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Çene kemiklerinin yeni tehlikesi: bisfosfonatlar

Yıl 2008, Cilt: 11 Sayı: 2, 134 - 139, 04.11.2011

Selin Ergun , Pelin Guneri Huseyin Koca

Öz

Bisphosphonate compounds have been used for the improvement of the lives of cancer patients by reducing complications such as hypercalcemia. They are preferred to treat bone metastases of solid tumors such as breast, prostate and lung cancer, and also utilized in the management of lytic lesions of multiple myeloma. Intravenous administration of high doses of bisphosphonates for the management of benign conditions occasionally lead to the development of osteonecrosis of the jaws. In many cases lesions appear spontaneously, or following an infection or a dental extraction. At present, there is no definite treatment for this particular druginduced necrosis of bone except conservative debridement of bone lesions, oral antibiotics and local irrigations. It is important to recognize the clinical and radiographic features of the bisphosohonate osteonecrosis of the jaws in order to provide early diagnosis and to improve the care of these patients.

 

ÖZET

Bisfosfonat bileşikleri malignansiye bağlı olarak gelişen hiperkalseminin düzenlenmesinde ve ayrıca, meme, prostat ve akciğer kanserlerine bağlı tümörlerin ve multipl myelomaya bağlı metastatik lezyonların tedavisinde kanser hastalarının hayat kalitelerini iyileştirmek amacıyla kullanılmaktadır. Bisfosfonatların yüksek dozlarda intravenöz olarak uygulanmaları nedeniyle ilaca bağlı bir yan etki olarak çenelerde osteonekroz gelişebilmektedir. Lezyonlar kendiliğinden oluşabildiği gibi, bir enfeksiyon ve diş çekimi genellikle olayı hızlandırmaktadır. İlaca bağlı olarak gelişen bu özgün kemik nekrozu için henüz kesin bir tedavi bulunmamaktadır. Konservatif yaklaşım uygulanan vakalarda, kemiğin açığa çıkmış olduğu hastaların büyük bölümünde oral antibiyotikler, antienflamatuvarlar ve açık yara bölgesinin lokal irrigasyonu önerilmektedir. Bisfosfonat osteonekrozuna ait klinik ve radyografik özelliklerin iyi bilinmesi ve bu tür hastalarda klinik ve radyolojik belirtilerin değerlendirilmesi, erken tanı ve tedavi açısından da önem taşımaktadır.

Anahtar Kelimeler: Bisfosfonatlar, osteonekroz, metastaz, hiperkalsemi, çene

Anahtar Kelimeler

Bisphosphonates; osteonecrosis; metastasis; hypercalcemia; jaw

Kaynakça

  • Alıcı S, Çekici S. Malign hastalıklarda bisfosfonatların rolü. Van Tıp Dergisi 2002; 9: 66-72.
  • Tanvetyanon T, Stiff PJ. Management of the adverse effects associated with intravenous bisphosphonates. Ann Oncol 2006; 17: 897-907.
  • Wikipedia: http://en.wikipedia.org/wiki/Bisphosphonate
  • Wang EP, Kaban LB, Strewler GJ, Raje N, Toulis MJ. Incidence of osteonecrosis of the jaw in patients with multiple myeloma and breast or prostate cancer on intravenous bisphosphonate therapy. J Oral Maxillofac Surg 2007; 65: 1328-1331.
  • Duman AE, Güven GS, Gürlek A. Erkek osteoporozu. Hacettepe Tıp Dergisi 2005; 36: 175-183.
  • Benhamou CL. Effects of osteoporosis medications on bone quality. Joint Bone Spine 2007; 74: 39-47.
  • Berardi D, Carlesi T, Rossi F, Calderini M, Volpi R, Perfetti G. Potential applications of bisphosphonates in dental surgical implants. Int J Immunopathol Pharmacol 2007; 20: 455-465.
  • Ficarra G, Beninati F, Rubino I, Vannucchi A, Longo G, Tonelli P, Pini Prato G. Osteonecrosis of the jaws in periodontal patients with a history of bisphosphonates treatment. J Clin Periodontol 2005; 32: 1123-1128.
  • Palomo L, Bissada N, Liu J. Bisphosphonate therapy for bone loss in patients with osteoporosis and periodontal disease: clinical perspectives and review of the literature. Quintessence Int 2006; 37: 103-107.
  • Wang HL, Weber D, McCauley LK. Effect of long-term oral bisphosphonates on implant wound healing: literature review and a case report. J Periodontol 2007; 78: 584-594.
  • Farrugia MC, Summerlin DJ, Krowiak E, Huntley T, Freeman S, Borrowdale R, Tomich C. Osteonecrosis of the mandible or maxilla associated with the use of new generation bisphosphonates. Laryngoscope 2006; 116: 115-120.
  • Mavrokokki T, Cheng A, Stein B, Goss A. Nature and frequency of bisphosphonate-associated osteonecrosis of the jaws in Australia. J Oral Maxillofac Surg 2007; 65: 415-423.
  • American Association of Oral and Maxillofacial Surgeons Position Paper on Bisphosphonate-Related Osteonecrosis of the Jaws. J Oral Maxillofac Surg 2007; 65: 369-376.
  • Yalçın P. Glukokortikoid osteoporozu. Romatizma 2000; 15: 145-150.
  • Weitzman R, Sauter N, Eriksen EF, Tarassoff PG, Lacerna LV, Dias R, Altmeyer A, Csermak-Renner K, McGrath L, Lantwicki L, Hohneker JA. Critical review: Updated recommendations for the prevention, diagnosis, and treatment of osteonecrosis of the jaw in cancer patients. Cril Revs Oncol Hemat 2007; 62: 148-152.
  • Şenel Çizmeci F, Baltacıoğlu E, Basmascı Çizmeci F, Bağış B, Özkaynak Ö, Tosun E. Bisfosfonat kullanımına bağlı gelişen mandibula ve maksilla nekrozları ve dental yaklaşım. ADO Klinik Bilimler Dergisi 2007; 1: 49-54.
  • Campisi G, Di Fede O, Musciotto A, Lo Casto A, Lo Muzio L, Fulfaro F, Badalamenti G, Russo A, Gebbia N. Bisphosphonate-related osteonecrosis of the jaw (BRONJ): run dental management designs and issues in diagnosis. Ann Oncol 2007;18: 168-172.
  • Eckert AW, Maurer P, Meyer L, Kriwalsky MS, Rohrberg R, Schneider D, Bilkenroth U, Schubert J. Bisphosphonate-related jaw necrosis-severe complication in maxillofacial surgery. Cancer Treat Rev 2007; 33: 58-63.
  • Lipton A, Milton S. The safety of zoledronic acid. Expert Opin Drug Saf 2007; 6: 305-313.
  • Migliorati CA, Siegel MA, Elting LS. Bisphosphonate-associated osteonecrosis: a long term complication of bisphosphonate treatment. Lancet Oncol 2006; 7: 508-514.
  • Olson KB, Hellie CM, Pienta KJ. Osteonecrosis of jaw in patient with hormone-refractory prostate cancer treated with zoledronic acid. Urology 2005; 66: 658.
  • Reid IR, Bolland MJ. Is bisphosphonate-associated osteonecrosis of the jaw caused by soft tissue toxicity? Bone 2007; 41: 318-320.
  • Cheng A, Mavrokokki A, Carter G, Stein B, Fazzalari NL, Wilson DF, Goss AN. The dental implications of bisphosphonates and bone disease. Aust Dent J 2005; 50: 4-13.
  • Van Poznak C, Estilo C. Osteonecrosis of the jaw in cancer patients receiving IV bisphosphonates. Oncology 2006; 20: 1053-1062.
  • Basu N, Reid DM. Bisphosphonate-associated osteonecrosis of the jaw. Menopause Int 2007; 13: 56-59.
  • Estefania Fresco R, Ponte Fernandez R, Aguirre Urizar JM. Bisphosphonates and oral pathology II. Osteonecrosis of the jaws: review of the literature before 2005. Med Oral Patol Oral Cir Bucal 2006; 11: 456-461.
  • Greenberg MS. Intravenous bisphosphonates and osteonecrosis. Oral Surg Oral Med Oral Pathol 2004; 98: 259-260.
  • Pazianas M, Miller P, Blumentals WA, Bernal M, Kothawala P. A review of the literature on osteonecrosis of the jaw in patients with osteoporosis treated with oral bisphosphonates: prevalance, risk factors, and clinical characteristics. Clin Ther 2007; 29: 1548-1558.
  • Bamias A, Kastritis E, Bamia C, Moulopoulos LA, Melakopoulos I, Bozas G, Koutsoukou V, Gika D, Anagnostopoulos A, Papadimitriou C, Terpos E, Dimopoulos MA. Osteonecrosis of the jaw in cancer after treatment with bisphosphonates: Incidence and risk factors. J Oral Maxillofac Surg 2006; 64: 995.
  • Zervas K, Verrou E, Teleioudis Z, Vahtsevanos K, Banti A, Mihou D, Krikelis D, Terpos E. Incidence, risk factors and management of osteonecrosis of the jaw in patients with multiple myeloma: A single-centre experience in 303 patients. Br J Haematol 2006; 134: 620.
  • Hoff AO, Toth BB, Altundag K, Guarneri V, Adamus A, Nooka AK, Sayegh GG, Johnson MM, Gagel RF, Hortobagyi GN. Osteonecrosis of the jaw in patients receiving intravenous bisphosphonate therapy. J Clin Oncol 2006; 24: 8S.
  • Ruggiero SL, Mehtora B, Rosenberg TJ, Engroff SL. Osteonecrosis of the jaws associated with the use of bisphosphonates: a review of 63 cases. J Oral Maxillofal Surg 2004; 62: 527-534.
  • Lugassy G, Shaham R, Nemets A, Ben-Dor D, Nahlieli O. Severe osteomyelitis of the jaw in long-term survivors of multiple myeloma: a new clinical entity. Am J Med 2004; 117: 440-441.

ÇENE KEMİKLERİNİN YENİ TEHLİKESİ: BİSFOSFONATLAR

Yıl 2008, Cilt: 11 Sayı: 2, 134 - 139, 04.11.2011

Selin Ergun , Pelin Guneri Huseyin Koca

Öz

Bisfosfonat bileşikleri malignansiye bağlı olarak gelişen hiperkalseminin düzenlenmesinde ve ayrıca, meme, prostat ve akciğer kanserlerine bağlı tümörlerin ve multipl myelomaya bağlı metastatik lezyonların tedavisinde kanser hastalarının hayat kalitelerini iyileştirmek amacıyla kullanılmaktadır. Bisfosfonatların yüksek dozlarda intravenöz olarak uygulanmaları nedeniyle ilaca bağlı bir yan etki olarak çenelerde osteonekroz gelişebilmektedir. Lezyonlar kendiliğinden oluşabildiği gibi, bir enfeksiyon ve diş çekimi genellikle olayı hızlandırmaktadır. İlaca bağlı olarak gelişen bu özgün kemik nekrozu için henüz kesin bir tedavi bulunmamaktadır. Konservatif yaklaşım uygulanan vakalarda, kemiğin açığa çıkmış olduğu hastaların büyük bölümünde oral antibiyotikler, antienflamatuvarlar ve açık yara bölgesinin lokal irrigasyonu önerilmektedir. Bisfosfonat osteonekrozuna ait klinik ve radyografik özelliklerin iyi bilinmesi ve bu tür hastalarda klinik ve radyolojik belirtilerin değerlendirilmesi, erken tanı ve tedavi açısından da önem taşımaktadır

Anahtar Kelimeler

Bisfosfonatlar osteonekroz metastaz hiperkalsemi çene

Kaynakça

  • Alıcı S, Çekici S. Malign hastalıklarda bisfosfonatların rolü. Van Tıp Dergisi 2002; 9: 66-72.
  • Tanvetyanon T, Stiff PJ. Management of the adverse effects associated with intravenous bisphosphonates. Ann Oncol 2006; 17: 897-907.
  • Wikipedia: http://en.wikipedia.org/wiki/Bisphosphonate
  • Wang EP, Kaban LB, Strewler GJ, Raje N, Toulis MJ. Incidence of osteonecrosis of the jaw in patients with multiple myeloma and breast or prostate cancer on intravenous bisphosphonate therapy. J Oral Maxillofac Surg 2007; 65: 1328-1331.
  • Duman AE, Güven GS, Gürlek A. Erkek osteoporozu. Hacettepe Tıp Dergisi 2005; 36: 175-183.
  • Benhamou CL. Effects of osteoporosis medications on bone quality. Joint Bone Spine 2007; 74: 39-47.
  • Berardi D, Carlesi T, Rossi F, Calderini M, Volpi R, Perfetti G. Potential applications of bisphosphonates in dental surgical implants. Int J Immunopathol Pharmacol 2007; 20: 455-465.
  • Ficarra G, Beninati F, Rubino I, Vannucchi A, Longo G, Tonelli P, Pini Prato G. Osteonecrosis of the jaws in periodontal patients with a history of bisphosphonates treatment. J Clin Periodontol 2005; 32: 1123-1128.
  • Palomo L, Bissada N, Liu J. Bisphosphonate therapy for bone loss in patients with osteoporosis and periodontal disease: clinical perspectives and review of the literature. Quintessence Int 2006; 37: 103-107.
  • Wang HL, Weber D, McCauley LK. Effect of long-term oral bisphosphonates on implant wound healing: literature review and a case report. J Periodontol 2007; 78: 584-594.
  • Farrugia MC, Summerlin DJ, Krowiak E, Huntley T, Freeman S, Borrowdale R, Tomich C. Osteonecrosis of the mandible or maxilla associated with the use of new generation bisphosphonates. Laryngoscope 2006; 116: 115-120.
  • Mavrokokki T, Cheng A, Stein B, Goss A. Nature and frequency of bisphosphonate-associated osteonecrosis of the jaws in Australia. J Oral Maxillofac Surg 2007; 65: 415-423.
  • American Association of Oral and Maxillofacial Surgeons Position Paper on Bisphosphonate-Related Osteonecrosis of the Jaws. J Oral Maxillofac Surg 2007; 65: 369-376.
  • Yalçın P. Glukokortikoid osteoporozu. Romatizma 2000; 15: 145-150.
  • Weitzman R, Sauter N, Eriksen EF, Tarassoff PG, Lacerna LV, Dias R, Altmeyer A, Csermak-Renner K, McGrath L, Lantwicki L, Hohneker JA. Critical review: Updated recommendations for the prevention, diagnosis, and treatment of osteonecrosis of the jaw in cancer patients. Cril Revs Oncol Hemat 2007; 62: 148-152.
  • Şenel Çizmeci F, Baltacıoğlu E, Basmascı Çizmeci F, Bağış B, Özkaynak Ö, Tosun E. Bisfosfonat kullanımına bağlı gelişen mandibula ve maksilla nekrozları ve dental yaklaşım. ADO Klinik Bilimler Dergisi 2007; 1: 49-54.
  • Campisi G, Di Fede O, Musciotto A, Lo Casto A, Lo Muzio L, Fulfaro F, Badalamenti G, Russo A, Gebbia N. Bisphosphonate-related osteonecrosis of the jaw (BRONJ): run dental management designs and issues in diagnosis. Ann Oncol 2007;18: 168-172.
  • Eckert AW, Maurer P, Meyer L, Kriwalsky MS, Rohrberg R, Schneider D, Bilkenroth U, Schubert J. Bisphosphonate-related jaw necrosis-severe complication in maxillofacial surgery. Cancer Treat Rev 2007; 33: 58-63.
  • Lipton A, Milton S. The safety of zoledronic acid. Expert Opin Drug Saf 2007; 6: 305-313.
  • Migliorati CA, Siegel MA, Elting LS. Bisphosphonate-associated osteonecrosis: a long term complication of bisphosphonate treatment. Lancet Oncol 2006; 7: 508-514.
  • Olson KB, Hellie CM, Pienta KJ. Osteonecrosis of jaw in patient with hormone-refractory prostate cancer treated with zoledronic acid. Urology 2005; 66: 658.
  • Reid IR, Bolland MJ. Is bisphosphonate-associated osteonecrosis of the jaw caused by soft tissue toxicity? Bone 2007; 41: 318-320.
  • Cheng A, Mavrokokki A, Carter G, Stein B, Fazzalari NL, Wilson DF, Goss AN. The dental implications of bisphosphonates and bone disease. Aust Dent J 2005; 50: 4-13.
  • Van Poznak C, Estilo C. Osteonecrosis of the jaw in cancer patients receiving IV bisphosphonates. Oncology 2006; 20: 1053-1062.
  • Basu N, Reid DM. Bisphosphonate-associated osteonecrosis of the jaw. Menopause Int 2007; 13: 56-59.
  • Estefania Fresco R, Ponte Fernandez R, Aguirre Urizar JM. Bisphosphonates and oral pathology II. Osteonecrosis of the jaws: review of the literature before 2005. Med Oral Patol Oral Cir Bucal 2006; 11: 456-461.
  • Greenberg MS. Intravenous bisphosphonates and osteonecrosis. Oral Surg Oral Med Oral Pathol 2004; 98: 259-260.
  • Pazianas M, Miller P, Blumentals WA, Bernal M, Kothawala P. A review of the literature on osteonecrosis of the jaw in patients with osteoporosis treated with oral bisphosphonates: prevalance, risk factors, and clinical characteristics. Clin Ther 2007; 29: 1548-1558.
  • Bamias A, Kastritis E, Bamia C, Moulopoulos LA, Melakopoulos I, Bozas G, Koutsoukou V, Gika D, Anagnostopoulos A, Papadimitriou C, Terpos E, Dimopoulos MA. Osteonecrosis of the jaw in cancer after treatment with bisphosphonates: Incidence and risk factors. J Oral Maxillofac Surg 2006; 64: 995.
  • Zervas K, Verrou E, Teleioudis Z, Vahtsevanos K, Banti A, Mihou D, Krikelis D, Terpos E. Incidence, risk factors and management of osteonecrosis of the jaw in patients with multiple myeloma: A single-centre experience in 303 patients. Br J Haematol 2006; 134: 620.
  • Hoff AO, Toth BB, Altundag K, Guarneri V, Adamus A, Nooka AK, Sayegh GG, Johnson MM, Gagel RF, Hortobagyi GN. Osteonecrosis of the jaw in patients receiving intravenous bisphosphonate therapy. J Clin Oncol 2006; 24: 8S.
  • Ruggiero SL, Mehtora B, Rosenberg TJ, Engroff SL. Osteonecrosis of the jaws associated with the use of bisphosphonates: a review of 63 cases. J Oral Maxillofal Surg 2004; 62: 527-534.
  • Lugassy G, Shaham R, Nemets A, Ben-Dor D, Nahlieli O. Severe osteomyelitis of the jaw in long-term survivors of multiple myeloma: a new clinical entity. Am J Med 2004; 117: 440-441.
Toplam 33 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Bölüm Review
Yazarlar

Selin Ergun

Pelin Guneri

Huseyin Koca

Yayımlanma Tarihi 4 Kasım 2011
Gönderilme Tarihi 4 Kasım 2011
Yayımlandığı Sayı Yıl 2008Cilt: 11 Sayı: 2

Kaynak Göster

EndNote Ergun S, Guneri P, Koca H (01 Kasım 2011) Çene kemiklerinin yeni tehlikesi: bisfosfonatlar. Cumhuriyet Dental Journal 11 2 134–139.

Cumhuriyet Dental Journal (Cumhuriyet Dent J, CDJ) is the official publication of Cumhuriyet University Faculty of Dentistry. CDJ is an international journal dedicated to the latest advancement of dentistry. The aim of this journal is to provide a platform for scientists and academicians all over the world to promote, share, and discuss various new issues and developments in different areas of dentistry. First issue of the Journal of Cumhuriyet University Faculty of Dentistry was published in 1998. In 2010, journal's name was changed as Cumhuriyet Dental Journal. Journal’s publication language is English.


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