薬剤関連顎骨壊死(MRONJ)の発症契機と予防法に関する臨床的検討  [in Japanese] A Clinical Study of Trigger and Prevention of Medication-related Osteonecrosis of the Jaw (MRONJ)  [in Japanese]

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Author(s)

    • 梅田 正博 UMEDA MASAHIRO
    • 長崎大学病院周術期口腔管理センター|長崎大学大学院医歯薬学総合研究科口腔腫瘍治療学分野 Perioperative Oral Management Center, Nagasaki University Hospital|Department of Clinical Oral Oncology, Nagasaki University Graduate School of Biomedical Sciences
    • 林田 咲 HAYASHIDA SAKI
    • 長崎大学大学院医歯薬学総合研究科口腔腫瘍治療学分野 Department of Clinical Oral Oncology, Nagasaki University Graduate School of Biomedical Sciences
    • 船原 まどか FUNAHARA MADOKA
    • 長崎大学大学院医歯薬学総合研究科口腔腫瘍治療学分野 Department of Clinical Oral Oncology, Nagasaki University Graduate School of Biomedical Sciences
    • 川北 晃子 KAWAKITA AKIKO
    • 長崎大学大学院医歯薬学総合研究科口腔腫瘍治療学分野 Department of Clinical Oral Oncology, Nagasaki University Graduate School of Biomedical Sciences
    • 鳴瀬 智史 NARUSE TOMOFUMI
    • 長崎大学大学院医歯薬学総合研究科口腔腫瘍治療学分野 Department of Clinical Oral Oncology, Nagasaki University Graduate School of Biomedical Sciences
    • 坂本 由紀 SAKAMOTO YUKI
    • 長崎大学大学院医歯薬学総合研究科口腔腫瘍治療学分野 Department of Clinical Oral Oncology, Nagasaki University Graduate School of Biomedical Sciences
    • 六反田 賢 ROKUTANDA SATOSHI
    • 長崎大学大学院医歯薬学総合研究科口腔腫瘍治療学分野 Department of Clinical Oral Oncology, Nagasaki University Graduate School of Biomedical Sciences
    • 柚鳥 宏和 YUTORI HIROKAZU
    • 長崎大学大学院医歯薬学総合研究科口腔腫瘍治療学分野 Department of Clinical Oral Oncology, Nagasaki University Graduate School of Biomedical Sciences
    • 柳本 惣市 YANAMOTO SOUICHI
    • 長崎大学大学院医歯薬学総合研究科口腔腫瘍治療学分野 Department of Clinical Oral Oncology, Nagasaki University Graduate School of Biomedical Sciences

Abstract

Objectives: Oral management strategies for prevention of medication-related osteonecrosis of the jaw (MRONJ) in patients receiving bone-modifying agents (BMA) have not been established. Hence, we investigated the triggering events and prevention methods for MRONJ.<br>Methods: Eighty-six patients who developed MRONJ (33 with malignancies and 53 with osteoporosis) were examined retrospectively, focusing on the triggers for these cases.<br>Results: Tooth extraction was a trigger for MRONJ in 7 of 33 patients (21.2%) with malignancies, and 26 of 53 (49.1%) with osteoporosis. The occurrence of MRONJ due to tooth extraction was less frequent in the former group than in the latter because tooth extraction is typically avoided for those with malignancy as per the recommendation of a position paper. MRONJ frequently occurred in patients who underwent extraction of infected teeth, whereas no patients developed MRONJ after extraction of symptomless teeth. These findings suggest that the trigger of MRONJ is a local infection rather than surgery-related damage to the bone. Duration of BMA administration before the development of MRONJ was greater than 6months.<br>Conclusions: For prevention of MRONJ, we think that teeth that may be a source of infection in future should be extracted before long-term administration of BMA.

Journal

  • Japanese Journal of Oral Diagnosis / Oral Medicine

    Japanese Journal of Oral Diagnosis / Oral Medicine 30(3), 249-255, 2017

    The Japanese Society of Oral Diagnosis / Oral Medicine

Codes

  • NII Article ID (NAID)
    130006179180
  • Text Lang
    JPN
  • ISSN
    0914-9694
  • Data Source
    J-STAGE 
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