医学
颌骨骨坏死
抗生素
阿莫西林
观察研究
内科学
克林霉素
梅德林
回顾性队列研究
数据提取
重症监护医学
双膦酸盐
骨质疏松症
微生物学
法学
生物
政治学
作者
Marco Cabras,Alessio Gambino,Roberto Broccoletti,Savino Sciascia,Paolo Giacomo Arduino
出处
期刊:Journal of Oral Science
[Nihon University School of Dentistry]
日期:2021-01-01
卷期号:63 (3): 217-226
被引量:13
标识
DOI:10.2334/josnusd.21-0016
摘要
A systematic review was carried out to identify if periprocedural administration of systemic antibiotics could decrease risk of medication-related osteonecrosis of the jaws (MRONJ) in patients under antiresorptive and/or biologic agents for teeth extraction. PubMed/MEDLINE and Scopus were systematically searched for case-series with more than 10 patients, retrospective/prospective studies, and trials concerning this issue. Manual searching of references from previous reviews was also carried out. Of 1,512 results, 17 studies were included, focusing on antibiotics for extraction in patients under intravenous bisphosphonates (8 studies), oral bisphosphonates (2 studies), oral and intravenous bisphosphonates (6 studies), and denosumab (1 study), of which 12 performed dental extraction with surgical flap. With no trials found, “quality in prognosis studies” (QUIPS) tool was used to evaluate risk of bias. First-line treatment was 2-3 grams of oral amoxicillin in 76.4% of studies; 300-600 mg of clindamycin was the alternative treatment in 23.5% of studies. Treatment ranged from 3 to 20 days, consisting of 6-7 days in 47% of studies. No microbiologic insight was provided. A significantly higher risk of MRONJ for patients unexposed to antibiotics was provided in one retrospective study. QUIPS tool revealed moderate-high risk of bias. With empirical data from bias-carrying, heterogeneous observational studies, the validity of antibiotics is yet to be established.
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