Loading...
Publication
Cirurgia dentoalveolar para pacientes sob terapêutica com bisfosfonatos: uma revisão sistemática integrativa
| Name: | Description: | Size: | Format: | |
|---|---|---|---|---|
| Projeto de pós-graduação_2022100042 | 4.17 MB | Adobe PDF |
Authors
Advisor(s)
Abstract(s)
O uso terapêutico dos bisfosfonatos é muito comum em doenças como a osteoporose, hipercalcemia, doença de Paget, mieloma múltiplo e metástase óssea. Este medicamento age diminuindo a reabsorção óssea pela inibição da ação dos osteoclastos, o que aumenta a densidade e melhora a resistência óssea, reduzindo o risco de fraturas. Entretanto, os efeitos colaterais do uso de bisfosfonatos podem levar a complicações graves na cavidade oral, sendo a mais relatada a osteonecrose pela utilização de medicamentos. A American Association of Oral and Maxillo Surgery vem publicando desde 2007 guidelines que tem como objetivo delinear como deve ser o manejo dos pacientes que estão a fazer uso de bisfosfonatos e precisam passar por procedimentos no âmbito da cirurgia oral. Assim, este trabalho tem como objetivo geral realizar um levantamento bibliográfico acerca das guidelines para o atendimento destes pacientes e elaborar uma lista de procedimentos que podem ser utilizados para estas situações, realizando, ao mesmo tempo, uma comparação bibliográfica destas guidelines com o que é descrito pela AAOMS. Dentro da metodologia, foi feita uma revisão sistemática integrativa nas databases da Pubmed, ScienceDirect e Bireme das guidelines encontradas, usando as palavras-chave ((bisphosphonates) AND (oral surgery OR dental surgery) AND (protocols OR guidelines) AND treatment OR procedures)), os critérios de inclusão foram: estudos publicados entre 2018 e 2023, que envolvessem pacientes que fizessem uso de bisfosfonatos e precisassem passar por algum procedimento cirúrgico; fossem caracterizados como relatos de caso, guidelines, protocolos e testes clínicos. Como critérios de exclusão, serão deixados de fora os artigos que não cumpram com os critérios de inclusão e que estejam duplicados nas plataformas pesquisadas. A pesquisa destacou a importância cuidadoso desses pacientes, especialmente aqueles que necessitam de cirurgia oral. A prevenção da doença foi identificada como um aspecto crucial, apesar da limitação de estudos disponíveis. A pesquisa concluiu que, embora haja pouca literatura sobre o tratamento da doença, há muitas informações sobre como preveni-la. As diretrizes da AAOMS e as pesquisas encontradas indicam que os procedimentos cirúrgicos podem ser realizados em pacientes antes de iniciar a terapia com bisfosfonatos, mas uma vez iniciada a terapia, são necessários cuidados como acompanhamento clínico e radiológico e boa higiene oral. Isso reforça a importância das medidas preventivas no atendimento desses pacientes. A pesquisa também sugere a necessidade de mais estudos sobre o tratamento da doença após o diagnóstico de BRONJ em estágios avançados.
The therapeutic use of bisphosphonates is very common in diseases such as osteoporosis, hypercalcemia, Paget's disease, multiple myeloma, and bone metastasis. This medication works by decreasing bone resorption by inhibiting the action of osteoclasts, which increases density and improves bone strength, reducing the risk of fractures. However, the side effects of using bisphosphonates can lead to serious complications in the oral cavity, the most reported being osteonecrosis due to medication use. The American Association of Oral and Maxillo Surgery has been publishing guidelines since 2007 that aim to outline how to manage patients who are using bisphosphonates and need to undergo procedures in the field of oral surgery. Thus, this work aims to carry out a bibliographic survey of the guidelines for the care of these patients and to prepare a list of procedures that can be used for these situations, at the same time, making a bibliographic comparison of these guidelines with what is described by AAOMS. Within the methodology, an integrative systematic review was carried out in the Pubmed, ScienceDirect and Bireme databases of the guidelines found, using the keywords ((bisphosphonates) AND (oral surgery OR dental surgery) AND (protocols OR guidelines) AND treatment OR procedures)), the inclusion criteria were: studies published between 2018 and 2023, involving patients who used bisphosphonates and needed to undergo some surgical procedure; were characterized as case reports, guidelines, protocols and clinical trials. As exclusion criteria, articles that do not comply with the inclusion criteria and that are duplicated on the researched platforms will be left out. The research highlighted the careful importance of these patients, especially those who need oral surgery. Disease prevention was identified as a crucial aspect, despite the limitation of available studies. The research concluded that, although there is little literature on the treatment of the disease, there is a lot of information on how to prevent it. The AAOMS guidelines and the research found indicate that surgical procedures can be performed on patients before starting therapy with bisphosphonates, but once therapy has started, care such as clinical and radiological follow-up and good oral hygiene are necessary. This reinforces the importance of preventive measures in the care of these patients. The research also suggests the need for more studies on the treatment of the disease after the diagnosis of BRONJ in advanced stages.
The therapeutic use of bisphosphonates is very common in diseases such as osteoporosis, hypercalcemia, Paget's disease, multiple myeloma, and bone metastasis. This medication works by decreasing bone resorption by inhibiting the action of osteoclasts, which increases density and improves bone strength, reducing the risk of fractures. However, the side effects of using bisphosphonates can lead to serious complications in the oral cavity, the most reported being osteonecrosis due to medication use. The American Association of Oral and Maxillo Surgery has been publishing guidelines since 2007 that aim to outline how to manage patients who are using bisphosphonates and need to undergo procedures in the field of oral surgery. Thus, this work aims to carry out a bibliographic survey of the guidelines for the care of these patients and to prepare a list of procedures that can be used for these situations, at the same time, making a bibliographic comparison of these guidelines with what is described by AAOMS. Within the methodology, an integrative systematic review was carried out in the Pubmed, ScienceDirect and Bireme databases of the guidelines found, using the keywords ((bisphosphonates) AND (oral surgery OR dental surgery) AND (protocols OR guidelines) AND treatment OR procedures)), the inclusion criteria were: studies published between 2018 and 2023, involving patients who used bisphosphonates and needed to undergo some surgical procedure; were characterized as case reports, guidelines, protocols and clinical trials. As exclusion criteria, articles that do not comply with the inclusion criteria and that are duplicated on the researched platforms will be left out. The research highlighted the careful importance of these patients, especially those who need oral surgery. Disease prevention was identified as a crucial aspect, despite the limitation of available studies. The research concluded that, although there is little literature on the treatment of the disease, there is a lot of information on how to prevent it. The AAOMS guidelines and the research found indicate that surgical procedures can be performed on patients before starting therapy with bisphosphonates, but once therapy has started, care such as clinical and radiological follow-up and good oral hygiene are necessary. This reinforces the importance of preventive measures in the care of these patients. The research also suggests the need for more studies on the treatment of the disease after the diagnosis of BRONJ in advanced stages.
Description
Keywords
Bisfosfonatos Cirurgia oral Protocolos Tratamentos Bisphosphonates Oral surgery Guidelines Treatment