Kostares Evangelos, Kostare Georgia, Kostares Michael, Pitsigavdaki Fani, Perisanidis Christos, Kantzanou Maria
Department of Microbiology, Medical School, National and Kapodistrian University of Athens, 115 27 Athens, Greece.
Department of Anatomy, Medical School, National and Kapodistrian University of Athens, 115 27 Athens, Greece.
J Clin Med. 2025 Aug 25;14(17):5988. doi: 10.3390/jcm14175988.
: Medication-related osteonecrosis of the jaw (MRONJ) is a rare but serious adverse effect associated with antiresorptive therapy, particularly following tooth extraction in osteoporotic patients. This study aimed to estimate the prevalence of MRONJ after tooth extraction in individuals with osteoporosis through a systematic review and meta-analysis. : A comprehensive search was conducted across three major databases (Medline, Scopus, Web of Science) up to January 2025, including observational studies reporting MRONJ following extractions in osteoporotic patients treated with antiresorptives. Pooled prevalence rates were calculated using a random-effects model, and study quality was assessed. Influence analyses as well as meta-regression were also performed. : Twenty-four studies were included, comprising 3784 patients and 5426 extractions. The pooled prevalence of MRONJ was 1.7% (95% confidence intervals (CI): 0.8-3.0%), with considerable heterogeneity (I = 77%). When considering only cases of bisphosphonate-related osteonecrosis of the jaw (BRONJ) following tooth extraction in patients with osteoporosis, the estimated prevalence was 0.7% (95% CI: 0.1-1.8%), with substantial heterogeneity (I = 61%). No individual study was identified as overly influential. Meta-regression revealed no significant associations between MRONJ prevalence and variables such as publication year, gender proportion, or extraction-to-patient ratio. : This meta-analysis underscores the importance of vigilance in managing osteoporotic patients undergoing extractions, emphasizing the need for consistent diagnostic criteria and preventive protocols to mitigate MRONJ risk.
药物性颌骨坏死（MRONJ）是一种罕见但严重的与抗吸收治疗相关的不良反应，特别是在骨质疏松患者拔牙后。本研究旨在通过系统评价和荟萃分析估计骨质疏松患者拔牙后MRONJ的患病率。
截至2025年1月，对三个主要数据库（Medline、Scopus、Web of Science）进行了全面检索，包括报告接受抗吸收药物治疗的骨质疏松患者拔牙后发生MRONJ的观察性研究。使用随机效应模型计算合并患病率，并评估研究质量。还进行了影响分析和荟萃回归。
纳入了24项研究，包括3784例患者和5426颗拔牙。MRONJ的合并患病率为1.7%（95%置信区间（CI）：0.8 - 3.0%），存在相当大的异质性（I² = 77%）。仅考虑骨质疏松患者拔牙后双膦酸盐相关颌骨坏死（BRONJ）的病例时，估计患病率为0.7%（95%CI：0.1 - 1.8%），存在实质性异质性（I² = 61%）。未发现任何个体研究具有过度影响力。荟萃回归显示MRONJ患病率与发表年份、性别比例或拔牙与患者比例等变量之间无显著关联。
这项荟萃分析强调了在管理接受拔牙的骨质疏松患者时保持警惕的重要性，强调需要一致的诊断标准和预防方案以降低MRONJ风险。
