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Introdução: O edentulismo constitui uma condição clínica associada a
constrangimentos psicossociais que provêm da deficiência a nível funcional e estético.
A colocação de implantes dentários é uma solução amplamente difundida nestas
situações. Contudo a osteointegração do implante parece encontrar-se dependente
de inúmeros fatores, nomeadamente a toma de bifosfonatos, fármacos estes também
frequentemente associados à osteonecrose dos maxilares.
Objetivos: Verificar qual a influência dos bifosfonatos na osteointegração de
implantes em pacientes que façam terapia com BFs e tenham sido submetidos a uma
cirurgia de colocação de um ou mais implantes.
Materiais e Métodos: A presente revisão sistemática foi elaborada de acordo com as
guidelines PRISMA. Quatro bases de dados foram utilizadas: PubMED/MEDLINE,
Scopus, Web of Science e DOAJ. Foram pesquisados de janeiro de 2000 até
dezembro de 2021 (inclusive) artigos que tratam da questão PICO. Foram incluídos
estudos em que os pacientes usavam bifosfonatos sistémicos e tivessem sido
submetidos a cirurgia de implantes dentários. Ainda, ensaios controlados aleatórios,
casos-controlo, series de casos, estudos retrospetivos e prospetivos foram incluídos
na pesquisa.
Resultados: Inicialmente obtivemos um total de 491 artigos em todas as bases de
dados bibliográficas, após removermos os duplicados resultaram 277 artigos. Depois
da leitura do título e resumo obtivemos 17 artigos para leitura integral, para avaliar a
sua elegibilidade. Por fim, foram incluídos 13 artigos nesta revisão sistemática.
Conclusão: Verificou-se um alto índice médio de insucesso na osteointegração de
implantes (59%) em pacientes que usam bifosfonatos. A taxa de insucesso foi menor
quando realizada a interrupção da terapêutica. Nos pacientes que não
descontinuaram a medicação, a taxa de insucesso foi menor nos que faziam uso de
BFs de 2ª geração. Fatores de risco como tabaco, diabetes e hipertensão foram
relacionados com taxas de insucesso mais altas.
Introduction: Edentulism is a clinical condition associated with psychosocial constraints resulting from a functional and aesthetic disability. The placement of dental implants is a widespread solution in these situations. However, the osseointegration of the implant seems to be dependent on numerous factors, namely the use of bisphosphonates, drugs that are also often associated with osteonecrosis of the jaws. Objective: To verify the influence of bisphosphonates on the osseointegration of implants in patients undergoing therapy with BPs and who have undergone surgery to place one or more implants. Materials and Methods: The present systematic review was prepared according to the PRISMA guidelines. Four databases were used to carry out the research: PubMED/MEDLINE, Scopus, Web of Science and DOAJ. We have researched from January 2000 to December 2021 (inclusive) articles regarding PICO matters. Studies in which patients were using systemic bisphosphonates and had undergone dental implant surgery were included. In addition, randomized controlled trials, case-controls, case series, retrospective and prospective studies were included in the search. Results: Initially, we obtained a total of 491 articles in all bibliographic databases, which, after removing the duplicates, resulted in 277 articles. After reading the title and abstract, 17 articles were obtained for full reading, to assess their eligibility. Finally, 13 articles were included in this systematic review. Conclusion: There was a high average failure rate in implant osseointegration (59%) in patients using bisphosphonates. The failure rate was lower when therapy was discontinued. In patients who did not discontinue the medication, the failure rate was lower in those who used 2nd generation. Risk factors such as tobacco, diabetes and hypertension were associated with higher failure rates.
Introduction: Edentulism is a clinical condition associated with psychosocial constraints resulting from a functional and aesthetic disability. The placement of dental implants is a widespread solution in these situations. However, the osseointegration of the implant seems to be dependent on numerous factors, namely the use of bisphosphonates, drugs that are also often associated with osteonecrosis of the jaws. Objective: To verify the influence of bisphosphonates on the osseointegration of implants in patients undergoing therapy with BPs and who have undergone surgery to place one or more implants. Materials and Methods: The present systematic review was prepared according to the PRISMA guidelines. Four databases were used to carry out the research: PubMED/MEDLINE, Scopus, Web of Science and DOAJ. We have researched from January 2000 to December 2021 (inclusive) articles regarding PICO matters. Studies in which patients were using systemic bisphosphonates and had undergone dental implant surgery were included. In addition, randomized controlled trials, case-controls, case series, retrospective and prospective studies were included in the search. Results: Initially, we obtained a total of 491 articles in all bibliographic databases, which, after removing the duplicates, resulted in 277 articles. After reading the title and abstract, 17 articles were obtained for full reading, to assess their eligibility. Finally, 13 articles were included in this systematic review. Conclusion: There was a high average failure rate in implant osseointegration (59%) in patients using bisphosphonates. The failure rate was lower when therapy was discontinued. In patients who did not discontinue the medication, the failure rate was lower in those who used 2nd generation. Risk factors such as tobacco, diabetes and hypertension were associated with higher failure rates.
Descrição
Palavras-chave
Bifosfonatos Implantes dentários Osteointegração Osteonecrose dos maxilares relacionada aos bifosfonatos Bisphosphonates Dental implants Osseointegration Bisphosphonate-related osteonecrosis of the jaws