The use of resin-based composite imitating gum tissue enhances the aesthetics of fillings located below the physiological gum line. The shear bond strength (SBS) between the gum-imitating composite and the traditional composite with different surface preparation methods was examined. The aim of the study was to evaluate which base material—G-aenial Universal Injectable (GC, Japan, flow) or G-aenial A’CHORD (GC, Japan, paste)—performs better, as well as to determine the most effective preparation method among sandpaper (control), 36% orthophosphoric acid (H₃PO₄), sandblasting, and 9.5% hydrofluoric acid (HF). The tested gum-imitating material was Amaris Gingiva (VOCO, Germany). The connection between the composites was evaluated using a Z005 (Zwick-Roell) universal device. Surface tests were carried out using an SJ-410 (Mitutoyo) profilometer. Evaluation of the prepared surface structures was performed using scanning electron microscopy (HITACHI S-4700). Etching with HF significantly improved the shear bond strength between composites. Sandblasting also enhanced the adhesion results, but the H₃PO₄ group achieved comparable results to the control group. However, since HF is not recommended for intraoral use, sandblasting (30 μm aluminum oxide particles applied with three passes at constant speed under a pressure of 2 bar from 1.5 cm) appears to be the most suitable clinical alternative.

Bisphosphonates (BPs) and Denosumab (DMB) are antiresorptive agents (AA) commonly used in treatment of osteoporosis, multiple myeloma (8.0%), breast cancer (3.3%), prostate cancer (2.9%) and other malignancies (0.7%), bone metastases, and cancer-induced hypercalcemia. However, this therapy is associated with a significant risk of medication-related osteonecrosis of the jaw (MRONJ), particularly after tooth extraction. The aim of this narrative review was to summarize current evidence on measures aimed to reduce the risk of MRONJ after tooth extraction, and to critically discuss the strength of evidence supporting each of these measures. Articles published in the years 2013–2025 were reviewed using PubMed, Scopus, Web of Science databases. Available studies were categorized and compared with the use of selected prevention methods. The duration of the treatment, route of administration, dosage and type of AA have a significant impact on the risk of developing MRONJ. Antibiotic prophylaxis is considered in most published preventive protocols. However, the evidence supporting a single optimal regimen is limited. Patients from a high-risk group of MRONJ, demonstrating cancer, who were administered intravenous antiresorptive agents for longer than three years or zoledronic acid, or those with a history of jawbone necrosis or inflammation require prolonged antibiotic therapy (started before the procedure and continued up to 14 days after the procedure). Moreover, studies on the use of platelet-rich fibrin (PRF) and Concentrated Growth Factors (CGF) as a preventive measure have shown promising results in observational studies, along with antibiotic prophylaxis and optimal oral hygiene. Pentoxifylline with tocopherol and low-level laser therapy (LLLT) are recognized as potentially useful non-invasive preventions. However, evidence is limited due to the small sample sizes and heterogenous protocols. Vitamin D levels should be monitored, and oral supplementation should be considered if needed. AA therapy suspension prior to the surgical procedure must always be consulted with the attending physician. A multidisciplinary approach along with well-planned pre- and postoperative care is essential for safe tooth extraction in patients receiving AA therapy.