Efetividade da associação da laserterapia e antibioticoterapia no tratamento da osteonecrose dos maxilares associada aos bisfosfonatos

• Autor(a) principal: Becker, Juliana Rossi [UNESP]
• Data de Publicação: 2016
• Tipo de documento: Trabalho de conclusão de curso
• Idioma: por
• Título da fonte: Repositório Institucional da UNESP
• Texto Completo: http://hdl.handle.net/11449/155203; http://www.athena.biblioteca.unesp.br/exlibris/bd/capelo/2017-05-03/000880871.pdf
• topic: Difosfonatos; Osteonecrose; Lasers; Arcada osseodentária; Diphosphonates

Bisphosphonates (BPs) consist of a range of drugs used in the treatment of osteopathy or some osteotropic malignancies. The BPs exert potent inhibitory effect on bone resorption. Among the adverse effects are the occurrence of Bisphosphonate-Related Osteonecrosis of the Jaw (BRONJ), which consists in the presence of exposed bone in the oral cavity for more than eight weeks in patients who are, or who used drugs to anti-resorptive and who have no previous history of radiotherapy in the jaws. The zoledronate is the bisphosphonate with the greatest power, which makes it to be one of the most related BRONJ. Invasive dental procedures are shown as one of the main factors capable of triggering the BRONJ. Not always conventional treatment proves effective, it is necessary to resort to the use of adjuvant therapies. The low-level laser (LLL) therapy is currently presented as a promising therapeutic strategy, especially due to its biostimulating capacity. The aim of this study was to evaluate the effectiveness of the association between surgery, antibiotic therapy and LLL therapy as a treatment strategy for BRONJ through the presentation of a clinical case. L. S., 52, female, caucasian, was referred to the Dental School of Araçatuba (UNESP) for diagnosis and treatment of bone lesions in the jaws. The patient reported that made use of zoledronate (oncological dose) for one year, and concluded such treatment. Five years later there were two painless bone lesions in both jaws, after extraction of the first upper molars, which persisted for about six months, even after antibiotic use. With clinical, radiographic tomographic and histopathologic examination established the diagnosis of BRONJ. The treatment consisted of curettage of necrotic bone, antibiotics, LLL sessions. The evaluation of the therapeutic approach adopted will be based on...