Implantes em pacientes com osteonecrose dos maxilares associado ao uso de bifosfonatos. Relato de caso e revisão de literatura

A osteoporose é responsável por causar condições devastadoras no tecido ósseo elevando o risco de fraturas, constituindo uma problemática importante de saúde pública. É comum o uso de medicamentos, como os bifosfonatos para o controle dessa patologia. Contudo, a associação do uso desse medicamento com a osteonecrose dos maxilares vem sendo amplamente discutido na literatura, assim como a dificuldade da reabilitação desses pacientes como implantes e do protocolo de tratamento dessa condição. Assim sendo, o objetivo do presente trabalho foi realizar uma revisão de literatura para discutir as principais falhas associadas a instalação de implantes em pacientes portadores de osteonecrose dos maxilares associada ao uso de bifosfonatos (OMAB), assim como as possibilidades de tratamento, e relatar um caso clínico. As informações obtidas na revisão nos permitiu concluir que o uso de bifosfonatos orais, como o alendronato, é capaz de levar ao desenvolvimento da OMAB sendo necessária bastante precaução na reabilitação oral com implantes dentários, tanto em pacientes que fazem uso, como pacientes que apresentam risco de futura utilização de bifosfonatos para o tratamento de desordens esqueléticas. Descritores: Osteoporose; Alendronato; Osteonecrose; Implantes Dentários.ReferênciasEsposito M, Hirsch JM, Lekholm U, Thomsen P. Biological factors contributing to failures of osseointegrated oral implants. (I). Success criteria and epidemiology. Eur J Oral Sci. 1998;106(1):527-51.Quirynen M, De Soete M, Van Steenberghe D. Infectious risks for oral implants: a review of the literature. Clin Oral Implants Res. 2002;13(1):1-19.Van Steenberghe D, Jacobs R, Desnyder M, Maffei G, Quirynen M. The relative impact of local and endogenous patient‐related factors on implant failure up to the abutment stage. 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