PDF(Pubmed)
Abstract：
Medication-Related Osteonecrosis of the Jaw (MRONJ) was first reported in 2003. Despite the progress in the understanding of this oral complication in cancer patients for the past 18 years, there is still discussion about the best way to define MRONJ, prevent the complication, how to diagnose, and the options of treatment available. The initial reports associated MRONJ to bisphosphonates and denosumab, medications that work as bone-modifying agents. Later, other agents such as the antiangiogenics, have also been reported to cause the oral complication, either alone or in combination with antiresorptives. Initially, these medications were prescribed to patients with osteoporosis and cancers patients with bone metastasis. Today, because of the effect of the medications in the bone remodeling system, patients with several other diseases such as giant cell tumors, rheumatoid arthritis, Paget\'s disease of bone, fibrous dysplasia, osteogenesis imperfecta, are managed with these medications, significantly increasing the population of individuals at risk for developing MRONJ. This mini review focused on the cancer patient. It updates the dental clinician on the recent scientific literature about MRONJ and provides information on how to diagnose and manage patients being treated with these medications, suggests protocols to prevent the development of MRONJ, and present ways to manage those patients who develop the oral complication.
摘要：
药物相关的颌骨坏死（MRONJ）于2003年首次报道。尽管在过去的18年中对癌症患者的这种口腔并发症的理解取得了进展，关于定义MRONJ的最佳方法仍然存在讨论，防止并发症，如何诊断,以及可用的治疗选择。初始报告与MRONJ和双膦酸盐和denosumab相关，作为骨调节剂的药物。稍后，其他药物，如抗血管生成药物，据报道也会导致口腔并发症，单独或与抗吸收剂联合使用。最初，这些药物用于骨质疏松症患者和骨转移癌症患者。今天,因为药物对骨骼重建系统的影响，患有其他几种疾病的患者，如巨细胞瘤，类风湿性关节炎,佩吉特骨病,纤维发育不良,成骨不全症,用这些药物管理，显着增加处于发展MRONJ风险的个体群体。这篇小型评论集中在癌症患者身上。它更新了牙科临床医生关于MRONJ的最新科学文献，并提供了如何诊断和管理使用这些药物治疗的患者的信息，建议防止MRONJ发展的协议，并提出了治疗口腔并发症患者的方法。
