放射線治療中および放射線治療後の抜歯による顎の骨粗鬆症。A Systematic Review

Osteoradionecrosis of the Jaws Due to Teeth Extractions during and after Radiotherapy: A Systematic Review.

抄録

Teeth extractions before or after radiotherapy (RT) could be procedures at high risk for osteoradionecrosis (ORN) onset. This systematic review was performed to investigate the ORN incidence following teeth extractions during and after RT for head and neck (H&N) cancer and to evaluate any other possible risk factor.

方法は以下の通りです。:

本システマティックレビューは、PRISMAプロトコルに従って実施し、PROSPERO登録番号はCRD42018079986であった。以下の検索エンジンで電子検索を行った。PubMed，Scopus，Web of Scienceで検索した。累積メタアナリシスを行った。

METHODS: This systematic review was conducted according to PRISMA protocol, and the PROSPERO registration number was CRD42018079986. An electronic search was performed on the following search engines: PubMed, Scopus, and Web of Science. A cumulative meta-analysis was performed.

結果:

2,281件の記録がスクリーニングされ，最終的に9件が対象となった。ORNの発生率は5.8％（462例中41例，95％CI＝2.3～9.4）で，3例が上顎に発生していた。その他の臨床的危険因子は検出されなかった。

RESULTS: Two thousand two hundred and eighty-one records were screened, and nine were finally included. This systematic review revealed an ORN incidence of 5.8% (41 patients out of 462, 95% CI = 2.3-9.4); 3 ORN developed in the maxilla. No other clinical risk factors were detected.

結論:

RT後の抜歯は、ORN発生の主要な危険因子であり、特に下顎に発生したが、ここ数年は減少傾向にある。他の可能性のある危険因子についてさらに研究を進めれば、この証拠を改善できるかもしれない。

CONCLUSION: Post-RT teeth extractions represent a major risk factor for ORN development, especially in the mandible, with a diminishing trend in the last years. Further research on other possible risk factors might improve this evidence.