López-Cedrún J L, Sanromán J F, García A, Peñarrocha M, Feijoo J F, Limeres J, Diz P
Oral and Maxillofacial Surgery Department, "Juan Canalejo" Hospital (CHUAC), La Coruña, Spain.
Br J Oral Maxillofac Surg. 2013 Dec;51(8):874-9. doi: 10.1016/j.bjoms.2013.06.011. Epub 2013 Jul 15.
Bisphosphonates have been associated with a serious adverse reaction known as bisphosphonate-related osteonecrosis of the jaws (BRONJ). The aim of this study was to describe its clinical characteristics in patients with dental implants who were taking bisphosphonates orally. We made a retrospective multicentre study in 3 hospitals in Galicia, Spain. The medical records and clinical and radiological follow-up of the oral cavity were reviewed for those patients given bisphosphonates and diagnosed with BRONJ after the placement of dental implants within the previous 3 years. The series comprised 9 white patients (mean age 66 years). The bisphosphonates were alendronate (n=6), ibandronate (n=2), and risedronate (n=1), and the most common indication was osteoporosis (n=7). The mean interval between the initiation of treatment and the onset of BRONJ lesions was 60 months. Most of the lesions were located around the mandibular implants (n=8). The mean interval between placement of dental implants and the onset of BRONJ was 34 (range 1-96) months. After treatment 7/9 patients recovered completely. The prevalence of BRONJ secondary to treatment with bisphosphonates taken orally after placement of dental implants may be higher than expected in a particular geographical region, but to date specific risk factors have not been identified. Clinical characteristics and the outcomes of treatment of lesions are similar to those seen in patients with BRONJ that is unrelated to placement of dental implants.
双膦酸盐与一种称为双膦酸盐相关颌骨坏死（BRONJ）的严重不良反应有关。本研究的目的是描述口服双膦酸盐的牙种植体患者中BRONJ的临床特征。我们在西班牙加利西亚的3家医院进行了一项回顾性多中心研究。对那些在过去3年内植入牙种植体后接受双膦酸盐治疗并被诊断为BRONJ的患者的病历以及口腔的临床和放射学随访资料进行了回顾。该系列包括9名白人患者（平均年龄66岁）。双膦酸盐为阿仑膦酸钠（n = 6）、伊班膦酸钠（n = 2）和利塞膦酸钠（n = 1），最常见的适应证是骨质疏松症（n = 7）。治疗开始至BRONJ病变出现的平均间隔时间为60个月。大多数病变位于下颌种植体周围（n = 8）。牙种植体植入至BRONJ发生的平均间隔时间为34（范围1 - 96）个月。治疗后7/9的患者完全康复。牙种植体植入后口服双膦酸盐治疗继发BRONJ的患病率在特定地理区域可能高于预期，但迄今为止尚未确定具体的危险因素。病变的临床特征和治疗结果与非牙种植体相关BRONJ患者所见相似。
