The diagnosis of osteomas in the paediatric population can pose a challenge to pathologists in excluding malignant bony tumours. We present the case of a 10-year old male presenting with a large left mandibular radiopaque lesion. This paper discusses the case of a central osteoma with osteoblastoma-like features, literature review, differential diagnosis of radiopaque lesions of the maxilla and mandible as well as a detailed discussion of the pathology of the lesion. Although similar lesions have been described in the sino-orbital region, this is believed to be the first report of this pathological entity in the mandible.

Paediatric orbital fractures require careful reconstruction to prevent long-term functional and aesthetic sequelae. Material selection is critical due to the anatomical and developmental considerations unique to children. Comparative data to guide decision making remain sparse and inconclusive. A systematic search was conducted in PubMed, Scopus, Web of Science, and Embase (through February 2025), following Preferred Reporting Items for Systematic Review and Meta-analyses (PRISMA) guidelines. Studies reporting outcomes and/or complications associated with implant materials used in the reconstruction of paediatric orbital fractures were included. Outcomes included postoperative diplopia, enophthalmos, restriction of eye movements, removal of material, and return to theatre (RTT). In total, 54 studies encompassing a total of 562 patients and 563 implants were included. Polymers (n = 169), alloplasts (n = 167) and autologous (n = 166) implants were the most commonly used reconstructive material. Late postoperative diplopia occurred in 7% of polymers (12/169), 6% of alloplasts (10/167), 29% of allografts (6/21), 24% of xenografts (6/25) and 33% of metals (2/6). Reported enophthalmos was highest in the autologous group (8%) but was only reported in 34 of the 54 studies. Infection, removal of implant material and RTT were low across all groups (1–4%). No donor site morbidity was reported. Robust studies with standardised outcomes and adequate follow-up are needed to inform evidence-based material selection in paediatric orbital reconstruction.

The evolution of TMJ-replacements has been driven by advancements in personalization, materials and digital planning technologies. However, there is little data on how surgeons perceive the prosthetic systems and their limitations in practice. The perspective from surgeons is critical to identifying the gap between current technology and clinical need. Using an international, structured survey based on a modified Delphi methodology, including expert validation, pilot testing and global distribution through professional networks, the status of the TMJ-replacement ecosystem was obtained. The questions covered aspects such as the workflow, the integration of components, the design features, the use of materials, the fixation strategy for each component, and usability of surgical guides. The responses were quantitatively analyzed using descriptive statistics. 250 surgeons were included; the majority of surgeons preferred to have all elements of the TMJ-replacement system provided by a single system or company (i.e., the prosthesis and plates), with 86.0% of surgeons indicating this preference and 71.2% of surgeons indicating that having access to STL files for use in surgical navigation is an important feature. Approximately 88.4% of surgeons indicated that flexibility in the design of the prosthesis is important, while 61.6% of respondents indicated that design issues contribute to failures of TMJ prostheses. Issues related to the fixation of the prosthetic components, particularly screw loosening, were also commonly reported by surgeons with respect to failure. Surgeons also indicated concerns with regard to the bulkiness (73.2%) and the fit accuracy (68.4%) of the surgical guides. In terms of material selection, 78.0% of respondents preferred to be able to choose the type of metal alloy for the TMJ replacement system. TMJ replacement is viewed by surgeons as a system-dependent procedure that requires the integration of design, materials, fixation and digital workflow. The currently available prosthetic solutions only partially meet the needs of surgeons.