Factors Exacerbating Clinical Symptoms and CT Findings in Patients with Medication-Related Osteonecrosis of the Jaw Receiving Conservative Therapy: A Multicenter Retrospective Study of 53 Cases.
Factors Exacerbating Clinical Symptoms and CT Findings in Patients with Medication-Related Osteonecrosis of the Jaw Receiving Conservative Therapy: A Multicenter Retrospective Study of 53 Cases.
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DOI：
10.3390/ijerph19137854
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发表时间：
2022-06-26
影响因子：
--
通讯作者：
Umeda, Masahiro
中科院分区：
文献类型：
--
作者：
Kojima, Yuka;Soutome, Sakiko;Otsuru, Mitsunobu;Hayashida, Saki;Sakamoto, Yuki;Sawada, Shunsuke;Umeda, Masahiro
关键词：
最近的报告表明，与保守治疗相比，手术治疗药物相关性颌骨骨坏死（MRONJ）患者的治疗效果更好。但由于年龄大、全身状况差等因素，选择保守治疗。保守治疗旨在缓解症状和防止病变恶化;然而，在某些情况下，病变可能会迅速扩大。本研究调查了53例MRONJ患者接受保守治疗的临床和影像学表现，并检查了临床表现和CT影像学上病变扩大的变化。临床结果改善且影像学结果无恶化被视为总体综合治疗成功。53例患者中，15例患者的临床症状消失或改善，6例患者的临床症状加重。相反，17例患者发生溶骨性病变扩大。保守治疗的综合治疗结果12例成功，41例失败。骨膜反应与不良综合治疗结局显著相关（p = 0.038）。MRONJ病变可能会进展，即使在接受保守治疗时临床表现有所改善。患者，特别是那些有骨膜反应的患者，无论临床结果如何，都必须密切随访CT检查。
Recent reports have shown that better treatment outcomes are obtained with surgical therapy in patients with medication-related osteonecrosis of the jaw (MRONJ) than with conservative therapy. However, conservative treatment is selected due to factors such as old age and poor general condition. Conservative therapy aims to relieve symptoms and prevent lesion exacerbation; however, the lesion may expand rapidly in some cases. This study investigated the clinical and imaging findings of 53 MRONJ patients undergoing conservative therapy, and the changes in the clinical findings and the lesion enlargement on CT imaging were examined. Improved clinical findings and no worsening of the imaging findings were considered overall comprehensive treatment successes. Among the 53 patients, the clinical symptoms disappeared or improved in 15 patients, whereas they worsened in 6. In contrast, osteolytic lesion enlargement occurred in 17 patients. The comprehensive treatment outcome of conservative therapy was successful in 12 patients and unsuccessful in 41 patients. The periosteal reaction was significantly correlated with poor comprehensive treatment outcomes (p = 0.038). MRONJ lesions may advance, even if they appear to improve clinically while undergoing conservative treatments. Patients, especially those with periosteal reactions, must be closely followed up with CT examinations, regardless of the clinical findings.
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影响因子：
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作者：
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影响因子：
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通讯作者：
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