Background and Objectives: Medication-related osteonecrosis of the jaw (MRONJ) was first recognized as a disease entity and reported in the literature in 2003. Within a few years, the incidence of MRONJ has increased significantly, to the point where now it can be seen in every dental clinic around the world. Its prevention and management still remain major challenges for dentists and oral and maxillofacial surgeons. Materials and Materials and Methods: This prospective clinical study was conducted at the Oral and Maxillofacial Surgery Clinic in Timisoara for a 6-month period and included a total of 85 patients under chronic antiresorptive and antiangiogenic medication. There were two groups of patients: G1 received PRF growth factors, while the other group, G2, was treated with classical surgical methods. Post-operative wound healing was assessed at 2, 4, and 8 weeks by monitoring the absence of local gingival dehiscence, suprainfection, or loco-regional fistulas, both in cases of dental extractions and sequestrectomies in MRONJ cases. Results: The use of PRF in post-extraction sockets in patients predisposed to developing MRONJ aids in local healing in 96% of cases, compared to cases where it was not used, in which normal healing occurred in only 64.29% of patients; there was a significant difference between the two groups (p = 0.016). In MRONJ confirmed cases, application of PRF after excisional debridement of necrotic bone does not appear to have the same therapeutic value as in post-extractional sockets, with a p-value of 0.299 indicating no statistical significance. Conclusions: PRF use can be considered an effective approach in preventing osteonecrotic complications following dental extractions in patients with antiresorptive treatment. Additional studies are needed to establish its role in MRONJ confirmed cases.

Background/Objectives: The most common form of supernumerary teeth is represented by the mesiodens. Very often, they are impacted, usually palatially, but can be found buccally or between the roots of the permanent central incisors. Their position can be normal, inclined, or inverted. In the possible case where the impacted mesiodens crown is oriented upwards towards the nasal cavity, they are called inverted mesiodens. The inverted mesiodens are mainly asymptomatic, and the main diagnostic methods are radiological, especially CBCT. Methods: This paper presents the intraoral approach through the nasal floor as a very reliable method for the surgical removal of inverted mesiodens. We report a protocol, including the diagnosis process, criteria for choosing this surgical approach, and description of the surgical procedure. Preoperative CBCT is mandatory for diagnosis and choice of the surgical approach. This is chosen based on measurements on the cross-sectional view of the CBCT investigation and is in compliance with our criteria related to the appropriate surgical approach. Results: Using this approach, the mesiodens were extracted without intraoperative or postoperative complications or accidents, and operating times were relatively short. Conclusions: The intraoral approach through the nasal floor for surgical removal of inverted mesiodens satisfies all the conditions to be a predictable, safe, and time-efficient technique. It has its limitations, mainly regarding the surgical skills of the operating team. The cone–beam computed tomography (CBCT) has a fundamental role in the diagnosis and treatment of included mesiodens.

Ameloblastoma is a benign epithelial tumor that has aggressive, destructive and unlimited growth potential, having the capacity for recurrence and malignant transformation. Regarding the symptoms and clinical signs, the presentation of ameloblastoma is poor. In children and young people, ameloblastoma can be difficult to diagnose, because it mimics other benign lesions. Its diagnosis requires a combination of imaging data, histopathological analysis and molecular tests. The methods of treatment consist of radical surgery (segmental resection) and conservative treatments (enucleation with bone curettage). The particularity of the presented case is represented by the late request for medical consultation, a direct consequence of the measures implemented to prevent and control the spread of COVID-19.

Background: Dentofacial deformities (DFDs) comprise heterogeneous sagittal, vertical, transverse, and asymmetry components, yet clinical severity is often summarized using isolated measurements. Objectives: To operationalize a reproducible composite DFD severity score and evaluate its cross-sectional associations with quality of life, function, airway-related screening indicators, and psychosocial burden. Methods: In this single-center cross-sectional study, consecutive adults assessed in an orthognathic surgery pathway underwent a prespecified 0–100 severity scoring framework integrating sagittal discrepancy (|Wits| and |ANB deviation|), vertical pattern (SN-MP angle), and asymmetry/transverse variables (chin deviation, asymmetry index, transverse discrepancy, and absolute overjet). Outcomes included the Oral Health Impact Profile-14 (OHIP-14), Orthognathic Quality of Life Questionnaire (OQLQ), FACE-Q facial appearance satisfaction scale, PHQ-9, GAD-7, STOP-Bang, functional testing, and CBCT-derived upper-airway metrics. Results: Severe DFDs had higher composite severity (62.9 ± 12.8 vs. 25.3 ± 10.9), larger sagittal discrepancy (|Wits| 6.3 ± 2.8 vs. 3.1 ± 1.8), and higher SN-MP angles (39.8 ± 7.4 vs. 34.7 ± 7.2) (all p < 0.001). Severe DFDs also had worse OQLQ (36.2 ± 6.2 vs. 24.1 ± 7.2), OHIP-14 (18.3 ± 4.2 vs. 12.4 ± 4.1), FACE-Q satisfaction (45.7 ± 10.3 vs. 67.6 ± 9.6), masticatory performance (59.4 ± 8.5 vs. 75.1 ± 7.5), and smaller airway area (126.7 ± 29.6 vs. 161.4 ± 27.7) (all p < 0.001). In multivariable logistic regression, |Wits|, SN-MP angle, asymmetry index, and lower airway area independently predicted severe status; PHQ-9 was associated with severity in unadjusted analyses but did not retain independent significance after multivariable adjustment. Model discrimination was high (AUC 0.91). Conclusions: This multidimensional severity framework captures clinically meaningful cross-sectional differences across morphologic, functional, airway-related, and psychosocial domains. Its interpretability remained stable in sensitivity analyses, but external and longitudinal validation is still required before broader implementation.

The mesiodens is the most common form of a supernumerary tooth. In the majority of cases they are impacted, usually palatally, but can be found buccally or between the roots of the permanent central incisors. Their position can be normal, inclined or inverted. If the crown of the impacted mesiodens is directed to the nasal cavity they are refer to as an inverted mesiodens. The inverted mesiodens is mainly asymptomatic and the main diagnostic methods are radiological, especially CBCT. This paper presents the nasal floor approach as a very reliable option for extracting inverted mesiodens. We report our protocol, including the diagnosis process, criteria for choosing this surgical approach and description of the surgical procedure. The intraoral approach through the nasal floor for surgical removal of inverted mesiodens satisfies all the conditions to be a predictable, safe and time efficient technique. It has its limitations, manly regarding the surgical skills of the operating team. The cone-beam computed tomography (CBCT) has a fundamental role in diagnosis and treatment of included mesiodens.

Background/Objectives: Bisphosphonates, a class of drugs that are widely used in the treatment of neoplastic diseases, can lead to the development of medication-related osteonecrosis of the jaw (MRONJ). This condition is challenging to manage due to the high incidence of postoperative complications: superinfections, local wound dehiscence, or fractures in pathological bone. The aim of this study is to evaluate the therapeutic role of bovine-derived xenografts in the management of MRONJ. Methods: This retrospective observational study evaluates the clinical outcomes of patients with confirmed stage II or III MRONJ, after surgical treatment with Bio-Oss application. All patients had received zoledronic acid therapy, which was discontinued for a minimum of four months prior to surgical intervention. The surgical protocol included local debridement, sequestrectomy, and grafting of the residual defect with a bone substitute, followed by periodic clinical evaluations and monitoring of local healing with a follow-up period of up to one year. Results: Of the total number of patients treated according to this surgical protocol, 85.71% achieved favorable healing without complications at 8 weeks. Cases with poor local healing results were more likely to have prolonged zoledronic acid administration. Conclusions: Within the limits of this retrospective observational study, the use of bovine-derived xenografts following sequestrectomy in stage II–III MRONJ was associated with satisfactory local healing in several cases. However, considering the limited sample size and lack of a comparator group, these findings should be interpreted cautiously. To better understand the connection between the length of antiresorptive therapy, surgical management techniques, and postoperative outcomes, more prospective, multicenter trials with bigger patient cohorts are needed.