Dental extraction as a risk factor for bisphosphonate related osteonecrosis of the jaw in cancer patients: an update.

A Utreja, K Almas, F Javed
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Abstract

Unlabelled: Osteonecrosis of the jaw (ONJ) is a complication related to the use of bisphosphonates (BPs). Patients receiving BPs for the treatment of malignancies are at an increased risk of developing bisphosphonate-related ONJ (BRONJ) as compared to patients receiving BPs for the treatment of other disorders such as osteoporosis. Additionally, tooth extractions have been suggested to increase the risk of BRONJ in individuals taking BPs.

Objective: To review the role of dental extraction as a risk factor for BRONJ in cancer patients.

Materials and methods: Databases were searched from January 1999 up to and including July 2012 using various combinations of the following keywords: "bisphosphonate", "osteonecrosis of the jaw", "cancer", "oral" and "dental extraction".

Results: Twenty two studies were included. Eighteen studies assessed the relationship between BRONJ and dental extractions in cancer patients, reporting the overall prevalence of BRONJ following extraction in this group as 3.25 +/- 2.23%. Four studies did not report a correlation between BRONJ and extractions, and recommended protocols to avoid the complication.

Conclusion: There is a plausible relationship between dental extractions and the development of BRONJ in cancer patients. Written informed consent must be obtained prior to dental procedures in patients at risk for developing BRONJ.

拔牙作为癌症患者双膦酸盐相关颌骨骨坏死的危险因素:最新进展。
未标记:颌骨骨坏死(ONJ)是与使用双磷酸盐(bp)相关的并发症。与接受bp治疗其他疾病(如骨质疏松症)的患者相比,接受bp治疗恶性肿瘤的患者发生双膦酸盐相关ONJ (BRONJ)的风险增加。此外,拔牙被认为会增加服用bp的人患BRONJ的风险。目的:探讨拔牙作为肿瘤患者BRONJ危险因素的作用。资料和方法:检索1999年1月至2012年7月的数据库,检索关键词包括:“双膦酸盐”、“颌骨骨坏死”、“癌症”、“口腔”和“拔牙”。结果:共纳入22项研究。18项研究评估了癌症患者的BRONJ与拔牙之间的关系,报告了该组拔牙后BRONJ的总体患病率为3.25 +/- 2.23%。四项研究没有报道BRONJ与拔牙之间的相关性,并推荐了避免并发症的方案。结论:拔牙与肿瘤患者BRONJ的发生有一定的关系。有发生BRONJ风险的患者在进行牙科手术前必须获得书面知情同意。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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