Abstract
Aim: Osteoporosis OP is a metabolic bone disease with decreased bone mass and increased bone fragility. This article aims to present the treatment of osteonecrosis of the jaw due to the use of oral bisphosphonate.Case: A 78-year-old female patient has a history of bisphosphonate use. She applied to our clinic with loss of implant, infection with fistulization and pain in left lower jaw. A necrotic bone and demarcation line was observed in the left mandible as a result of the patient’s CBCT examination. Serum Ctx values were measured during the preparation of the surgical procedure. As a result of further examination and evaluation, secestretomy and PRF were performed under antibiotic prophylaxis.Result: Osteonecrosis seen in jaws. The oral cavity was a condition characterized by avascular necrosis of the bone. Osteonecrosis cases due to oral bisphosphonate use are very rare. Oral bisphosphonate-induced osteonecrosis is generally safer and more sensitive to treatment than intravenous biphosphonated osteonecrosis. In addition, serum CTX is well correlated with oral bisphosphonates and treatment may be predicted for this reason
References
- Tekin Y, Bozdemir A.E, Barutçuoğlu B, Osteoporoz Tanısında Kullanılan Biyokimyasal Göstergeler. Türk Klinik Biyokimya Derg 2005;3:73-83.
- Çevikol A, Umay E, Karaahmet Ö.Z, Avluk Ö.Ç, Çakc, A., Osteoporozlu Hastalarda Bifosfonatların Devamlı veya Aralıklı Kullanımının Kırık, Kemik Yoğunluğu ve Biyokimyasal Parametrelere Etkisi. Türkiye Osteoporoz Dünyasından 2010;16:1-8.
- Jeffcoat, M.K., Safety Of Oral Bisphosphonates: Controlled Studies On Alveolar Bone. International Journal Of Oral And Maxillofacial Implants, 2006. 21:349-53.
- Prieto‐Alhambra, D., et al., Predictors of Fracture While on Treatment With Oral Bisphosphonates: A Population‐Based Cohort Study. Journal of Bone and Mineral Research, 2014;29:268-74. [CrossRef]
- Tayşi M, Şencan S, and Yıldırım S, Osteonecrosis Due to Use of Bisphosphonates and Other Systemic Drugs. Journal of Istanbul University Faculty of Dentistry 2013;47:60-5.
- Aksoy M.Ç, İahin M.Ç., Koçer Ö.K., Timuçin G.B, Bifosfonata Bağlı Çene Kemiklerinde Gelişen Osteonekroz: Atipik Klinik Görüntü. SDU Journal Of Health Science Institute/SDÜ Saglik Bilimleri Enstitüsü Dergisi, 2015;6:34-8.
- Hutcheson A., et al., A C-Terminal Crosslinking Telopeptide Test– Based Protocol for Patients on Oral Bisphosphonates Requiring Extraction: A Prospective Single-Center Controlled Study. Journal of Oral and Maxillofacial Surgery, 2014;72:1456-62. [CrossRef]
- Onur Ö.D, Kurtuluş B, Çevik P, Bifosfonat Kullanan Hastalarda Oral Cerrahi Uygulamalarda Karşilaşilabilecek Sorunlar Ve Tedavisi Oral Complications And Treatments In Patients Receiving Bisphosphonates. Journal of Istanbul University Faculty of Dentistry 2009;43: 113-22.
- Kharazmi M, Persson U, Warfvinge G, Pharmacovigilance Of Oral Bisphosphonates: Adverse Effects Manifesting In The Soft Tissue Of The Oral Cavity. Journal Of Oral And Maxillofacial Surgery, 2012;70:2793-7. [CrossRef]
- Marx R.E, Cillo J.E, Ulloa J.J, Oral Bisphosphonate-Induced Osteonecrosis: Risk Factors, Prediction Of Risk Using Serum CTX Testing, Prevention, And Treatment. Journal Of Oral And Maxillofacial Surgery, 2007;65: 2397-410. [CrossRef]
- Melo M.D, Obeid G, Osteonecrosis Of The Jaws In Patients With A History Of Receiving Bisphosphonate Therapy: Strategies For Prevention And Early Recognition. The Journal Of The American Dental Association, 2005;136:1675-81.
- Khan A.A, et al., Diagnosis And Management Of Osteonecrosis Of The Jaw: A Systematic Review And International Consensus. Journal of Bone and Mineral Research 2015;30:3-23. [CrossRef]
- Ruggiero S.L, et al., American Association Of Oral And Maxillofacial Surgeons Position Paper On Medication-Related Osteonecrosis Of The Jaw—2014 Update. Journal Of Oral And Maxillofacial Surgery, 2014;72:1938-56. [CrossRef]
Abstract
Amaç: Osteoporoz OP , kemik kütlesinde azalma ve kemik kırılganlığında artış ile seyreden metabolik bir kemik hastalığıdır. Bu makale oral bifosfonat kullanımına bağlı gelişen çene osteonekrozunu ve tedavisini sunmayı amaçlamaktadır.Olgu: 78 yaşında kadın hasta bifosfonat kullanımı hikayesi mevcut. Sol alt çenede implant kaybı, geçmeyen fistülizasyonla karakterize enfeksiyon ve ağrı şikayetiyle kliniğimize başvurmuştur. Hastadan yapılan cbct cone beam computed tomography incelemesi sonucunda sol mandibulada nekrotik kemik ve demarkasyon hattı gözlenmiştir. Hastanın cerrahi işleme hazırlanması sürecinde serum-Ctx C-terminal telopeptid değeri ölçümü alınmıştır. İleri tetkik ve değerlendirme sonucu antibiyotik profilaksisi altında sekestrotomi ve PRF uygulması yapılmıştır.Sonuç: Çenelerde görülen osteonekroz; oral kavitede kemiğin avasküler nekrozu ile karakterize bir durumdur. Oral bifosfonat kullanımına bağlı osteonekroz vakaları çok nadirdir. Oral bisfosfonata bağlı osteonekroz genellikle intravenöz bifosfonata bağlı osteonekrozdan daha güvenli ve tedaviye daha duyarlıdır. Ayrıca serum CTX ile iyi ilişkilidir ve bu nedenle daha öngörülebilirdir.Anahrae sözcükler: Bifosfonat, oral bifosfonat, osteonekroz, dental implant
References
- Tekin Y, Bozdemir A.E, Barutçuoğlu B, Osteoporoz Tanısında Kullanılan Biyokimyasal Göstergeler. Türk Klinik Biyokimya Derg 2005;3:73-83.
- Çevikol A, Umay E, Karaahmet Ö.Z, Avluk Ö.Ç, Çakc, A., Osteoporozlu Hastalarda Bifosfonatların Devamlı veya Aralıklı Kullanımının Kırık, Kemik Yoğunluğu ve Biyokimyasal Parametrelere Etkisi. Türkiye Osteoporoz Dünyasından 2010;16:1-8.
- Jeffcoat, M.K., Safety Of Oral Bisphosphonates: Controlled Studies On Alveolar Bone. International Journal Of Oral And Maxillofacial Implants, 2006. 21:349-53.
- Prieto‐Alhambra, D., et al., Predictors of Fracture While on Treatment With Oral Bisphosphonates: A Population‐Based Cohort Study. Journal of Bone and Mineral Research, 2014;29:268-74. [CrossRef]
- Tayşi M, Şencan S, and Yıldırım S, Osteonecrosis Due to Use of Bisphosphonates and Other Systemic Drugs. Journal of Istanbul University Faculty of Dentistry 2013;47:60-5.
- Aksoy M.Ç, İahin M.Ç., Koçer Ö.K., Timuçin G.B, Bifosfonata Bağlı Çene Kemiklerinde Gelişen Osteonekroz: Atipik Klinik Görüntü. SDU Journal Of Health Science Institute/SDÜ Saglik Bilimleri Enstitüsü Dergisi, 2015;6:34-8.
- Hutcheson A., et al., A C-Terminal Crosslinking Telopeptide Test– Based Protocol for Patients on Oral Bisphosphonates Requiring Extraction: A Prospective Single-Center Controlled Study. Journal of Oral and Maxillofacial Surgery, 2014;72:1456-62. [CrossRef]
- Onur Ö.D, Kurtuluş B, Çevik P, Bifosfonat Kullanan Hastalarda Oral Cerrahi Uygulamalarda Karşilaşilabilecek Sorunlar Ve Tedavisi Oral Complications And Treatments In Patients Receiving Bisphosphonates. Journal of Istanbul University Faculty of Dentistry 2009;43: 113-22.
- Kharazmi M, Persson U, Warfvinge G, Pharmacovigilance Of Oral Bisphosphonates: Adverse Effects Manifesting In The Soft Tissue Of The Oral Cavity. Journal Of Oral And Maxillofacial Surgery, 2012;70:2793-7. [CrossRef]
- Marx R.E, Cillo J.E, Ulloa J.J, Oral Bisphosphonate-Induced Osteonecrosis: Risk Factors, Prediction Of Risk Using Serum CTX Testing, Prevention, And Treatment. Journal Of Oral And Maxillofacial Surgery, 2007;65: 2397-410. [CrossRef]
- Melo M.D, Obeid G, Osteonecrosis Of The Jaws In Patients With A History Of Receiving Bisphosphonate Therapy: Strategies For Prevention And Early Recognition. The Journal Of The American Dental Association, 2005;136:1675-81.
- Khan A.A, et al., Diagnosis And Management Of Osteonecrosis Of The Jaw: A Systematic Review And International Consensus. Journal of Bone and Mineral Research 2015;30:3-23. [CrossRef]
- Ruggiero S.L, et al., American Association Of Oral And Maxillofacial Surgeons Position Paper On Medication-Related Osteonecrosis Of The Jaw—2014 Update. Journal Of Oral And Maxillofacial Surgery, 2014;72:1938-56. [CrossRef]
Details
| Primary Language | Turkish |
|---|---|
| Journal Section | Case Report |
| Authors | |
| Publication Date | December 1, 2018 |
| Published in Issue | Year 2018Issue: 4 |