Walter Christian, Sagheb Keyvan, Bitzer Jennifer, Rahimi-Nedjat Roman, Taylor Katherine Joyce
Oral and Maxillofacial Surgery-Plastic Surgery, University Medical Center of the Johannes Gutenberg-University Mainz, Augustusplatz 2, 55131, Mainz, Germany,
Clin Oral Investig. 2014 Dec;18(9):2221-6. doi: 10.1007/s00784-014-1205-6. Epub 2014 Feb 18.
Osteonecroses of the jaws are caused by several reasons. Bisphosphonate-associated osteonecrosis of the jaws (BP-ONJ) is known since 2003 with an increasing incidence in the first years. Along with more knowledge about the pathophysiology, preventive strategies were implemented trying to reduce the incidence. The aim of this retrospective study was to analyze the frequency and overall proportion of BP-ONJ within the field of osteonecrosis. The data was compared to a similar study performed in 2005.
All patients with osteonecrosis or osteomyelitis treated in the period from April 2005 to July 2012 in the Oral and Maxillofacial Surgery at the University of Mainz, Germany, were analyzed.
The reasons for osteonecrosis were bisphosphonates in 45 %, odontogenic or surgically induced osteonecrosis in 32 %, osteoradionecrosis in 17 %, traumas in 1 %, and in 4 % the reason remained unclear. The BP-ONJ became the most important factor for osteonecrosis. Its fraction in the years 2000-2005 was 10 % only.
Although preventive strategies are implemented, the number of new cases got bigger. The implemented prevention strategies did not manage to reduce the overall number of new cases. Furthermore, the launch of other medications with a similar side effect on the jawbone as the BP-ONJ for bisphosphonates might influence the overall distribution of osteonecroses.
颌骨骨坏死由多种原因引起。双膦酸盐相关颌骨骨坏死（BP-ONJ）自2003年被发现，最初几年发病率呈上升趋势。随着对其病理生理学了解的增加，人们实施了预防策略以降低发病率。这项回顾性研究的目的是分析BP-ONJ在骨坏死领域中的发生频率及总体占比。将这些数据与2005年进行的一项类似研究进行比较。
对2005年4月至2012年7月期间在德国美因茨大学口腔颌面外科接受治疗的所有骨坏死或骨髓炎患者进行分析。
骨坏死的原因中，双膦酸盐占45%，牙源性或手术引起的骨坏死占32%，放射性骨坏死占17%，创伤占1%，4%的病因不明。BP-ONJ成为骨坏死最重要的因素。其在2000 - 2005年期间的占比仅为10%。
尽管实施了预防策略，但新病例数量仍在增加。已实施的预防策略未能减少新病例的总数。此外，其他对颌骨有与双膦酸盐类药物导致BP-ONJ类似副作用的药物的推出，可能会影响骨坏死的总体分布情况。
