Bifosfonat Kullanan Hastalarda Protetik Tedavi Yaklaþýmý

Bifosfonat kullanan hastalar, dental tedavi öncesinde, tedavi sýrasýnda ve sonrasýnda dikkatlice deðerlendirilmeli ve bu hastalarda mümkün olduðunca konservatif tedaviler tercih edilmelidir. Bu hastalar, invaziv dental tedavi iþlemleri öncesinde, bifosfonat tedavisi uygulayan hekime konsulte edilmelidir. Özellikle implant uygulamalarý gibi cerrahi tedaviler gerekli görüldüðü durumlarda hastanýn hekimiyle iletiþim halinde olunmalý ve hastanýn medikal durumuyla ilgili bilgi alýnmalýdýr. Osteonekroz geliþme riski olan hastalar, konu ile ilgili bilgilendirilmeli ve dental tedavi sýrasýnda veya sonrasýnda osteonekroza sebep olabilecek durumlar deðerlendirilmelidir. Bifosfonat kullanan hastalarda, ilacýn kullaným þekli ve süresine baðlý olarak, travmatik dental tedaviler, invaziv iþlemler, protez vuruklarý; iyileþmeyen yumuþak doku yaralarý ve osteonekroz oluþumu açýsýndan risklidir. Bu durumda hasta-hekim iþ birliði, hastanýn düzenli aralýklarla takiplerinin yapýlmasý, hastaya aðýz hijyeni eðitiminin verilmesi ve hastanýn konuyla ilgi bilgilendirilmesi oldukça önemlidir. Literatürde, medikal anamnezinde bifosfonat tedavisi bulunan hastalarda, cerrahi dental tedavilerde göz önünde bulundurulmasý gereken yaklaþýmlar bulunmaktadýr. Bu nedenle, bu derlemede bifosfonat hikayesi bulunan hastalarda protetik tedavi yaklaþýmý vurgulanmýþtýr.

Prosthetic Treatment Approach In Bisphosphonate Using Patients

Bisphosphonate using patients should be carefully evaluated before, during and after dental treatment and conservative treatments should be preferred as much as possible for these patients. These patients should be consulted with the doctor administering bisphosphonate therapy before invasive dental treatment procedures. Especially in surgical treatments such as implant applications, the patient's doctor should be contacted and information about the patient's medical condition should be obtained. Patients at risk of developing osteonecrosis should be informed about the subject and conditions that may cause osteonecrosis during or after dental treatment should be evaluated. In bisphosphonate using patients, depending on the type and duration of use of the drug, traumatic dental treatments, invasive procedures, prosthesis injuries; it is risky in terms of non-healing soft tissue wounds and osteonecrosis formation. In this case, patient-dentist cooperation, regular follow-up of the patient, oral hygiene education to the patient and informing the patient about the subject are very important. In the literature, surgical dental treatments and related complications have been mentioned in bisphosphonate using patients. However, in this review, the prosthetic treatment approach was emphasized in patients with a bisphosphonate history.