双膦酸盐相关颌骨坏死（BRONJ）的诊断指南。
Guidelines for the diagnosis of bisphosphonate-related osteonecrosis of the jaw (BRONJ).
作者信息
Ruggiero Salvatore L
机构信息
Assistant Professor Department of Oral and Maxillofacial Surgery Stony Brook School of Dental Medicine Attending Long Island Jewish Medical Center Division of Oral and Maxillofacial Surgery New Hyde Park, New York, USA.
出版信息
Clin Cases Miner Bone Metab. 2007 Jan;4(1):37-42.
Abstract
Bisphosphonates are a class of agents used to treat osteoporosis and malignant bone metastases. Despite these benefits, osteonecrosis of the jaws has recently emerged as a significant complication in a subset of patients receiving these drugs. Based on a growing number of case reports and institutional reviews, bisphosphonate therapy may cause exposed and necrotic bone that is isolated to the jaw. This complication usually presents following simple dentoalveolar surgery and can cause a significant adverse effect on the quality of life for most patients. The pathogenesis for this complication appears to be related to the profound inhibition of osteoclast function and bone remodeling. This report will review the clinical signs and symptoms and risks associated with this new complication and provide a guideline for establishing a stage-specific diagnosis of BRONJ.
摘要
双膦酸盐是一类用于治疗骨质疏松症和恶性骨转移的药物。尽管有这些益处，但颌骨坏死最近已成为接受这些药物治疗的一部分患者的严重并发症。基于越来越多的病例报告和机构综述，双膦酸盐治疗可能导致局限于颌骨的暴露和坏死骨。这种并发症通常在简单的牙槽外科手术后出现，并且会对大多数患者的生活质量造成重大不利影响。这种并发症的发病机制似乎与破骨细胞功能和骨重塑的深度抑制有关。本报告将回顾与这种新并发症相关的临床体征、症状和风险，并提供建立颌骨坏死分期特异性诊断的指南。
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本文引用的文献
1
Role of ozone therapy in the treatment of osteonecrosis of the jaws in multiple myeloma patients.臭氧疗法在多发性骨髓瘤患者颌骨坏死治疗中的作用
Haematologica. 2007 Sep;92(9):1289-90. doi: 10.3324/haematol.11096.
2
American Association of Oral and Maxillofacial Surgeons position paper on bisphosphonate-related osteonecrosis of the jaws.美国口腔颌面外科医师协会关于双膦酸盐相关颌骨坏死的立场文件。
J Oral Maxillofac Surg. 2007 Mar;65(3):369-76. doi: 10.1016/j.joms.2006.11.003.
3
Ten vs five years of bisphosphonate treatment for postmenopausal osteoporosis: enough of a good thing.绝经后骨质疏松症双膦酸盐治疗十年与五年对比：好事过头亦为患。
JAMA. 2006 Dec 27;296(24):2968-9. doi: 10.1001/jama.296.24.2968.
4
Effects of continuing or stopping alendronate after 5 years of treatment: the Fracture Intervention Trial Long-term Extension (FLEX): a randomized trial.治疗5年后继续或停用阿仑膦酸盐的效果：骨折干预试验长期扩展研究（FLEX）：一项随机试验。
JAMA. 2006 Dec 27;296(24):2927-38. doi: 10.1001/jama.296.24.2927.
5
Osteonecrosis of the jaw--do bisphosphonates pose a risk?颌骨坏死——双膦酸盐会带来风险吗？
N Engl J Med. 2006 Nov 30;355(22):2278-81. doi: 10.1056/NEJMp068157.
6
Osteonecrosis of the jaws in newly diagnosed multiple myeloma patients treated with zoledronic acid and thalidomide-dexamethasone.接受唑来膦酸及沙利度胺-地塞米松治疗的新诊断多发性骨髓瘤患者的颌骨骨坏死
Blood. 2006 Dec 1;108(12):3951-2. doi: 10.1182/blood-2006-07-033571.
7
Bisphosphonate-related osteonecrosis of the jaw: background and guidelines for diagnosis, staging and management.双膦酸盐相关颌骨坏死：背景及诊断、分期与管理指南
Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2006 Oct;102(4):433-41. doi: 10.1016/j.tripleo.2006.06.004. Epub 2006 Jul 31.
8
Mayo clinic consensus statement for the use of bisphosphonates in multiple myeloma.梅奥诊所关于双膦酸盐在多发性骨髓瘤中应用的共识声明。
Mayo Clin Proc. 2006 Aug;81(8):1047-53. doi: 10.4065/81.8.1047.
9
Narrative [corrected] review: bisphosphonates and osteonecrosis of the jaws.叙述性（修正后）综述：双膦酸盐与颌骨坏死
Ann Intern Med. 2006 May 16;144(10):753-61. doi: 10.7326/0003-4819-144-10-200605160-00009.
10
Osteonecrosis of the jaw in multiple myeloma patients: clinical features and risk factors.多发性骨髓瘤患者颌骨骨坏死：临床特征与危险因素
J Clin Oncol. 2006 Feb 20;24(6):945-52. doi: 10.1200/JCO.2005.04.2465.
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