Medication-related osteonecrosis of the jaw (MRONJ) has become a well-known side effect of antiresorptive, and antiangiogenic drugs commonly used in cancer management. Despite a considerable amount of literature addressing MRONJ, it is still widely accepted that the underlying pathomechanism of MRONJ is unclear. However, several clinical and preclinical studies indicate that infection seems to have a major role in the pathogenesis of MRONJ. Although there is no conclusive evidence for the infection hypothesis yet, available data have shown a robust association between local infection and MRONJ development. This observation is very critical in order to implement policies to reduce the risk of MRONJ in patients under antiresorptive drugs. This critical review was conducted to collect the most reliable evidence regarding the link between local infection and MRONJ pathogenesis.

Background/Objectives: The aim of this study is to examine the relationship between cervical spine and jaw bone mineral density (BMD) and assess how cortical thickness and BMD influence primary implant stability (PIS) across different bone health conditions. Methods: The study included 29 patients (mean age: 63.7 ± 13.7 years; 13 women) and 15 healthy controls (mean age: 25.3 ± 3.0 years; seven women). Cervical spine (C2–C4) and mandibular BMD were evaluated using asynchronous calibration and manual segmentation. Cortical thickness was measured, and primary implant stability was assessed via insertion torque in Newton centimeters (Ncm). Results: Cervical spine BMD was significantly lower in the patient group compared to controls (203.0 ± 51.0 vs. 252.0 ± 21.7 mg/dL, p < 0.0001). No significant correlation was found between mandibular BMD and cervical spine BMD in both groups (patients: ρ = 0.1287; p = 0.506, controls r = −0.1214; p = 0.667). Linear regression analysis revealed that cortical thickness alone, not implant site BMD, significantly influenced PIS (F(2.74) = 5.597, p = 0.005). Conclusions: Asynchronous calibration accurately quantifies cervical and mandibular BMD. Cortical thickness rather than overall bone density emerges as a critical factor in determining implant stability. These findings suggest that clinicians should prioritize cortical thickness assessment when planning dental implant procedures, potentially improving outcomes across diverse patient bone health profiles.