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浓缩生长因子(CGF)在骨质疏松症患者颌骨药物相关性骨坏死(MRONJ)手术治疗中的作用:一项随机对照研究。

The effect of concentrated growth factor (CGF) in the surgical treatment of medication-related osteonecrosis of the jaw (MRONJ) in osteoporosis patients: a randomized controlled study.

作者信息

Yüce Meltem Ozden, Adalı Emine, Işık Gözde

机构信息

Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Ege University, Izmir, Turkey.

Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Izmir Democracy University, Izmir, Turkey.

出版信息

Clin Oral Investig. 2021 Jul;25(7):4529-4541. doi: 10.1007/s00784-020-03766-8. Epub 2021 Jan 3.

Abstract

OBJECTIVES

The purpose of this present study was to evaluate the efficiency of the growth factors delivered by concentrated growth factor (CGF) on the healing process of osteoporotic patients with medication-related osteonecrosis of the jaws (MRONJ).

METHODS

This randomized controlled study was composed of osteoporotic female patients who were treated with oral bisphosphonates (BPs) and diagnosed with MRONJ. For the CGF group, each patient was treated with a local application of CGF at the surgical site after removing the necrotic bone, while the surgical area was primarily closed as traditional surgical therapy for the control group. The patients underwent clinical examinations for 6 months postoperatively to check the presence of infection and dehiscence.

RESULTS

Complete healing was achieved in 19 patients of 28 patients (mean age: CGF group, 73.57 ± 5.1; control group, 73.64 ± 5.49) diagnosed with MRONJ. There was no significant difference in post-op healing data between groups during healing periods (p > 0.05). In the CGF group (n = 14) in three cases, bone exposure without infection was detected, and one of them showed a recurrent infection. In the control group (n = 14) in six cases, bone exposure without infection was detected, and three of them also showed recurrent infection.

CONCLUSION

Although our results were not statistically significant, our findings suggest that the local application of CGF appears to be an effective approach to the surgical treatment of MRONJ in osteoporosis patients by improving tissue regeneration.

CLINICAL RELEVANCE

A specific treatment protocol to manage MRONJ is still controversial. This study justifies that CGF can be used in combination with surgical treatment.

摘要

目的

本研究旨在评估浓缩生长因子(CGF)所递送的生长因子对患有药物相关性颌骨坏死(MRONJ)的骨质疏松症患者愈合过程的有效性。

方法

这项随机对照研究由接受口服双膦酸盐(BPs)治疗并被诊断为MRONJ的骨质疏松症女性患者组成。对于CGF组,每位患者在清除坏死骨后于手术部位局部应用CGF,而对照组的手术区域则按照传统手术疗法进行一期缝合。患者在术后6个月接受临床检查,以检查是否存在感染和裂开情况。

结果

28例被诊断为MRONJ的患者中(平均年龄:CGF组,73.57±5.1;对照组,73.64±5.49),19例实现了完全愈合。在愈合期间,两组之间的术后愈合数据无显著差异(p>0.05)。在CGF组(n=14)中,有3例检测到无感染的骨暴露,其中1例出现复发性感染。在对照组(n=14)中,有6例检测到无感染的骨暴露,其中3例也出现复发性感染。

结论

尽管我们的结果无统计学意义,但我们的研究结果表明,局部应用CGF似乎是通过改善组织再生来手术治疗骨质疏松症患者MRONJ的有效方法。

临床意义

治疗MRONJ的具体治疗方案仍存在争议。本研究证明CGF可与手术治疗联合使用。

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