Implications of the use of bisphosphonates in dental treatment – experience of the service of oral and maxillofacial surgery, Erasto Gaertner Hospital, Curitiba, Brazil

Resumo

Bisphosphonates (BP) are effective drugs in the
prevention and treatment of various bone pathologies, acting in
the regulation of osteoclast function through different mechanisms.
Despite the success in the treatment of various diseases, these
drugs have the ability to induce an avascular necrosis of bone
tissue, especially in the maxilla and mandible. Objective: Due
the significant increase number of cases of patients with oral
complications associated with BP therapy in the Department of
Oral and Maxillofacial Surgery of the Erasto Gaertner Hospital, the
study aimed to report our experience in the care of these patients.
Material and methods: Patients submitted to BP therapy were
enrolled prospectively between the years of 2011 and 2012. Clinical
examination was performed in all patients to evaluate dental health
as well oral mucosa. All patients are under follow-up in our service.
Results: 26 patients who used BP were attended in the ambulatory.
Twenty-three patients used BP for oncological indication and three for
osteoporosis. Most of patients were women (66%) with average age of 56 years old. The most frequent medication used was Pamidronate
(54%), followed by Zoledronic acid (30%) and Alendronate (15%).
Ten patients showed bone exposition, most of then in the mandible
(80%), with an average time of one year of exposure. Conclusion:
Dentists should advise their patients about the use of BP and the
implications for oral health and treatments. These patients must
have periodic consultations for evaluation and early detection of
osteonecrosis associated to BP for adequate treatment.