RESUMO
Osteonecrosis of the jaw associated to biphosphonate use is more common in cancer patients with bone metastases, that are using intravenous diphosphonates. When these drugs are used orally the risk of the complication is lower. We report 3 diabetic women aged 69, 76 and 82 years, receiving alendronate 70 mg every one week. The unveiling event was the extraction of several teeth without the use of antibiotics. All had bone pain, purulent discharge, loss of bone and halitosis. All improved five months after discontinuing alendronate.
Assuntos
Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Alendronato/efeitos adversos , Conservadores da Densidade Óssea/efeitos adversos , Doenças Maxilomandibulares/induzido quimicamente , Osteonecrose/induzido quimicamente , /tratamento farmacológico , Doenças Maxilares/induzido quimicamenteRESUMO
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Assuntos
Humanos , Síndrome da Disfunção da Articulação Temporomandibular/terapia , Acupuntura/métodos , Descompressão/métodos , Síndromes da Dor Miofascial/terapia , Artralgia/terapiaRESUMO
The use of bisphosphonates (BPs) has proven effective in the treatment of bone-related diseases, despite the potentialrisk of developing osteonecrosis of the jaw (ONJ). So far, results for the treatment of ONJ have not been satisfactory.In our study, we have treated two patients diagnosed with ONJ. In addition to local treatments a hydrogel wasapplied, with promising results. The fistulae disappeared 2-3 weeks into the treatment. After a six-month follow-upperiod there has been no sign of recurrence. The extent of maxillary bone exposure has diminished notably, althoughnot entirely disappeared. In all cases, the patients exhibit no other symptoms (they suffer from no pain or swelling orfunctional impotence). For this reason we believe this protocol might be useful in the case of patients who suffer frompain and fistulation secondary to BP-associated ONJ to improve the state of their lesions until definitive treatmentcan be undertaken.Although these findings are not conclusive, given that we are reporting data on two patients only, we believe thatthis might be an alternative treatment in refractory cases where other therapies are counter-indicated. A controlledrandomized and prospective study would be required to confirm our findings (AU)