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成骨不全症儿童和青少年的双膦酸盐相关性颌骨骨坏死和牙科手术程序:系统评价。

Bisphosphonate-related osteonecrosis of the jaws and dental surgery procedures in children and young people with osteogenesis imperfecta: A systematic review.

机构信息

Multidisciplinary Department of Medical-Surgical and Odontostomatological Specialties, University of Campania "Luigi Vanvitelli", Via L. de Crecchio, 6, 80138 Naples, Italy.

Department of Oral and Maxillo-facial Sciences, Sapienza University of Rome, Rome, Italy.

出版信息

J Stomatol Oral Maxillofac Surg. 2020 Nov;121(5):556-562. doi: 10.1016/j.jormas.2020.03.003. Epub 2020 Mar 7.

Abstract

BACKGROUND

Bisphosphonates (BPs) contrast the bone fragility and improve bone density in some metastatic cancers and bone diseases, such as Osteogenesis Imperfecta (OI). BPs use has been associated with osteonecrosis of the jaws (BRONJs) in adults needing for invasive dental procedures.

AIM

To conduct a systematic review on BRONJ occurrence after dental surgery in paediatric population under BPs therapy for OI, so as to identify the pre-surgical protocols adopted.

DESIGN

According to PRISMA guidelines, Pubmed, Web of Science (WoS) and Cochrane were investigated on September 2018, and re-checked on July 2019. Inclusion criteria were English-language papers on children/young adults (until 24 years old) reporting dental/oral surgery procedures.

RESULTS

Totally, 60 articles were found. After title/abstract reviews and duplicates exclusion, 22 eligible titles underwent full-text evaluation. Finally, 10 studies were included.

CONCLUSIONS

The lack of BRONJ occurrence in paediatric population suffering OI and treated with BPs, was confirmed, but the reasons are still debated, being the BPs therapies and the surgical strategies various and not standardized. Longitudinal studies should evaluate what happens to those former children once adult, to evaluate the delayed BRONJs onset associated with the occurrence of comorbidities during the adulthood.

摘要

背景

双膦酸盐(BPs)可改善某些转移性癌症和骨病(如成骨不全症[OI])患者的骨脆弱性并增加骨密度。在需要进行侵入性牙科手术的成年人中,BPs 的使用与颌骨骨坏死(BRONJ)相关。

目的

对接受 BP 治疗 OI 的儿科人群在牙科手术后发生 BRONJ 的情况进行系统评价,以确定术前采用的方案。

设计

根据 PRISMA 指南,于 2018 年 9 月在 Pubmed、Web of Science(WoS)和 Cochrane 进行检索,并于 2019 年 7 月再次检索。纳入标准为关于儿童/青少年(直至 24 岁)报告牙科/口腔手术的报告英语文献。

结果

共发现 60 篇文章。经过标题/摘要审查和排除重复项后,有 22 篇符合条件的标题进行了全文评估。最终纳入 10 项研究。

结论

接受 BP 治疗的 OI 患儿发生 BRONJ 的情况得到了证实,但原因仍存在争议,BPs 治疗和手术策略各不相同且未标准化。应开展纵向研究来评估那些曾经是儿童的人在成年后会发生什么情况,以评估与成年期发生的合并症相关的延迟 BRONJ 发病。

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