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Publication
Utilização de bisfosfonatos administrados localmente no tratamento dos defeitos ósseos maxilares e mandibulares
| Name: | Description: | Size: | Format: | |
|---|---|---|---|---|
| PPG_38855 | 796.27 KB | Adobe PDF |
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Abstract(s)
A necessidade de reconstrução e prevenção da perda óssea dos maxilares tem sido um tema de grande abordagem nos últimos anos. Entre estes temas, a utilização dos bisfosfonatos locais tem sido alvo de diversas pesquisas.
Este trabalho teve como objetivo revisar o mecanismo de ação dos bisfosfonatos e suas diferentes formulações para administração local, bem como os seus efeitos em associação aos enxertos ósseos, destacando os seus potenciais benefícios.
A metodologia envolveu uma revisão narrativa, com pesquisa bibliográfica nas bases de dados Pubmed Database, ScienceDirect, assim como a utilização de literatura acadêmica impressa. As palavras-chave usadas foram: “Bisphosphonates”, “Graft”. “Jaws”, “Reconstruction”, “Bone” e “Side effects”. Os critérios de seleção dos textos foram: revisões bibliográficas e metanálises, literatura acadêmica, escritas em Português e Inglês, com data de publicação entre 2000 e 2019. Foram incluídos os estudos in vivo publicados, excluindo-se quaisquer estudos in vitro. Somente aqueles que envolvessem ossos maxilares (maxila e mandíbula) foram considerados, excluindo-se os realizados em outros ossos. De entre os estudos recolhidos, apenas aqueles que envolviam aplicação local dos bisfosfonatos foram analisados, num total de 11 estudos.
Os grupos avaliados nos diversos estudos revisados apresentaram grande heterogeneidade de metodologia, no entanto permitiram concluir que os bisfosfonatos administrados localmente apresentam em sua maior parte resultados benéficos em relação a neoformação óssea como: menor reabsorção de enxerto, melhor qualidade de osso neoformado, menor reabsorção alveolar pós-extração, maior manutenção óssea a médio prazo, e aprimoramento das capacidades regenerativas dos biomateriais. Em algumas situações, os bisfosfonatos provocaram um pequeno grau de necrose tecidual ou regeneração óssea tarde, podendo estar associada a dose acima da adequada.
The need for reconstruction and prevention of maxillary bone loss has been a major theme in recent years. Among these topics, the use of local bisphosphonates has been the subject of several studies. This work aimed to review the mechanism of action of bisphosphonates and their different formulations for local administration, as well as their effects in association with bone grafts, highlighting their potential benefits. The methodology involved a narrative review, with bibliographic research in the databases Pubmed Database, ScienceDirect, as well as the use of printed academic literature. The keywords used were: "Bisphosphonates", "Graft". "Jaws", "Reconstruction", "Bone" and "Side effects". The criteria for selecting the texts were: bibliographic reviews and meta-analyzes, academic literature, written in Portuguese and English, published between 2000 and 2019. Published in vivo studies were included, excluding any in vitro studies. Only those involving maxillary bones (maxilla and mandible) were considered, excluding those concerning other bones. Among the studies collected, only those involving local application of bisphosphonates were analyzed, in a total of 11 studies. The groups evaluated in the several reviewed studies presented a great heterogeneity of methodology, but allowed to conclude that the locally administered bisphosphonates present beneficial results in relation to bone neoformation such as: less bone graft resorption, better neoformed bone quality, less post-extraction alveolar resorption, longer bone maintenance in the medium term, and enhancement of regenerative biomaterial capacities. In some situations, the bisphosphonates caused a small degree of tissue necrosis or late bone regeneration, which may be associated with a dose above the adequate one.
The need for reconstruction and prevention of maxillary bone loss has been a major theme in recent years. Among these topics, the use of local bisphosphonates has been the subject of several studies. This work aimed to review the mechanism of action of bisphosphonates and their different formulations for local administration, as well as their effects in association with bone grafts, highlighting their potential benefits. The methodology involved a narrative review, with bibliographic research in the databases Pubmed Database, ScienceDirect, as well as the use of printed academic literature. The keywords used were: "Bisphosphonates", "Graft". "Jaws", "Reconstruction", "Bone" and "Side effects". The criteria for selecting the texts were: bibliographic reviews and meta-analyzes, academic literature, written in Portuguese and English, published between 2000 and 2019. Published in vivo studies were included, excluding any in vitro studies. Only those involving maxillary bones (maxilla and mandible) were considered, excluding those concerning other bones. Among the studies collected, only those involving local application of bisphosphonates were analyzed, in a total of 11 studies. The groups evaluated in the several reviewed studies presented a great heterogeneity of methodology, but allowed to conclude that the locally administered bisphosphonates present beneficial results in relation to bone neoformation such as: less bone graft resorption, better neoformed bone quality, less post-extraction alveolar resorption, longer bone maintenance in the medium term, and enhancement of regenerative biomaterial capacities. In some situations, the bisphosphonates caused a small degree of tissue necrosis or late bone regeneration, which may be associated with a dose above the adequate one.
Description
Keywords
Bisfosfonatos Maxilares Reconstrução óssea Local Bisphosphonates Jaws Bone reconstruction Local