Resident, Section of Oral and Maxillofacial Surgery, Division of Diagnostic and Surgical Sciences, UCLA School of Dentistry, Los Angeles, CA.
Private Practice, El Paso, TX.
J Oral Maxillofac Surg. 2024 Sep;82(9):1139-1146. doi: 10.1016/j.joms.2024.06.025. Epub 2024 Jun 7.
Medication related osteonecrosis of the jaws (MRONJ), a rare side-effect of antiresorptive medications, is described as exposed bone in the oral cavity that lasts for at least 8 weeks. Most studies report a female predilection for MRONJ; these findings could be due to the increased use of antiresorptives in females, or due to inherent differences between male versus female patients.
The purpose of this study was to measure and compare the incidence and severity of osteonecrosis of the jaws (ONJ) between male and female mice.
STUDY DESIGN, SETTING, SAMPLE: We designed a randomized in-vivo animal study utilizing male and female mice treated with zoledronic acid (ZA). Experimental periodontitis was induced in 24 male and 24 female mice using a silk ligature following administration of saline or a potent bisphosphonate. After 8 weeks, animals were evaluated radiographically and histologically.
The independent variables were sex (male vs female) and treatment group (ZA vs saline control). Treatment was randomly assigned with balanced distribution between male and female animals.
The main outcome variable was ONJ status coded as present or absent. ONJ was defined as present if there was histologic contact between the ligature and the alveolar bone. Secondary outcomes of interest were radiographic and histologic parameters.
Statistical differences were analyzed using a two-way analysis of variance with Tukey's post hoc test using a P value of 0.05 for significance.
The final sample was composed of 24 vehicle treated and 24 ZA treated animals. In vehicle treated animals, 8% of female and 8% of male animals developed ONJ. In ZA treated animals, 83% of female and 92% of male animals developed ONJ. Sex was not associated with the risk (measured as incidence of disease) for developing ONJ or in the radiographic or histologic parameters that were assessed (P values >.1).
Sex does not appear to affect the incidence of MRONJ or the severity of the disease as assessed by the radiographic and histologic parameters.
药物相关性颌骨坏死（MRONJ）是一种抗吸收药物的罕见副作用，其特征为口腔内持续至少 8 周的暴露骨。大多数研究报告女性对 MRONJ 的易感性更高；这些发现可能是由于女性对抗吸收药物的使用增加，或者是由于男性与女性患者之间存在固有差异。
本研究旨在测量和比较雄性和雌性小鼠颌骨坏死（ONJ）的发生率和严重程度。
研究设计、地点和样本：我们设计了一项随机体内动物研究，利用接受唑来膦酸（ZA）治疗的雄性和雌性小鼠。在给予盐水或强效双膦酸盐后，用丝线结扎诱导 24 只雄性和 24 只雌性小鼠发生实验性牙周炎。8 周后，对动物进行放射学和组织学评估。
自变量为性别（雄性与雌性）和治疗组（ZA 与盐水对照）。治疗采用随机分配，雄性和雌性动物之间的分配平衡。
主要观察结果是 ONJ 状态，编码为存在或不存在。如果结扎物与牙槽骨之间存在组织学接触，则定义为存在 ONJ。感兴趣的次要观察结果包括放射学和组织学参数。
使用双因素方差分析，采用 Tukey 事后检验，显著性 P 值为 0.05。
最终样本由 24 只接受载体治疗和 24 只接受 ZA 治疗的动物组成。在载体治疗的动物中，8%的雌性和 8%的雄性动物发生 ONJ。在 ZA 治疗的动物中，83%的雌性和 92%的雄性动物发生 ONJ。性别与发生 ONJ 的风险（以疾病发生率衡量）或评估的放射学和组织学参数无关（P 值>.1）。
性别似乎不会影响 MRONJ 的发生率或放射学和组织学参数评估的疾病严重程度。
