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综合口腔护理在预防药物相关性颌骨坏死(MRONJ)中的潜在作用:单中心研究。

Potential role of comprehensive dental care in preventing medication related osteonecrosis of the jaw (MRONJ): a single centre study.

机构信息

Faculty of Dentistry, Al Zawiya University, 110 Jamal Abdulnasser Street, Al Zawiya, Libya.

Department of Oral & Maxillofacial Surgery, Faculty of Dentistry, Universiti Kebangsaan Malaysia, Kuala Lumpur, 50300, Malaysia.

出版信息

BMC Oral Health. 2024 Oct 26;24(1):1291. doi: 10.1186/s12903-024-05081-0.

DOI:10.1186/s12903-024-05081-0
PMID:39455955
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11512473/
Abstract

OBJECTIVE

Medication-related osteonecrosis of the jaw bones (MRONJ) is a well-known complication of antiresorptive and antiangiogenic drugs. Since the first report, more occurrences of MRONJ have been described worldwide. Dental extraction has been described by many studies as one of the risk factors for MRONJ. Comprehensive dental care (CDC) is a preventive dental method provided to patients prior to drug commencement. This study aims to determine the association between CDC and MRONJ.

PATIENTS AND METHODS

A retrospective analysis was performed on 75 medical records of patients on antiresorptive and/or antiangiogenic drugs between February 2018 and May 2021. Demographics and clinical and radiographic data were collected. Univariate and multivariate analyses were performed to determine the factors associated with MRONJ.

RESULTS

Of the 75 patients who met the inclusion criteria, 11 (14.7%) developed MRONJ. Three out of 11 patients (27.2%) developed MRONJ spontaneously, while eight patients (72.8%) developed it after trauma from dentures or dental extractions. Following a binary logistic regression analysis, the lack of CDC was identified as a significant predictor of MRONJ. Patients who did not receive CDC had an odds ratio of 8.64 (95% confidence interval (CI): 1.27-58.62, p = 0.03). However, dental extraction did not show a statistically significant association with MRONJ in both the univariate and multivariate analyses.

CONCLUSION

CDC before treatment with antiresorptive and antiangiogenic drugs is a potentially effective preventive method for reducing MRONJ. Dental extraction was not a significant factor in relation to MRONJ.

摘要

目的

颌骨药物相关性骨坏死(MRONJ)是一种已知的抗吸收和抗血管生成药物的并发症。自首例报告以来,世界各地已描述了更多的 MRONJ 病例。许多研究将拔牙描述为 MRONJ 的危险因素之一。综合牙科护理(CDC)是在药物开始前为患者提供的预防性牙科方法。本研究旨在确定 CDC 与 MRONJ 之间的关联。

患者和方法

对 2018 年 2 月至 2021 年 5 月期间使用抗吸收和/或抗血管生成药物的 75 名患者的病历进行了回顾性分析。收集了人口统计学、临床和影像学数据。进行了单变量和多变量分析,以确定与 MRONJ 相关的因素。

结果

在符合纳入标准的 75 名患者中,有 11 名(14.7%)发生了 MRONJ。11 名患者中有 3 名(27.2%)自发性发生 MRONJ,而 8 名患者(72.8%)因义齿或拔牙创伤而发生 MRONJ。在二元逻辑回归分析后,发现缺乏 CDC 是 MRONJ 的一个显著预测因素。未接受 CDC 的患者发生 MRONJ 的优势比为 8.64(95%置信区间(CI):1.27-58.62,p=0.03)。然而,在单变量和多变量分析中,拔牙与 MRONJ 均无统计学显著关联。

结论

在使用抗吸收和抗血管生成药物治疗前进行 CDC 是一种潜在有效的预防 MRONJ 的方法。拔牙与 MRONJ 无显著相关性。

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Risk of medication-related osteonecrosis of the jaw after dental extractions in patients receiving antiresorptive agents - A retrospective study of 240 patients.接受抗吸收剂治疗的患者在拔牙后发生药物相关性颌骨坏死的风险 - 一项 240 例患者的回顾性研究。
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The preventive care of medication-related osteonecrosis of the jaw (MRONJ): a position paper by Italian experts for dental hygienists.预防药物相关性颌骨坏死(MRONJ):意大利专家为口腔卫生师制定的立场文件。
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