Bisphosphonates are widely used to treat osteoporosis and malignant tumors due to their effectiveness in increasing bone density and inhibiting bone resorption. However, their association with bisphosphonate-related osteonecrosis of the jaws (BRONJ) following invasive dental procedures poses a significant challenge. This review explores the functions, mechanisms, and side effects of bisphosphonates, emphasizing their impact on dental procedures. Dental patients receiving bisphosphonate treatment are at higher risk of BRONJ, necessitating dentists’ awareness of these risks. Topical bisphosphonate applications enhance dental implant success, by promoting osseointegration and preventing osteoclast apoptosis, and is effective in periodontal treatment. Yet, systemic administration (intravenous or intraoral) significantly increases the risk of BRONJ following dental procedures, particularly in inflamed conditions. Prevention and management of BRONJ involve maintaining oral health, considering alternative treatments, and careful pre-operative and post-operative follow-ups. Future research could focus on finding bisphosphonate alternatives with fewer side effects or developing combinations that reduce BRONJ risk. This review underscores the need for further exploration of bisphosphonates and their implications in dental procedures.
双膦酸盐因其能有效增加骨密度和抑制骨吸收，被广泛用于治疗骨质疏松症和恶性肿瘤。然而，其在侵入性牙科手术后与双膦酸盐相关性颌骨坏死（BRONJ）的关联构成了重大挑战。本综述探讨了双膦酸盐的功能、机制及副作用，重点分析了其对牙科手术的影响。接受双膦酸盐治疗的牙科患者发生BRONJ的风险更高，这要求牙科医生必须充分认识这些风险。局部应用双膦酸盐可通过促进骨整合和防止破骨细胞凋亡来提高牙种植体的成功率，并在牙周治疗中显示出效果。然而，全身给药（静脉或口服）会显著增加牙科手术后发生BRONJ的风险，尤其是在存在炎症的情况下。BRONJ的预防和管理包括保持口腔健康、考虑替代治疗方案以及细致的术前和术后随访。未来的研究可侧重于寻找副作用更少的双膦酸盐替代品，或开发能降低BRONJ风险的联合疗法。本综述强调了对双膦酸盐及其在牙科手术中影响进行进一步探索的必要性。
肿瘤(癌症)患者之家