%) delayed extubation successfully in the first stage,with an average intubation time was 5.11 days. There were 49 patients (19.07%) who had postoperative complications, including 5 flap vascular crisis, 5 hemorrhage (1.95%), 24 pulmonary inflammation (9.34%), 3 secondary tracheal intubation (1.17%), 2 delayed tracheotomy(0.78%), 1 automatic discharge (0.39%), 9 postoperative delirium (3.50%), 7 postoperative maxillofacial infection (2.72%). The period of postoperative extubation was significantly affected by the difference between benign and malignant lesions, as well as the difference in tumor anatomic locations. CONCLUSIONS: Delayed extubation is a safe and effective airway management strategy for patients who have undergone oral and maxillofacial tumor resection combined with vascularized free tissue flap transplantation, which provides an alternative option for patients who cannot accept postoperative prophylactic tracheotomy. References | Related Articles | Metrics

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Influencing factors of cervical lymph node metastasis after radical surgery for oral squamous cell carcinoma in stages T1 and T2 and construction of a prediction model Zhang Wangru, Chen Yuanyuan, Li Zhiping, Meng Jian, Peng Sen 2025, 23 (5):  469-475.  doi: 10.19438/j.cjoms.2025.05.007 Abstract ( 15 )   PDF (1001KB) ( 25 )   PURPOSE: To investigate the influencing factors for cervical lymph node metastasis in stage T1 and T2 oral squamous cell carcinoma(OSCC) after radical surgery and to construct nomogram prediction models. METHODS: This retrospective cohort study collected clinical data from 134 patients diagnosed with stage T1-T2 OSCC at Xuzhou Central Hospital. The data included patients' general information, cervical lymph node metastasis, tissue differentiation degree, tumor budding, depth of invasion, lymphovascular invasion, peripheral nerve invasion, squamous cell carcinoma antigen (SCC-Ag) levels, et al. Logistic regression analysis was employed to identify independent factors influencing cervical lymph node metastasis, leading to the construction of a nomogram to visualize the prediction model. The study also involved drawing receiver operating characteristic curves, calibration curves, and clinical decision curves to evaluate the discrimination, calibration, and clinical validity of the prediction model. RESULTS: T stage, degree of tissue differentiation, depth of invasion and lymphovascular invasion were independent factors influencing cervical lymph node metastasis in early OSCC. The area under the curve(AUC) for the nomogram prediction model was 0.875, with a sensitivity of 87.80% and a specificity of 72.04%, demonstrating good discrimination and calibration. The clinical decision curve analysis revealed that this nomogram offered a significant net benefit in predicting the risk of cervical lymph node metastasis in early-stage OSCC, affirming its clinical validity. CONCLUSIONS: T stage, degree of tissue differentiation, depth of invasion, and lymphovascular invasion were independent risk factors for cervical lymph node metastasis in patients with T1-T2 stage oral squamous cell carcinoma. The established nomogram prediction model demonstrated strong detection performance and could be effectively utilized for patients with clinically early-stage OSCC. These precise treatment plans offered valuable reference points. References | Related Articles | Metrics

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Descending branch of hypoglossal nerve-facial nerve transfer: a novel effective technique for facial nerve defects after parotid gland tumor resection Ye Qicheng, Lu Hao, Xu Wanlin, Liu Shengwen, Yang Wenjun, Zhang Chenping 2025, 23 (5):  476-482.  doi: 10.19438/j.cjoms.2025.05.008 Abstract ( 17 )   PDF (2464KB) ( 14 )   PURPOSE: To investigate the clinical outcome of descending branch of hypoglossal nerve-facial nerve transfer for facial nerve defects after parotid gland tumor resection. METHODS: Two patients with facial nerve defects after parotid tumor resection underwent descending branch of hypoglossal nerve-facial nerve transfer. The House-Brackmann (H-B) scale, Terzis scale and Symmetry scale of oral commissure were used to assess the facial nerve function. RESULTS: The descending branch of hypoglossal nerve-facial nerve transfer was performed in two patients, for the facial nerve defects after parotid tumor resection. The descending branches of hypoglossal nerve were directly transfered to the zygomatic branch and buccal branches in one patient, while the inferior buccal branch and marginal branch for the other. Follow-up results revealed that two patients had good recovery of facial nerve functions, with no symptoms of tongue movement deviation or muscle atrophy. And the patients' speech and swallowing functions were quite normal. CONCLUSIONS: Descending branch of hypoglossal nerve-facial nerve transfer is an effective technique, which can be performed simply and easily. This technique provides a novel clinical strategy for functional reconstruction of complex facial nerve defects after parotid tumor surgery. References | Related Articles | Metrics

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Construction and effect evaluation of postoperative pain prediction model for children undergoing head and facial day surgery Shen Xiaomin, Yang Mei, Li Jingjie, Zheng Yongchao, Wang Xu 2025, 23 (5):  483-490.  doi: 10.19438/j.cjoms.2025.05.009 Abstract ( 23 )   PDF (1459KB) ( 13 )   PURPOSE: To develop and validate a machine learning-based prediction model for postoperative pain in pediatric patients undergoing head and facial day surgery. METHODS: A total of 893 children who underwent head and facial day surgery under general anesthesia were retrospectively included, the patients were categorized into pain (FLACC score ≥4) or non-pain (FLACC score <4) group based on assessments in the postanesthesia care unit (PACU). Variables were selected via the least absolute shrinkage and selection operator (LASSO) regression with fivefold cross-validation. Six machine learning algorithms—including logistic regression (LR), K-nearest neighbor(KNN), support vector machine (SVM), decision tree (DT), bidirectional recurrent neural network (BRNN), and artificial neural network (ANN)—were trained on a 7∶3 split dataset. Model performance was evaluated using the area under the receiver operating characteristic curve (AUROC). RESULTS: The incidence of postoperative pain was 23.63%. Key predictors included preoperative m-YPAS scores, parental SAI scores, surgical history, procedure type, age, gender and induction with sufentanil/ketamine. Four out of 6 different machine learning algorithms (LR, SVM, BRNN, and ANN) were able to maintain good performance in the test set (AUROC>0.70). Among the models, logistic regression achieved the highest AUROC (0.78, 95%CI: 0.72-0.84) in the test set. CONCLUSIONS: The prediction model based on machine learning in this study can effectively predict postoperative pain in pediatric patients undergoing head and facial day surgery. References | Related Articles | Metrics

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Construction of the postoperative follow-up checklist based on the patient experience of oral cancer Chen Yue, Wang Huanhuan, Li Ping, Mao Yan 2025, 23 (5):  491-496.  doi: 10.19438/j.cjoms.2025.05.010 Abstract ( 14 )   PDF (772KB) ( 13 )   PURPOSE: To construct and evaluate an outpatient follow-up list based on patients' experiences for oral cancer patients using the Delphi method. METHODS: The initial draft of the follow-up list was formed through literature analysis and semi-structured interviews. The follow-up list was established through two rounds of Delphi consultation with 16 oral and maxillofacial head and neck tumor experts. The expert opinions were statistically analyzed and summarized to establish the final follow-up list. RESULTS: The positive coefficient of the experts in the two rounds of inquiries was 100%, the authority coefficient was 0.94, and the Kendall coordination coefficient ranged from 0.123 to 0.314(P<0.05), indicating that the experts' opinions were concentrated and coordinated. The final list included 4 first-level indicators (disease symptom management, rehabilitation training, adjuvant therapy, and functional status), 16 second-level indicators, and 51 third-level indicators, covering multiple dimensions such as airway care, swallowing function training, psychological support, and social adaptation. CONCLUSIONS: The follow-up list based on patients' experiences is scientific, practical, and comprehensive, providing a standardized framework for outpatient follow-up of oral cancer patients. References | Related Articles | Metrics

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Application of colorimetric card combined with photography technology in postoperative monitoring of flap transplantation He Ran, Sun Yuanyuan, Gao Xiaoyue, Yang Yuelai, Zhu Yonggan 2025, 23 (5):  497-501.  doi: 10.19438/j.cjoms.2025.05.011 Abstract ( 23 )   PDF (818KB) ( 11 )   PURPOSE: To explore the application effect of colorimetric card combined with photography technology in postoperative monitoring of flap transplantation. METHODS: A prospective controlled study was conducted, enrolling 160 patients undergoing flap transplantation in the Department of Oromaxillofacial Head and Neck Oncology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine from January to December 2024. The patients were divided into the experimental group and the control group (80 cases in each group) using a random number table. The control group adopted traditional naked-eye observation to monitor flap blood supply, while the experimental group supplemented with a flap color observation colorimetric card assembly combined with photography technology to assess flap color and blood circulation status on the basis of traditional observation. The inter-observer consistency between doctors and nurses, incidence of flap crisis, timely detection rate of crisis, flap survival rate, and medical staff recognition were compared between the two groups. RESULTS: The inter-professional observational consistency of the experimental group (97.5%, 78/80) was significantly higher than that of the control group (76.3%, 61/80) (P<0.001). When comparing the incidence of flap crisis and flap survival rate between the two groups, there was no significant difference (P>0.05); however, the timely detection rate of flap crisis in the experimental group (84.6%, 11/13) was significantly higher than that in the control group (23.5%, 4/17, P<0.001). The evaluation of inter-professional recognition showed that the accuracy of nurses' reports and the collaboration of the medical team in the experimental group were significantly better than those in the control group (P<0.05), while there was no significant difference in the dependence on clinical decision-making between the two groups (P>0.05). CONCLUSIONS: The colorimetric card combined with photography technology is easy to operate, which can significantly improve the timely detection rate of flap crisis and inter-observer consistency between doctors and nurses, and promote doctor-nurse team collaboration, thus having high clinical promotion value. References | Related Articles | Metrics

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Evaluation of the effect of toripalimab and neoadjuvant chemotherapy in treating locally advanced resectable oral squamous cell carcinoma Chen Wenjian, Zhang Gong, Ji Yenan, Song Lei 2025, 23 (5):  502-507.  doi: 10.19438/j.cjoms.2025.05.012 Abstract ( 15 )   PDF (716KB) ( 14 )   PURPOSE: To evaluate the effectiveness of combining toripalimab with neoadjuvant chemotherapy for treating locally advanced resectable oral squamous cell carcinoma (OSCC). METHODS: A total of 98 patients with OSCC who received treatment in Qingdao Central Hospital, Rehabilitation University from January 2020 to January 2022 were randomly divided into experimental group and control group, with 49 cases in each group. The control group was treated with neoadjuvant chemotherapy consisting of albumin-bound paclitaxel and cisplatin, while the experimental group additionally received toripalimab on the basis of the control treatment. After 3 weeks of treatment, radical surgery was performed. The clinical efficacy at 6 months post-surgery, as well as immune function inflammatory cytokine levels, tumor markers, and quality of life before and after treatment were compared between the two groups using the Oral Health Impact Profile (OHIP) and University of Washington Quality of Life (UW-QOL) scales. A 2-year follow-up was conducted to record overall survival (OS) and survival rates. RESULTS: The experimental group showed improved clinical efficacy and immune function compared to the control group, with significantly lower inflammatory cytokine levels and tumor markers. Additionally, the experimental group exhibited a higher quality of life post-treatment (P<0.05). Follow-up results demonstrated that the experimental group had higher average OS and survival rates compared to the control group(P<0.05). CONCLUSIONS: Toripalimab in combination with neoadjuvant chemotherapy shows effectiveness in treating locally advanced resectable oral squamous cell carcinoma, enhancing clinical outcomes and survival rates. References | Related Articles | Metrics

Evidence--Based Medicine

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Evidence-based evaluation of the efficacy of tranexamic acid in reducing perioperative blood loss in orthognathic surgery patients Liu Yang, Li Chenxi, Gong Zhongcheng, Ding Mingchao, Sun Jialin 2025, 23 (5):  508-516.  doi: 10.19438/j.cjoms.2025.05.013 Abstract ( 21 )   PDF (1794KB) ( 16 )   PURPOSE: Based on meta-regression and trial sequential analysis, this study aimed to comprehensively evaluate the clinical efficacy with respect to tranexamic acid(TXA) for blood loss control in perioperative patients underwent orthognathic surgery. METHODS: Embase, PubMed, WanFang Data, VIP, China National Knowledge Infrastructure(CNKI), Chinese Clinical Trial Registry(ChiCTR) and Cochrane Central Register of Controlled Trials (CENTRAL) were electronically retrieved to collect clinical studies related to appraise the effectiveness in perioperative orthognathic surgery patients intravenously used TXA from inception to August, 2024. Quality assessment of the risk of bias for randomized controlled trials (RCTs) was performed using Cochrane Collaboration's Risk of Bias Tool (2.0), whereas the Newcastle-Ottawa Scale was used for assessment of the prospective cohort studies. Based on the results of methodological heterogeneity, corresponding meta-analyses were carried out with a random-effects or fixed-effects model applying R programming software. A trial sequential analysis of outcomes was carried out to investigate the reliability and conclusiveness of findings. RESULTS: The paired meta-analysis random-effects model (I2=81%) showed that compared with the control group, the use of TXA significantly reduced the amount of bleeding in perioperative patients [standardized mean difference(SMD) = -1.26; 95%CI (-1.81, -0.71), P<0.01]. Subgroup analysis revealed that TXA had a significant effect on reducing intraoperative bleeding in patients with different surgeries, with monomaxillary orthognathic surgery ranking as the most effective [SMD = -1.58; 95%CI (-2.41, -0.76), P<0.01], followed by bimaxillary orthognathic surgery [SMD = -0.97; 95%CI(-1.69, -0.25), P<0.01]. The result of meta regression showed there was no significant difference in the hemostatic effect of TXA on patients with increasing doses(5, 10, 15, 20 mg/kg) (P>0.05). Sensitivity analysis verified that the pooled values were stable and reliable. Egger's test indicated a certain degree of publication bias(Z=-3.10, P= 0.002). Low risk-of-bias trials showed benefit of tranexamic acid use with a sufficiently powered sample, through trial sequential analysis. CONCLUSIONS: Taken as a whole, existing evidence suggests that TXA can effectively reduce perioperative bleeding in patients undergoing orthognathic surgery, regardless of its dosage administered. However, further clinical researches are still needed to provide more baseline data, transfusion-related indicators, and information on adverse events such as vascular embolism, in order to comprehensively evaluate and analyze the efficacy and safety of a single dose of intravenous TXA for perioperative blood loss control in patients treated with orthognathic surgery. References | Related Articles | Metrics

Review Articles

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Advances in the application of lightweight deep learning models in diagnosis and treatment of dental diseases Gao Anqi, Huang Xinrui, Zhang Xiaofan, Zhang Shaoting, Hong Yi, Chen Lei, Wang Xudong 2025, 23 (5):  517-522.  doi: 10.19438/j.cjoms.2025.05.014 Abstract ( 25 )   PDF (718KB) ( 10 )   The lightweighting of medical deep learning models through adaptive compression techniques significantly reduces computational complexity while maintaining diagnostic accuracy, enabling deployment on edge devices and promoting the implementation of AI in clinical scenarios such as emergency care, surgical guidance, and portable monitoring. In the field of dental care, research on lightweight models has employed architectures such as MobileNet and YOLO, along with techniques like convolutional optimization and knowledge distillation, to accomplish imaging-based segmentation of anatomical structures such as teeth and jaws, and the diagnosis of diseases including caries and oral cancer. Some of these models have been integrated into edge devices such as smart toothbrushes and mobile applications. This paper reviewed the application progress of lightweight models in diagnosis and treatment of dental disease, aiming to provide references for further development and clinical transformation of related technologies. References | Related Articles | Metrics

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Current status of clinical research on cervical lymphatic surgery for Alzheimer's disease Chen Youjun, Li Xia, Wang Yan'an, Zhang Zhiyuan, Ren Zhenhu 2025, 23 (5):  523-526.  doi: 10.19438/j.cjoms.2025.05.015 Abstract ( 23 )   PDF (502KB) ( 23 )   Cervical lymphatic surgery, as an emerging therapeutic strategy, aims to alleviate the pathological progression of Alzheimer's disease (AD) by improving brain lymphatic drainage. Studies suggest that the cervical lymphatic system is closely associated with the clearance of brain waste products, and its dysfunction may lead to AD-related protein deposition and neurodegenerative pathologies. Currently, surgical techniques such as lymphovenous anastomosis have been attempted to restore lymphatic drainage. However, related clinical research remains in its preliminary investigation stages, with evidence primarily based on small-sample case reports and short-term observational outcomes. Although initial data indicate symptom improvement in some patients, there is a lack of large-scale randomized controlled trials and long-term efficacy validation, and the underlying mechanisms remain incompletely explained. Existing evidence is insufficient to support the widespread clinical application of this therapy, requiring further high-quality research to clarify its safety and efficacy. References | Related Articles | Metrics

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Advances in the study of retrograde peri-implantitis Chen Yan, Sun Jiahui, Yan Qi, Chen Jiaxian, Wang Li 2025, 23 (5):  527-531.  doi: 10.19438/j.cjoms.2025.05.016 Abstract ( 13 )   PDF (589KB) ( 10 )   Complications of implant restorations include surgical, mechanical and biological complications, of which peri-implantitis is the most common biological complication. Retrograde peri-implantitis is an inflammatory lesion in the apical region of the implant, which often leads to early failure of implant restorations. Its etiology is multiple and complex, and preoperative evaluation and intraoperative operational factors are crucial to take effective measures to control the development of the lesion and to improve the survival rate of implant retention. This article summarised the current status of research on the definition, prevalence, etiology, clinical manifestations and classification, treatment options and prognosis of retrograde peri-implantitis, with a view to providing a reasonable basis for clinical decision-making in the treatment of retrograde peri-implantitis. References | Related Articles | Metrics

Case Reports

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A case report of the greater horn hyoid syndrome and literature review Fang Chang, Li Chenxi, Parekejiang· Pataer, Gong Zhongcheng 2025, 23 (5):  532-536.  doi: 10.19438/j.cjoms.2025.05.017 Abstract ( 18 )   PDF (1365KB) ( 12 )   Hyoid bone syndrome is a type of faciocervical pain and occasionally concomitant clicking larynx that is caused by structural aberration of the greater horn of the hyoid bone at the attachment of the stylohyoid ligament. This paper presented a patient with hyoid bone syndrome that complained an intermittent ulcer hemorrhage in the tongue base. The clinical features and primary surgical treatment were described, and literatures covering its anatomical and physiological characteristics and management were reviewed thereof. References | Related Articles | Metrics