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.
Early Dental Failure and Medication-related Osteonecrosis of the Jaw in Patients Treated with Bisphosphonates:A Meta-analysis of Pro-portions
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,in-cluding 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.Osoftware.Results A total of 13 clinical observational stud-ies 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 fail-ure rate was 1.7％(95％CI:0.3％-3.9％),and the MRONJ incidence was 0.Among patients treated with intravenous bisphospho-nate,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.
BisphosphonatesDental implantEarly failureMedication-related osteonecrosis of the jawMeta-analysis
万方数据
维普
