Principais achados da osteonecrose da mandíbula em pacientes oncológicos pelo uso de bifosfonatos: uma revisão da literatura

Abstract

Osteonecrosis of the jaw is characterized by the condition of exposed necrotic bone persisting for more than eight weeks in patients without a history of head and neck radiotherapy, and who use/have used bone antiresorptive drugs such as bisphosphonates, used in the treatment of multiple myeloma and bone metastases. Bones are important metastatic sites for malignant tumors, so skeletal-related events negatively impact the quality of life of these patients. The predisposition of osteonecrosis of the jaw is increased by the use of nitrogen bisphosphonates used for long periods intravenously. The predisposing factors are tooth extractions, mechanical trauma and infections. The diagnosis is made by clinical examination, anamnesis and radiography. Treatment should focus on prevention. Faced with this problem, the objective of this study is to present the main findings in the literature on osteonecrosis of the jaw involving the use of bisphosphonates in cancer patients, through a literature review, with the following inclusion criteria: full articles available for free on PubMed, published between 2015 - 2022 and without language prioritization. As a result, it was observed that osteonecrosis of the mandible was more prevalent than that of the jaws, affecting women in most cases. The mortality rate of cancer patients affected by osteonecrosis of the jaw was higher compared to patients without this condition. The time of manifestation reported in the literature is up to 3 years, where tooth extraction has been listed as the main triggering factor of the disease. Therefore, prevention and knowledge about the disease on the part of health professionals are essential to minimize harm to the patient's health status, as they drastically affect the quality of life. More studies are needed to fully elucidate the pathophysiology of the disease.