Diagnóstico, tratamento e prevenção da osteonecrose maxilar relacionada a medicamentos
Autor(a) principal: | |
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Data de Publicação: | 2021 |
Outros Autores: | , , |
Tipo de documento: | Artigo |
Idioma: | por |
Título da fonte: | Revista Brasileira Multidisciplinar |
DOI: | 10.25061/2527-2675/ReBraM/2021.v24i2.1132 |
Texto Completo: | http://revistarebram.com/index.php/revistauniara/article/view/1132 |
Resumo: | Medication-related osteonecrosis of the jaws (MRONJ) is a rare and serious adverse effect of anti-resorptive and/or antiangiogenic therapy that can cause necrotic bone exposure in the oral cavity, which affects patients’ quality of life. The present study aimed to review literature regarding MRONJ with special focus on diagnostic and treatment. The databases PubMed, Scielo and Google Scholar were searched for reports regarding diagnostic and treatment of MRONJ. Even though this disorder shows poor response to treatment, there is an increase in cure rates when early diagnosed and treated. In this way, systematic dental follow-up of patients under anti-resorptive and/or antiangiogenic therapy is essential for the identification of signs and symptoms suggestive of MRONJ like pain, swelling or dental mobility. Radiographic and tomographic features like increase of bone density, bone sclerosis or osteolysis, persisting alveolar socket, periosteal neoformation, lamina dura widening and mandibular canal widening may indicate bone necrosis. Since there is no universally accepted treatment to cure MRONJ, the management involves symptom palliation and control of associated infection, and surgical excision of necrotic bone is recommended for more severe cases. Each case must be individually evaluated by a multidisciplinary team, allowing dental and medical discussion. The prevention of MRONJ by patients education, elimination of risk factors and oral health maintenance is still the most important measure in the management of these patients. |
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Diagnóstico, tratamento e prevenção da osteonecrose maxilar relacionada a medicamentososteonecrosisclinical clerkshipprimary preventiondental radiographyinfectionsosteonecroseprevenção primáriaradiografia dentáriainfecçõesMedication-related osteonecrosis of the jaws (MRONJ) is a rare and serious adverse effect of anti-resorptive and/or antiangiogenic therapy that can cause necrotic bone exposure in the oral cavity, which affects patients’ quality of life. The present study aimed to review literature regarding MRONJ with special focus on diagnostic and treatment. The databases PubMed, Scielo and Google Scholar were searched for reports regarding diagnostic and treatment of MRONJ. Even though this disorder shows poor response to treatment, there is an increase in cure rates when early diagnosed and treated. In this way, systematic dental follow-up of patients under anti-resorptive and/or antiangiogenic therapy is essential for the identification of signs and symptoms suggestive of MRONJ like pain, swelling or dental mobility. Radiographic and tomographic features like increase of bone density, bone sclerosis or osteolysis, persisting alveolar socket, periosteal neoformation, lamina dura widening and mandibular canal widening may indicate bone necrosis. Since there is no universally accepted treatment to cure MRONJ, the management involves symptom palliation and control of associated infection, and surgical excision of necrotic bone is recommended for more severe cases. Each case must be individually evaluated by a multidisciplinary team, allowing dental and medical discussion. The prevention of MRONJ by patients education, elimination of risk factors and oral health maintenance is still the most important measure in the management of these patients.A osteonecrose maxilar relacionada a medicamentos (MRONJ) é um raro e grave efeito adverso de terapia antirreabsortiva e/ou antiangiogênica que pode causar exposição de osso necrótico em cavidade bucal, o que implica na qualidade de vida dos pacientes. O presente trabalho teve por objetivo revisar a literatura sobre MRONJ enfatizando os critérios de diagnóstico e tratamento. As bases de dados PubMed, Scielo e Google scholar foram consultadas em busca de artigos que abordassem o tema. Embora apresente baixa resposta ao tratamento, o diagnóstico e tratamento precoce aumentam a chance de cura. Dessa forma, o acompanhamento odontológico sistemático de pacientes que estejam em terapia antirreabsortiva e/ou antiangiogênica é fundamental para a identificação de sinais ou sintomas sugestivos de MRONJ como dor, tumefação ou mobilidade dentária. Alterações radiográficas ou tomográficas como aumento da densidade óssea, esclerose óssea ou osteólise, persistência de alvéolo dentário, neoformação periosteal, espessamento da lâmina dura e estreitamento do canal mandibular podem ser indicativos da presença de necrose óssea. Como ainda não existe um tratamento universalmente aceito capaz de curar a MRONJ, a abordagem envolve paliação de sintomas e controle da infecção associada, reservando-se a remoção cirúrgica da área necrótica para casos mais graves. Salienta-se que cada caso deve ser avaliado individualmente por uma equipe multidisciplinar que permita a discussão entre a equipe de saúde bucal e equipe médica. A prevenção da MRONJ por meio da educação dos pacientes, eliminação dos fatores de risco e manutenção da saúde bucal constitui ainda a medida mais importante no manejo desses indivíduos.Revista Brasileira Multidisciplinar - ReBraM2021-05-01info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionapplication/pdfhttp://revistarebram.com/index.php/revistauniara/article/view/113210.25061/2527-2675/ReBraM/2021.v24i2.1132Revista Brasileira Multidisciplinar - ReBraM; v. 24 n. 2 (2021): Maio-Agosto; 233-2472527-26751415-3580reponame:Revista Brasileira Multidisciplinarinstname:Universidade de Araraquara (UNIARA)instacron:UNIARAporhttp://revistarebram.com/index.php/revistauniara/article/view/1132/709Copyright (c) 2021 Revista Brasileira Multidisciplinarhttps://creativecommons.org/licenses/by-nd/4.0info:eu-repo/semantics/openAccessHochmuller, MilenyPereira Velaski, Danielle Koth, Valesca SanderBarbieri, Silene 2021-09-13T15:14:21Zoai:ojs.revistarebram.com:article/1132Revistahttp://revistarebram.com/index.php/revistauniaraPRIhttps://revistarebram.com/index.php/revistauniara/oairevistauniara@uniara.com||2527-26752527-2675opendoar:2021-09-13T15:14:21Revista Brasileira Multidisciplinar - Universidade de Araraquara (UNIARA)false |
dc.title.none.fl_str_mv |
Diagnóstico, tratamento e prevenção da osteonecrose maxilar relacionada a medicamentos |
title |
Diagnóstico, tratamento e prevenção da osteonecrose maxilar relacionada a medicamentos |
spellingShingle |
Diagnóstico, tratamento e prevenção da osteonecrose maxilar relacionada a medicamentos Diagnóstico, tratamento e prevenção da osteonecrose maxilar relacionada a medicamentos Hochmuller, Mileny osteonecrosis clinical clerkship primary prevention dental radiography infections osteonecrose prevenção primária radiografia dentária infecções Hochmuller, Mileny osteonecrosis clinical clerkship primary prevention dental radiography infections osteonecrose prevenção primária radiografia dentária infecções |
title_short |
Diagnóstico, tratamento e prevenção da osteonecrose maxilar relacionada a medicamentos |
title_full |
Diagnóstico, tratamento e prevenção da osteonecrose maxilar relacionada a medicamentos |
title_fullStr |
Diagnóstico, tratamento e prevenção da osteonecrose maxilar relacionada a medicamentos Diagnóstico, tratamento e prevenção da osteonecrose maxilar relacionada a medicamentos |
title_full_unstemmed |
Diagnóstico, tratamento e prevenção da osteonecrose maxilar relacionada a medicamentos Diagnóstico, tratamento e prevenção da osteonecrose maxilar relacionada a medicamentos |
title_sort |
Diagnóstico, tratamento e prevenção da osteonecrose maxilar relacionada a medicamentos |
author |
Hochmuller, Mileny |
author_facet |
Hochmuller, Mileny Hochmuller, Mileny Pereira Velaski, Danielle Koth, Valesca Sander Barbieri, Silene Pereira Velaski, Danielle Koth, Valesca Sander Barbieri, Silene |
author_role |
author |
author2 |
Pereira Velaski, Danielle Koth, Valesca Sander Barbieri, Silene |
author2_role |
author author author |
dc.contributor.author.fl_str_mv |
Hochmuller, Mileny Pereira Velaski, Danielle Koth, Valesca Sander Barbieri, Silene |
dc.subject.por.fl_str_mv |
osteonecrosis clinical clerkship primary prevention dental radiography infections osteonecrose prevenção primária radiografia dentária infecções |
topic |
osteonecrosis clinical clerkship primary prevention dental radiography infections osteonecrose prevenção primária radiografia dentária infecções |
description |
Medication-related osteonecrosis of the jaws (MRONJ) is a rare and serious adverse effect of anti-resorptive and/or antiangiogenic therapy that can cause necrotic bone exposure in the oral cavity, which affects patients’ quality of life. The present study aimed to review literature regarding MRONJ with special focus on diagnostic and treatment. The databases PubMed, Scielo and Google Scholar were searched for reports regarding diagnostic and treatment of MRONJ. Even though this disorder shows poor response to treatment, there is an increase in cure rates when early diagnosed and treated. In this way, systematic dental follow-up of patients under anti-resorptive and/or antiangiogenic therapy is essential for the identification of signs and symptoms suggestive of MRONJ like pain, swelling or dental mobility. Radiographic and tomographic features like increase of bone density, bone sclerosis or osteolysis, persisting alveolar socket, periosteal neoformation, lamina dura widening and mandibular canal widening may indicate bone necrosis. Since there is no universally accepted treatment to cure MRONJ, the management involves symptom palliation and control of associated infection, and surgical excision of necrotic bone is recommended for more severe cases. Each case must be individually evaluated by a multidisciplinary team, allowing dental and medical discussion. The prevention of MRONJ by patients education, elimination of risk factors and oral health maintenance is still the most important measure in the management of these patients. |
publishDate |
2021 |
dc.date.none.fl_str_mv |
2021-05-01 |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
http://revistarebram.com/index.php/revistauniara/article/view/1132 10.25061/2527-2675/ReBraM/2021.v24i2.1132 |
url |
http://revistarebram.com/index.php/revistauniara/article/view/1132 |
identifier_str_mv |
10.25061/2527-2675/ReBraM/2021.v24i2.1132 |
dc.language.iso.fl_str_mv |
por |
language |
por |
dc.relation.none.fl_str_mv |
http://revistarebram.com/index.php/revistauniara/article/view/1132/709 |
dc.rights.driver.fl_str_mv |
Copyright (c) 2021 Revista Brasileira Multidisciplinar https://creativecommons.org/licenses/by-nd/4.0 info:eu-repo/semantics/openAccess |
rights_invalid_str_mv |
Copyright (c) 2021 Revista Brasileira Multidisciplinar https://creativecommons.org/licenses/by-nd/4.0 |
eu_rights_str_mv |
openAccess |
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application/pdf |
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Revista Brasileira Multidisciplinar - ReBraM |
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Revista Brasileira Multidisciplinar - ReBraM |
dc.source.none.fl_str_mv |
Revista Brasileira Multidisciplinar - ReBraM; v. 24 n. 2 (2021): Maio-Agosto; 233-247 2527-2675 1415-3580 reponame:Revista Brasileira Multidisciplinar instname:Universidade de Araraquara (UNIARA) instacron:UNIARA |
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Universidade de Araraquara (UNIARA) |
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UNIARA |
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UNIARA |
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Revista Brasileira Multidisciplinar |
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Revista Brasileira Multidisciplinar |
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Revista Brasileira Multidisciplinar - Universidade de Araraquara (UNIARA) |
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revistauniara@uniara.com|| |
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1822179506028281856 |
dc.identifier.doi.none.fl_str_mv |
10.25061/2527-2675/ReBraM/2021.v24i2.1132 |