服用抗骨吸收藥物病人口腔植體骨整合後引發的顎骨壞死－文獻回顧

服用抗骨吸收相關藥物的病人是否能夠進行植牙手術一直以來都是具有爭議的議題。美國口腔顎面外科學會認為植牙手術導致藥物引起之顎骨壞死風險與拔牙相當，其中骨質疏鬆的病人不論使用的藥物種類或劑量頻率，罹患藥物引起之顎骨壞死的風險都不高，可進行植體手術，但應盡量避免在靜脈注射抗骨吸收藥物的癌症病人口内種植牙科植體。目前沒有被全盤了解且重視的議題是病人口內若存在已成功骨整合的植體，之後才陸續接受抗骨吸收相關藥物的治療也有引發顎骨壞死的風險。2010年至今陸續有學者提到即使是已骨整合的植體，後續才服用抗骨吸收藥物，經歷功能性承載後仍可能會造成植體周圍的顎骨壞死，並命名這樣的狀況為植體存在本質誘發的顎骨壞死。本篇文章透過文獻回顧找尋相關的研究論文、闡述植體存在本質誘發的顎骨壞死，並著重在其預防與治療準則。

關鍵字

抗骨吸收藥物；藥物相關顎骨壞死；口腔植體引發顎骨壞死；臨床治療準則

並列摘要

The safety issue of patient under antiresorptive agent therapy when receiving implant surgery has been controversial for years. The American Association of Oral and Maxillofacial Surgeons(AAOMS) recognized the risk of patient suffering from MRONJ after implant surgery is equivalent to the risk after tooth extraction. Regardless of drug type, dose and frequency, osteoporosis patients under antiresorptive agent have low risk of MRONJ incidence. Even though it is safe for dentists to undergo implant surgery upon osteoporosis patients, experts suggest that patients who had ever received intravenous antiresorptive agent should be avoid from surgical procedure. Since the issue concerning about successfully osseointegrated implant cases may induce MRONJ after the future necessity of antiresorptive agent therapy is not well informed, functional loading may cause MRONJ afterwards were brought up since year 2010 by several scholars. This situation was named implant presence-triggered osteonecrosis (IPTO). Our aim is to review related research articles and focus on the prevention and treatment of IPTO.

並列關鍵字

Antiresorptive agent ； MRONJ ； IPTO ； Treatment protocols

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服用抗骨吸收藥物病人口腔植體骨整合後引發的顎骨壞死－文獻回顧

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