Öz
Bifosfonatlar (BP), metastatik kemik hastalıkları ve
osteoporoz tedavisinde kullanılan kemik rezorbsiyonu
inhibitörleridir. Bifosfanat kullanımına bağlı çenelerde
gelişen osteonekroz (BBÇO), çenelerinde radyasyon
tedavisi görmemiş, bifosfanat kullanan ya da
kullanmış hastalarda mandibula ya da maksillada 8
haftadan daha uzun süren kemik ekspozu ile
karakterize bir durum olarak tanımlanmıştır. Bu
çalışmada farklı merkeze yönlendirilen BBÇO vakaları
retrospektif olarak sunulmuştur. 2012 ve 2013
yıllarında GATA Haydarpaşa Eğitim Hastanesi Diş
Hekimliği, Kocaeli Üniversitesi Diş Hekimliği Fakültesi,
ve Kırıkkale Üniversitesi Diş Hekimliği Fakültesi, Ağız,
Diş ve Çene Cerrahisi kliniklerine başvuran BBÇO
tanısı konulmuş 18 hastanın demografik özellikleri,
anamnez bulguları, klinik muayene bulguları,
bifosfanat çeşidi ve kullanım bilgileri (süre, uygulama
yolu) ve eğer varsa ilgili sebep açısından
değerlendirmeleri yapılmıştır. Hastaların 12’ sinde
mandibula (% 67), 5’ inde maksilla (%28) ve 1 hastada
ise hem mandibula hem maksillada (%5) BBÇO
izlendi. Hastaların 2 tanesi osteoporozis (% 11)
nedeniyle 16 hasta ise (% 89) onkolojik tedavi
nedeniyle bifosfanat grubu ilaç kullanmaktaydı. Tıp ve
diş hekimliğini ortak olarak ilgilendiren konu olması
itibariyle bifosfanat grubu ilaç tedavisine başlanacak
hasta gruplarının ortak klinikler tesis edilerek takip
edilmeleri ve bilgi paylaşımlarıyla ortaya çıkabilecek
olası komplikasyonların azaltılabileceğini
düşünmekteyiz.
Anahtar Kelimeler
Kaynakça
- American Association of Oral and Maxillofacial Surgeons position paper on bisphosphonate-related osteonecrosis of the jaws-2009 Update, 2009. J Oral Maxillofac Surg, 67 (5) Supplement, 2-12.
- Bagan JV, Jimenez Y, Murillo J, et al. 2006. Jaw osteonecrosis associated with bisphosphonates: multiple exposed areas and its relationship to teeth extractions. Study of 20 cases. Oral Oncol, 42 (3), 327 -9.
- Bamias A, Kastritis E, Bamia C, Moulopoulos LA, Melakopoulos I, et al. 2005. Osteonecrosis of the jaw in cancer after treatment with bisphosphonates: incidence and risk factors. J Clin Oncol, 23:8580-7.
- Bedogni A, Blandamura S, Lokmic Z, et al. 2008. Bisphosphonate-associated jawbone osteonecrosis: a correlation between imaging techniques and histopathology. Oral Surg Oral Med Oral Pathol Oral Radiol Endod, 105(3), 358–364.
- Cummings SR, Black DM, Thompson DE, et al. 1998. Effect of alendronate on risk of fracture in women with low bone density but without vertebral fractures: results from the Fracture Intervention Trial. JAMA, 280, 2077-2082.
- Diamond TH, Bucci J, Kersley JH, Aslan P, Lynch WB, Bryant C, 2004. Osteoporosis and spinal fractures in men with prostate cancer: risk factors and effects of androgen deprivation therapy. J Urol, 172, 529-32.
Öz
Bisphosphonates (BP) are inhibitors of bone resorption
used in the treatment of metastatic bone diseases and
osteoporosis. Bisphosphonate induced osteonecrosis of
the jaws (BIONJ) is defined as the exposed bone lesions
which are present for 6 to 8 weeks in patients who used
or using medication of BP and did not received
radiotherapy on head and neck area. In the present
study, cases of BIONJ from different medical centers are
presented. Eighteen patients who were diagnosed with
the BIONJ and referred to Oral and Maxillofacial Surgery
clinics of GATA Haydarpasa Teaching Hospital, Kocaeli
University Faculty of Dentistry and Kirikkale University
Faculty of Dentistry between the years 2012 to 2013 were
included in study. Patients were evaluated in terms of
demographic characteristics, medical history, symptoms,
clinical findings, drugs (time, the path of the application)
and relevant reasons. Of the 18 patients, 12 of the cases
were in the mandible (67%) and 5 were in the maxilla
(28%) while one patient presented BIONJ both in the
mandible and maxilla. 2 of patients were prescribed the
bisphosphonates with osteoporosis while 16 of them
were because of the oncologic treatment. Conclusions:
We believe that the numbers of cases would be reduced
if the patients would be informed and treated in joint
facilities of medicine and dentistry.
Anahtar Kelimeler
Bisphosphonates BRONJ retrospective osteonecrosis of the jaws
Kaynakça
- American Association of Oral and Maxillofacial Surgeons position paper on bisphosphonate-related osteonecrosis of the jaws-2009 Update, 2009. J Oral Maxillofac Surg, 67 (5) Supplement, 2-12.
- Bagan JV, Jimenez Y, Murillo J, et al. 2006. Jaw osteonecrosis associated with bisphosphonates: multiple exposed areas and its relationship to teeth extractions. Study of 20 cases. Oral Oncol, 42 (3), 327 -9.
- Bamias A, Kastritis E, Bamia C, Moulopoulos LA, Melakopoulos I, et al. 2005. Osteonecrosis of the jaw in cancer after treatment with bisphosphonates: incidence and risk factors. J Clin Oncol, 23:8580-7.
- Bedogni A, Blandamura S, Lokmic Z, et al. 2008. Bisphosphonate-associated jawbone osteonecrosis: a correlation between imaging techniques and histopathology. Oral Surg Oral Med Oral Pathol Oral Radiol Endod, 105(3), 358–364.
- Cummings SR, Black DM, Thompson DE, et al. 1998. Effect of alendronate on risk of fracture in women with low bone density but without vertebral fractures: results from the Fracture Intervention Trial. JAMA, 280, 2077-2082.
- Diamond TH, Bucci J, Kersley JH, Aslan P, Lynch WB, Bryant C, 2004. Osteoporosis and spinal fractures in men with prostate cancer: risk factors and effects of androgen deprivation therapy. J Urol, 172, 529-32.
Ayrıntılar
| Diğer ID | JA26ST39AH |
|---|---|
| Bölüm | Olgu Sunumu |
| Yazarlar | |
| Yayımlanma Tarihi | 1 Ağustos 2014 |
| Gönderilme Tarihi | 1 Ağustos 2014 |
| Yayımlandığı Sayı | Yıl 2014 Cilt: 1 Sayı: 2 |
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