Treatment of Apical Periodontitis Induced BRONJ with Endodontic Treatment

Yıl 2024, Cilt: 34 Sayı: 3, 238 - 241, 28.07.2024

Bahadır Sancar Levent Akinci , Gönen Aras Talay

https://doi.org/10.17567/ataunidfd.1039378

Öz

Bisphosphonate related osteonecrosis of the jaw (BRONJ), which is one of the serious side effects of bisphosphonates, has an increasing clinical importance due to the widespread use of bisphosphonates in the treatment of many diseases such as osteoporosis, osteopenia, Paget's disease, osteogenesis imperfecta, and multiple myeloma. BRONJ can spontaneously develop in the jawbones. In addition, many factors such as tooth extraction, periodontal diseases, and local trauma can trigger BRONJ. In our case, it was detected that the lesion appearing like BRONJ in the left lower jaw of the 65 years old female patient with a history of oral bisphosphonate use developed due to apical periodontitis resulting from the tooth numbered 34. Root canal treatment was administered to the relevant tooth of the patient, the fistula tract was closed after this treatment, and as a result of the CBCT examination, it was observed that the enlargement in the necrotic bone area stopped. In addition, the patient's complaints about the relevant tooth disappeared. As a result, endodontic treatment is an effective treatment approach in the treatment of BRONJ developing due to apical periodontitis. In order to avoid the risk of BRONJ, a detailed oral examination should be performed before starting the bisphosphonate treatment, and necessary endodontic, restorative and periodontal treatments should be followed.

Anahtar Kelimeler

Apical Periodontitis, BRONJ, Endodontics, Osteoporosis.

Kaynakça

• 1. Atat DF, Supplement U, Derleme AK, Kodu M, Tarihi K. 2015;131–42.
• 2. Perez-Lopez FR. Postmenopausal osteoporosis and alendronate. Maturitas,2004; 48, 179-192.
• 3. Marx RE. Oral and Intravenous Bisphosphonates-lnduced Osteonecrosis of the Jaws: History, etiology, prevention and treatment. Hanover Park: Quintessence Books. 2006.
• 4. Sharma D, Ivanovski S, Slevin M, Hamlet S, Pop TS, Brinzaniuc K, et al. Bisphosphonate-related osteonecrosis of jaw (BRONJ): Diagnostic criteria and possible pathogenic mechanisms of an unexpected anti-angiogenic side effect. Vasc Cell. 2013;5(1):1–8.
• 5. Onur ÖD, Kurtuluş B, Çevİk P. bifosfonat kullanan hastalarda oral cerrahi uygulamalarda karşilaşilabilecek sorunlar ve tedavisi oral complications and treatments in patients receiving bisphosphonates. 2009;113–22.
• 6. R.-M. D, H.-J. P, Y. R, H.S. K, J. H, W. P. Teriparatide therapy for bisphosphonate-related osteonecrosis of the jaw associated with dental implants. Implant Dent. 2015;
• 7. V. R. Sunitha, P. A. Emmadi, R. Namasivayam VT, and Rajaraman. “The periodontal - endodontic continuum: A, review,” Journal of Conservative Dentistry, vol. 11, no. 2 pp. 54–, 62 2008.
• 8. O. Filleul, E. Crompot, and S. Saussez “Bisphosphonateinduced, osteonecrosis of the jaw: a review of 2 400 patient, cases,” Journal of Cancer Research and Clinical Oncology V, 136, no. 8, pp. 1117–1124 2010.
• 9. Ruggiero SL, Dodson TB, Fantasia J, Goodday R, Aghaloo T, Mehrotra B, et al.American Association of Oral and Maxillofacial Surgeons position paper on medicationrelatedosteonecrosis of the jaw--2014 update. J Oral Maxillofac Surg. 2014;72(10):1938-56.
• 10. Gallego L, Junquera L, Pelaz A, Díaz-Bobes C. Rubber dam clamp trauma during endodontic treatment: a risk factor of bisphosphonate-related osteonecrosis of the jaw? J Oral Maxillofac Surg 2011; 69: e93-e95.
• 11. Migliorati CA, Casiglia J, Epstein J, Jacobsen PL, Siegel MA WS, An M the care of patients with bisphosphonate-associated osteonecrosis:, 110, 136 AA of OM position paper. JADA 2005;, 1658-68.
• 12. Aksoy M.Ç, İahin M.Ç., Koçer Ö.K., Timuçin G.B BB, SDU ÇKGOAKG, Enstitüsü JOHSISB, Dergisi 2015;6:34-8.
• 13. Siqueira Jr, J. F., & Rôças, I. N. (2007). Bacterial pathogenesis and mediators in apical periodontitis. Brazilian Dental Journal, 18(4) 267–280.
• 14. Nair, P. N. R. (2004). Pathogenesis of Apical Periodontitis and the Causes of Endodontic Failures. Critical Reviews in Oral Biology & Medicine, 15(6) 348–381.
• 15. Marx RE, Sawatari Y. Bisphosphonate-Induced Exposed Bone ( Osteonecrosis / Osteopetrosis ) of the Jaws : Risk Factors , Recognition , Prevention , and Treatment. 2005;1567–75.
• 16. Kaptan F, Kazandag MK, Iseri U. Treatment of bisphosphonate related osteonecrosis following root canal therapy at the 1-year follow-up: Report of two cases. Ther Clin Risk Manag. 2013;9(1):477–82.
• 17. Dioguardi M, Troiano G. Endodontic Re-treatment of a Tooth with a Floor Perforation in a Patient in Treatment with Oral Bisphosphonate. J Gen Pract. 2016;4(3).
• 18. Alrahabi MK, Ghabbani HM. Clinical impact of bisphosphonates in root canal therapy. Saudi Med J. 2018;39(3):232–8.