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Bull Tokyo Dent Coll ; 54(2): 117-25, 2013.
Artigo em Inglês | MEDLINE | ID: mdl-23903583

RESUMO

Bisphosphonate-related osteonecrosis of the jaw (BRONJ) affects quality of life and is an important problem for dentists. A Japanese position paper on BRONJ was published in 2010. The purpose of this study was to review clinical data on the treatment of BRONJ obtained at the Clinic of Oral and Maxillofacial Surgery, Tokyo Dental College, Chiba Hospital to further our understanding of this disease. A total of 13 patients (6 men and 7 women) were included. All the patients included in this study had received Bisphosphonate (BP) therapy and had BRONJ. Five of them (38.5%) had received oral BP therapy for osteoporosis, while the remaining 8 (61.5%) had received parenteral BP therapy for bone metastases from breast or prostate cancer. Osteoporosis patients were treated with risedronate or alendronate. Breast or prostate cancer patients were treated with zoledronate. Two patients with rheumatoid arthritis were treated with corticosteroid. Three patients had diabetes mellitus. Eleven patients were treated with antibiotics, while 5 underwent surgical treatment. Discontinuation of BP was recorded in 7 patients during dental treatment. Sequestration was observed in 6 patients during an 11-month follow-up. Eventually, healing and improvement of the oral mucosa were observed in 3 patients. The current standard treatment for BRONJ does not always provide good results. It is necessary to accumulate further clinical data to establish more effective treatment strategies for BRONJ.


Assuntos
Osteonecrose da Arcada Osseodentária Associada a Difosfonatos/terapia , Administração Oral , Corticosteroides/uso terapêutico , Idoso , Idoso de 80 Anos ou mais , Alendronato/administração & dosagem , Alendronato/efeitos adversos , Antibacterianos/uso terapêutico , Artrite Reumatoide/tratamento farmacológico , Osteonecrose da Arcada Osseodentária Associada a Difosfonatos/tratamento farmacológico , Osteonecrose da Arcada Osseodentária Associada a Difosfonatos/cirurgia , Conservadores da Densidade Óssea/administração & dosagem , Conservadores da Densidade Óssea/efeitos adversos , Neoplasias Ósseas/tratamento farmacológico , Neoplasias Ósseas/secundário , Neoplasias da Mama/patologia , Complicações do Diabetes , Difosfonatos/administração & dosagem , Difosfonatos/efeitos adversos , Ácido Etidrônico/administração & dosagem , Ácido Etidrônico/efeitos adversos , Ácido Etidrônico/análogos & derivados , Feminino , Seguimentos , Humanos , Imidazóis/administração & dosagem , Imidazóis/efeitos adversos , Infusões Parenterais , Japão , Masculino , Pessoa de Meia-Idade , Procedimentos Cirúrgicos Bucais , Osteoporose/tratamento farmacológico , Neoplasias da Próstata/patologia , Ácido Risedrônico , Resultado do Tratamento , Cicatrização/fisiologia , Ácido Zoledrônico
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