关键词: Bisphosphonates Bone remodeling inhibition MRONJ Macrophage polarization Osteocyte

Mesh : Humans Bisphosphonate-Associated Osteonecrosis of the Jaw / therapy prevention & control Bone Density Conservation Agents / toxicity Diphosphonates / toxicity

来  源:   DOI:10.1007/s00204-023-03653-7

Abstract:
Medication-related osteonecrosis of the jaw (MRONJ), a severe side effect caused by antiresorptive antiangiogenic medication, particularly bisphosphonates (BPs), has become a challenging disease with serious and profound effects on the physical and mental health of patients. Although it occurs with high frequency and is harmful, the exact mechanism of MRONJ remains unknown, and systematic and targeted approaches are still lacking. Maxillofacial surgeons focus on the etiology of osteonecrosis in the mandible and maxilla as well as the appropriate oral interventions for high-risk patients. Adequate nursing care and pharmacotherapy management are also crucial. This review provides a current overview of the clinicopathologic feature and research of MRONJ caused by BPs, with an emphasis on the potential mechanisms and current therapy and prevention strategies of the disease. We are of the opinion that an in-depth comprehension of the mechanisms underlying MRONJ will facilitate the development of more precise and efficacious therapeutic approaches, resulting in enhanced clinical outcomes for patients.
摘要:
药物相关性颌骨坏死(MRONJ),抗吸收抗血管生成药物引起的严重副作用,特别是双膦酸盐(BPs),已成为一种具有挑战性的疾病,对患者的身心健康产生严重而深远的影响。虽然它发生频率高,而且有害,MRONJ的确切机制仍然未知,仍然缺乏系统和有针对性的方法。颌面外科医生专注于下颌骨和上颌骨骨坏死的病因以及对高危患者的适当口腔干预。适当的护理和药物治疗管理也至关重要。本文综述了BPs引起MRONJ的临床病理特征和研究现状。强调该疾病的潜在机制以及当前的治疗和预防策略。我们认为,对MRONJ潜在机制的深入理解将有助于开发更精确和有效的治疗方法,提高了患者的临床结局。
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