Risk factors associated with prognosis of patients with medication-related osteonecrosis of the jaw.

Autor: Tadokoro Y; Department of Oral and Maxillofacial Surgery, Kobe University Graduate School of Medicine, Kobe, Japan., Hasegawa T; Department of Oral and Maxillofacial Surgery, Kobe University Graduate School of Medicine, Kobe, Japan., Takeda D; Department of Oral and Maxillofacial Surgery, Kobe University Graduate School of Medicine, Kobe, Japan., Murakami A; Department of Oral and Maxillofacial Surgery, Kobe University Graduate School of Medicine, Kobe, Japan., Yatagai N; Department of Oral and Maxillofacial Surgery, Kobe University Graduate School of Medicine, Kobe, Japan., Arimoro S; Department of Oral and Maxillofacial Surgery, Kobe University Graduate School of Medicine, Kobe, Japan., Iwata E; Department of Oral and Maxillofacial Surgery, Kobe University Graduate School of Medicine, Kobe, Japan., Saito I; Department of Oral and Maxillofacial Surgery, Kobe University Graduate School of Medicine, Kobe, Japan., Kusumoto J; Department of Oral and Maxillofacial Surgery, Kobe University Graduate School of Medicine, Kobe, Japan., Akashi M; Department of Oral and Maxillofacial Surgery, Kobe University Graduate School of Medicine, Kobe, Japan.
Jazyk: angličtina
Zdroj: Head & neck [Head Neck] 2024 Feb; Vol. 46 (2), pp. 282-290. Date of Electronic Publication: 2023 Nov 14.
DOI: 10.1002/hed.27574
Abstrakt: 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.
(© 2023 Wiley Periodicals LLC.)
Databáze: MEDLINE
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