Osteonecrosis: literature review and case report

• Autor(a) principal: Musel, Mariane Veiga
• Data de Publicação: 2014
• Outros Autores: Miranda, Karine Ghiotto, Vita Petucoski, Thatyane Vitoria
• Tipo de documento: Artigo
• Idioma: por
• Título da fonte: Revista da Faculdade de Odontologia de Lins (Online)
• Texto Completo: https://www.metodista.br/revistas/revistas-unimep/index.php/Fol/article/view/2275

Introduction: Osteonecrosis is an alteration that affects the jaws, and is due to an adverse effect of the use of bisphosphonates, a group of medicines used for the prevention and treatment of osteoporosis, bone metastases, multiple myeloma, and Pagets disease. The bisphosphonate is incorporated into the bone matrix and the osteoclast in the form of pyrophosphate, remaining there for an indefinite period of time and with residual mineralized matrix. Proposition: Literature review on osteonecrosis and a case report. Material and methods: Databases from Science Direct, Elsevier, Journals of Capes, Pub Med, and clinical record. Case report: a 72 year-old married woman with leucoderma. The patient had an ulcerated lesion in the left ventral surface of the tongue, with three months duration and no resolution. She referred to the use of drugs for hypertension, stroke, labyrinthitis, osteoporosis, and alendronate sodium 70 mg per week for 5 years. The physical examination revealed an ulcerative lesion and ​​an area of fistulation in the right upper alveolar ridge next to the 16th tooth, for three months, when the tooth was extracted. She presented painful symptoms on palpation and regional lymphadenopathy. The diagnosis was osteonecrosis. A digital panoramic radiography and a computed tomography were performed. The final diagnosis was traumatic injury (tongue) and osteonecrosis caused by bisphosphonate. The patient was referred to surgical treatment and antibiotic therapy. After eight months she had not done the surgery yet, having eliminated several bone debris during this period. Conclusion: Dentists should be aware of the adverse effects of bisphosphonates as well as the need of early diagnosis of osteonecrosis and its prevention.