Osteonecrose mandibular associada ao uso de bisfosfonato de sódio em paciente com mieloma múltiplo

Clinical profile of individuals with bisphosphonate-related osteonecrosis of the jaw: an integrative review

“…Fifteen studies were included (Figure 1). 4,5,9,[16][17][18][19][20][21][22][23][24][25][26] A total of 141 different areas of BRONJ were reported in 128 individuals, of whom 105 (82.03%) were female 4,9,10,12,21,[16][17][18][19][20][21]24,25 and 23 (17.97%) were male. 5,9,10,[16][17][18][19]25 The subjects' minimum age was 38 years and maximum age was 90 years, with a mean of 63.34 ± 34.87 years.…”

“…The commonest diagnoses relating to BRONJ were: breast cancer, in 60 individuals 9,10,12,16,17,19,21 (46.87%); osteoporosis, 10,[17][18][19][23][24][25][26] in 25 (19.53%); multiple myeloma, 5,9,16,17,20 in 16 (12.50%); and prostate cancer, 9,10,16,18,19 in 16 (12.50%) ( Table 1). 4,5,9,10,12,[16][17][18][19][20][21][23][24][25][26] The types of BPs most related to BRONJ were: zoledronic acid 9,10,12,[16][17][18][19][20][21]26...…”

“…4,5,9,10,12,[16][17][18][19][20][21][23][24][25][26] The types of BPs most related to BRONJ were: zoledronic acid 9,10,12,[16][17][18][19][20][21]26 (ZOE), in a dose of 4 mg intravenously, in 80 cases (62.50%); and alendronate 4,10,[17][18][19][23][24][25][26] (ALE) in a dose of between 70 and 90 mg orally, in 26 cases (20.31%). However, other BPs such as pamidronate 5,9,10,16,19 (PAM) (10.93%), an association of ZOE and PAM 10,19,26 in six cases (4.68%) and an association of ZOE and ALE 10,26 in two cases (1.56%) were also used. The duration of BP use until a manifestation of BRONJ ranged from 5 to 15 months, with a mean of 45.8 ± 39.7 months.…”

“…The duration of BP use until a manifestation of BRONJ ranged from 5 to 15 months, with a mean of 45.8 ± 39.7 months. 4,5,9,[16][17][18][19][20][21][22][23][24][25][26] Regarding the location of the BRONJ, the mandible was the most affected by BRONJ, 4,9,10,[16][17][18][19][20]25 in 70 cases (54.68%), followed by the maxilla 9,10,12,[16][17][18][19]21,[23][24][25][26] manifestations were in both jaws, 16,17,19 the palatine torus 10 and the mylohyoid region 17 ( Table 2). 4,5,9,10,12,[16][17][18][19][20]…”

“…2 BPs may also be prescribed for other diseases such as rheumatoid arthritis, osteoporosis and osteopenia. [3][4][5] The mechanism of action of BPs consists of decreasing local vascular support and regulating bone metabolism, thereby reducing the action of osteoclasts and decreasing angiogenesis.…”