Response of Different Treatment Protocols to Treat Chronic Non-Bacterial Osteomyelitis (CNO) of the Mandible in Adult Patients: A Systematic Review
Abstract
:1. Introduction
2. Methods
2.1. Eligibility Criteria
2.2. Information Sources
2.3. Study Selection
2.4. Data Collection Process and Items
2.5. Risk of Bias within Studies
3. Results
3.1. Study Selection
3.2. Study Characteristics
3.3. Risk of Bias within Studies
4. Discussion
4.1. Follow-Up
4.2. Surgical Therapy
4.3. Pharmacological Therapy
4.4. Antibiotics
4.5. Antiresorptive Drugs
4.6. Use of NSAIDs
4.7. Nomenclature Recommendation
4.8. Limitations of the Review
5. Conclusions
Author Contributions
Funding
Conflicts of Interest
References
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P | #1 | ((mandible) OR mandibular) OR jaw | 180,180 |
I | #2 | (((((((((osteomyelitis [MeSH Terms]) OR "diffuse sclerosing osteomyelitis") OR "chronic non-bacterial osteomyelitis") OR CNO) OR DSO) OR PCO) OR SAPHO) OR CRMO)) | 28,673 |
O | #3 | ((((treatment) OR therapy) OR follow-up) OR outcome) | 10,715,195 |
P+I+O | #1+ #2+ #3 | ((((((((((((osteomyelitis [MeSH Terms]) OR "diffuse sclerosing osteomyelitis") OR "chronic non-bacterial osteomyelitis") OR CNO) OR DSO) OR PCO) OR SAPHO) OR CRMO)))) AND (((mandible) OR mandibular) OR jaw)) AND ((((treatment) OR therapy) OR follow-up) OR outcome) | 1141 |
Authors | Country | Study design | Patients (n) | Term | Gender | Age | Symptoms |
---|---|---|---|---|---|---|---|
Jacobsson and Hollender. [23] | Sweden | Retrospective study | 11 | DSO | F (7), M (4) | 22–53 | Pain, swelling, trismus, ankylosis from TMJ |
Kuijpers et al. [24] | Netherlands | Retrospective study | 6 | DSO | F (5), M (1) | 23–78 | |
Montonen et al. [25] | Finland | Prospective, randomized, double-blind and placebo controlled. | 10 | DSO | F (8), M (2) | 31–77 | Pain |
Yoshii et al. [19] | Japan | Retrospective study | 9 | DSOM | F (5), M (4) | 19–70 | Pain, swelling, trismus |
Authors | Imaging | Previous Treatment | Treatment | Therapeutic Regime | Outcome | Follow-Up |
---|---|---|---|---|---|---|
Jacobsson and Hollender. [23] | Radiographic and scintigraphic examinations | Short- and long-term antibiotic therapy, decortication, tooth extraction | Decortication (7), excision, resection, antibiotics, cortisone | Predinisolone 20/5 mg (12 d), penicillin (3 months) | Long-term antibiotic therapy decreased the interval between exacerbations and pain/decortication ceased the symptoms for 6–12 months | 3–19 y |
Kuijpers et al. [24] | Panoramic radiograph, CT | Analgesics (acetaminophen, NSAIDs), antibiotics (e.g., doxycycline, amoxicillin, vibramycin, clindamycin), physiotherapy, corticosteroids and/or surgery | Bisphosphonate (intravenous dose of 15 mg pamidronate, 3–5 d) | - | Symptoms decreased or disappeared | 18–46 months |
Montonen et al. [25] | Radiological examinations, scintigraphy and orthopantomography | Conservative or surgical therapy | Bisphosphonate | Disodiumclodronate (300 to 900 mg) or placebo intravenously | There was a greater pain relief after 6 em of treatment with bisphosphonate | 12 months |
Yoshii et al. [19] | Radiographic imaging | Surgical treatment | Long-term roxithromycin | 300 mg, oral, daily, 68 d–66 months | Pain was reduced and ceased completely in 7 of 9 patients | 12 months |
Risk of bias assessment | Jacobsson et al. | Kuijpers et al. | Montonen et al. | Yoshii et al. | Total |
---|---|---|---|---|---|
A clearly stated aim | 1 | 0 | 2 | 1 | 4 |
Inclusion of consecutive patients | 1 | 1 | 2 | 2 | 6 |
Prospective collection of data | 0 | 1 | 2 | 0 | 3 |
Endpoints appropriate to the aim of the study | 1 | 1 | 1 | 1 | 4 |
Unbiased assessment of the study endpoint | 0 | 0 | 2 | 1 | 3 |
Follow-up period appropriate to the aim of the study | 1 | 1 | 2 | 1 | 5 |
Loss to follow-up less than 5% | 2 | 1 | 2 | 2 | 7 |
Prospective calculation of the study size | 0 | 0 | 0 | 0 | 0 |
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Timme, M.; Bohner, L.; Huss, S.; Kleinheinz, J.; Hanisch, M. Response of Different Treatment Protocols to Treat Chronic Non-Bacterial Osteomyelitis (CNO) of the Mandible in Adult Patients: A Systematic Review. Int. J. Environ. Res. Public Health 2020, 17, 1737. https://doi.org/10.3390/ijerph17051737
Timme M, Bohner L, Huss S, Kleinheinz J, Hanisch M. Response of Different Treatment Protocols to Treat Chronic Non-Bacterial Osteomyelitis (CNO) of the Mandible in Adult Patients: A Systematic Review. International Journal of Environmental Research and Public Health. 2020; 17(5):1737. https://doi.org/10.3390/ijerph17051737
Chicago/Turabian StyleTimme, Maximilian, Lauren Bohner, Sebastian Huss, Johannes Kleinheinz, and Marcel Hanisch. 2020. "Response of Different Treatment Protocols to Treat Chronic Non-Bacterial Osteomyelitis (CNO) of the Mandible in Adult Patients: A Systematic Review" International Journal of Environmental Research and Public Health 17, no. 5: 1737. https://doi.org/10.3390/ijerph17051737