Introduction: an oro-antral communication is defined as a permanent pathological connection between the maxillary sinus and the septic oral cavity. Several flaps can be used for the closure (buccal flap, palatal flap, combination techniques) but relapses occur often in case of a large defects and underlying general conditions. Bichat fad pad flap is a multipotent pedicled fatty tissue that is easily accessible from the oral cavity that can be used for the closure of medium-sized defects, even in immunocompromised patients due to its stem cell capacity. Materials and methods: the medical information of the patients diagnosed with oro-antral communications who were admitted and treated in the Oral and Maxillo-Facial Clinic Targu Mures, between 2013 and 2020 were analyzed. A database containing general information, reported causes, associated diseases, surgical methods used during admission, and relapses, was created. The information was statistically processed. The written consent and ethical approval were obtained. Results: the study shows that from a total of 140 cases, 72 were treated using buccal advancement flap, 49 using Bichat fat pad flap, and 19 using palatal flaps. The dimensions of the communications ranged between 0.3 cm and 1.5 cm. Several statistically significant results could be found when comparing the surgical methods. Of the 72 patients treated with buccal advancement flaps, 25 presented relapses as opposed to the patients treated with Bichat fat pad flaps who showed no complications, p < 0.05. Analysing this aspect further, all large defects (10 cases) ranging from 0.6 cm to 1.5 cm treated with advancement buccal flaps (Rehrmann flaps) showed relapses (p < 0.05). Considering the general conditions, out of 7 patients who received radiotherapy 4 presented relapses, as opposed to the healthy patients, p < 0.05. Regarding the reintervention for the relapsed cases, the majority of the cases treated a second time with buccal advancement flap (5 out of 7 cases) failed as opposed to the Bichat fat pad flap with no further relapses (p < 0.05). Conclusions: the most frequently used surgical treatment is the buccal flap, which also has the highest relapse rate. Both primary treatment with Bichat fat-pad flap and re-treatment of relapses using this flap have had 100% success rates, even in patients with general associated conditions, in contrast with patients treated by using the buccal flap. The dimensions of the oro-antral communication and general conditions are crucial factors for the success of the surgical treatment.

Background: The use of dental implant rehabilitation in the treatment of complete and partial edentulism has become an integral treatment today. This treatment is performed on healthy patients, but in some situations, also on those with associated general ailments. The presence of associated conditions increases the degree of difficulty of this type of treatment and tests the doctor’s ability to manage the clinical case. The purpose of the study was to perform a meta-analysis of dental implants inserted over seven years and evaluate early implant failure in correspondence with age, sex, region of insertion, type of implant, and general state of health. Methods: A retrospective study was performed over 7 years of experience. For the study, 213 patients who fit the established inclusion criteria were selected. Patients were grouped taking into account age, sex, the type of implant used, and general associated conditions. The collected data were analyzed using IBM SPSS STATISTICS 25.0 for windows Results: There were no highlighted situations in which the rejection of the dental implant occurred 10 days postoperatively or later during the healing period. Conclusions: Our results confirm and strengthen the existing data in the specialized literature, especially those related to the loss of implants in patients with associated general diseases.

Background/Objectives: Dental implant success is influenced by a range of systemic and local factors. Emerging evidence suggests that metabolic markers such as lipid profiles and vitamin D levels may play a role in osseointegration and implant survival. The aim of this study was to evaluate the influence of low-density lipoprotein (LDL) cholesterol, high-density lipoprotein (HDL) cholesterol, triglycerides, and vitamin D levels on the short-term survival rate of dental implants. Materials and Methods: A prospective observational study was conducted on patients receiving dental implants. Preoperative serum levels of LDL, HDL, triglycerides, and vitamin D were recorded. A total of 556 conical, platform-switching implants were placed in 166 patients, smokers and no smokers with mean age 48 years ± 4.7. Implant survival was evaluated from 14 to 21 days after placement, at 6- and at a 12-month follow-up. Spearman’s rank correlation was performed to assess potential correlations between the abovementioned systemic factors and implant loss. Results: Out of 556 implants, 13 (2.34%) were lost from 14 to 21 days after placement, a further two (0.35%) were lost after 6 months after surgery and a further eight (1.44%) were lost 12 months after placement. No significant correlation was found between HDL levels, cholesterol levels, triglyceride levels and implant loss. Spearman’s correlation analysis revealed a strong negative correlation between vitamin D levels and implant loss with no statistical significance. Conclusions: Within the limitations of this study, no statistically significant associations were found between lipid profile markers or vitamin D levels and early dental implant loss. Further large-scale and long-term studies are warranted to validate these findings and better understand the interplay between systemic biochemical markers and implant survival rate.

Sunitinib is commonly used in the treatment of patients with renal cell carcinoma and is associated with serious side-effects. We present the first report of a recurrent submandibular fistula in a patient treated with sunitinib. A 68-year-old man was referred to our clinic for a cutaneous fistula situated on the right side of his lower jaw. The patient had been diagnosed with bone metastases from a renal carcinoma 2 years ago and had received a single 4 mg dose of zoledronic acid and subsequent treatment with sunitinib 37.5 mg once daily for the past 4 weeks. The patient was treated surgically by a perilesional incision and primary closure with sutures, advised on meticulous oral hygiene and was kept on an antimicrobial agent in the form of clindamycin. After reinitiating his oncological treatment with sunitinib the cutaneous fistula re-appeared and bone abnormalities were also detected on his X-ray. After 18 months a contralateral cutaneous fistula was observed along with a spontaneous avulsion of the patient’s left molar. Repeat surgical treatment and sequestrectomy was performed with the subsequent histopathological examination revealing a suspicion of osteonecrosis of the jaw and an associated Actinomyces infection.

Maxillary canine impaction is a common clinical condition often requiring a combined surgical–orthodontic approach; however, the effect of different surgical strategies on periodontal outcomes remains unclear. This systematic review aimed to evaluate periodontal outcomes following treatment of impacted maxillary canines, with particular focus on the influence of surgical technique (open vs. closed) and impaction site (palatal vs. buccal). A comprehensive search of PubMed, Scopus, and Web of Science was conducted up to January 2026 in accordance with PRISMA guidelines, and the protocol was registered in PROSPERO. Randomized controlled trials, controlled clinical studies, observational studies, case series, and case reports reporting periodontal parameters were included. Primary outcomes comprised probing pocket depth, keratinized tissue width, gingival thickness, plaque and bleeding indices, and gingival recession. Twenty-seven studies were included. Overall, treated canines were associated with periodontal conditions comparable to normally erupted teeth, with probing depths generally within physiological limits and minimal gingival recession. Buccally impacted canines tended to show slightly reduced keratinized tissue compared with palatal impactions, although without clear clinical relevance. No consistent superiority of open or closed techniques was identified. Surgical–orthodontic treatment is generally associated with favorable periodontal outcomes, and treatment selection should be individualized according to anatomical and orthodontic factors.

Osteonecrosis of the jaw represents interference by external and internal factors in the natural bone remodeling system. Numerous bone remodeling agents (BMAs), such as bisphosphonates, denosumab, and tyrosine kinase inhibitors, can lead to medication-related osteonecrosis of the jaw (MRONJ). This is a serious condition that ocurs as a side-effect of treatment in patients with osteoporosis or malignancies. Antiresorptive drugs are medications that target osteoclasts with the aim of preventing bone resorption and are used to treat osteoporosis, osteopenia, and a variety of other conditions, such as Paget’s disease. They are also used in cancer patients with active bone metastases where antiresorptive treatment is used for the prevention of skeletal complications. Poor dental health, infections, and especially dental surgery are the primary causes of MRONJ, while other risk factors, such as smoking, alcohol abuse, and diabetes mellitus, can also influence its development. Prevention is the key component of management, and thus awareness of the risk factors among prescribers is very important. The aim of our study was to evaluate current knowledge about MRONJ among BMA prescribers in an academic hospital and their awareness about oral health and dental check-ups. By using a custom-designed questionnaire addressed to general and internal medical practitioners, endocrinologists, rheumatologists, and oncologists as an instrument for collecting data, we tried to identify trends in BMA prescription among different specialists and their recommended preventative measures, with the aim of creating new strategies to prevent the occurrence of MRONJ. The survey revealed a low awareness among physicians of the potential risk factors and underlined the need for a concerted effort to improve patient management. In this sense, a multidisciplinary team approach that includes the patient, the drug prescriber, the dentist, and the oral surgeon could significantly improve the quality of life of patients with MRONJ.