Hellstein John W, Marek Cindy L
University of Iowa, USA.
Spec Care Dentist. 2006 Jan-Feb;26(1):8-12. doi: 10.1111/j.1754-4505.2006.tb01503.x.
Patient exposure to bisphosphonate drugs for the management of hypercalcemia of malignancy, osteolytic lesions of metastatic cancer and osteoporosis has led to increasing reports of osteochemonecrosis of the jaws (bis-phossy jaw). This serious and debilitating condition requires dental practitioners to be alert for signs and symptoms of this syndrome. Thus far, nitrogen containing bisphosphonates have been implicated as a causative agent. While only a small fraction of patients who have taken these agents will develop osteochemonecrosis, it seems that patients who have received intravenous bisphosphonates are at greater risk than those who have taken oral agents. Tooth extractions are the most frequently reported predisposing dental procedure. While appropriate management strategies for patients with osteochemonecrosis of the jaws are evolving, we are suggesting rational preventive protocols and therapies based upon current experience and knowledge. These recommendations may change over time as the profession gains more experience in managing these patients.
患者使用双膦酸盐药物治疗恶性肿瘤高钙血症、转移性癌溶骨性病变和骨质疏松症，导致颌骨骨坏死（双膦性颌骨坏死）的报告日益增多。这种严重且使人衰弱的病症要求牙科医生警惕该综合征的体征和症状。迄今为止，含氮双膦酸盐被认为是致病因素。虽然服用这些药物的患者中只有一小部分会发生骨坏死，但接受静脉注射双膦酸盐的患者似乎比口服药物的患者风险更高。拔牙是最常报告的诱发牙科手术。虽然针对颌骨骨坏死患者的适当管理策略正在不断发展，但我们根据目前的经验和知识提出合理的预防方案和治疗方法。随着该行业在管理这些患者方面积累更多经验，这些建议可能会随时间而改变。
