Prosthodontics Department, Saraswati Dental College & Hospital, Lucknow, India.
J Prosthodont. 2011 Oct;20(7):601-3. doi: 10.1111/j.1532-849X.2011.00738.x. Epub 2011 Sep 1.
Healthy jawbones ensure better tooth anchorage and the ability to masticate and maintain metabolism. This is achieved by a delicate balance between bone formation and resorption in response to functional demands. An imbalance in the expression of receptor activator of nuclear factor kappa-B (RANK) ligand (RANKL) and osteoprotegerin (OPG) or osteoclastogenesis inhibitory factor (OCIF) is believed to be the underlying mechanism of osteolysis in metastases, multiple myelomas, and cancer therapy-induced bone loss in patients. Considered mainly as bone-specific agents to treat postmenopausal osteoporosis, bisphosphonates, in combination with certain chemotherapeutic agents have proved to be effective in prevention of tumor formation and metastatic osteolysis in bone tissue. Osteonecrosis of the jaws associated with them has, however, been of grave concern to the prosthodontist, as it predisposes patients to a bone-deficient basal seat for dental prostheses. This manuscript reviews available information over the past 13 years on possible mechanisms of bone loss, bisphosphonate-induced osteonecrosis of jaw bones, and prosthodontic concerns.
健康的颌骨确保了更好的牙齿固位和咀嚼能力，并维持新陈代谢。这是通过骨形成和吸收之间的微妙平衡来实现的，以响应功能需求。核因子κB 受体激活剂（RANK）配体（RANKL）和骨保护素（OPG）或破骨细胞生成抑制因子（OCIF）表达的失衡被认为是转移、多发性骨髓瘤和癌症治疗引起的骨丢失中骨溶解的潜在机制。双膦酸盐被认为主要是骨特异性药物，用于治疗绝经后骨质疏松症，与某些化疗药物联合使用已被证明可有效预防肿瘤形成和骨组织中的转移性骨溶解。然而，与它们相关的颌骨坏死已引起修复科医生的严重关注，因为它使患者的牙齿修复基底部骨质不足。本文回顾了过去 13 年关于骨丢失、双膦酸盐引起的颌骨坏死以及修复学关注的可能机制的相关信息。
