Abstract：
OBJECTIVE: To determine the relation between the severity of periodontitis and osteonecrosis of the jaw (ONJ) occurrence among different cancer locations and estimate the effect of dental care on ONJ prevention in cancer patients.
METHODS: This population-based cross-sectional study was conducted through the Longitudinal Health Insurance Database, Taiwan. Patients with malignancies were collected and subdivided into groups according to their different cancer locations, the severity of periodontitis, and dental care. Multivariable logistic regression analysis was performed to assess the associations between ONJ and ONJ-related factors.
RESULTS: A total of 8,234 ONJ patients and 32,912 control patients were investigated. Lip, oral cavity, and pharynx malignancies had the highest ONJ risk among all cancer locations (OR from 3.07 to 9.56, P < 0.01). There is a linear relationship between different severities of periodontitis and ONJ. Patients with radiotherapy and severe periodontitis had the highest ONJ risk (adjusted OR, 9.56; 95% CI, 5.34-17.1). Patients with good dental care had a lower ONJ risk.
CONCLUSIONS: The periodontal condition and cancer location showed a significant impact on the risk of developing ONJ after adjusting for bisphosphonate use. Good dental care could decrease the risk of ONJ in cancer patients. The severity of periodontitis might be a target to predict the potency of ONJ.
CONCLUSIONS: Dentists must be vigilant about the increased risk of ONJ in cancer patients with periodontitis, especially in the head and neck cancer population. Good dental care is advised for cancer patients with severe periodontitis.
METHODS: This population-based cross-sectional study was conducted through the Longitudinal Health Insurance Database, Taiwan. Patients with malignancies were collected and subdivided into groups according to their different cancer locations, the severity of periodontitis, and dental care. Multivariable logistic regression analysis was performed to assess the associations between ONJ and ONJ-related factors.
RESULTS: A total of 8,234 ONJ patients and 32,912 control patients were investigated. Lip, oral cavity, and pharynx malignancies had the highest ONJ risk among all cancer locations (OR from 3.07 to 9.56, P < 0.01). There is a linear relationship between different severities of periodontitis and ONJ. Patients with radiotherapy and severe periodontitis had the highest ONJ risk (adjusted OR, 9.56; 95% CI, 5.34-17.1). Patients with good dental care had a lower ONJ risk.
CONCLUSIONS: The periodontal condition and cancer location showed a significant impact on the risk of developing ONJ after adjusting for bisphosphonate use. Good dental care could decrease the risk of ONJ in cancer patients. The severity of periodontitis might be a target to predict the potency of ONJ.
CONCLUSIONS: Dentists must be vigilant about the increased risk of ONJ in cancer patients with periodontitis, especially in the head and neck cancer population. Good dental care is advised for cancer patients with severe periodontitis.
摘要：
目的：确定不同癌症部位牙周炎严重程度与颌骨坏死（ONJ）发生之间的关系，并评估牙科护理对癌症患者ONJ预防的影响。
方法：这项基于人群的横断面研究是通过纵向健康保险数据库进行的，台湾。收集恶性肿瘤患者，并根据其不同的癌症部位进行分组，牙周炎的严重程度，和牙科护理。采用多变量logistic回归分析评价ONJ与ONJ相关因素之间的相关性。
结果：共调查了8,234名ONJ患者和32,912名对照患者。Lip,口腔,在所有癌症位置中，咽部恶性肿瘤的ONJ风险最高（OR为3.07至9.56，P<0.01）。不同严重程度的牙周炎与ONJ之间存在线性关系。放疗和重度牙周炎患者的ONJ风险最高（调整后的OR，9.56；95%CI，5.34-17.1）。良好牙齿护理的患者具有较低的ONJ风险。
结论：在调整使用双膦酸盐后，牙周状况和癌症位置对发展为ONJ的风险有显著影响。良好的牙齿护理可以降低癌症患者发生ONJ的风险。牙周炎的严重程度可能是预测ONJ效力的目标。
结论：牙医必须警惕牙周炎癌症患者发生ONJ的风险增加，尤其是在头颈部癌症人群中。对于患有严重牙周炎的癌症患者，建议良好的牙齿护理。
方法：这项基于人群的横断面研究是通过纵向健康保险数据库进行的，台湾。收集恶性肿瘤患者，并根据其不同的癌症部位进行分组，牙周炎的严重程度，和牙科护理。采用多变量logistic回归分析评价ONJ与ONJ相关因素之间的相关性。
结果：共调查了8,234名ONJ患者和32,912名对照患者。Lip,口腔,在所有癌症位置中，咽部恶性肿瘤的ONJ风险最高（OR为3.07至9.56，P<0.01）。不同严重程度的牙周炎与ONJ之间存在线性关系。放疗和重度牙周炎患者的ONJ风险最高（调整后的OR，9.56；95%CI，5.34-17.1）。良好牙齿护理的患者具有较低的ONJ风险。
结论：在调整使用双膦酸盐后，牙周状况和癌症位置对发展为ONJ的风险有显著影响。良好的牙齿护理可以降低癌症患者发生ONJ的风险。牙周炎的严重程度可能是预测ONJ效力的目标。
结论：牙医必须警惕牙周炎癌症患者发生ONJ的风险增加，尤其是在头颈部癌症人群中。对于患有严重牙周炎的癌症患者，建议良好的牙齿护理。
