OSTEONECROSE DOS MAXILARES ASSOCIADA A MEDICAMENTOS: UMA REVISÃO NARRATIVA

Autores

  • Kerian Dorothy Rehbein
  • Gabriela Cardoso De Cardoso
  • Gislene Corrêa
  • Frederico Saueressig
  • Beatriz Farias Vogt

DOI:

https://doi.org/10.51161/rems/2768

Palavras-chave:

BISFOSFONATOS, DENOSUMABE, OSTEONECROSE

Resumo

Introdução: A osteonecrose dos maxilares associada a medicamentos (OMAM) é uma condição debilitante grave e rara. Se caracteriza pela presença de tecido ósseo exposto ou sondado por fístula na região maxilofacial, persistente por oito semanas, em pacientes com histórico de uso de agentes antirreabsortivos ou antiangiogênicos e que não foram submetidos à radioterapia na região da cabeça e pescoço, nem apresentem metástases ósseas nos maxilares. Objetivo: Este trabalho objetiva realizar uma revisão narrativa da literatura e propõe breve discussão acerca da OMAM relacionada aos bisfofonatos e o denosumabe. Material e métodos: Utilizou-se estratégias de busca DeCS/MeSH terms para estruturar a pesquisa e então realizou-se a busca nas bases de dados Scopus, Google Scholar, MEDLINE/PubMed e Web of Science. Resultados: A fisiopatologia da OMAM possui caráter multifatorial. Trata-se de um processo de reparo ósseo prejudicado devido a mecanismos de inativação da atividade osteoclástica, defeito na remodelação óssea e ação anti-angiogênica. Fatores locais como higiene oral deficiente, doenças periodontais, infecções dentárias, próteses mal adaptadas e procedimentos cirúrgicos invasivos aumentam o risco de OMAM. O manejo e tratamento da OMAM é desafiador. Realizar a avaliação individualizada é imprescindível para a decisão terapêutica, sendo necessário introduzir tratamentos combinados para o controle dos sintomas. As abordagens variam de estratégias conservadoras (antimicrobianos e antibióticos) a cirúrgicas (debridamentos e ressecção), que podem ser associadas a terapêuticas alternativas. Muitas vezes, o objetivo do manejo da OMAM é controle da dor, da infecção e da progressão da necrose óssea, considerando os riscos de abordagem e a possibilidade de melhorar a qualidade de vida do paciente. Conclusão: A OMAM é uma doença grave e de difícil resolução, com potencial de prejudicar severamente a qualidade de vida do paciente e reduzir a adesão do mesmo ao tratamento antineoplásico. O exame odontológico e tratamento das demandas orais de pacientes elegíveis ao uso de bisfosfonatos e denosumabe previamente ao início do tratamento podem reduzir significativamente a ocorrência de sequelas causadas por essa patologia. Da mesma forma, é imprescindível orientar sobre os efeitos adversos dos fármacos, conscientizando o paciente sobre os devidos cuidados com a cavidade oral e a importância de acompanhamentos regulares.

Publicado

2021-12-16

Como Citar

Rehbein, K. D. ., Cardoso, G. C. D. ., Corrêa, G., Saueressig, F. ., & Vogt, B. F. . (2021). OSTEONECROSE DOS MAXILARES ASSOCIADA A MEDICAMENTOS: UMA REVISÃO NARRATIVA. Revista Multidisciplinar Em Saúde, 2(4), 16. https://doi.org/10.51161/rems/2768

Edição

v. 2 n. 4 (2021)

Seção

I Congresso Brasileiro de Saúde Pública On-line: Uma abordagem Multiprofissional

Licença

Creative Commons License
Este trabalho está licenciado sob uma licença Creative Commons Attribution 4.0 International License.

O conteúdo desta revista foi migrado para https://editoraintegrar.com.br

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Dispatcher.dispatch(Object:Request) % line  281, file: PKPApplication.inc.php
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                                                      SubmissionSearch._getMergedKeywordResults(Object:Journal, Array[4], , null, null, 500, 1) % line  194, file: SubmissionSearch.inc.php
                                                   SubmissionSearch._getMergedPhraseResults(Object:Journal, Array[4], null, null, null, 500, 1) % line  146, file: SubmissionSearch.inc.php
                                                SubmissionSearch._getMergedKeywordResults(Object:Journal, Array[3], null, null, null, 500, 1) % line  132, file: SubmissionSearch.inc.php
                                             SubmissionSearch._getMergedArray(Object:Journal, Array[1], null, null) % line  263, file: SubmissionSearch.inc.php
                                          SubmissionSearch.retrieveResults(Object:Request, Object:Journal, Array[1], null, null, null, Object:DBResultRange, Array[1]) % line   92, file: RecommendBySimilarityPlugin.inc.php
                                       RecommendBySimilarityPlugin.callbackTemplateArticlePageFooter(Templates::Article::Footer::PageFooter, Array[3]) % line  107, file: HookRegistry.inc.php
                                    HookRegistry.call(Templates::Article::Footer::PageFooter, Array[3]) % line 1267, file: PKPTemplateManager.inc.php
                                 PKPTemplateManager.smartyCallHook(Array[1], Object:Smarty_Internal_Template) % line   43, file: 42362804174f266c598cdb32c3208fc745b92101^1c372c95cd85572e0fbc9a53d0323a0b229cfc78_0.app.frontendpagesarticle.tpl.php
                              content_6781613650b432_13896783(Object:Smarty_Internal_Template) % line  123, file: smarty_template_resource_base.php
                           Smarty_Template_Resource_Base.getRenderedTemplateCode(Object:Smarty_Internal_Template) % line  114, file: smarty_template_compiled.php
                        Smarty_Template_Compiled.render(Object:Smarty_Internal_Template) % line  216, file: smarty_internal_template.php
                     Smarty_Internal_Template.render(false, 1) % line  232, file: smarty_internal_templatebase.php
                  Smarty_Internal_TemplateBase._execute(Object:Smarty_Internal_Template, null, 42362804174f266c598cdb32c3208fc745b92101, null, 1) % line  134, file: smarty_internal_templatebase.php
               Smarty_Internal_TemplateBase.display(frontend/pages/article.tpl, null, 42362804174f266c598cdb32c3208fc745b92101, null) % line  924, file: PKPTemplateManager.inc.php
            PKPTemplateManager.display(frontend/pages/article.tpl) % line  292, file: ArticleHandler.inc.php
         ArticleHandler.view(Array[1], Object:Request) % line  391, file: PKPRouter.inc.php
      PKPRouter._authorizeInitializeAndCallRequest(Array[2], Object:Request, Array[1], false) % line  231, file: PKPPageRouter.inc.php
   PKPPageRouter.route(Object:Request) % line  143, file: Dispatcher.inc.php
Dispatcher.dispatch(Object:Request) % line  281, file: PKPApplication.inc.php
PKPApplication.execute() % line   68, file: index.php

                                                                  ADOConnection.CacheExecute(3600, SELECT 				o.submission_id, 				MAX(s.context_id) AS journal_id, 				MAX(i.date_published) AS i_pub, 				MAX(p.date_published) A..., Array[2]) % line  132, file: DAO.inc.php
                                                               DAO.retrieveCached(SELECT 				o.submission_id, 				MAX(s.context_id) AS journal_id, 				MAX(i.date_published) AS i_pub, 				MAX(p.date_published) A..., Array[2], 3600) % line   91, file: ArticleSearchDAO.inc.php
                                                            ArticleSearchDAO.getPhraseResults(Object:Journal, Array[1], null, null, , 500, 1) % line  201, file: SubmissionSearch.inc.php
                                                         SubmissionSearch._getMergedPhraseResults(Object:Journal, Array[1], , null, null, 500, 1) % line  146, file: SubmissionSearch.inc.php
                                                      SubmissionSearch._getMergedKeywordResults(Object:Journal, Array[4], , null, null, 500, 1) % line  194, file: SubmissionSearch.inc.php
                                                   SubmissionSearch._getMergedPhraseResults(Object:Journal, Array[4], null, null, null, 500, 1) % line  146, file: SubmissionSearch.inc.php
                                                SubmissionSearch._getMergedKeywordResults(Object:Journal, Array[3], null, null, null, 500, 1) % line  132, file: SubmissionSearch.inc.php
                                             SubmissionSearch._getMergedArray(Object:Journal, Array[1], null, null) % line  263, file: SubmissionSearch.inc.php
                                          SubmissionSearch.retrieveResults(Object:Request, Object:Journal, Array[1], null, null, null, Object:DBResultRange, Array[1]) % line   92, file: RecommendBySimilarityPlugin.inc.php
                                       RecommendBySimilarityPlugin.callbackTemplateArticlePageFooter(Templates::Article::Footer::PageFooter, Array[3]) % line  107, file: HookRegistry.inc.php
                                    HookRegistry.call(Templates::Article::Footer::PageFooter, Array[3]) % line 1267, file: PKPTemplateManager.inc.php
                                 PKPTemplateManager.smartyCallHook(Array[1], Object:Smarty_Internal_Template) % line   43, file: 42362804174f266c598cdb32c3208fc745b92101^1c372c95cd85572e0fbc9a53d0323a0b229cfc78_0.app.frontendpagesarticle.tpl.php
                              content_6781613650b432_13896783(Object:Smarty_Internal_Template) % line  123, file: smarty_template_resource_base.php
                           Smarty_Template_Resource_Base.getRenderedTemplateCode(Object:Smarty_Internal_Template) % line  114, file: smarty_template_compiled.php
                        Smarty_Template_Compiled.render(Object:Smarty_Internal_Template) % line  216, file: smarty_internal_template.php
                     Smarty_Internal_Template.render(false, 1) % line  232, file: smarty_internal_templatebase.php
                  Smarty_Internal_TemplateBase._execute(Object:Smarty_Internal_Template, null, 42362804174f266c598cdb32c3208fc745b92101, null, 1) % line  134, file: smarty_internal_templatebase.php
               Smarty_Internal_TemplateBase.display(frontend/pages/article.tpl, null, 42362804174f266c598cdb32c3208fc745b92101, null) % line  924, file: PKPTemplateManager.inc.php
            PKPTemplateManager.display(frontend/pages/article.tpl) % line  292, file: ArticleHandler.inc.php
         ArticleHandler.view(Array[1], Object:Request) % line  391, file: PKPRouter.inc.php
      PKPRouter._authorizeInitializeAndCallRequest(Array[2], Object:Request, Array[1], false) % line  231, file: PKPPageRouter.inc.php
   PKPPageRouter.route(Object:Request) % line  143, file: Dispatcher.inc.php
Dispatcher.dispatch(Object:Request) % line  281, file: PKPApplication.inc.php
PKPApplication.execute() % line   68, file: index.php

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