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雙磷酸鹽類相關顎骨壞死的診斷與治療原則:文獻回顧

Diagnosis and Treatment Principles of Bisphosphonate Related Osteonecrosis of the Jaws: Review Article

摘要


隨著台灣漸漸邁入高齡化的社會,骨質疏鬆的議題受重視的程度已不可同日而語,其中雙磷酸鹽類藥物(Bisphosphonates)因其強力抑制破骨細胞活性的藥理特性已被廣泛運用在骨質疏鬆的預防與治療上,甚至是一些會造成惡性骨轉移腫瘤的首選藥物。然而近十年來卻陸續有文獻報告指出長期使用雙磷酸鹽類藥物者出現與口腔相關的嚴重副作用,如拔牙後傷口癒合不良、骨頭疼痛、骨頭暴露、顎骨壞死(Osteonecrosis of jaws)等。本文就此議題作一文獻回顧,提供臨床醫師辨別或是處理服用該類藥物引起相關顎骨壞死的患者所應有的認知與原則。

並列摘要


As Taiwan gradually become an aging society, people pay more attention to the issue of osteoporosis. Bisphosphonates has been widely used in the prevention and treatment of osteoporosis due to its strong inhibition of osteoclast activity property and even are the main choice for malignant bone metastases. However, more and more researches has pointed out that long-term use of bisphosphonates are associated with severe side effects over the past decade such as decreased bone healing, osteonecrosis of jaws with bone pain or exposure. For a review of the literatures on this topic, we offer the clinicians differential diagnosis and treatment principles when deal with patients taking these drugs cause-related osteonecrosis of the jaws.

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