Osteoquimionecrosis de los maxilares asociada a la administración de bifosfonatos por vía endovenosa: A propósito de seis casos

Abstract

Osteonecrosis of the jaws in cancer patients is associated, until now, with radiotherapy. Many cases of maxillary osteoquimionecrosis (MOQN) related to chemotherapy have been reported recently, more specifically with the use of bisphosphonates (inhibitors agents of osteoclastic activity) to treat bone metastasis. Bisphosphonates inhibit osteoclastic activity leading to a decrease of the resorption and the remodeling of bone and compromising its irrigation. Although the decrease in bone vascular contribution can be presented in any location, it seems logical that it most commonly affects the jaw, because of its terminal vascularization, and the fact that it is easily attackable by the external environment, either through the periodontium or the root canal. This article presents the complications observed in 6 cases of MOQN triggered after the execution of various oral surgical therapies in patients undergoing treatment with bisphosphonates for different diseases and their clinical management. The treatment of this type of MOQN is often unsatisfactory, since none of the treatment options described in the literature has given good results. All patients receiving or have received treatment with bisphosphonates should be considered as patients with risk of developing MOQN, and should be submitted to the same prophylactic measures outlined for the prevention of osteoradionecrosis.