双膦酸盐性颌骨坏死(bisphosphonate-related osteonecrosis of the jaw,BRONJ)是一类因长期使用唑来膦酸、帕米膦酸钠等双膦酸盐类药物所导致的药物并发症。它主要表现为服用双膦酸盐类药物的患者因拔牙等口内手术操作或自发地出现颌...双膦酸盐性颌骨坏死(bisphosphonate-related osteonecrosis of the jaw,BRONJ)是一类因长期使用唑来膦酸、帕米膦酸钠等双膦酸盐类药物所导致的药物并发症。它主要表现为服用双膦酸盐类药物的患者因拔牙等口内手术操作或自发地出现颌骨创口长期不愈、死骨暴露、局部软组织肿胀伴疼痛流脓等症状,影像学特点主要表现为局部片状骨密度增高影及不规则骨破坏影,且随着病变进展越发明显。目前对于该病的诊断及治疗仍未达成一致,笔者就近年来BRONJ的临床研究进展作一阐述。展开更多
Osteonecrosis of the jaw (ONJ) is an adverse effect of nitrogen-containing bisphosphonates. Advancing age, intravenous administration of zoledronic acid (ZOL), history of dento-alveolar surgery, and concomitant system...Osteonecrosis of the jaw (ONJ) is an adverse effect of nitrogen-containing bisphosphonates. Advancing age, intravenous administration of zoledronic acid (ZOL), history of dento-alveolar surgery, and concomitant systemic diseases such as diabetes are known as risk factors for developing ONJ. However, despite numerous studies, the exact pathophysiology remains unclear and management strategies are largely anecdotal. Once-yearly intravenously administered 5 mg ZOL was approved by the US Food and Drug Administration in 2007 for the treatment of osteoporosis and its efficacy with 3 year-regimen had been recently proven in preventing new clinical fracture. Although occurrences of ONJ have been reported to be rare with this drug administration, available data is very limited and long-term outcomes are lacking. We present a case of ONJ identified in an osteopenic patient with an intermittent but long standing sore mouth related to exposed mandibular bone. Once-yearly infusion of zoledronic acid used in the treatment of osteopenia may contribute to the spontaneous development of ONJ, especially in those presenting with multiple comorbidity factors. This report suggests the importance of health care professionals keeping abreast of new developments in this area and providing appropriate information to their patients.展开更多
双膦酸盐类(bisphosphonates,Bps)药物作为一种强有效的抗肿瘤和骨质疏松药广泛应用临床,但其引起的双膦酸盐相关性颌骨坏死(bisphosphonate-related osteonecrosis of the jaw,BRONJ)患者日渐增多,严重影响患者生存质量,国内外尚无有...双膦酸盐类(bisphosphonates,Bps)药物作为一种强有效的抗肿瘤和骨质疏松药广泛应用临床,但其引起的双膦酸盐相关性颌骨坏死(bisphosphonate-related osteonecrosis of the jaw,BRONJ)患者日渐增多,严重影响患者生存质量,国内外尚无有效对策,成为当今口腔医学界急需克服的难题。该文对该疾病的最新研究进展及风险评估进行阐述,以期为临床提供帮助。展开更多
文摘双膦酸盐性颌骨坏死(bisphosphonate-related osteonecrosis of the jaw,BRONJ)是一类因长期使用唑来膦酸、帕米膦酸钠等双膦酸盐类药物所导致的药物并发症。它主要表现为服用双膦酸盐类药物的患者因拔牙等口内手术操作或自发地出现颌骨创口长期不愈、死骨暴露、局部软组织肿胀伴疼痛流脓等症状,影像学特点主要表现为局部片状骨密度增高影及不规则骨破坏影,且随着病变进展越发明显。目前对于该病的诊断及治疗仍未达成一致,笔者就近年来BRONJ的临床研究进展作一阐述。
文摘Osteonecrosis of the jaw (ONJ) is an adverse effect of nitrogen-containing bisphosphonates. Advancing age, intravenous administration of zoledronic acid (ZOL), history of dento-alveolar surgery, and concomitant systemic diseases such as diabetes are known as risk factors for developing ONJ. However, despite numerous studies, the exact pathophysiology remains unclear and management strategies are largely anecdotal. Once-yearly intravenously administered 5 mg ZOL was approved by the US Food and Drug Administration in 2007 for the treatment of osteoporosis and its efficacy with 3 year-regimen had been recently proven in preventing new clinical fracture. Although occurrences of ONJ have been reported to be rare with this drug administration, available data is very limited and long-term outcomes are lacking. We present a case of ONJ identified in an osteopenic patient with an intermittent but long standing sore mouth related to exposed mandibular bone. Once-yearly infusion of zoledronic acid used in the treatment of osteopenia may contribute to the spontaneous development of ONJ, especially in those presenting with multiple comorbidity factors. This report suggests the importance of health care professionals keeping abreast of new developments in this area and providing appropriate information to their patients.
文摘双膦酸盐类(bisphosphonates,Bps)药物作为一种强有效的抗肿瘤和骨质疏松药广泛应用临床,但其引起的双膦酸盐相关性颌骨坏死(bisphosphonate-related osteonecrosis of the jaw,BRONJ)患者日渐增多,严重影响患者生存质量,国内外尚无有效对策,成为当今口腔医学界急需克服的难题。该文对该疾病的最新研究进展及风险评估进行阐述,以期为临床提供帮助。
