合并症是与抗吸收治疗无关的颌骨骨坏死的一个风险因素。

Comorbid conditions are a risk for osteonecrosis of the jaw unrelated to antiresorptive therapy.

机构信息

Faculty Member, NYU Langone Medical Center, Department of Plastic Surgery, Clinical Associate Professor, Department of Oral and Maxillofacial Surgery, NYU College of Dentistry, New York, NY, USA.

Senior Research Scientist, Department of Epidemiology and Health Promotion, NYU College of Dentistry, New York, NY, USA.

出版信息

Oral Surg Oral Med Oral Pathol Oral Radiol. 2019 Feb;127(2):140-150. doi: 10.1016/j.oooo.2018.09.012. Epub 2018 Oct 5.

DOI:10.1016/j.oooo.2018.09.012

PMID:30449690

Abstract

OBJECTIVE

Osteonecrosis of the jaw (ONJ) is commonly associated with antiresorptive therapy. There have been numerous reports of ONJ unrelated to antiresorptive therapy (ONJ), confounding risk assessment. This study aimed to determine if ONJ is associated with one or more particular comorbidities.

STUDY DESIGN

This was a retrospective case-control study of patients with ONJ and delayed healing (DH). Each case was matched for patient age and gender, as well as location of ONJ or DH lesion to a control patient who had a history of dentoalveolar surgery with uneventful healing and no history of antiresorptive therapy. Comorbidity data included medical conditions and smoking.

RESULTS

Of the 92 patients identified, 67 (73%) met the criteria for ONJ and 25 (27%) for DH. The most common trigger for ONJ and DH was extraction (50%). The presence of any comorbidity (i.e., at least 1) was more prevalent in ONJ than among controls (P = .04), and there were more comorbidities in patients with ONJ and DH than in controls [M(SD) = 1.94 (1.2) and 2.0 (1.3) vs 1.26 (0.89); both P < .001].

CONCLUSIONS

ONJ and DH are not limited to patients with a history of antiresorptive therapy. More comorbidities may signal increased risk for ONJ and DH.

摘要

目的

颌骨骨坏死（ONJ）通常与抗吸收治疗相关。有许多与抗吸收治疗（ONJ）无关的 ONJ 报告，这使得风险评估变得复杂。本研究旨在确定 ONJ 是否与一种或多种特定的合并症有关。

研究设计

这是一项回顾性病例对照研究，研究对象为 ONJ 和延迟愈合（DH）患者。每个病例都与对照患者的年龄和性别相匹配，以及 ONJ 或 DH 病变的位置与接受过牙牙槽手术且愈合良好且无抗吸收治疗史的对照患者相匹配。合并症数据包括医疗状况和吸烟。

结果

在确定的 92 名患者中，有 67 名（73%）符合 ONJ 标准，25 名（27%）符合 DH 标准。ONJ 和 DH 最常见的诱因是拔牙（50%）。ONJ 患者比对照组更常见存在任何合并症（即至少有 1 种）（P = .04），并且 ONJ 和 DH 患者的合并症多于对照组[M(SD) = 1.94（1.2）和 2.0（1.3）与 1.26（0.89）；均 P <.001]。