Oral diseases · 2025
Preventive Treatments for Osteonecrosis of the Jaw: A Systematic Review and Network Meta-Analysis.
СтатьяСистематический обзорМетаанализНазвание и аннотация: Перевод в очереди
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Ribeiro Lucas Nascimento, Severino-Lazo Raisa, Vasconcelos Belmiro Cavalcanti do Egito, de Moraes Sandra Lúcia Dantas, Carvalho Marianne de Vasconcelos
Аннотация
OBJECTIVES: A systematic review and network meta-analysis were conducted to address the following research question: "What is the most effective preventive treatment for reducing the risk of jaw osteonecrosis after tooth extraction in patients receiving medications associated with osteonecrosis?"
MATERIAL AND METHODS: Only randomized clinical trials conducted in adults with a history of medication use associated with osteonecrosis of the jaw, who were treated with a preventive method to reduce the risk of osteonecrosis after tooth extraction, were included. Risk of bias and quality of evidence were assessed using the Cochrane Collaboration tool. Bayesian random-effects mixed treatment comparison model was employed to compare all evaluated strategies: regenerative therapy, primary closure, secondary closure, epiperiosteal flap, and ozone infiltration. The network meta-analysis results were presented as point estimates with 95% credible intervals.
RESULTS: Five randomized clinical trials conducted between 2012 and 2024 were included after applying the predetermined criteria. These studies evaluated various interventions, including platelet-rich fibrin, platelet-rich plasma, oxygen-ozone therapy, and different surgical closure techniques. Bayesian network meta-analysis demonstrated no conclusive evidence of superiority for any intervention over primary closure.
CONCLUSION: No preventive strategy demonstrated superiority in reducing the risk of medication-related osteonecrosis of the jaw in patients undergoing tooth extraction.
TRIAL REGISTRATION: International Prospective Register of Systematic Reviews: CRD42024619828.
MATERIAL AND METHODS: Only randomized clinical trials conducted in adults with a history of medication use associated with osteonecrosis of the jaw, who were treated with a preventive method to reduce the risk of osteonecrosis after tooth extraction, were included. Risk of bias and quality of evidence were assessed using the Cochrane Collaboration tool. Bayesian random-effects mixed treatment comparison model was employed to compare all evaluated strategies: regenerative therapy, primary closure, secondary closure, epiperiosteal flap, and ozone infiltration. The network meta-analysis results were presented as point estimates with 95% credible intervals.
RESULTS: Five randomized clinical trials conducted between 2012 and 2024 were included after applying the predetermined criteria. These studies evaluated various interventions, including platelet-rich fibrin, platelet-rich plasma, oxygen-ozone therapy, and different surgical closure techniques. Bayesian network meta-analysis demonstrated no conclusive evidence of superiority for any intervention over primary closure.
CONCLUSION: No preventive strategy demonstrated superiority in reducing the risk of medication-related osteonecrosis of the jaw in patients undergoing tooth extraction.
TRIAL REGISTRATION: International Prospective Register of Systematic Reviews: CRD42024619828.