Purpose: The sphenoid bone (SB) extracranial ligaments (ECRLs) are the pterygoalar and pterygospinous ligaments (PTAL and PTSL) that are located at the SB lateral pterygoid plate, and inferior to the foramen ovale (FO). Their ossification may affect the mandibular nerve’s distribution. The intracranial ligaments’ (ICRLs) ossification (the caroticoclinoid ligament—CCLL, the anterior and posterior interclinoid ligaments—AICLL and PICLL) may impede the approaches to the sella. This study highlights the incidence of the ossified ECRLs and ICRLs location, their type (partial, or complete), considering laterality, gender, age, and ligaments’ simultaneous presence. Methods: The sample consisted of 156 Greek adult dried skulls of both genders and variable age. Results: Ossified ligaments were identified in 57.05%, predominantly extracranially (42.31%, P = 0.003). ECRLs were predominantly identified unilaterally (30.13%, P < 0.001). The majority of the ossified ICRLs were predominantly identified in male skulls (31.1%, P = 0.048) and the majority of the ECRLs (52.8%, P = 0.028) were predominantly identified at the age of 60 years and above. The PTAL was the most ossified (32.69%), followed by the CCLL (24.36%), the PTSL (16.03%), the PICLL (6.41%), and the AICLL (4.49%). Conclusions: Detailed knowledge of the SB morphology and ligaments’ ossification extent is essential to improve the technique of the FO percutaneous approach, and sellar approaches, to minimize complications.

Purpose: To estimate the prevalence of the sphenoidal emissary foramina (SEF), and the effect of possible moderators on it. Methods: A systematic online literature search was conducted. The pooled prevalence with 95% confidence intervals was estimated. Outlier and influential analyses were performed. The presence of small-study effect and publication bias were evaluated. Moderator analyses were executed to investigate the effect of the specimens’ continent of origin, type of study (dried skull or imaging), probing for the evaluation of SEF patency (conduction and instruments used), side dominance (bilateral or unilateral), morphometric data [SEF diameter, distances SEF–Foramen ovale (FO) and SEF–Foramen spinosum (FS)], and the methodology used for the morphometric measurements (caliper, DICOM Viewer, and image analysis software) on the estimated prevalence. Results: In total, 6,460 subjects from 26 studies were included in the meta-analysis. The overall SEF prevalence was estimated as 38.1%. The heterogeneity was high and statistically significant. No indications of publication bias and small-study effect were identified. The conducted subgroup analyses did not yield statistically significant differences in the SEF prevalence between groups, except of the type of side dominance. Both results of the univariable and multivariable regression analyses showed the association of the unilateral dominance with a decrease in the reported SEF prevalence. Conclusion: The identification of more unilateral than bilateral foramina in a given cohort is associated with a decrease in the reported crude SEF prevalence. Laterality-specific estimates should be established for a precisive estimation of the emissary foramina prevalence.

Our study aimed to estimate the prevalence of total free flap failure following free flap reconstruction for mandibular osteoradionecrosis (mORN) and assess the impact of potential moderators on this outcome. A comprehensive systematic literature search was independently conducted by two reviewers using the Medline, Scopus, Web of Science and Cochrane Library databases. Quality assessment of the selected studies was performed, and prevalence estimates with 95% confidence intervals (CI) were calculated. Outlier and influential analyses were conducted, and meta-regression analyses was employed to investigate the effects of continuous variables on the estimated prevalence. Ultimately, forty-six eligible studies (involving 1292 participants and 1344 free flaps) were included in our meta-analysis. The findings of our study revealed a prevalence of 3.1% (95% CI 1.3–5.4%) for total free flap failure after reconstruction for mORN. No study was identified as critically influential, and meta-regression analysis did not pinpoint any potential sources of heterogeneity. These findings provide valuable insights for researchers and serve as a foundation for future investigations into the management of mandibular osteoradionecrosis and the prevention of free flap failure in this context.

Background/Objectives: This systematic review and meta-analysis aimed to investigate the prevalence of surgical site infections (SSIs) following coronectomy of mandibular third molars. Methods: A comprehensive literature search was conducted in Medline, Scopus, Web of Science, and Google Scholar databases up to 30 July 2024. Two independent reviewers performed study selection, data extraction, and quality assessment using the Newcastle–Ottawa Scale. Observational studies assessing SSI prevalence following coronectomy were included. The pooled prevalence of SSI with 95% confidence intervals (CI) was calculated using a random-effects model. Heterogeneity was assessed using the I² statistic, and meta-regression was conducted to explore the influence of continuous variables. Results: A total of 22 studies involving 2173 coronectomy procedures were included. The overall pooled prevalence of SSI was 2.4% (95% CI: 1–4.3%), with substantial heterogeneity (I² = 81%). Meta-regression showed no significant effect of the examined variables on SSI prevalence. No study was identified as a significant outlier. Quality assessments revealed that all studies had moderate methodological quality. Conclusions: Considerable heterogeneity was observed, likely due to variations in study settings, geographical regions, and timeframes, among other factors. Therefore, this study underscores the need for further rigorous research to better understand SSI risk factors and enhance management strategies for this postoperative complication.

Purpose: Our study aims to estimate the prevalence of lingual nerve injury following bilateral sagittal split osteotomy (BSSO). Methods: Two reviewers independently conducted a systematic literature search in the Medline and Scopus databases. The pooled prevalence with 95% confidence intervals (CI) was estimated, and quality assessment, outlier analysis, and influential analysis were performed. Results: In total, eleven eligible studies comprising a total of 1,882 participants were included in this meta-analysis. One study was identified as critically influential. The overall prevalence of lingual sensory impairment was estimated to be as high as 0.1% (95% CI 0.0%-0.6%) with moderate heterogeneity observed between studies. Conclusion: It is important for healthcare professionals to be aware of this issue, despite the relatively low rate of lingual nerve deficit after BSSO. Additional research will provide a more comprehensive understanding of the underlying factors contributing to lingual nerve injury, leading to improved preventive measures and treatment strategies. Furthermore, insights gained from future studies will enable healthcare professionals to inform patients about the potential complications and manage their expectations before undergoing BSSO.