Ali Islam E, Sumita Yuka
Department of Maxillofacial Prosthetics, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan.
Department of Prosthodontics, Faculty of Dentistry, Mansoura University, Mansoura, Egypt.
Jpn Dent Sci Rev. 2022 Nov;58:9-12. doi: 10.1016/j.jdsr.2021.11.005. Epub 2021 Dec 18.
Medication-related osteonecrosis of the jaw (MRONJ) can be triggered by several antiresorptive and antiangiogenic medications, including bisphosphonates (BRONJ), denosumab (DRONJ), and other agents used to treat osteoporosis and metastatic bone cancer. Prosthodontists and surgeons continue to face new challenges because of this condition. Despite the current evidence showing that extensive surgical intervention and laser surgery have the highest healing rates, surgical reconstruction is not always possible for large jaw defects requiring prosthetic reconstruction. Moreover, surgical treatment may not be an option in some patients because of other medical conditions. In these patients, MRONJ may develop into a chronic disease with limited resolution and they may seek prosthetic rehabilitation for aesthetic and functional reasons. Therefore, prosthetic intervention may be necessary for some patients with MRONJ even in the absence of a surgical defect. Denture trauma has been reported to be a risk factor for MRONJ, and few reports have discussed the prosthodontic considerations needed for patients with this condition. The aim of this review is to highlight the prosthodontic considerations that would decrease the risk of triggering MRONJ in susceptible patients.
药物相关性颌骨坏死（MRONJ）可由多种抗吸收和抗血管生成药物引发，包括双膦酸盐（BRONJ）、地诺单抗（DRONJ）以及其他用于治疗骨质疏松症和转移性骨癌的药物。由于这种情况，口腔修复医生和外科医生持续面临新的挑战。尽管目前的证据表明广泛的手术干预和激光手术具有最高的愈合率，但对于需要进行修复重建的大型颌骨缺损，手术重建并非总是可行的。此外，由于其他医疗状况，手术治疗在某些患者中可能不是一种选择。在这些患者中，MRONJ可能发展为一种缓解有限的慢性疾病，并且他们可能出于美学和功能原因寻求修复康复。因此，即使在没有手术缺损的情况下，对于一些MRONJ患者，修复干预可能也是必要的。义齿创伤已被报道为MRONJ的一个风险因素，但很少有报告讨论这种情况下患者所需的口腔修复学考虑因素。本综述的目的是强调那些能够降低易感患者引发MRONJ风险的口腔修复学考虑因素。
