Department of Dentistry and Oral Surgery, Shinshu University School of Medicine, 3-1-1, Asahi, Matsumoto, 390-8621, Japan.
Clin Oral Investig. 2019 Aug;23(8):3203-3211. doi: 10.1007/s00784-018-2743-0. Epub 2018 Nov 8.
The purpose of this study was to investigate the treatment outcomes and prognostic factors of medication-related osteonecrosis of the jaw (MRONJ) in Japanese patients.
Among 409 cases, treatment outcomes and prognostic factors were investigated in 275 patients. In statistical analyses, the 1-year cumulative curative rate was calculated with the Kaplan-Meier method, and significance was examined with the Wilcoxon test. Cox's proportional hazards regression analysis was used for the multivariate analysis.
Resolution of the disease was achieved in 137 out of 275 MRONJ patients (49.8%). One-year cumulative curative rates were 39.8% in stage 1 patients, 26.3% in stage 2, and 19.0% in stage 3. The 1-year cumulative curative rates of treatment interventions were 17.2% for conservative treatment, 34.5% for sequestrectomy, and 40.7% for extended surgery including bone resection and segmental resection. As the prognostic factors of treatment outcomes, the type of medication, stage of MRONJ, and type of surgical intervention were identified as independent factors in a multivariate analysis.
These results suggest that surgical interventions may lead to a good prognosis in MRONJ patients.
This study indicated that surgical intervention for MRONJ might lead to improvement of prognosis and quality of life in MRONJ patients.
本研究旨在探讨日本患者药物相关性颌骨坏死（MRONJ）的治疗效果和预后因素。
在 409 例患者中，对 275 例患者的治疗效果和预后因素进行了调查。在统计分析中，采用 Kaplan-Meier 法计算 1 年累积治愈率，并采用 Wilcoxon 检验进行显著性检验。采用 Cox 比例风险回归分析进行多因素分析。
275 例 MRONJ 患者中，137 例（49.8%）疾病得到缓解。1 年累积治愈率分别为：1 期患者为 39.8%，2 期患者为 26.3%，3 期患者为 19.0%。保守治疗的 1 年累积治愈率为 17.2%，清创术为 34.5%，包括骨切除和节段切除的扩大手术为 40.7%。多因素分析显示，药物类型、MRONJ 分期和手术干预类型是治疗效果的独立预后因素。
这些结果表明，手术干预可能导致 MRONJ 患者的预后良好。
本研究表明，MRONJ 的手术干预可能改善患者的预后和生活质量。
