İlaç Kullanımına Bağlı Çene Kemiklerinin Osteonekrozunun Ortaya Çıkmasında Rol Oynayan Risk Faktörleri Ve Klinik, Radyografik Özellikleri

Çene kemiklerinde ilaç kullanımına bağlı gelişen osteonekroz, maksilla ve mandibulada kan desteğinin bozulması sonucunda kemik nekrozu ve ilerleyici kemik yıkımı ile gelişir. Etiyolojisinde kemik metabolizması hastalıklarının birçoğu ve malignitelerin tedavisinde kullanılan bifosfanatlar büyük rol oynar. Bifosfonatların dışında çeşitli ilaçların da çene kemiklerinde osteonekroza neden olduğu belirlenmiştir. Literatürde bifosfonat kullanmayan hastalarda da osteonekroza rastlanıldığı bildirilmiş, bu hastalarda bifosfonat dışında başka ilaçların kullanımının yanında diyabet gibi immün sistemi baskılayan bazı sistemik hastalıkların varlığı, cerrahi dental uygulamalar, protez kullanımı gibi lokal faktörler ile bazı genetik faktörlerin osteonekroz oluşumunda risk oluşturduğu belirtilmiştir. Tedavisi zor ve ilerleyici bir durum olduğundan, erken teşhis prognoz açısından önemlidir. Bu derlemenin amacı çene kemiklerinde ilaç kullanımına bağlı gelişen osteonekrozun oluşumunda rol oynayan risk faktörlerine dikkat çekmek, klinik ve radyografik özellikleri hakkında güncel bilgiler vermektir.
Anahtar Kelimeler:

Bifosfonat, çene, osteonekroz

Risk Factors Playing A Role on Medication Related Osteonecrosis of The Jaws And Clinical, Radiographic Characteristics

Medication-related osteonecrosis of the jaws develops with bone necrosis and progressive bone destruction as a result of impaired blood supply in the maxilla and mandible. Bisphosphonates used in the treatment of many bone metabolism diseases and malignancies play a major role in the etiology of osteonecrosis. It has been found that various drugs caused to osteonecrosis in the jaws, apart from bisphosphonates. In the literature, it has been reported that osteonecrosis is also encountered in patients who do not use bisphosphonates, besides the use of other drugs other than bisphosphonates, the presence of some systemic diseases that suppress the immune system such as diabetes, surgical dental procedures, local factors such as the use of prosthesis and some genetic factors pose a risk in the formation of osteonecrosis. Since it is difficult to treat and a progressive condition, early diagnosis is important in terms of prognosis. The aim of this review is to give actual information about the risk factors, clinical and radiographic features of medication-related osteonecrosis of the jaws.

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