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The Role of Dental Practitioners in the Management of Oncology Patients: The Head and Neck Radiation Oncology Patient and the Medical Oncology Patient.

This narrative review addresses the role of a dentist in the management of oncology patients, highlighting the oral complications that arise in head and neck radiation oncology patients and medical oncology patients. The prevention and management of these complications are discussed.

Three-dimensional bone evaluation after surgical treatment with plasma rich in growth factors of Medication Related Osteonecrosis of the Jaw (MRONJ): A report of 3 cases.

INTRODUCTION: Medication Related Osteonecrosis of the Jaw (MRONJ) is an adverse effect of antiresorptive and antiangiogenic agents that consists of progressive bone destruction in the maxillofacial area. The purpose of this study is to analyze the effect on bone volume of a surgical protocol using plasma rich in growth factors (PRGF) for successfully treating MRONJ. METHODS: Three patients were treated combining surgical debridement with PRGF. Cone bean computed tomography scans were taken prior to surgery and 12 months after to measure bone volume changes. Biopsies were taken for histology a

Antibacterial efficacy of MTAD final rinse and two percent chlorhexidine gel medication in teeth with apical periodontitis: a randomized double-blinded clinical trial.

INTRODUCTION: Clinical assessment of the efficacy of novel root canal disinfection protocols is an important focus in endodontic research. This randomized double-blinded study assessed the antibacterial efficacy of a final rinse with BioPure MTAD (MTAD) and intracanal medication with 2% chlorhexidine gel (CHX) in teeth with apical periodontitis. METHODS: Canals in 30 teeth (single-rooted and multi-rooted) were prepared by using 1.3% NaOCl, rinsed with MTAD or saline in random sequence, medicated with CHX for 7 days, irrigated with 1.3% NaOCl, and filled. Bacteriologic root canal samples were

Anaesthesia for mandibular premolars with symptomatic irreversible pulpitis - which nerve block is best?

A COMMENTARY ON: Sülek T, Dumani A, Küden C, Kussever H, Yoldas O. Anaesthetic effectiveness of mental/incisive nerve block versus inferior alveolar nerve block in mandibular first and second premolars with symptomatic irreversible pulpitis: a randomised clinical trial. J Endod 2025; https://doi.org/10.1016/j.joen.2025.01.016 . DESIGN: This study is a randomised, double-blinded, parallel-group clinical trial investigating the efficacy of Mental Nerve Block (MNB) and Inferior Alveolar Nerve Block (IANB) techniques for anaesthesia of mandibular Premolars with Symptomatic Irreversible Pulpitis (

Comprehensive Review of Prevention and Management Strategies for Medication-related Osteonecrosis of the Jaw (MRONJ).

PURPOSE: To assess and classify the strategies employed in various dental specialities for the prevention and management of medication-related osteonecrosis of the jaw (MRONJ). MATERIALS AND METHODS: A comprehensive literature review was conducted, acquiring studies sourced from Google Scholar and PubMed. The emphasis was on studies published in recent years, focusing on successful MRONJ prevention techniques across various dental specialties. RESULTS: Four types of prevention were identified. Primary prevention strategies include optimizing oral hygiene, managing dental caries, and extracti

Bisphosphonate-Related Osteonecrosis of the Jaw: A 10-Year Analysis of Risk Factors and Clinical Outcomes.

Background: Bisphosphonate-related osteonecrosis of the jaw (BRONJ) represents a severe complication associated with bisphosphonate therapy commonly used in patients with osteoporosis and malignancies. Methods: This retrospective study evaluates the risk factors and clinical outcomes of BRONJ patients treated at the Oral and Maxillofacial Surgery Clinic in Iaşi, Romania, with the goal of optimizing preventive and therapeutic strategies. Data from 72 BRONJ patients treated between January 2013 and December 2023 were analyzed. Results: The majority (83.3%) of patients had underlying malignancies

Clinical considerations for medication-related osteonecrosis of the jaw: a comprehensive literature review.

BACKGROUND: Medication-related osteonecrosis of the jaw (MRONJ), which was first reported as bisphosphonate-related osteonecrosis of the jaw (BRONJ) in bisphosphonate users, is a rare but severe soft and hard tissue disease induced by several types of medications. There has been a deluge of information about MRONJ, such as epidemiology, risk factors, clinical recommendations for dental treatment to prevent it, and treatment strategies in medication-prescribed users. The aim of this study was to comprehensively review recent articles and provide the current scientific information about MRONJ, e

Qualitative radiographic characteristics of MRONJ-affected bone in oral and parenteral drug administration: comparison of panoramic radiography and cone-beam CT.

BACKGROUND: Our aim was to compare the capacity of panoramic radiography (PR) and cone-beam computed tomography (CBCT) first for the detection of bone affected by medication-related osteonecrosis of the jaw (MRONJ) using qualitative radiographic parameters; and second for the evaluation of the relationship between drug administration route and associated bone changes. METHODS: PR and CBCT images of 24 MRONJ patients using oral or intravenous (IV) bisphosphonates were scored for the detection of osteolysis, osteosclerosis, lamina dura thickening, periodontal ligament widening, persistent extrac

Dissociations of oral foci of infections with infectious complications and survival after haematopoietic stem cell transplantation.

IntroductionHaematopoietic stem cell transplantation (HSCT) recipients are at increased risk for severe infections. This study examined the associations of common oral infections with survival and infectious complications in HSCT recipients.Materials and methodsAll autologous and allogeneic HSCT recipients transplanted in the University Hospital of Basel, Switzerland, between 2008 and 2016 and referred to oral infection control pre-HSCT were included in this retrospective case-control study. All patients had a clinical and a panoramic radiological dental examination taken immediately prior to

Chinese expert consensus on the diagnosis and clinical management of medication-related osteonecrosis of the jaw.

Medication-related osteonecrosis of the jaw (MRONJ) is a side effect that occurs after treatment for systemic diseases. However, most institutions currently rely on empirical methods to make diagnosis and treatment plans, and there is a lack of consensus or guidelines for the classification, staging and treatment of MRONJ in China. To address this gap and improve prognosis, an expert panel representing 11 renowned domestic medical colleges and affiliated hospitals in China was convened. The panel made a comprehensive literature review of previous treatment experiences and research findings to

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… Dental infections such as periodontitis, pulpitis and periapical periodontitis are common in the oral cavity. Trauma such as tooth extraction can result in local infection by oral flora, potentially triggering MRONJ. …

Osteonecrosis of the jaws in patients treated with bisphosphonates.

The literature describes an increasing presence of bisphosphonate-induced osteonecrosis of the jaws (ONJ), characterized by the exposure for over 8 weeks of necrotic bone in the maxillofacial region, after bisphosphonate therapy, in the absence of prior maxillary radiotherapy. The present literature review examines the etiopathogenesis, risk factors, clinical forms, diagnosis, treatment and prevention of bisphosphonate-induced ONJ. In addition, a review is made of all the series involving over 15 patients diagnosed with this disorder between 1 January 2011 and 15 May 2011. A PubMed-Medline sea

Последние достижения в области эндодонтического диагностирования и современных планов лечения

В целом, для достижения успеха в области эндодонтики необходимо проявлять осторожность и совершенство на всех этапах лечения [...]

Bilateral jaw involvement of Burkitt's lymphoma in a 5-year-old: Rare pediatric case with review of the literature.

INTRODUCTION AND IMPORTANCE: Burkitt lymphoma (BL) is a rapidly progressing tumor that requires urgent diagnosis and treatment. It is the first human neoplasm linked to a viral cause and is classified into three subtypes: sporadic, endemic, and immunodeficiency-associated. CASE PRESENTATION: We report a rare case of a 5-year-old boy who presented to the Oral and Maxillofacial Surgery Department with a two-month history of bilateral maxillary swelling and pain. He had no significant medical history. An incisional biopsy confirmed the diagnosis of Burkitt's lymphoma. The patient underwent chemo

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… Non-Hodgkin's Lymphoma can mimic common dental lesions such as periodontitis, chronic periapical periodontitis, pericoronitis, and osteomyelitis on imaging studies. …

One- versus two-visit endodontic treatment of teeth with apical periodontitis: a histobacteriologic study.

INTRODUCTION: This study analyzed the in vivo microbiological status of the root canal systems of mesial roots of mandibular molars with primary apical periodontitis after 1- or 2-visit endodontic treatment. METHODS: Mesial root canals were instrumented by using either a combination of K3 and LightSpeed instruments (mesiobuccal canals) or the ProTaper system (mesiolingual canals), with 5% NaOCl irrigation. Patency files were used. Smear layer was removed, and a final rinse with 5 mL of 2% chlorhexidine was performed. In the 2-visit group (7 roots, 14 canals), canals were medicated with calciu

A survey of endodontic practice amongst Flemish dentists.

AIM: The purpose of this study was to gather information on routine endodontic treatment performed by Flemish (Dutch-speaking Belgian) dentists. METHODOLOGY: A postal questionnaire was sent to all the 4545 Dutch-speaking dentists registered in Belgium. The questionnaire was made up of 38 questions with multiple-choice answers. Results from 32 questions are presented, covering subjects, such as demographic and professional activity, root-canal preparation and instrumentation, emergency procedures and postoperative complications, choice of irrigants and disinfectants, and choice of obturation t

Clinical antimicrobial efficacy of NiTi rotary instrumentation with NaOCl irrigation, final rinse with chlorhexidine and interappointment medication: a molecular study.

AIM: To evaluate clinically the antibacterial effects of root canal treatment procedures using molecular microbiology analyses. METHODOLOGY: Samples were taken from 14 necrotic root canals of teeth with apical periodontitis before (S1) and after instrumentation with NaOCl irrigation (S2), a final rinse with chlorhexidine (CHX) (S3) and then one-week interappointment medication with calcium hydroxide/CHX paste (S4). The parameters examined included the following: incidence of positive broad-range PCR results for bacterial presence; impact on bacterial community structures evaluated by PCR-Dena

Risk Factors for Medication-Related Osteonecrosis of the Jaw-A Binomial Analysis of Data of Cancer Patients from Craiova and Constanta Treated with Zoledronic Acid.

MRONJ (Medication-Related Osteonecrosis of the Jaw) is a condition observed in a subset of cancer patients who have undergone treatment with zoledronic acid in order to either prevent or treat bone metastases. The primary aim of this research was to establish the importance of risk factors in the development of medication-related osteonecrosis of the jaw in cancer patients receiving zoledronic acid therapy for bone metastases. The present study is an observational retrospective investigation conducted at two university centers, namely, Craiova and Constanța, and included cancer patients treate

Endodontics in Systemically Compromised Patients

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Assessment of evidence from teeth and the alveolar bone of skulls.

A notable lack of agreement on a standardised criterion for representing changes in alveolar bone persists, which limits its application in forensic dentistry. This study aimed to describe the data on loss of tooth substance and alveolar bone in skulls. Dental and trabecular bone information from 28 skulls from the German Helmer skull collection was collected through dental charting, intraoral photographs taken with a DSLR camera (Nikon D5600, Nikon Corporation, Japan), and small radiographs obtained using a handheld dental X-ray device (Nomad Pro 2, Kavo Kerr, Biberach, Germany). Adobe Photos

A Retrospective Observational Study of Risk Factors for Denosumab-Related Osteonecrosis of the Jaw in Patients with Bone Metastases from Solid Cancers.

This single-center retrospective observational study aimed to identify risk factors for developing denosumab-related osteonecrosis of the jaw (DRONJ) in stage IV solid cancer patients with bone metastases. In total, 123 consecutive patients who had received 120 mg of denosumab every 4 weeks at least twice between July 2014 and October 2018 were included. We surveyed their demographics, medical history, blood test, underlying disease, and intraoral findings. Fourteen patients (11.4%) developed DRONJ within a mean denosumab administration period of 4 months (range: 2-52 months). Univariate analy

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… We also found associations of DRONJ with existing apical/periapical periodontitis and periodontitis. … Asymptomatic or well-maintained teeth with periapical periodontitis or marginal periodontitis were statistically significant risk factors. No patients developed DRONJ at tooth extraction sites because denosumab was administered after complete mucoepithelial closure. …