Effectiveness of surgery and hyperbaric oxygen for antiresorptive agent-related osteonecrosis of the jaw: A subgroup analysis by disease stage.
Adult
Aged
Aged, 80 and over
Bisphosphonate-Associated Osteonecrosis of the Jaw
/ surgery
Bone Density Conservation Agents
/ adverse effects
Diphosphonates
/ therapeutic use
Female
Humans
Hyperbaric Oxygenation
/ methods
Japan
Male
Middle Aged
Neoplasms
/ chemically induced
Osteoporosis
/ drug therapy
Radiation-Sensitizing Agents
/ therapeutic use
Retrospective Studies
Treatment Outcome
Journal
PloS one
ISSN: 1932-6203
Titre abrégé: PLoS One
Pays: United States
ID NLM: 101285081
Informations de publication
Date de publication:
2021
2021
Historique:
received:
29
08
2020
accepted:
18
12
2020
entrez:
4
1
2021
pubmed:
5
1
2021
medline:
11
5
2021
Statut:
epublish
Résumé
Antiresorptive agent-related osteonecrosis of the jaw (ARONJ) is an adverse event induced by antiresorptive agents (ARAs). The purpose of this study was to evaluate variables, mainly surgery and hyperbaric oxygen (HBO) therapy, associated with treatment outcomes in patients with a diagnosis of ARONJ at a single center. We enrolled consecutive patients who presented to our hospital for the management of stage 2 or 3 ARONJ between January 2003 and December 2019. The relationship between potentially predictive factors and outcome variables was examined using statistical analyses, along with a subgroup analysis based on disease stage. Of 252 patients included in this study, 206 had stage 2 ARONJ and 46 had stage 3 ARONJ. There were 119 patients with osteoporosis and 133 with malignant disease. In total, 139 patients were healed, and the healing rate of patients with stage 3 ARONJ was lower than that of patients with stage 2 ARONJ. With regard to the combination of surgery and HBO therapy, most patients underwent HBO before and after surgery. In the univariable analysis, surgery showed a therapeutic effect in both stage 2 and 3 ARONJ, whereas HBO showed a therapeutic effect in stage 2 ARONJ. In the multivariable analysis for stage 2 ARONJ, extensive surgery showed a stronger association with healing than conservative surgery, whereas ≥46 sessions of HBO therapy was less associated with healing than was non-HBO therapy. Our findings suggest that extensive surgery is highly effective against ARONJ regardless of disease stage if there is a sequestrum separation and systemic tolerance, whereas HBO therapy before and after surgical approach can be effective. Further studies are needed to identify treatment strategies for patients with treatment-refractory ARONJ who may be forced to undergo long-term HBO therapy with the expectation of sequestrum separation.
Identifiants
pubmed: 33395446
doi: 10.1371/journal.pone.0244859
pii: PONE-D-20-27136
pmc: PMC7781475
doi:
Substances chimiques
Bone Density Conservation Agents
0
Diphosphonates
0
Radiation-Sensitizing Agents
0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
e0244859Déclaration de conflit d'intérêts
The authors have declared that no competing interests exist.
Références
J Oral Implantol. 2007;33(6):371-82
pubmed: 18240798
J Oral Maxillofac Surg. 2014 Oct;72(10):1938-56
pubmed: 25234529
J Oral Maxillofac Surg. 2003 Sep;61(9):1115-7
pubmed: 12966493
J Oral Maxillofac Surg. 2017 Jul;75(7):1404-1413
pubmed: 28039736
Oral Oncol. 2014 Nov;50(11):1049-57
pubmed: 25240948
Oral Oncol. 2011 Mar;47(3):191-4
pubmed: 21292541
Int J Oral Maxillofac Surg. 2016 Dec;45(12):1592-1599
pubmed: 27427547
J Oral Maxillofac Surg. 2012 Jul;70(7):1573-83
pubmed: 22698292
J Oral Maxillofac Surg. 2019 Sep;77(9):1816-1822
pubmed: 31054989
J Craniomaxillofac Surg. 2017 Aug;45(8):1183-1189
pubmed: 28684074
J Bone Miner Res. 2017 Oct;32(10):2022-2029
pubmed: 28585700
Lancet. 2011 Mar 5;377(9768):813-22
pubmed: 21353695
J Appl Physiol (1985). 2009 Feb;106(2):662-7
pubmed: 18845774
J Oral Maxillofac Surg. 2007 Jul;65(7):1321-7
pubmed: 17577496
Clin Oral Investig. 2020 Oct 2;:
pubmed: 33006027
J Bone Miner Res. 2015 Jan;30(1):3-23
pubmed: 25414052
Oral Maxillofac Surg. 2018 Dec;22(4):369-378
pubmed: 30327979
Clin Exp Dent Res. 2020 Oct;6(5):512-518
pubmed: 32614524
J Bone Miner Metab. 2017 Jan;35(1):6-19
pubmed: 28035494
Adv Skin Wound Care. 2007 Jul;20(7):382-8
pubmed: 17620739
J Am Dent Assoc. 2011 Nov;142(11):1243-51
pubmed: 22041409
Eur J Rheumatol. 2017 Mar;4(1):46-56
pubmed: 28293453
Oral Surg Oral Med Oral Pathol Oral Radiol. 2019 Feb;127(2):117-135
pubmed: 30393090
J Oral Maxillofac Surg. 2015 Dec;73(12 Suppl):S94-S100
pubmed: 26608159
Ann Oncol. 2014 Sep;25 Suppl 3:iii124-37
pubmed: 24782453
J Craniomaxillofac Surg. 2020 Apr;48(4):435-443
pubmed: 32178949
J Oral Biosci. 2019 Jun;61(2):99-104
pubmed: 31109863
Int J Hematol. 2006 Nov;84(4):343-5
pubmed: 17118761
J Oral Maxillofac Surg. 2012 Nov;70(11):2501-7
pubmed: 22883322
Odontology. 2015 Jan;103(1):105-8
pubmed: 23907202
J Rheumatol. 2008 Jul;35(7):1391-7
pubmed: 18528958
J Oral Maxillofac Surg. 1983 Jun;41(6):351-7
pubmed: 6574217
Implant Dent. 2011 Oct;20(5):331-6
pubmed: 21881516