Risk factors for medication-related osteonecrosis of the jaws in menopausal women

Jocarla Campos Serafim, Gustavo Azevedo Pitol, Ester Victorino Coser, B. Albergaria, S. C. Kano, T. Velloso
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Abstract

Aim: This study aimed to identify risk factors for medicationrelated osteonecrosis of the jaw (MRONJ) by carrying out clinical and radiographic evaluations of patients with osteopenia and osteoporosis using bisphosphonates (BFs). Methods: After approval by the CCS/UFES Ethics Committee (registration number 2,738,749), consultations were undertaken, and data were collected from medical records in cooperation with sectors from UFES and the University hospital. A total of 50 patients, 29 with osteoporosis and 21 with osteopenia were selected. Patients underwent a clinical and a panoramic dental x-ray examination to assess risk factors associated with oral health and dental interventions. Results: All patients had at least one local risk factor, the most frequent being tooth extraction (100%) and periodontal disease (50%) which, if associated with the use of BFs, could lead to MRONJ. Among the systemic risk factors, the most common were diabetes and corticosteroid therapy. The most used BF was alendronate, administered orally. Conclusion: The dental surgeon should evaluate all patients with osteopenia and osteoporosis using BFs to determine whether there are other risks. Whether there may be other potential risks, acknowledging upon key risks factors surrounding MRONJ are critical for early diagnosis and successful dental treatment.
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更年期妇女与药物相关的颌骨坏死的风险因素
目的:本研究旨在通过对使用双膦酸盐(BFs)的骨质疏松症和骨质疏松症患者进行临床和影像学评估,确定药物相关性颌骨坏死(MRONJ)的风险因素。研究方法在获得 CCS/UFES 伦理委员会(注册号 2,738,749)批准后,与 UFES 和大学医院的相关部门合作进行会诊并从病历中收集数据。研究共选取了 50 名患者,其中 29 人患有骨质疏松症,21 人患有骨质疏松症。患者接受了临床和全景牙科 X 光检查,以评估与口腔健康和牙科干预相关的风险因素。结果显示所有患者都至少有一个局部风险因素,其中最常见的是拔牙(100%)和牙周病(50%),如果这些因素与使用碱性磷酸酯有关,则可能导致 MRONJ。在全身性风险因素中,最常见的是糖尿病和皮质类固醇治疗。使用最多的碱性磷酸酯是阿仑膦酸钠,口服给药。结论:牙科医生应评估所有使用碱性磷酸酯的骨质增生和骨质疏松症患者,以确定是否存在其他风险。无论是否存在其他潜在风险,认识到围绕 MRONJ 的关键风险因素对于早期诊断和成功的牙科治疗至关重要。
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