使用双膦酸盐药物患者种植体早期失败率及术后药物相关性颌骨坏死的单组率Meta分析  

Early Dental Failure and Medication-related Osteonecrosis of the Jaw in Patients Treated with Bisphosphonates:A Meta-analysis of Proportions.

作　　者：叶鹏[1] 朱姗姗[1] 陆支越[1] 蔡业军[1] YE Peng;ZHU Shanshan;LU Zhiyue(Beijing Hospital,National Center of Gerontology,National Health Commission,Institute of Geriatric Medicine,Chinese Academy of Medical Science,Beijing 100730,China)

机构地区：[1]北京医院、国家老年医学中心、国家卫生健康委北京老年医学研究所、中国医学科学院老年医学研究院口腔科,100730

出　　处：《医学研究杂志》2024年第1期36-40,183,共6页Journal of Medical Research

基　　金：中央高水平医院临床科研业务费(BJ-2023-186);国家重点研发计划项目(2020YFC2009005-04)。

摘　　要：目的系统评价使用双膦酸盐药物(bisphosphonates,BPs)患者种植体早期失败率及种植术后药物相关性颌骨坏死(medication-related osteonecrosis of the jaw,MRONJ)发生率,为临床评估相关风险提供依据。方法计算机检索Cochrane Library、Wiley Online Library、PubMed、中国知网、万方数据知识服务平台,收集纳入各数据库建库至2022年5月发表的关于使用BPs患者种植体早期失败或种植术后发生MRONJ的临床研究。采用Stata 15.0软件对种植体早期失败率进行单组率Meta分析。结果共纳入13篇文献,其中口服BPs患者植入1182颗种植体,静脉注射BPs患者植入79颗,共计1261颗种植体。口服BPs患者合并种植体早期失败率为1.7%(95%CI:0.3%~3.9%),MRONJ发生率为0。静脉注射BPs患者种植体早期失败率为0,MRONJ发生率为5.6%。结论口服BPs患者种植体早期失败率及术后MRONJ发生率低,与健康人群基本相当。静脉使用BPs患者种植术后发生MRONJ风险较高,临床适应证选择应慎重。Objective To assess the early dental failure rate and medication-related osteonecrosis of the jaw(MRONJ)incidence in patients treated with bisphosphonates(BPs),and provide evidence for evaluation of clinical risk.Methods Electronic databases,including Cochrane Library,Wiley Online Library,PubMed,CNKI and Wanfang Data were searched to collect clinical studies concerning early dental failure and medication-related osteonecrosis of the jaw in patients treated with bisphosphonates.The data were collected from inception until May 2022.The meta-analysis was conducted using Stata 15.0software.Results A total of 13 clinical observational studies involving 1261 implants,wherein 1182 implants were placed in patients who took bisphosphonate orally,and 79 implants were placed in patients treated with intravenous bisphosphonate.In patients who had orally administrated bisphosphonates,the pooled early dental failure rate was 1.7%(95%CI:0.3%-3.9%),and the MRONJ incidence was 0.Among patients treated with intravenous bisphosphonate,the pooled early dental failure rate was 0,and the MRONJ incidence was 5.6%.Conclusion The early dental failure rate and MRONJ incidence in patients who take bisphosphonates orally is as low as in a healthy population.On account of the relatively high risk of post-operative MRONJ in patients treated with intravenous bisphosphonates,clinical indications must be opted prudently.

关 键 词：双膦酸盐药物 种植体 早期失败 药物相关性颌骨坏死 META分析 

分 类 号：R782[医药卫生—口腔医学]