Franken Anton A M, van Blijderveen Nico J C, Witjes Max J H, Netelenbos Coen J C
Isala Klinieken, Zwolle, the Netherlands.
Ned Tijdschr Geneeskd. 2011;155:A3077.
Osteonecrosis of the jaw in association with long-term use of bisphosphonates (BRONJ) is a relatively rare but serious side effect that is difficult to treat. The incidence of BRONJ in patients treated for osteoporosis is low at 0.1%. The incidence in cancer patients treated with high doses of intravenous bisphosphonates is higher, ranging between 3% and 10%. Risk factors for BRONJ are invasive treatments such as tooth extractions, root canal procedures and the placement of dental implants, as well as trauma caused by pressure from poorly fitting dental prostheses. High-risk patients should be examined by a dentist or an oral surgeon and, if necessary, undergo dental treatment prior to treatment with bisphosphonates. All patients taking bisphosphonates should maintain good oral hygiene, receive regular dental examinations and see a dentist if any oral symptoms develop. Physicians who prescribe medication as well as the patient's dentist and oral surgeon should be aware of the use of bisphosphonates and BRONJ as a possible adverse reaction. This requires cooperation and the exchange of information between a patient's health care providers.
与长期使用双膦酸盐相关的颌骨坏死（BRONJ）是一种相对罕见但严重的副作用，难以治疗。接受骨质疏松症治疗的患者中BRONJ的发生率较低，为0.1%。接受高剂量静脉注射双膦酸盐治疗的癌症患者中发生率较高，在3%至10%之间。BRONJ的危险因素包括侵入性治疗，如拔牙、根管治疗和牙种植体植入，以及不合适的假牙施加压力造成的创伤。高危患者应由牙医或口腔外科医生进行检查，必要时在使用双膦酸盐治疗前接受牙科治疗。所有服用双膦酸盐的患者都应保持良好的口腔卫生，定期接受牙科检查，出现任何口腔症状时应就医。开药的医生以及患者的牙医和口腔外科医生应了解双膦酸盐的使用情况以及BRONJ这种可能的不良反应。这需要患者的医疗服务提供者之间进行合作和信息交流。
