Journal of Oral Medicine and Pain

Korean Academy of Orofacial Pain and Oral Medicine (대한안면통증구강내과학회)
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Case report : The Bisphosphonate-associated Osteonecrosis of the Jaw(BONJ)

증례 보고: 악골에 발생한 비스포스포네이트 관련 골괴사증 (BONJ)

  • Kim, Kyun-Yo (Dept. of Oral Medicine, School of Dentistry, Kyungpook National University) ;
  • Ko, Yu-Jung (Dept. of Oral Medicine, School of Dentistry, Kyungpook National University) ;
  • Hur, Yun-Kyung (Dept. of Oral Medicine, School of Dentistry, Kyungpook National University) ;
  • Choi, Jae-Kap (Dept. of Oral Medicine, School of Dentistry, Kyungpook National University)
  • 김균요 (경북대학교 치의학전문대학원 구강내과학교실) ;
  • 고유정 (경북대학교 치의학전문대학원 구강내과학교실) ;
  • 허윤경 (경북대학교 치의학전문대학원 구강내과학교실) ;
  • 최재갑 (경북대학교 치의학전문대학원 구강내과학교실)
  • Published : 2009.09.30
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Abstract

Recently, bisphosphonate-associated osteonecrosis of the jaw(BONJ) is added to the list of diseases of the oromaxillofacial region. BONJ is defined as exposed bone in the jaw that does not heal within 8 weeks after identification, in a patient who has been received to bisphosphonates and has not taken radiation therapy to the craniofacial region. Bisphosphonates binded to bone mineral are concentrated in highly active remodeling site, reside in the skeleton for a long time, and do a role as powerful inhibitors of bone resorption. As the patients receiving bisphosphonates therapy grow in number, the patients of BONJ would go on increasing in Korea. We would like to present two patients who were suspected to BONJ, describe the outline of BONJ, and mention importance of our understanding about BONJ. BONJ is rare disease, but once it develops, its prognosis is very poor. Our adequate understanding of BONJ is necessary to prevent it and cope with it properly.

최근, 골다공증 치료 약물인 비스포스포네이트와 관련된 악골괴사증(BONJ)이 구강악안면 영역에서 발생할 수 있는 새로운 질환의 하나로 떠오르고 있다. 비스포스포네이트와 관련된 악골괴사증은 구강내로 노출된 악골이 관찰된 후 8주가 지나도 완전히 치유되지 않고 지속되는 상태를 말하며, 환자는 구강악안면 영역에 방사선 치료를 받은 병력이 없어야 하며, 비스포스포네이트로 치료 중이거나 치료받은 병력이 있어야 한다. 비스포스포네이트는 골에 결합하는 물질인데, 골개조가 활발히 일어나는 곳에 고농도로 집적되어 장기간 골격 내에 머물면서 골흡수를 강력히 억제하는 효과를 발휘한다. 한국에서도 골다공증이나 암환자에서 골전이를 막기 위해 비스포스포네이트로 치료를 받는 환자가 점차 늘고 있으며, 이는 또한 BONJ의 발생 가능성도 증가함을 의미한다. 우리는 BONJ로 의심되는 환자를 두 증례 소개하고자 하며, 이와 함께 BONJ가 어떤 질환이며, BONJ에 대한 치과의사의 인식의 중요성을 언급하고자 한다. BONJ는 드물게 발생하는 질환이긴 하나, 일단 발생하면 예후가 불량한 경우가 대부분이다. 그래서, BONJ에 대한 충분한 이해가 악골괴사를 예방하고, 치료하는 데 반드시 필요할 것이다.

Keywords

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