Clinical characteristics and recurrence-related factors of medication-related osteonecrosis of the jaw
Clinical characteristics and recurrence-related factors of medication-related osteonecrosis of the jaw
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DOI：
10.5125/jkaoms.2018.44.5.225
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发表时间：
2018-10-01
影响因子：
1
通讯作者：
Jun, Sang-Ho
中科院分区：
文献类型：
--
作者：
Kang, Mong-Hun;Lee, Dong-Keon;Jun, Sang-Ho
目的：本研究的目的是调查药物相关性颌骨骨坏死（MRONJ）患者的人口统计学和临床特征，并阐明影响手术治疗复发的因素。材料和方法：通过2013年至2017年的回顾性图表审查，根据人口统计学和临床特征以及治疗结果对共51例诊断为MRONJ的患者进行了分析结果：阿仑膦酸钠的用药剂量占总用药剂量的55.6%，其次是伊班膦酸钠（20.0%）、利塞膦酸钠（15.6%）和唑来膦酸钠（6.7%）。40例患者（88.9%）接受口服药物治疗。5例患者（11.1%）接受静脉注射治疗，平均用药时间为61.1 ± 42.9个月。共有10名患者（22.2%）在MRONJ诱导的牙科治疗前有一个药物假期，平均持续6.8：7.0个月。MRONJ发生在下颌骨的发生率为2.7倍，其中下颌骨41例（73.2%），上颌15例（26.8%），后牙（前磨牙-磨牙）的患病率为前牙（切牙-尖牙）的6倍（48例vs 8例，85.7%vs143%）。MRONJ最常见的牙科原因是拔牙（69.6%）。关于复发。根据部位或分期，复发率没有统计学差异。然而，复发发生在4的34例（11.8%）在初级封闭组和9的20例（45.0%）在二级愈合组，有统计学差异方面的封闭technique.Conclusion：确定的风险因素，在患者服用骨吸收抑制剂，可以帮助牙科临床医生，以确保预防和适当的治疗MRONJ。
Objectives: The purpose of this study was to investigate the demographic and clinical characteristics of patients with medication-related osteonecrosis of the jaw (MRONJ) and to elucidate factors affecting recurrence in surgical treatment.Materials and Methods: A total of 51 patients who were diagnosed with MRONJ were analyzed according to demographic and clinical features and treatment results through a retrospective chart review from 2013 to 2017 in the Department of Oral and Maxillofacial Surgery Korea University Anam Hospital, Seoul in Korea.Results: Alendronate composed the majority of medication doses (55.6%), followed by ibandronate (20.0%), risedronate (15.6%), and zoledronate (6.7%). Forty patients (88.9%) were given oral medication. and five patients (11.1%) were intravenously treated, and the mean duration of medication use was 61.1 +/- 42.9 months. A total of 10 patients (22.2%) had a drug holiday before MRONJ-induced dental treatment lasting an average of 6.8:7.0 months. MRONJ occurred 2.7 times more in the mandible, with 41 cases (73.2%) occurring in the mandible and 15 cases (26.8%) occurring in the maxilla, and the prevalence of affected posterior parts (premolar-molar) was six times greater than that of the anterior parts (incisor-canine) (48 cases vs 8 cases, 85.7% vs 143%). The most common dental cause of MRONJ was tooth extraction (69.6%). Regarding recurrence. there was no statistical difference in recurrence rate according to either site or stage. However, recurrence occurred in 4 out of 34 cases (11.8%) in the primary closure group and 9 out of 20 cases (45.0%) in the secondary healing group, and there was a statistical difference with respect to closure technique.Conclusion: The identified risk factors in patients taking bone resorption inhibitors can aid dental clinicians in ensuring prevention and proper treatment of MRONJ.