Insucessos em implantologia em doentes submetidos a tratamento com Bifosfonatos

: estudo de casos clínicos

Abstract

Bisphosphonates are drugs that decrease osteoclast activity and are used to treat metabolic diseases such as osteoporosis, Paget disease, osteogenesis imperfect and in cancer patients with bone metastases from solid tumors and multiple myeloma. Despite the success of BF as therapeutic agents in reducing the morbility of cancer patients, their prolonged use can lead to several complications, such as the emergence of osteonecrosis of the jaws, diagnosed by Marx for the first time in 2003. Thus the osteonecrosis of the jaws is defined as a clinical entity characterized by a region of necrotic exposed bone in the maxillofacial area, without resolution of eight to twelve weeks in patients treated with bisphosphonates which did not performed radiotherapy of the head and neck. The OMIB may develop spontaneously, but is more often related with trauma situations and invasive surgeries. Although the efficacy of BF in the treatment of various pathologies is irrefutable, more research is still needed for unrestricted use of them in the clinic, as well as the most effective therapy to obtain clinical success. This relates to the fact that they have various adverse effects, particularly in the oral cavity. The placement of implants in patients on therapy with BF and its inherent risks are still the subject of debate and controversy, with no specific action protocols that meet the consensus of the scientific community. This present research aims to evaluate the failures of implants in patients undergoing treatment with BF, as well as the characterization and enhancement of clinical history and new early diagnosis of OMIB. Nevertheless, I have considered also crucial in defining the prognosis, involving the evolution and definition of the therapeutic approaches. In this study were observed in two patients BF therapy, one of which undergoing therapy with oral BF and other therapy did intravenous BF. Both developed OMIB after implants placement. Was made for the relevant clinical cases, their discussion based on theoretical and applied treatment through the existing guideline

Date of Award	2012
Original language	Portuguese
Awarding Institution	Universidade Católica Portuguesa
Supervisor	Rui Amaral Mendes (Supervisor) & João Joaquim Tinoco Torres Lopes (Co-Supervisor)