Palavras-chave
Bisfosfonatos
Osteonecrose
Como Citar
Resumo
Os bisfosfonatos (BFs) são drogas inibidoras das células osteoclásticas utilizados como terapia de primeira escolha em desordens que atingem o metabolismo ósseo. Diante dos benefícios dos BFs foram descritos os primeiros relatos de osteonecrose dos maxilares, que clinicamente se apresenta como uma região de exposição óssea com necrose e secreção purulenta. Procedimentos cirúrgicos invasivos, tais como extrações dentárias e a instalação de implantes podem ser fatores desencadeantes de osteonecrose dos maxilares, portanto, o cuidado relacionado a esses pacientes deve ser redobrado. Objetivo: Relatar um caso de tratamento reabilitador com implante dentário em uma paciente usuária de Alendronato, promovendo uma discussão sobre manejo de tratamento e os protocolos de atendimento desses pacientes. Relato de caso: Paciente do sexo feminino, 56 anos de idade, leucoderma, com histórico de tratamento cirúrgico, quimioterápico e radioterápico de carcinoma ductal invasivo em mama esquerda e carcinoma metastático em axila esquerda e em uso contínuo de Zometa® (ácido zoledrônico - 4mg/100mL), apresentou queixa de mobilidade e mau odor referente ao elemento 11. Ao exame tomográfico evidenciou-se fratura radicular, associada a conjunto pino/coroa, com indicação para exodontia. Levando em consideração os riscos, benefícios e a autonomia da paciente em escolher reabilitação com implantes, uma cirurgia minimamente invasiva com carga imediata foi planejada. Conclusão: Pacientes que estão realizando tratamento com bisfosfonatos podem ser considerados para a instalação de implantes dentários, onde cada situação clínica deve ser avaliada individualmente, de forma que se minimize o trauma cirúrgico e o risco de desenvolvimento de osteonecrose dos maxilares relacionada à medicação.
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