Kimura Taku, Kusano Keisuke, Sakata Ken-Ichiro, Sato Jun, Kitagawa Yoshimasa
Department of Oral Diagnosis and Medicine, Hokkaido University, Sapporo, JPN.
Cureus. 2024 Sep 11;16(9):e69226. doi: 10.7759/cureus.69226. eCollection 2024 Sep.
Medication-related osteonecrosis of the jaws (MRONJ) has emerged as one of the major adverse effects of antiresorptive agents in the treatment of patients with cancer and osteoporosis. MRONJ presents as a chronic inflammation of the maxillary and/or mandibular bones accompanied by necrotic bone exposure and intra-/extraoral fistula. Given the increasing number of patients with MRONJ, surgical treatment is highlighted to be significantly beneficial for those patients. However, extensive surgical treatment generally induces physiological and psychological burden on patients with MRONJ. Specifically, older patients with advanced MRONJ require further concerns about their systemic conditions. Thus, oral surgeons are obliged to consider their conditions when determining the indications for extensive surgical treatment. Recently, our department has established a novel therapeutic strategy based on hyperbaric oxygen (HBO) therapy for patients with advanced MRONJ. In this study, we report cases of three older patients with MRONJ who received the combination of conventional treatment and HBO therapy, which resulted in successful management and the avoidance of extensive surgical treatment.
药物相关性颌骨坏死（MRONJ）已成为抗吸收剂治疗癌症和骨质疏松症患者的主要不良反应之一。MRONJ表现为上颌骨和/或下颌骨的慢性炎症，伴有坏死骨暴露和口内/口外瘘管。鉴于MRONJ患者数量不断增加，手术治疗对这些患者具有显著益处。然而，广泛的手术治疗通常会给MRONJ患者带来生理和心理负担。具体而言，晚期MRONJ的老年患者需要进一步关注其全身状况。因此，口腔外科医生在确定广泛手术治疗的适应症时必须考虑他们的状况。最近，我们科室为晚期MRONJ患者建立了一种基于高压氧（HBO）治疗的新型治疗策略。在本研究中，我们报告了3例接受传统治疗与HBO治疗相结合的老年MRONJ患者病例，这导致了成功的治疗并避免了广泛的手术治疗。
