Ribeiro Ney Robson Bezerra, Silva Leonardo de Freitas, Santana Diego Matos, Nogueira Renato Luiz Maia
*Oral and Maxillofacial Surgery of Batista Memorial Hospital †Oral and Maxillofacial Surgery of Doctor José Frota Institute ‡Oral and Maxillofacial Surgery of Doctor José Frota Institute §Stomatology and Oral and Maxillofacial Surgery of Federal University of Ceará dental school-UFC, Fortaleza, Ceará, Brazil.
J Craniofac Surg. 2015 Oct;26(7):e606-8. doi: 10.1097/SCS.0000000000002051.
Bisphosphonates are widely used for treatment or prevention of bone diseases characterized by high osteoclastic activity. Among the oral medicines used to treat osteoporosis, alendronate has been often used. Despite of the low rate of complications on its use, cases of osteonecrosis of the jaw have been reported on literature after tooth extractions. The main symptoms include pain, tooth mobility, swelling, erythema, and ulceration. The risk factors related to osteonecrosis of the jaw associated with bisphosphonate are exposition time to the medicine, routes of administration, and oral surgical procedures performed. The aim of this work is to report a case of a patient showing osteonecrosis of the jaw associated with the use of oral bisphosphonates after tooth extractions. The patient was treated through the suspension of the alendronate with the removal of the necrotic tissue and the foci of infection. After a year's follow-up, the patient showed no recurrence signs. From the foregoing, the interruption of the alendronate use and the surgical treatment associated to antibiotic therapy showed effective on the patient's treatment.
双膦酸盐被广泛用于治疗或预防以破骨细胞活性高为特征的骨疾病。在用于治疗骨质疏松症的口服药物中，阿仑膦酸钠经常被使用。尽管其使用并发症发生率较低，但文献报道拔牙后出现颌骨坏死病例。主要症状包括疼痛、牙齿松动、肿胀、红斑和溃疡。与双膦酸盐相关的颌骨坏死的危险因素有药物暴露时间、给药途径和所进行的口腔外科手术。这项工作的目的是报告一例患者在拔牙后出现与口服双膦酸盐使用相关的颌骨坏死病例。该患者通过停用阿仑膦酸钠、清除坏死组织和感染灶进行治疗。经过一年的随访，患者未出现复发迹象。综上所述，停用阿仑膦酸钠以及与抗生素治疗相关的手术治疗对该患者的治疗显示出有效性。
