Barker Kate, Rogers Simon
University Hospital Aintree, Longmoor Lane, Liverpool, UK.
Dent Update. 2006 Jun;33(5):270-2, 275. doi: 10.12968/denu.2006.33.5.270.
Bisphosphonates are used most commonly in the management of metastatic malignant disorders to bone and for osteoporosis. The number of patients on treatment is increasing. Although there is clear evidence of medical efficacy, there are increasing numbers of reports concerning bisphosphonate-associated osteonecrosis of the jaws. This side-effect poses significant problems and is very difficult to treat. The aim of this article is to outline the proposed pathogenesis, incidence, presenting signs and symptoms, and risk factors. Also, suggestions are made as to the most appropriate measures for prevention and management of bisphosphonate-associated jaw osteonecrosis.
General dental practitioners have a key role to play in identifying patients at risk of developing bisphosphonate-associated osteonecrosis of the jaws, preventing occurrence of the condition and initiating early specialist referral.
双膦酸盐最常用于转移性骨恶性疾病和骨质疏松症的治疗。接受治疗的患者数量在增加。尽管有明确的医学疗效证据,但关于双膦酸盐相关颌骨坏死的报告越来越多。这种副作用带来了重大问题且很难治疗。本文旨在概述其推测的发病机制、发病率、临床表现和症状以及危险因素。此外,还就双膦酸盐相关颌骨坏死的预防和管理提出了最合适的措施建议。
普通牙科医生在识别有发生双膦酸盐相关颌骨坏死风险的患者、预防该病发生以及尽早进行专科转诊方面发挥着关键作用。