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KMID : 1025720190380030082
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Journal of Dental Implant Research
2019 Volume.38 No. 3 p.82 ~ p.88
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Rehabilitation using implants in a patient with Medication Related Osteonecrosis of the Jaw (MRONJ) and possible role of rheumatoid arthritis as a co-morbidity: report of a case
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Kim Min-Ah
Lee Yeon-Ah
Noh Kwan-Tae
Ohe Joo-Young
Lee Jung-Woo
Jung Jun-Ho
Bak Ji-Yeol
Kwon Yong-Dae
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Abstract
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Although the relationship between rheumatoid arthritis (RA) and medication related osteonecrosis of the jaws (MRONJ) is not clear yet, RA is considered a risk factor for MRONJ. By presenting a rehabilitation case of MRONJ patient with RA, we described the implication of RA as a risk factor and the strategic points in oral rehabilitation in these patients. After surgical treatment in patient with MRONJ on anterior of the mandible, oral rehabilitation was performed through the overdenture using implants. RA, osteoporosis and the agents used in its treatment may disrupt the normal bone metabolism and contribute to the development of ONJ. Therefore, invasive dental surgery should be avoided in patients with these systemic diseases. Since excessive occlusal force can cause ONJ by damaging the oral mucosa, the oral rehabilitation method should be chosen to avoid excessive overload on the oral mucosa. In selected cases with controlled risk factors, dental implants may be considered as a treatment option in oral rehabilitation. In patients on the treatment of RA and osteoporosis, dentists should be aware of the potential risk for MRONJ occurrence and plan appropriate treatment with consideration of various risk factors.
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KEYWORD
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Osteonecrosis, Rheumatoid arthritis, Osteoporosis, Implant
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