• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.43 no.1
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• pp.16-22
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• 2017

Objectives: Bisphosphonate is the primary cause of bisphosphonate-related osteonecrosis of the jaw (BRONJ). Bisphosphonates are eliminated from the human body by the kidneys. It is anticipated that bisphosphonate levels in the body will increase if the kidney is in a weak state or if there is systemic disease that affects kidney function. The aim of this study was to analyze the relevance of renal function in the severity of BRONJ. Materials and Methods: Ninety-three patients diagnosed with BRONJ in Pusan National University Dental Hospital from January 2012 to December 2014 were included in this study. All patients underwent a clinical exam, radiographs, and serologic lab test, including urine analysis. The patient's medical history was also taken, including the type of bisphosphonate drug, the duration of administration and drug holiday, route of administration, and other systemic diseases. In accordance with the guidelines of the 2009 position paper of American Association of Oral and Maxillofacial Surgeons, the BRONJ stage was divided into 4 groups, from stage 0 to 3, according to the severity of disease. IBM SPSS Statistics version 21.0 (IBM Co., USA) was used to perform regression analysis with a 0.05% significance level. Results: BRONJ stage and renal factor (estimated glomerular filtration rate) showed a moderate statistically significant correlation. In the group with higher BRONJ stage, the creatinine level was higher, but the increase was not statistically significant. Other factors showed no significant correlation with BRONJ stage. There was a high statistically significant correlation between BRONJ stage and 'responder group' and 'non-responder group,' but there was no significant difference with the 'worsened group.' In addition, the age of the patients was a relative factor with BRONJ stage. Conclusion: With older age and lower renal function, BRONJ is more severe, and there may be a decrease in patient response to treatment.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.44 no.5
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• pp.225-231
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• 2018

Objectives: The purpose of this study was to investigate the demographic and clinical characteristics of patients with medication-related osteonecrosis of the jaw (MRONJ) and to elucidate factors affecting recurrence in surgical treatment. Materials and Methods: A total of 51 patients who were diagnosed with MRONJ were analyzed according to demographic and clinical features and treatment results through a retrospective chart review from 2013 to 2017 in the Department of Oral and Maxillofacial Surgery, Korea University Anam Hospital, Seoul in Korea. Results: Alendronate composed the majority of medication doses (55.6%), followed by ibandronate (20.0%), risedronate (15.6%), and zoledronate (6.7%). Forty patients (88.9%) were given oral medication, and five patients (11.1%) were intravenously treated, and the mean duration of medication use was $61.1{\pm}42.9$ months. A total of 10 patients (22.2%) had a drug holiday before MRONJ-induced dental treatment lasting an average of $6.8{\pm}7.0$ months. MRONJ occurred 2.7 times more in the mandible, with 41 cases (73.2%) occurring in the mandible and 15 cases (26.8%) occurring in the maxilla, and the prevalence of affected posterior parts (premolar-molar) was six times greater than that of the anterior parts (incisor-canine) (48 cases vs 8 cases, 85.7% vs 14.3%). The most common dental cause of MRONJ was tooth extraction (69.6%). Regarding recurrence, there was no statistical difference in recurrence rate according to either site or stage. However, recurrence occurred in 4 out of 34 cases (11.8%) in the primary closure group and 9 out of 20 cases (45.0%) in the secondary healing group, and there was a statistical difference with respect to closure technique. Conclusion: The identified risk factors in patients taking bone resorption inhibitors can aid dental clinicians in ensuring prevention and proper treatment of MRONJ.

• Korean Security Journal
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• no.44
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• pp.7-35
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• 2015

The objective of this article is to inform and document the contemporary development of the private security industry in Queensland Australia, a premier holiday destination that provide entertainment for the larger region. The purpose of this review is to examine the comtemporary development of mandated licensing regimes regulating the industry, and the necessary reform agenda. The overall aim is threefold: first, to chart the main outcomes of the two-wave of reforms since the mid-'90s; second, to examine the effectiveness of changes in modes of regulation; and third, to identify the criteria that can be considered a best practice based on Button(2012) and Prenzler and Sarre's(2014) criteria. The survey of the Queensland regulatory regime has demonstrated that, despite the federal-guided reforms, there remain key areas where further initiatives remain pending, markedly case-by-case utilisation of more proactive strategies such as on-site alcohol/drug testing, psychological evaluations, and checks on close associates; lack of binding training arrangement for technical services providers; and targeted auditing of licensed premises and the vicinity of venues by the Office of Fair Trading, a licensing authority. The study has highlighted the need for more determined responses and active engagements in these priority areas. This study of the development of the licensing regimes in Queensland Australia provides useful insights for other jurisdictions including South Korea on how to better manage licensing system, including the measures required to assure an adequate level of professional competence in the industry. It should be noted that implementing a consistency in delivery mode and assessment in training was the strategic imperative for the Australian authority to intervene in the industry as part of stimulating police-private partnerships. Of particular note, competency elements have conventionally been given a low priority in South Korea, as exemplified through the lack of government-sponsored certificate; this is an area South Korean policymakers must assume an active role in implementing accredited scheme, via consulting transnational templates, including Australian qualifications framework.