Abordagem do doente submetido a tratamento com bifosfonatos

: estudo observacional numa população hospitalar

Abstract

Bisphosphonates are stable chemical substances analogue to inorganic pyrophosphates. Due to their inherent inhibitory bone reabsorption potential and antiangiogenic action, BFs are broadly used in diseases such as osteoporosis, Paget’s disease, osteogenesis imperfecta, polycystic fibrous dysplasia, multiple myeloma and tumours with highly metastatic potential. In 2003, Marx reported for the first time, the most serious adverse effect associated to BFs therapy, bisphosphonates induced osteonecrosis (OMIB), which incidence is growing and pathophysiological mechanism is not completely clarified. Although not exclusive of oncological patients under therapy with IV BFs, in this group OMIB has a higher incidence. This dissertation aims to show the crucial role that the dentist plays in the diagnosis, prevention and OMIB treatment. There are guidelines for OMIB treatment, however, in the scientific community there is still some controversy about the most appropriate way leading to clinical success. Despite these guidelines the prevention and an approach as conservative as possible have been advocated. Five patients under current BFs therapy or previously submitted to it were observed and two of them had already developed OMIB. The clinical cases as well as the theoretical foundations were presented and clinical protocols of actuation were set.

Date of Award	29 Dec 2011
Original language	Portuguese
Awarding Institution	Universidade Católica Portuguesa
Supervisor	Jorge Leitão (Supervisor) & Tinoco Torres Lopes (Co-Supervisor)