(1) Background: Hypersensitivity reactions to metals may arise in predisposed patients chronically exposed to metallic materials, including dental implants made of titanium alloys. The purpose of this article was to systematically review titanium allergy manifestations in patients treated with dental implants and report a clinical case; (2) Methods: A systematic electronic search was performed for articles published in the English language until July 2021. The following eligibility criteria were adopted: (1) Population: individuals undergoing titanium and/or titanium alloy implant-supported rehabilitations; (2) Exposure: peri-implant soft tissue reactions attributable to implant insertion; (3) Outcome: evidence of titanium allergy, diagnostic methods, and forms of resolution; (3) Results: The included studies, in summary, presented evidence that titanium should not be considered an inert material, being able to trigger allergic reactions, and may be responsible for implant failure. A 55-year-old male patient received 3 implants in the posterior region of the left mandible and presented an epulis-like lesion developed from the peri-implant mucosa. The immunohistochemical analysis of the biopsy specimen confirmed the initial diagnosis of allergic reaction to titanium; (4) Conclusions: Although the evidence is weak, and titanium allergy has a low incidence, hypersensitivity reactions should not be underestimated. A rapid and conclusive diagnosis is mandatory to prevent further complications.

Magnesium (Mg) alloys have received attention in the literature as potential biomaterials for use as absorbable implants in oral and maxillofacial and orthopedic surgery applications. This study aimed to evaluate the available clinical studies related to patients who underwent bone fixation (patients), and received conventional fixation (intervention), in comparison to absorbable metals (comparison), in terms of follow-up and complications (outcomes). A systematic review and meta-analysis were performed in accordance with the PRISMA statement and PROSPERO (CRD42020188654), PICO question, ROBINS-I, and ROB scales. The relative risk (RR) of complications and failures were calculated considering a confidence interval (CI) of 95%. Eight studies (three randomized clinical trial (RCT), one retrospective studies, two case-control studies, and two prospective studies) involving 468 patients, including 230 Mg screws and 213 Titanium (Ti) screws, were analyzed. The meta-analysis did not show any significant differences when comparing the use of Mg and Ti screws for complications (p = 0.868). The estimated complication rate was 13.3% (95% CI: 8.3% to 20.6%) for the comparison group who received an absorbable Mg screw. The use of absorbable metals is feasible for clinical applications in bone surgery with equivalent outcomes to standard metal fixation devices.

The aim of this study was to analyze the effect of ozone (OZN) therapy on the dynamics of bone tissue in ovariectomized rats treated with zoledronic acid (ZOL). Female Wistar rats aged 6 months ( n = 110) were subjected to bilateral ovariectomy (OVX). At month 3 post-OVX, 10 animals were euthanized to characterize the bone tissue architecture using microtomography (micro-CT). The remaining animals were divided into two groups: ZOL group, administered with ZOL (100 μg/kg body weight); saline (SAL) group (0.45 mL of SAL solution), both for 28 days. At month 3 post-treatment, 10 animals from each group were euthanized to characterize the bone architecture using micro-CT. The remaining animals were divided into the following groups: ZOL ( n = 20), ZOL + OZN ( n = 20); SAL ( n = 20), and SAL + OZN ( n = 20). The animals in ZOL + OZN and SAL + OZN groups were intraperitoneally administered with OZN (0.7 mg/kg body weight) once every 2 days. On days 30 and 60, six animals from each group were euthanized for analysis and structural characterization of bones in the femoral head and spine. Some samples of the femoral neck were subjected to biomechanical tests, while some samples were analyzed under a laser confocal microscope. The other samples collected from the femoral neck and spine were analyzed for area of neoformed bone and used for performing inflammatory cell and osteocyte counts. Data were submitted to statistical analysis considering a significance level of p < 0.05. Bone volume percentage and osteocyte and inflammatory cell counts were upregulated in the femoral head region of the ZOL + OZN group. Biomechanical analysis of the femoral neck revealed that the modulus of elasticity was similar between the ZOL and ZOL + OZN groups but differed significantly between the SAL and SAL + OZN groups. The positive areas for calcein and alizarin in the ZOL and ZOL + OZN groups were higher than those in the SAL and SAL + OZN groups. This suggested a positive synergistic effect of OZN and ZOL on the maintenance of bone mass and restoration of bone tissue vitality in ovariectomized rats.

Background/Objectives: Medication-related osteonecrosis of the jaw (MRONJ) is a challenging condition often associated with bisphosphonate use, leading to impaired bone healing and difficult clinical management. Given the lack of predictable therapeutic options, this study investigated the effects of systemic ozone therapy on MRONJ healing. This study aimed to analyze the effects of systemic ozone therapy on oral hard and soft tissue healing in senescent rats with medication-related osteonecrosis of the jaw (MRONJ) induced by antiresorptive therapy. Methods: Twenty-eight senescent Wistar rats, aged eighteen months and weighing ~350 g, were used for this study. The animals were divided into four groups. The negative control (SAL) group received saline applications, while the control-treated (SAL+OZ) group received saline applications and ozone therapy (0.7 mg/kg). The MRONJ (ZOL) group received Zoledronate, an intravenous antiresorptive drug (100 μg/kg), and the MRONJ-treated (ZOL+OZ) group received zoledronate application and was treated with systemic ozone therapy (0.7 mg/kg). All rats underwent molar extraction in the third week of the experiment and were euthanized in the seventh week of the experiment. The mandibles were resected, reduced, and prepared for microtomographic analysis, histopathological/histometric analysis, and immunohistochemistry. Results: The ZOL group presented characteristics of vitreous, non-vital, and dense bone, poor vascularization, and high values of inflammation markers compatible with MRONJ. In contrast, the ZOL+OZ group exhibited improvement in alveolar bone and soft tissue healing, a decrease in nonvital bone area, and modulation of local inflammation. Conclusions: It can be concluded that Ozone therapy improved oral hard and soft tissue healing of MRONJ in senescent female rats subjected to antiresorptive drugs and might be considered for future clinical applications.

Aunque el dolor orofacial es una condición de etiopatogenia multifactorial y en ocasiones es difícil de diagnosticar, una posible causa de esta condición son los cambios musculares, que a su vez pueden originarse en condiciones sistémicas, como la hipocalcemia. El presente artículo tiene como objetivo presentar una situación clínica de dolor orofacial por hipocalcemia en una paciente joven con enfermedad renal crónica. El paciente acudió a atención hospitalaria con fuertes quejas de dolor en el rostro, siendo evaluado por el equipo de Cirugía Maxilofacial y el equipo médico de Neurología, sin la determinación precisa de una etiología. A pesar de que se le prescribió medicación oral, el paciente regresó con la queja de dolor y con un nuevo síntoma de calambres en el rostro, ante lo cual se solicitó pruebas hematológicas donde se encontró una condición de hipocalcemia. El enfoque terapéutico consistió en suplementos de calcio por vía oral, que fue suficiente para suprimir las molestias faciales. Se concluye que existe una correlación entre la concentración de calcio en sangre y los cambios musculares en el rostro, requiriendo estudios clínicos para explicar mejor esta relación.

Posterior mandible region is considered a highly predicable place for primary stability during dental implant placement. Although, this region can present a significant decrease in bone density, which can lead to implant dislocation during insertion. The present case reports an unusual dislocation of dental implant in a 59 old healthy patient's mandible and a secure solution for this kind of complication. During the drilling, bone quality type IV was observed. In sequence, implant was abruptly inserted in the perforation site and dropped into the bone marrow. Panoramic radiograph showed the implant inside bone marrow, close to mandibular base. The implant was removed through the surgical site. The screw of the implant prosthesis transfer was used to reach the displaced implant. A second implant with the same dimensions as the first one, differing by the external hexagon, was inserted into the same implant site. Therefore, the authors strongly recommend the use of the presented technique prior to osteotomy on mandibular body, reserving the second in the impossibility of reaching the internal connection of the displaced implant.