PDF(Pubmed)
Abstract：
Objectives: To verify medication-related osteonecrosis of the jaw (MRONJ) frequency among patients with plasma cell myeloma (PCM) that had been treated with bisphosphonates, to identify predisposing factors that could influence the development of osteonecrosis. Methods: This observational retrospective study was performed at the Department of Hematology of Hospital Center of Porto (CHUP), Portugal. Results: The study population (n = 112) had a 15.2% (n = 17) prevalence of osteonecrosis. Clinically, bone exposure was the most frequently observed sign, present in 100% (n = 17) of the patients, followed by inflammation in 82.4% (n = 14), orofacial pain in 70.6% (n = 12), suppuration in 47.1% (n = 8), and intra or extra-oral fistula in 17.6% (n = 3) of the cases. The most frequent triggering local factor was dental extraction (82.4%). There was a dependence between the presence of extractions and the development of MRONJ (p < 0.001) but not with the time elapsed from the initiation of infusions with BPs and dental extractions (p = 0.499). In the sample of patients with multiple myeloma (MM), 13.8% were found to be more likely to develop MRONJ after an extraction. Conclusions: The most common local predisposing factor was dental extraction. No dependence was observed between the development of osteonecrosis and the time elapsed from the beginning of treatment with bisphosphonates infusions to surgical procedures.
摘要：
目的：验证已使用双膦酸盐治疗的浆细胞骨髓瘤（PCM）患者与药物相关的颌骨坏死（MRONJ）频率，确定可能影响骨坏死发展的诱发因素。方法：这项观察性回顾性研究在波尔图医院中心血液科（CHUP）进行，葡萄牙。结果：研究人群（n=112）的骨坏死患病率为15.2%（n=17）。临床上,骨暴露是最常见的体征，存在于100%(n=17)的患者中，其次是82.4%(n=14)的炎症，70.6%(n=12)的口面部疼痛，47.1％（n=8）的化脓，17.6%(n=3)的病例出现口内或口外瘘。最常见的触发局部因素是拔牙（82.4％）。提取的存在与MRONJ的发展之间存在依赖性（p<0.001），但与从BPs输注和牙齿提取开始的时间无关（p=0.499）。在多发性骨髓瘤（MM）患者的样本中，发现13.8％的人在提取后更有可能发展为MRONJ。结论：拔牙是最常见的局部诱发因素。在骨坏死的发展与从双膦酸盐输注开始治疗到外科手术的时间之间没有观察到依赖性。
