抗骨吸收藥物或藥物相關顎骨壞死在顎骨之影像學變化

Abstract

本研究的主要目的是找尋服用抗骨吸收藥物、或者發生藥物相關之顎骨壞死的病人放射學影像之客觀量測數據。以期透過這些客觀數據協助醫師早期診斷、擬定治療策略及計畫。資料來源透過回溯性的方式搜集使用藥物前後的環口全景X光影像、以及發生藥物相關之顎骨壞死之錐狀束電腦斷層，分別使用碎形維度以及測量皮質骨厚度並觀察其變化程度與藥物相關之顎骨壞死之發生、藥物種類、藥物使用時間、原發癌症的關係。以目前結果來說，可發現使用抗骨吸收藥物後碎形維度有顯著上升的趨勢，但若發生藥物相關之顎骨壞死碎形維度反而會顯著下降。皮質骨厚度則是於特定區域會呈現相對於控制組有顯著上升的趨勢。這些發現可提供現階段對於服用抗骨吸收藥物、或者發生藥物相關之顎骨壞死的病人另一些客觀數據的評估。但受限於回溯性的研究設計，仍有部分組別無法將條件控制完善，還需要往後更多相關研究來佐證及應用。

The main purpose of this study is to identify objective radiographic measurements in patients who have taken anti-resorptive agents or experienced medication-related osteonecrosis of the jaw (MRONJ). The objective data collected through this study is intended to assist physicians in early diagnosis, treatment planning, and strategy development. The data was retrospectively collected from panoramic radiographs taken before and after drug use and cone-beam computed tomography scans taken after the occurrence of MRONJ. Fractal dimension and cortical bone thickness measurements were used to observe their changes in relation to occurrence of MRONJ, drug type, duration of use, and primary cancer. The results thus far indicate a significant increase in fractal dimension after using anti-resorptive drugs, but a significant decrease in fractal dimension when MRONJ occurs. Moreover, cortical bone thickness shows a significant increase in certain regions compared to the control group. These findings provide additional objective data for evaluating patients who have taken anti-resorptive drugs or experienced MRONJ. However, the retrospective study design is limited, and some groups were not able to control for certain conditions adequately, indicating a need for further relevant research to confirm and apply the findings.