Nihat AKBULUT, Emrah SOYLU, Aras ERDİL, Ahmet ALTAN

Çenelerin İlaca Bağlı Osteonekrozu ve Güncel Tedavi Yaklaşımları

Çenelerin ilaca bağlı osteonekrozu (MRONJ); antirezorptif, antianjiyogenik ve bisfosfonat tedavileri esnasında veyasonrasında uygulanan maksillofasyal cerrahi işlemler ile ortaya çıkan; yeni tanımlanan ve halen etyopatogenezi tamanlaşılamamış bir hastalıktır. Amerikan Maksillofasyal Cerrahlar Birliği’nin oluşturduğu komisyon tarafından hastalığıntanımı, evrelendirilmesi ve tedavi yaklaşımları konusunda çalışmalar değerlendirilmekte ve bu konularda görüş bildirenkılavuzlar yayınlanmakta olup; hastalığın tedavi yaklaşımları konusunda henüz tartışmalar devam etmektedir. Kemik veyumuşak dokuların etkilenme düzeyine bağlı olarak, hastalığın tedavisinde konservatif ve cerrahi yöntemlerkullanılmaktadır. Hastalığın oluşumunun önlenmesi için ağız, diş ve çene cerrahlarına başvuran hastaların bu hastalıkhakkında bilgilendirilmesi ve koruyucu yöntemler hakkında motive edilmeleri büyük önem taşımaktadır. Bu derlemede,en son yayınlanan 2014 yılındaki kılavuz sonrasından 2018 yılına kadar literatürde bildirilen ve uygulanmış tedavilerikonu alan makaleler derlenmiştir.

Medication Related Osteonecrosis of Jaws and Current Treatment Modalities

Medication-related osteonecrosis of the jaws (MRONJ), resulting from maxillofacial surgical procedures applied during or after bisphosphonate, antiresorptive and antiangiogenic treatments is a recently defined disease and its etiopathogenesis is still unexplained. There are debates on the treatment approaches of the disease, and the commission established by the American Association for Maxillofacial Surgery publishes guidelines on the definition, staging and treatment procedures of the disease. Nowadays, surgical and conservative treatment methods are used depending on the impact level of bone and soft tissues. It is of utmost importance to prevent the occurence of this disease in patients, who are referred to oral and maxillofacial surgeons, informed about this disease and from the most recent guideline in 2014 motivated about preventive methods. In this review, the articles published in the literature about the applied treatments the guideline in until 2018 were compiled.

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