Background/Objectives: This study aims to determine the validity of a recently developed and published index (the modified Composite Radiographic Index—CRIm) as an indicator of disease gravity and progression in the CBCT scans of patients with medication-related osteonecrosis of the jaw (MRONJ) and to detect possible correlations between the radiologic findings and clinical staging of the disease. Methods: This study included 43 MRONJ patients with CBCT scans from the School of Dentistry of National and Kapodistrian University of Athens, approved by the Research Ethics Committee. Clinical staging (0–3) was provided based on AAOMS 2022 guidelines. A total of 52 CBCT scans were analyzed, with maxillae and mandibles evaluated separately when both were involved. Two independent observers assessed eight radiologic features, including lytic changes, sclerosis, periosteal reaction, sequestration, non-healing extraction sockets, and other findings (sinus involvement, inferior alveolar canal involvement, and jaw fracture). The CRIm was applied to quantify osseous changes, scoring each feature (0 (absent), 1 (localized/single), 2 (extensive/multiple)), yielding a range of 0–12. For the statistical analysis, Fisher’s exact test and Spearman’s correlation coefficient were used. Results: Clinical Stage 1 consisted of 19 jaws, Stage 2 consisted of 16 jaws, and Stage 3 consisted of 17 jaws. No affected jaws were recorded with Stage 0. A statistically significant correlation between the clinical stage and lytic changes, sequestration, and inferior alveolar canal involvement was found (p-value < 0.05). Extensive lytic changes, sclerosis, sequestration, periosteal bone formation, and inferior alveolar canal involvement were mostly observed in clinical Stage 3. Furthermore, a statistically significant correlation between clinical stage and CRIm classification was found (rho = 0.446; p-value < 0.001). Conclusions: The CRIm tends to increase as the clinical stages of MRONJ advance, suggesting a correlation between them.

One of the most common malocclusions encountered in everyday practice by orthodontists is skeletal Class II malocclusion, namely a protrusion of the maxilla, a retrusion of the mandible or a combination of both. To correct it, many clinicians use functional devices that guide the mandible into a more forward position. This stimulates bone growth, correcting the skeletal discrepancy. Controversy exists as to whether these appliances accelerate the growth rate, helping the mandible reach its final size earlier, or whether the growth of the mandible is observed as a positive response to the stimuli. This study examined whether the protrusion of the mandible in rats accelerates the growth rate or increases the overall growth of the mandible in the long run. Relapse was also assessed by removing the appliance prior to the end of the experiment. Seventy-two four-week-old Wistar rats were used. The treatment group, which consisted of 36 rats, had a device fitted on their upper incisors that led to a protrusion of their mandible. The device, a bite-jumping appliance, consisted of an iron-cast inclined plane and was fitted for 24 h a day, inducing a 3.5 mm anterior protrusion and 3 mm inferior displacement of the mandible. The control group consisted of 36 rats that were fed the same soft diet as the treatment group. Both groups were divided into three subgroups. The first was sacrificed 30 days after the onset of the experiment, the second at 60 days, and the last subgroup had the appliance removed for 30 days and was sacrificed 90 days after the onset of the experiment. At the beginning of the experiment, as well as at each time interval prior to the sacrifice of the animals, the appliances were removed, and cone beam-computed tomography was performed on every animal. Linear measurements were made on each 3D scan, measuring the growth of the mandible. Measurements of mandibular growth were higher compared to the control group. For instance, Gonion-Menton was 1.18 mm higher on month 2 compared to month 1 in the control group, whereas the same measurement marked a 1.82 mm difference in the experimental group. Condylion–Menton on the same intervals marked a 0.84 mm difference in the control, whereas a 1.35 mm difference was noted in the experimental group. Given the results, true mandibular growth is achieved using functional appliances for Class II malocclusion correction in rats.

Purpose: The purpose of this study is to apply the Composite Radiographic Index modified (CRIm) in CBCT scans of patients with Medication related osteonecrosis of the jaws (MRONJ) in order to detect its validity, and corelate the radiologic findings with the clinical staging of the disease. Methods: This study included 43 patients with MRONJ diagnosis and CBCT scans performed in the School of Dentistry and approved by the Research Ethics Committee. Clinical staging for every patient (0-3) was provided according to AAOMS 2022 guidelines. In cases of patients with both jaws affected, each jaw was evaluated independently resulting to 52 CBCT scans. The 52 CBCT scans were assessed under standardized viewing conditions by 2 observers who evaluated independently the following 8 radiologic features: lytic changes, sclerosis, periosteal reaction, sequestration, non-healing extraction sockets and other findings (sinus implication, inferior alveolar canal involvement, jaw fracture). The CRIm index was constructed to assess the extent of osseous changes. The radiologic features were scored as absent (0), localized/single (1), extensive/multiple (2), yielding a theoretical range of 0–12. For statistical analysis Fisher’s exact test and Spearman’s correlation coefficient were performed. Results: A statistically significant association of clinical stage with lytic changes, sequestration and inferior alveolar canal involvement was found. Also, a statistically significant correlation of clinical stage with CRIm index classification was obtained. Conclusions: The CRIm index tends to increase as the clinical stages of MRONJ advance, suggesting a correlation between the clinical stage of MRONJ and the CRIm index.

Background: Craniofacial growth is regulated by a complex interaction of genetic, functional, and systemic metabolic factors. Mechanical loading generated during mastication plays a fundamental role in mandibular development through bone modeling and remodeling mechanisms. In contrast, Type I diabetes mellitus is associated with impaired bone metabolism, which may compromise skeletal growth. Although the independent effects of functional loading and metabolic disorders on bone tissue have been widely investigated, their combined influence on mandibular development remains insufficiently understood. Objective: This study primarily aimed to evaluate the effect of Type I diabetes mellitus on mandibular growth in growing rats and, secondarily, to assess the impact of dietary consistency (hard versus soft food) on mandibular development under diabetic and non-diabetic conditions, as well as determine whether diabetes modifies the mandibular adaptive response to increased masticatory loading. Materials and Methods: An experimental animal study was conducted using twenty-four male Wistar rats aged one month. The animals were randomly allocated into four groups according to metabolic status (control or diabetic) and dietary consistency (hard or soft diet). Type I diabetes mellitus was experimentally induced in the relevant groups using streptozotocin. All animals underwent cone beam computed tomography (CBCT) scanning at baseline (Day 1) and at the end of the experimental period (Day 28). Linear measurements were obtained using specialized software following euthanasia. Two-way ANOVA was used to evaluate the effects of diabetes, diet, and their interaction, using appropriate post hoc tests for multiple comparisons. Categorical variables were analyzed using the chi-square test. A p-value < 0.05 was considered statistically significant. Results: Longitudinal morphometric analysis demonstrated that Type I diabetes mellitus significantly impaired mandibular growth. Diabetic animals exhibited reduced growth rates and smaller final mandibular dimensions compared with controls. Hard diet intake significantly enhanced mandibular development in control animals, reflecting a strong adaptive response to increased functional loading. However, this osteogenic response was markedly attenuated in diabetic rats. Under soft-diet conditions, differences between control and diabetic groups were diminished, indicating that reduced mechanical stimulation limits adaptive growth responses. Significant interaction effects between diabetes and dietary consistency were observed in several morphometric parameters, particularly those related to mandibular body length, ramus height, and condylar position. Conclusions: Type I diabetes mellitus exerts a detrimental effect on mandibular growth in growing rats and compromises the adaptive response of craniofacial structures to mechanical loading. Although a hard diet functions as a potent osteogenic stimulus, its growth-promoting effect is substantially reduced in the presence of metabolic dysfunction.