Mitsuhata Chieko, Kozai Katsuyuki
Department of Pediatric Dentistry, Graduate School of Biomedical & Health Sciences, Hiroshima University, Japan.
Jpn Dent Sci Rev. 2022 Nov;58:155-161. doi: 10.1016/j.jdsr.2022.03.001. Epub 2022 Apr 30.
Since most of the reports of BRONJ onset are adults, in order to clarify the current situation of BRONJ onset in children, it is necessary to search for articles and report on the current status and actual conditions of surgical treatment of children with BP preparations who are being followed up in our clinic. In previous reports both inside and outside Japan, there was no mention of jaw bone necrosis during tooth extraction or surgery in children who were receiving or had a history of BP administration. There were 15 children with a history of BP administration who manage the oral cavity in our clinic. No unpleasant events in the extraction of deciduous teeth were confirmed in medical records. It is necessary to intervene early on oral management of pediatric BP-administered children, especially BP-and steroid-administered children, obtain plaque control to keep the oral cavity cleaner, respond early to infectious diseases, and manage to prevent inflammation from spreading to the jawbone. When surgical treatment is unavoidable, it is important to consider reducing the invasion as much as possible and to cooperate with the medical department such as administration of antibiotics to prevent infection.
由于大多数关于颌骨坏死性骨髓炎(BRONJ)发病的报告都是针对成年人的,为了阐明儿童BRONJ的发病现状,有必要检索相关文章,并报告在我们诊所接受随访的使用双膦酸盐(BP)制剂儿童的手术治疗现状和实际情况。在日本国内外以往的报告中,均未提及正在接受BP治疗或有BP治疗史的儿童在拔牙或手术过程中出现颌骨坏死的情况。在我们诊所,有15名有BP治疗史的儿童接受口腔管理。病历中未证实乳牙拔除过程中出现任何不良事件。对于接受BP治疗的儿童,尤其是同时接受BP和类固醇治疗的儿童,有必要尽早进行口腔管理,控制牙菌斑以保持口腔清洁,对传染病尽早做出反应,并设法防止炎症扩散至颌骨。当不可避免地需要进行手术治疗时,重要的是尽可能减少侵袭,并与医疗部门合作,如使用抗生素预防感染。