Department of Oral and Maxillofacial Surgery, University of Heidelberg, Im Neuenheimer Feld 400, D-69120 Heidelberg, Germany.
Medicina (Kaunas). 2023 Jan 31;59(2):277. doi: 10.3390/medicina59020277.
: The purpose of this study was to evaluate the impact of surgical and conservative, non-surgical treatment on general health-related (QoL) and oral health-related quality of life (OHRQoL) in patients suffering from AAOMS stage I MRONJ. In the course of this prospective clinical study, QoL and OHRQoL using QLQ-C30 and QHIP G14 questionnaire were longitudinally assessed in N = 174 prospectively enrolled patients with indication of treatment of MRONJ stage I over a period of 12 months. Patients received conservative or surgical treatment. The measurement time points were preoperatively (T0), 12 weeks (T1), 6 months (T2) and 1 year after operation (T3). For OHRQoL, no significant ( > 0.05) differences were found between both treatment groups for all timepoints (T0-T3). In the surgical treatment group, OHIP scores of T1, T2 and T3 were significantly lower than baseline measures (T0) (T0-T1 (2.99, = 0.024), T0-T2 (5.20, < 0.001), T0-T3 (7.44, < 0.001)). For conservative treatment group OHIP, scores of T2 and T3 were significantly lower than baseline measures (T0) (T0-T2 (9.09, = 0.013), T0-T3 (12.79, < 0.001)). There was no statistically significant effect of time on QLQ-C30 scores in both groups (surgical treatment: F(3, 174) = 1.542, < 0.205, partial η = 0.026; conservative treatment: F(3, 30) = 0.528, = 0.667, partial η = 0.050). QLQ-C30 scores turned out to be significantly lower in the non-surgical group at T1 ( = 0.036) and T3 ( = 0.047) compared to the surgical treatment group. Surgical and conservative treatment of MRONJ stage I significantly improves patients' OHRQoL. Surgical treatment is superior to conservative treatment of MRONJ stage I regarding general QoL. Therefore, surgical treatment of MRONJ stage I should not be omitted for QoL reasons.
本研究旨在评估手术与非手术（保守）治疗对 AAOMS Ⅰ期 MRONJ 患者一般健康相关（QoL）和口腔健康相关生活质量（OHRQoL）的影响。在这项前瞻性临床研究中，使用 QLQ-C30 和 QHIP G14 问卷对 N = 174 例有 MRONJ Ⅰ期治疗指征的患者进行了前瞻性评估，这些患者在 12 个月的时间内接受了保守或手术治疗。患者在术前（T0）、12 周（T1）、6 个月（T2）和术后 1 年（T3）进行了 QoL 和 OHRQoL 测量。在 OHRQoL 方面，在所有时间点（T0-T3），两组之间均未发现有统计学意义的（>0.05）差异。在手术治疗组中，T1、T2 和 T3 的 OHIP 评分均显著低于基线测量值（T0）（T0-T1（2.99，=0.024），T0-T2（5.20，<0.001），T0-T3（7.44，<0.001））。对于保守治疗组，T2 和 T3 的 OHIP 评分均显著低于基线测量值（T0）（T0-T2（9.09，=0.013），T0-T3（12.79，<0.001））。在两组中，时间对 QLQ-C30 评分均无统计学意义（手术治疗：F（3，174）=1.542，<0.205，偏η=0.026；保守治疗：F（3，30）=0.528，=0.667，偏η=0.050）。与手术治疗组相比，非手术组在 T1（=0.036）和 T3（=0.047）时 QLQ-C30 评分显著较低。Ⅰ期 MRONJ 的手术和保守治疗均显著改善了患者的 OHRQoL。在一般 QoL 方面，手术治疗优于Ⅰ期 MRONJ 的保守治疗。因此，不应因 QoL 原因而忽视Ⅰ期 MRONJ 的手术治疗。
