Aplicações da teriparatida sobre osteonecrose dos maxilares associada ao uso de bifosfanatos na implantodontia: uma revisão integrativa
DOI:
https://doi.org/10.55892/jrg.v7i14.1005Palavras-chave:
Teriparatida, Osteonecrose Associada a Bisfosfonatos da Mandíbula, Osteonecrose, Implantes DentáriosResumo
A odontologia constantemente preocupa-se com a qualidade óssea dos seus pacientes. Tal variável determinará o sucesso clínico de intervenções cirúrgicas, instalação de implantes e manutenção de dentes na cavidade bucal. Nessa perspectiva, pacientes com osteoporose são uma população que exige maior atenção. O tratamento atual da osteoporose acontece por meio do uso de bifosfonatos, todavia, seu uso está associado a quadros de osteonecrose dos maxilares. A teriparatida é um medicamento que passou a ser estudado para controle do metabolismo ósseo e demonstra potencial para uso odontológico. Diante disso, o presente estudo buscou validar o uso da teriparatida em contexto de osteonecrose dos maxilares associada a bifosfanatos e sua influência na Implantodontia. A teriparatida é um fármaco recombinante do hormônio da paratireóide e possui efeitos anabólicos no metabolismo ósseo, estimulando a diferenciação de osteoblastos e aumentando a atividade dos osteócitos. Dessa forma, o anabólico ósseo pode ser pensado para recuperação de quadros clínicos com grandes perdas de tecido mineralizado, auxiliando no processo de reabilitação do paciente. Na odontologia, o uso da teriparatida está associado com maiores e melhores níveis de osseointegração de implantes e efeitos positivos nos tecidos periodontais. Seu uso pode, ainda, ser potencializado pela suplementação de vitamina D e cálcio. Diante dos presentes achados, o uso da teriparatida pode ser uma alternativa para o controle da osteoporose frente aos bifosfonatos no período em que se planeja realizar a instalação de implantes dentários ou cirurgias ósseas na região de cabeça e pescoço, diminuindo os riscos de necrose da região. Todavia, é importante enfatizar que os estudos clínicos ainda carecem de desenhos experimentais mais robustos e com amostras maiores para que a teriparatida seja, de fato, uma escolha válida e segura para os pacientes.
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