药物相关性颌骨坏死对比化脓性颌骨骨髓炎影像学及临床特点的研究  

Study on Imaging and Clinical Features of MRONJ by Comparing with Suppurative Osteomyelitis of the Jaw.

作　　者：苏传超 林梓桐[1] 王靖斐 顾镇 薛逸文 邓润智[1] SU Chuanchao;LIN Zitong;WANG Jingfei;GU Zhen;XUE Yiwen;DENG Runzhi(Department of Oral and Maxillofacial Surgery,Nanjing Stomatological Hospital,Affiliated Hospital of Medical School,Institute of Stomatology,Nanjing University,Nanjing 210008,China.)

机构地区：[1]南京大学医学院附属口腔医院·南京市口腔医院口腔颌面外科,南京大学口腔医学研究所,江苏南京210008

出　　处：《口腔医学研究》2024年第12期1065-1070,共6页Journal of Oral Science Research

摘　　要：目的:通过与化脓性颌骨骨髓炎进行对比,总结药物相关性颌骨坏死(medication-related osteonecrosis of the jaw,MRONJ)的影像学及临床特点。方法:回顾性分析MRONJ与化脓性颌骨骨髓炎患者的影像学和临床资料。结果:MRONJ病例中:100%(对比化脓性颌骨骨髓炎的14.0%)见骨硬化,30.8%(对比5.0%)见多象限骨硬化,43.6%(对比4.0%)见死骨,25.6%(对比0%)见死骨伴多象限骨硬化;89.7%(对比20.0%)诱因是拔牙。结论:相较于化脓性颌骨骨髓炎,MRONJ观察到骨硬化、多象限骨硬化和死骨影像表现的概率更高,多象限骨硬化伴死骨影像出现时提示其很可能是MRONJ;拔牙是MRONJ的最主要诱因。Objective:To summerize the imaging and clinical features of MRONJ(medication-related osteonecrosis of the jaw)by comparing with suppurative osteomyelitis of the jaw.Methods:The imaging and clinical data of patients with MRONJ were retrospectively analyzed with those of patients with suppurative osteomyelitis of the jaw.Results:In the cases of MRONJ,100%(compared to 14.0%of suppurative osteomyelitis of the jaw)were observed with osteosclerosis,30.8%(compared to 5.0%)were observed with multiquadrant osteosclerosis,43.6%(compared to 4.0%)were observed with sequestrum,25.6%(compared to 0%)were observed with sequestrum and multiquadrant osteosclerosis,and 89.7%(compared to 20.0%)of the inducements were tooth extraction.Conclusion:Compared to suppurative osteomyelitis of the jaw,the probability of oberving osteosclerosis,multiquadrant osteosclerosis,and sequestrum on MRONJ are higher,and when multiquadrant osteosclerosis and sequestrum appear simultaneously,it is very likely to be MRONJ.Tooth extraction is the most major inducement of MRONJ.

关 键 词：药物相关性颌骨坏死 双膦酸盐 影像学特点 死骨 骨质硬化 

分 类 号：R782.4[医药卫生—口腔医学]