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Background/Objectives: Pathological fractures of the mandible are uncommon and often result from underlying conditions such as osteoradionecrosis, malignancies, or medication-related osteonecrosis of the jaw (MRONJ). Their management is challenging due to compromised bone quality and complex patient comorbidities. This study presents a 15-year experience from a tertiary oral and maxillofacial surgery center, highlighting the clinical characteristics, etiologies, treatment approaches, and outcomes of these fractures. Methods: A retrospective review was conducted on patients diagnosed with pathological mandibular fractures between 2010 and 2024. Data collected included demographics, fracture etiology and location, diagnostic imaging, treatment modality, complications, and long-term outcomes. Results: Fifty patients met the inclusion criteria. The mean age was 66.4 years, with a predominance of male patients (78%). The most common etiology was osteoradionecrosis (48%), followed by primary malignancy (22%) and MRONJ (16%). In 82% of cases, surgical management was required, most frequently involving marginal or segmental mandibular resection (gnathectomy), with or without immediate reconstruction. Conservative treatment was reserved for select cases with high surgical risk. Complications occurred in 54% of patients, including persistent fistulas, pathological communication with the skin or oral cavity, and the need for revision surgery. Long-term follow-up revealed variable survival, with many patients experiencing reduced quality of life due to complex postoperative courses. Conclusions: Pathological fractures of the mandible present significant diagnostic and therapeutic challenges, particularly in patients with osteoradionecrosis or malignancies. Early diagnosis and individualized, multidisciplinary treatment planning are essential. This study underscores the need for a standardized classification system and treatment algorithm to guide management and improve outcomes in this complex patient population.

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Background/Objectives: Accurate surgical margin delineation is essential in the treatment of non-melanoma skin cancers (NMSCs), particularly basal cell carcinoma (BCC) and cutaneous squamous cell carcinoma (cSCC), to reduce recurrence and metastasis. Dermoscopy improves diagnostic accuracy for skin tumors, but its utility for preoperative margin assessment remains underexplored. To compare dermoscopy-guided versus clinical visual inspection for preoperative margin assessment in NMSC excision, focusing on histological clearance rates and surgical outcomes. Methods: This systematic review and meta-analysis followed PRISMA 2020 guidelines. MEDLINE, Cochrane CENTRAL, Scopus, and Web of Science were searched from inception to 1 July 2025. Eligible studies included adult patients undergoing surgical excision of histologically confirmed BCC or cSCC, with preoperative margin evaluation using either dermoscopy or clinical examination. The primary outcome was the rate of complete histological excision. Study quality was assessed using the Newcastle–Ottawa Scale. A random-effects meta-analysis using the Freeman–Tukey transformation was performed. Results: Nine cohort studies comprising 900 NMSC lesions were included. Dermoscopy-guided excision demonstrated pooled histological clearance of 98.7% (95% CI: 97–99.8%), compared to 80–94% with clinical assessment. Moderate heterogeneity was observed (I2 = 42%). However, variability in study design and limited data for cSCC restricted broader conclusions. Conclusions: Dermoscopy may enhance margin assessment and histological clearance in NMSC surgery, especially for BCC. Further standardized, high-quality studies are needed to confirm its role in surgical planning and extend evidence to SCC.

Background: Temporomandibular disorders (TMDs) encompass a group of conditions characterized by anatomical, histological, and/or functional abnormalities that affect the muscular and/or articular components of the temporomandibular joint. Prolotherapy is an injectable treatment modality for chronic musculoskeletal pain that involves dextrose solution administration in the joint. Aims: To summarize, the aims involve considering the existing quality of clinical evidence on the efficacy of prolotherapy versus placebo and other active comparators, such as autologous blood products or botulinum toxin, in improving the outcomes of TMDs. Methods: A literature search in MEDLINE, Scopus, and Cochrane databases was performed, following the PRISMA statement guidelines, to identify randomized controlled trials (RCTs) of patients with TMDs receiving prolotherapy. The maximal incisor opening (MIO), visual analogue score (VAS) for pain, and frequency of dislocations were analyzed as the outcomes. The weighted mean difference was used to pool outcomes. The risk of bias was recorded for the included studies. Results: Six studies comparing prolotherapy to placebo were identified. Prolotherapy is uniformly more efficient in reducing the VAS for pain when compared to the placebo (mean difference = 1.20, 95%CI: 0.56–1.84, p < 0.001). Perceived jaw mobility was improved among prolotherapy patients, (mean difference = 0.47, 95%CI: 0.05–0.90, p = 0.003) when compared to the placebo. A beneficial effect for prolotherapy with regard to MIO (mean difference = 0.84, 95%CI: −2.12–3.80, p = 0.58) was not confirmed. Prolotherapy appears to be more efficient than autologous blood products in reducing VAS for pain (mean difference = 0.49, 95%CI: 0.11–0.87, p = 0.01). Prolotherapy was found to be more effective in reducing pain, MIO, and clicking when compared to an occlusal splint in a single study. Conclusions: Prolotherapy is also a promising modality for TMDs, despite the limited number of randomized clinical trials. Existing evidence supports its use to reduce TMD-related pain, even against other modalities. Further research is needed to better describe the benefit of prolotherapy for other outcomes.