Actual problems in dentistry Actual problems in dentistry Проблемы стоматологии 2077-7566 2412-9461 55052 10.18481/2077-7566-2022-18-3-65-70 ЛЕКЦИИ / ЛИТЕРАТУРНЫЕ ОБЗОРЫ LITERATURE REVIEW ЛЕКЦИИ / ЛИТЕРАТУРНЫЕ ОБЗОРЫ OSTEOMODIFYING AGENTS AND BIPHOSPHONATE OSTEONECROSIS OF THE JAW: FOREIGN STUDIES ОСТЕОМОДИФИЦИРУЮЩИЕ АГЕНТЫ И БИФОСФОНАТНЫЙ ОСТЕОНЕКРОЗ ЧЕЛЮСТЕЙ: ЗАРУБЕЖНЫЕ ИССЛЕДОВАНИЯ https://orcid.org/0000-0002-8381-2535 Шелегова Ирина Георгиевна Shelegova Irina Georgievna irina-stomat@rambler.ru Нуриева Наталья Сергеевна Nurieva Natal'ya Sergeevna natakipa@mail.ru ООО "Центральная стоматология" Челябинск Россия ООО "Центральная стоматология" Челябинск Russian Federation Южно-Уральский государственный медицинский университет Россия Южно-Уральский государственный медицинский университет Russian Federation 23 11 2022 23 11 2022 18 3 65 70 12 11 2022 https://dental-press.ru/en/nauka/article/55052/view

Предмет. Актуальность данного обзора связана с увеличением числа пациентов, принимающих остеомодифицирующие агенты. Они используются при лечении метастазов в кости злокачественных опухолей и при остеопорозе. Известно серьезное осложнение, связанное с приемом остеомодифицирующих агентов — бифосфонатов: бифосфонатный остеонекроз челюстей; также появляются данные о развитии остеонекроза челюстей при приеме деносумаба. Однако патогенез данного осложнения полностью не изучен. Изучение этиологических факторов и патогенетических механизмов развития остеонекроза челюстей, связанного с приемом остеомодифицирующих агентов, позволит предотвратить его на ранней стадии и улучшить качество жизни пациентов. Цель — анализ зарубежных исследований о влиянии на организм человека остеомодифицирующих агентов и о связанном с ними остеонекрозе челюстей. Методология. Обзор литературы выполнен на основании анализа опубликованных исследований. По ключевым словам на электронном ресурсе журнала «Nature» подобраны зарубежные научные работы, в которых приводятся результаты исследований влияния на организм человека остеомодифицирующих агентов и рассматриваются связанные с ними случаи остеонекроза челюстей. Результаты. Остеомодифицирующие агенты увеличивают плотность костной ткани посредством нескольких механизмов. Однако некоторые остеомодифицирующие агенты повышают риск развития атипичных переломов бедренных костей, предплечий, позвонков, увеличивают частоту возникновения остеонекроза челюстей и некоторых видов рака. Продолжаются исследования факторов риска развития данных осложнений у пациентов, принимающих остеомодифицирующие агенты. Выводы. Остеомодифицирующие агенты широко применяются в онкологии и профилактике возрастных изменений костной системы человека. Во всем мире ведутся исследования терапевтических эффектов и осложнений терапии остеомодифицирующими агентами.

Subject. The relevance of this review is related to the increasing number of patients taking osteomodifying agents. Osteomodifying agents are used in the treatment of bone metastases of malignant tumors and osteoporosis. A serious complication associated with the use of osteomodifying agents – bisphosphonates – is bisphosphonate osteonecrosis of the jaw. There are also data on the development of osteonecrosis of the jaw when taking denosumab. However, the pathogenesis of this complication is not fully understood. Study of etiological factors and pathogenetic mechanisms of jaw osteonecrosis development, associated with taking osteomodifying agents will allow to prevent it at early stages and improve quality of life of patients. Objectives – analysis of foreign studies on the impact of osteomodifying agents on the human body and associated osteonecrosis of the jaws. Methodology. The literature review was carried out on the basis of the analysis of the published studies. Using the key words in the electronic resource of the journal "Nature" the foreign scientific studies with the results of the research on the influence of the osteomodifying agents on the human body and the cases of osteonecrosis of the jaws associated with them were selected. Results. OMAs increase bone density through several mechanisms. However, some osteomodifying agents increase the risk of atypical fractures of the femur, forearms, and vertebrae, and increase the incidence of osteonecrosis of the jaw and some cancers. Research continues on risk factors for these complications in patients taking osteomodifying agents. Conclusion. Osteomodifying agents are widely used in oncology and prevention of age-related changes in the human bone system. Therapeutic effects and complications of therapy with osteomodifying agents are studied worldwide.

 остеомодифицирующие агенты бифосфонаты костные метастазы остеопороз остеонекроз челюстей osteomodifying agents bisphosphonates bone metastases osteoporosis osteonecrosis of the jaw

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