Surgical and conservative treatment outcomes of medication-related osteonecrosis of the jaw located at tori: a retrospective study.

IF 1.7 Q3 DENTISTRY, ORAL SURGERY & MEDICINE Oral and Maxillofacial Surgery-Heidelberg Pub Date : 2024-09-01 Epub Date: 2024-02-29 DOI:10.1007/s10006-024-01214-5
Hameda Amin, Sanne Werner Moeller Andersen, Simon Storgård Jensen, Thomas Kofod
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Abstract

Purpose: Tori and exostoses are considered risk factors for the development of medication-related osteonecrosis of the jaw (MRONJ). The aims of this study were to present the prevalence of MRONJ located at tori in the Copenhagen ONJ Cohort, evaluate the surgical treatment of MRONJ located at tori and explore trauma to tori as an additional risk factor in patients on antiresorptive medication.

Methods: Data from a consecutive series of 506 patients with MRONJ (Copenhagen ONJ Cohort) were reviewed for the presence of tori and MRONJ located at tori. Demographic and medical data were analyzed, and healing outcomes and pain after the prophylactic removal of tori, surgical treatment of MRONJ located at tori, and conservative treatment of MRONJ located at tori were evaluated and compared using Fisher's exact test.

Results: MRONJ located at tori was frequent and could be identified in 53% of the patients with tori, which accounts for a prevalence of 5.1% in the entire cohort. Of the 28 surgically treated patients, 27 (96.4%) healed uneventfully with no exposed bone after their first or second revision surgery. Fourteen (41.2%) patients with tori underwent therapeutic removal, eight (23.5%) underwent prophylactic removal, and six (17.6%) underwent both therapeutic and prophylactic removals. Two (33.3%) of the six conservatively treated patients healed spontaneously. Both treatment types resulted in a significant decrease in pain.

Conclusion: Prophylactic and therapeutic surgical removal of tori are reliable treatments and should be considered if a patient's general health allows surgery.

Trial registration: The study was approved by the Regional Scientific Ethical Committee (H-6-2013-010) on November 20, 2013, and was retrospectively registered.

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位于颌骨环的药物性颌骨坏死的手术和保守治疗效果:一项回顾性研究。
目的:骨托和骨外膜被认为是发生药物相关性颌骨坏死(MRONJ)的危险因素。本研究旨在介绍哥本哈根颌骨队列中位于tori的MRONJ的发病率,评估位于tori的MRONJ的手术治疗,并探讨tori创伤作为服用抗骨质吸收药物患者的额外风险因素:方法:对506名MRONJ患者(哥本哈根ONJ队列)的连续系列数据进行审查,以确定是否存在转子和位于转子上的MRONJ。对人口统计学和医学数据进行了分析,并对预防性切除环状突起、手术治疗位于环状突起处的MRONJ和保守治疗位于环状突起处的MRONJ后的愈合效果和疼痛进行了评估,并使用费雪精确检验进行了比较:结果:位于转子上的 MRONJ 很常见,在 53% 的转子患者中可以发现,在整个队列中的发病率为 5.1%。在28名接受过手术治疗的患者中,27人(96.4%)在第一次或第二次翻修手术后顺利痊愈,没有骨头外露。14名(41.2%)患者接受了治疗性切除,8名(23.5%)患者接受了预防性切除,6名(17.6%)患者同时接受了治疗性和预防性切除。在接受保守治疗的六名患者中,有两人(33.3%)自愈。两种治疗方式都能明显减轻疼痛:试验登记:该研究于2013年11月20日获得地区科学伦理委员会批准(H-6-2013-010),并进行了回顾性登记。
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来源期刊
Oral and Maxillofacial Surgery-Heidelberg
Oral and Maxillofacial Surgery-Heidelberg DENTISTRY, ORAL SURGERY & MEDICINE-
CiteScore
3.20
自引率
5.60%
发文量
118
期刊介绍: Oral & Maxillofacial Surgery founded as Mund-, Kiefer- und Gesichtschirurgie is a peer-reviewed online journal. It is designed for clinicians as well as researchers.The quarterly journal offers comprehensive coverage of new techniques, important developments and innovative ideas in oral and maxillofacial surgery and interdisciplinary aspects of cranial, facial and oral diseases and their management. The journal publishes papers of the highest scientific merit and widest possible scope on work in oral and maxillofacial surgery as well as supporting specialties. Practice-oriented articles help improve the methods used in oral and maxillofacial surgery.Every aspect of oral and maxillofacial surgery is fully covered through a range of invited review articles, clinical and research articles, technical notes, abstracts, and case reports. Specific topics are: aesthetic facial surgery, clinical pathology, computer-assisted surgery, congenital and craniofacial deformities, dentoalveolar surgery, head and neck oncology, implant dentistry, oral medicine, orthognathic surgery, reconstructive surgery, skull base surgery, TMJ and trauma.Time-limited reviewing and electronic processing allow to publish articles as fast as possible. Accepted articles are rapidly accessible online.Clinical studies submitted for publication have to include a declaration that they have been approved by an ethical committee according to the World Medical Association Declaration of Helsinki 1964 (last amendment during the 52nd World Medical Association General Assembly, Edinburgh, Scotland, October 2000). Experimental animal studies have to be carried out according to the principles of laboratory animal care (NIH publication No 86-23, revised 1985).
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