Tratamiento de la osteonecrosis mandibular relacionada con medicamentos - revisión de literatura
DOI:
https://doi.org/10.33448/rsd-v10i2.12168Palabras clave:
Osteonecrosis de los maxilares asociada a difosfonatos; Osteonecrosis; Atención odontológica.Resumen
Introducción: La osteonecrosis de los maxilares asociada al uso de medicamentos es una enfermedad que se presenta por el uso de terapias con fármacos antirresortivos, como bifosfonatos y denosumab, o antiangiogénicos. Si bien la manifestación de esta enfermedad no tiene una alta incidencia, su aparición genera un impacto significativo en la vida del paciente, provocando síntomas dolorosos, con supuración y mal olor. A pesar de los diversos tratamientos utilizados, no existe consenso sobre la mayor efectividad de un tratamiento en comparación con otro. Así, este trabajo tiene como objetivo demostrar las diferentes modalidades de tratamiento y los beneficios aliados a cada uno. Materiales y Métodos: Búsquedas realizadas en la base de datos PubMed / MEDLINE sobre el tema Osteonecrosis de la mandíbula asociada al uso de medicamentos, junto con operadores booleanos, durante mayo, junio y julio de 2020. Resultados: La búsqueda resultó en 143 artículos y, después aplicando los criterios de elegibilidad, se seleccionaron 49 (23 estudios prospectivos, 17 retrospectivos y 9 series de casos), que comprenden 2617 pacientes y 2848 lesiones. Los tratamientos se dividieron en 5 modalidades (terapias adyuvantes, tratamientos quirúrgicos agresivos, terapias tisulares, tratamiento asistido por medicamentos y terapias quirúrgicas conservadoras). Conclusión: Se proponen varios tratamientos y parece claro que las cirugías agresivas son las terapias con mejores resultados, especialmente cuando se combinan con terapia tisular o adyuvante. Las cirugías conservadoras juegan un papel importante, especialmente en pacientes con condiciones sistémicas que contraindican cirugías mayores.
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Derechos de autor 2021 Arthur Caetano de Almeida; Luiz Fernando Barbosa de Paulo; Luana Soares Vasconcelos; Lívia Bonjardim Lima
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