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BRONJ(bisphosphonate related osteonecrosis of jaw)의 진단과 치료

Diagnosis and Management of BRONJ (bisphosphonate related osteonecrosis of jaw)

팽준영
대한치과의사협회 (korea dental association)|2011.07|대한치과의사협회지 (Journal of Korean Dental Association)|제49권 제7호|pp. 378-388|DOI 10.22974/jkda.2011.49.7.002

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참고문헌

키워드

BisphosphonateBRONJOsteonecrosisAAOMS guideline for BRONJ
주제분류치의학

초록

비스포스포네이트와 연관된 악골괴사(bisphosphonate related osteonecrosis of jaw, 이하 BRONJ)는 2003년 경 보고되기 시작하였고, 비스포스포네이트를 장기간 경구 혹은 주사로 투여받은 환자에서 국내외에서도 많은 연구가 진행되고 있으며 증례가 증가하고 있는 추세이다. 발생을 예측하기 힘들고 일단 발생하고 나면 치료에 어려움이 있어 의사와 치과의사의 많은 관심이 필요한 질환이다. 많은 관련단체들이 예방과 진단, 그리고 치료법에 대한 지침을 내놓고 있는 가운데, 우리나라에서도 2009년도에 대한내분비학회, 대한골대사학회, 대한골다공증학회 및 대한구강악안면외과학회가 공동으로 비스포스포네이트 관련 악골(턱뼈)괴사에 대한 공동 지침(position statement)을 내놓은 바 있다. 하지만, 지침서에서는 다양한 증례에서의 고려사항을 자세히 설명할 수 없고, 일반적으로 지켜야할 확립된 사항을 제시하고 있어 실제의 치료과정에서는 치료와 관련된 의학적 근거에 대한 다양한 고려가 있어야 할 것으로 생각된다.

Abstract

BRONJ(Bisphosphonate Related Osteonecrosis of Jaws) is not easy to be managed because it responds less predictably to established surgical treatment algorithms for osteomyelitis or osteoradionecrosis. The guidelines recommend that any kind of surgery should be delayed if possible. In the latest stage-dependent recommendations of the AAOMS in 2009, a conservative regime with antibiotics, antibacterial mouthe rinses and pain control in stages 0 to II. Some investigators have described the benefits of early osteotomy with primary wound closure. However, there are only a few publications with a standardized surgical concepts. In this reviews, various aspects of diagnosis and management of BRONJ will be discussed.

참고문헌 (28)

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관련 논문AI추천

비스포스포네이트(Bisphosphonate)를 복용하는 환자에서 발생하는 골괴사증황경균대한치과의사협회 · 대한치과의사협회지2011 · 제49권 제7호골다공증 치료 약제와 턱뼈괴사증의 이해김선종, 김진우대한치과의사협회 · 대한치과의사협회지2021 · 제59권 제11호Bisphosphonate-related osteonecrosis of jaw의 치료에 대한 고찰박군찬, 박재안, 배정호, 백지선, 신재명, 유경하, 윤규호, 정정권대한구강악안면외과학회 · 대한구강악안면외과학회지2010 · 제36권 제3호비스포스포네이트 연관 악골 괴사(BRONJ)의 치과적 견해이정근대한골다공증학회 · OSTEOPOROSIS2011 · 제9권 제1호경구 bisphosphonate를 복용하는 환자에서 발생한 bisphosphonate-related osteonecrosis of jaw에 대한 임상적 특징 및 처치: 증례보고윤현중, 이상화, 최우성대한구강악안면외과학회 · 대한구강악안면외과학회지2010 · 제36권 제6호비스포스포네이트 관련 악골 골괴사: 문헌고찰김수관, 김은식, 김지원, 김철만, 오지수, 유재식, 임경섭치의학연구원 · Oral Biology Research2014 · 제38권 제1호

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