抗骨吸收剂相关的颌骨坏死（ARONJ）是与骨改建药物（BMAs）治疗进展性癌症相关的严重不良事件。虽然许多研究已调查了ARONJ的危险因素，但都未提供足够的澄清。我们旨在确定牙齿拔除治疗前与ARONJ的发展之间是否存在关联。我们纳入了511名在开始BMAs治疗前入院的患者。对ARONJ的发病率及其危险因素进行了回顾性评估，重点关注牙齿拔除治疗前和已拔牙的放射学结果。在511名患者中，135名在接受BMAs治疗前进行了牙齿拔除。观察到ARONJ分别在拔牙组和非拔牙组的患者中发生了17.7%和7.2%（p=0.0002）。关于牙齿拔除前的全景X线检查结果，ARONJ组的根尖周围病变的发生率明显高于非ARONJ组（分别为50%和27%，p=0.034），ARONJ组周围牙齿骨硬化变化的比例明显高于非ARONJ组（分别为58.3%和24.4%，p=0.0004）。有绝望程度需要在BMA治疗之前进行拔除的牙齿是MRONJ的危险因素。然而，应考虑拔除此类牙齿，因为已知这能够降低BMA治疗开始后MRONJ发生的风险。此外，本研究中发现的牙根周围组织病变和拔牙后骨硬化变化的放射学结果可作为ARONJ的新预测因素。版权所有 © 2023. Elsevier Inc. 发表。

Antiresorptive agent-related osteonecrosis of the jaw (ARONJ) is a serious adverse event associated with therapies for advanced cancer involving bone-modifying agents (BMAs). Although many studies have investigated the risk factors for ARONJ, none have provided sufficient clarifications. We aimed to determine whether there is a correlation between tooth extraction before BMA therapy and the development of ARONJ.We included 511 patients who were admitted to our department before BMA therapy. The incidence of ARONJ and its risk factors was retrospectively evaluated, focusing on tooth extraction before BMA therapy and radiological findings of the extracted tooth.Of the 511 patients, 135 underwent tooth extraction before undergoing BMA therapy. ARONJ was observed in 17.7 % and 7.2 % of patients in the extraction and non-extraction groups, respectively (p = 0.0002). Regarding the findings of panoramic radiographs before tooth extraction, the incidence of periapical disease was significantly higher in the ARONJ group than that in the non-ARONJ group (50 % and 27 %, respectively, p = 0.034), and the proportion of bone sclerotic changes in the surrounding teeth was significantly higher in the ARONJ group (58.3 %) than in the non-ARONJ group (24.4 %) (p = 0.0004).The presence of a hopeless tooth that requires extraction prior to BMA therapy is a risk factor for MRONJ. However, extraction of such teeth should be considered, as this is known to decrease the risk of MRONJ development after BMA therapy initiation. Moreover, the radiological findings of periapical disease and bone sclerotic changes in the extracted teeth identified in this study can be used as novel predictive factors for ARONJ.Copyright © 2023. Published by Elsevier Inc.