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1例罕见的与牙科种植体相关的贝伐单抗相关性颌骨坏死病例。

A rare case of bevacizumab-related osteonecrosis of the jaw associated with dental implants.

作者信息

Maluf Gustavo, Caldas Rogério Jardim, Fregnani Eduardo Rodrigues, da Silva Santos Paulo Sérgio

机构信息

Private Clinic, Brasília, DF, Brazil.

, Brasília, Brasil.

出版信息

Int J Implant Dent. 2019 Oct 1;5(1):34. doi: 10.1186/s40729-019-0188-0.

Abstract

BACKGROUND

Medication-related osteonecrosis of the jaw (MRONJ) is characterized by the development of bone necrosis in the jaws of patients receiving antiresorptive and/or antiangiogenic medications. No scientific reports have been published yet on bevacizumab-related osteonecrosis of the jaw (BeRONJ) when associated with dental implant placement and adjuvant ozone therapy.

CASE PRESENTATION

A 54-year-old female patient with a history of metastatic breast cancer and bevacizumab use presented with a dental infection. Dental extraction followed immediately by dental implant placement was planned after suspension of the bevacizumab treatment. The patient presented with pain, drainage of purulent secretion, and bone exposure 5 weeks post-surgery. Complete healing was achieved at postoperative 7 months.

CONCLUSIONS

The combination of adjuvant ozone therapy and surgical debridement was effective for the treatment of MRONJ; however, the risk of MRONJ may persist after the suspension of bevacizumab for 28 days.

摘要

背景

药物相关性颌骨坏死(MRONJ)的特征是接受抗吸收和/或抗血管生成药物治疗的患者颌骨出现骨坏死。关于贝伐单抗相关性颌骨坏死(BeRONJ)与牙种植体植入及辅助臭氧治疗相关的情况,尚未有科学报告发表。

病例报告

一名54岁有转移性乳腺癌病史且使用过贝伐单抗的女性患者出现牙齿感染。在暂停贝伐单抗治疗后,计划立即进行拔牙并随后植入牙种植体。患者术后5周出现疼痛、脓性分泌物引流及骨暴露。术后7个月实现完全愈合。

结论

辅助臭氧治疗与手术清创相结合对MRONJ治疗有效;然而,在暂停使用贝伐单抗28天后,MRONJ的风险可能仍然存在。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f947/6768921/ff5e28204bbe/40729_2019_188_Fig1_HTML.jpg

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