Literatürde anlatılan çenelerdeki ilaçlarla ilişkili osteonekroz vakalarının analizi
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Tarih
2019
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Selçuk Üniversitesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Amaç: Bu çalışmanın amacı son beş yıl içerisinde literatürde anlatılan çenelerin ilaca bağlı osteonekroz (MRONJ) vakalarında; osteonekroz nedeni olarak belirlenen ilaç ya da ilaçtan farklı etkenler, osteonekroz gelişimine katkıda bulunan sistemik ya da lokal faktörler, bu vakalarda kullanılan görüntüleme yöntemleri, tedavi seçenekleri gibi faktörleri analiz etmektir. Gereç ve Yöntem: 2013-2018 yılları arasında MRONJ ile ilgili literatürde bildirilen 113 olgu sunumu incelendi. Literatür araştırması PubMed üzerinden yapıldı. Hastanın yaşı, cinsiyeti, sistemik hastalığı, geçmişte uygulanan dental işlemlere ait veriler, osteonekroz lezyonunun lokalizasyonu, hastada gözlenen semptomlar, teşhiste kullanılan görüntüleme yöntemleri, tercih edilen tedavi seçenekleri, tedavi sonrası nüks olup olmaması açısından olgu sunumları incelendi. Bulgular: İncelenen olgu sunumlarında hastaların yaş ortalaması 66.7 ± 12.28 idi. Vakalarda MRONJ çoğunlukla (% 62.8) kadınlarda görüldüğü belirlendi. Osteonekroz oluşumunda en sık rol oynayan risk faktörü ilaçlardı (%55, en fazla metotreksat). Osteonekroza neden olan ilacın kullanım nedeni olarak en çok (% 67.1) kanser tespit edildi. MRONJ nedeni olarak bifosfanat dışı ilaçlardan en sık (% 18.3) belirlenen ilaç denosumabdı. Hastaların % 63.5’inde osteonekroz öncesi dental tedavi hikayesi vardı. Vakalarda osteonekrozun % 68.9’nun mandibulada ortaya çıktığı gözlendi. Hastalarda en sık belirlenen semptom ağrıydı (% 65.7). İncelenen olguların hepsinde konservatif tedavi kullanılırken, 69 hastada buna ek olarak (% 62.7 ) cerrahi tedavi ve 9 hastada lazer tedavisi uygulandığı belirlendi. Sonuç: MRONJ sıklıkla bifosfonat kullanımına bağlı ortaya çıksa da kanser nedeniyle kullanılan antianeoplastik ilaçlar ve romatoid artrit gibi sistemik hastalıklar nedeniyle kullanılan bazı ilaçlar nedeniyle de oluşabilmektedir. Osteonekroza neden olan ilaçların çeşitliliğinin fazla olması nedeniyle hastaların sistemik durumlarında kullanılan ya da kullanılacak ilaçların sorgulanması osteonekrozun önlenmesi ve tanısında önemlidir.
Background: The aim of the study was to analyze factors such as medications or other non-medicative agents determined as cause of osteonecrosis, systemic or local factors leading to the development of osteonecrosis and imaging techniques, treatment options in the medication related osteonecrosis cases in jaws (MRONJ) described in the literature. Methods: 113 cases reported in the literature related to MRONJ between 2013-2018 were examined. The literature survey was conducted on PubMed. Case reports were evaluated in terms of the age, gender, systemic disease of the patient, dental procedures applied in the past, localization of the osteonecrosis lesion, the symptoms observed in the patient, the imaging modalities used in the diagnosis, treatment options, recurrence after the treatment. Results: The mean age of the patients was 66.7 ± 12.28 years. In cases, MRONJ was observed mostly in women (62.8%). The most common risk factor in the development of osteonecrosis was the drugs (55%, more methotrexate). The most common cause of the use of the drug causing osteonecrosis was cancer (67.1%). The most (18.3 %) determined non-bisphosphonate drug related to osteonecrosis was denosumab. 63.5% of patients had a history of dental treatment before osteonecrosis. 68.9% of osteonecrosis cases were observed in the mandible. The most common symptom was pain (65.7%). While conservative treatment was used in all of the cases, surgical treatment additional to this therapy in 69 patients and laser treatment in 9 patients were performed. Conclusion: Although MRONJ is often caused by bisphosphonate use, it may also occur due to the antineoplastic drugs used for cancer and some drugs used for systemic diseases such as rheumatoid arthritis. Because of the large variety of drugs caused osteonecrosis, questioning of drugs that will be used or used in the systemic conditions of patients is important in the diagnosis and prevention of osteonecrosis.
Background: The aim of the study was to analyze factors such as medications or other non-medicative agents determined as cause of osteonecrosis, systemic or local factors leading to the development of osteonecrosis and imaging techniques, treatment options in the medication related osteonecrosis cases in jaws (MRONJ) described in the literature. Methods: 113 cases reported in the literature related to MRONJ between 2013-2018 were examined. The literature survey was conducted on PubMed. Case reports were evaluated in terms of the age, gender, systemic disease of the patient, dental procedures applied in the past, localization of the osteonecrosis lesion, the symptoms observed in the patient, the imaging modalities used in the diagnosis, treatment options, recurrence after the treatment. Results: The mean age of the patients was 66.7 ± 12.28 years. In cases, MRONJ was observed mostly in women (62.8%). The most common risk factor in the development of osteonecrosis was the drugs (55%, more methotrexate). The most common cause of the use of the drug causing osteonecrosis was cancer (67.1%). The most (18.3 %) determined non-bisphosphonate drug related to osteonecrosis was denosumab. 63.5% of patients had a history of dental treatment before osteonecrosis. 68.9% of osteonecrosis cases were observed in the mandible. The most common symptom was pain (65.7%). While conservative treatment was used in all of the cases, surgical treatment additional to this therapy in 69 patients and laser treatment in 9 patients were performed. Conclusion: Although MRONJ is often caused by bisphosphonate use, it may also occur due to the antineoplastic drugs used for cancer and some drugs used for systemic diseases such as rheumatoid arthritis. Because of the large variety of drugs caused osteonecrosis, questioning of drugs that will be used or used in the systemic conditions of patients is important in the diagnosis and prevention of osteonecrosis.
Açıklama
Anahtar Kelimeler
Osteonekroz, Bifosfonat, Metotreksat, Osteonecrosis, Bisphosphonate, Methotrexate
Kaynak
Selçuk Üniversitesi Diş Hekimliği Fakültesi Dergisi
WoS Q Değeri
Scopus Q Değeri
Cilt
6
Sayı
4
Künye
Aydemir, M. E., Bozdemir, E., (2019). Literatürde anlatılan çenelerdeki ilaçlarla ilişkili osteonekroz vakalarının analizi. Selçuk Üniversitesi Diş Hekimliği Fakültesi Dergisi, 6 (4), 125-129.
