Capocci Mauro, Romeo Umberto, Cocco Fabio, Bignozzi Isabella, Annibali Susanna, Ottolenghi Livia
Department of Oral and Maxillofacial Sciences, "Sapienza" University of Rome, 6 Caserta Street, 00161 Rome, Italy.
Department of Chemistry and Pharmacy and Department of Surgery, Microsurgery and Medicine Sciences, University of Sassari, Viale S. Pietro, 07100 Sassari, Italy.
Int J Dent. 2014;2014:719478. doi: 10.1155/2014/719478. Epub 2014 Sep 22.
Aim. To describe 7 years of activity of "CROMa" (Coordination of Research on Osteonecrosis of the Jaws) project of "Sapienza" University of Rome. Materials and Methods. A preventive and therapeutic care pathway was created for patients with bisphosphonates (BPs) exposure. Demographic, social, behavioural, pharmacological, and clinical variables were registered in a dedicated database. Results. In the project, 502 patients, 403 females and 99 males, were observed. Bone pathologies were 79% osteometabolic diseases (OMD) and 21% metastatic cancer (CA). Females were 90% in OMD group and 41% in CA. BP administration was 54% oral, 31% IV, and 11% IM; 89% of BPs were amino-BP and 11% non-amino-BP. Consistently with bone pathology (OMD/CA), alendronate appears to be prevalent for OMD (40% relative), while zoledronate was indicated in 92% of CA patients. Out of 502 cases collected, 28 BRONJ were detected: 17 of them were related to IV BP treatment. Preventive oral assessment was required for 50% of CA patients and by 4% of OMD patients. Conclusions. The proposed care pathway protocols for BP exposed patients appeared to be useful to meet treatment and preventive needs, in both oncological and osteometabolic diseases patients. Patients' and physicians' prevention awareness can be the starting point of a multilevel prevention system.
目的。描述罗马“萨皮恩扎”大学“CROMa”（颌骨骨坏死研究协调）项目7年的活动情况。材料与方法。为接触双膦酸盐（BP）的患者创建了一种预防和治疗护理路径。人口统计学、社会、行为、药理学和临床变量被记录在一个专用数据库中。结果。在该项目中，观察了502例患者，其中女性403例，男性99例。骨病理情况为79%是骨代谢疾病（OMD），21%是转移性癌症（CA）。女性在OMD组中占90%，在CA组中占41%。BP给药方式为口服占54%，静脉注射占31%，肌肉注射占11%；89%的BP是氨基BP，11%是非氨基BP。与骨病理情况（OMD/CA）一致，阿仑膦酸盐在OMD中似乎更为普遍（相对占40%），而唑来膦酸在92%的CA患者中被使用。在收集的502例病例中，检测到28例颌骨坏死性骨炎（BRONJ）：其中17例与静脉注射BP治疗有关。50%的CA患者和4%的OMD患者需要进行预防性口腔评估。结论。为接触BP的患者提出的护理路径方案似乎有助于满足肿瘤和骨代谢疾病患者的治疗和预防需求。患者和医生的预防意识可以成为多层次预防系统的起点。
