Shah N P, Nayee S, Pazianas M, Sproat C
Royal London Hospital, London.
Oral Medicine Dept. of Oral Medicine, Guy's Hospital London, SE1 9RT.
Br Dent J. 2017 May 12;222(9):727-730. doi: 10.1038/sj.bdj.2017.412.
There is evidence, although limited, for beneficial effects of bisphophonates (BPs) across multiple dental specialties. Within implant dentistry BP coatings have been shown to significantly increase pull out forces and bone density in animal models, and significantly increase implant stability whilst reducing marginal bone loss in humans. Adjunctive topical and systemic application of BPs during conventional periodontal treatment have shown significant improvements in probing depth and clinical attachment level in various forms of periodontal disease. Within orthodontics, BPs have been shown to significantly reduce root resorption and have benefits with respect to anchorage maintenance. Case reports have suggested the use of BPs in the management of diffuse sclerosing osteomylitis. Whilst this review highlights these potential benefits and acknowledges there are no reported cases of osteonecrosis of the jaw associated with locally applied BP, there remains a paucity of human and long-term studies exploring BPs in the context of significant clinical benefit. Further human studies are required to understand the long-term clinical outcomes of these drugs when used as primary therapeutic agents, or adjuncts to conventional treatment.
有证据表明（尽管有限），双膦酸盐（BPs）在多个牙科专业领域具有有益作用。在种植牙科领域，在动物模型中，BP涂层已被证明可显著增加拔出力和骨密度，在人类中可显著提高种植体稳定性，同时减少边缘骨丢失。在传统牙周治疗期间辅助局部和全身应用BPs，已显示在各种形式的牙周病中，探诊深度和临床附着水平有显著改善。在正畸领域，BPs已被证明可显著减少牙根吸收，并在支抗维持方面有好处。病例报告表明BPs可用于弥漫性硬化性骨骨髓炎的治疗。虽然本综述强调了这些潜在益处，并承认没有报告与局部应用BP相关的颌骨坏死病例，但在显著临床获益背景下探索BPs的人体和长期研究仍然匮乏。需要进一步的人体研究来了解这些药物作为主要治疗剂或传统治疗辅助剂使用时的长期临床结果。
