Urade Masahiro
Department of Oral and Maxillofacial Surgery, Hyogo College of Medicine.
Clin Calcium. 2009 Sep;19(9):1332-8.
Bisphosphonate-related osteonecrosis of the jaws (BRONJ) is a newly emerging condition in a long-term administration of mainly intravenous bisphosphonates for the treatment of hypercalcemia associated with malignancy, multiple myeloma, and metastatic breast and prostate cancers. The incidence of BRONJ is not so high, but it is very refractory to ordinary dental treatments, and the bone exposure, a typical symptom, continues for several months. Although many cases of BRONJ have been reported worldwide, the precise pathogenesis remains obscure. Diabetes mellitus (DM) is one of the systemic risk factors contributing in the development of BRONJ. DM is generally associated with microvascular ischemia of the bone, endothelial cell dysfunction, decreased bone turnover and remodeling, resulting in a delayed wound healing and easy to infection. In this issue, the relation of DM as a systemic risk factor with development of BRONJ as well as the incidence, clinical manifestations and prevention and treatment of BRONJ are described.
双膦酸盐相关颌骨坏死（BRONJ）是一种新出现的病症，主要发生在长期静脉注射双膦酸盐以治疗与恶性肿瘤、多发性骨髓瘤以及转移性乳腺癌和前列腺癌相关的高钙血症的过程中。BRONJ的发病率不高，但对普通牙科治疗非常难治，其典型症状骨暴露会持续数月。尽管全球已报道了许多BRONJ病例，但其确切发病机制仍不清楚。糖尿病（DM）是导致BRONJ发生的全身危险因素之一。DM通常与骨微血管缺血、内皮细胞功能障碍、骨转换和重塑减少有关，导致伤口愈合延迟且易感染。在本期中，描述了作为全身危险因素的DM与BRONJ发生的关系以及BRONJ的发病率、临床表现、预防和治疗。
