BİFOSFONAT KULLANIMINA BAĞLI ÇENE KEMİKLERİNDE GÖRÜLEN OSTEONEKROZ VAKALARININ MEDİKAL VE CERRAHİ TEDAVİLERİ SONRASI UZUN DÖNEM TAKİPLERİ

Necip Fazıl Erdem; Zeynep Gümüşer

doi:10.17567/ataunidfd.522770

BİFOSFONAT KULLANIMINA BAĞLI ÇENE KEMİKLERİNDE GÖRÜLEN OSTEONEKROZ VAKALARININ MEDİKAL VE CERRAHİ TEDAVİLERİ SONRASI UZUN DÖNEM TAKİPLERİ

Öz

Amaç: Bu çalışman amacı bifosfonata bağlı çene kemiğinin osteonekrozu (Bisphosphonate Related Osteonecrosis of the Jaws [BRONJ]) tanısı konmuş hastaların, yapılan medikal ve cerrahi tedavileri sonra- sında tedavilerinin başarısını görmek ve uzun dönem takibin önemini vurgulamaktır.

Gereç ve Yöntem: BRONJ tanısı konulmuş, altısı kadın ikisi erkek olmak üzere 8 hastanın ilaç ve cerrahi tedavileri ve uzun dönem klinik ve radyolojik takip sonuçları değerlendirilmiştir. Ruggiero ve arkadaşları- nın oluşturduğu evrelendirmeye göre vakalar evrelen- dirilmiş ve tedavileri yapılmıştır. Hastaların üçü osteo- poroz (biri intravenöz, ikisi oral yoldan), kalan beşi malignite (intravenöz yoldan) nedeneniyle bifosfonat kullanmaktadır.

Bulgular: Hastalar 8 ila 43 ay arasında değişen, ortalama 23.8 aylık süreyle bifosfonat grubu ilaç almışlardır. Hastaların ortalama yaşları 61.2 ve tedavi sonrası ortalama takip süreleri ise 12.5 aydır. , 8 vakanın beşi evre 3, diğer üçü ise evre 2 olarak değer- lendirilmiştir. Evre 3 hastaların hiçbirinde, medikal ve cerrahi tedavi sonrası belirtilen takip süresince klinik ve radyolojik olarak BRONJ rekürrensi görülmemiştir. Evre 2 vakalarda ise ilaç tedavisi sonrası hastalık semptomatik olarak kontrol altına alınmıştır.

Sonuç : Sonuç olarak uygulanan bu tedavi protokolü ve bu çalışmaya dahil edilen vakalardan elde edilen veriler, cerrahi tedavinin gerektiğinde uygun zamanda yapılmasının önemini güçlendirmiştir. Ayrıca hiperbarik oksijen tedavisinin BRONJ vakalarında yardımcı tedavi yöntemlerinden biri olarak düşünülebileceği söylene- bilir. Bifosfonat kullanım nedenleri hastaların cerrahi ya da medikal yolla tedavi edilmelerinde direkt olarak etkili olmamıştır.

Anahtar kelimeler: Bifosfonat, çene osteonekrozu, hiperbarik oksijen tedavisi

LONG TERM FOLLOW UP OF PATIENTS WITH BISPHOSPHONATE RELATED OSTEONECROSIS OF THE JAWS AFTER MEDICAL AND SURGICAL TREATMENT

ABSTRACT

Aim: The aim of this study is to observe the success of medical and surgical treatment of the patients who have been diagnosed as the bisphosphonate related osteonecrosis of the jaws (BRONJ) and emphasize the importance of long term follow up of these patients. Material and Methods: The medical and surgical treatments and long term clinical and radiological follow ups of 8 BRONJ cases, of whom 6 women and 2 men, were evaluated in this study. All cases were staged according to a staging system that was imple- mented by Ruggiero et al. and treated accordingly. Three of the patients (one intravenously and two orally) were on bisphosphonate due to osteoporosis and five of them (intravenously) due to malignant diseases. Results: Patients were on bisphosphonate for an interval of 8 to 43 months with a mean time period of 23.8 months. The mean age of the patients was 61.2 and the mean postoperative follow up time was 12.5 months. According to Ruggiero et al BRONJ staging, 5 of 8 cases were at stage-3 and the rest of them were at stage-2. None of the stage-3 cases that were treated medically and surgically showed any BRONJ recurrence clinically and radiographically during their follow up periods. Also, all three stage-2 BRONJ cases were kept under control symptomatically with medical treatment protocol.

Conclusion: As a conclusion, the treatment protocol and outcome data of this study on BRONJ cases have reinforced the importance of surgical treatment that is performed at an appropriate time. Also it is possible to emphasize that hyperbaric oxygen treatment can be an adjuvant treatment method for BRONJ cases. The reason of bisphosphonate usage of these patients did not directly have any effect on either they treated surgically or medically.Key Words: Bisphosphonate, jaw osteonecrosis, hyperbaric oxygen treatment

Anahtar Kelimeler

Bifosfonat,çene osteonekrozu

Kaynakça

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Ayrıntılar

Birincil Dil

Türkçe

Konular

Sağlık Kurumları Yönetimi

Bölüm

Araştırma Makalesi

Yazarlar

Necip Fazıl Erdem
0000-0002-5374-3233

Zeynep Gümüşer Bu kişi benim
0000-0002-7834-4343

Yayımlanma Tarihi

15 Ocak 2019

Gönderilme Tarihi

16 Şubat 2018

Kabul Tarihi

13 Temmuz 2018

Yayımlandığı Sayı

Yıl 2019 Cilt: 29 Sayı: 1

DOI

https://doi.org/10.17567/ataunidfd.522770

IZ

https://izlik.org/JA75NC64WN

Kaynak Göster

RIS / Bibtex

APA

Erdem, N. F., & Gümüşer, Z. (2019). BİFOSFONAT KULLANIMINA BAĞLI ÇENE KEMİKLERİNDE GÖRÜLEN OSTEONEKROZ VAKALARININ MEDİKAL VE CERRAHİ TEDAVİLERİ SONRASI UZUN DÖNEM TAKİPLERİ. Atatürk Üniversitesi Diş Hekimliği Fakültesi Dergisi, 29(1), 89-97. https://doi.org/10.17567/ataunidfd.522770

AMA

1.Erdem NF, Gümüşer Z. BİFOSFONAT KULLANIMINA BAĞLI ÇENE KEMİKLERİNDE GÖRÜLEN OSTEONEKROZ VAKALARININ MEDİKAL VE CERRAHİ TEDAVİLERİ SONRASI UZUN DÖNEM TAKİPLERİ. Ata Diş Hek Fak Derg. 2019;29(1):89-97. doi:10.17567/ataunidfd.522770

Chicago

Erdem, Necip Fazıl, ve Zeynep Gümüşer. 2019. “BİFOSFONAT KULLANIMINA BAĞLI ÇENE KEMİKLERİNDE GÖRÜLEN OSTEONEKROZ VAKALARININ MEDİKAL VE CERRAHİ TEDAVİLERİ SONRASI UZUN DÖNEM TAKİPLERİ”. Atatürk Üniversitesi Diş Hekimliği Fakültesi Dergisi 29 (1): 89-97. https://doi.org/10.17567/ataunidfd.522770.

EndNote

Erdem NF, Gümüşer Z (01 Ocak 2019) BİFOSFONAT KULLANIMINA BAĞLI ÇENE KEMİKLERİNDE GÖRÜLEN OSTEONEKROZ VAKALARININ MEDİKAL VE CERRAHİ TEDAVİLERİ SONRASI UZUN DÖNEM TAKİPLERİ. Atatürk Üniversitesi Diş Hekimliği Fakültesi Dergisi 29 1 89–97.

IEEE

[1]N. F. Erdem ve Z. Gümüşer, “BİFOSFONAT KULLANIMINA BAĞLI ÇENE KEMİKLERİNDE GÖRÜLEN OSTEONEKROZ VAKALARININ MEDİKAL VE CERRAHİ TEDAVİLERİ SONRASI UZUN DÖNEM TAKİPLERİ”, Ata Diş Hek Fak Derg, c. 29, sy 1, ss. 89–97, Oca. 2019, doi: 10.17567/ataunidfd.522770.

ISNAD

Erdem, Necip Fazıl - Gümüşer, Zeynep. “BİFOSFONAT KULLANIMINA BAĞLI ÇENE KEMİKLERİNDE GÖRÜLEN OSTEONEKROZ VAKALARININ MEDİKAL VE CERRAHİ TEDAVİLERİ SONRASI UZUN DÖNEM TAKİPLERİ”. Atatürk Üniversitesi Diş Hekimliği Fakültesi Dergisi 29/1 (01 Ocak 2019): 89-97. https://doi.org/10.17567/ataunidfd.522770.

JAMA

1.Erdem NF, Gümüşer Z. BİFOSFONAT KULLANIMINA BAĞLI ÇENE KEMİKLERİNDE GÖRÜLEN OSTEONEKROZ VAKALARININ MEDİKAL VE CERRAHİ TEDAVİLERİ SONRASI UZUN DÖNEM TAKİPLERİ. Ata Diş Hek Fak Derg. 2019;29:89–97.

MLA

Erdem, Necip Fazıl, ve Zeynep Gümüşer. “BİFOSFONAT KULLANIMINA BAĞLI ÇENE KEMİKLERİNDE GÖRÜLEN OSTEONEKROZ VAKALARININ MEDİKAL VE CERRAHİ TEDAVİLERİ SONRASI UZUN DÖNEM TAKİPLERİ”. Atatürk Üniversitesi Diş Hekimliği Fakültesi Dergisi, c. 29, sy 1, Ocak 2019, ss. 89-97, doi:10.17567/ataunidfd.522770.

Vancouver

1.Necip Fazıl Erdem, Zeynep Gümüşer. BİFOSFONAT KULLANIMINA BAĞLI ÇENE KEMİKLERİNDE GÖRÜLEN OSTEONEKROZ VAKALARININ MEDİKAL VE CERRAHİ TEDAVİLERİ SONRASI UZUN DÖNEM TAKİPLERİ. Ata Diş Hek Fak Derg. 01 Ocak 2019;29(1):89-97. doi:10.17567/ataunidfd.522770