Relationship between tooth extraction and development of medication-related osteonecrosis of the jaw in cancer patients.
Relationship between tooth extraction and development of medication-related osteonecrosis of the jaw in cancer patients.
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DOI：
10.1038/s41598-021-96480-8
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发表时间：
2021-08-26
影响因子：
4.6
通讯作者：
Saito T
中科院分区：
文献类型：
--
作者：
Soutome S;Otsuru M;Hayashida S;Murata M;Yanamoto S;Sawada S;Kojima Y;Funahara M;Iwai H;Umeda M;Saito T
人们避免拔牙，因为拔牙被认为是药物相关颌骨坏死 (MRONJ) 的主要危险因素。然而，MRONJ 也可能从感染源的牙齿发展而来。本研究旨在阐明拔牙是否是接受骨改性剂 (BMA) 的癌症患者发生 MRONJ 的危险因素。这项回顾性观察研究纳入了来自两家医院的 189 名患者（361 只颌骨）。通过比较发生和未发生 MRONJ 的患者特征，确定了 MRONJ 的危险因素。此外，在使用倾向评分匹配方法调整混杂因素后，分析了 BMA 治疗期间拔牙的效果。 MRONJ 发生在 33 名患者的颌部。 BMA给药时间较长、牙齿数量较少、存在局部感染症状以及感染牙齿是MRONJ的独立危险因素。然而，BMA 治疗期间拔牙并不会增加风险。倾向评分匹配分析显示，拔牙可显着降低发生 MRONJ 的风险。可能成为感染源的牙齿会增加 MRONJ 的风险，因此即使在 BMA 给药期间也需要拔除牙齿。
Tooth extraction has been avoided since it has been considered a major risk factor for medication-related osteonecrosis of the jaw (MRONJ). However, MRONJ may also develop from tooth that is an infection source. This study aimed to clarify whether tooth extraction is a risk factor for the development of MRONJ in cancer patients receiving bone-modifying agents (BMAs). This retrospective observational study included 189 patients (361 jaws) from two hospitals. The risk factors of MRONJ were identified by comparing patient characteristics between those who did and did not develop MRONJ. Furthermore, the effect of tooth extraction during BMA therapy was analyzed after adjusting for confounding factors using the propensity score matching method. MRONJ occurred in 33 patients jaws. A longer duration of BMA administration, fewer number of teeth, presence of symptoms of local infection, and infected teeth were independent risk factors of MRONJ. However, tooth extraction during BMA therapy did not increase the risk. Propensity score matching analysis showed that tooth extraction significantly lowered the risk of MRONJ development. Teeth that can be an infection source increases the risk of MRONJ, and thus, they need to be extracted even during BMA administration.
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影响因子：
1.9
作者：
Lodi, Giovanni;Sardella, Andrea;Carrassi, Antonio
通讯作者：
Carrassi, Antonio
影响因子：
45.3
作者：
Yarom, Noam;Shapiro, Charles L.;Saunders, Deborah P.
通讯作者：
Saunders, Deborah P.
影响因子：
3.7
作者：
Soutome S;Hayashida S;Funahara M;Sakamoto Y;Kojima Y;Yanamoto S;Umeda M
通讯作者：
Umeda M
影响因子：
--
作者：
Petrovic, Milan;Jelovac, Drago B.;Konstantinovic, Vitomir
通讯作者：
Konstantinovic, Vitomir
影响因子：
4
作者：
Hasegawa, T.;Hayashida, S.;Komori, T.
通讯作者：
Komori, T.