Lucas Nascimento Ribeiro, Raisa Severino-Lazo, Belmiro Cavalcanti do Egito Vasconcelos, Sandra Lúcia Dantas de Moraes, Marianne de Vasconcelos Carvalho
{"title":"颌骨骨坏死的预防性治疗：系统综述和网络荟萃分析。","authors":"Lucas Nascimento Ribeiro, Raisa Severino-Lazo, Belmiro Cavalcanti do Egito Vasconcelos, Sandra Lúcia Dantas de Moraes, Marianne de Vasconcelos Carvalho","doi":"10.1111/odi.70015","DOIUrl":null,"url":null,"abstract":"<p><strong>Objectives: </strong>A systematic review and network meta-analysis were conducted to address the following research question: \"What is the most effective preventive treatment for reducing the risk of jaw osteonecrosis after tooth extraction in patients receiving medications associated with osteonecrosis?\"</p><p><strong>Material and methods: </strong>Only randomized clinical trials conducted in adults with a history of medication use associated with osteonecrosis of the jaw, who were treated with a preventive method to reduce the risk of osteonecrosis after tooth extraction, were included. Risk of bias and quality of evidence were assessed using the Cochrane Collaboration tool. Bayesian random-effects mixed treatment comparison model was employed to compare all evaluated strategies: regenerative therapy, primary closure, secondary closure, epiperiosteal flap, and ozone infiltration. The network meta-analysis results were presented as point estimates with 95% credible intervals.</p><p><strong>Results: </strong>Five randomized clinical trials conducted between 2012 and 2024 were included after applying the predetermined criteria. These studies evaluated various interventions, including platelet-rich fibrin, platelet-rich plasma, oxygen-ozone therapy, and different surgical closure techniques. Bayesian network meta-analysis demonstrated no conclusive evidence of superiority for any intervention over primary closure.</p><p><strong>Conclusion: </strong>No preventive strategy demonstrated superiority in reducing the risk of medication-related osteonecrosis of the jaw in patients undergoing tooth extraction.</p><p><strong>Trial registration: </strong>International Prospective Register of Systematic Reviews: CRD42024619828.</p>","PeriodicalId":19615,"journal":{"name":"Oral diseases","volume":" ","pages":""},"PeriodicalIF":2.9000,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Preventive Treatments for Osteonecrosis of the Jaw: A Systematic Review and Network Meta-Analysis.\",\"authors\":\"Lucas Nascimento Ribeiro, Raisa Severino-Lazo, Belmiro Cavalcanti do Egito Vasconcelos, Sandra Lúcia Dantas de Moraes, Marianne de Vasconcelos Carvalho\",\"doi\":\"10.1111/odi.70015\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objectives: </strong>A systematic review and network meta-analysis were conducted to address the following research question: \\\"What is the most effective preventive treatment for reducing the risk of jaw osteonecrosis after tooth extraction in patients receiving medications associated with osteonecrosis?\\\"</p><p><strong>Material and methods: </strong>Only randomized clinical trials conducted in adults with a history of medication use associated with osteonecrosis of the jaw, who were treated with a preventive method to reduce the risk of osteonecrosis after tooth extraction, were included. Risk of bias and quality of evidence were assessed using the Cochrane Collaboration tool. Bayesian random-effects mixed treatment comparison model was employed to compare all evaluated strategies: regenerative therapy, primary closure, secondary closure, epiperiosteal flap, and ozone infiltration. The network meta-analysis results were presented as point estimates with 95% credible intervals.</p><p><strong>Results: </strong>Five randomized clinical trials conducted between 2012 and 2024 were included after applying the predetermined criteria. These studies evaluated various interventions, including platelet-rich fibrin, platelet-rich plasma, oxygen-ozone therapy, and different surgical closure techniques. Bayesian network meta-analysis demonstrated no conclusive evidence of superiority for any intervention over primary closure.</p><p><strong>Conclusion: </strong>No preventive strategy demonstrated superiority in reducing the risk of medication-related osteonecrosis of the jaw in patients undergoing tooth extraction.</p><p><strong>Trial registration: </strong>International Prospective Register of Systematic Reviews: CRD42024619828.</p>\",\"PeriodicalId\":19615,\"journal\":{\"name\":\"Oral diseases\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":2.9000,\"publicationDate\":\"2025-07-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Oral diseases\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1111/odi.70015\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"DENTISTRY, ORAL SURGERY & MEDICINE\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Oral diseases","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1111/odi.70015","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"DENTISTRY, ORAL SURGERY & MEDICINE","Score":null,"Total":0}
Preventive Treatments for Osteonecrosis of the Jaw: A Systematic Review and Network Meta-Analysis.
Objectives: A systematic review and network meta-analysis were conducted to address the following research question: "What is the most effective preventive treatment for reducing the risk of jaw osteonecrosis after tooth extraction in patients receiving medications associated with osteonecrosis?"
Material and methods: Only randomized clinical trials conducted in adults with a history of medication use associated with osteonecrosis of the jaw, who were treated with a preventive method to reduce the risk of osteonecrosis after tooth extraction, were included. Risk of bias and quality of evidence were assessed using the Cochrane Collaboration tool. Bayesian random-effects mixed treatment comparison model was employed to compare all evaluated strategies: regenerative therapy, primary closure, secondary closure, epiperiosteal flap, and ozone infiltration. The network meta-analysis results were presented as point estimates with 95% credible intervals.
Results: Five randomized clinical trials conducted between 2012 and 2024 were included after applying the predetermined criteria. These studies evaluated various interventions, including platelet-rich fibrin, platelet-rich plasma, oxygen-ozone therapy, and different surgical closure techniques. Bayesian network meta-analysis demonstrated no conclusive evidence of superiority for any intervention over primary closure.
Conclusion: No preventive strategy demonstrated superiority in reducing the risk of medication-related osteonecrosis of the jaw in patients undergoing tooth extraction.
Trial registration: International Prospective Register of Systematic Reviews: CRD42024619828.
期刊介绍：
Oral Diseases is a multidisciplinary and international journal with a focus on head and neck disorders, edited by leaders in the field, Professor Giovanni Lodi (Editor-in-Chief, Milan, Italy), Professor Stefano Petti (Deputy Editor, Rome, Italy) and Associate Professor Gulshan Sunavala-Dossabhoy (Deputy Editor, Shreveport, LA, USA). The journal is pre-eminent in oral medicine. Oral Diseases specifically strives to link often-isolated areas of dentistry and medicine through broad-based scholarship that includes well-designed and controlled clinical research, analytical epidemiology, and the translation of basic science in pre-clinical studies. The journal typically publishes articles relevant to many related medical specialties including especially dermatology, gastroenterology, hematology, immunology, infectious diseases, neuropsychiatry, oncology and otolaryngology. The essential requirement is that all submitted research is hypothesis-driven, with significant positive and negative results both welcomed. Equal publication emphasis is placed on etiology, pathogenesis, diagnosis, prevention and treatment.
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