Tooth Extraction in Patients Taking Intravenous Bisphosphonates: A Preventive Protocol and Case Series
Tooth Extraction in Patients Taking Intravenous Bisphosphonates: A Preventive Protocol and Case Series
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DOI：
10.1016/j.joms.2009.07.068
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发表时间：
2010-01-01
影响因子：
1.9
通讯作者：
Carrassi, Antonio
中科院分区：
文献类型：
--
作者：
Lodi, Giovanni;Sardella, Andrea;Carrassi, Antonio
目的：为了测试一种预防拔牙后发生双膦酸盐相关性颌骨骨坏死（BRONJ）的方案的有效性。患者和方法：在该前瞻性病例系列中，需要拔牙的接受静脉双膦酸盐治疗的连续受试者接受了旨在降低BRONJ风险的方案，基于局部和全身感染控制，通过机械和化学方法减少局部细菌负荷加上抗生素预防。我们对23例接受静脉双膦酸盐（主要是唑来膦酸盐）治疗的患者进行了38次拔牙，平均17.5个月（范围：3-36个月）。五名患者已经有了在其他地方拔牙引起的BRONJ的迹象。平均随访时间为229.5天（范围，14-965天），并没有BRONJ的情况下recorded.Conclusions：尽管研究设计的方法学上的局限性，提出的预防方案似乎可以降低BRONJ的风险拔牙后，在一组受试者静脉注射双膦酸盐。(C)2010年美国口腔颌面外科医师协会口腔颌面外科68：107-110，2010年
Purpose: To test the efficacy of a protocol in preventing the development of bisphosphonate-related osteonecrosis of the jaw (BRONJ) after tooth extraction.Patients and Methods: In this prospective case series, consecutive subjects treated with intravenous bisphosphonates who needed tooth extraction underwent a protocol aimed at reducing the risk of BRONJ, based on local and systemic infection control by means of mechanical and chemical reduction of the local bacterial load plus antibiotic prophylaxis.Results: We performed 38 extractions in 23 patients treated with intravenous bisphosphonates, mainly zoledronate, for a mean of 17.5 months (range, 3-36 months). Five patients already had signs of BRONJ caused by tooth extractions performed elsewhere. The mean follow-up was 229.5 days (range, 14-965 days), and no case of BRONJ was recorded.Conclusions: Despite the methodologic limitations of the study design, the proposed preventive protocol appears to reduce the risk of BRONJ after tooth extraction in a group of subjects treated with intravenous bisphosphonates. (C) 2010 American Association of Oral and Maxillofacial Surgeons Oral Maxillofac Surg 68:107-110, 2010