静脉注射双膦酸盐患者的拔牙：预防方案及病例系列

Tooth extraction in patients taking intravenous bisphosphonates: a preventive protocol and case series.

作者信息

Lodi Giovanni, Sardella Andrea, Salis Annalisa, Demarosi Federica, Tarozzi Marco, Carrassi Antonio

机构信息

Unità di Medicina e Patologia Orale, Università degli Studi di Milano, Milan, Italy.

出版信息

J Oral Maxillofac Surg. 2010 Jan;68(1):107-10. doi: 10.1016/j.joms.2009.07.068.

DOI:10.1016/j.joms.2009.07.068

PMID:20006163

Abstract

PURPOSE

To test the efficacy of a protocol in preventing the development of bisphosphonate-related osteonecrosis of the jaw (BRONJ) after tooth extraction.

PATIENTS AND METHODS

In this prospective case series, consecutive subjects treated with intravenous bisphosphonates who needed tooth extraction underwent a protocol aimed at reducing the risk of BRONJ, based on local and systemic infection control by means of mechanical and chemical reduction of the local bacterial load plus antibiotic prophylaxis.

RESULTS

We performed 38 extractions in 23 patients treated with intravenous bisphosphonates, mainly zoledronate, for a mean of 17.5 months (range, 3-36 months). Five patients already had signs of BRONJ caused by tooth extractions performed elsewhere. The mean follow-up was 229.5 days (range, 14-965 days), and no case of BRONJ was recorded.

CONCLUSIONS

Despite the methodologic limitations of the study design, the proposed preventive protocol appears to reduce the risk of BRONJ after tooth extraction in a group of subjects treated with intravenous bisphosphonates.

摘要