摘要
药物相关性颌骨坏死(MRONJ)近年来发病率不断增高,目前认为其机制可能为骨重建抑制学说、血管生成抑制学说、口腔微生物感染学说、免疫抑制学说、细胞毒性、颌骨微裂纹形成及单核苷酸多态性等,但基于单机制进行防治效果均不理想。药物治疗前规范的口腔检查及相关疾病预处理,药物治疗期间定期口腔随访对MRONJ的预防具有重要意义。在MRONJ治疗过程中,准确判断其分期,根据指南进行标准化治疗的同时,也需考虑患者具体情况,进行个性化调整。本文将国内外最新相关研究及指南和四川大学华西口腔医院口腔颌面外科近年来对MRONJ诊治经验相结合,对其发病机制及防治策略展开阐述和讨论,供同行参考。
The morbidity rate of medication-related osteonecrosis of the jaws(MRONJ)increased rapidly in recent years.Thusfar,the mechanism of MRONJ has no consensus.The possible mechanisms may include bone remodeling inhibition theory,angiogenesis inhibition theory,oral microorganism infection theory,immunosuppression theory,cytotoxicity-targeted oral epithelial cells,microcrack formation of maxillary or mandibular bone,and single nucleotide polymorphism.However,the efficacy of prevention and treatment based on a single mechanism is not ideal.Routine oral examination before MRONJ-related drug treatment,treatment of related dental diseases,and regular oral follow-up during drug treatment are of great significance for the prevention of MRONJ.During the treatment of MRONJ,the stage of MRONJ must be determined accurately,treatment must be standardized in accordance with the guidelines,and personalized adjustments must be made considering the specific conditions of patients.This review aimed to combine the latest research and guidelines for MRONJ and the experiences on the treatment of MRONJ in the Maxillofacial Surgery Department of West China Hospital of Stomatology,Sichuan University,and discuss the strategies to improve the clinical process.
作者
潘剑
刘济远
Pan Jian;Liu Jiyuan(State Key Laboratory of Oral Diseases&National Clinical Research Center for Oral Diseases&Dept.of Oral and Maxillofacial Surgery,West China Hospital of Stomatology,Sichuan University,Chengdu 610041,China)
出处
《华西口腔医学杂志》
CAS
CSCD
北大核心
2021年第3期245-254,共10页
West China Journal of Stomatology
基金
四川省科技计划项目(2020YFS0182)
四川大学华西口腔医院临床研究项目(LCYJ2019-1)。
关键词
药物相关性颌骨坏死
机制
预防
诊断
治疗
medication-related osteonecrosis of the jaws
mechanism
prevention
diagnosis
treatment
