Utreja A, Almas K, Javed F
Division of Orthodontics, Dpt of Craniofacial Sciences, School of Dental Medicine, Univ. of Connecticut Health Center, Farmington, USA.
Odontostomatol Trop. 2013 Jun;36(142):38-46.
Osteonecrosis of the jaw (ONJ) is a complication related to the use of bisphosphonates (BPs). Patients receiving BPs for the treatment of malignancies are at an increased risk of developing bisphosphonate-related ONJ (BRONJ) as compared to patients receiving BPs for the treatment of other disorders such as osteoporosis. Additionally, tooth extractions have been suggested to increase the risk of BRONJ in individuals taking BPs.
To review the role of dental extraction as a risk factor for BRONJ in cancer patients.
Databases were searched from January 1999 up to and including July 2012 using various combinations of the following keywords: "bisphosphonate", "osteonecrosis of the jaw", "cancer", "oral" and "dental extraction".
Twenty two studies were included. Eighteen studies assessed the relationship between BRONJ and dental extractions in cancer patients, reporting the overall prevalence of BRONJ following extraction in this group as 3.25 +/- 2.23%. Four studies did not report a correlation between BRONJ and extractions, and recommended protocols to avoid the complication.
There is a plausible relationship between dental extractions and the development of BRONJ in cancer patients. Written informed consent must be obtained prior to dental procedures in patients at risk for developing BRONJ.
颌骨坏死（ONJ）是一种与双膦酸盐（BP）使用相关的并发症。与接受BP治疗骨质疏松等其他疾病的患者相比，接受BP治疗恶性肿瘤的患者发生双膦酸盐相关颌骨坏死（BRONJ）的风险增加。此外，拔牙被认为会增加服用BP个体发生BRONJ的风险。
综述拔牙作为癌症患者发生BRONJ的危险因素的作用。
使用以下关键词的各种组合，对1999年1月至2012年7月（含）的数据库进行检索：“双膦酸盐”、“颌骨坏死”、“癌症”、“口腔”和“拔牙”。
纳入22项研究。18项研究评估了癌症患者中BRONJ与拔牙之间的关系，报告该组拔牙后BRONJ的总体患病率为3.25±2.23%。4项研究未报告BRONJ与拔牙之间的相关性，并推荐了避免该并发症的方案。
拔牙与癌症患者发生BRONJ之间存在合理的关系。对于有发生BRONJ风险的患者，在进行牙科手术前必须获得书面知情同意。
