J Am Dent Assoc. 2018 May;149(5):382-391. doi: 10.1016/j.adaj.2017.12.028.
The purpose of this study was to evaluate whether intravenous (IV) bisphosphonate (BP) therapy can change the radiographic patterns of multiple myeloma (MM) in the jawbones.
The authors evaluated panoramic radiographs obtained from 188 patients with MM for the presence of solitary osteolytic lesions, multiple osteolytic lesions, diffuse osteoporosis, diffuse sclerosis, lamina dura abnormalities, nonhealing alveolar sockets, and bone sequestration. The authors compared results obtained from patients treated with IV BPs with those obtained from patients who had never been exposed to BPs.
Multiple osteolytic lesions (P = .001), diffuse osteoporosis (P = .001), and diffuse sclerosis (P = .0036) occurred more often in the mandible in both groups. Solitary osteolytic lesions occurred less frequently in the BP group (P = .0078). Lamina dura abnormalities (P = .0006) and nonhealing alveolar sockets (P = .0021) were associated with BP treatment.
IV BP therapy changes the radiographic patterns of MM in the jawbones.
The effect of BPs in the maxillofacial area is a matter of concern for health practitioners because this type of medication causes several alterations of the jawbones in patients with cancer.
本研究旨在评估静脉（IV）双膦酸盐（BP）治疗是否会改变颌骨多发性骨髓瘤（MM）的影像学表现。
作者评估了 188 例 MM 患者的全景片，以评估是否存在孤立性溶骨性病变、多发性溶骨性病变、弥漫性骨质疏松症、弥漫性硬化症、硬骨膜异常、未愈合的牙槽窝和骨隔离。作者比较了接受 IV BPs 治疗的患者与从未接触过 BPs 的患者的结果。
两组下颌骨中均更常出现多发性溶骨性病变（P=.001）、弥漫性骨质疏松症（P=.001）和弥漫性硬化症（P=.0036）。BP 组发生孤立性溶骨性病变的频率较低（P=.0078）。硬骨膜异常（P=.0006）和未愈合的牙槽窝（P=.0021）与 BP 治疗有关。
IV BP 治疗改变了颌骨 MM 的影像学表现。
BP 在颌面部的作用引起了医疗保健人员的关注，因为这种类型的药物会导致癌症患者颌骨发生多种改变。
