경구용 bisphosphonate로 인해 하악골에 발생한 골괴사증: 증례보고
Oral bisphosphonates induced osteonecrosis of the mandible : A case report
손효정, 장호열, 금윤선, 이장렬, 김현철, 이상철,
소속 상세정보
손효정 ( Son Hyo-Jeong ) - 리빙웰치과병원
장호열 ( Jang Ho-Yeol ) - 리빙웰치과병원
금윤선 ( Keum Yun-Seon ) - 리빙웰치과병원
이장렬 ( Lee Jang-Yeol ) - 리빙웰치과병원
김현철 ( Kim Hyoun-Chull ) - 리빙웰치과병원
이상철 ( Lee Sang-Chull ) - 리빙웰치과병원
KMID : 0355620090350020106
Abstract
Bisphosphonates have been approved for Paget’s disease, cancer - related hypercalcemia, bone involvement in multiple myeloma or solid tumors and osteoporosis. Although, underlying pathophysiological mechanisms remain unclear, it seems that bisphosphonates inhibit osteoclast precursor cells, modulate migratory and adhesive characteristics and induce apoptosis of osteoclasts. Furthermore impacts on angiogenesis, microenvironment and signal transduction between osteoclasts and osteoblasts. In this report, we present a case of oral bisphosphonates induced osteonecrosis of the mandible in a 84-year-old patient who received for two years. Two tapered screw vent implants(Zimmer, USA) were placed in the area of first and second molar. Two weeks later after crowns restored, some inflammatory signs and symptoms were observed on the second molar area. Sequestrum was formed and the sequestrum was removed with the implant. Frequent follow-up checks and oral hygiene maintenances were done and the first molar implant was restored. There is insufficient evidence suggests that duration of oral bisphosphonate therapy correlates with the development and severity of osteonecrosis. Therefore, dentists should not overlook the possibility of development of bisphosphonate induced osteonecrosis in patients who have taken oral forms of medication for less than three years.
키워드
Osteoporosis;Oral bisphosphonates;Osteonecrosis;Complication
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