비스포스포네이트 관련 악골괴사의 진단 및 치료에 대한 임상적 연구

• 영문명: Clinical study of diagnosis and treatment of bisphosphonate-related osteonecrosis of the jaws
• 발행기관: 대한구강악안면외과학회
• 저자명: 김경욱(Kyung-Wook Kim) 김범진(Beom-Jin Kim) 이충현(Chung-Hyun Lee)
• 간행물 정보: 『대한구강악안면외과학회지』대한구강악안면외과학회지 제37권 제1호, 54~61쪽, 전체 8쪽
• 주제분류: 의약학 > 내과학
• 파일형태: PDF
• 발행일자: 2011.02.28

영문 초록

Introduction: Bisphosphonates is used widely for the treatment of the Paget’s disease, multiple myeloma, bone metastases of malignant tumors with the prevention of pain and their pathological fracture. However, it was recently suggested that bisphosphonates related osteonecrosis of the jaw (BRONJ) is a side effect of bisphosphonate use. Materials and Methods: Twenty-four individuals, who were referred to the Department of Oral and Maxillofacial surgery, Dankook University Dental Hospital, were selected from those who had exposed bone associated with bisphosphonates from January, 2005 to December, 2009 according to the criteria of American Association of Oral and Maxillofacial Surgeons (AAOMS) for BRONJ. The patients group consisted of 7 males and 17 females between the age of 46 to 78 years (average 61.8 years). Each patient had panoramic imaging, computed tomography (CT), whole body bone scanning performed for a diagnosis and biopsy sampling from the necrotizing tissue. C-terminal cross-linking telopeptide of type I collagen (CTX) level of patients who had undergone surgical intervention was measured 7 days before surgery. Results: The main cause of bone exposure was post-extraction (15), chronic periodontitis (4), persistent irritation of the denture (3). Twenty people had undergone BRONJ treatment for two to eight months except for 4 people who had to maintain the bisphosphonates treatment to prevent a metastasis and bone trabecular pain with medical treatment. When the bisphosphonate treatment was suspended at least for 3 months and followed up according to the AAOMS protocols, the exposed necrotizing bones were found to be covered by soft tissue. Conclusion: Prevention therapy, interruption of bisphophonates for at least 3 months and cooperation with the physician for conservative treatment are the essential for treating BRONJ patient with high risk factors. The CTX level of BRONJ patients should be checked before undergoing surgical intervention. Surgical treatments should be delayed in the case of a CTX level <150 pg/mL.

목차

Ⅰ. 서 론

Ⅱ. 연구대상 및 방법

Ⅲ. 결 과

Ⅳ. 고 찰

Ⅴ. 결 론

키워드

Bisphosphonates Osteonecrosis Jaw Diseases Therapeutics