Kushner George M, Alpert Brian
University of Louisville, School of Dentistry, Louisville, Kentucky 40202, USA.
Curr Opin Otolaryngol Head Neck Surg. 2011 Aug;19(4):302-6. doi: 10.1097/MOO.0b013e328348b257.
The purpose of this article is to review a new pathologic entity named bisphosphonate-related osteonecrosis of the jaws (BRONJ).
BRONJ was observed and first reported in 2001-2002 when clinicians noticed cases of refractory osteomyelitis after simple dental procedures such as dental extractions in patients who had received bisphosphonate therapy. The condition was initially seen in patients who received i.v. bisphosphonates for malignancies such as multiple myeloma and metastatic breast cancer. However, with the use of bisphosphonate therapy for osteoporosis, BRONJ is seen in patients without a cancer diagnosis.
The incidence of BRONJ remains unclear. Treatment recommendations based on sound scientific data are sparse. The management of BRONJ remains a difficult and controversial situation that continues to challenge the clinician.
本文旨在综述一种名为双膦酸盐相关颌骨坏死(BRONJ)的新病理实体。
BRONJ于2001年至2002年被观察到并首次报道,当时临床医生注意到接受双膦酸盐治疗的患者在进行诸如拔牙等简单牙科手术后出现难治性骨髓炎病例。这种情况最初见于接受静脉注射双膦酸盐治疗多发性骨髓瘤和转移性乳腺癌等恶性肿瘤的患者。然而,随着双膦酸盐用于治疗骨质疏松症,在未诊断出癌症的患者中也出现了BRONJ。
BRONJ的发病率仍不清楚。基于可靠科学数据的治疗建议很少。BRONJ的管理仍然是一个困难且有争议的情况,持续挑战着临床医生。