Dept. of Oral and Maxillofacial Surgery, Nanjing Stomatological Hospital, Affiliated Hospital of Medical School, Research Institute of Stomatology, Nanjing University, Nanjing 210008, China.
Hua Xi Kou Qiang Yi Xue Za Zhi. 2024 Oct 1;42(5):629-635. doi: 10.7518/hxkq.2024.2024133.
This study aimed to explore the effect of surgery combined with bone perforation for treating stage Ⅱ medication-related osteonecrosis of the jaw (MRONJ).
A total of 21 patients with stage Ⅱ mandibular MRONJ who underwent surgical treatment from June 2020 to June 2023 were included in this study. Retrospective analysis was conducted on their clinical data, including gender, age, primary disease, drug name and administration method, pre-surgery drug cessation, and prognosis. The cohort comprised 14 males and 7 females, with an average age at onset of 68.33±10.74 years. According to the guidelines of the American Association of Oral and Maxillofacial Surgeons, the included patients had stage Ⅱ mandibular MRONJ. The treatment approach consisted of partial mandibulectomy combined with bone perforation techniques, ensuring tension-free suturing of soft tissues. Follow-up was performed regularly, and the curative effect was evaluated. The SF-12 health survey was used to assess the quality of life for all patients before and after surgery.
A total of 21 patients were followed up for 8-38 months after surgery, and the mucosal healing of 17 patients was good (80.95%). The postoperative quality of life score (83.62±5.90) was significantly higher than that before operation (63.67±4.70, <0.05).
Surgery combined with bone perforation te-chnique is an effective treatment method with high success rate in refractory stage Ⅱ MRONT patients.
本研究旨在探讨手术联合骨穿孔治疗Ⅱ期药物相关性下颌骨骨髓炎(MRONJ)的效果。
回顾性分析 2020 年 6 月至 2023 年 6 月期间接受手术治疗的 21 例Ⅱ期下颌 MRONJ 患者的临床资料,包括性别、年龄、基础疾病、药物名称及使用方法、术前停药情况及预后。该队列包括 14 例男性和 7 例女性,发病时的平均年龄为 68.33±10.74 岁。根据美国口腔颌面外科协会的指南,纳入的患者为Ⅱ期下颌 MRONJ。治疗方法包括部分下颌骨切除术联合骨穿孔技术,确保软组织无张力缝合。定期进行随访,并评估疗效。所有患者在术前和术后均采用 SF-12 健康调查量表评估生活质量。
21 例患者术后随访 8-38 个月,17 例患者黏膜愈合良好(80.95%)。术后生活质量评分(83.62±5.90)明显高于术前(63.67±4.70,<0.05)。
手术联合骨穿孔技术是治疗难治性Ⅱ期 MRONT 患者的有效方法,成功率高。