Tratamento da osteonecrose dos maxilares associada ao uso de medicamentos - revisão de literatura
DOI:
https://doi.org/10.33448/rsd-v10i2.12168Palavras-chave:
Osteonecrose da arcada osseodentária associada a difosfonatos; Osteonecrose; Assistência odontológica.Resumo
Introdução: A osteonecrose dos maxilares associada ao uso de medicamentos é uma doença que se dá pelo uso de terapias com drogas antirreabsortivas, como bisfosfonatos e Denosumab, ou antiangiogênicos. Embora a manifestação desta doença não tenha alta incidência, sua ocorrência gera um impacto significativo na vida do paciente, levando à sintomatologia dolorosa, com supuração e odor fétido. Apesar dos vários tratamentos empregados, não existe um consenso acerca da maior eficácia de um tratamento frente a outro. Assim, este trabalho objetiva demonstrar as diferentes modalidades de tratamento e os benefícios aliados a cada uma. Materiais e Métodos: Buscas feitas na base de dados PubMed/MEDLINE sobre o tema Osteonecrose dos Maxilares Associada ao Uso de Medicamentos, aliado a operadores boleanos, durante os meses Maio, Junho e Julho de 2020. Resultados: A pesquisa resultou em 143 artigos e, após a aplicação dos critérios de elegibilidade, 49 foram selecionados (23 estudos prospectivos, 17 retrospectivos e 9 séries de caso), englobando 2617 pacientes e 2848 lesões. Os tratamentos foram divididos em 5 modalidades (terapias adjuvantes, tratamentos cirúrgicos agressivos, terapias teciduais, tratamento assistido por medicamentos e terapias cirúrgicas conservadoras).Conclusão: Vários tratamentos são propostos e parece claro que as cirurgias agressivas são as terapias com melhores resultados, sobretudo quando aliadas a uma terapia tecidual ou adjuvante. As cirurgias conservadoras apresentam papel importante, principalmente, em pacientes portadores de condições sistêmicas que contraindiquem as cirurgias maiores.
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