Rayman S, Almas K, Dincer E
Dental Hygiene, Eugenio Maria de Hostos Community College,The City University of New York, New York, NY, USA.
Int J Dent Hyg. 2009 May;7(2):90-5. doi: 10.1111/j.1601-5037.2008.00331.x.
Osteonecrosis means the process of bone death. Bisphosphonates (BPs) are becoming recognized increasingly as having a significant impact on dental treatments. BPs are the most widely used class of anti-resorptive drugs. They prevent bone resorption through osteoclast inhibition and are considered the standard of care for the management of metastatic bone disease. BPs are used for the treatment of skeletal disorders such as osteoporosis, hypercalcaemia of malignancy, osteolytic lesions arising from solid tumours and Paget's disease, breast cancer or prostate cancer. Jaw necrosis appears to be associated with the intravenous (i.v.) use of BPs. The aim of this review paper is to update the understanding of healthcare professionals to the osteonecrosis of jaws, mechanism of action and classification of BPs, management of the patients with BP-related osteonecrosis (BRON) of the jaws. An interdisciplinary approach has been emphasized to prevent and manage the condition. Finally, the role of dental practitioners including dental hygienists has been discussed to early diagnose the BRON and improve the quality of life of patients with the condition.
骨坏死是指骨组织死亡的过程。双膦酸盐（BPs）对牙科治疗的重大影响日益受到认可。双膦酸盐是使用最广泛的一类抗吸收药物。它们通过抑制破骨细胞来防止骨吸收，被认为是转移性骨病治疗的标准用药。双膦酸盐用于治疗骨骼疾病，如骨质疏松症、恶性肿瘤引起的高钙血症、实体瘤和佩吉特病、乳腺癌或前列腺癌引发的溶骨性病变。颌骨坏死似乎与静脉注射双膦酸盐有关。这篇综述文章的目的是更新医疗保健专业人员对颌骨坏死、双膦酸盐的作用机制和分类、颌骨双膦酸盐相关骨坏死（BRON）患者管理的认识。强调采用跨学科方法来预防和管理这种疾病。最后，讨论了包括牙科保健员在内的牙科从业者在早期诊断BRON以及改善该病患者生活质量方面的作用。
