Magremanne Michèle, Reychler Hervé
Consultant, Department of Oral and Maxillofacial Surgery, Cancer Center Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, Brussels, Belgium.
Department Head, Department of Oral and Maxillofacial Surgery, Cancer Center Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, Brussels, Belgium.
J Oral Maxillofac Surg. 2014 Feb;72(2):334-7. doi: 10.1016/j.joms.2013.06.188. Epub 2013 Jul 25.
Osteonecrosis of the jaw (ONJ) is a well-known side effect of bisphosphonate (BP) therapy. ONJ is specifically related to the intravenous form of BPs and is usually seen in combination with other risk factors, such as dental surgery, concurrent corticosteroids, chemotherapy, and tobacco use. The risk of developing ONJ in patients treated with oral BPs for osteoporosis is lower than that in patients with cancer but is still significant. Zoledronic acid is a third-generation nitrogen-containing BP. It was first used in the treatment of malignancy as a monthly infusion and then approved for the treatment of osteoporosis as a yearly infusion and is an attractive option that is more reliable than the oral form. ONJ related to the use of yearly zoledronic acid is rarely reported in the literature and is most likely underestimated. Pentoxifylline and tocopherol have been used in the treatment of osteoradionecrosis for many years, with observed lesion improvement. The authors present a case of ONJ development after 3 yearly zoledronic acid infusions for corticosteroid-induced osteoporosis. The patient was successfully managed using conservative treatment with pentoxifylline and tocopherol.
颌骨骨坏死（ONJ）是双膦酸盐（BP）治疗众所周知的副作用。ONJ与静脉注射形式的BP特别相关，通常与其他风险因素同时出现，如牙科手术、同时使用皮质类固醇、化疗和吸烟。接受口服BP治疗骨质疏松症的患者发生ONJ的风险低于癌症患者，但仍然显著。唑来膦酸是第三代含氮BP。它最初作为每月一次的静脉输注用于治疗恶性肿瘤，然后作为每年一次的静脉输注被批准用于治疗骨质疏松症，是一种比口服形式更可靠的有吸引力的选择。与每年使用唑来膦酸相关的ONJ在文献中很少报道，很可能被低估。己酮可可碱和生育酚已用于治疗放射性骨坏死多年，观察到病变有所改善。作者报告了一例因皮质类固醇诱导的骨质疏松症每年接受3次唑来膦酸静脉输注后发生ONJ的病例。该患者通过使用己酮可可碱和生育酚的保守治疗成功治愈。
