A clinical retrospective study of implant as a risk factor for medication-related osteonecrosis of the jaw: surgery vs loading?

IF 2 Q2 DENTISTRY, ORAL SURGERY & MEDICINE Maxillofacial Plastic and Reconstructive Surgery Pub Date : 2023-09-14 DOI:10.1186/s40902-023-00398-2
Yong-Dae Kwon, Hyunmi Jo, Jae-Eun Kim, Joo-Young Ohe
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Abstract

Background: Risk factors for developing medication-related osteonecrosis of the jaw (MRONJ) include the general condition of the patient, smoking habit, poor oral hygiene, and the type, duration, and administration route of the drug, dentoalveolar surgery, such as implant placement. This study aimed to discuss whether implants may induce osteonecrosis in older patients receiving long-term medication and to analyze the radiological pattern of the bone necrosis.

Methods: This study included 33 patients diagnosed with dental implant-associated medication-related osteonecrosis of the jaw. Data regarding the medical history, type of medication used, durations of administration, laboratory test results, onset of bone necrosis since implant placement, type of opposing teeth, and radiological pattern of the bone necrosis on cone-beam computed tomography were recorded in patients with and without implants.

Results: The most commonly used drug was bisphosphonate, with an average duration of use of 61.37 (± 53.72) months. The laboratory results showed average serum C-terminal cross-linking telopeptide (CTX) level of 0.23 ng/mL, vitamin D, 23.42 ng/mL, and osteocalcin, 4.92 ng/mL. Osteonecrosis occurred after an average of 51.03 (± 39.75) months following implant placement. Radiological evaluation revealed obvious sequestration in the implant-absent group, and the formation of a unit sequestration with an implant fixture (en bloc) was observed in the implant-present group. The patients underwent surgical treatment of sequestrectomy and explantation.

Conclusion: Implant placement, especially loading, may be considered a potential risk factor for the development of osteonecrosis in patients undergoing antiresorptive treatment.

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种植体作为药物相关性颌骨骨坏死危险因素的临床回顾性研究:手术与负荷?
背景:发生药物相关性颌骨骨坏死(MRONJ)的危险因素包括患者的一般情况、吸烟习惯、口腔卫生不良、药物的类型、持续时间和给药途径、牙槽手术,如种植体植入。本研究旨在探讨长期接受药物治疗的老年患者植入物是否会导致骨坏死,并分析骨坏死的影像学表现。方法:本研究纳入33例诊断为牙种植体相关药物相关性颌骨骨坏死的患者。记录有种植体和没有种植体的患者的病史、用药类型、给药时间、实验室检查结果、植入后骨坏死的发生、对牙类型和锥束计算机断层扫描骨坏死的放射学模式。结果:最常用的药物为双膦酸盐,平均使用时间为61.37(±53.72)个月。实验室结果显示,血清c端交联末端肽(CTX)平均水平为0.23 ng/mL,维生素D为23.42 ng/mL,骨钙素为4.92 ng/mL。骨坏死发生的平均时间为植入后51.03(±39.75)个月。放射学评估显示无植入物组有明显的隔离,有植入物组观察到与植入物固定物形成单位隔离(en bloc)。患者均行隔离切除和外植体手术治疗。结论:种植体的放置,特别是负荷,可能被认为是接受抗吸收治疗的患者发生骨坏死的潜在危险因素。
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来源期刊
Maxillofacial Plastic and Reconstructive Surgery
Maxillofacial Plastic and Reconstructive Surgery DENTISTRY, ORAL SURGERY & MEDICINE-
CiteScore
4.30
自引率
13.00%
发文量
37
审稿时长
13 weeks
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