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Other literature type . 2008
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Bisfosfonatos e osteonecrose dos maxilares

Authors: Felgueiras, José Carlos;

Bisfosfonatos e osteonecrose dos maxilares

Abstract

Os bisfosfonatos são potentes inibidores dos osteoclastos que, por interacção com estas células, produzem uma marcada diminuição da reabsorção óssea, sendo por isso utilizados no tratamento de doenças que interferem com a remodelação óssea. Apesar do sucesso dos bisfosfonatos como agentes terapêuticos na redução da morbilidade dos doentes oncológicos, nos últimos anos, têm surgido casos de osteonecrose dos maxilares. A osteonecrose dos maxilares é definida como uma necrose óssea na cavidade oral, provocada, por exemplo, por uma má cicatrização do tecido ósseo, principalmente após qualquer intervenção traumática que deixe o osso maxilar exposto, como, por exemplo, uma extracção dentária. Deste modo, torna-se relevante estudar a associação destes fármacos com a osteonecrose dos maxilares, reconhecer o grupo de pacientes de risco, sinais e sintomas, pautas de actuação preventivas e terapêuticas. A revisão bibliográfica foi efectuada na base de dados da Medline (www.pubmed.com), utilizando as palavras-chave: “jaw osteonecrosis”, “bisphosphonates”, “pamidronate”, “zoledronate”, “alendronate”, “phossy jaws”. Os artigos seleccionados foram do tipo meta-análises, revisões bibliográficas e estudos clínicos controlados randomizados, dos últimos 5 anos. Embora a sua eficácia no tratamento de doentes oncológicos seja irrefutável, são ainda necessárias pesquisas para a utilização irrestrita destes medicamentos na clínica, devido aos últimos relatos de efeitos adversos, principalmente na cavidade oral, e também porque grande parte do conhecimento dos seus efeitos nos componentes do sistema estomatognático provém de estudos em animais e in vitro. A prevenção é a melhor forma de tratamento desta complicação. Bisphosphonates are potent inhibitors of osteoclasts that, for interaction with these cells, producing a marked decrease in bone resorption, and it is used to treat diseases that interfere with bone turnover. Despite the success of bisphosphonates as therapeutic agents in reducing the morbidity of cancer patients in recent years have arisen cases of osteonecrosis of the jaw. The osteonecrosis of the jaw is defined as a bone necrosis in the oral cavity, caused by, for example, a poor healing of bone tissue, particularly after any traumatic intervention that leave exposed jaw bone, such as a tooth extraction. Thus, it is important to study the association of these drugs with osteonecrosis of the jaw, recognize the group of patients at risk, signs and symptoms, guidelines for preventive and therapeutic actions. The literature review was made in the database of Medline (www.pubmed.com), using the keywords: "jaw osteonecrosis," "bisphosphonates", "pamidronate", "zoledronate", "alendronate", "phossy jaws" . The articles selected were meta-analyses, reviews and bibliographic randomized controlled clinical studies, of the last 5 years. Although its effectiveness in treating cancer patients is irrefutable, are still necessary research to unrestricted use of these drugs in the clinic because of recent reports of adverse effects, mainly in the oral cavity, and also because much of the knowledge of their effects on components of the stomatognathic system comes from studies in animals and in vitro. Prevention is the best way of dealing with this complication.

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selected citations
These citations are derived from selected sources.
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
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