Perda tardia de implante dent�rio devido a osteonecrose associada ao uso de bisfosfonatos: relato de caso

Fernando Vacilotto Gomes; Frederico Mattis; Luciano Mayer

Perda tardia de implante dent�rio devido a osteonecrose associada ao uso de bisfosfonatos: relato de caso

Fernando Vacilotto Gomes, Frederico Mattis, Luciano Mayer

Resumo

�� In�meras linhas de pesquisa tem associado o uso dos bisfosfonatos (BFs) a diversos tratamentos odontol�gicos. Sua utiliza��o � de grande valia na preven��o da reabsor��o �ssea, como coadjuvante nos tratamentos periodontais; na inibi��o da reabsor��o radicular em casos de endodontia de dentes que sofreram trauma; na manuten��o da posi��o dent�ria p�s-tratamentos ortod�nticos e na pr�pria osseointegra��o de implantes dent�rios. A reabilita��o de pacientes com implantes dent�rios vem se tornando uma realidade cada vez mais rotineira nos consult�rios odontol�gicos. Poucas s�o suas contraindica��es, entretanto o grupo de pacientes que faz uso de bisfosfonatos (f�rmacos an�logos dos pirofosfatos end�genos), podem apresentar uma rea��o adversa indesej�vel chamada de osteonecrose associada aos bisfosfonatos (OAB). O presente trabalho tem como objetivo alertar os implantodontistas da poss�vel ocorr�ncia tardia da osteonecrose dos maxilares associada a bisfosfonatos BRONJ (do ingl�s Bisphosphonate-Related Osteonecrosis of the Jaw) em regi�o de implantes j� osseointegrados atrav�s de um relato de caso cl�nico onde a paciente desenvolveu OAB 1 ano ap�s ser reabilitada.

Palavras-chave

osteonecrose, bisfosfonatos, implante dent�rio, BRONJ

Texto completo:

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Refer?ncias

Marx RE. Pamidronate (Aredia) and zoledronate (Zometa) induced avascular necrosis of the jaws: a growing epidemic. J Oral Maxillofac Surg 200361(9):11157.

Mcleod NMH, Davies BJB, Brennan PA. Bisphosphonate osteonecrosis of the jaws an increasing problem for the dental practitioner. Brit Dent J 200711:6414.

Montoya-Carralero JM, Parra-Mino P, Ram�rez-Fern�ndez P, Morata-Murcia IM, Mompe�n-Gamb�n MDC, Calvo-Guirado LJ. Dental implants in patients treated with oral bisphosphonates: a bibliographic review. Med Oral Patol Oral Cir Bucal 201015(1):e659.

Tang CS, Naylor AE. Single unit implants versus conventional treatments for compromised teeth: a brief review of the evidence. J Dent Educ 2005(4):4148.

Lyman L. Implant reconstruction of the bonegrafted maxilla review of the literature and resentation of 8 cases. J Oral Maxillofac Surg 200664:67482.

Listgarten MA. Clinical Trials of endosseous implants: issues in analysis and interpretation. Ann Periodontol 19971:299313.

Starck WJ, Epker BN. Failure of osseointegrated dental implants after diphosphonate therapy for osteoporosis: a case report. Int J Oral Maxillofac Implants 199510(1): 748.

Migliorati CA, Casiglia J, Epstein J, Jacobsen PL, Siegel M, Woo SB. Managing the care of patients with bisphosphonateassociated osteonecrosis An American Academy of Oral Medicine position paper. J Am Dent Assoc 2006136(12):165868.

Assael LA. A Time for Perspective on Biphosphonates. J Oral Maxillofac Surg 200664:8779.

Scully C, Madrid C, Bagan J. Dental endosseous implants in patients on bisphosphonate therapy, Implant Dentistry 2006 15:21215.

Michael R, Markiewicz BS, Joseph E, Margarone III, Campbell JH, Aguirre A. isphosphonateassociated osteonecrosis of the jaws. A review of current knowledge. J Am Dent Assoc 005136(12):166974.

Marx RE. Bisphosphonateinduced expose bon� of the jaws: risk factors, recognition, prevention and treatment. J Oral Maxillofac Surg 200563(11):156775.

Rodan GA, Fleisch HA. Bisphosphonates: mechanisms of action (Perspectives). J. Clin. Invest. Ann Arbor 199697(12):26926.

Leite AF, Figueiredo PT, Melo NS, Acevedo AC, Cavalcanti MG, Paula LM et al. Iphosphonatesassociated osteonecrosis of the jaws. Report of a case and literature review. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2006102:1421.

Dimitrakopoulos I, Magopoulos C, Karakasis D. Biphosphonatesinduced avascular osteonecrosis of the jaws: a clinical report of 11 cases.Int J Oral Maxillofac Surg 200635:5883.

Melo MD, Obeid G. Osteonecrosis of the maxilla in a Patient with a History of Biphosphonates herapy. Journal of the Canadian Dental Association 200571(2): 111113a.

Heufelder MJ, Hendricks J, Remmerbach T, Frerich B, Hemprich A, Wilde F. Principles of oral surgery for prevention of bisphosphonate-related osteonecrosis of the jaw. Oral Surg Oral Med Oral Pathol Oral Radiol. 2014 Jun;117(6):429-35.

Ferreira Jr CD, Casado PL, Barboza ESP. Osteonecrose Associada aos bisfosfonatos da Odontologia. R. Periodontia 2007;17(4):24-30.

Grahaam JW. Bisphosohonates and Orthodontic: clinical Implications. J. Clin. Orthod. Boulder 2006;40(7):425-8.

Marx RE, Cillo, JE, Jr & Ulloa JJ. Oral Bisphosphonate-Induced Osteonecrosis: Risk Factors, Prediction of Risk Using Serum CTX Testing, Prevention, and Treatment. Journal of Oral and Maxillofacial Surgery. 2007;65(12):2397-410.

Merigo E, Manfredi M, Meleti M, Corradi D, Vescovi P. Jaw bone necrosis without previous dental extractions associated with the use of bisphosphonates (pamidronate and zoledronate): a four-case report. J Oral Pathol Med. 2005;34(10):613-7.

Franco JEM, Cai S, Lima LAPA, Gon�alves AS, Campos TN. RPG Rev P�s Grad 2010;17(3):151-7.

Andersen R, Loebel N, Hammond D, Wilson M. Treatment of periodontal disease by photodisinfection compared to scaling and root planing. J Clin Dent. 2007;18(2):34-8.

Marotti J, Tortamano-Neto P, Cai S, Ribeiro MS, Franco JEM, Campos TN. Descontamina��o da superf�cie de implantes dent�rios por meio da terapia fotodin�mica. In: 26a Reuni�o Anual da SBPqO, 2009, �guas de Lind�ia. Brazilian Oral Research (Proceedings of the 26th SBPqO Annual Meeting). S�o Paulo: SDO, 2009. v. 23. p.179.

Heras Rinc�n I, Zubillaga Rodr�guez I, Castrillo Tambay M, Montalvo Moreno JJ. Osteonecrosis of the jaws nd bisphosphonates. Report of fifteen cases. Therapeutic recommendations. Med Oral Patol Oral Cir Bucal. 2007;12(4):267-71.

Koka S, Babu NMS, Norell A. Survival of dental implants in post-menopausal bisphosphonate users. J osthodont Res. 2010;54(3):108-11.

Martin DC, ORyan FS, Indresano AT, Bogdanos P, Wang B, Hui RL, et al. Characteristics of implant failures n patients with a history of oral bisphosphonate therapy. J Oral Maxillofac Surg. 2010;68(3):508-14.

Bonviva� Bula - http://www.medicinanet.com.br/bula/995/bonviva.htm - Acessado em 18 de agosto de 2015.

MS. Minist�rio da sa�de. Secretaria de aten��o � sa�de. Brasil. 2012: nota t�cnica n�178/2012. Acessado em 18 de agosto de 2015: < http://bvsms.saude.gov.br/bvs/saudelegis/sas/2014/prt0536_03_07_2014.html>

Magopoulos C, Karakinaris G, Telioudis Z, Vahtsevanos K, Dimitrakopoulos I, Antoniadis K et al. Osteonecrosis of the jaws due to bisphosphonate use. A review of 60 cases and treatment proposals. Am J Otolaryngol 2007; 28(3):15863.

AAOMS. American Association of Oral and Maxillofacial Surgeons position paper on bisphosphonate-related osteonecrosis of the jaws. J Oral Maxillofac Surg 2007; 65(3):36976.