Nicolatou-Galitis Ourania, Papadopoulou Erofili, Sarri Triantafyllia, Boziari Polyxeni, Karayianni Aikaterini, Kyrtsonis Marie-Christine, Repousis Panagiotis, Barbounis Vassilios, Migliorati Cesar A
Dental Oncology Unit, Clinic of Hospital Dentistry, School of Dentistry, University of Athens, Athens, Greece.
Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2011 Aug;112(2):195-202. doi: 10.1016/j.tripleo.2011.02.037. Epub 2011 May 31.
The objectives of this study were to define the incidence, pain, and healing in cancer patients treated with intravenous bisphosphonates.
The study included long-term follow-up of 99 bisphosphonate-using patients (group A) and conservative treatment of 67 patients with bisphosphonate-related osteonecrosis of the jaw (BRONJ, group B) using 3 antibiotic schemes and oral hygiene.
The frequency of zoledronic acid single-agent use was 85.9% and 69.8% in group A and B, respectively. Median follow-up was 13 months (group A) and 16 months (group B). Two patients in group A developed BRONJ (2%). Of those with BRONJ in group B who completed follow-up, healing occurred in 14.9% (7/47) and pain subsided in 80.9% (38/47). Healing was significant in patients who received pamidronate followed by zoledronic acid (P = .023) and with BRONJ stages 0 and stage I (P = .003).
This case series suggests that oral hygiene and conservative antibiotic therapy play a role in healing and pain alleviation in BRONJ. Oral hygiene and follow-up may decrease incidence of BRONJ.
本研究的目的是确定接受静脉注射双膦酸盐治疗的癌症患者的发病率、疼痛情况及愈合情况。
该研究包括对99例使用双膦酸盐的患者（A组）进行长期随访，以及对67例患有双膦酸盐相关颌骨坏死（BRONJ，B组）的患者采用3种抗生素方案并结合口腔卫生进行保守治疗。
A组和B组中唑来膦酸单药使用频率分别为85.9%和69.8%。中位随访时间A组为13个月，B组为16个月。A组有2例患者发生BRONJ（2%）。在B组完成随访的BRONJ患者中，14.9%（7/47）实现愈合，80.9%（38/47）疼痛缓解。接受帕米膦酸后使用唑来膦酸的患者（P = 0.023）以及BRONJ 0期和I期患者（P = 0.003）愈合情况显著。
该病例系列表明，口腔卫生和保守抗生素治疗对BRONJ的愈合和疼痛缓解有作用。口腔卫生和随访可能会降低BRONJ的发病率。
