Bone exposure associated with the use of bisphosphonates: case report
DOI:
https://doi.org/10.33448/rsd-v9i12.10254Keywords:
Osteonecrosis; Diphosphonates; Low-level light therapy; Ozone.Abstract
Osteonecrosis of the jaws associated with bisphosphonates is a condition defined as the development of necrotic bone in the oral cavity persistent for more than 8 weeks of a patient who is receiving treatment with bisphosphonates and has not received radiation therapy in the head and neck. These medications inhibit osteoclastic activity, are mainly used in the treatment of patients with metabolic diseases, or with several malignant neoplasms involving bones. These lesions present a mandibular predominance, occasionally, usually, after a small trauma to the bone tissue or due to an invasive dental procedure. Being characterized as ulcerations of the oral mucosa, often painful, because it exposes the underlying bone. On radiographic examination, these lesions show increased radiopacity before clinical necrotic evidence, occurring predominantly in areas of high bone remodeling. Therefore, the objective is to report a clinical case of a 49-year-old patient who compared an outpatient clinic at the Escola Bahiana de Medicina e Saúde Pública, with the main complaint of a hardened lesion in the right posterior maxillary vestibular region, avoiding pain or suppuration. On physical examination, it was observed permanent exposure above unit 17, without inflammation. In addition, one patient reported a withdrawal of the mammary glands due to a malignant neoplastic lesion with metastasis in the lung and bone, associated with the use of chemotherapeutic agents for the treatment. Surgical removal of the exposed bone store was adopted, associated later with laser therapy and ozone therapy. Therefore, the intention is to recuperate the local blood supply, exposing the patient to a minimum trauma, and hopefully gradually block the injury.
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