关键词: MRONJ ONJ diagnosis guidelines prevention treatment

来  源:   DOI:10.3390/diagnostics13132137   PDF(Pubmed)

Abstract:
(1) Background: Medication-related osteonecrosis of the jaws (MRONJ) is an adverse drug reaction characterized by progressive bone disruption and necrosis in the mandibular and/or maxillary bones. It occurs in individuals who have received antiresorptive drugs without prior radiotherapy. Since its first reported cases in the USA in 2003, extensive literature has emerged worldwide, leading to significant advancements in understanding MRONJ\'s pathogenesis and management. (2) Results: This article aims to compare the current national recommendations provided by the Italian Society of Maxillofacial Surgery (SICMF)/Italian Society of Oral Pathology and Medicine (SIPMO) and the American Association of Oral and Maxillofacial Surgeons (AAOMS). (3) Conclusions: Historically, the AAOMS advocated for a more conservative approach compared to the Italian guidelines. However, in their 2022 update, the AAOMS adopted a different perspective based on reported evidence, highlighting the advantages of early surgical treatment. Despite resolving some initial controversies, differences still exist between the two sets of recommendations, particularly regarding diagnosis and staging.
摘要:
(1)背景:药物相关性颌骨坏死(MRONJ)是一种药物不良反应,其特征是下颌骨和/或上颌骨进行性骨破坏和坏死。它发生在没有事先放疗的接受抗再吸收药物的个体中。自2003年在美国首次报告病例以来,世界范围内出现了广泛的文献,在理解MRONJ的发病机制和管理方面取得了重大进展。(2)结果:本文旨在比较意大利颌面外科学会(SICMF)/意大利口腔病理与医学学会(SIPMO)和美国口腔颌面外科医师协会(AAOMS)提供的当前国家建议。(3)结论:历史上,与意大利准则相比,AAOMS主张采取更保守的方法。然而,在他们的2022年更新中,AAOMS根据报告的证据采取了不同的观点,突出早期手术治疗的优势。尽管解决了一些最初的争议,两组建议之间仍然存在差异,特别是关于诊断和分期。
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