Immediate loading post-extraction in an intravenous bisphosphonate user: Case report

• Autor(a) principal: Dutra Lobo Sousa , João Paulo
• Data de Publicação: 2023
• Outros Autores: Alves Gonçalves, Pedro Paullo, Dutra Mendonça, Thiago, Araújo, Juliana Batista, Costa Casanovas, Rosana
• Tipo de documento: Artigo
• Idioma: por
• Título da fonte: Brazilian Journal of Implantology and Health Sciences
• Texto Completo: https://bjihs.emnuvens.com.br/bjihs/article/view/455
• topic: Implantes dentários; Bisfosfonatos; Osteonecrose; Dental implants; Bisphosphonates; Osteonecrosis

Bisphosphonates are drugs that inhibit osteoclastic cells and are used as the first choice therapy in disorders that affect bone metabolism. In view of the benefits of BFs, the first reports of osteonecrosis of the jaws were described, which clinically presents itself as a region of bone exposure with necrosis and purulent secretion. Invasive surgical procedures, such as tooth extractions and the installation of implants can be triggering factors for osteonecrosis of the jaws, care related to these patients should be redoubled. Objective: To report the case of a patient who received a rehabilitation treatment with a dental implant and who used Alendronate, promoting a discussion on treatment management and the care protocols for these patients. Case report: Female patient, 56 years old, caucasian, with a history of surgical, chemotherapy and radiotherapy treatment of invasive ductal carcinoma in the left breast and metastatic carcinoma in the left armpit and in continuous use of Zometa® (zoledronic acid - 4mg /100mL), complained of mobility and bad odor related to element 11. Tomographic examination showed root fracture, associated with a post/crown assembly, with indication for extraction. Taking into account the risks, benefits and patient autonomy in choosing rehabilitation with implants, a minimally invasive surgery with immediate loading was planned.Conclusion: Patients who are undergoing treatment with bisphosphonates can be considered for the installation of dental implants, where each clinical situation must be evaluated individually, in order to minimize surgical trauma and the riskof development of medication-related osteonecrosis of the jaws in these individuals.