Bisphosphonate related osteonecrosis of the jaws: spontaneous or dental origin?
Bisphosphonate related osteonecrosis of the jaws: spontaneous or dental origin?
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DOI：
10.1016/j.oooo.2013.05.005
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发表时间：
2013-09-01
影响因子：
2.9
通讯作者：
van Merkesteyn, J. P. Richard
中科院分区：
文献类型：
--
作者：
Pichardo, Sarina E. C.;van Merkesteyn, J. P. Richard
目标。双膦酸盐在世界范围内广泛使用，主要用于治疗骨质疏松症和骨骼骨转移。然而，一个严重的副作用是双磷酸盐相关的颌骨坏死（BRONJ）。 BRONJ 背后的机制仍不清楚。文献中提出了几个起源。颌骨中牙齿的存在可能起着重要作用。因此本研究对45例患者进行回顾性分析。研究设计。对 45 名诊断为 BRONJ 的患者的档案进行了分析，包括临床特征、双磷酸盐的使用、牙科病史，包括脱位时刻和（既往）治疗。结果。 97.5% (n = 44) 的患者发现某种或推测的牙齿病灶，例如拔牙、之前的牙科治疗或修复体投诉是 BRONJ 的引发因素。结论。与文献中的发现相反，在我们组的 45 例患者中，有 44 例发现了牙病灶。这意味着几乎所有病例中 BRONJ 都是从牙槽骨开始，随后扩散到颌骨。
Objective(s). Bisphosphonates are frequently used worldwide mostly in osteoporosis and skeletal bone metastases. However, a serious side-effect is bisphosphonate related osteonecrosis of the jaws (BRONJ). The mechanism behind BRONJ remains unclear. In literature several origins are suggested. Presence of the teeth in the jaws may play an important role. Therefore in this study 45 patients were analyzed retrospectively.Study design. Files of 45 patients with a diagnosis of BRONJ were analyzed, meaning clinical features, bisphosphonate use, dental history including luxating moment and (previous) treatment.Results. In 97.5% (n = 44) a certain or presumable dental focus, such as extractions, a previous dental treatment or prosthesis complaints were found as initiating factor of BRONJ.Conclusion. In contrast to findings in literature, in our group of patients a dental focus was found in 44 of 45 cases. This implies a dentoalveolar start of BRONJ with subsequent spreading into the jaws in nearly all cases.