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首页> 美国卫生研究院文献>Bone Reports >The progress of medication-related osteonecrosis of the jaw with conservative initial treatment: A 12-year retrospective study of 129 patients
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The progress of medication-related osteonecrosis of the jaw with conservative initial treatment: A 12-year retrospective study of 129 patients

机译：保守初始治疗的颌骨用药相关骨折的进展情况：129例患者的12年重点研究

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This retrospective study aimed to examine the course and prognosis of medication-related osteonecrosis of the jaw (MRONJ) initially treated conservatively and the effects of various factors affecting treatment outcomes. We evaluated 129 patients with MRONJ between January 2008 and December 2018 at a university hospital. The factors examined included sex, age, stage of MRONJ (1–3), type of bone modifying agents (bisphosphonate or denosumab), primary disease (osteoporosis or malignant tumor), medical history (diabetes and rheumatoid arthritis), use of corticosteroids, the trigger of MRONJ (teeth extraction or others), and separation of sequestrum, using logistic regression analysis. Patients with MRONJ were treated conservatively as the initial treatment in accordance with the position paper of the American Association of Oral and Maxillofacial Surgeons. Of the 129 patients, 59 (45.7%) were cured, and the condition of 70 (54.3%) remained unchanged or worsened. The overall cure rates at 12, 36, and 60 months were 25.8%, 50.8%, and 72.4% respectively. The cure rate of stage 1 was lower than that of stages 2 and 3 at 80 months. In multivariate analysis, it was found that 37 (64.9%) of 57 patients with osteoporosis as a primary disease were cured (odds ratio [OR], 7.7; 95% confidence interval [CI], 2.4–24.4). In addition, 40 (69.0%) of 58 patients with separation of sequestrum were cured (OR, 8.9; 95% CI, 3.4–23.5). The cure rate was significantly higher in patients with osteoporosis than in those with cancer when the treatment outcomes of primary disease were compared using the Kaplan-Meier method (p < 0.01). It was also significantly higher in patients who had separation of sequestrum than in those who did not (p < 0.05). Our results suggest that primary disease and separation of sequestrum were associated with favorable outcomes in patients with MRONJ initially treated conservatively. MRONJ had a poor prognosis with conventional treatment carried according to the stage of the disease. This was especially prominent when conservative treatment was employed for mild cases.
机译：这种回顾性研究旨在审查颌骨（MronJ）的药物相关骨折的课程和预后最初守护，以及影响治疗结果的各种因素的影响。我们在2008年1月至2018年12月在大学医院进行了129例Mronj患者。所检查的因素包括性，年龄，mronj（1-3），骨改性剂（双膦酸盐或denosumab）的类型，原发性疾病（骨质疏松症或恶性肿瘤），病史（糖尿病和类风湿性关节炎），使用皮质类固醇，使用Logistic回归分析的Mronj（齿提取或其他）的触发和分离失真。根据美国口腔和颌面外科医学家的初始纸张，患有Mronj的患者作为初始治疗。在129名患者中，59例（45.7％）固化，70例（54.3％）的病症保持不变或恶化。 12,36和60个月的整体固化率分别为25.8％，50.8％和72.4％。阶段1的固化率低于80个月的阶段2和3。在多变量分析中，发现37例（64.9％）57例骨质疏松症患者作为主要疾病的固化（差距[或]，7.7; 95％置信区间[CI]，2.4-24.4）。此外，固化的40例（69.0％）的58名分离患者（或8.9; 95％CI，3.4-23.5）。骨质疏松症患者的治愈率显着高于使用Kaplan-Meier方法进行癌症的治疗结果（P <0.01）。患者分离除了没有（P <0.05）的患者中也显着高。我们的研究结果表明，母疾病的原发性疾病和分离与Mromj初期保守治疗的患者有利的结果。 Mronj预后不良，常规治疗根据疾病的阶段进行。当保守治疗用于轻度病例时，这尤其突出。

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