Bonacina Riccardo, Mariani Umberto, Villa Francesco, Villa Alessandro
Department of Dentistry, Azienda Ospedaliera Ospedali Riuniti di Bergamo, Bergamo, Italy.
J Can Dent Assoc. 2011;77:b147.
To describe and evaluate the effectiveness of oral and dental prevention strategies for cancer patients who were about to begin bisphosphonate (BP) intravenous therapy with zoledronate.
Patients were divided into 2 groups according to their history with BPs: group PA (preventive approach) and group OB (observation). Group PA patients had never been previously treated with BPs, and group OB patients had already undergone therapy with BPs. All patients received a complete oral and dental examination and had a panoramic radiograph. If necessary, oral hygiene, and restorative and rehabilitation therapy were offered to patients. All patients participated in regular checkups every 6 months. Group PA patients underwent oral surgical procedures, as needed.
A total of 282 patients (162 women, 120 men) were included in this analysis (PA: n = 217; OB: n = 65). In group OB, 4.6% of patients presented with osteonecrosis of the jaw (ONJ) at first visit and 10.8% developed new ONJ during the 18-month follow-up period. No patients in group PA had ONJ. Anti-angiogenic therapy was associated with ONJ (p < 0.01) and patients with a higher number of zoledronate infusions were significantly more likely to develop ONJ (p < 0.01).
Although the incidence of BP-related ONJ is fairly low, it remains a painful and difficult complication to treat. An interdisciplinary preventive approach is essential to prevent and manage this condition.
描述并评估针对即将开始使用唑来膦酸进行双膦酸盐（BP）静脉治疗的癌症患者的口腔和牙齿预防策略的有效性。
根据患者使用BP的病史将其分为两组：PA组（预防措施组）和OB组（观察组）。PA组患者此前从未接受过BP治疗，OB组患者已经接受过BP治疗。所有患者均接受了全面的口腔和牙齿检查，并拍摄了全景X光片。必要时，为患者提供口腔卫生、修复和康复治疗。所有患者每6个月参加一次定期检查。PA组患者根据需要接受口腔外科手术。
本分析共纳入282例患者（162例女性，120例男性）（PA组：n = 217；OB组：n = 65）。在OB组中，4.6%的患者初诊时出现颌骨坏死（ONJ），10.8%的患者在18个月的随访期内出现新的ONJ。PA组无患者发生ONJ。抗血管生成治疗与ONJ相关（p < 0.01），唑来膦酸输注次数较多的患者发生ONJ的可能性显著更高（p < 0.01）。
尽管BP相关ONJ的发生率相当低，但它仍然是一种痛苦且难以治疗的并发症。跨学科的预防方法对于预防和管理这种情况至关重要。
