ビスホスホネート投与患者に生じた顎骨壊死の早期発見への取り組み

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  • The early detection of osteonecrosis of the jaws associated with the use of bisphosphonates
  • ビスホスホネート トウヨ カンジャ ニ ショウジタ ガッコツ エシ ノ ソウキ ハッケン エノ トリクミ

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We perform oral examinations for bisphosphonateprescribed patients to detect bisphosphonate-related osteonecrosis of the jaw (BRONJ) at an early stage, in collaboration with breast cancer oncologists at Tokyo Medical University Hospital. In this study, we clinically evaluated the results of oral examinations for the early detection and prevention of BRONJ.<BR>Materials and methods: We performed oral examinations for the past 2 years and 2 months, on 36 patients who had been prescribed bisphosphonate, of whom 23 breast cancer patients who had been examined early were evaluated precisely.<BR>Results: Of 31 patients who were prescribed bisphosphonate, 7 of them were affected by BRONJ but in the other 24 patients bone exposure was not detected during follow-up. The other 5 patients were examined before prescription. Regarding the breast cancer patients, 5 were affected by the BRONJ, but bone exposure was not detected in 18. No BRONJ patient was found to have bone exposure at the first visit. Statistically significant differences were seen between the two groups in terms of oral hygiene and acute transformation of inflammatory dental disease.<BR> Conclusions: It is suspected that acute transformation of inflammatory dental disease is a major factor to induce bone exposure. Oral examinations involve some difficulty, but are important for bisphosphonate-prescribed patients for the early detection and prevention of BRONJ.

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