Background: Medication-related osteonecrosis of the jaws (MRONJ) is a mucosal lesion of the maxillofacial region with necrotic bone exposure. MRONJ is believed to be multifactorial. Tooth extraction is debatably a risk factor for MRONJ. The targets of the present study were to examine MRONJ occurrence in patients using bone modifying agents (BMAs) for oncology indications and undergoing a dental extraction, and to assess whether suspected predisposing factors can predict MRONJ. Materials and Methods: This retrospective, cohort study included all patients fitting the inclusion criteria and a large tertiary medical center. Data were obtained from the hospital’s medical records using a structured questionnaire. Results: We performed 103 extractions on 93 patients. Local inflammation/infection of the extraction site was most associated with a complication (p = 0.001) OR = 13.46, 95% CI = (1.71, 105.41), OR = 13.5. When the indication for extraction was periodontal disease, vertical root fracture, or periapical pathosis, the odds of developing MRONJ were 4.29 times higher than for all other indications (p = 0.1), OR = 4.29, 95% CI = (1.16, 15.85). A significant association was found between the time of onset of BMA treatment and time of extraction and the development of MRONJ, OR = 3.34, 95% CI = (1.01, 10.18). Other variables did not correlate with the development of MRONJ. Conclusion: Local inflammation/infection and onset of BMA treatment prior to extraction yield a 10.23 times higher chance of developing MRONJ following tooth extraction. Future protocols should use this information to minimize MRONJ incidence.

Objectives Assess the unique clinical and radiological sequelae following oro‐antral communications/fistulae (OAC/OAF) due to implant dentistry vs other etiologies. Materials and Methods A structured form served to collect data from medical records. All consecutive patients who underwent surgical closure of OACs/OAFs between 2003 and 2020, at a single center were included. Demographic, radiological, clinical, operative and postoperative characteristics were collected. The differences between groups (cases with implant dentistry etiology [IDE] vs cases with other etiologies) were assessed statistically. Results Data were gathered from 121 cases. The findings show that IDE cases were more likely to be of older age (OR = 1.07, CI [1.02, 1.13] P = .02); to have a foreign body in the maxillary sinus (OR = 21.04, CI [4.34, 114.92] P < .01); to have fluid passage (OR = 11.40, CI [1.87, 118.73] P = .02) and purulent discharge through the fistula (OR = 3.52, CI [0.86, 16.34] P = .09). Conclusions Clinical and radiological sequelae due to OACs/OAFs secondary to implant dentistry procedures are more severe compared to other etiologies. The suggested pathogenesis is foreign body reaction. Early and accurate diagnosis of the foreign body location, followed by its early removal is recommended.

Background and Objectives: The success rates of surgical dental implant insertions are high. However, knowledge of patients’ recovery is still lacking. “Health-related quality of life” (HRQOL) questionnaires are gaining popularity in all fields of medicine. The present survey assessed the perception of recovery after the surgical placement of dental implants. Materials and Methods: Forty individuals (26 women and 14 men; mean age, 55 ± 12 years) filled a questionnaire evaluating patients’ perception of recovery for 7 consecutive days post-surgery. Confounding factors included age, gender, oral habits, smoking, bruxism, bone quality (tactile evaluation) and quantity, implant location, number of implants, implant type, length and diameter, one-stage vs. two-stage, and the need for bone grafting. Results: The most serious difficulties were found in swelling, which became minimal after 5 days, followed by eating everyday food, ability to enjoy everyday food, maximal pain and average pain (3 days); analgesics consumption (2.5 days); limitations in daily routine, mouth opening, and speech (2 days); swallowing and sleep (1.5 days); and, within 1 day, all other measures attained minimal levels. Gender, and implant location (anterior vs. posterior) were significant predictor variables exerting their different characteristic delayed recoveries. Conclusions: (1) Patients should expect, in general, recovery within 4 days after dental implant placement; (2) women will experience a delayed recovery, (3) implants placed in the intercanine area will result in postoperative eating difficulties for nearly one week, and (4) the number of implants placed during the same appointment has no effect on post treatment recovery.

Background: Within medicine, it is common to use risk prediction tools towards clinical decision making. One of the most widely accepted assessment tools is the American Society of Anesthesiologists Physical Status (ASA PS) classification. Oral and maxillofacial procedures performed in an ambulatory setting would be considered low risk for the procedure itself. However, little is known concerning the impact of ASA PS on surgical outcomes. The aim of the present research was to evaluate the effect of ASA PS classification on early implant failure (EIF). Methods: Retrospective cohort study based on dental records. All treatments were performed by experienced oral and maxillofacial surgeons and experienced prosthodontists. Inclusion criteria: ASA physical status 1,2,3, consecutive individuals. Variables included the following: age, gender, implant location, implant length, implant width, smoking, and early implant failure. Results: Univariate tests at the patient level showed no statistically difference between the different classifications of ASA PS (1,2,3). Multivariate model using logistic regression at individual level showed that two factors were found to be associated with an increased risk for EIF—augmented bone and implant brand. Conclusions: ASA PS 3 is not a contraindication for implant-supported prostheses. EIF in ASA PS 3 is not significantly different from ASA PS 1,2. In contrast, factors such as bone augmentation and implant brand might be significant risk factors for EIF, regardless of ASA PS.