對於使用抗骨吸收藥物患者之牙科照護

The Dental Care of Patients Taking Antiresorptive Agents

李欣哲(Hsin-Che Lee) ； 曾麗玲(Li-Ling Tseng) ； 吳昭南(Chao-Nan Wu) ； 謝耀東(Yao-Dung Hsieh)

《臺灣牙周病醫學會雜誌》 19卷3期 (2014/09) Pp. 214-226

https://doi.org/10.6121/TAP.2014.19.3.04

摘要

目前臺灣的牙醫師在臨床上常常會遇到許多骨質疏鬆或接受癌症術後預防治療的患者使用雙磷酸鹽類（bisphosphonates）藥物，而一般牙醫師聽到這些患者使用這一類型之抗骨吸收藥物（antiresorptive agents）的時候，往往聞之色變、對治療卻步三分，深怕造成顎骨壞死（osteonecrosis of the jaws, ONJ）的結果。本文獻回顧將針對此中幾點迷思予以澄清：抗骨吸收藥物不是只有雙磷酸鹽類、不是所有抗骨吸收藥物都會導致顎骨壞死、使用抗骨吸收藥物的患者不代表不能進行牙科相關治療。希望藉由本文獻回顧，讓讀者對於治療使用抗骨吸收藥物的患者，有更清楚之參考。

關鍵字

骨質疏鬆 ； 雙磷酸鹽類 ； 抗骨吸收藥物 ； 顎骨壞死

並列摘要

At present in Taiwan, dentists in clinical practice often encounter patients taking bisphosphonates for the treatment of osteoporosis or for the prevention of bone-metastatic cancer. General dental practitioners usually hesitate to treat patients who have a history of taking antiresorptive agents due to the possibility of osteonecrosis of the jaws (ONJ). The present review article focuses on clarifying some clinical myths in this area. Bisphosphonates are not the only antiresorptive agents and not all antiresorptive agents will cause osteonecrosis of the jaws. There is no rigid contraindication related to carry out dental treatment on patients taking antiresorptive agents. The present article should give the reader a clearer outlook concerning the management of patients who are undergoing treatment involving antiresorptive agents.

並列關鍵字

osteoporosis ； bisphosphonates ； antiresorptive agents ； osteonecrosis of the jaws