RESUMO
Osteoporosis is an important cause of fractures in postmenopausal women. Bisphosphonates are the first line of treatment for osteoporosis. However, long-term use of these medications has been related to atypical femoral fractures (AFF). We present a case of a 71-year-old postmenopausal woman, with a history of osteoporosis being treated with bisphosphonates for 6 years. The patient developed pain in her left hip and thigh over a period of 3-4 months. Radiographic studies showed an AFF and she was managed conservatively. Stopping bisphosphonate therapy should be an initial step in managing or limiting the progression of AFF. A drug holiday should be considered in patients who have been treated for more than 3-5 years to prevent AFFs. The risk of developing AFFs should never be ignored in this subset of patients.
RESUMO
Objetivo. Evaluar la tasa de sobrevivencia y la capacidad preventiva de los sellantes de ion¢mero de vidrio de alta viscosidad colocadosde acuerdo al protocolo propuesto por el tratamiento restaurador atraumatico (TRA), en primeros molares permanentes en ni¤os de 6a 12 a¤os de edad, en una comunidad de alto riesgo. Material y mtodos. Se trataron 75 primeras molares permanentes de 34 ni¤osde la Instituci¢n Educativa Jos Olaya Balandra en el balneario de Bujama, distrito de Mala, Ca¤ete, Per£. Los sellantes se colocaronutilizando ion¢mero de vidrio de alta viscosidad siguiendo el protocolo del TRA y fueron evaluados luego de 12 meses utilizando loscriterios de la Organizaci¢n Mundial de la Salud (OMS). Resultados. Las piezas evaluadas mostraron que 56,4% present¢ sellantescompletos (c¢digo 0); el 23,6% sellantes parcialmente presentes sin caries (c¢digo 1); el 1,8% sellantes parcialmente presentes consignos de caries (c¢digo 2), y el 18,2% present¢ ausencia de sellantes sin presencia de caries (c¢digo 3). Empleando el criterio deefectividad biol¢gica se establece que 98,18% de las piezas inicialmente tratadas permanecieron libres de caries. Existi¢ una diferenciasignificativa (p<0,05) en relaci¢n a la ubicaci¢n de la pieza, observ ndose mayores tasas de retenci¢n en las primeras molares inferiores(67,9%) al compararlas con las superiores (44,4%). Conclusiones. Los sellantes TRA demostraron tener un gran potencial para prevenirlesiones de caries oclusales en primeras molares permanentes a los de 12 meses de seguimiento.
Objective. To evaluate the survival rate and preventive capacity of high viscosity glass ionomer sealants placed according to theprotocol proposed by ART, in first permanent molars in children aged 6 to 12 years old, in a high risk Peruvian community. Materialand methods. 75 first permanent molars were treated from 34 children of the school Jose Olaya Balandra in Bujama, district of Malain Ca¤ete, Peru. Sealants were placed using high viscosity glass ionomer following the ART protocol and they were evaluated after 12months using the World Health Organiation (WHO) criteria. Results. Evaluated pieces showed that 56, 4% had completed sealant (Code0), 23, 6% partially sealants present without caries (code 1), 1,8% partially sealants present with signs of decay (Code 2) and 18,2% hadno sealant without the presence of caries (code 3). Using the biological effectiveness criterion states that 98, 18% of the parts treatedinitially remained free of decay. There was a statistically significant difference (p <0,05) relative to the location of the piece, showinghigher retention rates in the first molars (67, 9%) when compared to higher (44,4%). Conclusions. The ART sealants showed a greatpotential to prevent oclusal caries lesions in first permanent molars after 12 months of follow up.
