Background: Medication-related osteonecrosis of the jaw (MRONJ) is a type of jawbone necrosis caused by the use of drugs for some types of cancer and osteoporosis. The current study aimed to evaluate the associations between hyperglycemia and the development of medication-related osteonecrosis of the jaw. Methods: Our research group investigated data collected between 1 January 2019 and 31 December 2020. A total of 260 patients were selected from the Inpatient Care Unit, Department of Oromaxillofacial Surgery and Stomatology, Semmelweis University. Fasting glucose data were used and included in the study. Results: Approximately 40% of the necrosis group and 21% of the control group presented with hyperglycemia. There was a significant association between hyperglycemia and MRONJ (p < 0.05, p = 0.003). Vascular anomaly and immune dysfunction caused by hyperglycemia can lead to necrosis after tooth extraction. Necrosis is more common in the mandible (75.0%) and in the case of parenteral antiresorptive treatment (intravenous Zoledronate and subcutaneous Denosumab). Hyperglycemia is a more relevant risk factor than bad oral habits (26.7%). Conclusions: Ischemia is a complication of abnormal glucose levels, a possible risk factor for necrosis development. Hence, uncontrolled or poorly regulated plasma glucose levels can significantly increase the risk of jawbone necrosis after invasive dental or oral surgical interventions.

Purpose: Approximately 19% of the global adult population is affected by periodontal diseases. Healing is a protracted process that is significantly influenced by the patient's motivation, proficiency, and cooperation. The prevalence of periodontal diseases in patients with diabetes mellitus is extremely high, and the relationship is bidirectional. In previous investigations, metformin (MF), a biguanide antidiabetic medicine, has demonstrated promising results when administered locally to periodontal defects. The study aimed to systematically assess available literature that evaluate the effectiveness of 1% metformin gel in the treatment of periodontal disease. We attempted to include clinical trials on patients with periodontitis treated with local administration of 1% metformin gel, compared to a placebo. Methods: Using identical MeSH terms, we conducted a systematic search in three databases. Our analysis encompassed human studies that measured the periodontal pocket depth, the clinical attachment level, and the depth of the intra-bony defect. Meta-analyses were carried out using random effects model to compare the mean differences between the study group, which received 1% MF gel locally in addition to traditional scaling and root planing (SRP), and the control group, which received a placebo in addition to conventional treatment. Results: Following the selection procedure, six articles were selected for inclusion in our meta-analysis, out of the 246 articles identified through the systematic search. After three and six months of follow-up, meta-analyses revealed statistically significant differences between the control and study groups. The overall effect for PD was a 1.33 mm reduction (95% confidence interval (CI): -1.66; -1.01) after three months and 1.87 mm (-2.24; -1.39) after six months. The overall effect of CAL was 1.80 mm (-2.26; -1.34) after three months and 2.14 mm (-2.71; -1.58) after six months. The change in IBD after a six-month follow-up was 1.16 mm (-1.40; -0.92). Conclusion: The application of 1% MF gel enhances the healing process in periodontal diseases, when employed in conjunction with conventional therapy.

The COVID-19 pandemic has significantly impacted healthcare systems worldwide, including dental care. This study aimed to investigate the effects of the pandemic on the management of medication-related osteonecrosis of the jaw (MRONJ). Abnormal blood glucose levels may contribute to the development of MRONJ and act as an important risk factor. This retrospective study included 217 patients with MRONJ. The patients were divided into two groups: the pre-COVID-19 group (16 March 2018 to 16 March 2020; 75 patients; 46 females and 29 males; average age, 74.5 years) and the post-COVID-19 group (1 June 2022 to 1 June 2024; 142 patients; 91 females and 51 males; average age, 69.6 years). Data pertaining to demographic characteristics, length of hospital stay, glucose levels, location of lesions, and underlying diseases were collected. The average length of hospital stays was 4 and 5 days in the pre- and post-COVID-19 groups, respectively. The average fasting glucose levels were 5.5 and 5.9 mmol/L in the pre- and post-COVID-19 groups, respectively. Localization patterns shifted, with a higher incidence in the maxilla in the post-COVID-19 group. These findings suggest a significant increase in MRONJ cases and changes in clinical outcomes due to the pandemic. The increase in the number of patients treated after the pandemic highlights the importance of ongoing vigilance and adaptation in preventing MRONJ, with a particular focus on risk factors.

Background/Objectives: As current methods of measuring blood glucose levels are inconvenient and painful for patients, using salivary glucose as a non-invasive biomarker to estimate glucose levels may improve patient compliance. This study aims to quantify the association between salivary glucose levels and blood glucose levels and to assess how heterogeneity between studies and the methodological differences affect the potential clinical use of salivary glucose. Methods: The PRISMA guidelines were used for this review, and the protocol was registered on PROSPERO (CRD42023471213). Four databases were searched: PubMed, EMBASE, Cochrane’s Library Trials, and Web of Science. The search was conducted on 22 November 2023 and updated on 18 August 2025. No filters were applied for the search. Human studies, where paired salivary and blood samples were taken both from patients with diabetes and healthy individuals after at least 8 h of fasting, were included in the analysis. We extracted correlation coefficients and group means differences. Risk of bias was assessed with QUADAS-2, and the between-study heterogeneity was examined using random-effects models. Results: Through the systematic search, 15,162 articles were found, 25 of which were included in our meta-analysis. The analysis showed a weak correlation between whole-mouth saliva samples and blood samples (r² value: 0.05) and a slightly stronger correlation between parotid saliva samples and blood samples (r² value: 0.11). These low r² values reflect weak associations and are reported descriptively. The difference between the mean salivary glucose level of patients with diabetes and controls was 4.43 mg/dL (95% CI: 2.05; 6.80). The high heterogeneity (I² values approaching 100% for mean difference analyses) limits the interpretability of pooled estimates. Conclusions: Current evidence indicates that salivary and blood glucose levels associate weakly, and the study results are highly heterogeneous. Given the weak and highly heterogeneous associations observed across studies, current evidence does not support the use of salivary glucose measurement as an alternative to blood glucose measurement for the time being. Further standardized research is required before any conclusion about clinical applicability can be drawn.