Background: Medication-related osteonecrosis of the jaw (MRONJ) is a type of jawbone necrosis caused by the use of drugs for some types of cancer and osteoporosis. The current study aimed to evaluate the associations between hyperglycemia and the development of medication-related osteonecrosis of the jaw. Methods: Our research group investigated data collected between 1 January 2019 and 31 December 2020. A total of 260 patients were selected from the Inpatient Care Unit, Department of Oromaxillofacial Surgery and Stomatology, Semmelweis University. Fasting glucose data were used and included in the study. Results: Approximately 40% of the necrosis group and 21% of the control group presented with hyperglycemia. There was a significant association between hyperglycemia and MRONJ (p < 0.05, p = 0.003). Vascular anomaly and immune dysfunction caused by hyperglycemia can lead to necrosis after tooth extraction. Necrosis is more common in the mandible (75.0%) and in the case of parenteral antiresorptive treatment (intravenous Zoledronate and subcutaneous Denosumab). Hyperglycemia is a more relevant risk factor than bad oral habits (26.7%). Conclusions: Ischemia is a complication of abnormal glucose levels, a possible risk factor for necrosis development. Hence, uncontrolled or poorly regulated plasma glucose levels can significantly increase the risk of jawbone necrosis after invasive dental or oral surgical interventions.

Diabetes mellitus has become a worldwide epidemic and is frequently accompanied by a number of complications proportional to the duration of hyperglycemia. The aim of this narrative review is to assess the most up-to-date guidelines on DM provided by both diabetes and dental associations. Furthermore, to gather evidence on the uni/bidirectional relationships of elevated HbA1c levels on dental surgery, implantology, bone augmentation, and periodontology and to demonstrate the importance of measuring HbA1c levels before invasive dental treatments. HbA1c and blood glucose measurements are a minimally invasive method for preventing complications in diabetes mellitus. The authors conducted a literature review to determine which oral conditions are affected by diabetes mellitus. MEDLINE served as a source with the use of a specific search key. Regarding oral complications of diabetes, prevention is the most vital factor. With this publication, we hope to assist physicians and dentists to make prompt diagnoses and to help in recognizing various oral manifestations of diabetes and follow the existing guidelines.

Background/Aim: Diabetes mellitus (DM) is one of the most common chronic metabolic disorders. Our research aimed to demonstrate the relationship between DM and oral cancer. Patients and Methods: We pursued a retrospective research study in Hungary between January 2019 and December 2020. We investigated 597 inpatient records and compared them to the results of our previous studies (1998-2002 and 2012-2015). Results: The frequency of patients with DM in the oral cancer group is 2.45 times higher today than 20 years ago. The prevalence rate of DM and oral malignancies increased from 14.6% to 35.8%. In the oral cancer group, 54.4% of the patients had elevated blood glucose levels and of these, 61.1% of them had type 2 diabetes, 34.2% had impaired fasting glycemia, and only 4.7% had type 1 diabetes. We observed that 45.3% of them were smokers. Of those whose blood sugar levels were under 6.1 mmol/l, the mean body mass index was 25.33 [standard deviation (SD)=±4.5;, while among patients with DM, it was 26.92 (SD=±5.8;). Conclusion: It may be necessary to continuously monitor the patient's blood sugar level to maintain euglycemic levels when managing patients with malignant oral lesions.

Background/Aim: This study aimed to investigate the link between preoperative glycated hemoglobin (HbA1c) levels and oral cancer patients and diabetes mellitus (DM). We aimed to highlight the importance of point-of-care HbA1c measurements in oral cancer patients.

Objectives: Medication-related osteonecrosis of the jaw (MRONJ) is a type of jawbone necrosis caused by the use of drugs for some types of cancer and osteoporosis. Previous research has shown that normoglycemia plays an important rolein the development and treatment of oral lesions. The current study aimed to evaluate the associationsbetween chronic vascular disease, inflammation, and immune deficiency during dysglycemia and the developmentof MRONJ. Materials and Methods: Our research group investigated data collected between January 1, 2019, and December 31, 2020. In total, 260 patients at the Inpatient Care Unit, Department of Oromaxillofacial Surgery and Stomatology, Semmelweis University were selected. Results: There was a significant association between hyperglycemia and MRONJ. Vascular anomaly and immune dysfunction caused byhyperglycemia can leadto the development of necrosis after tooth extraction. The risk of jawbone necrosis can be reduced by premedication. Conclusions: Ischemia is a complication of abnormal glucose level, which is a possible risk factor of MRONJ development. Hence, uncontrolled or poorly regulated plasma glucose levels can significantly increase the risk of jawbone necrosis. Clinical relevance: Uncontrolled or poorly regulated plasma glucose levels significantly increasesthe risk of jawbone necrosis after invasive dental or oral surgical interventions. The number of patients with dysglycemia and anti-resorptive therapy is increasing. Therefore, patients with these conditions will be provided with medical care in dental offices more frequently.

Összefoglaló. Bevezetés: A diabetes mellitus és a különböző szájüregi elváltozások szoros kapcsolatát számos irodalmi adat bizonyítja. Munkacsoportunk az elsők között tárta fel az oralis malignus daganatok és a cukorbetegség epidemiológiai összefüggéseit. A nemzetközi szakirodalomban már megjelentek olyan publikációk, amelyek a cukorháztartás és a gyógyszer okozta állcsontnekrózis közötti kapcsolatot vizsgálták. Célkitűzés: Jelen tanulmányunkban arra a kérdésre kerestük a választ, hogy a hazai populációban a biszfoszfonát okozta állcsontnekrózisban szenvedő betegek körében milyen gyakorisággal fordul elő diagnosztizált cukorbetegség és emelkedett éhomi vércukor. Megvizsgáltuk továbbá, hogy van-e összefüggés a rendellenes cukorháztartás és a betegek alapbetegsége, valamint az állcsontnekrózis lokalizációja, súlyossága között. Módszer: Az adatgyűjtés során a 2018. június 1. és 2020. december 31. közötti időszak betegdokumentációját tanulmányoztuk. A vizsgálatba 349 főt vontunk be, akik ezen időszak alatt a Semmelweis Egyetem Arc-Állcsont-Szájsebészeti és Fogászati Klinikájának Fekvőbeteg Osztályán kerültek ellátásra. A betegeket két csoportra osztottuk: biszfoszfonát okozta állcsontnekrózisban szenvedőkre, valamint kontrollcsoportra. Eredmények: A két vizsgált csoportot összehasonlítva megállapítottuk, hogy a biszfoszfonát okozta állcsontnekrózisban szenvedő betegcsoportban szignifikánsan több a diabetes mellitusban szenvedő és az emelkedett éhomi vércukorral rendelkező beteg. Megbeszélés: Kutatásunk eredményei alapján felmerül, hogy a diabeteses vagy hyperglykaemiás betegek esetében a dysglykaemia microvascularis szövődményei miatt a biszfoszfonát okozta állcsontnekrózis előfordulási valószínűsége szignifikánsan gyakoribb. Következtetés: Az emelkedett vércukorszint szignifikánsan növeli az állcsontnekrózis valószínűségét invazív fogorvosi, illetve szájsebészeti beavatkozások után. Orv Hetil. 2022; 163(15): 599–605. Summary. Introduction: The close association between diabetes mellitus and various oral lesions is evidenced by several literature data. Our team was among the first to explore the epidemiological link between oral malignancies and diabetes mellitus. Publications have already been published in the international literature examining the relationship between glucose homeostasis and bisphosphonate-related jaw necrosis. Objective: In the present study, we sought to answer the question of the incidence of diagnosed diabetes mellitus and elevated fasting blood glucose in patients with bisphosphonate-related jaw necrosis in the Hungarian population. We also examined whether there is a correlation between abnormal diabetes mellitus and the patient’s underlying disease and the localization and severity of jaw necrosis. Method: During the data collection, we studied patient documentation from June 1, 2018 to December 31, 2020. The study included 349 people admitted during this period at the Department of Inpatient Care at the Department of Oromaxillofacial Surgery and Stomatology at Semmelweis University. Patients were divided into two groups, bisphosphonate-related jaw necrosis, and a control group. Results: Comparing the two groups, we found significantly more patients with diabetes mellitus and high fasting blood glucose in the bisphosphonate-related jaw necrosis group. Discussion: Based on the results of our research, we found that bisphosphonate-related jaw necrosis is significantly more likely to occur in diabetic or hyperglycemic patients due to microvascular complications of dysglycemia. Conclusion: Elevated blood glucose level significantly increases the likelihood of jaw necrosis after more invasive dental and oral surgery. Orv Hetil. 2022; 163(15): 599–605.