Montefusco Vittorio, Gay Francesca, Spina Francesco, Miceli Rosalba, Maniezzo Massimo, Teresa Ambrosini Maria, Farina Lucia, Piva Sheila, Palumbo Antonio, Boccadoro Mario, Corradini Paolo
Department of Hematology, Allogeneic Bone Marrow Transplantation Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy.
Leuk Lymphoma. 2008 Nov;49(11):2156-62. doi: 10.1080/10428190802483778.
Osteonecrosis of the jaw (ONJ) can be a severe complication of patients with multiple myeloma (MM) treated with bisphosphonates. Dental procedures are a major risk factor for ONJ occurrence. We retrospectively analysed the data of 178 patients with MM to evaluate if antibiotic prophylaxis before dental procedures may prevent ONJ. A correlation between dental procedures, antibiotic prophylaxis, incidence of ONJ and relevant clinical features was performed. Overall nine out of 178 patients developed ONJ (5 year crude cumulative incidence: 7.7%). Only one case of ONJ was not correlated with dental procedures. Seventy-five patients received at least one dental procedure and 43 received antibiotic prophylaxis. Eight cases of ONJ were observed, all in the group of patients without antibiotic prophylaxis. The only variable significantly associated with ONJ was antibiotic prophylaxis (p = 0.012), which had a protective effect. Thus, we speculated that antibiotic prophylaxis may prevent ONJ occurrence after dental procedures.
颌骨骨坏死（ONJ）可能是接受双膦酸盐治疗的多发性骨髓瘤（MM）患者的一种严重并发症。牙科手术是ONJ发生的主要危险因素。我们回顾性分析了178例MM患者的数据，以评估牙科手术前使用抗生素预防是否可预防ONJ。对牙科手术、抗生素预防、ONJ发生率及相关临床特征之间的相关性进行了分析。178例患者中共有9例发生ONJ（5年粗累积发生率：7.7%）。仅1例ONJ与牙科手术无关。75例患者接受了至少一次牙科手术，43例接受了抗生素预防。观察到8例ONJ，均在未接受抗生素预防的患者组中。与ONJ显著相关的唯一变量是抗生素预防（p = 0.012），其具有保护作用。因此，我们推测抗生素预防可能预防牙科手术后ONJ的发生。
