Department of Biologic Materials and Sciences, University of Michigan, Ann Arbor, Michigan 48109, USA.
Curr Opin Support Palliat Care. 2010 Sep;4(3):200-6. doi: 10.1097/SPC.0b013e32833d303b.
Osteonecrosis of the jaw (ONJ) is an uncommon condition noted to occur in patients with cancer who are receiving intravenous bisphosphonates. The cause of ONJ remains unknown. The leading hypotheses addressing the mechanism of ONJ are reviewed here.
The present clinical data suggest that ONJ may occur in approximately 5% of patients with metastatic bone disease. The ability to predict an individual's risk of developing ONJ remains elusive. It is likely that an altered bone microenvironment and/or host defense mechanisms effected by medications used to treat patients with metastatic bone disease contributes to the development of ONJ. Medications that significantly reduce osteoclastic activity are associated with ONJ. Preclinical models of ONJ are being developed but to establish such an intricate systemic condition in animals is challenging.
The ONJ field has progressed via knowledge gained by case reports, population-based studies, and emerging animal models. Still, there are myths that need to be resolved and important clues that need to be investigated. Understanding the pathophysiology of this condition will be critical to improve patient care. Communications between oncologists, dentists, basic scientists, and patients are central to effective treatment and research for this condition.
颌骨骨坏死（ONJ）是一种在接受静脉注射双膦酸盐的癌症患者中发生的罕见疾病。ONJ 的病因仍不清楚。这里回顾了针对 ONJ 发病机制的主要假说。
目前的临床数据表明，大约有 5%的转移性骨疾病患者会发生 ONJ。预测个体发生 ONJ 的风险仍然难以捉摸。患有转移性骨疾病的患者使用的药物改变了骨微环境和/或宿主防御机制，可能导致 ONJ 的发生。显著降低破骨细胞活性的药物与 ONJ 相关。目前正在开发 ONJ 的临床前模型，但在动物中建立如此复杂的系统性疾病具有挑战性。
通过病例报告、基于人群的研究和新兴的动物模型，ONJ 领域取得了进展。尽管如此，仍有一些神话需要解决，还有一些重要的线索需要调查。了解该疾病的病理生理学将是改善患者护理的关键。肿瘤学家、牙医、基础科学家和患者之间的沟通对于这种疾病的有效治疗和研究至关重要。
