Oteri Giacomo, De Ponte Francesco Saverio, Runci Michele, Peditto Matteo, Marcianò Antonia, Cicciù Marco
Department of Biomedical, Dental Science and Morphological and Functional Images, Dental School, Messina, Italy.
J Craniofac Surg. 2018 Mar;29(2):403-408. doi: 10.1097/SCS.0000000000004087.
The aim of this study is to analyze the clinical outcome and the change in oral-health-related quality of life (QoL) of osteoporotic patients affected by medication-related osteonecrosis of the jaws (MRONJ). Forty-one patients, consecutively treated for a 10-year period, were retrospectively analyzed. All the patients underwent a marginal osseous resective jaw surgery. A clinical 12 months postoperative evaluation has been performed and the complete mucosal healing, the absence of swelling and suppuration, and no signs of disease recurrence were defined like success parameters. Quality-of-life surveys tests like EORTC QQ-C30 and QLQ-HN35 appendices in conjunction with a perceived oral health visual analog scale (VAS) were administered before (time of diagnosis of MRONJ) and after surgery (at least 6 months) in order to record the different oral health status of the treated patients. The majority of MRONJ-diagnosed patients complained symptoms like pain, eating discomfort, and sense problems, with occasional involvement of the social dimension. There was a prevalence of troubles with social eating and social contact.The complete mucosal healing was achieved in 100% of the patients and the administered survey tests reported a significant improvement in all the investigated spheres. Similarly, an increased mean score of perceived oral health VAS was reported.Marginal-resective surgery of the necrotic jaw bone can be an effective treatment of osteoporotic patients affected by localized MRONJ. Quality-of-life parameters are demonstrated to be useful for recording the patient-centered outcome of MRONJ treatment.
本研究的目的是分析患有药物性颌骨坏死(MRONJ)的骨质疏松症患者的临床结局以及口腔健康相关生活质量(QoL)的变化。对连续治疗10年的41例患者进行了回顾性分析。所有患者均接受了颌骨边缘性骨切除手术。术后进行了12个月的临床评估,将完全黏膜愈合、无肿胀和化脓以及无疾病复发迹象定义为成功参数。在(MRONJ诊断时)手术前和手术后(至少6个月)进行了诸如欧洲癌症研究与治疗组织(EORTC)QQ-C30和QLQ-HN35附录等生活质量调查测试,并结合口腔健康视觉模拟量表(VAS),以记录接受治疗患者的不同口腔健康状况。大多数被诊断为MRONJ的患者抱怨疼痛、进食不适和感觉问题等症状,偶尔涉及社会层面。社交进食和社交接触存在问题的情况较为普遍。100%的患者实现了黏膜完全愈合,所进行的调查测试显示所有调查领域均有显著改善。同样,口腔健康VAS的平均得分也有所提高。坏死颌骨的边缘性切除手术可能是治疗患有局限性MRONJ的骨质疏松症患者的有效方法。生活质量参数被证明有助于记录以患者为中心的MRONJ治疗结局。