Current knowledge and future directions on bisphosphonate-related osteonecrosis of the jaw in cancer patients.
作者信息
Adamo Vincenzo, Caristi Nicola, Saccà Marcello Maugeri, Ferraro Giuseppa, Arcanà Concetta, Maisano Roberto, Santini Daniele, Tonini Giuseppe
机构信息
Policlinico Universitario G. Martino, Department of Human Pathology, Medical Oncology and Integrated Therapies Unit, Messina, Italy.
出版信息
Expert Opin Pharmacother. 2008 Jun;9(8):1351-61. doi: 10.1517/14656566.9.8.1351.
BACKGROUND
Bisphosphonate-related osteonecrosis of the jaw (BRONJ) is a severe adverse event of long-term use of bisphosphonates that heavily affects the quality of life of cancer patients.
OBJECTIVE
To review epidemiologic data, pathobiology, risk factors, diagnosis and management of BRONJ.
METHODS
Articles were identified by searching the PubMed and MEDLINE databases and recent meetings abstracts.
RESULTS/CONCLUSION: BRONJ pathobiology is thought to be related to bisphosphonate-induced suppression of normal bone remodeling and impairment of bone blood flow. Dental extractions, daily masticatory traumas, oral infections, chemotherapy and antiangiogenic drugs can also play an active role. Collaboration between oncologists and dentists is essential to prevent BRONJ. A conservative approach based on pain control, oral rinses, antibiotics and limited debridement represents the current management. Optimization of therapy based on reduction of bisphosphonate doses or exposure time, newer bisphosphonates and biomolecular agents could favorably impact on BRONJ incidence.
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