与药物相关的下巴骨髓缩:多模式医疗管理的不断发展的研究
Ali Abdolrahmani1, Joel B Epstein2,3, Firoozeh Samim4
1Oral Medicine & Oral Pathology Clinic, Montreal General Hospital, Montreal, QC, Canada.
概括
与药物相关的骨 (MRONJ) 可以通过PENT-E,teriparatide,光生物调节和光动力学疗法等疗法来管理. 这些治疗方法在增强 MRONJ 患者的愈合和潜在地避免手术方面表现有前途.
科学领域:
- 口腔和牙面部外科手术
- 药理学 药理学是指药理学的学科.
- 生物医学工程 生物医学工程
背景情况:
- 与药物相关的下巴骨硬化 (MRONJ) 是抗吸收和抗血管原药物的严重并发症.
- 牙科手术,特别是拔牙,可以引发MRONJ发作,尽管它也可以自发发生.
- 当前的指导方针往往优先考虑避免拔牙,但这并不总是可行的.
研究的目的:
- 为 MRONJ.提供当前预防和治疗策略的最新审查.
- 评估MRONJ管理的新兴医疗和辅助疗法.
- 探索对MRONJ进行手术干预的替代方案.
主要方法:
- 在PubMed/MEDLINE,Embase和Scopus进行了全面的文献搜索.
- 包括的研究包括随机对照试验,系统性审查,观察性研究和案例研究.
- 批判性地评估了MRONJ目前的医疗治疗和辅助疗法.
主要成果:
- 氧菲林和阿尔法托科菲罗尔 (PENT-E),特里巴,光生物调制 (PBM) 和光动力疗法 (PDT) 证明了MRONJ患者的愈合效果.
- 这些疗法,单独使用或与手术一起使用,减少了不适,改善了伤口愈合和骨形成.
- 增长因素也显示了改善MRONJ结果的潜力.
结论:
- 辅助疗法,如PENT-E,teriparatide,PBM和PDT显示出对MRONJ愈合的承诺.
- 目前的指导方针往往侧重于用于二次感染的抗生素,而不是初级MRONJ治疗.
- 在对MRONJ进行外科手术之前,应考虑医疗管理,需要进一步研究.
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