Çenelerin Bisfosfonata Bağlı Osteonekrozu ve Güncel Tedaviler

Yıl 2017, Cilt: 20 Sayı: 2, 122 - 131, 31.08.2017

Damla Torul Mehmet Cihan Bereket

https://doi.org/10.7126/cumudj.345953

Öz

Bifosfonatlar osteoklastik
aktivitenin güçlü inhibitörü olan farmakolojik ajanlardır. Günümüzde osteolitik
kemik hastalığı, malignite kaynaklı hiperkalsemi, metastatik kemik hastalıkları
ve osteoporoz gibi birçok farklı kemik hastalığı veya ilişkili komplikasyonun
tedavisinde kullanılmaktadırlar. Bifosfonatlar bu hastalıkların iskeletsel komplikasyonlarını
önemli ölçüde azaltsa da özellikle yüksek kemik döngüsünün görüldüğü çene kemiklerinde
tedaviye dirençli, ekspoze nekrotik kemik ile karakterize özgün bir
osteonekroza neden olmaktadırlar. Bifosfonat kullanımına bağlı olarak gelişen
bu komplikasyonun henüz kesin bir tedavisi bulunmamaktadır. Hastaların, bu
durumun ekonomik ve sosyal yönleri nedeniyle mağdur olmasına sebep olan bu komplikasyonla
mücadele etmek için yeni tedavi arayışları hala sürmektedir. Bu derlemede
bifosfonatların kimyasal yapıları, etki mekanizmaları ve osteonekrozun güncel
tanı /tedavi yöntemleri hakkında bilgi verilmesi amaçlanmıştır.

Anahtar Kelimeler

Bifosfonatlar, malign hastalıklar, komplikasyonlar, osteonekroz, tedavi seçenekleri

BISPHOSPHONATE INDUCED OSTEONECROSIS OF THE JAWS AND CURRENT THERAPIES

Öz

Bisphosphonates
are pharmacological agents which are the potent inhibitors of osteoclastic
activity. Nowadays, bisphosphonates are used to treat a variety of bone disease
or related complications such as metastatic or osteolytic bone disease,
hypercalcemia of malignant origin and osteoporosis. Although, bisphosphonates
are significantly reduces the skeletal complications of these diseases, they
are inevitably cause a specific osteonecrosis characterized by treatment
resistant exposed necrotic bone, especially seen in the jaw bones where the
bone turnover is high. Currently there is no definitive treatment for this
complication induced by the use of bisphosphonates. The search for new
treatments methods to prevent the complications that cause patients to become a
victim of the economic and social aspects of this situation is still ongoing.

This review is intended to provide information
about the chemical structure of bisphosphonates, their mechanisms of action and
current diagnosis/treatment methods of the osteonecrosis. 

Anahtar Kelimeler

Bisphosphonates, malignant diseases, complications, osteonecrosis, treatment options

Kaynakça

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