Correlação entre bifosfonatos e usuário de prótese muco-suportadas e osteonecrose dos maxilares : revisão sistemática

Abstract

In this research, a systematic review of papers dealing with the relationship between osteonecrosis in patients using bisphosphonates and local predisposition factors was performed. It aims to determine the relationship between users of bisphosphonates in muco-supported and / or dento-muco-supported prostheses and incidence of osteonecrosis. A detailed search in four databases was performed: MedLine (PubMed), Web of Science, Scopus and Cochrane, by two independent reviewers from June to November 2018, using the search strategy developed by PubMed (MedLine) and adapted to other databases. A total of 1352 potentially relevant articles were identified in all databases. Deleting the duplicates, 740 articles left, of which, after title and abstract analysis 691 studies were excluded because they did not meet the eligibility criteria. From the 49 studies maintained for the detailed review, 37 studies were excluded because they did not present a relationship between the use of bisphosphonates with prosthesis users. A total of 12 studies fulfilled all the selection criteria and were included in the systematic review. Although the PRISMA criteria work with the idea of randomized clinical trials, and that prospective and retrospective studies should be included, only two articles did not fit this classification. According to the findings, we can conclude that bisphosphonate users who use dento-mucous or muco-supported prostheses are susceptible to osteonecrosis lesions due to trauma caused by the use of prostheses, requiring the use of hygiene protocols and the choice of materials for the preparation of more malleable prostheses and which prevent or minimize trauma to the adjacent mucosa.