Associação entre Eventos Endodônticos e Casos de Osteonecrose dos Maxilares por Exposição a Bisfosfonato
ASSOCIATION BETWEEN ENDODONTIC EVENTS AND CASES OF JAW OSTEONECROSIS BY BISPHOSPHONATE EXPOSURE
DOI:
https://doi.org/10.37157/fimca.v4i1.10Palavras-chave:
Bisfosfonato, Alendronato, Pamidronato, Osteonecrose, Endodontia, Bisphosphonate, Alendronate, Zoledronate, Pamidronate, Osteonecrosis, EndodonticsResumo
Introdução: Pacientes em tratamento com bisfosfonatos ou mesmo com queixa principal de uma lessão bucal com diagnóstico provável de osteonecrose dos ossos maxilares por uso de bisfosfonatos podem ser frequentes na rotina diária de atendimento odontológico. Objetivos: A presente pesquisa objetiva revisar de forma sistematizada os estudos existentes sobre a relação entre procedimentos endodônticos e eventos de osteonecrose em ossos maxilares expostos a Bisfosfonatos. Materiais e Métodos: A estratégia de busca sistemática de artigos contemplou as principais fontes de evidência científica, bases de dados convencionais e também fontes de dados não publicados, além de busca manual das referências bibliográficas dos artigos pré-selecionados. A busca foi feita utilizando-se as palavras-chave obtidas por descritores relacionados com a pergunta a ser respondida. Resultados: A busca inicial resultou em 683 artigos. Apés a aplicação dos critetérios de eligibilidade, oito artigos foram selecionados para a tabulação e coleta de dados. Apenas dois estudos avaliaram causalidade entre procedimentos endodônticos e eventos de osteonecrose nos ossos maxilares, em pacientes usuários de bisfosfonatos. Dos procedimentos odontolôgicos avaliados, os menos frequentemente relacionados com os casos dessa patologia foram as terapias endodônticas (0,8% dos casos). Conclusão: A realização de procedimentos endodônticos em pacientes que fazem uso de bisfosfonatos pode resultar em casos de osteonecrose dos ossos maxilares. Entretanto, mais estudos são necessários para investigar a possiíel relação de causalidade entre o fator de exposição (procedimentos endodônticos) e o desfecho (osteonecrose dos maxilares, em pacientes usuários de bisfosfonatos) estudados.
Introduction: Patients treated with bisphosphonates or even with a major complaint of a buccal lesion with probable diagnosis of osteonecrosis of the maxillary bones due to the use of bisphosphonates may be frequent in the daily routine of dental care. Objectives: The present study aims to systematically review existing studies on the relationship between endodontic procedures and events of osteonecrosis in maxillary bones exposed to bisphosphonates. Materials and Methods: The systematic search strategy of articles included the main sources of scientific evidence, conventional databases as well as unpublished data sources, and manual search of the bibliographic references of the pre- selected articles. The search was done using the keywords obtained by descriptors related to the question to be answered. Results: The initial search resulted in 683 articles. After applying the eligibility criteria, eight articles were selected for tabulation and data collection. Only two studies evaluated causality between endodontic procedures and events of osteonecrosis in maxillary bones in patients using bisphosphonates. Of the dental procedures evaluated, the least frequently related cases of this pathology were endodontic therapies (0.8% of cases). Conclusion: Performing endodontic procedures in patients who use bisphosphonates may result in cases of osteonecrosis of the maxillary bones. However, further studies are needed to investigate the possible causal relationship between the exposure factor (endodontic procedures) and the outcome (osteonecrosis of the jaws in patients using bisphosphonates).
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