薬剤関連顎骨壊死

Medication-related osteonecrosis of the jaw

血液供給障害により骨の一部が壊死する疾患として大腿骨頭壊死が知られているが，口腔・顎顔面領域では高線量の放射線治療後に起こる放射線性骨壊死が知られている。下顎骨後方舌側に骨露出・腐骨形成を呈し，その後自然治癒していくoral ulceration and bone sequestration（OUBS）という疾患があるが，その原因はいまだ不明である^1）。

Osteonecrosis of the jaw, which is associated with antiresorptive agents like bisphosphonate and denosumab, is first reported at 2003 and now called as medication-related osteonecrosis of the jaw（MRONJ）. Almost of MRONJ is considered to be refractory osteomyelitis due to dental infections. Several MRONJ-imaging features on dental radiography, panoramic radiography, CBCT, CT, MRI and functional imaging have been reported to date. However, MRONJ-specific imaging features are still not established. Further investigation clarifying early imaging signs would be necessary to reduce the risk of developing MRONJ.