Abstract：
Medication-related osteonecrosis of the jaw (MRONJ) is defined by the American Association of Oral and Maxillofacial Surgeons (AAOMS) as the presence of an exposed bone area in the maxillofacial region, present for more than eight weeks in patients treated with the use of antiresorptive or antiangiogenic agents, with no history of radiation or metastatic disease. Bisphosphonates (BF) and denosumab (DS) are widely used in adults for the management of patients with cancer and osteoporosis, and recently there has been an increase in their use in child and young patients for the management of disorders such as osteogenesis imperfecta (OI), glucocorticoid-induced osteoporosis, McCune-Albright syndrome (MAS), malignant hypercalcemia, and others. There are differences between case reports in adults compared to child and young patients related to the use of antiresorptive/antiangiogenic drugs and the development of MRONJ. The aim was to analyze the presence of MRONJ in children and young patients, and the relation with oral surgery. A systematic review, following the PRISMA search matrix based on the PICO question, was conducted in PubMed, Embase, ScienceDirect, Cochrane, Google Scholar, and manual search in high-impact journals between 1960 and 2022, publications in English or Spanish, including randomized and non-randomized clinical trials, prospective and retrospective cohort studies, cases and controls studies, and series and case reports. A total of 2792 articles were identified and 29 were included; all of them published between 2007 and 2022, identifying 1192 patients, 39.68% male and 36.24% female, aged 11.56 years old on average, using these drugs mainly for OI (60.15%); 4.21 years on average was the therapy time and 10.18 drug doses administered on average; oral surgery was observed in 216 subjects, reporting 14 cases of MRONJ. We concluded that there is a low presence of MRONJ in the child and youth population treated with antiresorptive drugs. Data collection is weak, and details of therapy are not clear in some cases. Deficiencies in protocols and pharmacological characterization were observed in most of the included articles.
摘要：
美国口腔颌面外科医师协会（AAOMS）将药物相关的颌骨坏死（MRONJ）定义为颌面部区域存在裸露的骨骼区域，在使用抗再吸收或抗血管生成剂治疗的患者中出现超过八周，无放疗或转移性疾病史。双膦酸盐（BF）和denosumab（DS）在成人中广泛用于治疗癌症和骨质疏松症患者，最近，在儿童和年轻患者中使用它们来治疗成骨不全症（OI）等疾病，糖皮质激素诱导的骨质疏松症，McCune-Albright综合征(MAS),恶性高钙血症,和其他人。与使用抗吸收/抗血管生成药物和MRONJ的发展有关，成人病例报告与儿童和年轻患者相比存在差异。目的是分析MRONJ在儿童和年轻患者中的存在，以及与口腔外科的关系。系统的审查，遵循基于PICO问题的PRISMA搜索矩阵，是在PubMed中进行的，Embase,ScienceDirect,科克伦,谷歌学者，以及1960年至2022年间在高影响力期刊上的手动搜索，英文或西班牙文出版物，包括随机和非随机临床试验，前瞻性和回顾性队列研究，病例和对照研究，系列和病例报告。共确定了2792篇文章，纳入了29篇；所有这些文章都在2007年至2022年之间发表，确定了1192名患者，男性39.68%，女性36.24%，平均年龄11.56岁，使用这些药物主要用于OI（60.15％）；平均治疗时间为4.21年，平均给药剂量为10.18；在216名受试者中观察到口腔手术，报告MRONJ14例。我们得出的结论是，在接受抗再吸收药物治疗的儿童和青年人群中，MRONJ的含量较低。数据收集薄弱，在某些情况下，治疗细节尚不清楚。在大多数纳入的文章中观察到方案和药理学表征的缺陷。
