Martin Major

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.

Objectives: The aim of this matched prospective cohort study was to examine the microarchitecture of the augmented bone following a modified alveolar ridge splitting procedure and compare it to that of native bone. Methods: In the test group, patients underwent a modified ridge split osteotomy procedure to restore the width of the posterior segment of the mandible. Patients with sufficient bone width for dental implant placement in the posterior region of the mandible following 3-month-long spontaneous healing after tooth removal were included in the control group. In both study groups, bone biopsy samples were harvested and dental implants were placed. Histomorphometry and micro-CT analysis were performed. Results: Altogether, 15 patients were included in this study (7 patients in the test group, with 14 bone core biopsies harvested, and 8 patients in the control group, with 13 bone core biopsies harvested). Percentage bone volume (BV/TV) in the micro-CT analysis (22.088 ± 8.094% and 12.075 ± 4.009% for the test and control group, respectively) showed statistically significant differences between study groups. Conclusions: Based on histological and micro-CT analyses, the modified ridge splitting procedure with autologous bone block harvested from the retromolar area results in a dental implant recipient bone microarchitecture superior to that of the extraction sockets left to heal undisturbed for a 3-month-long healing period.