Department of Head and Neck Surgery, Tata Memorial Hospital, Mumbai, India.
Eur J Surg Oncol. 2010 Jun;36(6):541-5. doi: 10.1016/j.ejso.2009.12.003. Epub 2010 Jan 13.
To highlight the misdiagnosis or delay in the detection of Bisphosphonate induced necrosis of Jaw (BINJ). It is associated with prolonged administration of intravenous bisphosphonates that are routinely used in the management of osteoporosis, Paget's disease, Multiple Myeloma, bone metastases. It improves quality of life, delays the skeletal complication, decreases the pain and hypercalcemia.
We prospectively collected data of those patients who were receiving bisphosphonates for management of their primary illness and developed BINJ. This pathology being a new entity most oncologists are still ignorant about its existence.
Use of intravenous bisphosphanates can lead to BINJ which may mimic malignancy or metastasis. None of our patients were counseled, oncologists did not perform routine oral examinations, dentists went ahead with unwarranted interventions, radiologist raised false alarm and oral surgeons undertook unnecessary biopsies. Misled by clinical presentation and radiological appearance, all patients were initially misdiagnosed and underwent unwarranted interventions.
A careful dental clinical examination and appropriate imaging study is recommended before starting bisphosphonate therapy. The doctors prescribing Bisphosphonates especially intravenous preparations should not only counsel the patients but also routinely examine patient's oral cavity.
强调双膦酸盐引起的下颌骨坏死（BINJ）的误诊或漏诊。它与长期静脉内使用双膦酸盐有关，这些药物通常用于治疗骨质疏松症、佩吉特病、多发性骨髓瘤、骨转移。它可以提高生活质量、延缓骨骼并发症、减轻疼痛和高钙血症。
我们前瞻性地收集了那些因原发性疾病而接受双膦酸盐治疗并发生 BINJ 的患者的数据。这种病理学是一种新的实体，大多数肿瘤学家仍然不知道它的存在。
静脉内使用双膦酸盐可导致 BINJ，其可能类似于恶性肿瘤或转移。我们的患者都没有接受咨询，肿瘤学家没有进行常规口腔检查，牙医进行了不必要的干预，放射科医生发出了错误的警报，口腔外科医生进行了不必要的活检。由于临床表现和影像学表现的误导，所有患者最初都被误诊并进行了不必要的干预。
在开始双膦酸盐治疗之前，建议进行仔细的口腔临床检查和适当的影像学研究。开具双膦酸盐特别是静脉制剂的医生不仅应告知患者，还应常规检查患者的口腔。
