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骨质疏松症患者颌骨药物相关性骨坏死:预防与管理

Medication-related osteonecrosis of the jaw in osteoporotic patients: prevention and management.

作者信息

Chan Boon Hui, Yee Ruixiang, Puvanendran Rukshini, Ang Seng Bin

机构信息

Dental Service, KK Women's and Children's Hospital, Singapore.

Family Medicine Service, KK Women's and Children's Hospital, Singapore.

出版信息

Singapore Med J. 2018 Feb;59(2):70-75. doi: 10.11622/smedj.2018014.

Abstract

Osteoporosis is a major, growing healthcare issue. This is especially of concern in an ageing population like that of Singapore. Osteoporotic patients are at risk of fractures, which can result in increased morbidity and mortality. The use of antiresorptive therapy with bisphosphonates or denosumab has been proven to reduce fracture risk. However, the use of these medications has rarely been associated with the development of osteonecrosis of the jaw, a potentially debilitating condition affecting one or both jaws. Appropriate understanding of the patient's antiresorptive therapy regime, as well as early institution of preventive dental measures, can play an important role in preventing medication-related osteonecrosis of the jaw (MRONJ). Regular monitoring and prompt referral to specialist care is warranted for patients with established MRONJ.

摘要

骨质疏松症是一个日益严重的重大医疗保健问题。在像新加坡这样的老龄化人口中,这一问题尤为令人担忧。骨质疏松症患者有骨折风险,这可能导致发病率和死亡率上升。使用双膦酸盐或地诺单抗进行抗吸收治疗已被证明可降低骨折风险。然而,使用这些药物很少与颌骨坏死的发生相关,颌骨坏死是一种可能使人衰弱的疾病,会影响一侧或双侧颌骨。正确了解患者的抗吸收治疗方案,以及尽早采取预防性牙科措施,对于预防药物相关颌骨坏死(MRONJ)可发挥重要作用。对于已确诊MRONJ的患者,有必要进行定期监测并及时转诊至专科治疗。

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