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Abordagem cirúrgica em pacientes medicados com bifosfonatos em medicina dentária
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Abstract(s)
É necessária alguma precaução quando existe a necessidade de realização de procedimentos orais invasivos em pacientes medicados com bifosfonatos. Estes fármacos têm uma elevada afinidade para os cristais de hidroxiapatite, depositando-se na superfície óssea onde permanecem por longos períodos de tempo.
Uma das grandes e mais severas complicações desta terapia é o risco de desenvolvimento de osteonecrose dos maxilares. O médico dentista tem o papel de elaborar uma história clínica completa e elaborada onde deve confirmar a dose, a duração e se o paciente toma outra medicação, de modo a avaliar se existem outros fatores que acresçam o risco de osteonecrose dos maxilares.
Em medicina dentária tratamentos invasivos como extrações dentárias, colocação de implantes ou cirurgia periodontal e apical podem estar associados com o desenvolvimento de osteonecrose nestes pacientes. Pelo que, os médicos dentistas têm a função fundamental de prevenção e redução da incidência da ONM. Para isso é essencial que estes profissionais de saúde tenham uma boa precessão sobre o que é a ONM, as
possíveis complicações e o tipo de abordagem a adotar em pacientes com esta condição.
Caution is advised when there is a need to perform invasive oral procedures in patients taking bisphosphonates. These drugs have a high affinity for hydroxyapatite crystals, depositing on the bone surface where they remain for long periods of time. One of the major and most severe complications of this therapy is the risk of developing osteonecrosis of the jaws. The dentist has the role of preparing a complete and consistent clinical history where he must confirm the dose, duration and if the patient takes another medication, in order to assess whether there are other factors that may increase the risk of osteonecrosis of the jaws. In dentistry, invasive treatments such as tooth extractions, implant placement or periodontal and apical surgery may be related to the risk of developing osteonecrosis in these patients. Therefore, dentists have a fundamental role in preventing and reducing the incidence of ONJ. For this reason, it is essential that these health professionals have a good precession about what ONJ is, the possible complications and the type of approach to adopt in patients with this condition.
Caution is advised when there is a need to perform invasive oral procedures in patients taking bisphosphonates. These drugs have a high affinity for hydroxyapatite crystals, depositing on the bone surface where they remain for long periods of time. One of the major and most severe complications of this therapy is the risk of developing osteonecrosis of the jaws. The dentist has the role of preparing a complete and consistent clinical history where he must confirm the dose, duration and if the patient takes another medication, in order to assess whether there are other factors that may increase the risk of osteonecrosis of the jaws. In dentistry, invasive treatments such as tooth extractions, implant placement or periodontal and apical surgery may be related to the risk of developing osteonecrosis in these patients. Therefore, dentists have a fundamental role in preventing and reducing the incidence of ONJ. For this reason, it is essential that these health professionals have a good precession about what ONJ is, the possible complications and the type of approach to adopt in patients with this condition.
Description
Dissertação para obtenção do grau de Mestre no Instituto Universitário Egas Moniz
Keywords
Bifosfonatos Intervenção cirúrgica Fatores de risco Osteonecrose dos maxilares