Division of Reconstructive Surgery for Oral and Maxillofacial Region, Faculty of Dentistry & Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan.
Minamiuonuma City Yukiguni Yamato Hospital Dentistry/ Pediatric Dentistry, Minamiuonuma, Japan.
Oral Maxillofac Surg. 2024 Jun;28(2):849-857. doi: 10.1007/s10006-024-01221-6. Epub 2024 Feb 1.
This study aimed to verify whether tooth extraction before the administration of bone-modifying agents (BMA) was effective in preventing the onset of medication-related osteonecrosis of the jaw (MRONJ).
This retrospective study included patients with a history of receiving BMA for cancer treatment. The patients were classified into three groups based on the timing of tooth extraction: no tooth extraction before the onset of MRONJ, tooth extraction before the administration of BMA, and tooth extraction after the administration of BMA. The incidence of MRONJ was compared between the groups. Fisher's exact test and Bonferroni correction were used to test for differences in proportions between the three groups.
The total number of subjects was 123. Twenty-four patients (19.5%) developed MRONJ. The incidence rates were 12.3% (10/81), 17.9% (5/28), and 64.3% (9/14) in the non-extraction group, the extraction before BMA administration group, and the extraction after BMA administration group, respectively, showing statistically significant differences between the extraction after BMA administration group and the non-extraction groups and between the extraction after BMA administration group and the extraction before BMA administration group (p < 0.001, p = 0.0049). On the other hand, there was no statistically significant difference in incidence between the non-extraction and the extraction before BMA administration group (p = 0.5274).
Tooth extraction before the administration of BMA is effective in preventing the onset of MRONJ in patients receiving BMA for cancer treatment. Prevention of MRONJ development in patients receiving BMA for cancer treatment contributes to the maintenance of patients' quality of life.
本研究旨在验证在给予骨修饰剂（BMA）之前拔牙是否能有效预防药物相关性颌骨坏死（MRONJ）的发生。
本回顾性研究纳入了接受 BMA 治疗癌症的患者。根据 MRONJ 发生前拔牙的时间，将患者分为三组：无 MRONJ 发生前拔牙、BMA 给药前拔牙和 BMA 给药后拔牙。比较三组之间 MRONJ 的发生率。Fisher 确切检验和 Bonferroni 校正用于检验三组之间比例的差异。
共纳入 123 例患者。24 例（19.5%）发生 MRONJ。非拔牙组、BMA 给药前拔牙组和 BMA 给药后拔牙组的发生率分别为 12.3%（10/81）、17.9%（5/28）和 64.3%（9/14），BMA 给药后拔牙组与非拔牙组之间以及 BMA 给药后拔牙组与 BMA 给药前拔牙组之间的差异有统计学意义（p<0.001，p=0.0049）。另一方面，非拔牙组和 BMA 给药前拔牙组之间的发生率差异无统计学意义（p=0.5274）。
在给予 BMA 之前拔牙可有效预防接受 BMA 治疗癌症的患者发生 MRONJ。预防接受 BMA 治疗癌症的患者发生 MRONJ 有助于维持患者的生活质量。
