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双膦酸盐相关性颌骨坏死1例

Bisphosphonates-related osteonecrosis of the jaw:A case report

摘要Osteonecrosis of the mandible is also called avascular necrosis of the jaw,and it is a rare complication of bisphosphonates.It is characterized with pain,swelling,exposure of bone,local infection and pathologic fractures of the jaw.With the widespread usage of bisphosphonates in bone metastasis of malignant tumors and osteoporosis,this rare complication has received more attention in recent years.Here,we reported a case of bisphosphonates-related osteonecrosis of the jaw(BRONJ)caused by intra-venous zoledronic acid for osteoporosis.A 62-year-old female patient with 7-year history of Sj?gren's syn-drome and 3-year history of osteoporosis developed BRONJ after 3-year treatment of zoledronic acid.Two months before she went to the Peking University International Hospital,she visited the dentist for perio-dontal purulent secretion and extracted one tooth from the right mandible.However,the condition was not improved and she felt persistent pain and swelling in the right mandible.Hence,she received repeated root curettage,but there was no improvement.Finally,she was diagnosed with osteonecrosis of the man-dible based on the digital volume tomography scan,which showed right mandibular osteonecrosis bone de-struction.She underwent surgical debridement of the necrotic bone and administered intravenous antibio-tics at the Peking University International Hospital.Histopathological analysis of the bone biopsy further confirmed the diagnosis of BRONJ.Her condition was improved successfully during a 3-year follow-up.Osteonecrosis of the mandible become more common with the increased use of bisphosphonates.Recent study has reported that osteonecrosis of the mandible is more likely to occur in patients with Sj?gren's syndrome.In addition,age,long-term and irregular administration of glucocorticoids,irregular oral examination and treatment also might be the risk factors in the pathogenesis of osteonecrosis of the mandi-ble.For the elder osteoporosis patients who would receive or had received bisphosphonate-related drugs,oral health status and the disease states associated with necrosis of the mandible such as Sj?gren's syn-drome should be comprehensively measured and fully evaluated during the whole process.Furthermore,to better understand and prevent or reduce the occurrence of this complication,we reviewed the patho-genesis,diagnosis,treatment,and prevention of BRONJ.

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北京大学学报(医学版)

北京大学学报(医学版)

2025年57卷2期

388-392页

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