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Abstract：
Introduction Medication-related osteonecrosis of the jaw (MRONJ) develops from odontogenic infection. However, there are also some cases of MRONJ developing from sites with no teeth, no root canal lesions, or no periodontal disease. This study aimed to retrospectively review radiographic images of MRONJ cases and examine the differences in characteristics between MRONJ suspected to be related to dental infection (odontogenic MRONJ) and MRONJ that occurred without dental involvement or of unknown cause (non-odontogenic MRONJ). Materials and methods One hundred and forty-five patients were diagnosed with MRONJ at Kansai Medical University Hospital and Kansai Medical University Medical Center. The following variables were investigated: sex, age, primary disease, MRONJ site, body mass index, smoking habit, diabetes, corticosteroids, type of antiresorptive agent, administration period, CT findings (separation of sequestrum, osteolysis, periosteal reaction, and osteosclerosis), trigger, leukocytes, neutrocytes, neutrophil-lymphocyte ratio, serum albumin, and serum creatinine levels. Results In the univariate analysis, significant differences between odontogenic and non-odontogenic MRONJs were found in patients whose primary disease was malignancy, receiving denosumab (DMB), and with short administration period of antiresorptive agent, no osteolysis, periosteal reaction, and serum creatinine level. In multivariate analysis, non-odontogenic MRONJ was significantly more common in patients with no osteolysis and with periosteal reaction. Conclusion Non-odontogenic MRONJ tends to occur more frequently in patients treated with high-dose DMB, and there were significantly more cases of non-osteolytic MRONJ without radiographic evidence of osteolysis or with periosteal reactions.
摘要：
引言药物相关性颌骨坏死(MRONJ)由牙源性感染发展。然而,也有一些MRONJ从没有牙齿的部位发育的病例，无根管病变,或者没有牙周病.本研究旨在回顾性回顾MRONJ病例的影像学图像，并检查怀疑与牙齿感染有关的MRONJ（牙源性MRONJ）和没有牙齿受累或原因不明的MRONJ（非牙源性MRONJ）之间的特征差异。材料与方法在关西医科大学医院和关西医科大学医学中心诊断为MRONJ的一百四十五名患者。调查了以下变量：性别，年龄,原发疾病,MRONJ网站，身体质量指数,吸烟习惯,糖尿病,皮质类固醇,类型的抗吸收剂，管理期间，CT检查结果（分离死核，骨质溶解,骨膜反应,和骨硬化)，触发器,白细胞,中性粒细胞，中性粒细胞-淋巴细胞比率，血清白蛋白,和血清肌酐水平.结果在单变量分析中，在原发疾病为恶性肿瘤的患者中发现牙源性和非牙源性MRONJs之间存在显着差异，接收denosumab（DMB），并且抗吸收剂的给药时间短，没有骨质溶解,骨膜反应,和血清肌酐水平.在多变量分析中，非牙源性MRONJ在无骨质溶解和有骨膜反应的患者中更为常见.结论非牙源性MRONJ在接受大剂量DMB治疗的患者中更易发生,无骨质溶解或骨膜反应的非溶骨性MRONJ病例明显增多。
