Department of Internal Medicine, Maimonides Medical Center, Brooklyn, NY, USA.
Am J Ther. 2009 Jan-Feb;16(1):65-7. doi: 10.1097/MJT.0b013e31817149d6.
Cancer patients receiving bisphosphonate therapy, both intravenously and orally, are predisposed to developing osteonecrosis of the jaw. We present a case of a 66-year-old man with metastatic prostate cancer who spontaneously developed avascular necrosis of the mandible after being on intravenous zoledronic acid for 1 year. Jaw osteonecrosis commonly presents with mild to severe jaw pain. Although most of the reported cases give a history of dental procedures, there have been cases of osteonecrosis developing spontaneously. In cases of established osteonecrosis of the jaw, there is little evidence to suggest that the discontinuation of bisphosphonate therapy aides in healing, as bisphosphonates have a very long half-life in the bone tissue. Treatment measures include evaluation by dental and oncological services, consideration for antibiotic therapy, and mainly a minimally to nonsurgical approach. In the absence of a definitive cure, the emphasis rests greatly on prevention.
接受双膦酸盐治疗的癌症患者，包括静脉内和口服治疗，都有发生颌骨坏死的倾向。我们报告了一例 66 岁的转移性前列腺癌男性患者，在静脉注射唑来膦酸治疗 1 年后，自发发生下颌骨无菌性坏死。颌骨骨坏死通常表现为轻度至重度颌骨疼痛。尽管大多数报道的病例都有牙科手术史，但也有自发发生骨坏死的病例。在已确诊的颌骨骨坏死病例中，几乎没有证据表明停止使用双膦酸盐治疗有助于愈合，因为双膦酸盐在骨组织中的半衰期非常长。治疗措施包括牙科和肿瘤学服务评估、考虑抗生素治疗，主要是采用微创或非手术方法。由于没有明确的治愈方法，因此预防措施非常重要。
