{"created":"2023-06-20T14:29:05.633420+00:00","id":5092,"links":{},"metadata":{"_buckets":{"deposit":"6dceb9a1-d88b-49e3-b89b-dc70d37a6399"},"_deposit":{"created_by":14,"id":"5092","owners":[14],"pid":{"revision_id":0,"type":"depid","value":"5092"},"status":"published"},"_oai":{"id":"oai:dmu.repo.nii.ac.jp:00005092","sets":["81:226"]},"author_link":["9945","4387","46621","55","46614","10429","122","46616","46611","10633","128","46619","7294","46620","46612","46617","46613","46615","46618","58"],"item_10001_biblio_info_7":{"attribute_name":"書誌情報","attribute_value_mlt":[{"bibliographicIssueDates":{"bibliographicIssueDate":"2021-10-25","bibliographicIssueDateType":"Issued"},"bibliographicIssueNumber":"3","bibliographicPageEnd":"218","bibliographicPageStart":"211","bibliographicVolumeNumber":"48","bibliographic_titles":[{"bibliographic_title":"Dokkyo Journal of Medical Sciences"}]}]},"item_10001_description_34":{"attribute_name":"要旨","attribute_value_mlt":[{"subitem_description":"　薬剤関連顎骨壊死（以下，MRONJ）の治療では積極的に外科療法を推奨する報告が多くみられる一方，保存療法に関して有効性や治療成績を示した報告は少ない．われわれはMRONJ治療の現状について臨床統計学的に解析し，保存療法の治療効果と限界および外科療法への切り替え時期について検討を行った．\n対象は，2008年から2020年までに当科で治療を行ったMRONJ患者157例（男性44例，女性113例，平均年齢74歳）とした．\n　保存療法と外科療法の治療効果比較では，保存療法の有効率（61.7％），治癒率（38.3％）に対し外科療法の有効率，治癒率はともに94.4％と有意に高い治療効果を示していた（P＜0.001）．単変量・多変量解析における有効/無効での比較では，初診時stageが，また治癒/未治癒の比較では，初診時stageと原疾患がそれぞれ治療効果と有意に相関していた．\n　MRONJの初診時stageが保存療法の治療効果に有意に関連しており，初診時stage 0/1症例や骨粗鬆症症例に対しては早期の外科療法にこだわらず，保存療法単独でも治癒が期待できる可能性があると考えられた．その一方で，初診時stage 2/3や悪性腫瘍症例では最終的に外科療法の適用を考慮すべきであり，十分な保存療法を継続しながら外科療法の導入を適切に判断する必要があると考えられた．","subitem_description_type":"Other"}]},"item_10001_description_35":{"attribute_name":"要旨(英)","attribute_value_mlt":[{"subitem_description":"  Surgical treatment for medication-related osteonecrosis of the jaw（MRONJ）is widely recommended, but few reports have examined the outcomes of conservative treatment.\nWe performed a retrospective cohort study to investigate the therapeutic effects and limitations of conservative therapy and the timing of switching to surgical therapy for MRONJ. The subjects were 157 patients（44 males, 113 females, average age 74 years）with MRONJ treated at the Department of Oral and Maxillofacial Surgery, Dokkyo Medical University School of Medicine from\n2008 to 2020.\n  We evaluated the effectiveness of treatment based on the change in stage；“healing”：shift to stage 0 or below, “improvement”：down staging, and further classified the sum of healing and improvement as“ efficacy”.\n  The outcomes were significantly better in surgical treatment compared to conservative treatment（efficacy rate： 9 4 . 4％ vs. 6 1 . 7％, healing rate：9 4 . 4％ vs. 3 8 . 3％, P＜ 0.001）. In univariate and multivariate analyses, stage at primary diagnosis was significantly correlated with treatment efficacy；and both stage at primary diagnosis and underlying disease were significantly correlated with healing. Stage at primary diagnosis was also significantly related to the therapeutic effect of conservative treatment. Patients with stage 0/1 osteoporosis were cured by conservative treatment alone without early surgery, whereas stage 2/3 cases and patients with malignant tumors should be considered for surgery. These findings indicate\nthe need to make an appropriate decision on the introduction of surgical treatment while continuing with adequate conservative treatment.","subitem_description_type":"Other"}]},"item_10001_publisher_8":{"attribute_name":"出版者","attribute_value_mlt":[{"subitem_publisher":"獨協医学会"}]},"item_10001_source_id_11":{"attribute_name":"書誌レコードID","attribute_value_mlt":[{"subitem_source_identifier":"AA00629581","subitem_source_identifier_type":"NCID"}]},"item_10001_source_id_9":{"attribute_name":"ISSN","attribute_value_mlt":[{"subitem_source_identifier":"03855023","subitem_source_identifier_type":"ISSN"}]},"item_10001_text_24":{"attribute_name":"著者所属","attribute_value_mlt":[{"subitem_text_value":"獨協医科大学 口腔外科学"},{"subitem_text_value":"獨協医科大学 口腔外科学"},{"subitem_text_value":"獨協医科大学 口腔外科学,上都賀総合病院 歯科口腔外科"},{"subitem_text_value":"獨協医科大学 口腔外科学"},{"subitem_text_value":"獨協医科大学 口腔外科学, 菅間記念病院 歯科口腔外科"},{"subitem_text_value":"獨協医科大学 口腔外科学"},{"subitem_text_value":"獨協医科大学 口腔外科学"},{"subitem_text_value":"獨協医科大学 口腔外科学"},{"subitem_text_value":"獨協医科大学 口腔外科学"},{"subitem_text_value":"獨協医科大学 口腔外科学"}]},"item_10001_text_25":{"attribute_name":"著者所属(英)","attribute_value_mlt":[{"subitem_text_language":"en","subitem_text_value":"Department of Oral and Maxillofacial Surgery, Dokkyo Medical University School of Medicine"},{"subitem_text_language":"en","subitem_text_value":"Department of Oral and Maxillofacial Surgery, Dokkyo Medical University School of Medicine"},{"subitem_text_language":"en","subitem_text_value":"Department of Oral and Maxillofacial Surgery, Dokkyo Medical University School of Medicine, Section of Dentistry and Oral and Maxillofacial Surgery, Kamitsuga General Hospital"},{"subitem_text_language":"en","subitem_text_value":"Department of Oral and Maxillofacial Surgery, Dokkyo Medical University School of Medicine"},{"subitem_text_language":"en","subitem_text_value":"Department of Oral and Maxillofacial Surgery, Dokkyo Medical University School of Medicine, Section of Dentistry and Oral and Maxillofacial Surgery, Kamma Memorial Hospital"},{"subitem_text_language":"en","subitem_text_value":"Department of Oral and Maxillofacial Surgery, Dokkyo Medical University School of Medicine"},{"subitem_text_language":"en","subitem_text_value":"Department of Oral and Maxillofacial Surgery, Dokkyo Medical University School of Medicine"},{"subitem_text_language":"en","subitem_text_value":"Department of Oral and Maxillofacial Surgery, Dokkyo Medical University School of Medicine"},{"subitem_text_language":"en","subitem_text_value":"Department of Oral and Maxillofacial Surgery, Dokkyo Medical University School of Medicine"},{"subitem_text_language":"en","subitem_text_value":"Department of Oral and Maxillofacial Surgery, Dokkyo Medical University School of Medicine"}]},"item_10001_text_33":{"attribute_name":"記事種別","attribute_value_mlt":[{"subitem_text_value":"原著"}]},"item_creator":{"attribute_name":"著者","attribute_type":"creator","attribute_value_mlt":[{"creatorNames":[{"creatorName":"俵藤, 俊暉"}],"nameIdentifiers":[{"nameIdentifier":"46611","nameIdentifierScheme":"WEKO"}]},{"creatorNames":[{"creatorName":"福本, 正知"}],"nameIdentifiers":[{"nameIdentifier":"10429","nameIdentifierScheme":"WEKO"}]},{"creatorNames":[{"creatorName":"澤谷, 祐大"}],"nameIdentifiers":[{"nameIdentifier":"9945","nameIdentifierScheme":"WEKO"}]},{"creatorNames":[{"creatorName":"上村, 亮太"}],"nameIdentifiers":[{"nameIdentifier":"46612","nameIdentifierScheme":"WEKO"}]},{"creatorNames":[{"creatorName":"大島, 遼"}],"nameIdentifiers":[{"nameIdentifier":"46613","nameIdentifierScheme":"WEKO"}]},{"creatorNames":[{"creatorName":"長谷川, 智則"}],"nameIdentifiers":[{"nameIdentifier":"7294","nameIdentifierScheme":"WEKO"}]},{"creatorNames":[{"creatorName":"泉, さや香"}],"nameIdentifiers":[{"nameIdentifier":"4387","nameIdentifierScheme":"WEKO"}]},{"creatorNames":[{"creatorName":"藤田, 温志"}],"nameIdentifiers":[{"nameIdentifier":"10633","nameIdentifierScheme":"WEKO"}]},{"creatorNames":[{"creatorName":"和久井, 崇大"}],"nameIdentifiers":[{"nameIdentifier":"122","nameIdentifierScheme":"WEKO"}]},{"creatorNames":[{"creatorName":"川又, 均"}],"nameIdentifiers":[{"nameIdentifier":"55","nameIdentifierScheme":"WEKO"}]},{"creatorNames":[{"creatorName":"Hyodo, Toshiki ","creatorNameLang":"en"}],"nameIdentifiers":[{"nameIdentifier":"46614","nameIdentifierScheme":"WEKO"}]},{"creatorNames":[{"creatorName":"Fukumoto, Chonji ","creatorNameLang":"en"}],"nameIdentifiers":[{"nameIdentifier":"46615","nameIdentifierScheme":"WEKO"}]},{"creatorNames":[{"creatorName":"Sawatani, Yuta","creatorNameLang":"en"}],"nameIdentifiers":[{"nameIdentifier":"46616","nameIdentifierScheme":"WEKO"}]},{"creatorNames":[{"creatorName":"Kamimura, Ryouta ","creatorNameLang":"en"}],"nameIdentifiers":[{"nameIdentifier":"46617","nameIdentifierScheme":"WEKO"}]},{"creatorNames":[{"creatorName":"Oshima, Ryo","creatorNameLang":"en"}],"nameIdentifiers":[{"nameIdentifier":"46618","nameIdentifierScheme":"WEKO"}]},{"creatorNames":[{"creatorName":"Hasegawa, Tomonori ","creatorNameLang":"en"}],"nameIdentifiers":[{"nameIdentifier":"46619","nameIdentifierScheme":"WEKO"}]},{"creatorNames":[{"creatorName":"Izumi, Sayaka ","creatorNameLang":"en"}],"nameIdentifiers":[{"nameIdentifier":"46620","nameIdentifierScheme":"WEKO"}]},{"creatorNames":[{"creatorName":"Fujita, Atsushi","creatorNameLang":"en"}],"nameIdentifiers":[{"nameIdentifier":"46621","nameIdentifierScheme":"WEKO"}]},{"creatorNames":[{"creatorName":"Wakui, Takahiro","creatorNameLang":"en"}],"nameIdentifiers":[{"nameIdentifier":"128","nameIdentifierScheme":"WEKO"}]},{"creatorNames":[{"creatorName":"Kawamata, Hitoshi","creatorNameLang":"en"}],"nameIdentifiers":[{"nameIdentifier":"58","nameIdentifierScheme":"WEKO"}]}]},"item_files":{"attribute_name":"ファイル情報","attribute_type":"file","attribute_value_mlt":[{"accessrole":"open_date","date":[{"dateType":"Available","dateValue":"2022-02-08"}],"displaytype":"detail","filename":"DJMS-48-3-10.pdf","filesize":[{"value":"338.9 kB"}],"format":"application/pdf","licensetype":"license_note","mimetype":"application/pdf","url":{"label":"DJMS-48-3-儀藤-本文","url":"https://dmu.repo.nii.ac.jp/record/5092/files/DJMS-48-3-10.pdf"},"version_id":"8acaef69-e00e-443b-83a5-a8a4b93cebf6"}]},"item_keyword":{"attribute_name":"キーワード","attribute_value_mlt":[{"subitem_subject":"MRONJ","subitem_subject_scheme":"Other"},{"subitem_subject":"顎骨壊死","subitem_subject_scheme":"Other"},{"subitem_subject":"骨吸収抑制薬","subitem_subject_scheme":"Other"},{"subitem_subject":"保存療法","subitem_subject_scheme":"Other"},{"subitem_subject":"外科療法","subitem_subject_scheme":"Other"},{"subitem_subject":"MRONJ（medication-related osteonecrosis of the jaw）","subitem_subject_language":"en","subitem_subject_scheme":"Other"},{"subitem_subject":"osteonecrosis of the jaw","subitem_subject_language":"en","subitem_subject_scheme":"Other"},{"subitem_subject":"bone resorption inhibitor","subitem_subject_language":"en","subitem_subject_scheme":"Other"},{"subitem_subject":"conservative therapy","subitem_subject_language":"en","subitem_subject_scheme":"Other"},{"subitem_subject":"surgical therapy","subitem_subject_language":"en","subitem_subject_scheme":"Other"}]},"item_language":{"attribute_name":"言語","attribute_value_mlt":[{"subitem_language":"jpn"}]},"item_resource_type":{"attribute_name":"資源タイプ","attribute_value_mlt":[{"resourcetype":"journal article","resourceuri":"http://purl.org/coar/resource_type/c_6501"}]},"item_title":"薬剤関連顎骨壊死における ─保存療法の効果と限界および外科療法への切り替え時期の検討─","item_titles":{"attribute_name":"タイトル","attribute_value_mlt":[{"subitem_title":"薬剤関連顎骨壊死における ─保存療法の効果と限界および外科療法への切り替え時期の検討─"},{"subitem_title":"Outcomes and Limitations of Conservative treatment and Timing of Switching to Surgical Treatment for Medication-Related Osteonecrosis of the Jaw","subitem_title_language":"en"}]},"item_type_id":"10001","owner":"14","path":["226"],"publish_date":"2022-02-08","publish_status":"0","recid":"5092","relation_version_is_last":true,"title":["薬剤関連顎骨壊死における ─保存療法の効果と限界および外科療法への切り替え時期の検討─"],"weko_creator_id":"14","weko_shared_id":-1},"updated":"2023-06-20T14:50:21.481778+00:00"}