Background: This study aimed to evaluate the efficacy of pentoxifylline and tocopherol therapy in patients with medication-related osteonecrosis of the jaw (MRONJ). Methods: During this study, 43 patients participated, including 21 women and 22 men with a mean age of 66.8 years, who showed 63 areas of osteitis altogether. The diagnosis was made based on X-ray imaging and histopathological findings. All the subjects received pharmacological treatment with pentoxifylline 400 mg and tocopherol 400 IU. The study scheme consisted of initial observation and two follow-up examinations every 5–6 months. MRONJ severity, peripheral blood parameters, and CRP levels were evaluated. The obtained results were statistically analyzed. Results: Complete remission occurred in 46% of the subjects, with a higher rate among those taking bisphosphonates intravenously compared to oral administration. The efficacy of pentoxifylline and tocopherol treatment was not influenced by gender or lesion location. Moreover, the worst response to treatment was observed in the group with the highest disease stage, as determined in the initial study. Conclusions: Pentoxifylline and tocopherol therapy in MRONJ was effective in patients taking oral and intravenous bisphosphonates, in patients with osteoporosis, and undergoing oncological treatment. This treatment approach allows surgery to be avoided or significantly reduced. The good response to pharmacotherapy observed in patients with early stages of MRONJ shows an urgent need to monitor the patients treated with bisphosphonates carefully to diagnose MRONJ at the initial phase.

Objectives: The aim of the study was to compare the perinatal outcome between the normal weight, overweight and obese pregnant women who delivered in the third-level center of reference. Moreover, the objective was to analyze the usefulness of predelivery body mass index (BMI) in prediction of preterm delivery, prolonged second stage of labor, instrumental vaginal delivery, cesarean section, fetal macrosomia, dystocia and newborn acidosis. Material and methods: The retrospective study included 2104 patients, divided into three groups, with BMI between 18.5 and 24.9; 25.0 and 29.9; higher than or equal 30.0 kg/m², respectively. The data was assessed from the medical history. Results: The predelivery obesity increases the risk of cesarean section (aOR 1.63), macrosomia (aOR 8.89) and dystocia (aOR 3.40) in comparison to normal weight women. Moreover, the obese females had three times greater risk of having a macrosomic child (aOR 3.57) and 1.5 times greater risk of cesarean section (aOR 1.52) than overweight group. The role of predelivery BMI in the prediction of cesarean delivery (AUC 0.550; sensitivity 0.39; specificity 0.71, p < 0.001, cut-off value 28.7 kg/m²), macrosomia (AUC 0.714; sensitivity 0.66; specificity 0.70; p < 0.001, cut-off value 29.0 kg/m²) and dystocia (AUC 0.658; sensitivity 0.77; specificity 0.53, p < 0.001, cut-off value 27.0 kg/m²) was significant. Conclusions: The predelivery obesity increases the risk of cesarean section, macrosomia and shoulder dystocia and is a useful parameter in the prediction of perinatal outcomes. The establishing cut-off value for predelivery BMI was the lowest in prediction of shoulder dystocia. Objectives: The aim of the study was to compare the perinatal outcome between the normal weight, overweight and obese pregnant women who delivered in the third-level center of reference. Moreover, the objective was to analyze the usefulness of predelivery body mass index (BMI) in prediction of preterm delivery, prolonged second stage of labor, instrumental vaginal delivery, cesarean section, fetal macrosomia, dystocia and newborn acidosis. Material and methods: The retrospective study included 2104 patients, divided into three groups, with BMI between 18.5 and 24.9; 25.0 and 29.9; higher than or equal 30.0 kg/m², respectively. The data was assessed from the medical history. Results: The predelivery obesity increases the risk of cesarean section (aOR 1.63), macrosomia (aOR 8.89) and dystocia (aOR 3.40) in comparison to normal weight women. Moreover, the obese females had three times greater risk of having a macrosomic child (aOR 3.57) and 1.5 times greater risk of cesarean section (aOR 1.52) than overweight group. The role of predelivery BMI in the prediction of cesarean delivery (AUC 0.550; sensitivity 0.39; specificity 0.71, p < 0.001, cut-off value 28.7 kg/m²), macrosomia (AUC 0.714; sensitivity 0.66; specificity 0.70; p < 0.001, cut-off value 29.0 kg/m²) and dystocia (AUC 0.658; sensitivity 0.77; specificity 0.53, p < 0.001, cut-off value 27.0 kg/m²) was significant. Conclusions: The predelivery obesity increases the risk of cesarean section, macrosomia and shoulder dystocia and is a useful parameter in the prediction of perinatal outcomes. The establishing cut-off value for predelivery BMI was the lowest in prediction of shoulder dystocia.

Medication-related osteonecrosis of the jaw (MRONJ) represents a major clinical challenge for oral and maxillofacial surgery departments as well as dental practices. With increasing life expectancy and the more frequent use of medications associated with osteonecrosis, the incidence of MRONJ continues to rise. To date, there are no uniform treatment standards with scientifically proven effectiveness for this condition. To evaluate the impact of platelet-rich fibrin (PRF) on the outcomes of MRONJ treatment and to identify factors that may influence the effectiveness of PRF therapy, we conducted a comparative prospective study including 22 patients divided into two groups: patients treated with PRF and patients treated without PRF. PRF was prepared according to the PRF Duo Quattro Process protocol for PRF (Nice, France). The study was registered at ClinicalTrials.gov (NCT07464678). The following parameters were assessed: age, smoking status, gender, lesion location, body mass index (BMI), C-reactive protein (CRP) concentration, pain intensity, presence or absence of fistulas, soft tissue healing and radiological findings. Patients were evaluated preoperatively and postoperatively at 14 days, 6 weeks, and 6 months. The study demonstrated a reduction in pain after surgery among patients treated with PRF. In addition, the use of PRF resulted in improved healing outcomes in patients with elevated CRP. Higher BMI was associated with poorer therapeutic response to PRF. Improvements in soft tissue healing and disease stage were observed in the PRF group; however, these differences did not reach statistical significance. All findings should be interpreted with caution due to the limited sample size. There is still no standardized treatment for MRONJ. The use of platelet-rich fibrin as an inexpensive and safe adjunctive therapy may provide clinical benefits for patients, particularly through a significant reduction in pain. Further large-scale, multicenter studies are required to confirm these findings.

Radiation-induced and drug-induced bone necrosis present significant challenges for maxillofacial surgery departments and dental clinics. While the incidence of osteoradionecrosis (ORN) has decreased, the number of cases of medication-related osteonecrosis of the jaw (MRONJ) has markedly increased. This trend is associated with higher life expectancy and more frequent use of medications linked to MRONJ. To date, no uniform, scientifically validated treatment standards have been established for these conditions. The aim of the study was to evaluate treatment outcomes in patients with ORN and MRONJ, as well as to identify risk factors for complications, with particular emphasis on differences in clinical presentation and management. A retrospective analysis of medical records over a five-year period was conducted, including the charts of patients diagnosed with MRONJ and ORN who were hospitalized at the Department of Maxillofacial Surgery, Poznan University of Medical Sciences, Poland, and subsequently followed up in the outpatient setting. Selected parameters included C-reactive protein (CRP), smoking status, type of necrosis, sex, and hospitalization time. Differences in patient characteristics, including age, sex, smoking status, and clinical presentation, were observed between the groups. Patients with MRONJ were, on average, 5 years older than those with ORN and exhibited a significantly higher concentration of CRP, indicating a more pronounced inflammatory response. Smoking was identified as a weak but notable predictor of the need for mandibular resection. Additionally, elevated concentrations of CRP were associated with longer hospitalization and a higher incidence of complications, potentially contributing to prolonged hospital stays and an increased risk of adverse outcomes. The findings highlight distinct clinical courses for MRONJ and ORN, underscoring the need for differentiated treatment strategies. Given the lack of standardized treatment protocols, the observed variations in clinical outcomes suggest the necessity for more targeted therapeutic approaches. Further research is essential to establish effective treatment protocols.

Graves' orbitopathy (GO) is a chronic autoimmune condition causing inflammation in the orbit, leading to exophthalmos (bulging eyes) and a "startled" look. Untreated, it can cause corneal ulcers or vision loss, making early diagnosis vital. This report details a 37-year-old female admitted for urgent surgery due to progressive GO since December 2023. Presenting with asymmetric exophthalmos, superior orbital muscle enlargement, and excess retrobulbar fat, she was qualified for right orbital decompression surgery. The procedure involved lateral and medial orbital wall access, resection of a bone segment, and removal of 3.5 ml of periorbital fat. This increased orbital volume and successfully reduced the exophthalmos. The patient was also referred for strabismus and eyelid retraction correction, with potential blepharoplasty. Orbital decompression is sometimes an emergency procedure in advanced GO. Treatment is individualised and interdisciplinary, combining drugs, radiotherapy, and surgery based on disease severity.