ビスフォスフォネートに関連したと考えられる下顎骨壊死の２例

Abstract

In recent years, bisphosphonates inhibiting bone resorption have been used to treat multiple myeloma, bone metastases from mammary and prostate carcinomas, and osteoporosis and have been proven to be useful. However, mainly in Europe and the USA, osteonecrosis of the jaw (ONJ) has been reported as an adverse reaction of bisphosphonates, although it was not obvious during clinical trials. More recently, a few cases of ONJ have been reported in Japan, and surveys of bisphosphonate-associated ONJ in the oral and maxillofacial region have begun.In this paper, we present two cases of bisphosphonate-associated ONJ. The first case was diagnosed in a 68-year-old woman. It was treated as poor healing of a postextraction wound, and 1 year later, we found out that the diagnosis was ONJ caused by bisphosphonates used to treat osteoporosis on reviewing her medical history. The second case was in a 64-year-old woman who received bisphosphonates for multiple myeloma. Although clinical symptoms now are stable in both cases, ONJ continues to progress radiographically. Therefore, the establishment of effective therapy for ONJ is needed. Our experience highlights the importance of carefully reviewing patients' past history and shows that dentists require knowledge on ONJ to correctly diagnose this condition.