8 research outputs found
Relationship Between Osteonecrosis of the Jaw and Bisphosphonate Treatment
Terapija bisfosfonatima i njezina etiopatogenetska povezanost s aseptiÄkom osteonekrozom Äeljusti važan je javnozdravstveni problem danaÅ”njice. Svrha je rada pregledom suvremene znanstvene literature utvrditi posljedice viÅ”estrukog djelovanja bisfosfonata (antiosteoklastiÄna aktivnost, citotoksiÄnost na meka i
koÅ”tana tkiva, antiangiogeneza, genski Äimbenici, poremeÄena ravnoteža izmeÄu osteoklasta i osteoblasta).
Terapija bisfosfonatima jedan je od najÄeÅ”Äih uzroka razvoja osteonekroze Äeljusti. EpidemioloÅ”ki podaci pokazuju da se javlja u bolesnika koji su uzimali jedan ili kombinanciju nitrogenih bisfosfonata. Najvažniji
Äimbenici rizika za ovu nuspojavu su vrsta bisfosfonata (napose visokopotentni pamidronat i zoledronat koji se daju intravenski), njihova doza i duljina medikacije te vrsta bolesti zbog koje se propisuje terapija.
Pojava osteonekroze Äeljusti zabilježena je uglavnom u onkoloÅ”kih bolesnika i u samo 5 % bolesnika s osteoporozom koji su lijeÄeni bisfosfonatima. U patogenezi osteonekroze povezane s bisfosfonatima važno je, sa stajaliÅ”ta dentalnomedicinske prakse, dobro opÄe oralno zdravlje jer se osteonekroza javlja napose
nakon prethodnoga parodontoloŔkog i oralnokirurŔkog zahvata.Bisphosphonate treatment and its aetiopathogenic association with aseptic osteonecrosis of the jaw is one of the more prominent public health issues today. The aim of this review is to see into the mechanisms of bisphosphonate effects on bones described in literature (anti-osteoclastic activity, cytotoxicity, antiangiogenesis, genetic factors, and imbalance between osteoclasts and osteoblasts). Bisphosphonate treatment is the dominant cause of jaw necrosis. Epidemiological data show an exclusive incidence of osteonecrosis of the jaw in patients who took one or a combination of nitrogen-containing bisphosphonates. Risk factors vary by the bisphosphonate potency (particularly risky are the highly potent pamidronate and zoledronate, which are given intravenously), dosage, duration of treatment, and the illness. Jaw necrosis is most common in oncology patients, and only 5 % in patients with osteoporosis. From a dental-medical point of view, a good oral health is important because osteonecrosis often appears after a periodontal or oral surgical procedure