辅助治疗在药物相关性颌骨坏死管理中的应用：系统评价。
Adjuvant therapies in the management of medication-related osteonecrosis of the jaws: Systematic review.
机构信息
Department of Dentistry, State University of Maringá, Maringá, Brazil.
Oral Oncology Center, São Paulo State University (Unesp), School of Dentistry, Araçatuba, São Paulo, Brazil.
出版信息
Head Neck. 2019 Dec;41(12):4209-4228. doi: 10.1002/hed.25944. Epub 2019 Sep 10.
BACKGROUND
We investigated the efficacy of hyperbaric oxygen (HBO), low-intensity laser (LIL), and platelet-rich plasma (PRP) in the management of medication-related osteonecrosis of the jaws (MRONJ).
METHODS
A literature search was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. Two examiners independently assessed eligibility and risk of bias and extracted data.
RESULTS
There was improvement in 75.6% of the 41 patients submitted to HBO, with positive effects on pain relief and decreased size and number of lesions at a faster rate, with better effects when the drug was discontinued. For LIL, 158 (64.2%) of the 246 patients/sites improved the symptoms and 98 (39.8%) healed completely. Fourteen (17.3%) of the 81 patients treated with PRP significantly improved the symptoms and 65 (80.2%) completely healed.
CONCLUSIONS
These therapies served as safe and effective adjuvant modalities for MRONJ treatment. The lack of randomized clinical trials evidences the need for more high-quality investigations on the subject.
背景
我们研究了高压氧（HBO）、低强度激光（LIL）和富血小板血浆（PRP）在治疗药物相关性颌骨坏死（MRONJ）中的疗效。
方法
根据系统评价和荟萃分析的首选报告项目进行文献检索。两名审查员独立评估了纳入标准和偏倚风险，并提取了数据。
结果
在接受 HBO 治疗的 41 名患者中，有 75.6%的患者病情得到改善，疼痛缓解效果更好，病变的大小和数量减少得更快，在停止使用药物时效果更好。在接受 LIL 治疗的 246 名患者/部位中，有 158 名（64.2%）症状得到改善，98 名（39.8%）完全治愈。在接受 PRP 治疗的 81 名患者中，有 14 名（17.3%）症状显著改善，65 名（80.2%）完全治愈。
结论
这些治疗方法是治疗 MRONJ 的安全有效的辅助手段。缺乏随机临床试验证据表明，需要对这一主题进行更多高质量的研究。
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