비스포스포네이트 관련 악골괴사에 대한 후향적 연구
Retrospective study on the bisphosphonate-related osteonecrosis of jaw
한윤식, 이인우, 서진원, 김성민, 황순정, 최진영, 이종호, 정필훈, 김명진, 서병무, 명훈, 이호,
소속 상세정보
한윤식 ( Han Yoon-Sic ) - 서울대학교 치의학대학원 구강악안면외과학교실
이인우 ( lee In-Woo ) - 서울대학교 치의학대학원 구강악안면외과학교실
서진원 ( Suh Jin-Won ) - 서울대학교 치의학대학원 구강악안면외과학교실
김성민 ( Kim Soung-Min ) - 서울대학교 치의학대학원 구강악안면외과학교실
황순정 ( Hwang Soon-Jung ) - 서울대학교 치의학대학원 구강악안면외과학교실
최진영 ( Choi Jin-Young ) - 서울대학교 치의학대학원 구강악안면외과학교실
이종호 ( Lee Jong-Ho ) - 서울대학교 치의학대학원 구강악안면외과학교실
정필훈 ( Choung Pill-Hoon ) - 서울대학교 치의학대학원 구강악안면외과학교실
김명진 ( Kim Myung-Jin ) - 서울대학교 치의학대학원 구강악안면외과학교실
서병무 ( Seo Byoung-Moo ) - 서울대학교 치의학대학원 구강악안면외과학교실
명훈 ( Myoung Hoon ) - 서울대학교 치의학대학원 구강악안면외과학교실
이호 ( Lee Ho ) - 서울대학교 치의학대학원 구강악안면외과학교실
KMID : 0355620110370060470
Abstract
Introduction: The incidence of bisphosphonate-related osteonecrosis of the jaw (BRONJ) has increased gradually in patients who have undergone surgical treatment for osteomyelitis. In this study, a retrospective analysis of BRONJ patients was carried out using the data of osteomyelitis patients treated surgically.
Materials and Methods : Osteomyelitis patients, who underwent curettage, sequestrectomy, saucerization or decortications, and partial mandibulectomy at Seoul National University Dental Hospital from 2004 to 2010 were enrolled in this study. The patients were classified and categorized into two groups based on the surgical records and progress notes. One group comprised of patients with osteomyelitis and osteoporosis, and the other group included patients with osteomyelitis only. The epidemiological data of the BRONJ patients was analyzed to identify any trend in the incidence of BRONJ in osteomyelitis patients.
Results: Among 200 patients who underwent surgical intervention for osteomyelitis, 64 (32.0%) were identified as having osteoporosis as the underlying disease. In these 64 patients, more than 81.3% had been prescribed bisphosphonates. Females were far more affected by BRONJ than males. The incidence of BRONJ also increased with age. The posterior part of the mandible was affected more frequently by BRONJ.
Conclusion: Although the availability of potent antibiotics and increased oral hygiene care can reduce the overall incidence of osteomyelitis, BRONJ can increase the total incidence. To prevent BRONJ, it is recommended that an oral examination be performed before prescribing bisphosphonates. Moreover, the patients should be educated about the potential risks of dental procedures that might be causal factors for BRONJ. Furthermore, patient swho take bisphosphonates for the treatment of osteoporosis should undergo periodic follow up oral examinations to prevent BRONJ.
키워드
Bisphosphonates;Osteonecrosis;Jaw;Osteomyelitis;Osteoporosis
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