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Osteonecrose dos maxilares associada a fármacos anti-reabsorção óssea
| Name: | Description: | Size: | Format: | |
|---|---|---|---|---|
| PPG_24224 | 2.08 MB | Adobe PDF |
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Advisor(s)
Abstract(s)
Os fármacos anti-reabsorção óssea mais utilizados atualmente são os bifosfonatos que
são medicamentos que inibem a actividade osteoclástica. O mecanismo de ação destes
fármacos consiste na redução da reabsorção óssea pois inibem a apoptose dos
osteoclastos e promovem a inibição da angiogénese.
Estes fármacos são utilizados no tratamento de doenças como a osteoporose,
hipercalcemia, doença de Paget e em pacientes oncológicos com metástases ósseas de
tumores sólidos e mieloma múltiplo. Por outro lado, estes fármacos além de todos os
benefícios que têm para os pacientes nestas condições, podem ter como complicação a
osteonecrose dos maxilares (ONM).
A ONM é uma complicação oral grave caracterizada, na maioria, por uma osteomielite
inicial que normalmente evolui para uma exposição de osso necrosado acompanhada
por dor na maxila ou na mandíbula. Nos doentes oncológicos têm sido diagnosticados
vários casos de necrose óssea mais frequentemente na mandíbula. Esta patologia
(ONM) apesar de ter baixa incidência e do seu aparecimento ser relativamente recente,
levou à introdução de algumas recomendações internacionais para o uso de
bifosfonatos, principalmente em pacientes oncológicos.
Para a execução deste trabalho recorri a fontes de pesquisas como as bases de dados
como a PubMed, B-On e, também ao Repositório Institucional da Universidade
Fernando Pessoa das quais resultaram 198 artigos e duas monografias realizadas por exalunos
da Universidade Fernando Pessoa.
Com a realização deste trabalho foi possível esclarecer algumas dúvidas acerca dos
efeitos que os fármacos anti-reabsorção óssea têm no organismo e mais especificamente
na cavidade oral, de forma a estar consciente dos riscos que estes pacientes correm, caso
lhes sejam realizados procedimentos como é o caso, das exodontias ou da colocação de
implantes.
The bone antiresorptive drugs bone that are currently used are the bisphosphonates which are drugs that inhibit osteoclast activity. The mechanism of action of these drugs is to reduce bone resorption as inhibit the apoptosis of osteoclasts. These drugs are used to treat diseases such as osteoporosis, hyperkalemia, Paget's disease, and in cancer patients with bone metastases from solid tumors and multiple myeloma. On the other hand, in addition to all the benefits these drugs have for patients in these conditions, may have a complication, the osteonecrosis of the jaw (ONJ). The ONJ is a serious complication of oral mostly by an initial osteomyelitis usually evolves into a necrotic bone exposure accompanied by pain in the maxilla or mandible. In cancer patients have been diagnosed several cases of bone necrosis more often in the jaw.This pathology (ONJ) despite having low incidence and its appearance is relatively recent, it led to the introduction of some international recommendations for the use of bisphosphonates, particularly in cancer patients. For the execution of this work I resorted to sources of research such as databases like PubMed, B-On and also to the University Institutional Repository Fernando Pessoa which resulted in 198 articles and two monographs made by former students of the University. With this work it was possible to clarify some doubts about the effects that the bone antiresorptive drugs have on the body and more specifically in the oral cavity in order to be aware of the risks that these patients are, if their procedures are carried out as is case of tooth extraction or implant placement.
The bone antiresorptive drugs bone that are currently used are the bisphosphonates which are drugs that inhibit osteoclast activity. The mechanism of action of these drugs is to reduce bone resorption as inhibit the apoptosis of osteoclasts. These drugs are used to treat diseases such as osteoporosis, hyperkalemia, Paget's disease, and in cancer patients with bone metastases from solid tumors and multiple myeloma. On the other hand, in addition to all the benefits these drugs have for patients in these conditions, may have a complication, the osteonecrosis of the jaw (ONJ). The ONJ is a serious complication of oral mostly by an initial osteomyelitis usually evolves into a necrotic bone exposure accompanied by pain in the maxilla or mandible. In cancer patients have been diagnosed several cases of bone necrosis more often in the jaw.This pathology (ONJ) despite having low incidence and its appearance is relatively recent, it led to the introduction of some international recommendations for the use of bisphosphonates, particularly in cancer patients. For the execution of this work I resorted to sources of research such as databases like PubMed, B-On and also to the University Institutional Repository Fernando Pessoa which resulted in 198 articles and two monographs made by former students of the University. With this work it was possible to clarify some doubts about the effects that the bone antiresorptive drugs have on the body and more specifically in the oral cavity in order to be aware of the risks that these patients are, if their procedures are carried out as is case of tooth extraction or implant placement.
Description
Keywords
Osteonecrose Bifosfonatos Anti-reabsorção óssea