ÖZET
Amaç:
Çene kemiklerinin osteonekrozu, özellikle kanser, romatoid artrit ve osteoporoz hastalarının tedavileriyle ilişkili olarak da ortaya çıkabilen, yaşam kalitesini önemli ölçüde düşürebilen bir hastalıktır. Son yıllarda nekrotik kemiğin total rezeksiyonu, ölü boşluğun antiseptik malzemelerle doldurulması ve mukozanın dikkatlice onarılmasını içeren cerrahi tedavi seçeneği konservatif tedavilere göre daha tercih edilir olmuştur.
Gereç ve Yöntem:
Bu öncesi ve sonrası çalışmasında kliniğimize 2018 ve 2020 yılları arasında başvuran ve preoperatif ve postoperatif değerlendirmeleri tamamlanmış 11 hasta dahil edilmiştir. Hastalar ameliyat öncesi ve sonrasında Genel Oral Sağlık Değerlendirme (GOHA) indeksi kullanılarak değerlendirilmiştir. Ameliyat öncesi ve sonrası skorlar cerrahi tedavinin etkinliğinin ortaya konması için karşılaştırılmıştır. Bunun yanında hastaların demografik ve medikal arka planlarının bu skorlara etkisi de araştırılmıştır.
Bulgular:
Hastaların demografik ve medikal arka planlarının preoperatif ve postperatif GOHA indeksi skorlarına istatistiki olarak anlamlı etkilerinin olmadığı gözlenmiştir (p>0,05). Bununla birlikte, cerrahi tedavi sonrası hastaların GOHA indeksi skorlarında istatistiki olarak anlamlı bir düşüş gözlenmiştir (preoperatif ortalama: 38,87,+/- 6,44; postoperatif ortalama: 31,0, +/- 8,28; p<0,05).
Sonuç:
Çene kemiklerinde osteonekroz ile başvuran hastaların tedavisinde optimum bir sonuç elde edebilmek için hastaların bireysel özellikleri ve radyografik görüntüleri göz önüne alınarak bireysel bir tedavi stratejisi geliştirmek gerekir. Cerrahi öncesinde varsa etiyolojide yer alan medikasyonların düzenlenmesi ve osteomiyelit eşliği durumunda ise uygun antibiyotiklerin başlanması gerekir. Postoperatif dönemde ise mukozal iyileşmenin sağlanabildiği anda erken dönemde oral ve dental rehabilitasyonun başlanması önemlidir.
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