This study investigates the impact of bisphosphonate therapy on the stomatognathic system in 80 patients with cancer of the breast and prostate with bone metastases. Bisphosphonates are integral for managing skeletal complications in these malignancies but are associated with bisphosphonate-related osteonecrosis of the jaw (BRONJ), affecting 0.8–18.5% of patients. BRONJ manifests with pain, neuropathy, tissue swelling, mucosal ulceration, tooth mobility, and abscesses, yet its pathogenesis remains elusive, complicating risk prediction. The research employed comprehensive dental and radiological evaluations. Dental status was assessed using DMFT and OHI-S indices, Eichner’s classification, and clinical periodontal measurements like the pocket depth (PD), clinical attachment loss (CAL), and modified Sulcus Bleeding Index (mSBI). A radiological analysis included panoramic X-rays for radiomorphometric measurements and TMJ lateral radiographs. Results indicated a significant decline in oral hygiene in patients with cancer after bisphosphonate therapy, marked by increased DMFT and OHI-S scores. Periodontal health also showed deterioration, with increased PD and CAL readings. The incidence of BRONJ symptoms was noted, although exact figures are not quantified in this abstract. The study also revealed changes in radiomorphometric parameters, suggesting bisphosphonates’ impact on bone density and structure. No substantial alterations were observed in TMJ function, indicating a need for extended observation to understand bisphosphonates’ long-term effects on the stomatognathic system. These findings highlight the importance of continuous dental monitoring and prophylaxis in patients undergoing bisphosphonate therapy. Implementing meticulous oral care protocols is essential for mitigating BRONJ risk and managing the complex oral health challenges in patients with cancer.
本研究探讨了双膦酸盐治疗对80例乳腺癌及前列腺癌伴骨转移患者口颌系统的影响。双膦酸盐是控制此类恶性肿瘤骨骼并发症的关键药物，但可能引发双膦酸盐相关性颌骨坏死（BRONJ），其发生率在0.8%至18.5%之间。BRONJ临床表现为疼痛、神经病变、组织肿胀、黏膜溃疡、牙齿松动及脓肿等症状，但其发病机制尚未明确，导致风险预测困难。本研究采用全面的口腔及影像学评估方法：通过DMFT指数、OHI-S指数、艾希纳分类法及牙周临床指标（包括探诊深度、临床附着丧失和改良龈沟出血指数）评估口腔状况；影像学分析涵盖全景片放射形态计量测量及颞下颌关节侧位片。结果显示，双膦酸盐治疗后癌症患者口腔卫生状况显著恶化，表现为DMFT和OHI-S评分升高；牙周健康状况亦呈下降趋势，探诊深度和临床附着丧失值增加。研究观察到BRONJ相关症状的出现（本摘要未量化具体数据），同时放射形态计量参数变化提示双膦酸盐对骨密度及骨结构产生影响。颞下颌关节功能未见显著改变，表明需延长观察周期以明确双膦酸盐对口颌系统的长期影响。这些发现强调了双膦酸盐治疗患者持续口腔监测与预防的重要性，实施精细化的口腔护理方案对降低BRONJ风险、应对癌症患者复杂口腔健康问题具有关键意义。
肿瘤(癌症)患者之家