双磷酸盐相关性颌骨坏死12例临床分析

目的探讨双磷酸盐相关性颌骨坏死(BONJ)的临床特点和预防对策。方法收集2006年1月至2010年12月诊治的BONJ患者临床数据进行回顾性分析。纳入标准为曾使用或目前正在使用BPs药物、颌骨骨质外露持续8周以上、颌骨没有接受过放射线治疗。结果有12例患者诊断为BONJ,使用药物时间为10～90个月。临床表现以颌骨疼痛、牙齿松动、死骨外露等为主,合并感染后流脓和瘘管形成等。X线示骨质破坏,边缘欠光滑。7例手术治疗能令病情得到控制,但5例保守治疗者病情反复,迁延不愈。结论 BONJ诊断不难,但缺乏理想的治疗方法,重在预防。

Bisphosphonate-associated osteonecrosis of the jaws of 12 cases

Objective To summarize the clinical feature and prevention of Bisphosphonate(BPs)-associated Osteonecrosis of the jaws(BONJ).Methods Our department has obtained the clinic data of BONJ from January 2006 to December 2010 for retrospective review.The criteria is the patients have been receiving BPs;their jaw bone have exposed for more than 8 weeks;they have not been treated with radiotherapy.Results 12 cases of BONJ have been receiving BPs ranged from 10 to 90 months.The clinical manifestations included Jaw pain,loose teeth and exposure of sequeatrum,co-infection with pyorrhea,fistula formation.Panoramic x-ray showed:Bone damage and presented with an ill-defined radiopacity surrounded by a rim of radiolucency.7 patients undergone surgery have been controled.While 5 cases received conservative treatment resulted in delayed healing.Conclusion It is not difficult to make a diagnosis,but there is no ideal treatment for BONJ.Hence,prevention is essentially the key measure.