Department of Odontology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
Department of Oral & Maxillofacial Surgery, Copenhagen University Hospital, Copenhagen, Denmark.
Oral Maxillofac Surg. 2024 Sep;28(3):1117-1125. doi: 10.1007/s10006-024-01214-5. Epub 2024 Feb 29.
Tori and exostoses are considered risk factors for the development of medication-related osteonecrosis of the jaw (MRONJ). The aims of this study were to present the prevalence of MRONJ located at tori in the Copenhagen ONJ Cohort, evaluate the surgical treatment of MRONJ located at tori and explore trauma to tori as an additional risk factor in patients on antiresorptive medication.
Data from a consecutive series of 506 patients with MRONJ (Copenhagen ONJ Cohort) were reviewed for the presence of tori and MRONJ located at tori. Demographic and medical data were analyzed, and healing outcomes and pain after the prophylactic removal of tori, surgical treatment of MRONJ located at tori, and conservative treatment of MRONJ located at tori were evaluated and compared using Fisher's exact test.
MRONJ located at tori was frequent and could be identified in 53% of the patients with tori, which accounts for a prevalence of 5.1% in the entire cohort. Of the 28 surgically treated patients, 27 (96.4%) healed uneventfully with no exposed bone after their first or second revision surgery. Fourteen (41.2%) patients with tori underwent therapeutic removal, eight (23.5%) underwent prophylactic removal, and six (17.6%) underwent both therapeutic and prophylactic removals. Two (33.3%) of the six conservatively treated patients healed spontaneously. Both treatment types resulted in a significant decrease in pain.
Prophylactic and therapeutic surgical removal of tori are reliable treatments and should be considered if a patient's general health allows surgery.
The study was approved by the Regional Scientific Ethical Committee (H-6-2013-010) on November 20, 2013, and was retrospectively registered.
齿突和外生骨赘被认为是药物相关性下颌骨坏死（MRONJ）发展的危险因素。本研究的目的是在哥本哈根 ONJ 队列中报告位于齿突的 MRONJ 的患病率，评估位于齿突的 MRONJ 的手术治疗，并探讨抗吸收药物治疗患者的齿突外伤是否为额外的危险因素。
回顾性分析了连续 506 例 MRONJ 患者（哥本哈根 ONJ 队列）的数据，以评估是否存在齿突和位于齿突的 MRONJ。分析了人口统计学和医学数据，并使用 Fisher 确切检验评估和比较了预防性去除齿突、位于齿突的 MRONJ 的手术治疗、位于齿突的 MRONJ 的保守治疗的愈合结果和疼痛。
位于齿突的 MRONJ 很常见，在有齿突的患者中可识别出 53%，在整个队列中占 5.1%。在 28 例接受手术治疗的患者中，27 例（96.4%）在首次或第二次翻修手术后无骨外露，愈合顺利。14 例（41.2%）有齿突的患者接受了治疗性切除，8 例（23.5%）接受了预防性切除，6 例（17.6%）接受了治疗性和预防性切除。保守治疗的 6 例患者中有 2 例（33.3%）自发性愈合。两种治疗类型均显著减轻疼痛。
预防性和治疗性手术切除齿突是可靠的治疗方法，如果患者的一般健康状况允许手术，应考虑进行手术。
该研究于 2013 年 11 月 20 日经地区科学伦理委员会（H-6-2013-010）批准，并进行了回顾性注册。
