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Brazilian Oral and Maxillofacial Surgery has had a prominent position in the international scientific and clinical scenario for decades. This leading role is not accidental, but the result of continuous investment in academic training, university infrastructure, ethical commitment, and consistent scientific production, developed mainly within universities, with emphasis on their stricto sensu postgraduate programs. Contemporary clinical practice in Oral and Maxillofacial Surgery requires decisions based on solid scientific evidence. In this context, research plays a vital role, connecting clinical observation to laboratory, preclinical, and clinical studies, allowing the responsible incorporation of new techniques, biomaterials, and therapeutic approaches into routine care.

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Dear colleagues, the presidency of the Brazilian College of Oral and Maxillofacial Surgery and Traumatology (CBCTBMF) is not a status symbol, but a commitment to service. Leading the CBCTBMF requires understanding that this is a collective construction, supported by the legacy of pioneers and constant renewal promoted by new generations of the specialty. Leadership is expressed in the coherence between talk and practice, in the sobriety of attitudes, and in the responsibility of each decision. Principles should concretely guide the management of the common good, with transparency, care, and permanent attention, so that planning translates into effective actions and real benefits to the professional practice of the oral and maxillofacial surgeon.

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1. How was your career influenced by your father's professional trajectory? When I was a teenager, I would accompany my parents to lunches and dinners, and I would often meet someone who would talk to my father with some deference. My father was a pioneer, and nothing compares to a pioneer. Besides being a good professor, he was a very approachable person. So, this encouraged me. I started dental school without him ever telling me, “be a dentist” or “be a surgeon”. Among my father’s six children, I was the only who studied Dentistry. In college, I liked the specialty and enjoyed watching him teach. My father was a good professor; he drew very well with the chalk. When he finished a class, there was a maxilla, a parotid gland, that you would look at and say, “what a beautiful thing!”. I did not inherit that gift from him. Thus, it was very direct; I automatically started having opportunities in maxillofacial surgery. Since my father was a surgeon, when I was in my third semester of college, I was already assisting.

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Introduction: The development of surgical procedures enables the successful treatment of several dentofacial deformities. Objective: This study evaluated the strength of two different types of titanium plates. Methods: The non-parametric Mann-Whitney test was applied to compare the variables, since data did not show homoscedasticity/normality. Two types of plates were tested: 10 Lindorf plates (pre-shaped for 4-mm advancement), with 11 holes from the 1.5mm system; and 10 L-shaped plates from the 2.0mm system with 4 holes. Results: The group with 11-hole Lindorf plates showed greater strength (219.74 ± 9.29 N), compared to the 4-hole L-shaped plate group (149.24 ± 34.17 N), with statistically significant difference (p<0.05). Conclusion: The 11-hole Lindorf plate showed superior strength compared to the 4-hole L-shaped plate for fixation of Le Fort I osteotomy.

Introduction: The literature presents several studies focused on the evaluation of peri-implant bone biomechanics, indicating that complete mandibular fixed rehabilitations supported by three implants can be successfully performed. Objective: This in silico study aimed to evaluate the fatigue resistance of dental implant abutments in three configurations — three implants, four straight implants, and four implants in the All-on-Four system — made of Grade 4 titanium and Grade 4 hard titanium, comparing their performance. Materials and methods: The study was developed using Autodesk Inventor 2022 and ANSYS 2022R2 software to analyze the fatigue of mini abutments in the three proposed configurations, considering both titanium materials. Results: All configurations presented safety factors above 1, indicating no fatigue failure. Mini abutments made of Grade 4 hard titanium showed slightly higher safety factor values, compared with Grade 4 titanium, suggesting superior mechanical performance. Conclusion: Within the simulated conditions, the evaluated implants did not show fatigue failure, regardless of configuration or titanium grade used.

Introduction: Third molar extraction is a common oral surgery procedure and may negatively affect patients’ quality of life before surgery, particularly due to anxiety. Oral health-related quality of life and anxiety can be assessed using the Oral Health Impact Profile (OHIP-14) and the State-Trait Anxiety Inventory (STAI-T). Objective: This study aimed to evaluate the correlation between STAI-T and OHIP-14 in patients undergoing third molar extraction. Methods: A convenience sample of 66 patients aged 15-66 years, scheduled for third molar extraction, in Curitiba, Brazil, was evaluated. Participants completed the OHIP-14 questionnaire, and anxiety was assessed using the STAI-T. Statistical analysis was performed using GraphPad Prism 9. Results: Overall OHIP-14 scores showed a greater perceived impact on quality of life among women than men (13.22 vs. 11.03, respectively). Women reported higher impact in physical pain and psychological discomfort domains, whereas men showed greater concern in the handicap domain. Nearly one-third of women presented severe anxiety (p = 0.031). A strong but non-significant correlation was found between OHIP-14 domain 6 and STAI-T, while a borderline association was observed for domain 3. Conclusion: Trait anxiety was not significantly associated with self-perceived oral health-related quality of life in patients awaiting third molar extraction.

Introduction: Intravenous magnesium sulfate has been used as an analgesic adjunct in different surgical settings, due to its antagonistic action on N-methyl-D-aspartate (NMDA) receptors and modulation of neuronal excitability, potentially contributing to control the pain and reduce the opioid use in the postoperative period of orthognathic surgery. Methods: This systematic review was conducted in accordance with the PRISMA 2020 guidelines and registered in PROSPERO (CRD42024580418). The review included randomized controlled trials comparing intravenous magnesium sulfate with placebo or other pharmacological agents in patients undergoing orthognathic surgery. The search was performed in five electronic databases and the gray literature, without time restrictions. The primary outcomes were postoperative pain intensity and use of analgesic drugs. Results: Four studies (n = 328) were included. Magnesium sulfate significantly reduced pain during the intermediate and late postoperative periods (>12 h). There was no significant difference in rescue analgesic use within the first eight hours; however, an intraoperative opioid-sparing effect was reported in one study. Magnesium sulfate was also associated with a lower incidence of postoperative nausea and vomiting and greater hemodynamic stability. Conclusion: Intravenous magnesium sulfate shows potential as an adjunct for late postoperative analgesia and to reduce the opioid use in orthognathic surgery; however, more robust studies are required to support definitive clinical recommendations.

Introduction: Maxillary segmentation planning requires integration between surgeon and orthodontist, since it can cause damage to root structures and even extend into areas with low bone support. Artificial intelligence (AI) tools have shown to be promising in increasing the accuracy of virtual planning. Objective: This study evaluated an AI tool for root positioning in the planning of segmental maxillary osteotomies. Method: Eight patients submitted to Le Fort I segmentation for correction of dentofacial deformities were analyzed using computed tomography (CT). Automatic three-dimensional segmentation of anatomical structures, including tooth roots, was performed with an AI tool integrated into the NEMOFAB software. Root divergence was analyzed, estimating correlation and surgical risk. Results: The tool successfully identified root positioning in all patients. Statistically significant difference was found between clinical and tomographic assessments of root divergence (p = 0.025). Tomographic analysis revealed adequate root spacing in all patients, with 25% of previously diagnosed divergences considered as unsatisfactory in this new analysis method, which increased the accuracy. Conclusion: AI-assisted segmentation has been shown to improve preoperative assessment of root positioning, proving to be an excellent diagnostic tool. Besides assisting in planning by pointing out the divergence after treatment, the tool can also enable the creation of cutting guides in cases of unusual morphology.

Introduction: Despite the significant advances in surgical techniques, virtual planning and multidisciplinary protocols, orthognathic surgery is still susceptible to unsatisfactory results, requiring surgical reintervention in some cases. Objectives: This case report describes the surgical, esthetic and functional rehabilitation of a patient who had already undergone orthognathic surgery, but did not achieve a good result from both aesthetic and functional standpoints. Case report: Orthognathic correction was surgically performed, and a polymethyl methacrylate (PMMA) prosthesis was placed to compensate for an esthetic deficiency in the zygomatic region, restoring facial harmony and masticatory function. Conclusion: The association between corrective orthognathic surgery and PMMA prosthesis proved to be effective in the rehabilitation of complex cases with unsatisfactory previous results, contributing to the functional and esthetic restoration of the face.

Introduction: Central giant cell granuloma (CGCG) is an uncommon intraosseous lesion of the jaws, accounting for less than 7% of all benign jaw tumors. It is suggested that there are aggressive or non-aggressive CGCGs. While non-aggressive CGCGs rarely recur, aggressive forms are associated with higher recurrence rates. Conservative approaches can lead to high recurrence rates. Objective: The aim of the study is to report a case of a 19 years old female, reported to the oral and maxillofacial surgery department at Federal University of Paraná with pain and swelling in the left mandibular region. Case report: Panoramic radiography showed a large lesion on the left side of mandible molar region. Tomographic analysis showed cortical destruction associated with an invasive lesion. An incisional biopsy was performed under local anaesthesia, and histopathological analysis confirmed a central giant cell granuloma. The initial treatment plan involved six intralesional corticosteroid injections to reduce the lesion's size. However, after three sessions, complications arose and the treatment was discontinued. Subsequently, an en bloc resection was performed under general anaesthesia, using a reconstruction plate and 2.4 mm screws for fixation. Conclusion: One-year follow- up showed no lesion relapse, as well as a favorable mandible contouring with good facial aesthetics outcomes.

Introduction: Temporomandibular joint (TMJ) ankylosis is characterized by fusion of the mandibular head to the articular fossa, with trauma as main etiological factor. Treatment aims to restore mandibular function and anatomy, utilizing approaches ranging from alloplastic prostheses to autogenous grafts, such as the coronoid process. Objective: This study aims to report the case of a 21-year-old male patient with osseous ankylosis of the right TMJ, presenting with limited mouth opening (17 mm), apnea, and feeding difficulties. Case report: Clinical examination revealed facial asymmetry and mandibular anteroposterior deficiency. Computed tomography confirmed the presence of an ankylotic block. Surgical treatment involved resection of ankylosis and rotation of the coronoid process for mandibular reconstruction, combined with orthognathic surgery. After six months of follow-up and physiotherapy, the patient showed improvement in anteroposterior relationship, reduction of asymmetry, and mouth opening of 37 mm. Discussion: TMJ ankylosis can impair growth, breathing, and feeding, making early treatment essential. Conclusion: The use of the coronoid process has shown good outcomes in the literature, presenting a viable, cost-effective alternative with reduced morbidity.

Introduction: A detailed understanding of the mandibular canal anatomy and its possible variations is crucial to prevent complications during dental procedures. The absence of a systematic approach to identify these variations may lead even experienced clinicians to overlook them, increasing the risk of nerve injury. Objective: This study reports four clinical cases in which the mandibular canal showed an intimate relationship with the roots of third molars and presented an atypical pathway, compared with the standard described in the literature. Cone-beam computed tomography (CBCT) was used for three-dimensional assessment of canal position and trajectory, revealing considerable anatomical variability with potential clinical impact on surgical planning and anesthetic efficacy. Conclusion: The mandibular canal demonstrates considerable anatomical variability that can critically affect treatment planning and surgical safety. While panoramic radiography serves as a useful initial screening tool, its limited spatial resolution restricts diagnostic accuracy. Cone-beam computed tomography (CBCT) provides the necessary three-dimensional detail for precise assessment, allowing safer interventions and reducing the likelihood of inferior alveolar nerve injury.

Introduction: Odontogenic keratocyst (OKC) is a cystic lesion with aggressive behavior and high relapse rate. In pediatric patients, surgical management requires conservative approaches, to reduce morbidity and preserve bone growth. Objective: This is an observational and descriptive case report, performed during clinical, radiographic, and tomographic follow-up of a pediatric patient diagnosed with OKC in the mandible. Case report: Treatment was performed in two stages: decompression of the lesion with placement of a decompression device, and surgical enucleation and peripheral ostectomy under general anesthesia. Results: The 9-year-old male patient presented with increased volume in the right mandibular region. Imaging exams revealed an extensive radiolucent lesion, confirmed by biopsy as OKC. A decompression device was placed. Subsequently, enucleation and peripheral ostectomy were performed under general anesthesia. Follow-up showed new bone formation and no signs of infection. After two years and eleven months, localized relapse was observed, associated with tooth 45, treated by re-enucleation and extraction, with complete resolution and minimal morbidity. Conclusion: The technique adopted proved to be an effective approach for the treatment of OKC in these patients, reducing surgical morbidity. Follow-up was essential for early detection of relapse and effective treatment.

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