Medication related osteonecrosis of the jaw (MRONJ) is a serious complication that occurs after the use of anti bone resorption, anti angiogenesis, and other drugs.In recent years, scholars have found that Teriparate has therapeutic effects on MRONJ. This article elaborates on the diagnostic criteria and staging of MRONJ through literature review, summarizes the therapeutic effects, administration methods, combination therapy, and possible treatment mechanisms of Teriparate for MRONJ, and provides a basis and reference for the clinical application and scientific research of Teriparate in the treatment of MRONJ.

Medication-related osteonecrosis of the jaw（MRONJ）is a serious complication that occurs in the jaw and is mainly related to the use of drugs such as antiresorptive and antiangiogenic drugs. This article reviews the latest research progress on the pathogenesis, risk factors, diagnostic methods, and prevention strategies of MRONJ. The pathogenesis of MRONJ involves the effects of drugs on bone metabolism, angiogenesis inhibition, local infection and immune response. Early diagnosis and prevention are essential to improve outcomes. At present, the treatment of MRONJ is mainly surgical, and there are also some emerging treatments, such as the synergistic therapy of pentoxifylline+α-tocopherol and the application of new technologies to assist in surgical treatment. Large-scale clinical studies are needed in the future to optimize the prevention and treatment strategies of MRONJ.

Medication-related osteonecrosis of the jaw (MRONJ) is a necrotic disease of the jaw induced by prolonged use of specific medications, primarily characterized by bone exposure, persistent pain, and non-healing wounds. Current evidence suggests that its pathogenesis may involve inhibition of bone remodeling, suppression of angiogenesis and microcirculation, disruption of the soft tissue barrier, and infection. Dysbiosis of the oral microbiota and complex polymicrobial infections play critical roles in the onset, progression, and chronicity of MRONJ. This review systematically summarizes the pathogenic mechanisms of microecological imbalance, the microbial profiles, detection methods, and microbe-related therapeutic strategies in MRONJ. It focuses on the complexity of microbe-drug interactions and outlines future research directions, aiming to provide a basis for precise clinical interventions.

Drug-related osteonecrosis of the jaw is a severe oral complication caused by anti-resorptive drugs and anti-angiogenic agents. Current clinical management faces significant challenges, with a considerable proportion of patients often having surgical contraindications. There is an urgent need to explore effective non-surgical treatment strategies to alleviate symptoms, improve quality of life, and develop adjunct therapies to reduce recurrence rates and optimize prognosis. This article systematically reviews the latest advancements in non-surgical treatments for drug-related osteonecrosis of the jaw, focusing on the research status, efficacy evidence, and translational potential of pharmacological therapies (such as teriparatide and pentoxyfilline), physical therapies (including hyperbaric oxygen and ozone), as well as stem cell and exosome-based therapies in addressing these critical clinical issues.

Medication related osteonecrosis of the jaw (MRONJ) is a necrotic disease of the jaw caused by bone resorption inhibitors, anti angiogenic drugs, targeted drugs, or steroid drugs. The pathogenesis of this disease is not yet clear, and its clinical diagnosis and treatment still face many challenges. This article systematically reviews the current mainstream diagnostic methods, including the imaging diagnostic progress of MRONJ and the application of biomarkers; The treatment progress is carried out from three aspects: conservative treatment, adjuvant treatment, and surgical treatment, in order to promote a more systematic and comprehensive understanding of MRONJ.

Artificial intelligence (AI), with its ability to simulate and perform human cognitive tasks, has showed extremely broad application prospects in numerous fields. In the field of stomatology, AI technology can promote the process of diagnostic automation, improve the accuracy of diagnosis and treatment, and accelerate the intelligentization of medical services. This review focuses on the application research progress of AI technology in the fields of dental pulp disease, periodontal disease, oral and maxillofacial surgery, oral restoration, and pediatric dentistry, and looks forward to future development trends and potential research directions, providing reference for its wide application in the field of dentistry.

Objective: To investigate the surgical treatment and efficacy of severe advanced medication-related osteonecrosis of the jaw (MRONJ). Material and Methods: Patients who underwent stage 3 MRONJ surgery in the Department of Oral and Maxillofacial Surgery, Nanjing Stomatological Hospital from January 2020 to January 2025 were included in this study. The basic clinical data, surgical methods and prognosis of the patients were collected and statistically analyzed. Results: A total of 64 patients (68 lesions) were included in this study, including 29 males and 35 females. 25 lesions were located in the maxilla and 43 lesions were located in the mandible. The primary disease was malignant tumor in 61 cases and osteoporosis in 3 cases. The medication history included zoledronic acid (n=29), denosumab (n=24), monotherapy (n=41) and combination therapy (n=23). The average duration of medication was 3.7±1.2 years. Subtotal maxillectomy was performed in 25 cases, of which 2 cases were treated with fenestration and drainage, and 4 cases were treated with buccal fat pad flap. 43 patients underwent segmental mandibular osteotomy, of which 38 patients used reconstruction titanium plate for jaw reconstruction, and the remaining 5 patients used the guide flange prosthesis to help restore the occlusal relationship after operation. The patients were followed up for 12-24 months, 55 patients achieved mucosal healing at the last follow-up, and the total cure rate was 85.94%. Conclusions: Surgical treatment of stage 3 medication-related osteonecrosis of the jaw can achieve good results. Various intraoperative repair methods can help the mucosa to achieve good primary healing.

Objective: To evaluate the effects of tooth whitening with different auxiliary light sources on color, microhardness and surface dissolution amount of dental hard tissues. Material and Methods: A total of 30 human premolars, 60 bovine enamel and 30 bovine dentin specimens were prepared for whitening, surface microhardness and erosive tissue loss assessments, respectively. Human teeth were divided into 3 groups and treated with 35% hydrogen peroxide gel combined with halogen and LED lights for 3×10 minutes (HAL group), with LED alone (LED group) for 3×12 minutes, or with no light for 3×10 minutes (NLC group). Tooth color changes were assessed with a dental spectrophotometer using CIEDE2000 and visual analysis using the Vitapan shade guide. Bovine enamel and dentin surfaces were treated with the same protocols to assess the effects of whitening on enamel surface microhardness and enamel and dentin surface tissue loss. Enamel and dentin tissue losses were also compared to a positive (1% citric acid) and a negative control (distilled water). Analysis of variance (ANOVA) with Tukey tests were used to compare findings among the study groups. Results: Whitening outcomes were significantly better in the HAL and LED groups than in the NLC group in color improvements as shown by∆E00 values (3.4±1.3, 3.1±0.8, 1.9±0.6 respectively, P<0.05). The mean shade improved 3.5±0.53, 3.5±0.97 and 1.7±1.16 respectively according visual analysis. Slight decreases in enamel surface microhardness occurred in all 3 groups (6.4±2.5%, 4.0±1.8%, 4.2±2.4% respectively, P>0.05). Significant enamel or dentin tissue loss occurred only in the positive control (4.3±0.7µm in enamel, 6.7±1.0µm in dentin) but not the negative control and the 3 whitening groups (range 0.01-0.18µm). Conclusions: Tooth whitening with either type of light sources improved the whitening outcomes compared to no light, though the LED light alone needed a slightly longer treatment duration to reach the same whitening outcomes. Whitening treatments with 35% H₂O₂ with or without lights did not cause significant surface changes of dental hard tissues.

Objective: To report the surgical treatment process and efficacy of a patient diagnosed as stage 3 medication-related osteonecrosis of the jaw(MRONJ) with pathological fracture of the mandible, and to explore the clinical experience of segmental osteotomy without titanium plate repair reconstruction. Diagnosis and treatment: According to the definition of MRONJ and the proposed staging criteria of the American Association of Oral and Maxillofacial Surgeons(AAOMS), the patient was diagnosed definitively stage 3 of mandible. The surgical plan was made after the preoperative examination was completed. After communicating with patient, only segmental osteotomy of mandible was selected. After operation, a winged inclined guide plate was made to improve the occlusal function of the patient. Results: This case achieved the goal of recovery and functional reconstruction, and the patient was satisfied with the current treatment and functional recovery. Conclusions: For mandibular stage 3 patients who cannot tolerate complex general anesthesia surgery, segmental osteotomy alone and a winged inclined guide plate may be considered to improve occlusal relationship.

Objective: To evaluate the impact of the “Internet+” case-based teaching model on enhancing clinical decision-making ability among medical students in the context of medication-related osteonecrosis of the jaw (MRONJ). Methods: A convenience sampling method was adopted. A total of 39 fifth-year undergraduate students majoring in stomatology (Class of 2020) undergoing clinical surgical rotation were assigned to the control group and received traditional teaching. Another cohort of 39 students (Class of 2021) constituted the intervention group and received a reformed teaching model based on Internet+ progressive case learning. Teaching effectiveness was assessed using the self-rating scale of active learning and critical thinking (SSACT), a satisfaction questionnaire, and theoretical/technical examinations. Results: The effectiveness of the “Internet+” case-based teaching reform in MRONJ was comprehensively evaluated across multiple dimensions. The intervention group achieved significantly higher theoretical scores (52.87±3.51vs 44.10±4.81), practical scores (34.00±4.46 vs 30.85±7.28), and total scores (86.95±5.97 vs 74.75±9.08) compared with the control group (all P<0.01). In the study group, there were greater improvements in active learning ability (improvement of 18.94±1.97 vs 14.53±3.09), critical thinking (improvement of 39.54±6.58 vs 33.31±4.75), and total score of clinical thinking ability (improvement of 87.10±9.68 vs 68.54±6.30). Feedback suggested that this model was positively perceived for fostering pre-class preparation, information retrieval, and teamwork. Conclusions: The “Internet+” case-based teaching approach for MRONJ, through the integration of virtual and in-person learning, significantly enhances students’ evidence-based clinical decision-making in complex osteonecrosis cases. Its multidimensional interactive teaching and evaluation framework provides a replicable paradigm for educational reform in oral and maxillofacial surgery.