Osteonecrosis maxilar por medicamentos, un enemigo oculto. Una revisión integradora
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Antecedentes: La osteonecrosis maxilar por medicamentos (ONM) es una complicación grave asociada al uso prolongado de medicamentos antirresortivos (como bifosfonatos y denosumab) y antiangiogénicos (como bevacizumab y sunitinib) en pacientes con osteoporosis o cáncer. Se producen una infección progresiva del hueso maxilar o el mandibular y, en consecuencia, una necrosis avascular del hueso. La incidencia de ONM es mayor en personas con cáncer a quienes se les administran frecuentemente altas dosis de antirresortivos por vía endovenosa. Se han identificado factores de riesgo asociados a la terapia antirresortiva o antiangiogénica que pueden contribuir a la aparición de ONM. Objetivo: Revisar y analizar las opciones terapéuticas disponibles actuales para tratar pacientes con riesgo o que ya presentan ONM. Métodos: En esta revisión integrativa de la literatura se realizaron búsquedas de publicaciones en las bases de datos de ScienceDirect, PubMed, SciELO y ResearchGate realizadas entre 2003 y 2020. Los términos de búsqueda fueron “osteonecrosis maxilar asociada a bifosfonatos”, “osteonecrosis maxilar asociada a medicamentos” y “osteonecrosis maxilar”. Resultados: Se seleccionaron 64 artículos en los que las exodoncias se identifican como el principal factor de riesgo para desarrollar ONM (52 % - 61 %). Un segundo factor identificado fue la aparición espontánea de lesiones de necrosis ósea. Conclusiones: Es importante implementar medidas preventivas en la atención médica y odontológica antes, durante y después de los tratamientos con antirresortivos y antiangiogénicos para minimizar los riesgos de ONM en los pacientes.
angiogenesis inhibitors, antiresorptive medicines, bisphosphonates, cancer, denosumab, dental extractions, dentistry, neoplasms, oncology, osteonecrosis, osteoporosisantiangiogénicos, antirresortivos, bifosfonatos, cáncer, denosumab, exodoncias, inhibidores de la angiogénesis, neoplasmas, odontología, oncología, osteonecrosis, osteoporosisantiangiogênico, antirreabsortivos, bifosfonatos, câncer, denosumabe, extrações, inibidores de angiogénese, neoplasias, odontologia, oncologia, osteonecrose, osteoporose
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