Osteopathology of the jaw associated with bone resorption inhibitors: what have we learned in the last 8 years?
Osteopathology of the jaw associated with bone resorption inhibitors: what have we learned in the last 8 years?
复制标题
与骨吸收抑制剂相关的颌骨病理学：过去 8 年我们学到了什么？
作者：
C. Jacobsen;P. Metzler;J. Obwegeser;W. Zemann;K. Graetz
正在研究的问题
在发现与双膦酸盐治疗相关的下颌骨坏死 8 年后，我们在治疗 112 名患有该疾病的患者中积累了大量经验。这种疾病虽然不常见，但仍然是患者和治疗专家的负担，并且不存在足够的标准化分类和治疗方法。本文总结了收集的患者数据、获得的经验以及随之而来的知识、诊断措施和治疗方面的变化。
方法
回顾性分析了 112 名因双磷酸盐相关颌骨病变而转诊至特殊诊所的患者的数据，并与文献数据进行了比较。
结果
数据分析总共包括 110 名患者，其中 70% 为女性。其中四分之一的患者有骨质疏松症作为基础疾病，超过一半的患者有拔牙作为局部影响因素。四分之三的患者病变位于下颌骨，几乎所有患者都表现出感染的临床症状。总共有 58% 的患者接受了手术治疗，7 年内完全缓解率为 78%。
结论
患者数据和文献的总结表明，有关双膦酸盐相关颌骨骨病理学的知识变得越来越具体。与这种疾病相关的药物范围有所增加，而且治疗选择也显示出越来越多的成功。 BRONJ 发现后不久发布的分类需要修订并纳入新知识。
QUESTIONS UNDER STUDY
8 years after discovery of osteonecrosis of the jaw associated with bisphosphonate therapy a lot of experience has been garnered in treating 112 patients with this disease. This disease, although uncommon, is still a burden for the patient as well as the treating specialists and an adequate standardised classification as well as therapy does not exist. This article presents a summary of collected patient data, garnered experience and consequential changes in knowledge, in diagnostic measures and therapy.
METHODS
The data of in total 112 patients referred to the Special Clinics for patients with bisphosphonate-associated lesions of the jaw was retrospectively analysed and compared with data from the literature.
RESULTS
In total, 110 patients, 70% women, were included in the data analysis. A quarter of those patients had osteoporosis as the underlying disease, more than half of all patients had extractions as the local influencing factor. The lesion was localised in the mandible in three quarters of all patients and almost all patients showed clinical signs of infection. In total, 58% of all patients were treated surgically with a complete remission rate of 78% over 7 years.
CONCLUSIONS
This summary of patient data and literature shows that knowledge about bisphosphonate-associated osteopathology of the jaw becomes more and more specific. The range of drugs associated with this disease has increased, but also therapeutic options show more and more success. Classifications, published shortly after the discovery of BRONJ need to be revised and new knowledge included.