Prevention of medication related osteonecrosis of the jaw after dentoalveolar surgery: An institution's experience.
Prevention of medication related osteonecrosis of the jaw after dentoalveolar surgery: An institution's experience.
复制标题
DOI：
10.4317/jced.56837
复制
发表时间：
2020-08-01
影响因子：
--
通讯作者：
Odabasi, Onur
中科院分区：
文献类型：
--
作者：
Sahin, Onur;Tatar, Birkan;Odabasi, Onur
背景：牙槽外科是药物相关性颌骨坏死(MRONJ)的易感因素。材料和方法：在这项回顾研究中，44名患者按照我们所描述的治疗程序进行了63例牙槽外科手术。术后1)抗生素的应用2)牙槽外科手术3)富含白细胞和血小板的纤维蛋白(L-PRF)填塞窝沟4)术后应用低强度激光治疗5)术后14天拆除缝线6)远期疗效评价。术后1个月所有患者黏膜均完全愈合。结论：由于MRONJ的发病机制尚不完全清楚，危险因素较多，目前尚无明确的防治方案。预防和治疗MRONJ需要进行个人风险评估。由于其高成功率，所描述的手术方案可被认为降低了牙槽外科手术后发生MRONJ的风险。关键词：拔牙，药物相关性颌骨坏死，预防牙科，L-PRF，低强度激光治疗。
BACKGROUND: Dentoalveolar surgery is a predisposing factor for medication related osteonecrosis of the jaw (MRONJ). The aim of our study was to evaluate the described surgical procedures to prevent the development of MRONJ after dentoalveolar surgery in patients receiving bisphosphonates.MATERIAL AND METHODS: In this retrospective study, sixty-three dentoalveolar surgeries were performed on 44 patients taking bisphosphonate in accordance with the treatment procedures we described. The following procedures were applied to patients 1) use of antibiotics 2) performed dentoalveolar surgical procedures 3) fill the socket with leukocyte- and platelet-rich fibrin (L-PRF) 4) post-operative application of low level laser therapy through Nd: YAG laser 5) sutures were removed on post-op 14th day 6) long-term results were evaluated.RESULTS: Healing of all patients was uneventful. Complete mucosal healing was achieved in all patients at 1 month. There is no failure was observed in long-term follow-up.CONCLUSIONS: Because of the pathophysiology of MRONJ is not fully understood and has many risk factors, definitive protocols on prevention and treatment have not been established yet. Personal risk assessment is required for the prevention and treatment of MRONJ. The described surgical protocol may be considered to reduce the risk of developing MRONJ after dentoalveolar surgery due to its high success rate. Key words:Tooth extraction, medication related osteonecrosis of the jaw, preventive dentistry, L-PRF, low level laser therapy.