医学
颌骨骨坏死
骨溶解
骨硬化
双膦酸盐相关性颌骨骨坏死
穿孔
外科
不利影响
放射科
双膦酸盐
牙科
骨质疏松症
内科学
冶金
材料科学
冲孔
作者
Yoshiaki Tadokoro,Takumi Hasegawa,Daisuke Takeda,Aki Murakami,Nanae Yatagai,Satomi Arimoro,Eiji Iwata,Izumi Saito,Junya Kusumoto,Mitsuru Akashi
出处
期刊:Head & neck
[Wiley]
日期:2023-11-14
卷期号:46 (2): 282-290
摘要
Abstract Objectives Medication‐related osteonecrosis of the jaw (MRONJ) is a severe adverse effect of antiresorptive and/or antiangiogenic agents. As the treatment application for MRONJ is controversial, we aimed to identify the risk factors for poor prognosis and to help determine appropriate management. Methods This study included 119 patients. Relevant clinical data were obtained for all the patients. In computed tomography images, osteosclerosis, osteolysis, cortical perforation (buccal or lingual), periosteal reaction, and sequestration were evaluated. Results Multivariate analyses showed statistically significant associations between poor prognosis in patients with MRONJ and conservative treatment alone (hazard ratio [HR] 1.89), osteolysis (HR 4.67), and the absence of sequestration (HR 5.33). Conclusions Conservative treatment alone without clear objectives needs to be avoided, and osteolytic change could be the criteria for surgical intervention. As the boundary between the lesion and vital bone is indistinct, we recommend extensive surgery in cases with unpredictable sequestration.
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