OSTEONECROSE DOS MAXILARES RELACIONADA AO USO DE MEDICAMENTOS: UMA REVISAO DE LITERATURA
OSTEONECROSE DOS MAXILARES RELACIONADA AO USO DE MEDICAMENTOS: UMA REVISAO DE LITERATURA
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DOI: https://doi.org/10.22533/at.ed.4121225050613
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Palavras-chave: Osteonecrose dos Maxilares. Bisfosfonatos. Denosumabe. Medicamentos Antirreabsortivos. Osteonecrose Associada a Medicamentos.
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Keywords: Osteonecrosis of the Jaw. Bisphosphonates. Denosumab. Antiresorptive Agents. Medication-Related Osteonecrosis of the Jaw.
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Abstract: Medication-Related Osteonecrosis of the Jaw (MRONJ) is an adverse effect that can occur in patients who have used antiresorptive medications. The aim of this study was to conduct a narrative literature review on the relationship between the use of antiresorptive medications and osteonecrosis of the jaw and its influence on dentistry, elucidating available treatment options for this condition. A search for articles was conducted in electronic databases, including Google Scholar, PubMed, and the Virtual Health Library (BVS). The terms “Bisphosphonates,” “Treatment,” “Medication-related osteonecrosis,” “Osteonecrosis,” and “Jaws” were used, combined with the boolean operators "AND/OR." Only studies published between 2010 and 2025 in English and Portuguese were included, resulting in eleven articles for the review. MRONJ is characterized by exposed bone that persists for more than eight weeks in patients who are or have been on antiresorptive therapy and have not undergone radiotherapy in the maxillofacial region. It occurs more frequently in patients who have used intravenous antiresorptives, particularly those undergoing therapy for oncological metastases. The most common site of occurrence is the mandible. The antiresorptives most commonly associated with MRONJ are bisphosphonates, followed by denosumab and angiogenesis inhibitors. Conservative therapies are often the first line of treatment; however, for more advanced lesions, surgical interventions, such as sequestrectomy and bone resection, may be necessary. Adjuvant therapies, including low-level laser therapy and platelet-derived factors (PRF and PRP), have shown promising efficacy in tissue regeneration. Determining the most appropriate treatment for each stage remains a challenge. However, advancements in the understanding of this condition, combined with ongoing research on new therapies and treatment protocols, will be crucial for improving clinical outcomes and the quality of life of affected patients.
- Luiza Pires Kirchoff
- Luísa Ferreira da Rocha
- Luiza Siqueira dos Santos
- Martina Zanon Custodio
- Samantha Simoni Santi