Objective: To explore the high risk factors of bisphosphonates related osteonecrosis of the jaws (BRONJ) and provide the theoretical basis for the prevention of BRONJ. Methods: The risk factors of BRONJ were screened by a conditional logistic regression method, and the relationship between exposure and BRONJ was explored through 1:3 matched incidence group and non-diseased group. Results: The final logistic regres-sion equation variables were the history of tooth extraction and the route of drug administration. The use of bisphosphonates with a history of tooth extraction had 8 times greater risk of BRONJ than without a history of tooth extraction, and the risk was 11 times greater with injection than with oral administration of bisphospho-nates. Conclusion: Tooth extraction and intravenous bisphosphonates are two independent risk factors; patients receiving intravenous bisphosphonates should pay attention to oral invasive operations and avoid tooth extrac-tion surgery.%目的:探索双膦酸盐相关性颌骨坏死(bisphosphonate related osteonecrosis of the jaws,BRONJ)发生的高危风险因素,为BRONJ的预防提供科学依据.方法:通过巢式病例对照研究的方法,以1:3匹配BRONJ发病组和未发病组,使用条件Logistic回归方法筛选BRONJ发病的高危因素,探索暴露因素与BRONJ发生之间关系.结果:最终进入Logistic回归方程变量因素分别为拔牙史和给药途径.有拔牙史的双膦酸盐使用患者罹患BRONJ是无拔牙史患者的8倍,而注射给药是口服给药罹患BRONJ风险的11倍.结论:拔牙和静脉给药是BRONJ发生的两个独立危险因素,双膦酸盐的静脉用药患者更要注意口腔有创操作,避免拔牙手术.
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