Rugani Petra, Acham Stephan, Kirnbauer Barbara, Truschnegg Astrid, Obermayer-Pietsch Barbara, Jakse Norbert
Department of Oral Surgery and Radiology, Medical University of Graz, Graz, Austria,
Clin Oral Investig. 2015 Jul;19(6):1329-38. doi: 10.1007/s00784-014-1384-1. Epub 2014 Dec 17.
There is no general consensus for treatment of medication-related osteonecrosis of the jaw (MRONJ). A stage-related approach that primarily aims to minimize morbidity and preserve function was prospectively evaluated.
Treatment goals are stable mucosal closure and absence of clinical symptoms. Patients were enrolled between March 2010 and October 2011. MRONJ lesions were treated either by conservative means or surgically by debridement or resective surgery.
In total, 38 patients were treated. Six patients were healed by undergoing conservative measures; nine were treated palliatively. Four patients dropped out after surgery in the recall phase. In 17 of 19 patients (89.5%) surgical treatment was successful. After a 1-year observation period, the success rate was 92% (23 of 25), including all patients treated as per protocol.
In stage-related treatment, conservative means or surgical debridement can be successful at early stages. Extensive resection is solely indicated in cases of extended necrosis.
The number of patients with MRONJ is steadily increasing. Guidelines to deal with this condition are helpful for both clinicians and dental practitioners.
对于药物相关性颌骨坏死（MRONJ）的治疗尚无普遍共识。前瞻性评估了一种主要旨在将发病率降至最低并保留功能的分期治疗方法。
治疗目标是实现黏膜稳定闭合且无临床症状。患者于2010年3月至2011年10月入组。MRONJ病变采用保守方法治疗，或通过清创术或切除手术进行手术治疗。
共治疗38例患者。6例患者通过保守治疗痊愈；9例接受姑息治疗。4例患者在随访阶段手术后退出。19例患者中有17例（89.5%）手术治疗成功。经过1年观察期，成功率为92%（25例中的23例），包括所有按方案治疗的患者。
在分期治疗中，保守方法或手术清创在早期阶段可能成功。广泛切除仅适用于广泛坏死的病例。
MRONJ患者数量在稳步增加。处理这种情况的指南对临床医生和牙科医生都有帮助。
