Background: Nitric oxide is a small gaseous molecule with significant bioactivity. It has been observed that NO may have a dual role dependent on its production and concentrations in the bone microenvironment. The objective of the study was to assess the concentration of total nitric oxide malonyldialdehyde, nitrotyrosine, and asymmetric dimethylarginine in the serum of patients with mandibular fractures and to understand the relationship between these compounds, in order to expand the knowledge base of the role of nitric oxide and its activity indicators in the process of bone fracture healing. Material and Methods: The study included 20 patients with mandibular fractures who were undergoing inpatient and outpatient treatments and a control group of 15 healthy people. Results were analyzed with respect to the measurement time. Total nitric oxide concentration in the blood serum was determined according to the Griess reaction, while the concentration of malonyldialdehyde, nitrotyrosine, and asymmetric dimethylarginine was estimated using the immunoenzymatic method (i.e., enzyme-linked immunosorbent assay). Results: Before the procedure, as well as on the first day and 2 and 6 weeks after the procedure, higher concentrations of total nitric oxide and lower concentrations of malonyldialdehyde were observed in the blood serum of patients with mandibular fractures compared to the control group. No statistically significant differences were found in nitrotyrosine concentrations in the blood serum of patients throughout the measurement period. However, a significantly higher asymmetric dimethylarginine concentration was observed in the patient serum before the procedure and on the first day of operation as compared with the control group. Analysis of the results observed in patient serum with respect to the number of fractures within the mandible demonstrated the same trend of concentrations for the tested compounds for the entire study group. Conclusions: In summary, our results revealed that the intensity of local processes resulting from mandibular fractures is associated with the concentration of nitric oxide, confirming its significant role, as well as that of its indicators, in the process of bone fracture healing in this patient population.

Titanium (Ti) biomaterials are widely used in the surgical management of maxillofacial trauma, in oncology and orthognathic surgery. Although Ti is considered highly biocompatible, adverse reactions at the implant site have been reported in numerous clinical studies. However, the influence of Ti mandibular implants on glutathione metabolism, nitrosative stress and systemic inflammation has not been investigated to date. The study aimed to evaluate the acute (short-term) effects of Ti mandibular implants on the circulating biomarkers of the antioxidant defense system, on oxidative and nitrosative stress, as well as the inflammatory response of the blood plasma/erythrocytes, in maxillofacial surgery patients compared to the control group. The experimental group consisted of 40 patients with bilateral mandibular fractures, who received osteosynthesis treatment with the use of Ti-6Al-4V alloy miniplates and screws. The control group comprised 40 ageand gender-matched patients who were qualified for the surgical treatment of craniofacial defects through bimaxillary osteotomy. An increase in the activity of pro-oxidant enzymes (↑ nicotinamide adenine dinucleotide phosphate (NADPH) oxidase (NOX), ↑ xanthine oxidase (XO)), impaired glutathione metabolism (↓ total glutathione, ↑ oxidized glutathione (GSSG), ↓ reduced glutathione (GSH), ↓ redox status), higher levels of oxidative stress (↓ total thiols, ↑ malondialdehyde (MDA), ↑ lipid hydroperoxides (LOOHs)), ↓ total antioxidant status (TAS)), carbonyl stress (↑ dityrosine, ↑ N-formylkynurenine) and nitrosative stress (↑ nitric oxide (NO), ↑ S-nitrosothiols, ↑ peroxynitrite, ↑ nitrotyrosine), as well as an intensified systemic inflammatory response (↑ interleukin (IL)-1β, ↑ IL-6), were observed in maxillofacial surgery patients. Despite the fact that the study examined only the circulating biomarkers of redox balance and inflammation, the results suggest that a systemic inflammatory response can be triggered by local immune reactions. Systemic inflammation and oxidative stress may stem from an early adaptive immune response to foreign objects in the body. Although further research is required, the removal of the existing Ti mandibular implants should be considered.

Titanium and its alloys are widely used in dental implantology due to their favorable mechanical properties and well-documented long-term clinical performance. Among them, Ti-6Al-4V is particularly common in load-bearing applications. Nevertheless, a growing body of experimental and clinical evidence suggests that Ti-6Al-4V implants cannot be regarded as biologically inert in all patients. Adverse tissue responses, such as impaired healing, chronic peri-implant inflammation, and unexplained implant failure, have been reported even in the absence of classical risk factors, including infection, mechanical overload, or confirmed metal allergy. This critical review challenges the prevailing assumption that these complications are driven primarily by mechanical or immunoallergic mechanisms. Instead, oxidative stress is proposed as a central and unifying factor underlying adverse tissue reactions to Ti-6Al-4V dental implants. Corrosion, tribocorrosion, and mechanical wear lead to the release of titanium-, aluminum-, and vanadium-containing particles and ions, which promote excessive generation of reactive oxygen species at the implant–tissue interface. The resulting redox imbalance disrupts bone remodeling, impairs osteogenic differentiation, and maintains a pro-inflammatory microenvironment. Importantly, pathology arises not merely from increased reactive oxygen species production, but from the failure of local antioxidant defense systems to counteract this burden. Insufficient enzymatic and transcriptional antioxidant responses result in persistent redox imbalance, sustained innate immune activation, and progressive tissue intolerance. Oxidative stress is therefore conceptualized not as a secondary byproduct of inflammation, but as a primary driver of immune dysregulation through chronic macrophage activation and inflammasome signaling. This redox-driven feedback loop amplifies tissue damage and compromises long-term osseointegration independently of classical adaptive immune sensitization. Recognizing oxidative stress as a key determinant of implant–tissue interactions offers a more coherent framework for understanding implant-related complications and underscores the need for redox-aware biomaterial strategies and individualized patient risk assessment.

Facial bone fractures represent a significant clinical challenge due to their impact on function, aesthetics, and quality of life. Despite advances in imaging and surgical techniques, early and accurate assessment of the healing process remains limited. Conventional diagnostic methods often detect complications, such as delayed union or non-union, too late for optimal intervention. Oxidative stress—an imbalance between reactive oxygen species (ROS) and antioxidant defenses—plays a critical role in bone regeneration. In this review, biomarkers are presented in two main categories: (1) oxidative damage biomarkers (lipid peroxidation products: malondialdehyde, 4-hydroxynonenal, and F2-isoprostanes) and (2) antioxidant biomarkers (glutathione, enzymatic antioxidants: SOD, GPx, CAT). Their potential as non-invasive diagnostic and prognostic tools in craniofacial fracture healing is evaluated, along with emerging therapeutic strategies. Monitoring their levels in blood samples may provide real-time insights into the dynamics of fracture repair, enabling earlier detection of healing disturbances and informing personalized treatment approaches.

Background: Concrescent teeth belong to the group of double teeth with disturbed anatomy of shape and structure. The concrescence consists of the aggregation of root cementum of adjacent teeth. This anomaly usually concerns the upper teeth in the lateral part of the jaw. Concrescent teeth can be treated conservatively, endodontically, orthodontically and surgically. Objective: The aim of this article is to present the case of the concrescence of upper teeth, a second molar tooth with an impacted third molar, and to draw the attention of clinicians to this rare anomaly that may cause medical and legal problems. Case presentation: This article presents the case of a 53-year-old woman who reported to the dentist’s office to extract tooth 17 due to chronic periodontitis and an impacted and abnormally placed tooth 18. Result: During the extraction, concrescence of the teeth was noted. The teeth were removed, and the alveoli were surgically treated. The postoperative period was uncomplicated. Conclusion: In this paper, the authors draw the attention of clinicians to the fact that the occurrence of concrescent teeth in clinical practice is rare and that it is difficult to diagnose this anomaly on the basis of routine radiological diagnostics based on 2D images. They also point to the necessity of a thorough physical examination and a thorough assessment of teeth before extraction, the extension of imaging diagnostics by conical CT scan in justified cases, and informing the patient about possible complications. In order to avoid serious complications, the extraction of the concrescent teeth should be performed by an experienced specialist in dental or maxillofacial surgery.

Objectives: Periapical periodontitis, which is a periodontal dysfunction, is a current clinical problem. Due to the frequency of occurrence and the adverse effects they cause, they are considered a social disease. They require detailed diagnostics to implement appropriate treatment. Mathematical calculations based on data obtained from radiological images used in routine clinical practice may help differentiate the forms of periodontitis. This study aimed to evaluate the areas affected by periodontitis in comparison to the healthy tissues of the periapical area. Methods: The study analyzed texture components using the gray-level co-occurrence matrix (GLCM) and the gray-level run-length matrix (GRLM) on an orthopantomogram (OPG) from 50 patients with clinically confirmed periodontitis treated at the Department of Maxillofacial and Plastic Surgery, University of Bialystok. Texture analysis was performed on defined regions of interest (ROIs) to distinguish diseased from healthy tissues. We employed four classification algorithms to assess model performance. Results: The data set included 50 patients, with 76 cases of periodontitis and 50 healthy ROIs. The reference standard was clinical diagnosis confirmed by two specialist doctors. The best-performing algorithm achieved an AUC of 98%. Conclusions: The obtained results showed significant statistical differences in the inflamed regions compared to the control, which may aid in diagnosing and selecting the treatment method for periodontitis.