A survey of bisphosphonate-related osteomyelitis/osteonecrosis of the jaws
A survey of bisphosphonate-related osteomyelitis/osteonecrosis of the jaws
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双膦酸盐相关性颌骨骨髓炎/骨坏死的调查
DOI：
10.5794/jjoms.53.594
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发表时间：
2007
期刊：
影响因子：
--
通讯作者：
Y. Ueyama
中科院分区：
文献类型：
--
作者：
M. Shimahara;Y. Ariyoshi;Y. Imai;H. Mizuki;J. Shimada;K. Furusawa;S. Morita;Y. Ueyama
双膦酸盐用于治疗骨转移性疾病和恶性肿瘤引起的高钙血症，以及治疗骨质疏松症。最近，在英文文献中报告了一些双膦酸盐相关性骨髓炎和颌骨骨坏死的患者。本报告描述了日本患有双磷酸盐相关骨髓炎和颌骨骨坏死的患者。受试者登记使用的问卷发送到239个机构认证的培训设施，由日本口腔颌面外科医师协会在2006年。研究了来自18个不同机构的30例患者（4例男性和26例女性）（诊断时的平均年龄为66.9岁）。局部表现以疼痛伴或不伴肿胀最为常见。下颌骨受累22例，上颌骨受累6例，双颌受累2例。20例患者接受静脉注射双膦酸盐，8例仅接受口服双膦酸盐，1例接受两种类型的治疗。双膦酸盐治疗的原因是乳腺癌骨转移（13例）、多发性骨髓瘤（6例）、骨质疏松症（8例）和恶性肿瘤相关的高钙血症。超过50%的患者在双膦酸盐治疗前或治疗期间接受了口腔手术，包括拔牙，而5名患者没有接受牙科治疗。除了抗生素治疗外，还进行了手术，包括死骨切除术和刮宫术。至于结果，8名患者完全治愈，而17名患者在撰写本文时仍在接受治疗。
Bisphosphonates are used for the management of bone metastatic disease and hypercalcemia caused by malignancy, as well as the treatment of osteoporosis. Recently, a number of patients with bisphosphonate-associated osteomyelitis and osteonecrosis of the jaws have been reported in the English-language literature. This report describes patients with bisphosphonate-related osteomyelitis and osteonecrosis of the jaws in Japan. The subjects were enrolled using questionnaires sent to 239 institutions certified as training facilities by the Japanese Society of Oral and Maxillofacial Surgeons in 2006. Thirty patients (4 men and 26 women) from 18 different institutions (mean age at diagnosis, 66.9 years) were studied. As for local features, pain with or without swelling was the most common symptom and sign. The mandible was affected in 22 patients, the maxilla in 6, and both jaws in 2. Twenty patients received intravenous bisphosphonates, 8 received only oral bisphosphonates, and 1 received both types of treatment. The reasons for bisphosphonate treatment were bone metastasis from breast carcinoma (13 patients), multiple myelomas (6 patients), osteoporosis (8 patients), and hypercalcemia related to malignancy. More than 50 % of the patients underwent oral surgery including tooth extraction just before or during treatment with bisphosphonates, while 5 patients received no dental treatment. In addition to antibiotic therapy , surgery, including sequestrectomy and curettage, was performed. As for outcome, 8 of the patients were completely cured, while 17 patients remained under treatment at the time of this writing.