{"id":1485,"date":"2022-06-13T11:13:58","date_gmt":"2022-06-13T02:13:58","guid":{"rendered":"https:\/\/yobou.work\/?p=1485"},"modified":"2022-11-17T18:21:42","modified_gmt":"2022-11-17T09:21:42","slug":"%e3%80%90%e3%82%a8%e3%83%93%e3%83%87%e3%83%b3%e3%82%b9%e3%80%91%e9%aa%a8%e5%90%b8%e5%8f%8e%e6%8a%91%e5%88%b6%e8%96%ac%e9%96%a2%e9%80%a3%e9%a1%8e%e9%aa%a8%e5%a3%8a%e6%ad%bbaronj-bronj%e3%81%ae","status":"publish","type":"post","link":"https:\/\/yobou.work\/?p=1485","title":{"rendered":"\u3010\u30a8\u30d3\u30c7\u30f3\u30b9\u3011\u9aa8\u5438\u53ce\u6291\u5236\u85ac\u95a2\u9023\u984e\u9aa8\u58ca\u6b7bARONJ (BRONJ)\u306e\u767a\u75c7\u306f\u4e88\u9632\u3067\u304d\u308b\u304b"},"content":{"rendered":"<p><img data-recalc-dims=\"1\" decoding=\"async\" class=\"aligncenter size-large wp-image-1487\" src=\"https:\/\/i0.wp.com\/yobou.work\/wp-content\/uploads\/2022\/06\/P1020255.jpg?resize=665%2C499\" alt=\"\" width=\"665\" height=\"499\" srcset=\"https:\/\/i0.wp.com\/yobou.work\/wp-content\/uploads\/2022\/06\/P1020255.jpg?resize=1024%2C768&amp;ssl=1 1024w, https:\/\/i0.wp.com\/yobou.work\/wp-content\/uploads\/2022\/06\/P1020255.jpg?resize=300%2C225&amp;ssl=1 300w, https:\/\/i0.wp.com\/yobou.work\/wp-content\/uploads\/2022\/06\/P1020255.jpg?resize=768%2C576&amp;ssl=1 768w, https:\/\/i0.wp.com\/yobou.work\/wp-content\/uploads\/2022\/06\/P1020255.jpg?resize=1536%2C1152&amp;ssl=1 1536w, https:\/\/i0.wp.com\/yobou.work\/wp-content\/uploads\/2022\/06\/P1020255.jpg?resize=660%2C495&amp;ssl=1 660w, https:\/\/i0.wp.com\/yobou.work\/wp-content\/uploads\/2022\/06\/P1020255.jpg?w=1920&amp;ssl=1 1920w, https:\/\/i0.wp.com\/yobou.work\/wp-content\/uploads\/2022\/06\/P1020255.jpg?w=1330 1330w\" sizes=\"(max-width: 665px) 100vw, 665px\" \/><\/p>\n<p>&nbsp;<\/p>\n<h2><strong>\uff11\uff0eARONJ(BRONJ)\u3068\u306f\uff1f<\/strong><\/h2>\n<p>\u3000\u30d3\u30b9\u30db\u30b9\u30db\u30cd\u30fc\u30c8\u95a2\u9023\u984e\u9aa8\u58ca\u6b7b\u306f2003\u5e74\uff0c\u7c73\u56fd\u30de\u30a4\u30a2\u30df\u5927\u5b66Robert E. Marx\u6559\u6388\u306b\u3088\u3063\u3066\u521d\u3081\u3066\u5831\u544a\u3055\u308c\u307e\u3057\u305f<sup>\uff11\uff09<\/sup>\uff0e\u4e16\u754c\u4e2d\u3067\u6570\u591a\u304f\u5831\u544a\u3055\u308c\uff0c\u65e5\u672c\u3067\u3082\u6570\u591a\u304f\u306e\u60a3\u8005\u3055\u3093\u304c\u767a\u75c7\u3057\u3066\u3044\u307e\u3059<sup>\uff12)<\/sup>\uff0e\u672c\u90a6\u3067\u306f2010\u5e74\u306b\u95a2\u9023\uff15\u5b66\u4f1a\u306b\u3088\u308b\u300c<a href=\"https:\/\/www.jsoms.or.jp\/medical\/work\/guideline\/bisphos01\/\">\u30d3\u30b9\u30db\u30b9\u30db\u30cd\u30fc\u30c8\u95a2\u9023\u984e\u9aa8\u58ca\u6b7b\u306b\u5bfe\u3059\u308b\u30dd\u30b8\u30b7\u30e7\u30f3\u30da\u30fc\u30d1\u30fc<\/a>\u300d\u304c\u767a\u884c\u3055\u308c2012\u5e74\uff0c2016\u5e74\u306b\u6539\u5909\u3055\u308c\u3066\u3044\u307e\u3059\uff0e<\/p>\n<p>&nbsp;<\/p>\n<p>\u3000Receptor activator of NF-\u03baB ligand(RANKL)\u306b\u5bfe\u3059\u308b\u30d2\u30c8\u578bIgG2\u30e2\u30ce\u30af\u30ed\u30fc\u30ca\u30eb\u6297\u4f53\u88fd\u5264\u3067\u3042\u308b\u30c7\u30ce\u30b9\u30de\u30d6\uff08\u5546\u54c1\u540d\uff1a\u30d7\u30e9\u30ea\u30a2\uff0c\u30e9\u30f3\u30de\u30fc\u30af\uff09\u304c\u958b\u767a\u3055\u308c\uff0c\u30e9\u30f3\u30de\u30fc\u30af\u304c2012\u5e74\uff0c\u30d7\u30e9\u30ea\u30a2\u304c2013\u5e74\u306b\u65e5\u672c\u3067\u8ca9\u58f2\u304c\u958b\u59cb\u3055\u308c\u9aa8\u7c97\u9b06\u75c7\uff0c\u95a2\u7bc0\u30ea\u30a6\u30de\u30c1\uff0c\u60aa\u6027\u816b\u760d\u306b\u81e8\u5e8a\u5fdc\u7528\u3055\u308c\u3066\u3044\u307e\u3059\uff0eBRONJ\u3068\u4f5c\u7528\u30e1\u30ab\u30cb\u30ba\u30e0\u306f\u7570\u306a\u308a\u307e\u3059\u304c\uff0c\u540c\u69d8\u306e\u9aa8\u58ca\u6b7b\u304c\u540c\u7a0b\u5ea6\u306b\u767a\u751f\u3059\u308b\u3053\u3068\u304b\u3089<sup>\uff13)<\/sup>\uff0c\u73fe\u5728\u3067\u306fBRONJ\uff08\u30d3\u30b9\u30db\u30b9\u30db\u30cd\u30fc\u30c8\u88fd\u5264\u95a2\u9023\u984e\u9aa8\u58ca\u6b7b\uff09\u3068\u3044\u3046\u7528\u8a9e\u306b\u4ee3\u308f\u308aARONJ \uff08\u9aa8\u5438\u53ce\u963b\u5bb3\u85ac\u95a2\u9023\u984e\u9aa8\u58ca\u6b7b\uff09\u3068\u3044\u3046\u7528\u8a9e\u304c\u4f7f\u7528\u3055\u308c\u3066\u3044\u307e\u3059\uff0e<\/p>\n<p>&nbsp;<\/p>\n<p>\u3000\u4eca\u56de\u306f\uff0c\u53e3\u8154\u5916\u79d1\u533b\u306e\u307f\u306a\u3089\u305a\uff0c\u6b6f\u79d1\u533b\u306b\u3068\u3063\u3066\u7121\u8996\u3067\u304d\u306a\u3044ARONJ\u306e\u300c\u767a\u75c7\u4e88\u9632\u300d\u306e\u90e8\u5206\u306b\u7126\u70b9\u3092\u5f53\u3066\uff0c\u4e00\u822c\u958b\u696d\u6b6f\u79d1\u533b\u306e\u5148\u751f\u3084\u6b6f\u79d1\u885b\u751f\u58eb\u3055\u3093\u306b\u53d6\u308a\u7d44\u3093\u3067\u3082\u3089\u3048\u308b\u5177\u4f53\u7684\u306a\u65b9\u6cd5\u3068\u30a8\u30d3\u30c7\u30f3\u30b9\u306b\u3064\u3044\u3066\u8003\u3048\u3066\u307f\u305f\u3044\u3068\u601d\u3044\u307e\u3059\uff0e\u306a\u304a\uff0c\u4eca\u56de\u306f\u73fe\u6642\u70b9(2022\u5e746\u6708\u6642\u70b9)\u3067\u6700\u65b0\u7248\u306e2016\u5e74\u7248\u306e\u30dd\u30b8\u30b7\u30e7\u30f3\u30da\u30fc\u30d1\u30fc<sup>\uff14\uff09<\/sup>\u3084\u4ed6\u8ad6\u6587\u3092\u53c2\u8003\u306b\u8a18\u4e8b\u3092\u4f5c\u6210\u3057\u3066\u3044\u307e\u3059\uff0e\u75c5\u56e0\u8ad6\u3084\u5206\u985e\uff0c\u305d\u3057\u3066\u6cbb\u7642\u306b\u969b\u3057\u3066\u306f\u6700\u65b0\u7248\u306e\u30dd\u30b8\u30b7\u30e7\u30f3\u30da\u30fc\u30d1\u30fc\u7b49\u3067\u5404\u81ea\u3054\u78ba\u8a8d\u3092\u304a\u9858\u3044\u3057\u307e\u3059\uff0e<\/p>\n<p><strong>\u00a0<\/strong><\/p>\n<p>&nbsp;<\/p>\n<h2><strong>\uff12\uff0e\u767a\u751f\u4e88\u9632\u306b\u3064\u3044\u3066<\/strong><\/h2>\n<p>\u3000ARONJ\u306e\u5177\u4f53\u7684\u306a\u4e88\u9632\u7b56\u306b\u3064\u3044\u30666\u9805\u76ee\u3092\u6319\u3052\uff0c\u30a8\u30d3\u30c7\u30f3\u30b9\u3068\u3068\u3082\u306b\u89e3\u8aac\u3057\u3066\u3044\u304d\u307e\u3059\uff0e<\/p>\n<p>&nbsp;<\/p>\n<p><strong>(1)<\/strong><strong>\u75be\u60a3\u30fb\u6295\u4e0e\u7d4c\u8def\u306e\u78ba\u8a8d<\/strong><\/p>\n<p>&nbsp;<\/p>\n<p><strong>\u3000\u2460\u9aa8\u7c97\u9b06\u75c7\u306e\u5834\u5408<\/strong><\/p>\n<p>\u3000\u30d3\u30b9\u30db\u30b9\u30db\u30cd\u30fc\u30c8\u88fd\u5264\u7b49\u306e\u7d4c\u53e3\u6295\u4e0e\u30fb\u6ce8\u5c04\u6295\u4e0e\u306e\u4ed6\u306b\uff0c\u30c7\u30ce\u30b9\u30de\u30d6\u304c\u5e83\u304f\u7528\u3044\u3089\u308c\u3066\u3044\u307e\u3059\uff0e\u9aa8\u7c97\u9b06\u75c7\u3078\u306e\u5fdc\u7528\u3067\u306f\uff0c\u4f4e\u7528\u91cf\u3067\u3042\u308b\u305f\u3081\uff0c\u7d4c\u53e3\u6295\u4e0e\u3068\u6ce8\u5c04\u6295\u4e0e\u3067\u306f\u984e\u9aa8\u58ca\u6b7b\u306e\u30ea\u30b9\u30af\u306f\u540c\u7b49\u3067\u3042\u308b<sup>\uff15\uff09<\/sup>\u3068\u8003\u3048\u3089\u308c\u3066\u3044\u307e\u3059\uff0e<\/p>\n<p>\u6ce8\u5c04\u85ac\u306f\u60a3\u8005\u3055\u3093\u304c\u6301\u3063\u3066\u304f\u308b\u304a\u85ac\u624b\u5e33\u3067\u306f\u78ba\u8a8d\u304c\u3067\u304d\u305a\uff0c\u60a3\u8005\u3055\u3093\u81ea\u8eab\u3082\u8a73\u3057\u304f\u628a\u63e1\u3057\u3066\u3044\u306a\u3044\u3053\u3068\u3082\u591a\u3044\u305f\u3081\uff0c\u4e3b\u6cbb\u533b\u3078\u306e\u5bfe\u8a3a\u304c\u5fc5\u8981\u306b\u306a\u308b\u30b1\u30fc\u30b9\u304c\u3042\u308a\u307e\u3059\uff0e\u30d3\u30b9\u30db\u30b9\u30db\u30cd\u30fc\u30c8\u7cfb\u88fd\u5264\u3068\u30c7\u30ce\u30b9\u30de\u30d6\u4ee5\u5916\u306fARONJ\u304c\u767a\u75c7\u3059\u308b\u3053\u3068\u306f\u3042\u308a\u307e\u305b\u3093\u306e\u3067\uff0c\u9aa8\u7c97\u9b06\u75c7\uff1dARONJ\u3068\u52d8\u9055\u3044\u3057\u306a\u3044\u3088\u3046\u306b\u3059\u308b\u5fc5\u8981\u304c\u3042\u308a\u307e\u3059\uff0e<\/p>\n<p>&nbsp;<\/p>\n<p><strong>\u3000\u2461\u95a2\u7bc0\u30ea\u30a6\u30de\u30c1\u306e\u5834\u5408<\/strong><\/p>\n<p>\u3000\u30c7\u30ce\u30b9\u30de\u30d6\u306f\u5f93\u6765\u306e\u9aa8\u7c97\u9b06\u75c7\u306b\u52a0\u3048\u30662017\u5e747\u6708\u306b\u300c\u95a2\u7bc0\u30ea\u30a6\u30de\u30c1\u306b\u4f34\u3046\u9aa8\u3073\u3089\u3093\u306e\u9032\u884c\u6291\u5236\u300d\u306e\u52b9\u80fd\u30fb\u52b9\u679c\u304c\u8ffd\u52a0\u3055\u308c\u307e\u3057\u305f\uff0e6\u304b\u6708\u306b\uff11\u5ea6\u3042\u308b\u3044\u306f3\u304b\u6708\u306b\uff11\u5ea6\u6ce8\u5c04\u85ac\u3068\u3057\u3066\u7528\u3044\u3089\u308c\u307e\u3059\uff0e<\/p>\n<p>&nbsp;<\/p>\n<p><strong>\u3000\u2462\u60aa\u6027\u816b\u760d\u306e\u5834\u5408<\/strong><\/p>\n<p>\u3000\u4e73\u304c\u3093\u3084\u80ba\u304c\u3093\u7b49\u60aa\u6027\u816b\u760d\u306b\u3088\u308b\u9aa8\u8ee2\u79fb\u306e\u6cbb\u7642\u3067\u306f\u30d3\u30b9\u30db\u30b9\u30db\u30cd\u30fc\u30c8\u88fd\u5264\uff0c\u30c7\u30ce\u30b9\u30de\u30d6(\u30e9\u30f3\u30de\u30fc\u30af)\u304c\u70b9\u6ef4\u85ac\u3067\u4f7f\u7528\u3055\u308c\u307e\u3059\uff0e\u9aa8\u8ee2\u79fb\u306f\u75bc\u75db\u3092\u4f34\u3044\uff0c\u75c5\u7684\u9aa8\u6298\u306b\u3088\u308bQOL\u4f4e\u4e0b\u3092\u5f15\u304d\u8d77\u3053\u3059\u305f\u3081\uff0c\u30d3\u30b9\u30db\u30b9\u30db\u30cd\u30fc\u30c8\u88fd\u5264\u3084\u30c7\u30ce\u30b9\u30de\u30d6\u304c\u4f7f\u7528\u3055\u308c\u308b\u306e\u3067\u3059\uff0e\u60aa\u6027\u816b\u760d\u306b\u5bfe\u3059\u308b\u30d3\u30b9\u30db\u30b9\u30db\u30cd\u30fc\u30c8\u88fd\u5264\u306f\u9aa8\u7c97\u9b06\u75c7\u3068\u7570\u306a\u308a\u9ad8\u7528\u91cf\u3067\u6295\u4e0e\u3055\u308c\u308b\u305f\u3081\uff0cARONJ\u306e\u767a\u75c7\u983b\u5ea6\u304c\u9ad8\u3044\u3053\u3068\u304c\u308f\u304b\u3063\u3066\u3044\u307e\u3059<sup>\uff16)<\/sup>\uff0e<\/p>\n<p>\u3000\u307e\u305f\uff0c\u30d3\u30b9\u30db\u30b9\u30db\u30cd\u30fc\u30c8\u88fd\u5264\u3068\u6bd4\u8f03\u3057\u3066\u30c7\u30ce\u30b9\u30de\u30d6\u306b\u3088\u308b\u60aa\u6027\u816b\u760d\u6cbb\u7642\u306fARONJ\u306e\u767a\u75c7\u30ea\u30b9\u30af\u304c\u9ad8\u3044\u3068\u3059\u308b\u30b7\u30b9\u30c6\u30de\u30c6\u30a3\u30c3\u30af\u30ec\u30d3\u30e5\u30fc<sup>7)<\/sup>\u304c\u898b\u3089\u308c\u307e\u3057\u305f\uff0e<\/p>\n<p>&nbsp;<\/p>\n<p><strong>(2)<\/strong><strong>\u7d2f\u7a4d\u6295\u4e0e\u671f\u9593\u306e\u78ba\u8a8d<\/strong><\/p>\n<p>\u3000AAOMS\u306f\u9aa8\u7c97\u9b06\u75c7\u306b\u5bfe\u3059\u308b\u30d3\u30b9\u30db\u30b9\u30db\u30cd\u30fc\u30c8\u88fd\u5264\u4f4e\u7528\u91cf\u6295\u4e0e\u306e\u6295\u4e0e\u671f\u9593\u304c\uff12\u5e74\u672a\u6e80\u3067\u3042\u308c\u3070\u5b89\u5168\uff0c\uff12\uff5e\uff14\u5e74\u3067\u3042\u308c\u3070\u30ea\u30b9\u30af\u304c\u9ad8\u307e\u308b\uff0c\uff14\u5e74\u4ee5\u4e0a\u3067\u3042\u308c\u3070\u767a\u75c7\u7387\u304c\u9ad8\u304f\u306a\u308b<sup>\uff16)<\/sup>\u3068\u5831\u544a\u3057\u3066\u3044\u307e\u3059\uff0e\uff12\u5e74\u672a\u6e80\u3060\u304b\u3089\u7d76\u5bfe\u306b\u5b89\u5168\uff0c\uff14\u5e74\u4ee5\u4e0a\u3067\u3082\u4f11\u85ac\u3059\u308c\u3070\u5b89\u5168\u3068\u306f\u306a\u308a\u307e\u305b\u3093\uff0e\u30c7\u30ce\u30b9\u30de\u30d6\u306e\u7d2f\u7a4d\u6295\u4e0e\u671f\u9593\u306b\u3088\u308b\u5f71\u97ff\u306b\u95a2\u3057\u3066\u306f\u5831\u544a\u304c\u5c11\u306a\u304f\uff0c\u30d3\u30b9\u30db\u30b9\u30db\u30cd\u30fc\u30c8\u3068\u306e\u534a\u6e1b\u671f\u306a\u3069\u306e\u9055\u3044\u304b\u3089\u6bd4\u8f03\u7684\u5f71\u97ff\u306f\u5c11\u306a\u3044\u306e\u304b\u306a\u3068\u601d\u3044\u307e\u3059\u304c\uff0c\u4eca\u5f8c\u306e\u5831\u544a\u3092\u5f85\u3061\u305f\u3044\u3068\u601d\u3044\u307e\u3059\uff0e<\/p>\n<p>&nbsp;<\/p>\n<p><strong>(3)BP<\/strong><strong>\u88fd\u5264\u306e\u4f11\u85ac<\/strong><\/p>\n<p>\u3000\u4f11\u85ac\u3092\u652f\u6301\u3059\u308b\u5831\u544a\u3068\u4f11\u85ac\u3092\u652f\u6301\u3057\u306a\u3044\u5831\u544a\u304c\u3042\u308a\u307e\u3059\uff0e<\/p>\n<p>&nbsp;<\/p>\n<p><strong>\u3000\u2460\u4f11\u85ac\u3092\u652f\u6301\u3059\u308b\u5831\u544a<\/strong><\/p>\n<p>\u3000AAOMS\u306fBP\u88fd\u5264\u306e\u4e88\u9632\u7684\u4f11\u85ac\u306f\uff14\u5e74\u4ee5\u4e0a\u6295\u4e0e\u3092\u53d7\u3051\u3066\u3044\u308b\u5834\u5408\u306b2\u304b\u6708\u7a0b\u5ea6\u4f11\u85ac\u3092\u691c\u8a0e\u3059\u308b\u3053\u3068\u3092\u63d0\u5531<sup>\uff16\uff09<\/sup>\u3057\u3066\u3044\u307e\u3059\uff0e\u3082\u3061\u308d\u3093\uff0c\u9aa8\u6cbb\u7652\u5f8c\u306b\u306f\u30d3\u30b9\u30db\u30b9\u30db\u30cd\u30fc\u30c8\u88fd\u5264\u3092\u6295\u4e0e\u518d\u958b\u3057\u307e\u3059\uff0e<\/p>\n<p>&nbsp;<\/p>\n<p><strong>\u3000\u2461\u4f11\u85ac\u3092\u652f\u6301\u3057\u306a\u3044\u5831\u544a<\/strong><\/p>\n<p>\u3000\u4f11\u85ac\u7fa4\u3068\u975e\u4f11\u85ac\u7fa4\u3067\u6709\u610f\u5dee\u306f\u306a\u304b\u3063\u305f<sup>8)<\/sup>\u3068\u5831\u544a\u3055\u308c\u305f\u308a\uff0c\u4f11\u85ac\u306b\u3088\u308a\u4e88\u9632\u3067\u304d\u308b\u304b\u3069\u3046\u304b\u306f\u4e0d\u660e<sup>9\uff09<\/sup>\u30c7\u30ce\u30b9\u30de\u30d6\u3092\u542b\u3080MRONJ\u306e\u4f11\u85ac\u3092\u652f\u6301\u3059\u308b\u30a8\u30d3\u30c7\u30f3\u30b9\u306f\u306a\u3044\u3068\u3044\u3046\u30b7\u30b9\u30c6\u30de\u30c6\u30c3\u30af\u30ec\u30d3\u30e5\u30fc\u304c\u5b58\u5728\u3057\u3066\u3044\u307e\u3059<sup>10)<\/sup>\uff0e \u4f11\u85ac\u306b\u3088\u308b\u9aa8\u6298\u306a\u3069\u306fQOL\u3092\u8457\u3057\u304f\u4f4e\u4e0b\u3055\u305b\u3066\u3057\u307e\u3044\u307e\u3059\u3057\uff0c\u307e\u3057\u3066\u9aa8\u8ee2\u79fb\u306b\u7e4b\u304c\u308b\u3088\u3046\u306a\u3053\u3068\u304c\u3042\u308c\u3070\u751f\u547d\u4e88\u5f8c\u306b\u76f4\u7d50\u3057\u3066\u3057\u307e\u3044\u307e\u3059\uff0e\u65e5\u672c\u306e\uff12\uff10\uff11\uff16\u5e74\u306b\u51fa\u3055\u308c\u305f\u9aa8\u5438\u53ce\u85ac\u95a2\u9023\u984e\u9aa8\u58ca\u6b7b\u306b\u95a2\u3059\u308b\u30dd\u30b8\u30b7\u30e7\u30f3\u30da\u30fc\u30d1\u30fc\u3067\u306f\uff0c\u539f\u5247\u7684\u306b\u6b6f\u79d1\u6cbb\u7642\u306e\u524d\u306b\u30d3\u30b9\u30db\u30b9\u30db\u30cd\u30fc\u30c8\u3092\u4f11\u85ac\u3059\u308b\u5fc5\u8981\u306f\u306a\u3044\u3068\u3057\u3066\u3044\u307e\u3059<sup>11)<\/sup>\uff0e<\/p>\n<p>&nbsp;<\/p>\n<p>\u3000\u591a\u304f\u306e\u8ad6\u6587\u3084\u30dd\u30b8\u30b7\u30e7\u30f3\u30da\u30fc\u30d1\u30fc\u3067\uff0c\u4f11\u85ac\u3059\u308b\u5fc5\u8981\u306f\u306a\u3044\u3068\u3057\u3066\u3044\u308b\u7406\u7531\u3067\u3059\u304c\uff0c\u534a\u6e1b\u671f\u304c2,3\u5e74\u306e\u30d3\u30b9\u30db\u30b9\u30db\u30cd\u30fc\u30c8\u88fd\u5264\u3092\uff13\u304b\u6708\u7a0b\u5ea6\u4f11\u85ac\u3057\u3066\u3082ARONJ\u306e\u767a\u75c7\u4e88\u9632\u306b\u52b9\u679c\u304c\u3042\u308b\u304b\u3068\u3044\u3046\u306e\u306f\u7591\u554f\u3067\uff0c\u4f11\u85ac\u306b\u3088\u308b\u306f\u3063\u304d\u308a\u3068\u3057\u305f\u30a8\u30d3\u30c7\u30f3\u30b9\u306b\u4e4f\u3057\u3044\u304b\u3089\u3060\u3068\u8003\u3048\u3066\u3044\u307e\u3059\uff0e\u3084\u306f\u308a\uff0c\u75c5\u7684\u9aa8\u6298\u3084\u9aa8\u8ee2\u79fb\u306a\u3069\u3092\u8003\u616e\u3059\u308b\u3068\uff0c\u3084\u305f\u3089\u306b\u4f11\u85ac\u306f\u3055\u305b\u306a\u3044\u307b\u3046\u304c\u3088\u3044\u3068\u3044\u3046\u3053\u3068\u306a\u306e\u3067\u3057\u3087\u3046\uff0e<\/p>\n<p>&nbsp;<\/p>\n<p>\u3000\u4e00\u65b9\uff0c\u30c7\u30ce\u30b9\u30de\u30d6\u306e\u5834\u5408\uff0c\u8840\u4e2d\u534a\u6e1b\u671f\u304c\u7d041\u304b\u6708\u306a\u306e\u3067\uff0c\u4f11\u85ac\u305b\u305a\u306b\u6cbb\u7642\u6642\u671f\u3084\u5185\u5bb9\u3092\u691c\u8a0e\u3059\u308b\u3053\u3068\u304c\u53ef\u80fd<sup>11)<\/sup>\u3067\uff0c\u4f11\u85ac\u305b\u305a\u306b\u6295\u4e0e\u5f8c\uff13\u304b\u6708\u304b\u3089\uff14\u304b\u6708\u306e\u7d42\u308f\u308a\u307e\u3067\u306b\u629c\u6b6f\u3084\u30a4\u30f3\u30d7\u30e9\u30f3\u30c8\u3092\u5b9f\u65bd\u3059\u308b\u306e\u304c\u597d\u307e\u3057\u3044<sup>6)<\/sup>\u3068\u3044\u3046\u5831\u544a\u304c\u3042\u308a\u307e\u3059\uff0e<\/p>\n<p>&nbsp;<\/p>\n<p><strong>(4)<\/strong><strong>\u629c\u6b6f\u5275\u306e\u9589\u9396<\/strong><\/p>\n<p>&nbsp;<\/p>\n<p>\u30002016\u5e74\u306e\u30dd\u30b8\u30b7\u30e7\u30f3\u30da\u30fc\u30d1\u30fc\u3067\u306f\uff0c\u629c\u6b6f\u5f8c\u306e\u9aa8\u9732\u51fa\u304c\u30ea\u30b9\u30af\u3068\u8003\u3048\u3089\u308c\u3066\u9589\u9396\u5275\u304c\u63a8\u5968\u3055\u308c\u3066\u3044\u307e\u3059<sup>11\uff09<\/sup>\uff0e\u3057\u304b\u3057\uff0c\u5b8c\u5168\u306a\u9589\u9396\u5275\u3092\u76ee\u6307\u3059\u3068\u9aa8\u92ed\u7e01\u90e8\u306e\u51e6\u7406\u3084\u6e1b\u5f35\u5207\u958b\u306a\u3069\u5916\u79d1\u7684\u4fb5\u8972\u304c\u5927\u304d\u304f\u306a\u308b\u3053\u3068\u3082\u8003\u616e\u3059\u308b\u3079\u304d\u3060\u3068\u601d\u3044\u307e\u3059\uff0eARONJ\u306e\u767a\u75c7\u304c\u629c\u6b6f\u304c\u539f\u56e0\u3067\u306f\u306a\u304f\u629c\u6b6f\u306e\u539f\u56e0\u3068\u306a\u3063\u305f\u5c40\u6240\u611f\u67d3\u3067\u3042\u308b\u306a\u3089\uff0c\u5b8c\u5168\u9589\u9396\u5275\u306e\u307b\u3046\u304c\u3080\u3057\u308d\u30ea\u30b9\u30af\u304b\u3082\u3057\u308c\u306a\u3044<sup>\uff15)<\/sup>\u3068\u3059\u308b\u5831\u544a\u3082\u898b\u3089\u308c\u307e\u3057\u305f\uff0e<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p><strong>(5)<\/strong><strong>\u6b6f\u79d1\u6cbb\u7642\uff0c\u53e3\u8154\u30b1\u30a2<\/strong><\/p>\n<p>&nbsp;<\/p>\n<p>\u3000\u6b6f\u5468\u75c5\u3084\u6839\u5c16\u6027\u6b6f\u5468\u708e\u306fBRONJ\u306e\u30ea\u30b9\u30af\u56e0\u5b50\u306b\u306a\u308b<sup>\uff112)<\/sup>\u3068\u3044\u3046\u5831\u544a\u3084\uff0c\u6b6f\u79d1\u691c\u8a3a\u3068\u4e88\u9632\u7684\u6b6f\u79d1\u51e6\u7f6e\u304c\u767a\u751f\u7387\u306e\u6e1b\u5c11\u306b\u7e4b\u304c\u3063\u305f<sup>13\uff09<\/sup>\u629c\u6b6f\u524d\u5f8c\u306e\u53e3\u8154\u885b\u751f\u72b6\u614b\u306e\u6539\u5584\u304c\u6709\u52b9<sup>\uff14\uff09<\/sup>\u3068\u3044\u3046\u5831\u544a\u304b\u3089\uff0c\u4fb5\u8972\u7684\u6b6f\u79d1\u6cbb\u7642\u306e\u524d\u306b\u611f\u67d3\u306e\u9664\u53bb\u3092\u76ee\u7684\u3068\u3057\u305f\u6b6f\u79d1\u6cbb\u7642\u3084\u53e3\u8154\u30b1\u30a2\u306f\u63a8\u5968\u3055\u308c\u308b\u3068\u8003\u3048\u3089\u308c\u307e\u3059\uff0e<\/p>\n<p>&nbsp;<\/p>\n<p>\u3000\u6b6f\u79d1\u6cbb\u7642\u3067\u3059\u304c\uff0c\u78ba\u7acb\u3055\u308c\u305f\u30ac\u30a4\u30c9\u30e9\u30a4\u30f3\u306b\u5f93\u3063\u3066\u884c\u3048\u3070\uff0c\u9ad8\u30ea\u30b9\u30af\u60a3\u8005\u3067\u3042\u3063\u3066\u3082\u5b89\u5168\u304b\u3064\u4e88\u6e2c\u53ef\u80fd\u306a\u65b9\u6cd5\u3067\u884c\u3046\u3053\u3068\u304c\u3067\u304d\u308b<sup>14\uff09<\/sup>\u3068\u3044\u3046\u5831\u544a\u3084\uff0c\u77ef\u6b63\u6cbb\u7642\u30fb\u6839\u7ba1\u6cbb\u7642\u306f\u30ea\u30b9\u30af\u56e0\u5b50\u3067\u306f\u306a\u3044<sup>\uff14\uff09<\/sup>\uff0c\u6839\u7ba1\u6cbb\u7642\u306fBP\u6295\u4e0e\u60a3\u8005\u306b\u304a\u3051\u308bONJ\u306e\u30ea\u30b9\u30af\u3092\u5897\u52a0\u3055\u305b\u306a\u304b\u3063\u305f<sup>14\uff09<\/sup>\u3068\u3044\u3046\u5831\u544a\u304c\u3042\u308b\u3088\u3046\u306b\u4e00\u822c\u7684\u306a\u6b6f\u79d1\u6cbb\u7642\u306f\u53ef\u80fd\u3068\u8003\u3048\u3089\u308c\u307e\u3059\uff0e\u305f\u3060\uff0c\u307e\u308c\u3068\u306f\u601d\u308f\u308c\u307e\u3059\u304c\uff0cSRP\u306b\u3088\u308bARONJ\u767a\u75c7\u306e\u5831\u544a<sup>\uff115)<\/sup>\u3084\u6839\u7ba1\u6cbb\u7642\u306b\u3088\u308bARONJ\u767a\u75c7\u306e\u5831\u544a(\u30c7\u30ce\u30b9\u30de\u30d6)\u304c\u3042\u308b<sup>\uff116)<\/sup>\u305f\u3081\uff0c\u6b6f\u79d1\u6cbb\u7642\u306e\u969b\u306b\u306f\u6ce8\u610f\u3092\u3057\u306a\u304c\u3089\u5b9f\u65bd\u3059\u308b\u3068\u3044\u3046\u3053\u3068\u306b\u306a\u308b\u3068\u601d\u3044\u307e\u3059\uff0e<\/p>\n<p>&nbsp;<\/p>\n<p>\u3000\u4e00\u65b9\uff0c\u611f\u67d3\u5de3\u9664\u53bb\u306e\u305f\u3081\u306e\u629c\u6b6f\u3067\u3059\u304c\uff0c\u629c\u6b6f\u306fMRONJ\u767a\u75c7\u306e\u30ea\u30b9\u30af\u3092\u6709\u610f\u306b\u4f4e\u4e0b\u3055\u305b\u308b\u3053\u3068\u304c\u793a\u3055\u308c\u305f<sup>17\uff09<\/sup>\uff0e\u3068\u3044\u3046\u5831\u544a\u304c\u307f\u3089\u308c\u307e\u3057\u305f\uff0e\u3053\u308c\u306f\uff0c\u629c\u304f\u3079\u304d\u6b6f\u3092\u653e\u7f6e\u3057\u3066\u304a\u304f\u3053\u3068\u306f\u597d\u307e\u3057\u304f\u306a\u304f\uff0c\u611f\u67d3\u5de3\u3068\u306a\u308a\u3048\u308b\u629c\u6b6f\u9069\u5fdc\u6b6f\u306f\u9069\u5207\u306b\u629c\u6b6f\u3055\u308c\u308b\u3079\u304d\u3060\u3068\u3044\u3046\u3053\u3068\u306a\u306e\u3060\u3068\u601d\u3044\u307e\u3059\uff0e<\/p>\n<p>&nbsp;<\/p>\n<p><strong>(6)<\/strong><strong>\u8853\u524d\u6297\u83cc\u85ac\u6295\u4e0e<\/strong><\/p>\n<p>&nbsp;<\/p>\n<p>\u3000\u629c\u6b6f\u306a\u3069\u4fb5\u8972\u6027\u6b6f\u79d1\u51e6\u7f6e\u306e\u524d\u306b\u6297\u83cc\u85ac\u3092\u6295\u4e0e\u3059\u308b\u8853\u524d\u6297\u83cc\u85ac\u6295\u4e0e\u306f2016\u5e74\u306e\u30dd\u30b8\u30b7\u30e7\u30f3\u30da\u30fc\u30d1\u30fc\u306b\u3082\u8a18\u8f09\u304c\u3042\u308b<sup>\uff14)<\/sup>\u3088\u3046\u306b\uff0c\u652f\u6301\u3055\u308c\u3066\u3044\u308b\u8ad6\u6587\u304c\u591a\u304f\u3042\u308a\u307e\u3057\u305f\uff0e\u307e\u305f\uff0c\u5b9f\u969b\u306b\u6297\u83cc\u85ac\u6295\u4e0e\u306b\u3088\u3063\u3066\u767a\u751f\u7387\u306e\u6e1b\u5c11\u306b\u7e4b\u304c\u3063\u305f<sup>18\uff09<\/sup>\u3068\u3059\u308b\u5831\u544a\u304c\u898b\u3089\u308c\u3066\u3044\u307e\u3059\uff0e\u629c\u6b6f\u306a\u3069\u4fb5\u8972\u7684\u6cbb\u7642\u304c\u907f\u3051\u3089\u308c\u306a\u3044\u5834\u5408\u306f\u8853\u524d\u6297\u83cc\u85ac\u6295\u4e0e\u306f\u6709\u52b9\u3060\u3068\u8003\u3048\u3066\u3044\u307e\u3059\uff0e\u8853\u524d\u6297\u83cc\u85ac\u6295\u4e0e\u306b\u5f53\u305f\u3063\u3066\u306f\u65e5\u672c\u5316\u5b66\u7642\u6cd5\u5b66\u4f1a\uff0c\u65e5\u672c\u5916\u79d1\u611f\u67d3\u75c7\u5b66\u4f1a\u8853\u5f8c\u611f\u67d3\u4e88\u9632\u6297\u83cc\u85ac\u9069\u6b63\u4f7f\u7528\u306b\u95a2\u3059\u308b\u30ac\u30a4\u30c9\u30e9\u30a4\u30f3<sup>19)<\/sup>\u306b\u5f93\u3044\uff0c\u9069\u6b63\u4f7f\u7528\u3092\u5fc3\u304c\u3051\u308b\u5fc5\u8981\u304c\u3042\u308a\u307e\u3059\uff0e\u30ac\u30a4\u30c9\u30e9\u30a4\u30f3\u306b\u57fa\u3065\u304f\u51e6\u65b9\u4f8b\u3092\u4ee5\u4e0b\u306b\u793a\u3057\u307e\u3059\u306e\u3067\uff0c\u53c2\u8003\u306b\u3055\u308c\u3066\u304f\u3060\u3055\u3044\uff0e<\/p>\n<p>&nbsp;<\/p>\n<p>(\u30da\u30cb\u30b7\u30ea\u30f3\u30a2\u30ec\u30eb\u30ae\u30fc\u304c\u306a\u3044\u5834\u5408\u306e\u51e6\u65b9\u4f8b) <sup>19)<\/sup><\/p>\n<p>\u629c\u6b6f\u524d\u306b\u30a2\u30e2\u30ad\u30b7\u30b7\u30ea\u30f31\u56de250mg\uff5e1g\u30921\u6642\u9593\u524d\u306b\u6295\u4e0e\uff0e<\/p>\n<p>\u8853\u5f8c\u6295\u4e0e\u306f\u4fb5\u8972\u3084\u60a3\u8005\u81ea\u8eab\u306e\u611f\u67d3\u9632\u5fa1\u80fd\u306b\u3088\u308b\uff0e<\/p>\n<p>\u30a4\u30f3\u30d7\u30e9\u30f3\u30c8\u57cb\u5165\u624b\u8853\u306e\u5834\u5408\u306f\u30a2\u30e2\u30ad\u30b7\u30b7\u30ea\u30f31\u56de250mg\uff5e1g\u30921\u6642\u9593\u524d\u306b\u6295\u4e0e\uff0e<\/p>\n<p>\u8853\u5f8c\u6295\u4e0e\u306f\u4e0d\u8981\uff0e<\/p>\n<p>&nbsp;<\/p>\n<p>\u3000\u8853\u524d\u6295\u4e0e\u306b\u95a2\u3057\u3066\u306f\uff0c\u514d\u75ab\u6291\u5236\u5264\u3084\u30b9\u30c6\u30ed\u30a4\u30c9\u3092\u6295\u4e0e\u3055\u308c\u3066\u3044\u308b\u7b49\u306e\u514d\u75ab\u6291\u5236\u72b6\u614b\u3067\u3042\u308c\u3070\uff0c\u7279\u306b\u5f37\u304f\u63a8\u5968\u3055\u308c\u308b\u3082\u306e\u3068\u601d\u308f\u308c\u307e\u3059\uff0e\u305f\u3060\uff0c\u3053\u308c\u3089\u306e\u75be\u60a3\u3092\u6709\u3059\u308b\/\u670d\u7528\u3057\u3066\u3044\u308b\u5834\u5408\u306b\u306f\u304b\u304b\u308a\u3064\u3051\u533b\u3068\u9023\u643a\u3057\uff0c\u30ea\u30b9\u30af\u3092\u898b\u6975\u3081\u305f\u4e0a\u3067\u629c\u6b6f\u3059\u308b\u3053\u3068\u304c\u5fc5\u8981\u3060\u3068\u601d\u308f\u308c\u307e\u3059\uff0e<\/p>\n<p>&nbsp;<\/p>\n<h2><strong>\uff13\uff0e\u307e\u3068\u3081<\/strong><\/h2>\n<p>\u3000\u672c\u8a18\u4e8b\u4f5c\u6210\u306e\u969b\u306b\u307e\u3068\u3081\u305f\u500b\u4eba\u7684\u306a\u307e\u3068\u3081\u3067\u3059\uff0e\u81e8\u5e8a\u5fdc\u7528\u3055\u308c\u308b\u969b\u306f\u5fc5\u305a\u3054\u81ea\u8eab\u3067\u3054\u78ba\u8a8d\u304f\u3060\u3055\u3044\uff0e<\/p>\n<p>&nbsp;<\/p>\n<p>\u30fb\u30c7\u30ce\u30b9\u30de\u30d6\u3067\u3082\u30d3\u30b9\u30db\u30b9\u30db\u30cd\u30fc\u30c8\u7cfb\u88fd\u5264\u3068\u540c\u69d8\u306e\u9aa8\u58ca\u6b7b\u304c\u751f\u3058\u308b\u3053\u3068\u306b\u3088\u308aBRONJ\u304b\u3089AROMJ\u3082\u3057\u304f\u306fMRONJ\u306b\u5909\u5316\u3057\u3066\u3044\u308b\uff0e<\/p>\n<p>\u30fb\u30d3\u30b9\u30db\u30b9\u30db\u30cd\u30fc\u30c8\u88fd\u5264\u306a\u306e\u304b\u30c7\u30ce\u30b9\u30de\u30d6\u306a\u306e\u304b\uff0c\u9aa8\u7c97\u9b06\u75c7\u306b\u5bfe\u3059\u308b\u6295\u4e0e\u304b\u816b\u760d\u306b\u5bfe\u3059\u308b\u6295\u4e0e\u304b\u3092\u628a\u63e1\u3057\u3066\u304a\u304f\u5fc5\u8981\u304c\u3042\u308b\uff0e<\/p>\n<p>\u30fb\u7d4c\u53e3\u6295\u4e0e\u306e\u5834\u5408\uff0cMRONJ\u306e\u767a\u75c7\u306e\u53ef\u80fd\u6027\u306f\u5c11\u306a\u304f\uff0c\u591a\u304f\u306e\u5834\u5408\uff0c\u629c\u6b6f\u306f\u901a\u5e38\u901a\u308a\u5b9f\u65bd\u3059\u308b\u3053\u3068\u304c\u3067\u304d\u308b\uff0e<\/p>\n<p>\u30fb\u534a\u6e1b\u671f\u306e\u77ed\u3044\u30c7\u30ce\u30b9\u30de\u30d6\u306e\u4f4e\u7528\u91cf\u6295\u4e0e\u306e\u5834\u5408\uff0c\u6295\u4e0e\u524d\u30fb\u5f8c\uff12\u304b\u6708\u3092\u907f\u3051\u308c\u3070\u6bd4\u8f03\u7684\u5b89\u5168\u306b\u629c\u6b6f\u30fb\u30a4\u30f3\u30d7\u30e9\u30f3\u30c8\u57cb\u5165\u304c\u3067\u304d\u308b\u53ef\u80fd\u6027\u304c\u9ad8\u3044\uff0e<\/p>\n<p>\u30fb\u8853\u524d\u304b\u3089\u306e\u53e3\u8154\u6e05\u6383\u3092\u76ee\u7684\u3068\u3057\u305f\u53e3\u8154\u30b1\u30a2\u3084\u611f\u67d3\u5de3\u3092\u6e1b\u5c11\u3055\u305b\u308b\u3053\u3068\u3092\u76ee\u7684\u3068\u3057\u305f\u6b6f\u79d1\u6cbb\u7642\u304c\u63a8\u5968\u3055\u308c\u3066\u3044\u308b\uff0e<\/p>\n<p>\u30fb\u4f11\u85ac\u306fAAOMS\u304cBP\u88fd\u5264\u306e\u4e88\u9632\u7684\u4f11\u85ac\u306f\uff14\u5e74\u4ee5\u4e0a\u6295\u4e0e\u3092\u53d7\u3051\u3066\u3044\u308b\u5834\u5408\u306b\u63a8\u5968\u3057\u3066\u3044\u308b\u304c\uff0c\u63a8\u5968\u3057\u306a\u3044\u3068\u3059\u308b\u30a8\u30d3\u30c7\u30f3\u30b9\u306e\u307b\u3046\u304c\u591a\u3044\uff0e<\/p>\n<p>\u30fb\u9589\u9396\u5275\u304c\u3088\u3044\u304b\u958b\u653e\u5275\u304c\u3088\u3044\u304b\u306f\u8b70\u8ad6\u306e\u4f59\u5730\u304c\u3042\u308a\uff0c\u30dd\u30b8\u30b7\u30e7\u30f3\u30da\u30fc\u30d1\u30fc\u3067\u306f\u9589\u9396\u5275\u304c\u63a8\u5968\u3055\u308c\u3066\u3044\u308b\u3082\u306e\u306e\u8cea\u306e\u9ad8\u3044\u30a8\u30d3\u30c7\u30f3\u30b9\u306f\u5b58\u5728\u3057\u306a\u3044\uff0e<\/p>\n<p>\u30fb\u4fb5\u8972\u7684\u6b6f\u79d1\u6cbb\u7642\u524d\u306b\u884c\u3046\u8853\u524d\u6297\u83cc\u85ac\u6295\u4e0e\u306f\u6709\u52b9\u3067\u3042\u308b\u53ef\u80fd\u6027\u304c\u9ad8\u3044\uff0e\u8853\u524d\u6297\u83cc\u85ac\u6295\u4e0e\u3092\u5b9f\u65bd\u3059\u308b\u5834\u5408\u306f\u30ac\u30a4\u30c9\u30e9\u30a4\u30f3\u306b\u5f93\u3063\u3066\u6295\u4e0e\u3092\u5b9f\u65bd\u3059\u308b\uff0e<\/p>\n<p>\u30fb\u514d\u75ab\u6291\u5236\u72b6\u614b\u3067\u3042\u308b\u5834\u5408(\u514d\u75ab\u6291\u5236\u5264\u3084\u30b9\u30c6\u30ed\u30a4\u30c9\u6295\u4e0e\u306a\u3069)\u306b\u306f\u304b\u304b\u308a\u3064\u3051\u533b\u3068\u9023\u643a\u3057\uff0c\u5bfe\u51e6\u3059\u308b\u3079\u304d\uff0e<\/p>\n<p>&nbsp;<\/p>\n<p>\u548c\u8a33\u30fb\u5185\u5bb9\u7b49\u306b\u9593\u9055\u3044\u3042\u308c\u3070\u3054\u6307\u6458\u3044\u305f\u3060\u3051\u307e\u3059\u3068\u52a9\u304b\u308a\u307e\u3059\uff0e<\/p>\n<p>&nbsp;<\/p>\n<h2><strong>4<\/strong><strong>\uff0eQ&amp;A<\/strong><\/h2>\n<p>&nbsp;<\/p>\n<p><strong>Q\uff11 \u30dd\u30b8\u30b7\u30e7\u30f3\u30da\u30fc\u30d1\u30fc\u3068\u306f\uff1f<\/strong><\/p>\n<p>\u3000A\u3000\u30ac\u30a4\u30c9\u30e9\u30a4\u30f3\u307e\u3067\u53b3\u5bc6\u306a\u6307\u91dd\u3067\u306f\u3042\u308a\u307e\u305b\u3093\u304c\uff0c\u75be\u60a3\u306b\u95a2\u4fc2\u3059\u308b\u4eba\u304c\u5171\u6709\u3059\u3079\u304d\u60c5\u5831\u3084\u8003\u3048\u65b9\u3092\u307e\u3068\u3081\u305f\u3082\u306e\u3067\u3059\uff0e<\/p>\n<p>&nbsp;<\/p>\n<p><strong>Q\uff12 ARONJ\u60a3\u8005\u306b\u6027\u5dee\uff0c\u90e8\u4f4d\u5dee\u306f\u3042\u308b\u304b\uff1f<\/strong><\/p>\n<p>\u3000A\u3000\u65e5\u672c\u53e3\u8154\u5916\u79d1\u5b66\u4f1a\u306b\u3088\u308b\u5b9f\u614b\u8abf\u67fb\u3067\u306f\u5973\u602771%\uff0c\u7537\u602729%\u3068\u5831\u544a\u3055\u308c\u3066\u3044\u307e\u3059\uff0e\u307e\u305f\uff0c\u4e0b\u984e3,183\u540d\uff0c\u4e0a\u984e1,382\u540d\u3068\u7d04\uff12\u500d\u4e0b\u984e\u306b\u591a\u3044\u3068\u3044\u3046\u7d50\u679c\u304c\u5f97\u3089\u308c\u3066\u3044\u307e\u3059<sup>\uff12)<\/sup><\/p>\n<p>&nbsp;<\/p>\n<p><strong>Q\uff13\u3000BRONJ\uff0cDRONJ\uff0cARONJ\uff0cMRONJ\u306e\u7528\u8a9e\u306f\u3069\u308c\u3092\u4f7f\u7528\u3059\u308b\u3079\u304d\u304b\uff1f<\/strong><\/p>\n<p>\u3000A\u3000\u73fe\u5728\u306fBRONJ\uff0cDRONJ\u3092\u7dcf\u79f0\u3057\u3066ARONJ\u3042\u308b\u3044\u306fMRONJ\u3068\u547c\u79f0\u3059\u308b\u3053\u3068\u304c\u591a\u304f\u306a\u3063\u3066\u3044\u307e\u3059\uff0e\u4ee5\u4e0b\u3092\u53c2\u7167\u3057\u3066\u304f\u3060\u3055\u3044\uff0e<\/p>\n<p>BRONJ\uff1aBisphosphonate-related osteonecrosis of the jaw\u306e\u7565\u3067\uff0c\u30d3\u30b9\u30db\u30b9\u30db\u30cd\u30fc\u30c8\u95a2\u9023\u984e\u9aa8\u58ca\u6b7b\u3068\u8a33\u3055\u308c\u307e\u3059\uff0e<\/p>\n<p>DRONJ\uff1aDenosumab related osteonecrosis of the jaw\u306e\u7565\u3067\uff0c\u30c7\u30ce\u30b9\u30de\u30d6\u95a2\u9023\u984e\u9aa8\u58ca\u6b7b\u3068\u8a33\u3055\u308c\u307e\u3059\uff0e<\/p>\n<p>ARONJ\uff1aAnti resorptive agents related osteonecrosis of the jaw\u306e\u7565\u3067\uff0c\u9aa8\u5438\u53ce\u963b\u5bb3\u85ac\u95a2\u9023\u984e\u9aa8\u58ca\u6b7b\u3068\u8a33\u3055\u308c\u307e\u3059\uff0e<\/p>\n<p>MRONJ\uff1aMedication related osteonecrosis of the jaw\u306e\u7565\u3067\uff0c\u85ac\u5264\u95a2\u9023\u6027\u984e\u9aa8\u58ca\u6b7b\u3068\u8a33\u3055\u308c\u307e\u3059\uff0e<\/p>\n<p>&nbsp;<\/p>\n<p><strong>Q\uff14\u3000SRP\uff0c\u6b6f\u5468\u5916\u79d1\u306f\u53ef\u80fd\u304b\uff1f<\/strong><\/p>\n<p>\u3000A\u3000\u6ce8\u5c04\u85ac\u306e\u75c7\u4f8b\u3067SRP\u306b\u3088\u3063\u3066ARONJ\u306e\u5831\u544a\u304c\u3042\u308b\u3068\u306e\u3053\u3068\u3067\u3059<sup>15)<\/sup>\uff0e\u305f\u3060\uff0c\u6b6f\u79d1\u691c\u8a3a\u3068\u4e88\u9632\u7684\u6b6f\u79d1\u51e6\u7f6e\u304c\u767a\u751f\u7387\u306e\u6e1b\u5c11\u306b\u7e4b\u304c\u3063\u305f<sup>13\uff09<\/sup>\u3068\u306e\u5831\u544a\u3082\u3042\u308b\u305f\u3081\uff0c\u3080\u3084\u307f\u3084\u305f\u3089\u306bSRP\u3092\u542b\u3080\u6b6f\u5468\u57fa\u672c\u6cbb\u7642\u3092\u63a7\u3048\u308b\u3068\u3044\u3046\u306e\u306f\u3061\u3087\u3063\u3068\u8003\u3048\u3082\u306e\u3067\u3059\uff0e\u307e\u305f\uff0c\u9aa8\u9732\u51fa\u3092\u4f34\u3046\u6b6f\u5468\u5916\u79d1\u306fARONJ\u767a\u75c7\u306e\u30ea\u30b9\u30af\u306b\u306a\u308a\u307e\u3059\uff0e\uff17mm\u3092\u8d85\u3048\u308b\u6b6f\u5468\u30dd\u30b1\u30c3\u30c8\u306b\u5bfe\u3057\u3066\u3082\u6b6f\u5468\u57fa\u672c\u6cbb\u7642\u306f\u6b6f\u5468\u5916\u79d1\u3068\u540c\u7b49\u306e\u7d50\u679c\u304c\u5f97\u3089\u308c\u305f<sup>20)<\/sup>\u3068\u5831\u544a\u304c\u3042\u308b\u305f\u3081\uff0c\u75c7\u4f8b\u306b\u5fdc\u3058\u3066\u8853\u5f0f\u9078\u629e\u306b\u3064\u3044\u3066\u614e\u91cd\u306b\u8003\u616e\u3059\u3079\u304d\u3068\u8003\u3048\u307e\u3059\uff0e<\/p>\n<p>&nbsp;<\/p>\n<p><strong>Q\uff15\u3000\u30c7\u30ce\u30b9\u30de\u30d6\u6295\u4e0e\u4e2d\u306e\u60a3\u8005\u3055\u3093\u306b\u629c\u6b6f\u30fb\u30a4\u30f3\u30d7\u30e9\u30f3\u30c8\u3067\u304d\u308b\u30bf\u30a4\u30df\u30f3\u30b0\u306f\uff1f<\/strong><\/p>\n<p>\u3000A\u3000\u30d3\u30b9\u30db\u30b9\u30db\u30cd\u30fc\u30c8\u88fd\u5264\u3067\u306f\u306a\u304f\uff0c\u30c7\u30ce\u30b9\u30de\u30d6\u306e\u5229\u70b9\u3068\u3057\u3066\u534a\u6e1b\u671f\u304c\u77ed\u3044\u3053\u3068\u304c\u6319\u3052\u3089\u308c\u307e\u3059\uff0e\u8840\u4e2d\u534a\u6e1b\u671f\u304c\u7d041\u304b\u6708\u306a\u306e\u3067\uff0c\u4f11\u85ac\u305b\u305a\u306b\u6cbb\u7642\u6642\u671f\u3084\u5185\u5bb9\u3092\u691c\u8a0e\u3059\u308b\u3053\u3068\u304c\u53ef\u80fd<sup>11)<\/sup>\u3067\uff0c\u4f11\u85ac\u305b\u305a\u306b\u6295\u4e0e\u5f8c\uff13\u304b\u6708\u304b\u3089\uff14\u304b\u6708\u306e\u7d42\u308f\u308a\u307e\u3067\u306b\u629c\u6b6f\u3084\u30a4\u30f3\u30d7\u30e9\u30f3\u30c8\u3092\u5b9f\u65bd\u3059\u308b\u306e\u304c\u597d\u307e\u3057\u3044<sup>\uff15)<\/sup>\u3068\u3055\u308c\u3066\u3044\u308b\u306e\u3067\uff0c\u7c21\u5358\u306b\u307e\u3068\u3081\u308b\u3068\u6295\u4e0e\u524d\u5f8c\uff12\u304b\u6708\u9593\u3092\u907f\u3051\u308c\u3070\u53ef\u80fd\u3068\u8003\u3048\u3066\u3088\u3044\u3068\u601d\u3044\u307e\u3059\uff0e\u8aac\u660e\u30fb\u540c\u610f\u6587\u66f8\u3092\u7528\u610f\u3057\uff0c\u60a3\u8005\u3055\u3093\u306b\u7d0d\u5f97\u3057\u3066\u3044\u305f\u3060\u3044\u305f\u4e0a\u3067\u51e6\u7f6e\u3059\u308b\u5fc5\u8981\u6027\u304c\u3042\u308b\u3068\u601d\u3044\u307e\u3059\uff0e<\/p>\n<p>&nbsp;<\/p>\n<p><strong>Q\uff16\u3000\u9aa8\u5438\u53ce\u963b\u5bb3\u85ac\u306b\u3088\u308b\u60aa\u6027\u816b\u760d\u6cbb\u7642\u4e2d\u60a3\u8005\u306b\u5bfe\u3057\u30a4\u30f3\u30d7\u30e9\u30f3\u30c8\u306f\u53ef\u80fd\u304b\uff1f<\/strong><\/p>\n<p>\u3000A\u3000\u9aa8\u5438\u53ce\u963b\u5bb3\u85ac(\u30d3\u30b9\u30db\u30b9\u30db\u30cd\u30fc\u30c8\u30fb\u30c7\u30ce\u30b9\u30de\u30d6)\u3092\u7528\u3044\u305f\u60aa\u6027\u816b\u760d\u6cbb\u7642\u4e2d\u60a3\u8005\u306b\u5bfe\u3057\u3066\u306f\u30a4\u30f3\u30d7\u30e9\u30f3\u30c8\u3092\u907f\u3051\u308b\u3079\u304d\u3067\uff0c\u9aa8\u7c97\u9b06\u75c7\u60a3\u8005\u306e\u5834\u5408\u306f\u533b\u79d1\u6b6f\u79d1\u9023\u643a\u306b\u3088\u308a\u5341\u5206\u5354\u8b70\u304c\u5fc5\u8981<sup>11\uff09<\/sup>\u3068\u3055\u308c\u3066\u3044\u307e\u3059\uff0e\u307e\u305f\uff0c\u30a4\u30f3\u30d7\u30e9\u30f3\u30c8\u5b66\u4f1a\u306e\u6cbb\u7642\u6307\u91dd\u306b\u306f\uff0c\u30b9\u30c6\u30ed\u30a4\u30c9\u6027\u9aa8\u7c97\u9b06\u75c7\u60a3\u8005\u306b\u30a4\u30f3\u30d7\u30e9\u30f3\u30c8\u4f53\u57cb\u5165\u306f\u539f\u5247\u3068\u3057\u3066\u7981\u5fcc\u3068\u3055\u308c\u3066\u3044\u307e\u3059<sup>21)<\/sup>\uff0e<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<h2><strong>\uff14\uff0e\u53c2\u8003\u6587\u732e<\/strong><\/h2>\n<p>1) Marx RE. Pamidronate (Aredia) and zoledronate (Zometa) induced avascular necrosis of the jaws: a growing epidemic. J Oral Maxillofac Surg. 2003 Sep;61(9):1115-7.<\/p>\n<p>&nbsp;<\/p>\n<p>2) \u516c\u76ca\u793e\u56e3\u6cd5\u4eba\u65e5\u672c\u53e3\u8154\u5916\u79d1\u5b66\u4f1aBRONJ\u6cbb\u7642\u306b\u95a2\u3059\u308b\u5b9f\u614b\u8abf\u67fb\uff12\uff10\uff11\uff15\u5e74\uff11\uff12\u6708<\/p>\n<blockquote class=\"wp-embedded-content\" data-secret=\"ckG0kCBPs3\"><p><a href=\"https:\/\/www.jsoms.or.jp\/medical\/work\/study\/bronj\/\">BRONJ \u6cbb\u7642\u306b\u95a2\u3059\u308b\u5b9f\u614b\u8abf\u67fb<\/a><\/p><\/blockquote>\n<p><iframe loading=\"lazy\" class=\"wp-embedded-content\" sandbox=\"allow-scripts\" security=\"restricted\" style=\"position: absolute; clip: rect(1px, 1px, 1px, 1px);\" title=\"&#8220;BRONJ \u6cbb\u7642\u306b\u95a2\u3059\u308b\u5b9f\u614b\u8abf\u67fb&#8221; &#8212; \u4f1a\u54e1\u30fb\u533b\u7642\u95a2\u4fc2\u8005\uff5c\u65e5\u672c\u53e3\u8154\u5916\u79d1\u5b66\u4f1a\" src=\"https:\/\/www.jsoms.or.jp\/medical\/work\/study\/bronj\/embed\/#?secret=ckG0kCBPs3\" data-secret=\"ckG0kCBPs3\" width=\"600\" height=\"338\" frameborder=\"0\" marginwidth=\"0\" marginheight=\"0\" scrolling=\"no\"><\/iframe><\/p>\n<p>&nbsp;<\/p>\n<p>3) Henry DH, Costa L, Goldwasser F, Hirsh V, Hungria V, Prausova J, Scagliotti GV, Sleeboom H, Spencer A, Vadhan-Raj S, von Moos R, Willenbacher W, Woll PJ, Wang J, Jiang Q, Jun S, Dansey R, Yeh H. Randomized, double-blind study of denosumab versus zoledronic acid in the treatment of bone metastases in patients with advanced cancer (excluding breast and prostate cancer) or multiple myeloma. J Clin Oncol. 2011 Mar 20;29(9):1125-32.<\/p>\n<p>&nbsp;<\/p>\n<p>4) \u7c73\u7530\u4fca\u4e4b\uff0c\u8429\u91ce\u3000\u6d69\uff0c\u6749\u672c\u5229\u55e3\uff0c\u307b\u304b\uff0e\u984e\u9aa8\u58ca\u6b7b\u691c\u8a0e\u59d4\u54e1\u4f1a\uff0e\u9aa8\u5438\u53ce\u6291\u5236\u85ac\u95a2\u9023\u984e\u9aa8\u58ca\u6b7b\u306e\u75c5\u614b\u3068\u7ba1\u7406\uff1a\u984e\u9aa8\u58ca\u6b7b\u691c\u8a0e\u59d4\u54e1\u4f1a\u306e\u30dd\u30b8\u30b7\u30e7\u30f3\u30da\u30fc\u30d1\u30fc 2016<\/p>\n<p>&nbsp;<\/p>\n<p>5) \u5cb8\u672c \u88d5\u5145, \u9ad8\u5ca1 \u4e00\u6a39\u3000\u9aa8\u5438\u53ce\u6291\u5236\u85ac\u95a2\u9023\u984e\u9aa8\u58ca\u6b7b\u306e\u6700\u65b0\u60c5\u5831\u3000\u65e5\u672c\u53e3\u8154\u30a4\u30f3\u30d7\u30e9\u30f3\u30c8\u5b66\u4f1a\u8a8c\u30002017 \u5e74 30 \u5dfb 3 \u53f7 p. 191-199<\/p>\n<p>&nbsp;<\/p>\n<p>6) Ruggiero SL, Dodson TB, Fantasia J, Goodday R, Aghaloo T, Mehrotra B, O&#8217;Ryan F; American Association of Oral and Maxillofacial Surgeons. American Association of Oral and Maxillofacial Surgeons position paper on medication-related osteonecrosis of the jaw&#8211;2014 update. J Oral Maxillofac Surg. 2014 Oct;72(10):1938-56.<\/p>\n<p>&nbsp;<\/p>\n<p>7) Limones A, S\u00e1ez-Alcaide LM, D\u00edaz-Parre\u00f1o SA, Helm A, Bornstein MM, Molinero-Mourelle P. Medication-related osteonecrosis of the jaws (MRONJ) in cancer patients treated with denosumab VS. zoledronic acid: A systematic review and meta-analysis. Med Oral Patol Oral Cir Bucal. 2020 May 1;25(3):e326-e336.<\/p>\n<p>&nbsp;<\/p>\n<p>8) \u85e4\u76db\u771f\u6a39\uff0c\u9ce5\u8c37\u90e8\u7d14\u884c\u3089\u3000\u9aa8\u5438\u53ce\u6291\u5236\u85ac\u95a2\u9023\u984e\u9aa8\u58ca\u6b7b\u306e\u767a\u751f\u3068\u6cbb\u7652\u306b\u95a2\u3059\u308b\u524d\u5411\u304d\u591a\u65bd\u8a2d\u5171\u540c\u7814\u7a76\u3000\u53e3\u8154\u5916\u79d1\u5b66\u4f1a\u96d1\u8a8cvol68 No.4\u3000571-583<\/p>\n<p>&nbsp;<\/p>\n<p>9) Khan AA, Morrison A, Hanley DA, Felsenberg D, McCauley LK, O&#8217;Ryan F, Reid IR, Ruggiero SL, Taguchi A, Tetradis S, Watts NB, Brandi ML, Peters E, Guise T, Eastell R, Cheung AM, Morin SN, Masri B, Cooper C, Morgan SL, Obermayer-Pietsch B, Langdahl BL, Al Dabagh R, Davison KS, Kendler DL, S\u00e1ndor GK, Josse RG, Bhandari M, El Rabbany M, Pierroz DD, Sulimani R, Saunders DP, Brown JP, Compston J; International Task Force on Osteonecrosis of the Jaw. Diagnosis and management of osteonecrosis of the jaw: a systematic review and international consensus. J Bone Miner Res. 2015 Jan;30(1):3-23.<\/p>\n<p>&nbsp;<\/p>\n<p>10)Ottesen C, Schiodt M, Gotfredsen K. Efficacy of a high-dose antiresorptive drug holiday to reduce the risk of medication-related osteonecrosis of the jaw (MRONJ): A systematic review. Heliyon. 2020 Apr 27;6(4):e03795.<\/p>\n<p>&nbsp;<\/p>\n<p>11) \u984e\u9aa8\u58ca\u6b7b\u691c\u8a0e\u59d4\u54e1\u4f1a\u3000\u9aa8\u5438\u53ce\u6291\u5236\u85ac\u95a2\u9023\u984e\u9aa8\u58ca\u6b7b\u306e\u75c5\u614b\u3068\u7ba1\u7406: \u984e\u9aa8\u58ca\u6b7b\u691c\u8a0e\u59d4\u54e1\u4f1a\u30dd\u30b8\u30b7\u30e7\u30f3\u30da\u30fc\u30d1\u30fc2016<\/p>\n<blockquote class=\"wp-embedded-content\" data-secret=\"eCvK9TgFgi\"><p><a href=\"https:\/\/www.jsoms.or.jp\/medical\/work\/guideline\/bisphos01\/\">\u984e\u9aa8\u58ca\u6b7b\u306b\u95a2\u3059\u308b\u30dd\u30b8\u30b7\u30e7\u30f3\u30da\u30fc\u30d1\u30fc<\/a><\/p><\/blockquote>\n<p><iframe loading=\"lazy\" class=\"wp-embedded-content\" sandbox=\"allow-scripts\" security=\"restricted\" style=\"position: absolute; clip: rect(1px, 1px, 1px, 1px);\" title=\"&#8220;\u984e\u9aa8\u58ca\u6b7b\u306b\u95a2\u3059\u308b\u30dd\u30b8\u30b7\u30e7\u30f3\u30da\u30fc\u30d1\u30fc&#8221; &#8212; \u4f1a\u54e1\u30fb\u533b\u7642\u95a2\u4fc2\u8005\uff5c\u65e5\u672c\u53e3\u8154\u5916\u79d1\u5b66\u4f1a\" src=\"https:\/\/www.jsoms.or.jp\/medical\/work\/guideline\/bisphos01\/embed\/#?secret=eCvK9TgFgi\" data-secret=\"eCvK9TgFgi\" width=\"600\" height=\"338\" frameborder=\"0\" marginwidth=\"0\" marginheight=\"0\" scrolling=\"no\"><\/iframe><\/p>\n<p>&nbsp;<\/p>\n<p>12) Otto S, Tr\u00f6ltzsch M, Jambrovic V, Panya S, Probst F, Ristow O, Ehrenfeld M, Pautke C. Tooth extraction in patients receiving oral or intravenous bisphosphonate administration: A trigger for BRONJ development? J Craniomaxillofac Surg. 2015 Jul;43(6):847-54.<\/p>\n<p>&nbsp;<\/p>\n<p>13) Ripamonti CI, Maniezzo M, Campa T, Fagnoni E, Brunelli C, Saibene G, Bareggi C, Ascani L, Cislaghi E. Decreased occurrence of osteonecrosis of the jaw after implementation of dental preventive measures in solid tumour patients with bone metastases treated with bisphosphonates. The experience of the National Cancer Institute of Milan. Ann Oncol. 2009 Jan;20(1):137-45.<\/p>\n<p>&nbsp;<\/p>\n<p>14) Vahtsevanos K, Kyrgidis A, Verrou E, Katodritou E, Triaridis S, Andreadis CG, Boukovinas I, Koloutsos GE, Teleioudis Z, Kitikidou K, Paraskevopoulos P, Zervas K, Antoniades K. Longitudinal cohort study of risk factors in cancer patients of bisphosphonate-related osteonecrosis of the jaw. J Clin Oncol. 2009 Nov 10;27(32):5356-62.<\/p>\n<p>&nbsp;<\/p>\n<p>15) \u30d3\u30b9\u30db\u30b9\u30db\u30cd\u30fc\u30c8\uff08BP\uff09\u88fd\u5264\u6295\u4e0e\u60a3\u8005\u3078\u306e\u5bfe\u5fdc\u3000Q\uff11\uff11A\u3000\u65e5\u672c\u533b\u5e2b\u4f1a\u30fb\u65e5\u672c\u6b6f\u79d1\u533b\u5e2b\u4f1a\u3000\u5e73\u621022\u5e7411\u6708<\/p>\n<p>http:\/\/www.kagoshima.med.or.jp\/people\/osirase\/anzen\/BP_QA.pdf<\/p>\n<p>&nbsp;<\/p>\n<p>16) \u53e4\u7530 \u6d69\u53f2, \u516b\u4e0a \u516c\u5229\u3089\u3000\u6cbb\u7652\u304c\u5f97\u3089\u308c\u305f\u4e0a\u984e\u306e\u30c7\u30ce\u30b9\u30de\u30d6\u95a2\u9023\u984e\u9aa8\u58ca\u6b7b\u306e1\u4f8b\u3000\u65e5\u672c\u53e3\u8154\u8a3a\u65ad\u5b66\u4f1a\u96d1\u8a8c2016\u5e74 29 \u5dfb 2 \u53f7 98-103<\/p>\n<p>&nbsp;<\/p>\n<p>17) Soutome S, Otsuru M, Hayashida S, Murata M, Yanamoto S, Sawada S, Kojima Y, Funahara M, Iwai H, Umeda M, Saito T. Relationship between tooth extraction and development of medication-related osteonecrosis of the jaw in cancer patients. Sci Rep. 2021 Aug 26;11(1):17226.<\/p>\n<p>&nbsp;<\/p>\n<p>18) Mozzati M, Arata V, Gallesio G. Tooth extraction in osteoporotic patients taking oral bisphosphonates. Osteoporos Int. 2013 May;24(5):1707-12.<\/p>\n<p>&nbsp;<\/p>\n<p>19) \u7af9\u672b\u82b3\u751f\uff0c\u5cb8\u672c\u88d5\u5145\u3089\u3000\u8853\u5f8c\u611f\u67d3\u4e88\u9632\u6297\u83cc\u85ac\u9069\u6b63\u4f7f\u7528\u306e\u305f\u3081\u306e\u5b9f\u8df5\u30ac\u30a4\u30c9\u30e9\u30a4\u30f3\uff0e\u65e5\u5316\u7642\u4f1a\u8a8c\u30002016\uff1b 64\uff1a153-232\uff0e<\/p>\n<p>&nbsp;<\/p>\n<p>20) Kaldahl WB, Kalkwarf KL, Patil KD, Molvar MP, Dyer JK. Long-term evaluation of periodontal therapy: I. Response to 4 therapeutic modalities. 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