Evaluation of the preliminary clinical effect of flap-raising combined with cortical-perforation technique in tooth extraction cases of patients with potential risk of medication-related osteonecrosis of the jaw
10.3760/cma.j.cn112144-20210104-00003
- VernacularTitle:翻瓣联合骨管技术拔牙方案在药物相关性颌骨坏死潜在风险患者中的应用初探
- Author:
Yuxing GUO
1
;
Diancan WANG
;
Xiaojing LIU
;
Enbo WANG
;
Jingang AN
;
Xin PENG
;
Chuanbin GUO
Author Information
1. 北京大学口腔医学院·口腔医院口腔颌面外科 国家口腔医学中心 国家口腔疾病临床医学研究中心 口腔数字化医疗技术和材料国家工程实验室 口腔数字医学北京市重点实验室 100081
- Keywords:
Tooth extraction;
Anti-resorption;
Anti-angiogenesis;
Medication-related osteonecrosis of the jaw
- From:
Chinese Journal of Stomatology
2021;56(5):452-457
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To evaluate the preliminary clinical effect of flap-raising and cortical-perforation based extraction method in patients with potential risk of medication-related osteonecrosis of the jaw (MRONJ).Methods:Eighteen patients, who needed teeth extraction in the Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology from February 2016 to November 2020, with a history of using anti-resorption/anti-angiogenesis medication were included in this retrospective study. According to the characteristics of the patient′s medication history, patients were stratified into three categories, low-dose anti-resorption drug group, high-dose anti-resorption drug group, and high-dose anti-resorption combined with anti-angiogenesis targeted drug group. There were 15 females and 3 males, the average age was 62.4 years (range from 27 to 87 years) old. A total of 31 teeth were indicated for extraction due to chronic infection. The flap-raising and cortical-perforation techniques were used to extract the affected teeth, and the patients were followed up closely. By observing the healing status and swelling degree of the mucosa of tooth extraction sites, whether there was a fistula, pus and bone exposure of jaw bone,the healing of the tooth extraction sites were evaluated.Results:Among the 18 patients, there were 9 cases of osteoporosis and 9 cases of malignant tumors. Classified by medication-using history, 10 cases were treated with low-dose anti-resorption drugs, 5 cases were high-dose anti-resorption drugs, and 3 cases were high-dose anti-resorption drugs combined with anti-angiogenesis drugs. A total of 31 teeth of the patients were extracted by flap-raising and cortical-perforation based extraction method. Thirteen patients completed treatment underwent local anesthesia and five cases were performed under general anesthesia. The shortest follow-up period was 3 months with an average of 13.2 months. Seventeen patients recovered well after the tooth extraction. One patient had the mandible exposed at one extraction site one month after the surgery, resulting in MRONJ.Conclusions:In patients with potential risks of MRONJ, the application of flap-raising and cortical-perforation based teeth extraction method could safely and effectively alleviate the dental inflammation in the oral cavity.
