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药物相关性颌骨骨坏死的发病机制与多学科管理。

Pathogenesis and multidisciplinary management of medication-related osteonecrosis of the jaw.

机构信息

The First Affiliated Hospital of Harbin Medical University, Harbin, China.

School of Stomatology, Harbin Medical University, Harbin, China.

出版信息

Int J Oral Sci. 2020 Oct 21;12(1):30. doi: 10.1038/s41368-020-00093-2.

Abstract

Medication-related osteonecrosis of the jaw (MRONJ) is a serious side effect of bone-modifying agents and inhibits angiogenesis agents. Although the pathogenesis of MRONJ is not entirely clear, multiple factors may be involved in specific microenvironments. The TGF-β1 signalling pathway may have a key role in the development of MRONJ. According to the clinical stage, multiple variables should be considered when selecting the most appropriate treatment. Therefore, the prevention and management of treatment of MRONJ should be conducted in patient-centred multidisciplinary team collaborative networks with oncologists, dentists and dental specialists. This would comprise a closed responsibility treatment loop with all benefits directed to the patient. Thus, in the present review, we aimed to summarise the pathogenesis, risk factors, imaging features, clinical staging, therapeutic methods, prevention and treatment strategies associated with MRONJ, which may provide a reference that can inform preventive strategies and improve the quality of life for patients in the future.

摘要

药物相关性颌骨坏死(MRONJ)是骨修饰剂和抗血管生成剂的严重副作用。尽管 MRONJ 的发病机制尚不完全清楚,但多个因素可能涉及特定的微环境。TGF-β1 信号通路可能在 MRONJ 的发生发展中起关键作用。根据临床分期,在选择最合适的治疗方法时应考虑多种变量。因此,MRONJ 的预防和管理应在以肿瘤学家、牙医和口腔专家为核心的多学科团队协作网络中进行。这将形成一个闭环责任治疗循环,所有的好处都指向患者。因此,在本综述中,我们旨在总结 MRONJ 相关的发病机制、危险因素、影像学特征、临床分期、治疗方法、预防和治疗策略,这可能为未来的预防策略和提高患者生活质量提供参考。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cf73/7578793/ebe2e38f53b6/41368_2020_93_Fig1_HTML.jpg

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