Oral Medicine, Oral Pathology and Laser Assisted Surgery Unit, University of Parma, Italy.
Int J Oral Maxillofac Surg. 2011 Mar;40(3):277-84. doi: 10.1016/j.ijom.2010.11.002. Epub 2010 Dec 15.
Bisphosphonates (BPs) are used to treat metabolic bone diseases, such as osteoporosis. In this study the occurrence of bisphosphonates-related osteonecrosis of the jaws (BRONJ) is reported in 25 patients who received BP therapy for osteoporosis with different drug schedules. From June 2005 to May 2009, 25 patients affected by BRONJ were observed. A history of oral surgery was reported for 18 patients (72%). Of the 22 patients treated by the authors, 20 (91%) recorded healing improvement with a mean follow-up of 16.6 months, with particular regard for those treated with oral surgery and laser applications (10/22, 45%) who were all characterised by complete mucosal healing over time. The risk of developing BRONJ in patients treated with BP for osteoporosis is lower than in cancer patients, but is not negligible. It is advisable for the prescribing physician to recommend a dental check-up prior to treatment, at least for patients who have not been to the dentist in the last 12 months. An early surgical and possible laser-assisted approach for patients who develop BRONJ is recommended.
双膦酸盐（BPs）用于治疗代谢性骨疾病，如骨质疏松症。本研究报告了 25 例接受 BP 治疗骨质疏松症的患者发生双膦酸盐相关下颌骨坏死（BRONJ）的情况，这些患者采用了不同的药物治疗方案。2005 年 6 月至 2009 年 5 月，观察了 25 例 BRONJ 患者。18 例患者（72%）有口腔手术史。作者治疗的 22 例患者中，20 例（91%）记录到愈合改善，平均随访 16.6 个月，特别是接受口腔手术和激光治疗的患者（10/22，45%），随着时间的推移，所有患者的黏膜均完全愈合。与癌症患者相比，接受 BP 治疗骨质疏松症的患者发生 BRONJ 的风险较低，但并非可以忽略不计。建议处方医生在治疗前建议进行牙科检查，至少对于过去 12 个月未去看牙医的患者。对于发生 BRONJ 的患者，建议采用早期手术和可能的激光辅助方法。
