İlaçlara Bağlı Çene Kemiği Osteonekrozlarının Tedavisinde Kök Hücre Uygulamaları

Abstract

Bifosfonatlar, osteoporoz ve Paget hastalığının tedavisinde metastatik kemik tümörlerinin önlenmesinde sıklıkla tercih edilen ilaçlardır. Bifosfonatlara bağlı gelişen çene kemiklerinde lokalize osteonekroz vakalarının artması; yaşam kalitesinin negatif olarak etkilenmesi ve morbiditenin artması araştırmacıları erken dönemde tanımlanmasına ve etkin tedavi şeklinin araştırılmasına yöneltmiştir. Bifosfonatların yanı sıra, diğer antirezorptif ve antianjiojenik ilaçların da çene kemiklerinde osteonekroza neden olabileceğinin anlaşılmasıyla, American Association of Oral and Maxillofacial Surgeons (AAOMS) ‘’bisfosfonata bağlı çene kemiği osteonekrozu (BİÇKON)” terminolojisinin “ ilaçlara bağlı çene kemiği osteonekrozu (İÇKON)’’ olarak değiştirilmesini önermiştir. Literatürde İÇKON vakalarının derlendiği birçok çalışma bulunmasına rağmen İÇKON tedavisinde kök hücre etkinliğine yönelik bir derleme çalışması bulunmamaktadır. Bu derlemenin amacı günümüzde birçok hastalığın tedavisinde kullanılan kök hücrelerin İÇKON tedavisindeki etkinliğini değerlendirmektir.

Keywords

• Çene kemiği osteonekrozu
• antirezorptif tedavi
• ilaçla ilişkili osteonekroz
• kök hücre
• mezenkimal kök hücre

Stem Cell Therapies in Treatment of the Medication Related Osteonecrosis of the Jaw

Abstract

Bisphosphonates are often preferred drugs for the treatment of osteoporosis, Paget's disease and in the prevention of metastatic bone tumors. The increase of localized osteonecrosis cases in jaw bones related to bisphosphonates; negative effects on quality of life and increased morbidity led researchers to identify early and to investigate the effective treatment modality. It was understood that in addition to bisphosphonates other antiresorptive and antiangiogenic drugs could cause osteonecrosis as well, so the American Association of Oral and Maxillofacial Surgeons (AAOMS) suggested to use "medication related osteonecrosis of jaw (MRONJ)" terminology instead of "bisphosphonate-related osteonecrosis of jaw (BRONJ)". Despite the fact that many studies about the MRONJ in the literature, there is no review of stem cell activity in the treatment of MRONJ. The aim of this review is to evaluate the efficacy of stem cell used in the treatment of many diseases, in the treatment of MRONJ.

Keywords

• jaw bone osteonecrosis
• antiresoprtive therapy
• medication related osteonecrosis
• stem cell
• mesenchymal stem cell.

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