Evaluation of Early-Stage Osteonecrosis Findings and Oral Health in Patients Using Biphosphonate for Osteoporosis

Öz

Objective: The aim of study is to evaluate the oral health status and early osteonecrosis findings in patients using bisphosphonates for osteoporosis. Methods: 110 postmenopausal female patients who were using bisphosphonates for osteoporosis were included to this study. Oral health status was evaluated with the oral index including caries, vertical and horizontal bone loss, tooth loss, and periapical lesion on panoramic radiographs. Early-stage bisphosphonate-related osteonecrosis findings of the jaws to be evaluated are as follows; lamina dura thickening, focal or diffuse bone sclerosis, widening of the periodontal space, persistent alveolar socket, thickening of the external oblique line. Results: Early-stage MRONJ findings were determined in 68.2% of the patients. Thickening of the external oblique line (33.6%), thickening of the lamina dura (28.2%), and focal/diffuse bone sclerosis (23.6%) were the most common findings. It was determined that 30.9% of the patients did not have caries, 88.2% had horizontal bone loss, 49.1% had more than 10 missing teeth, and 36.3% had a periapical lesion. Conclusion: It was determined that most of the participants had more dental problems and the presence of early stage MRONJ sign.The patients in need of dental treatment can be determined with the cooperation of medical doctors and dentists. Additionally, signs of osteonecrosis can be noticed at an early stage. This is important in terms of monitoring and treatment of the patients.

Anahtar Kelimeler

• Bisphosphonate
• Osteonecrosis
• Osteoporosis
• Oral health

Osteoporoz Nedeniyle Bifosfonat Kullanan Hastalarda Erken Evre Osteonekroz Bulgularının ve Ağız Sağlığının Değerlendirilmesi

Öz

Amaç: Çalışmanın amacı osteoporoz nedeniyle bifosfonat kullanan hastalarda oral sağlık durumunun ve erken dönem osteonekroz bulgularının değerlendirilmesidir. Yöntem: Çalışmaya osteoporoz nedeniyle bifosfonat kullanımı olan postmenopozal dönemdeki 110 kadın hasta dahil edildi. Hastaların panoramik radyografları üzerinde: oral sağlık durumunun değerlendirilmesinde çürük, vertikal ve horizontal kemik kaybı, diş kaybı, periapikal lezyon varlığını içeren oral indeks kullanıldı. Ayrıca erken evre ilaçla ilişkili osteonekroz bulguları olan lamina durada kalınlaşma, fokal veya diffüz kemik sklerozu, peridontal aralıkta genişleme, persiste alveolar soket, eksternal oblik çizginin kalınlaşması gibi bulgular kaydedildi. Bulgular: Hastaların %68.2'sinde erken evre MRONJ bulgusunun olduğu belirlendi. Eksternal oblik çizginin kalınlaşması (%33.6), lamina durada kalınlaşma (%28.2) ve fokal/diffüz kemik sklerozu (%23.6) en fazla gözlenen bulgulardı. Hastaların %30.9'unda çürüğün olmadığı, %88.2'sinde horizontal kemik kaybı, %49.1'inde 10 dişten fazla eksik dişi olduğu ve %36.3'ünde periapikal lezyon bulunduğu belirlendi. Sonuç: Katılımcıların çoğunda dental problemlerin fazla olduğu ve erken evre MRONJ bulgusunun varlığı tespit edildi. Tıp ve diş hekimlerinin birlikte çalışması ile dental tedavi ihtiyacı olan hastalar belirlenebilir. Ayrıca osteonekroz bulguları erken evrede fark edilebilir. Bu durum hastaların takibi ve tedavisi açısından önemlidir.

Anahtar Kelimeler

• Bifosfonat
• Osteonekroz
• Osteoporoz
• Ağız sağlığı

Kaynakça

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