Rehabilitation using implants in a patient with Medication Related Osteonecrosis of the Jaw (MRONJ) and possible role of rheumatoid arthritis as a co-morbidity: report of a case
김민아, 이연아, 노관태, 오주영, 이정우, 정준호, 박지열, 권용대,
소속 상세정보
김민아 ( Kim Min-Ah ) - Kyung Hee University School of Dentistry Department of Oral and Maxillofacial Surgery
이연아 ( Lee Yeon-Ah ) - Kyung Hee University School of Medicine Department of Internal Medicine
노관태 ( Noh Kwan-Tae ) - Kyung Hee University School of Dentistry Department of Prosthodontics
오주영 ( Ohe Joo-Young ) - Kyung Hee University School of Dentistry Department of Oral and Maxillofacial Surgery
이정우 ( Lee Jung-Woo ) - Kyung Hee University School of Dentistry Department of Oral and Maxillofacial Surgery
정준호 ( Jung Jun-Ho ) - Kyung Hee University School of Dentistry Department of Oral and Maxillofacial Surgery
박지열 ( Bak Ji-Yeol ) - Kyung Hee University School of Dentistry Department of Oral and Maxillofacial Surgery
권용대 ( Kwon Yong-Dae ) - Kyung Hee University School of Dentistry Department of Oral and Maxillofacial Surgery
KMID : 1025720190380030082
Abstract
Although the relationship between rheumatoid arthritis (RA) and medication related osteonecrosis of the jaws (MRONJ) is not clear yet, RA is considered a risk factor for MRONJ. By presenting a rehabilitation case of MRONJ patient with RA, we described the implication of RA as a risk factor and the strategic points in oral rehabilitation in these patients. After surgical treatment in patient with MRONJ on anterior of the mandible, oral rehabilitation was performed through the overdenture using implants. RA, osteoporosis and the agents used in its treatment may disrupt the normal bone metabolism and contribute to the development of ONJ. Therefore, invasive dental surgery should be avoided in patients with these systemic diseases. Since excessive occlusal force can cause ONJ by damaging the oral mucosa, the oral rehabilitation method should be chosen to avoid excessive overload on the oral mucosa. In selected cases with controlled risk factors, dental implants may be considered as a treatment option in oral rehabilitation. In patients on the treatment of RA and osteoporosis, dentists should be aware of the potential risk for MRONJ occurrence and plan appropriate treatment with consideration of various risk factors.
키워드
Osteonecrosis; Rheumatoid arthritis; Osteoporosis; Implant
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