Attending Doctor, Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing, China and Attending Doctor, Department of Oral and Maxillofacial Surgery, The Third Hospital of Hebei Medical University, Shijiazhuang, China.
Associate Professor, Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing, China.
J Oral Maxillofac Surg. 2021 Aug;79(8):1683-1688. doi: 10.1016/j.joms.2020.12.045. Epub 2021 Jan 6.
The progression of medication-related osteonecrosis of the jaw (MRONJ) is influenced by many factors. This study aimed to identify the clinical risk factors associated with severe MRONJ (stage 3).
The data of patients with MRONJ who were hospitalized between July 2013 and December 2019 were retrospectively analyzed. Demographic and clinical factors were the independent variables, and the clinical stage of MRONJ lesions was the dependent variable. Multivariate logistic regression analysis was performed to identify the risk factors for advanced stage disease (MRONJ stage 3).
A total of 79 patients (with 93 MRONJ lesions) were included. In multivariate regression analysis, the risk factors associated with stage 3 MRONJ were age ≤65 years (odds ratio [OR] = 3.968, 95% confidence interval [CI]: 1.280-12.301; P = .017); chemotherapy (OR = 3.687, 95% CI: 1.048-12.972; P = .042); preoperative MRONJ duration ≥12 months (OR = 7.616, 95% CI: 1.865-31.110; P = .005); lesion location in maxilla (OR = 1.150, 95% CI: 1.006-1.315; P = .041); lesion location in posterior jaw, that is, in molar area (OR = 1.384, 95% CI; 1.118-1.715; P = .003); and serum albumin <40 g/L (OR = 6.257, 95% CI: 1.313-29.815; P = .021).
Age ≤65 years, chemotherapy, preoperative MRONJ duration ≥12 months, lesion location in maxilla, lesion location in the molar area, and serum albumin <40 g/L may increase the risk for severe MRONJ.
药物相关性下颌骨坏死（MRONJ）的进展受到多种因素的影响。本研究旨在确定与严重 MRONJ（3 期）相关的临床危险因素。
回顾性分析 2013 年 7 月至 2019 年 12 月期间住院治疗的 MRONJ 患者的临床资料。将患者的年龄、性别、基础疾病、合并用药、MRONJ 发病相关因素、手术情况等作为自变量，MRONJ 病变的临床分期作为因变量，采用多因素 Logistic 回归分析方法分析严重 MRONJ（MRONJ 3 期）的相关危险因素。
共纳入 79 例患者（93 处 MRONJ 病变）。多因素回归分析显示，年龄≤65 岁（OR=3.968，95%CI：1.28012.301；P=0.017）、化疗（OR=3.687，95%CI：1.04812.972；P=0.042）、术前 MRONJ 病程≥12 个月（OR=7.616，95%CI：1.86531.110；P=0.005）、上颌骨病变（OR=1.150，95%CI：1.0061.315；P=0.041）、磨牙后区病变（OR=1.384，95%CI：1.1181.715；P=0.003）、血清白蛋白＜40 g/L（OR=6.257，95%CI：1.31329.815；P=0.021）是导致 MRONJ 病情进展为 3 期的危险因素。
年龄≤65 岁、化疗、术前 MRONJ 病程≥12 个月、病变位于上颌骨、病变位于磨牙后区、血清白蛋白＜40 g/L 可能会增加严重 MRONJ 的风险。
