Dr. D.Y. Patil Vidyapeeth, Pune

Maxillofacial reconstruction requires precise restoration of bone volume and anatomical alignment. Traditional bone grafting methods have limitations, such as donor site morbidity, limited availability, and suboptimal anatomical congruence. Three-dimensional (3D) printed bone substitutes offer patient-specific solutions that may overcome these challenges. To systematically evaluate and quantify the clinical efficacy of 3D-printed bone substitutes compared with traditional grafting techniques in maxillofacial reconstruction, focusing on outcomes including bone regeneration, surgical precision (distance and angular deviation), and operative duration. A comprehensive search of PubMed, Scopus, and Cochrane Library was conducted up to March 2025. Randomized controlled trials and cohort studies comparing 3D-printed bone substitutes with traditional methods in maxillofacial or craniofacial surgery were included. Meta-analyses were performed using Comprehensive Meta-Analysis software v3.7, applying fixed- or random-effects models based on heterogeneity (I2 threshold of 25%). In total, 12 studies (three RCTs and nine cohort studies) were included in the meta-analysis. 3D-printed bone substitutes demonstrated significantly superior outcomes in key surgical metrics compared with traditional methods. Bone regeneration volume was markedly higher in the 3D group, with a standardized mean difference (SMD) of 0.737 (95% CI: 0.640-0.834; p<0.0001), indicating a moderate-to-large effect size. Operative efficiency also improved, with a mean reduction in surgical duration of -12.32min (95% CI: -14.08 to -10.56; p<0.0001). However, greater positional deviation was observed with 3D-printed plates, including distance deviation (MD=1.328; 95% CI: 1.08-1.57; p<0.0001) and angular deviation (MD=1.643°; 95% CI: 1.11-2.18; p<0.0001). 3D-printed bone substitutes significantly improve bone regeneration and reduce operative time in maxillofacial surgery. However, greater positional and angular deviations suggest the need for enhanced surgical navigation. These findings support the integration of 3D-printing in clinical practice, with emphasis on precision improvement in future applications.

Objective To assess the diagnostic accuracy and reliability of orthopantomogram (OPG) compared to cone beam computed tomography (CBCT) in evaluating the mandibular buccal shelf anatomy, with specific emphasis on the proximity to the inferior alveolar nerve canal (IANC), across various skeletal malocclusions and vertical growth patterns. Methods A cross-sectional study with a retrospective design was conducted using OPG and CBCT images of 90 patients obtained prior to treatment, stratified based on skeletal malocclusion into Class I, II, and III groups ( n = 30 each), and further subdivided based on facial divergence (hypodivergent, normodivergent, hyperdivergent). Linear measurements extending from the cementoenamel junction (CEJ) to the superior margin of the IANC were obtained at eight predefined anatomical landmarks. Independent t -test and one-way analysis of variance were used for data analysis, considering P &lt; .05 as statistically significant. Results OPG and CBCT measurements showed no statistically significant differences across all malocclusion and growth patterns ( P &gt; .05). A consistent decrease in CEJ to IANC distance from the mesial CEJ of the first molar to the distal CEJ of the second molar was observed, most pronounced in hyperdivergent individuals. Class III hypodivergent subjects exhibited the greatest bone height (21.19 ± 1.28 mm), whereas Class II hyperdivergent individuals showed the lowest bone height (15.68 ± 1.72 mm), indicating a closer proximity of the IANC. Conclusion OPG is a reliable alternative to CBCT for buccal shelf assessment, offering reduced radiation exposure and cost. Anatomical variations across skeletal and vertical growth patterns significantly impact screw placement safety, emphasizing the need for individualized site selection based on malocclusion and divergence patterns.

ABSTRACTAimTo examine whether the oral microbiota of e‐cigarette users differs from that of never smokers and current smokers.Materials and MethodsPubMed, Scopus and Web of Science were searched on 27 August 2025. Human studies using molecular methods to compare oral microbiota in saliva, subgingival plaque and oral mucosal swabs among e‐cigarette users, never smokers and current smokers were included. Primary outcomes were alpha diversity, beta diversity and differential taxonomic abundance. Risk of bias was assessed using JBI tools and certainty of evidence using GRADE.ResultsTwelve studies were included; most were cross‐sectional and heterogeneous in design, exposure and samples. Alpha diversity findings were inconsistent across samples, whereas beta diversity more consistently indicated distinct microbial communities in e‐cigarette users compared with never smokers and current smokers. Taxonomic differences were heterogeneous and sample‐dependent, with some enrichment of genera such as Veillonella, Leptotrichia, and Fusobacterium compared with never smokers.ConclusionsElectronic cigarette use is associated with sample‐specific oral microbiota differences that partly overlap with, but differ from, those observed in never smokers and current smokers. However, the certainty of evidence is very low due to predominantly cross‐sectional designs and methodological limitations, underscoring the need for longitudinal studies with standardised exposure and protocols.