当科におけるビスフォスフォネート製剤投与患者についての臨床的検討

• Published in: 日本口腔外科学会雑誌 Vol. 58; no. 6; pp. 342 - 349
• Main Authors: 青木, 久美子, 稲掛, 耕太郎, 桐田, 忠昭, 藤本, 昌紀, 上田, 順宏, 今井, 裕一郎, 山本, 一彦, 堀田, 聡
• Format: Journal Article
• Language: Japanese
• Published: 社団法人 日本口腔外科学会 20.06.2012
• Subjects: ビスフォスフォネート; 周術期管理; 血清I型コ ラーゲン架橋N末端テロペプチド; 顎骨壊死
• ISSN: 0021-5163; 2186-1579
• DOI: 10.5794/jjoms.58.342

Clinical analysis was performed in patients treated with bisphosphonates （BPs） in our clinic. The subjects were 112 patients who were treated in our department from June 2005 to February 2010. Twenty patients developed bisphosphonate-related osteonecrosis of the jaw （BRONJ）. Among these patients, 9 had received oral BPs for more than 1 year, and 11 had received intravenous BPs for more than 3 months. The mandible was involved in 13 patients and the maxilla in 7. Two patients （10.0％） were in stage 0, 3 （15.0％） in stage 1, 12 （60.0％） in stage 2, and 3 （15.0％） in stage 3. Among 92 patients without BRONJ, 38 received surgical treatment, and 54 received oral hygiene control. Seven of the 38 patients who underwent surgical treatment showed delayed healing. They also showed significantly decreased serum levels of N-telopeptide of type I collagen （NTX）. These findings, indicate that patients treated with oral BPs for more than 1 year or intravenous BPs for more than 3 months are at high risk for BRONJ and therefore should be managed carefully. SerumNTX may be an useful predictive marker of BRONJ for the perioperative management of patients treated with BPs.