著者

藤盛 真樹 鳥谷部 純行 角 伸博 嶋﨑 康相 宮澤 政義 宮手 浩樹 北田 秀昭 佐藤 雄治 三澤 肇 山下 徹郎 中嶋 頼俊 針谷 靖史 小林 一三 西方 聡 太子 芳仁 杉浦 千尋 笠原 和恵 浅香 雄一郎 榊原 典幸 岡田 益彦 柴山 尚大 末次 博 鈴木 豊典 阿部 貴洋 谷村 晶広 工藤 章裕 道念 正樹 川口 泰 野島 正寛 牧野 修治郎

出版者

公益社団法人 日本口腔外科学会

雑誌

日本口腔外科学会雑誌 (ISSN:00215163)

巻号頁・発行日

vol.68, no.4, pp.168-183, 2022-04-20 (Released:2022-06-20)

参考文献数

38

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Tooth extraction is reported as the main trigger of bisphosphonate (BP) -related osteonecrosis of the jaw (BRONJ). A method to prevent BRONJ has not been scientifically proven. The American Association of Oral and Maxillofacial Surgeons (AAOMS) differs from the International Task Force on Osteonecrosis of the Jaw with regard to the prevention of BRONJ via prophylactic withdrawal before tooth extraction. We performed a multicenter prospective study regarding the development of BRONJ after tooth extraction in BP-treated patients for the purpose of determining factors associated with the frequency of BRONJ. We extracted teeth from patients with a history of current or prior treatment with BP preparations; teeth were extracted using a common treatment protocol. The presence or absence of BRONJ and adverse events were evaluated. A total of 1,323 cases were targeted for this study; 2,371 teeth were extracted. The overall incidence of BRONJ was 1.74%; in the prophylactic withdrawal group it was 1.73%, whereas in the prophylactic non-withdrawal group it was 1.75%. Factors associated with the onset of BRONJ were sex, preparation adaptation classification, oral hygiene state, site of tooth extraction, and Denosumab usage. From analysis that considered the effect of confounding using the propensity score, prophylactic BP withdrawal did not result in a reduction of BRONJ (onset odds ratio with withdrawal: 1.13, 95%CI 0.36-3.57).

著者

坂田 健一郎 山崎 裕 佐藤 淳 榊原 典幸 浅香 卓哉 北川 善政

出版者

特定非営利活動法人 日本口腔科学会

雑誌

日本口腔科学会雑誌 (ISSN:00290297)

巻号頁・発行日

vol.69, no.3, pp.197-203, 2020 (Released:2020-10-09)

参考文献数

30

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The effectiveness of zinc replacement therapy is reported to be approximately 70%. However, the effectiveness of this therapy in our department has been lower than that reported in the field of otolaryngology. In the present study, we examined the effectiveness of zinc replacement therapy in patients with taste disorder. Forty patients were administered only zinc formulations(Polaprezinc, 150mg/day) for ≥8 weeks. The time until effect, serum zinc level and other parameters were used to evaluate improvement in the taste disorder. In the present study, three cut-off values were determined based on the serum zinc levels.The overall improvement rate among the patients in this study was 50%. The improvement rates by serum zinc level were 57% at <60μg/dl, 56% at 60-69μg/dl, 60% at 70-79μg/dl, and 14% at ≥80μg/dl. There was a significant difference in the improvement rate between the patient groups with serum zinc levels of <80 and ≥80μg/dl(57% vs. 14%, p<0.05). The times until effective expression in the 20 subjects with improvement were less than 2 months in 20% and more than 2 months in 80%, with significant differences among the two groups(p<0.05). Polaprezinc was effective in 60% of the cases where serum zinc level measured in blood tests was less than 80μg/dl. Effectiveness was not observed when the serum zinc level was more than 80μg/dl. Therefore, zinc supplementation therapy should be conducted over the long term after proper selection of the patients.