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      Osteonecrosis del maxilar inferior por bifosfonatos: Presentación de caso

      case-report

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          Abstract

          La osteonecrosis del maxilar inferior secundaria a la administración de bifosfonatos es una patología infrecuente. Se produce en los pacientes medicados con esta droga, ya sea por vía oral o endovenosa, que luego de realizarse un procedimiento odontológico presentan necrosis ósea en la mandíbula. Desde el primer reporte en el año 2003, se evidenció un crecimiento exponencial de esta patología. Presentamos dos casos clínicos de osteonecrosis del maxilar inferior por la administración de bifosfonatos, con el objetivo de difundir y crear conciencia entre los profesionales de la salud, considerando que no existe un tratamiento efectivo para esta entidad.

          Translated abstract

          The osteonecrosis of the jaw originated by the biphosphonate administration is an infrequent pathology in patients under treatment with biophosphonates given orally or through parenteral administration after some odontological treatment. These patients manifested osteonecrosis of the jaw. Since the first case of osteonecrosis of the maxilar bone was reported in 2003, the number of patients with osteonecrosis of the jaw who have been treated with these drugs has increased notoriously. We report 2 clinical cases of patients with osteonecrosis of the jaw treated with bifosfonatos, in order to make this pathology known among the health professionals and raise awareness considering that there is no effective treatment.

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          Most cited references15

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          Bisphosphonate-associated osteonecrosis of the jaw: report of a task force of the American Society for Bone and Mineral Research.

          ONJ has been increasingly suspected to be a potential complication of bisphosphonate therapy in recent years. Thus, the ASBMR leadership appointed a multidisciplinary task force to address key questions related to case definition, epidemiology, risk factors, diagnostic imaging, clinical management, and future areas for research related to the disorder. This report summarizes the findings and recommendations of the task force. The increasing recognition that use of bisphosphonates may be associated with osteonecrosis of the jaw (ONJ) led the leadership of the American Society for Bone and Mineral Research (ASBMR) to appoint a task force to address a number of key questions related to this disorder. A multidisciplinary expert group reviewed all pertinent published data on bisphosphonate-associated ONJ. Food and Drug Administration drug adverse event reports were also reviewed. A case definition was developed so that subsequent studies could report on the same condition. The task force defined ONJ as the presence of exposed bone in the maxillofacial region that did not heal within 8 wk after identification by a health care provider. Based on review of both published and unpublished data, the risk of ONJ associated with oral bisphosphonate therapy for osteoporosis seems to be low, estimated between 1 in 10,000 and <1 in 100,000 patient-treatment years. However, the task force recognized that information on incidence of ONJ is rapidly evolving and that the true incidence may be higher. The risk of ONJ in patients with cancer treated with high doses of intravenous bisphosphonates is clearly higher, in the range of 1-10 per 100 patients (depending on duration of therapy). In the future, improved diagnostic imaging modalities, such as optical coherence tomography or MRI combined with contrast agents and the manipulation of image planes, may identify patients at preclinical or early stages of the disease. Management is largely supportive. A research agenda aimed at filling the considerable gaps in knowledge regarding this disorder was also outlined.
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            Osteonecrosis of the jaw and bisphosphonates.

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              Bisphosphonates for osteoporosis.

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                Author and article information

                Journal
                rar
                Revista argentina de radiología
                Rev. argent. radiol.
                Sociedad Argentina de Radiología (SAR) y Federación Argentina de Diagnóstico por Imágenes y Terapia Radiante (FAARDIT) (Ciudad Autónoma de Buenos Aires, , Argentina )
                1852-9992
                March 2015
                : 79
                : 1
                : 40-46
                Affiliations
                [01] Buenos Aires orgnameEmprendimientos de Salud (EDES) orgdiv1Hospital Español orgdiv2Servicio de Tomografía computada y resonancia magnética Argentina
                [03] Buenos Aires orgnameHospital Español orgdiv1Servicio de Anatomía patológica Argentina
                [02] Buenos Aires orgnameHospital Español orgdiv1Servicio de Cirugía maxilofacial Argentina
                Article
                S1852-99922015000100005 S1852-9992(15)07900100005
                449be981-fe10-44ae-b008-71432ce84a87

                This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

                History
                : 06 March 2013
                : 22 August 2012
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 15, Pages: 7
                Product

                SciELO Argentina

                Categories
                Caso clinico

                Osteonecrosis maxilar,Jaws,Biphosphonates,Osteonecrosis of the jaw,Maxilar inferior,Bifosfonatos

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