van Kempen E E J, Boswinkel W A, Brand H S
Ned Tijdschr Tandheelkd. 2020 Jan;127(1):13-17. doi: 10.5177/ntvt.2020.01.19102.
A 52-year-old man with a history of krokodil (desomorphine) use was admitted to the department of oral and maxillofacial surgery with drug intoxication and severe pain in his jaw. During clinical and radiological examination, several sites of exposed necrotic bone with purulent discharge were seen. In krokodil-using patients osteonecrosis of the jaw is a frequently occurring manifestation. Other oral aspects associated with the use of krokodil include mucosal changes, a high risk of caries and periodontitis. Systemic effects can interfere with dental and oral and maxillofacial treatment. Treatment consists of sequestrectomy of the necrotic bone under general anaesthesia. The clinical picture of osteonecrosis in krokodil users is similar to cases of 'phossy jaw' and Medication Related Osteonecrosis of the Jaw (MRONJ).
一名有使用克他命（去甲吗啡）病史的52岁男子因药物中毒和下颌剧痛入住口腔颌面外科。在临床和影像学检查中，发现了几处暴露的坏死骨并有脓性分泌物。在使用克他命的患者中，颌骨坏死是一种常见的表现。与使用克他命相关的其他口腔问题包括黏膜改变、龋齿和牙周炎的高风险。全身影响会干扰牙科及口腔颌面治疗。治疗包括在全身麻醉下对坏死骨进行死骨切除术。克他命使用者的骨坏死临床表现与“磷毒性颌骨坏死”和药物相关性颌骨坏死（MRONJ）病例相似。
