Bifosfonat ve denosumab kullanımı ile eksternal servikal rezorpsiyon oluşumu arasındaki ilişkinin değerlendirilmesi
Küçük Resim Yok
Tarih
2022
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
İnönü Üniversitesi
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Amaç: Bifosfonat veya denosumab tedavisi altındaki osteoporoz hastalarında eksternal sevikal rezorpsiyon (ESR) görülme olasılığının incelenmesi ve rezorpsiyonların ilacın kullanımının hangi döneminde gerçekleştiğini tespit etmektir. Gereç ve Yöntem: Çalışmaya osteoporoz şikâyetiyle Fizik Tedavi ve Rehabilitasyon Anabilim Dalına (ABD) başvuran bifosfonat veya denosumab tedavisi gören yetişkin toplam 90 hasta katılmıştır. Anamnezinde osteoporoz harici sistemik hastalığın varlığı, periodontal hastalık, ortodontik tedavi, dental travma, intrakoronal beyazlatma geçmişi olan; çene tümörlerinin varlığı, bruksizm, viral enfeksiyon bulunan ve gebe hastalar çalışma dışı bırakılmıştır. Hastalar bifosfonat ve denosumab ilaç tedavisi altında olanlar olmak üzere 2 gruba ayrılmıştır. 90 hastanın 44'ü bifosfonat grubu, 46'sı denosumab grubu ilaç tedavisi alan hastalardan oluşmaktadır. Gruplar ilaç kullanım dönemine göre ilaç tedavisine yeni başlamış olan hastalar, ilaç tedavisi devam eden hastalar, ilaç tedavisi sonlanmış hastalar olmak üzere 3 alt gruba ayrılmıştır. Çalışmaya dâhil edilen hastaların klinik muayeneleri ve radyografik muayeneleri Endodonti ABD kliniğinde yapılmıştır. Muayene bulgularına göre eksternal servikal rezorpsiyon gözlenen bölgeler kayıt altına alınmıştır. Hastalar 2 yıl boyunca 3 aylık kontrollere çağırılmışlardır. Panoramik ve periapikal radyografi alındıktan sonra eksternal servikal rezorpsiyondan şüphe duyulan hastalardan konik ışınlı bilgisayarlı tomografi alınmıştır. Bulgular: 90 hasta arasından toplam 7 hastanın 13 dişinde ESR'ye rastlanmıştır. Bifosfonat ve Denosumab grupları arasında ESR açısından istatistiksel olarak anlamlı farklılık bulunmamıştır (p=0.711). Buna karşılık ilaç kullanım dönemine göre alt gruplar arasında bifosfonat grubu tedavisi devam eden hasta grubunda ESR daha fazla tespit edilmiştir (p=0.023). Sonuç: Bifosfonat ve denosumab grubu ilaç kullanımı olan hastalarda ağız içi müdahalelerde olabildiğince ilaca bağlı olarak çene kemiklerinde görülen osteonekroz (MRONJ) gelişme riskinden dolayı diş çekiminden kaçınılmalıdır. ESR'nin erken tespiti diş çekiminden ve travmatik cerrahi işlemlerden kaçınılması için önemlidir.
Aim: To investigate the possibility of external cervical resorption in osteoporosis patients under bisphosphonate or denosumab treatment and to determine the period of use of the drug. Materials and Methods: A total of 90 adult patients receiving bisphosphonate or denosumab treatment, who applied to the Physical Therapy and Rehabilitation Department with the complaint of osteoporosis, participated in the study. Presence of systemic disease other than osteoporosis in the anamnesis, periodontal disease, orthodontic treatment, dental trauma and intracoronal bleaching history. The presence of jaw tumors, bruxism, viral infection and pregnant patients were excluded from the study. The patients were divided into two groups as those under bisphosphonate and denosumab drug therapy, and of 90 patients, 44 were in the bisphosphonate group and forty six were in the denosumab group drug therapy. The groups were divided into three subgroups according to the period of drug use: patients who have just started drug therapy, patients whose drug therapy continues, and patients whose drug therapy has been terminated. Intraoral examinations and radiographic examinations of the patients included in the study were performed in Endodontics AD. According to the examination findings, the regions where external cervical resorption was observed were recorded. The patients were called for 3-month follow-ups for two years. After taking panoramic and periapical radiography, cone-beam computed tomography was obtained from patients with suspected external cervical resorption. Results: ECR was found in 13 teeth of 7 patients out of 90 patients. There was no statistically significant difference in terms of ECR between the bisphosphonate and Denosumab groups (p=0.711). On the other hand, ECR was found to be higher in the patient group whose bisphosphonate treatment continued compared to the period of drug use (p=0.023). Conclusion: In patients using bisphosphonate and denosumab group drugs, tooth extraction should be avoided as much as possible due to the risk of medication-related osteonecrosis of the jaw (MRONJ) development in intraoral interventions. Early detection of ESR is important to avoid tooth extraction and traumatic surgical
Aim: To investigate the possibility of external cervical resorption in osteoporosis patients under bisphosphonate or denosumab treatment and to determine the period of use of the drug. Materials and Methods: A total of 90 adult patients receiving bisphosphonate or denosumab treatment, who applied to the Physical Therapy and Rehabilitation Department with the complaint of osteoporosis, participated in the study. Presence of systemic disease other than osteoporosis in the anamnesis, periodontal disease, orthodontic treatment, dental trauma and intracoronal bleaching history. The presence of jaw tumors, bruxism, viral infection and pregnant patients were excluded from the study. The patients were divided into two groups as those under bisphosphonate and denosumab drug therapy, and of 90 patients, 44 were in the bisphosphonate group and forty six were in the denosumab group drug therapy. The groups were divided into three subgroups according to the period of drug use: patients who have just started drug therapy, patients whose drug therapy continues, and patients whose drug therapy has been terminated. Intraoral examinations and radiographic examinations of the patients included in the study were performed in Endodontics AD. According to the examination findings, the regions where external cervical resorption was observed were recorded. The patients were called for 3-month follow-ups for two years. After taking panoramic and periapical radiography, cone-beam computed tomography was obtained from patients with suspected external cervical resorption. Results: ECR was found in 13 teeth of 7 patients out of 90 patients. There was no statistically significant difference in terms of ECR between the bisphosphonate and Denosumab groups (p=0.711). On the other hand, ECR was found to be higher in the patient group whose bisphosphonate treatment continued compared to the period of drug use (p=0.023). Conclusion: In patients using bisphosphonate and denosumab group drugs, tooth extraction should be avoided as much as possible due to the risk of medication-related osteonecrosis of the jaw (MRONJ) development in intraoral interventions. Early detection of ESR is important to avoid tooth extraction and traumatic surgical
Açıklama
Anahtar Kelimeler
Diş Hekimliği, Dentistry
