Background and Objectives: Osteonecrosis of the jaw (ONJ) occurring after infection with SARS-CoV-2 has emerged as an increasingly reported complication in the post-COVID-19 era. Post-COVID-19 osteonecrosis of the jaw (PC-ONJ) has been described in association with both COVID-19-associated mucormycosis (CAM) and non-fungal phenotypes. This narrative review aims to synthesize and critically analyze the available evidence regarding terminology and classification, epidemiology and risk factors, pathophysiological mechanisms, clinical and imaging characteristics, diagnostic challenges, and management strategies relevant to oral and maxillofacial surgery practice. Materials and Methods: An extensive literature search was conducted in the PubMed/MEDLINE, Scopus, Web of Science, ScienceDirect, and Google Scholar databases. The search targeted peer-reviewed publications published between 2020 and 2025, reflecting the post-pandemic emergence of this clinical spectrum. Original studies, systematic and narrative reviews, multicenter case series, consensus guidelines, and well-documented case reports were considered. Results: Available data, largely derived from case reports and small series, demonstrate a predominance of maxillary involvement and frequent association with diabetes mellitus and systemic corticosteroid therapy. Proposed mechanisms include COVID-19-associated endothelial dysfunction, microvascular thrombosis, immune dysregulation, metabolic imbalance, and treatment-related effects. Clinically, patients may present with persistent orofacial pain, tooth mobility, exposed or probeable bone, and frequent sinonasal extension, with symptoms sometimes preceding bone exposure. Diagnostic challenges arise from the overlap with medication-related osteonecrosis of the jaw (MRONJ), osteoradionecrosis (ORN), and chronic osteomyelitis. Imaging is essential for assessing disease extent but remains insufficient for etiologic differentiation, making histopathological examination and targeted microbiological investigations necessary, particularly to exclude invasive fungal infection. Conclusions: Management must be etiology-driven. CAM requires urgent antifungal therapy combined with surgical debridement, whereas non-fungal forms are generally managed with conservative surgery and appropriate antimicrobial stewardship. Standardized diagnostic criteria and prospective multicenter studies are needed to reduce nosological ambiguity and optimize clinical decision-making in this emerging post-viral condition.

Objectives: Temporomandibular joint (TMJ) disorders are an increasingly common problem affecting patients. This systematic review aimed to analyze the available literature regarding the effectiveness of intra-articular ozone gas injections and their effects on pain reduction and jaw mobility. Methods: The review was conducted in accordance with PRISMA 2020 guidelines. Bielefeld Academic Search Engine, Cochrane Library, Google Scholar, PubMed, and references were searched (October 2025). Randomized controlled trials evaluating intra-TMJ gas injection compared to other intra-articular administration were included in the review. Analyses were performed both within and between groups. Risk of bias was assessed using the Cochrane RoB-2 tool, and the certainty of evidence was assessed using the GRADE approach. Results: Five studies out of 180, including a total of 230 patients, were included in the review. The studies reported using ozone at concentrations of 10-30 μg/mL. All included studies reported reductions in pain and improvements in mandibular mobility after treatment. In some comparisons, ozone-based interventions showed more favorable outcomes than control interventions; however, the findings were not consistent across outcomes, and the certainty of evidence was limited. Conclusions: Current evidence is insufficient to determine the effectiveness of intra-articular ozone injections for TMJ disorders. Some studies suggest possible short-term benefits in pain reduction and jaw mobility; however, the evidence is limited by high risk of bias, heterogeneity in treatment protocols, and very low certainty, particularly for longer-term outcomes. More rigorous and standardized randomized trials are required.

Medication-related osteonecrosis of the jaw (MRONJ) represents a major clinical challenge for oral and maxillofacial surgery departments as well as dental practices. With increasing life expectancy and the more frequent use of medications associated with osteonecrosis, the incidence of MRONJ continues to rise. To date, there are no uniform treatment standards with scientifically proven effectiveness for this condition. To evaluate the impact of platelet-rich fibrin (PRF) on the outcomes of MRONJ treatment and to identify factors that may influence the effectiveness of PRF therapy, we conducted a comparative prospective study including 22 patients divided into two groups: patients treated with PRF and patients treated without PRF. PRF was prepared according to the PRF Duo Quattro Process protocol for PRF (Nice, France). The study was registered at ClinicalTrials.gov (NCT07464678). The following parameters were assessed: age, smoking status, gender, lesion location, body mass index (BMI), C-reactive protein (CRP) concentration, pain intensity, presence or absence of fistulas, soft tissue healing and radiological findings. Patients were evaluated preoperatively and postoperatively at 14 days, 6 weeks, and 6 months. The study demonstrated a reduction in pain after surgery among patients treated with PRF. In addition, the use of PRF resulted in improved healing outcomes in patients with elevated CRP. Higher BMI was associated with poorer therapeutic response to PRF. Improvements in soft tissue healing and disease stage were observed in the PRF group; however, these differences did not reach statistical significance. All findings should be interpreted with caution due to the limited sample size. There is still no standardized treatment for MRONJ. The use of platelet-rich fibrin as an inexpensive and safe adjunctive therapy may provide clinical benefits for patients, particularly through a significant reduction in pain. Further large-scale, multicenter studies are required to confirm these findings.

Burkitt lymphoma is a very fast-growing non-Hodgkin lymphoma (NHL) characterized by rapid tumor progression and increased lymphocyte proliferation. It often involves the jaw and facial bones. The current case report represented a 37-year-old male patient with Burkitt's lymphoma who sought dental care for persistent and dull pain and paresthesia on the left side of his mandible extending to the periauricular region. The initial diagnosis suggested a dental origin, leading to the lower left third molar (LL8) extraction. Despite this, the patient continued to experience worsening pain, which radiated to the lower extremities, accompanied by fatigue and weakness. The patient was referred to an oral and maxillofacial medicine specialist, where ultrasonography (US) revealed hypoechoic masses. A subsequent biopsy of a submandibular mass confirmed the diagnosis of Burkitt's lymphoma. The patient was referred to an oncologist and underwent chemotherapy and radiotherapy. After 3 years of follow-up, the patient is in remission. This unique case presentation related to systemic involvement as well as generalized bone pain (suggesting systemic involvement or more advanced disease) alone underscores the importance of a thorough diagnostic approach when facing unusual or persistent symptoms. It can also significantly impact future patient care by highlighting the need for a comprehensive evaluation and the importance of maintaining a high level of suspicion, particularly in cases where the initial diagnosis does not fully explain the patient's symptoms.

Osteoarthritis is a degenerative joint disease that disrupts the cellular homeostasis within cartilage tissues, promoting further disease progression that can lead to debilitating pain. Cartilage of the temporomandibular joint (TMJ) is unique among diarthrodial joints because they are of neural crest origin, rather than the mesoderm germ layer. TMJ cartilage also has different cellular architecture, where it is composed of a superficial fibrous layer, a proliferative layer, and a fibrocartilage layer overlying subchondral bone. Understanding of the cytopathological changes that occur during TMJ osteoarthritis (TMJOA) could potentiate therapies to mitigate disease progression and repair diseased tissues. Here, we analyzed the unique cell populations present in healthy and OA-induced condylar cartilage of adult rats through single-cell RNA-sequencing. TMJOA was established via our previous rat model to study the changes in the cellular composition of the condyle in response to OA. Several cell types could be uniquely identified, and the prominent matrix producing cells were fibroblasts and chondrocyte subsets. Our trajectory and pseudotime analysis revealed three cell fates stemming from a fibrochondrocyte-like population and two chondrocyte cell fates that stem from a shared progenitor population. We also found that Pleiotrophin is uniquely expressed in the proliferative zone by cells with a chondrocyte progenitor phenotype. In OA cartilage, differential gene expression in the fibroblast group revealed responses to inflammation, possibly through activation of chondrocyte differentiation. The chondrocyte group was highly metabolically active, indicative of rapid repair or remodeling. Cell-cell signaling analysis revealed that chondrocyte and chondrocyte progenitor communication became highly activated. Additionally, intracellular pathways that may contribute to cellular dysfunction and tissue remodeling were highly active, while pathways related to tissue catabolism appeared less active.

This study aimed to assess the performance of a deep learning algorithm for detecting tooth ankylosis on cone-beam computed tomography (CBCT) scans. A dataset of CBCT scans taken from phantoms simulating tooth ankylosis, including 60 teeth and a total of 4971 axial sections, was used to design an ankylosis detection model using the YOLOv8 algorithm. The first dataset (42 teeth, 70%) with 3822 axial sections comprised the training dataset, while the second dataset (18 teeth, 30%) with 1149 axial sections comprised the test dataset. The YOLOv8 algorithm was used to optimize the precise and efficient detection of the ankylotic area. Training loss was monitored during the learning process. Also, precise optimizations such as adaptive learning rate were used to ensure model convergence. The dice, precision, recall, and F1 score were calculated to assess the model's performance. Training loss of the designed model reached < 10% after 100 training epochs. The model showed 80% precision, 82% dice, 90.9% recall, and 83.9% F1 score. The designed model using the YOLOv8 algorithm performed optimally in efficient and precise detection of tooth ankylosis on CBCT scans and could be integrated into the clinical workflow, aiding clinicians and radiologists. Future studies are recommended to focus on further refinement of this model using larger datasets, architectural optimization, combining in-vivo and in-vitro datasets for model generalizability, and comparing radiologists' and the model's performance.

The purpose of this study was to compare and evaluate the efficacy of intra-articular injection of liquid platelet-rich fibrin (liquid-PRF) or liquid phase concentrated growth factors (LPCGF) with arthrocentesis for temporomandibular disorders. This randomized controlled trial included 60 patients with internal disc derangement who were randomly assigned to three groups: liquid-PRF injection, LPCGF injection, and arthrocentesis. The clinical parameters evaluated were pain on function, tenderness on palpation, temporomandibular joint sounds, jaw deviation, maximum mouth opening (MMO), and maximum protrusive and laterotrusive (ipsilateral and contralateral) jaw movements. Radiographic parameters included vertical joint space height (measured on panoramic radiographs) and articular disc position, disc shape, and total joint space (assessed on magnetic resonance imaging). Treatment outcomes were compared between the groups using ANOVA for continuous variables and the χ[2] test for categorical variables. LPCGF patients reported significantly lower mean ± standard deviation pain scores at 6 months than the liquid-PRF and arthrocentesis patients (LPCGF 1.80 ± 0.83, liquid-PRF 2.60 ± 0.94, arthrocentesis 3.30 ± 0.65; P < 0.001). Furthermore, the LPCGF patients had significantly higher MMO (LPCGF 37.60 ± 3.20 mm, liquid-PRF 32.65 ± 1.81 mm, arthrocentesis 31.05 ± 1.31 mm; P < 0.001), as well as mean protrusive and contralateral movements (all P < 0.001), than the liquid-PRF and arthrocentesis patients. Overall, LPCGF demonstrated superior performance for the clinical outcomes analysed when compared with liquid-PRF and arthrocentesis; however, radiographic outcomes did not differ significantly.