Ruan Han-Jin, Chen Heng, Hou Jin-Song, An Jin-Gang, Guo Yu-Xing, Liu Bing, Tian Lei, Pan Jian, Li Jin-Song, Jiang Can-Hua, Tian Zhen, Xu Jie, Zhu Ling, Sun Chang-Fu, Zhi Ke-Qian, Qu Qing, Zong Chun-Lin, Li Meng-Yu, Zhang Zhi-Yuan, He Yue
Department of Oral and Maxillofacial-Head and Neck Oncology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, College of Stomatology, Shanghai Jiao Tong University, National Center for Stomatology, National Clinical Research Center for Oral Diseases, Shanghai Key Laboratory of Stomatology, Shanghai Research Institute of Stomatology, Research Unit of Oral and Maxillofacial Regenerative Medicine, Chinese Academy of Medical Sciences, Shanghai, China.
Department of Oral and Maxillofacial Surgery, Hospital of Stomatology, Guanghua School of Stomatology, Guangdong Provincial Key Laboratory of Stomatology, Sun Yat-sen University, Guangzhou, China.
J Bone Oncol. 2024 Nov 19;49:100650. doi: 10.1016/j.jbo.2024.100650. eCollection 2024 Dec.
Medication-related osteonecrosis of the jaw (MRONJ) is a side effect that occurs after treatment for systemic diseases. However, most institutions currently rely on empirical methods to make diagnosis and treatment plans, and there is a lack of consensus or guidelines for the classification, staging and treatment of MRONJ in China. To address this gap and improve prognosis, an expert panel representing 11 renowned domestic medical colleges and affiliated hospitals in China was convened. The panel made a comprehensive literature review of previous treatment experiences and research findings to address issues of definitions, etiology and risk factors, diagnosis, treatment and prevention methods. The panel concluded that the diagnosis of MRONJ can be made on the basis of a history of related medications and typical clinical manifestations, with either typical radiographic manifestations or histopathological manifestations, after excluding jaw metastasis. Surgical treatment should be considered for symptomatic patients with sequestrum or bone abnormalities accompanied by recurrent infections, and He's classification was considered a practical clinical MRONJ staging system. Multidisciplinary comprehensive treatment should be proposed to achieve optimal treatment outcomes.
药物相关性颌骨坏死（MRONJ）是全身性疾病治疗后出现的一种副作用。然而，目前大多数机构依靠经验方法制定诊断和治疗方案，中国在MRONJ的分类、分期及治疗方面缺乏共识或指南。为填补这一空白并改善预后，召集了代表中国11所知名国内医学院及其附属医院的专家小组。该小组对既往治疗经验和研究结果进行了全面的文献综述，以解决定义、病因和危险因素、诊断、治疗及预防方法等问题。该小组得出结论，MRONJ的诊断可在排除颌骨转移后，根据相关用药史和典型临床表现，结合典型的影像学表现或组织病理学表现做出。对于有死骨或骨异常并伴有反复感染的有症状患者，应考虑手术治疗，He氏分类被认为是一种实用的临床MRONJ分期系统。应提出多学科综合治疗以实现最佳治疗效果。
