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handle: 10284/2352 , http://hdl.handle.net/10284/2352
Cada vez mais os pacientes que necessitam de tratamento ortodôntico fazem terapias concomitantes. De forma a relacionar o tratamento ortodôntico com os bisfosfonatos (BFs), foi feita uma revisão bibliográfica, baseada em informação obtida por pesquisa manual e via online, no “Google”, “MEDLINE/PubMed”, “Science Direct ” e “B-On”. As palavras-chave foram: “orthodontic tooth movement”, “bisphosphonates”, “orthodontics”, “osteonecrosis”, “bone resorption”, “rats”, “root resorption”, “rapid expansion”, “retention”. Só nos últimos 40 anos, os BFs têm sido implementados no tratamento de desordens do metabolismo do cálcio, por inibirem a reabsorção óssea. Estes podem ser administrados em crianças e adultos, por via oral e intra-venosa. Como o movimento ortodôntico dentário (MOD) consiste na aposição e reabsorção ósseas localizadas, a sua amplitude é afectada (inibida) por este medicamento. Este efeito pode ser desejável ou indesejável. Assim, a terapia com BFs pode prevenir a reabsorção radicular, associada ao MOD; preservar os resultados dos procedimentos que requerem neoformação óssea (ex. expansão maxilar ou distracção mandibular); promover retenção mais segura, após expansão; sistemicamente diminuem as fracturas ósseas e têm propriedades anti-angiogénicas e antineoplásicas. Contudo, podem provocar cicatrização óssea comprometida e osteonecrose. São necessários mais estudos prospectivos e ensaios clínicos randomizados, de forma a avaliar e potenciar os efeitos benéficos da terapia com BFs no tratamento ortodôntico. Increasingly, patients who require orthodontic treatment make concomitant therapies. In order to relate the orthodontic treatment with bisphosphonates (BFS), a literature review was made, based on information obtained through manual and online search, using "Google", "MEDLINE / PubMed", “Science Direct ” and "B-On". The key words were: "orthodontic tooth movement", "bisphosphonates," "orthodontics", "osteonecrosis," "bone resorption", "rats", "root resorption", "rapid expansion," "retention". Only in the last 40 years, the BFS has been implemented in the treatment of disorders of calcium metabolism, by inhibiting bone resorption. They can be administrated to children and adults, oral and intravenous. As the orthodontic tooth movement (OTM) consists in apposition and bone resorption, its amplitude is affected (inhibited) by this drug. This effect may be desirable or undesirable. Thus the BFS therapy can prevent root resorption associated with the OTM, preserve the results of procedures that require new bone formation (eg maxillary expansion and jaw distraction), promoting safer retention after expansion; systemically reduce bone fractures and have anti-angiogenic and antineoplastic properties. However, they can cause impaired bone healing and osteonecrosis. Further prospective randomized studies and clinical trials are needed, to assess and enhance the beneficial effects of therapy with BFS in orthodontic treatment.
Retention, Rapid expansion, Orthodontic tooth movement, Osteonecrosis, Orthodontics, Bone resorption, Root resorption, Bisphosphonates, Rats
Retention, Rapid expansion, Orthodontic tooth movement, Osteonecrosis, Orthodontics, Bone resorption, Root resorption, Bisphosphonates, Rats
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