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Characteristics of bisphosphonate-related osteonecrosis of the jaw after kidney transplantation

 Wonse Park  ;  Soo-Hyung Lee  ;  Kyung-Ran Park  ;  Seung-Hee Rho  ;  Won-Yoon Chung  ;  Hyung Jun Kim 
 JOURNAL OF CRANIOFACIAL SURGERY, Vol.23(5) : 510-514, 2012 
Journal Title
Issue Date
Adrenal Cortex Hormones/adverse effects ; Bisphosphonate-Associated Osteonecrosis of the Jaw/etiology* ; Comorbidity ; Female ; Humans ; Immunosuppressive Agents/adverse effects ; Kidney Transplantation* ; Male ; Maxillary Diseases/etiology* ; Middle Aged ; Risk Factors
Bisphosphonate ; osteonecrosis ; jaw ; renal transplant ; dental care
Renal transplantation is the definitive treatment of chronic renal failure, and osteoporosis in patients after renal transplantation is caused by the use of high-dose corticosteroids, reduced renal function, and the use of immunosuppressant. While bisphosphonates inhibit osteoclastic activities, they are the drug of choice for the treatment and prevention of osteoporosis. Bisphosphonate-related osteonecrosis of the jaw (BRONJ) becomes a problematic issue. There are few reports on BRONJ in patients after renal transplantation, so many oral bisphosphonates commonly prescribed in patients after renal transplantation to prevent osteoporosis have no warning of BRONJ. We analyzed the records of patients with BRONJ from January 2009 to December 2010. Among the patients with BRONJ, we selected patients who underwent transplantation of the kidney. Demographic data, drug-related factors, and clinical characteristics were evaluated using chart review. A total of 128 patients were categorized as having BRONJ, and there were 3 patients with a history of kidney transplantation. The average age was 54.6 years, and 2 victims were men. All patients received oral bisphosphonates for more than 2 years (range, 2-7 y; average, 58.6 mo). All patients had hypertension, diabetes mellitus, history of high-dose corticosteroids, and taking immunosuppressant drugs. Bisphosphonate-related osteonecrosis of the jaw occurred in the maxilla in all patients, which is classified as stage 3 because of the involved sinus. Extraction was the main provoking factor in all patients. In conclusion, even at a relatively young age, BRONJ in the maxilla can be developed by intake of oral bisphosphonate after kidney transplantation. Dental care for patients before and after undergoing renal transplantation should be emphasized to reduce the risk of BRONJ.
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Appears in Collections:
2. College of Dentistry (치과대학) > Dept. of Advanced General Dentistry (통합치의학과) > 1. Journal Papers
2. College of Dentistry (치과대학) > Dept. of Oral Biology (구강생물학교실) > 1. Journal Papers
2. College of Dentistry (치과대학) > Dept. of Oral and Maxillofacial Surgery (구강악안면외과학교실) > 1. Journal Papers
Yonsei Authors
Park, Kyung Ran(박경란)
Park, Wonse(박원서) ORCID logo https://orcid.org/0000-0002-2081-1156
Chung, Won Yoon(정원윤) ORCID logo https://orcid.org/0000-0001-8428-9005
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