Gen Dent. 2023 Jul-Aug;71(4):72-76.
Medication-related osteonecrosis of the jaw (MRONJ) is an uncommon and severe condition in patients who are receiving treatment with antiresorptive and/or antiangiogenic drugs, which are frequently used to treat or prevent cancer metastases. The treatment of MRONJ is challenging because the choice of a specific dental treatment depends on several factors, including the systemic condition of the patient, type and dosage of medications, and clinical and radiographic characteristics of the dental lesions. This case report describes the conservative endodontic treatment of an odontogenic infection in a patient at risk of developing MRONJ owing to bisphosphonate treatment. Endodontic retreatment was performed to control the odontogenic infection and avoid tooth extraction. Certain factors favor the use of a conservative approach, such as a localized and small infection, the absence of systemic factors (such as metabolic disorders or medications) that can impair bone healing, and good oral hygiene.
药物相关性颌骨坏死（MRONJ）是一种在接受抗吸收和/或抗血管生成药物治疗的患者中罕见且严重的疾病，这些药物常用于治疗或预防癌症转移。MRONJ 的治疗具有挑战性，因为特定的牙科治疗选择取决于多个因素，包括患者的全身状况、药物的类型和剂量以及牙科病变的临床和影像学特征。本病例报告描述了一名因双膦酸盐治疗而有发生 MRONJ 风险的患者的牙源性感染的保守性牙髓治疗。进行牙髓再治疗是为了控制牙源性感染并避免拔牙。某些因素有利于采用保守方法，例如局部和小的感染、不存在可能影响骨愈合的全身因素（如代谢紊乱或药物）以及良好的口腔卫生。
