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Clinical efficacy analysis of mucoperiosteal flap combined with perforation technique for tooth extraction in medication-related osteonecrosis of the jaw risk population: a retrospective study.

BACKGROUND: To analyze and summarize the clinical efficacy of mucoperiosteal flap combined with perforation technique for tooth extraction in medication-related osteonecrosis of the jaw risk (MRONJ) population, and to provide clinical treatment options for such patients. METHODS: This study included 51 patients receiving antiresorptive drug (ARD) treatment who underwent tooth extraction at the Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology between November 2016 and February 2024. Preoperative clinical data were collected and analyzed. Based

Medication-Related Osteonecrosis of the Jaw: Successful Medical Management of Complex Maxillary Alveolus with Sinus Involvement.

Medication-related osteonecrosis of the jaw (MRONJ) in cancer patients presents a considerable challenge in management. Current management is primarily based on interventions in a limited number of cases assessing a single approach. Medical management typically is reported to include antimicrobial therapy with or without surgery. Advances in the understanding of pathogenesis have led to the investigation of additional medical interventions for early-stage necrosis. We present 3 patients with advanced-stage MRONJ of the maxilla using combined medical modalities including antimicrobial therapy,

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… Oral Radiol Endodontics. 2010;110(5):593–6. 10.1016/j.tripleo.2010.05.067. 15. Magremanne M, Reychler H. Pentoxifylline and tocopherol in the treatment of yearly zoledronic acid-related osteonecrosis of the jaw in a corticosteroid-induced osteoporosis. …

Влияние лечения рака на оральные структуры и лицо черепа - последствия для протезирования и онкологического риска.

ЦЕЛЬ ОБЗОРА: Настоящее исследование направлено на выявление осложнений и трудностей при проведении остеоинтеграции имплантатов в онкологических пациентах, учитывая влияние лечения на микроархитектуру краниофасциальной области, микробиомо рта и воспаление полости рта. НОВЫЕ ДАННЫЕ: Хирургическая резекция, радиотерапия, химиотерапия и таргетная терапия значительно влияют на состояние костей, слизистых оболочек и мягких тканей, а также на возможности и ограничения протезирования. Химиотерапия значительно влияет на метаболизм кальция и фосфора. Было замечено, что существует увеличенный риск перел

Medication Related Osteonecrosis of the Jaw: 2021 Position Statement of the Korean Society for Bone and Mineral Research and the Korean Association of Oral and Maxillofacial Surgeons.

Antiresorptives are the most widely prescribed drugs for the treatment of osteoporosis. They are also used in malignant bone metastases, multiple myeloma, and Paget's disease, and provide therapeutic efficacy on those diseases. However, it was reported that the occurrence of osteonecrosis of the jaw (ONJ) could be related to antiresorptive exposures, and there have been many cases regarding this issue. Therefore, a clearer definition and treatment guidelines were needed for this disease. The American Society for Bone and Mineral Research and the Amnerican Association of Oral and Maxillofacial

Bortezomib treatment produces nocifensive behavior and changes in the expression of TRPV1, CGRP, and substance P in the rat DRG, spinal cord, and sciatic nerve.

To investigate neurochemical changes associated with bortezomib-induced painful peripheral neuropathy (PN), we examined the effects of a single-dose intravenous administration of bortezomib and a well-established "chronic" schedule in a rat model of bortezomib-induced PN. The TRPV1 channel and sensory neuropeptides CGRP and substance P (SP) were studied in L4-L5 dorsal root ganglia (DRGs), spinal cord, and sciatic nerve. Behavioral measures, performed at the end of the chronic bortezomib treatment, confirmed a reduction of mechanical nociceptive threshold, whereas no difference occurred in the

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… Journal of Endodontics. 2011;37(7):934–937. doi: 10.1016/j.joen.2011.03.035. 87. Guo A. Immunocytochemical localization of the vanilloid receptor 1 (VR1): relationship to neliropeptides, the P2X3 purinoceptor and IB4 binding sites. …

Prevention and treatment of oral adverse effects of antiresorptive medications for osteoporosis - A position paper of the Brazilian Society of Endocrinology and Metabolism (SBEM), Brazilian Society of Stomatology and Oral Pathology (Sobep), and Brazilian Association for Bone Evaluation and Osteometabolism (Abrasso).

Antiresorptive therapy is the main form of prevention of osteoporotic or fragility fractures. Medication-related osteonecrosis of the jaw (MRONJ) is a relatively rare but severe adverse reaction to antiresorptive and antiangiogenic drugs. Physicians and dentists caring for patients taking these drugs and requiring invasive procedures face a difficult decision because of the potential risk of MRONJ. The aim of this study was to discuss the risk factors for the development of MRONJ and prevention of this complication in patients with osteoporosis taking antiresorptive drugs and requiring invasiv

From Osteoclast Differentiation to Osteonecrosis of the Jaw: Molecular and Clinical Insights.

Bone physiology relies on the delicate balance between resorption and formation of its tissue. Bone resorption depends on a process called osteoclastogenesis in which bone-resorbing cells, i.e., osteoclasts, are produced by the differentiation of more undifferentiated progenitors and precursors. This process is governed by two main factors, monocyte colony-stimulating factor (M-CSF) and receptor activator of NFκB ligand (RANKL). While the former exerts a proliferating effect on progenitors/precursors, the latter triggers a differentiation effect on more mature cells of the same lineage. Bone h

Evaluation of Large Language Model-Based Chatbots for Dental Trauma Management: A Comparative Study Based on Accuracy, Consistency and Information Quality.

This study evaluated and compared the accuracy, consistency, readability, and information quality of three LLM-based chatbots, namely ChatGPT-5, Claude AI (Sonnet 4.0), and Perplexity (Mistral Large 2), in addressing traumatic dental injury questions. Forty true/false statements were submitted to each chatbot three times at weekly intervals to assess accuracy and consistency. Additionally, chatbot responses for 25 open-ended case-based questions were evaluated for readability, understandability and actionability, information reliability and quality. For true/false questions, Perplexity showed

How Well Are Dental Students Equipped to Handle Traumatic Dental Injuries in Children?

To evaluate dental students' knowledge and confidence in managing dental trauma (TDI). An observational questionnaire-based study involving fourth-year BDSc (Hons) students from 2022 and 2023 at UQ, following their Traumatic Dental Injury module. A 44-item questionnaire assessed knowledge in managing TDI in primary dentition and fractures, subluxations and avulsion of permanent teeth. Confidence was self-reported. Scores were categorised as Below average (0%-49.9%), Average (50%-74.9%) and Above average (75%-100%). Data analysis used Jamovi (Version 2.3.18), with Prism GraphPad (Version 10.0.2

Impact of EDTA Formulations and Activation Methods on Stem Cell Response, Antimicrobial Activity and Dentine Integrity: An In Vitro Study.

This study evaluated the effects of 17% trisodium EDTA and 15% disodium EDTA (EDTAd), with or without activation, on SCAP response, antimicrobial activity and dentine chemical alterations. SCAP viability (Live/Dead) and metabolic activity (Alamar Blue) were assessed, along with antibiofilm and intratubular disinfection against Enterococcus faecalis and Streptococcus mutans, after irrigation with EDTA or EDTAd delivered by conventional irrigation (CI), ultrasonic activation (UA) or diode laser activation (LA). Dentine alterations were analysed by Fourier-transform infrared spectroscopy (FTIR) a

Accuracy and Operative Time of Three Dynamic Navigation Systems for Fibre Post Removal: An In Vitro Comparative Study.

This in vitro study compared the accuracy and operative removal time of three dynamic navigation systems for fibre post removal using standardised 3D-printed tooth replicas. Forty-eight identical maxillary incisor replicas containing cemented fibre posts were randomly allocated to three navigation-guided groups and a freehand group (n = 12). Virtual drilling paths were planned from cone-beam computed tomography images, and all procedures were performed by a single operator. Pre- and postoperative micro-computed tomography scans were used to measure coronal, apical and angular deviation. All na

Early Non-Invasive Detection of Arterial Stiffness Related to Endothelial Dysfunction in Apical Periodontitis Patients: A Systematic Review and Meta-Analysis.

This systematic review and meta-analysis evaluated the association between apical periodontitis (AP) and non-invasive markers of arterial stiffness, including carotid intima-media thickness (c-IMT), endothelial flow reserve (EFR), flow mediated dilatation (FMD), carotid plaques and aortic atherosclerotic burden (AAB) in systemically healthy individuals. PubMed/MEDLINE, Cochrane, Scopus and EMBASE were searched. Quality assessment was done using the Newcastle-Ottawa Scale. Six studies were selected, with two at low and four at moderate risk of bias. Five studies (two c-IMT; three EFR) underwent

Irrigation Dynamics of the TruNatomy Needle in a Minimally Prepared Root Canal: A Computational Fluid Dynamics Analysis.

This study investigated the irrigation dynamics of the TruNatomy irrigation needle in a minimally shaped root canal using Computational Fluid Dynamics (CFD). The root canal geometry of an extracted maxillary first molar was reconstructed via micro-Computed Tomography (CT) scan, and the needle dimensions were obtained through stereomicroscopic analysis for Computer-Aided Design (CAD) modelling. The needle was virtually placed 1 mm short of the working length, and a prevalidated CFD model simulated the irrigation process. Irrigant penetration was confined to the needle tip, with a maximum veloci

Beyond the Naked Eye: Automated Detection of Digital Manipulation in Dental Radiographs Using Probabilistic Detection Model.

This study evaluated how reliably humans can detect digital manipulations in dental radiographs and introduced an unsupervised, artefact-aware artificial intelligence (AI) system to identify subtle, visually imperceptible changes. A dataset of 384 anonymised periapical radiographs was used, with equal numbers of original and synthetically altered images. Manipulations included copy-move, splicing, inpainting and lesion modification using clinically relevant techniques. The AI framework combined Error Level Analysis with a probabilistic Gaussian Mixture Model and included artefact suppression l

Efficacy of Calcium Silicate-Based, Simvastatin, Levofloxacin and Calcium Hydroxide Intracanal Medicaments Against Mature Enterococcus faecalis Biofilm. An In Vitro Study.

This in vitro study investigated the antibiofilm efficacy of calcium silicate-based, Simvastatin, Levofloxacin and calcium hydroxide intracanal medicaments against mature Enterococcus faecalis biofilm. Ninety dentine specimens were inoculated with Enterococcus faecalis biofilm for three weeks and divided into five groups (n = 18): (1) calcium silicate-based; (2) Simvastatin; (3) Levofloxacin; (4) calcium hydroxide (CH); (5) positive control, no medicament. After two weeks of intracanal medicament application, live/dead bacterial cells were assessed using confocal laser scanning microscopy. The

Determinants of Vital Pulp Therapy Success in Cariously Exposed Mature Permanent Teeth: An Umbrella Review.

Vital pulp therapy (VPT) is a biologically conservative alternative to root canal treatment in mature permanent teeth; however, variability in success rates and uncertainty regarding prognostic and procedural factors necessitate higher-order evidence synthesis. This umbrella review aimed to synthesize systematic reviews evaluating determinants of VPT outcomes in cariously exposed mature permanent teeth, and to appraise methodological quality and primary study overlap. Electronic searches across major databases and grey literature were conducted. Methodological quality was assessed using AMSTAR

Effects of Calcium Hydroxide Paste and Access Cavities on Fracture Strength of Mature and Simulated Immature Human Teeth: Ex Vivo.

The aim was to examine whether a Ca(OH)2 paste affects fracture strength of teeth. Sixty extracted maxillary central incisors were prepared to simulate immature teeth. Another 40 were used as mature teeth. The ten groups (n = 10) were: (1) immature control; (2) immature + access; (3) immature + access + 1 m Ca(OH)2; (4) immature + access + 12 m Ca(OH)2; (5) immature + no access + 1 m Ca(OH)2; (6) immature + no access + 12 m Ca(OH)2; (7) mature + access + 1 m Ca(OH)2; (8) mature + access + 12 m Ca(OH)2; (9) mature control; (10) mature + access. After preparation and Ca(OH)2 use, the teeth were

Two Severely Compromised Teeth Restored Using Digital Planning Combined With Double Orthodontic Magnetic Extrusion: A Case Report.

Tooth tissue loss due to dental caries is frequently challenging to restore, and this loss is made worse by proximal tooth borders that extend below the gingival margin. This report describes a digitally designed case in which the ferrule and supracrestal tissue attachment were preserved by simultaneous double magnetic extrusion of two root filled teeth. A 67-year-old male presented with the chief concern of a fractured maxillary left canine. The maxillary left lateral incisor and canine underwent rapid magnetic extrusion to create ferrules (3 mm). Eighteen months after treatment, the restorat

Conventional vs. Ready-To-Use Bioceramic Cements: In Vitro Bond Strength Performance in Blood-Contaminated Dentine.

This study evaluated the performance of MTA and ready-to-use cement (Bio C Repair) in dentine repair under different blood contamination conditions. 120 bovine root dentine-disks were divided into control and blood-contaminated groups and then subdivided on the basis of cement type and exposure time (immediate or 15-min delay). The control was stored in a humid environment at 37°C for 28 days, whereas the contaminated group was stored in blood. Push-out bond strength was assessed using a universal testing machine (1 mm/min). Three samples per subgroup underwent EDS-X and SEM analysis. MTA exhi

Effectiveness of Root Canal Irrigation and Dressing for the Treatment of Asymptomatic Apical Periodontitis: A Systematic Review Assessing Complementary Timeframes.

Sodium hypochlorite (NaOCl), ethylenediaminetetraacetic acid (EDTA), and calcium hydroxide (Ca(OH)2) are used in root canal treatment. However, further research is needed to assess their effectiveness at time points not considered in previous guidelines. This review complements the systematic review by Rossi-Fedele and Rödig (2023) by considering time points excluded by the latter. A search was conducted in PubMed-MEDLINE, Scopus, EMBASE, Google Scholar, and repositories between March and May 2024. Four studies met the inclusion criteria, providing data from 212 teeth for irrigation and 108 fo