药物相关的颌骨骨坏死(MRONJ):牙科非创伤性治疗:抗菌漱口水。

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摘要

2007年,美国骨矿物研究外科(ASBMR)将MRONJ定义为“暴露于口腔环境的坏死骨区域,持续时间超过8周,长期使用双膦酸盐(BP)治疗,没有对头部和颈部进行放射治疗”。从历史上看,最早与这种疾病相关的药物是BP,这导致了MRONJ这个术语的产生。然而,科学家需要将其他药物纳入骨坏死的发病机制,如其他抗吸收药物:Denosumab (DS)和抗血管生成药物。目前,MRONJ的治疗是有争议的,并且取决于疾病的阶段。一些作者推荐高洗牙和切除骨等,更倾向于非创伤性治疗,集中在防腐剂和跨学科(牙医-医生)控制。最常用的防腐剂是聚维酮碘、利福霉素、氯化十六烷基吡啶和氯己定。酒精制剂起效最快,其次是氯己定,然后是聚维酮碘。然而,氯己定的残留抗菌活性最大。含有氯己定和酒精的配方结合了酒精的快速发作和氯己定的持续作用。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
“Medication Related Osteonecrosis of the Jaw (MRONJ): Dental Atraumatic Treatment: Antiseptic Mouthwashes”.
The American Surgery of Bone Mineral Research (ASBMR) in 2007 defined MRONJ as “necrotic bone area exposed to the oral environment with more than eight weeks of permanence, in the presence of chronic treatment with Bisphosphonates (BP), in the absence of radiation therapy to the head and neck”. Historically, the first drugs associated with the condition were BP, which led to coining of the term MRONJ. However, scientist need to include other drugs in the etiopathogenesis of osteonecrosis, such as other antiresorptive: Denosumab (DS) and antiangiogenic agents. MRONJ treatment is controversial nowadays and depend on Stages of the illness. Some authors recommend high toilettes and resection bone so other, prefer atraumatic therapies focused in antiseptic agents and interdisciplinary (dentist-physician) control. The most common antiseptic agents used are Povidone Iodine, Rifamycin, Cetyl pyridinium chlorid and Chlorhexidine. Alcohol preparations have the fastest onset of action, followed by chlorhexidine and then povidone iodine. However, residual antimicrobial activity is greatest with chlorhexidine. Formulations that contain both chlorhexidine and alcohol combine the rapid onset of alcohol with the persisting effects of chlorhexidine.
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