双膦酸盐导致上、下颌骨大面积坏死病例报道

doi:10.3969/j.issn.1005-4979.2020.01.011

《口腔颌面外科杂志》 ›› 2020, Vol. 30 ›› Issue (1): 53-55. doi: 10.3969/j.issn.1005-4979.2020.01.011

双膦酸盐导致上、下颌骨大面积坏死病例报道

林文清(), 胡砚平()

厦门医学院附属口腔医院口腔颌面外科，福建厦门 361000

收稿日期:2019-10-12 修回日期:2019-12-03 出版日期:2020-02-28 发布日期:2020-02-21
通讯作者: 胡砚平，主任医师. E-mail: huyanpingphd@163.com
作者简介:
林文清（1987—），男，福建厦门人，主治医师，硕士. E-mail: 598762795@qq.com

A Case Report of Medication-related Osteonecrosis of the Maxilla and Mandible

LIN Wenqing(), HU Yanping()

Department of Oral and Maxillofacial Surgery, School and Hospital of Stomatology, Xiamen Medical College, Xiamen 361000, Fujian Province, China

Received:2019-10-12 Revised:2019-12-03 Online:2020-02-28 Published:2020-02-21

摘要/Abstract

摘要：

药物相关性颌骨坏死（medication related osteonecrosis of the jaw，MRONJ）是由于使用抗骨吸收或肿瘤靶向治疗类药物而产生的一种严重不良反应。临床上以颌骨骨外露、感染流脓、死骨形成为主要特征。近年来相关报道逐渐增多，但因药物引起上、下颌骨同时出现大面积坏死的病例尚罕见报道。现报告我院1例肺癌患者，因病长期应用双膦酸盐而引起药物性上、下颌骨大面积坏死的详细资料，并结合文献探讨此类病例的临床诊治要点。

关键词: 双膦酸盐, 颌骨坏死, 药物相关性

Abstract:

Medication-related osteonecrosis of the jaw (MRONJ) is a severe complication of bone modulating drugs or other targeted agent therapies. MRONJ's clinical appearances include exposed bone, pus, and sequestra in the maxilla or mandible regions. Related reports have gradually increased in recent years. This article reported a typical case of bisphosphonate-related osteonecrosis of both the maxilla and mandible, with literatures review.

Key words: bisphosphonates, osteonecrosis of jaw, medication-related

中图分类号:

R782.4

林文清, 胡砚平. 双膦酸盐导致上、下颌骨大面积坏死病例报道[J]. 《口腔颌面外科杂志》, 2020, 30(1): 53-55.

LIN Wenqing, HU Yanping. A Case Report of Medication-related Osteonecrosis of the Maxilla and Mandible[J]. 《Journal of Oral and Maxillofacial Surgery》, 2020, 30(1): 53-55.

https://journal06.magtech.org.cn/Jweb_joms/CN/Y2020/V30/I1/53

图/表 3

图1 右上颌骨坏死口内像

Figure 1 Intraoral image of the right maxillary necrosis

图2 曲面断层片示上、下颌骨破坏

Figure 2 Panoramic radiography showing bone destruction of the maxilla and mandible

图3 各断面锥形束CT的影像学表现注：A.上颌骨轴位；B.上颌骨冠状位；C.上颌骨矢状位；D.下颌骨轴位。

Figure 3 Images of the cone beam computed tomography in various sections

参考文献 11

[1]	Marx RE. Pamidronate (Aredia) and zoledronate (Zometa) induced avascular necrosis of the jaws: a growing epidemic[J]. J Oral Maxillofac Surg, 2003, 61(9): 1115-1117. doi: 10.1016/S0278-2391(03)00720-1 URL
[2]	Aghaloo T, Hazboun R, Tetradis S. Pathophysiology of osteonecrosis of the jaws[J]. Oral Maxillofac Surg Clin North Am, 2015, 27(4): 489-496. doi: 10.1016/j.coms.2015.06.001 URL
[3]	Otto S, Pautke C, van den Wyngaert T, et al. Medication-related osteonecrosis of the jaw: prevention, diagnosis and management in patients with cancer and bone metastases[J]. Cancer Treat Rev, 2018, 69: 177-187. doi: S0305-7372(18)30101-4 pmid: 30055439
[4]	贺捷, 邱蔚六. 二膦酸盐与颌骨骨坏死[J]. 中国口腔颌面外科杂志, 2010, 8(4): 370-375.
[5]	王杞章, 刘济远, 潘剑. 药物性颌骨坏死的研究进展[J]. 华西口腔医学杂志, 2018, 36(5): 568-572.
[6]	Boquete-Castro A, Gómez-Moreno G, Calvo-Guirado JL, et al. Denosumab and osteonecrosis of the jaw. A systematic analysis of events reported in clinical trials[J]. Clin Oral Implants Res, 2016, 27(3): 367-375.
[7]	Kos M. Incidence and risk predictors for osteonecrosis of the jaw in cancer patients treated with intravenous bisphosphonates[J]. Arch Med Sci, 2015, 11(2): 319-324. doi: 10.5114/aoms.2015.50964 pmid: 25995747
[8]	Otto S, Tröltzsch M, Jambrovic V, et al. Tooth extraction in patients receiving oral or intravenous bisphosphonate administration: a trigger for BRONJ development[J]? J Craniomaxillofac Surg, 2015, 43(6): 847-854. doi: 10.1016/j.jcms.2015.03.039 URL
[9]	Kim RH, Lee RS, Williams D, et al. Bisphosphonates induce senescence in normal human oral keratinocytes[J]. J Dent Res, 2011, 90(6): 810-816. doi: 10.1177/0022034511402995 pmid: 21427353
[10]	Abu-Id MH, Warnke PH, Gottschalk J, et al. "Bis-phossy jaws" - high and low risk factors for bisphosphonate-induced osteonecrosis of the jaw[J]. J Craniomaxillofac Surg, 2008, 36(2): 95-103. doi: 10.1016/j.jcms.2007.06.008 pmid: 18234504
[11]	谢新凤, 杨万群, 黄飚, 等. 双膦酸盐相关性颌骨坏死的CT诊断[J]. 放射学实践, 2018, 33(5): 488-492.

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