Department of Dentistry, Mario Kroeff Hospital, Rio de Janeiro, Brazil.
Department of Surgery, Stomatology, Pathology and Radiology, University of Sao Paulo, Bauru School of Dentistry, Alameda Dr. Octávio Pinheiro Brisolla, 9-75, Bauru, São Paulo, 17012-901, Brazil.
Support Care Cancer. 2021 Dec;29(12):7687-7694. doi: 10.1007/s00520-021-06362-y. Epub 2021 Jun 18.
To investigate the association of oral health condition with the occurrence of medication-related osteonecrosis of the jaw (MRONJ) in a cancer population.
A multicenter cross-sectional study was conducted with cancer patients exposed to bisphosphonates for at least 7 months. Dental and periodontal conditions were assessed by epidemiological indices.
The sample consisted of 80 patients under bisphosphonate therapy, nine of which were allocated to group 1 (with MRONJ) and 71 to group 2 (without MRONJ). Osteonecrosis cases presented 19 decayed, missing, and filled teeth on average. Moderate gingival inflammation was noted in both groups and together with severe inflammation exceeded 50% of the groups. The presence of dental calculus was detected in about half of the individuals in both groups. Shallow periodontal pockets were detected in about 25% of both groups. Deep periodontal pockets were more prevalent among patients with osteonecrosis. Regular oral hygiene was detected in approximately 25% of individuals in both groups. There was a strong positive correlation between the clinical staging of osteonecrosis and decayed, missing, and filled teeth index (DMFTI).
Patients had a poor oral health condition. All but one osteonecrosis case had no previous history of tooth extraction; oral infections seemed to play a major role in the development of bone necrosis. Advanced osteonecrosis stages were associated with a higher DMFTI.
调查口腔健康状况与癌症患者中发生药物相关性颌骨坏死（MRONJ）的关系。
对至少接受双膦酸盐治疗 7 个月的癌症患者进行了一项多中心横断面研究。通过流行病学指标评估牙齿和牙周状况。
本样本包括 80 名接受双膦酸盐治疗的患者，其中 9 名患者被分配到组 1（有 MRONJ），71 名患者被分配到组 2（无 MRONJ）。坏死病例平均有 19 颗龋齿、缺失和填补的牙齿。两组均有中度牙龈炎症，与严重炎症一起超过了 50%的组。两组中约有一半的个体存在牙石。浅牙周袋在两组中均约占 25%。深牙周袋在患有骨坏死的患者中更为常见。两组中约有 25%的个体定期进行口腔卫生。骨坏死的临床分期与龋齿、缺失和填补的牙齿指数（DMFTI）之间存在强烈的正相关。
患者的口腔健康状况较差。除 1 例骨坏死病例外，其余病例均无拔牙史；口腔感染似乎在骨坏死的发生中起主要作用。晚期骨坏死与更高的 DMFTI 相关。
