Osteonecrose dos maxilares associada ao uso de bisfosfonato: Relato de caso

Abstract

Bone tissue constantly remodels throughout life, and changes in this process of cell renewal cause bone problems, such as osteoporosis, Paget's disease, multiple myeloma and neoplasms, among others. Bisphosphonates (BFs) are anti-resorptive drugs used in the treatment of diseases of bone metabolism, controlling the activity of osteoclasts. BFs can be divided between non-nitrogen and nitrogen, which are more potent and able to remain deposited on the bones for many years. A serious side effect of using these medications is osteonecrosis of the jawbone (ONJ), which develops due to the high rate of bone remodeling in this region. ONJ is a disease that causes bone necrosis mainly in the oral cavity, usually starting from injuries to the oral tissues and invasive dental procedures, which can cause everything from pain and alteration of the sensorineural function of the maxillary region to functional limitations and reduced quality of life caused by great loss of bone mass. The literature has not yet determined a universal protocol for the treatment of the different stages of ONJ, with debate about the choice of the type of treatment and the correct time to perform it. The dental professional must be prepared to deal with cases of patients affected by the pathology, since the number of patients undergoing therapy with bisphosphonates has been increasing over the years. This bibliographic review aims to gather hypotheses about the pathophysiology of the disease, its clinical manifestations, risk of development, prevention and treatment of already established ONJ injuries.