PDF(Pubmed)
Abstract：
This study investigates the impact of bisphosphonate therapy on the stomatognathic system in 80 patients with cancer of the breast and prostate with bone metastases. Bisphosphonates are integral for managing skeletal complications in these malignancies but are associated with bisphosphonate-related osteonecrosis of the jaw (BRONJ), affecting 0.8-18.5% of patients. BRONJ manifests with pain, neuropathy, tissue swelling, mucosal ulceration, tooth mobility, and abscesses, yet its pathogenesis remains elusive, complicating risk prediction. The research employed comprehensive dental and radiological evaluations. Dental status was assessed using DMFT and OHI-S indices, Eichner\'s classification, and clinical periodontal measurements like the pocket depth (PD), clinical attachment loss (CAL), and modified Sulcus Bleeding Index (mSBI). A radiological analysis included panoramic X-rays for radiomorphometric measurements and TMJ lateral radiographs. Results indicated a significant decline in oral hygiene in patients with cancer after bisphosphonate therapy, marked by increased DMFT and OHI-S scores. Periodontal health also showed deterioration, with increased PD and CAL readings. The incidence of BRONJ symptoms was noted, although exact figures are not quantified in this abstract. The study also revealed changes in radiomorphometric parameters, suggesting bisphosphonates\' impact on bone density and structure. No substantial alterations were observed in TMJ function, indicating a need for extended observation to understand bisphosphonates\' long-term effects on the stomatognathic system. These findings highlight the importance of continuous dental monitoring and prophylaxis in patients undergoing bisphosphonate therapy. Implementing meticulous oral care protocols is essential for mitigating BRONJ risk and managing the complex oral health challenges in patients with cancer.
摘要：
这项研究调查了双膦酸盐治疗对80例乳腺癌和前列腺癌骨转移患者的口颌系统的影响。双膦酸盐是治疗这些恶性肿瘤的骨骼并发症不可或缺的，但与双膦酸盐相关性颌骨坏死（BRONJ）相关，影响0.8-18.5%的患者。BRONJ表现出疼痛，神经病,组织肿胀,粘膜溃疡，牙齿活动性,和脓肿，然而其发病机制仍然难以捉摸，复杂的风险预测。该研究采用了全面的牙科和放射学评估。使用DMFT和OHI-S指数评估牙科状况，艾希纳的分类，和临床牙周测量，如口袋深度(PD)，临床附着丧失(CAL)，并修改了沟出血指数(mSBI)。放射学分析包括用于放射形态测量的全景X射线和TMJ横向X射线照片。结果表明，双膦酸盐治疗后，癌症患者的口腔卫生显着下降，以增加DMFT和OHI-S分数为标志。牙周健康状况也显示恶化，增加PD和CAL读数。注意到BRONJ症状的发生率，尽管在这个摘要中没有量化确切的数字。该研究还揭示了放射形态参数的变化，提示双膦酸盐对骨密度和结构的影响。没有观察到TMJ功能的实质性改变，这表明需要进行长期观察，以了解双膦酸盐对口颌系统的长期影响。这些发现强调了在接受双膦酸盐治疗的患者中持续牙科监测和预防的重要性。实施细致的口腔护理方案对于降低BRONJ风险和管理癌症患者复杂的口腔健康挑战至关重要。
