2023 Fiscal Year Final Research Report
The Clinical and Molecular Biological Study on the Prevention of Medication-Related Osteonecrosis of the Jaw: The Impact of Administration Duration and Drug Holiday
| Project/Area Number |
20K18833
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| Research Category |
Grant-in-Aid for Early-Career Scientists
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| Allocation Type | Multi-year Fund |
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| Review Section |
Basic Section 57080:Social dentistry-related
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| Research Institution | Kyushu Dental College |
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Principal Investigator |
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| Project Period (FY) |
2020-04-01 – 2024-03-31
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| Keywords | 顎骨壊死 / 骨吸収抑制薬 / ビスフォスフォネート製剤 / リスク因子 / MRONJ / 抜歯 / 口腔管理 |
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| Outline of Final Research Achievements |
Invasive dental procedures, such as tooth extractions, have been considered risk factors for Medication-Related Osteonecrosis of the Jaw (MRONJ), leading to the avoidance of extractions in patients on antiresorptive medications. This study aimed to identify MRONJ risk factors following tooth extraction. Initially, a retrospective study examined approximately 8,000 teeth in patients on antiresorptive medications. The analysis found a correlation between dental infection indicators, such as apical periodontitis, deep periodontal pockets, widened periodontal ligament spaces, periapical sclerosis, and local infection signs, and MRONJ incidence. Next, the dental background factors of extraction and non-extraction cases were compared, revealing that MRONJ incidence was significantly higher in extraction cases. These results suggest that, even in patients receiving antiresorptive medications, actively extracting teeth that could become sources of infection may help prevent MRONJ.
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| Free Research Field |
口腔衛生学
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| Academic Significance and Societal Importance of the Research Achievements |
（1）高用量ARA投与患者172例（3725歯）を検討した。人単位の検討ではBPよりもDMB投与患者の方がその後のMRONJ発症率が高かった。抜歯との関係は、全歯の検討では抜歯例で発症率は高くなっていたが、歯科的背景因子を傾向スコアマッチング法で検討すると、抜歯例の方がその後のMRONJ発症を有意に抑制していた。
（2）357例（5038歯）で検討した。人単位の検討はMRONJ他部位再発を有意に予測される因子はみられなかった。抜歯との関係は、全歯の検討では抜歯例で有意に発症が多かったが、歯科的背景因子を傾向スコアマッチング法で検討すると、抜歯例の方がその後のMRONJ発症を有意に抑制していた。
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