Efeito do Resveratrol no tratamento profilático da Osteonecrose dos maxilares induzida por bifosfonatos em ratos Wistar: avaliação radiográfica e clínica

Abstract

The increasing incidence of cases of osteonecrosis of the jaws (ONM) has become a con cern among health professionals, especially physicians and dentists. Its main causes are re lated to the inhibition of bone remodeling due to osteoclast dysfunction, deregulated in flammatory processes associated with infectious conditions and interruption of the local angiogenesis process. This condition is usually initiated after dental interventions (eg ex traction and/or insertion of implants) in patients who use antiresorptive drugs, especially bisphosphonates, which are used in clinical medicine for the treatment of osteoporosis and the prevention of metastases bone in certain neoplasms. So far, there is no effective pre ventive therapy that eliminates or reduces the risk/severity of ONJ when there is a clinical indication for dental care, representing ONJ as a possible and relevant complication, with a painful and invasive treatment, which may affect significantly the quality of life of the pa tient. Given the above, resveratrol is a phytopharmaceutical that has shown itself to be po tentially promising for osteometabolic disorders. This drug has a high antioxidant and anti inflammatory potential widely described in the literature, as well as activity in bone remo deling and inducing angiogenesis in different experimental models. In this context, the ob jective of this project will be to evaluate in vivo, the systemic use of resveratrol in preven tive therapy of post-extraction ONJ, induced by the previous use of bisphosphonates. For this purpose, ONM will be induced by performing extraction (1st mandibular molar) in rats submitted to previous use of bisphosphonates (zoledronic acid). The animals will be divided into 3 groups: Group 01 (Control) – ONM: Without induction / Preventive the rapy: Placebo; Group 02 (BF + Placebo) – ONM: With induction / Preventive therapy: Pla cebo; Group 03 (BF + RP) – ONM: With induction / preventive therapy: pure resveratrol; 1) Evaluation of clinical signs related to ONM - Mucosal aspect in relation to clinical signs of inflammation (erythema and edema) (JABBOUR et al., 2014); - Presence of intra-oral or extra-oral fistula that could be deepened to the bone (as de fined for the diagnosis of ONJ) (ZANDI et al., 2015); 2) Radiographic evaluation – measurement of the area with bone sequestration, presence/absence of residual roots; quality of bone repair; Parametric and non-parametric tests were performed according to data distribution, with a significance level of 5%. With the implementation of this pro ject, based on the results obtained, it is concluded that the use of bisphosphonate accen tuated the picture of mandibular osteonecrosis and, on the other hand, resveratrol re duced the clinical parameters, suggesting a reduction in the severity of ONJ.