Osteonecrosis de los maxilares: fisiopatología, diagnóstico y tratamiento

María Catalina Cortés-Motta, Rafael Fernández-Grisales

Resumen


El esqueleto humano es un conjunto organizado de piezas óseas que conformany proporcionan soporte estructural al cuerpo. Diferentes funcioneshan sido descritas: soporte dinámico y mecánico, protección y mantenimientode la homeostasis mineral. Para esto, el hueso debe mantenersu metabolismo activo y ser capaz de adaptar su estructura a estímulosmecánicos reparando los daños estructurales a través del proceso de remodelacióndurante toda la vida. La osteoporosis, enfermedad de Paget,cáncer/infecciones en el hueso, van a alterar la fisiología del tejido dandolugar a la pérdida de su integridad. Los bifosfonatos (BFs) son agentesfarmacológicos diseñados para el tratamiento de estas enfermedades, suprincipal mecanismo de acción es la inhibición de la resorción osteoclásticadel hueso. La osteonecrosis de los maxilares (ONM) relacionada con lamedicación consiste en la destrucción progresiva del tejido óseo, siendouno de los efectos adversos de este tipo de tratamiento. Por esta razón, elobjetivo de este artículo fue hacer una revisión acerca de los principalesaspectos farmacológicos y clínicos de la ONM relacionada con los bifosfonatosen odontología. El diagnóstico clínico y el tratamiento adecuado sonfundamentales para reducir el riesgo de osteonecrosis en pacientes bajoterapia antiresortiva o antes de iniciar su administración. Por esta razón,la prevención es aún más importante.

DOI: http://dx.doi.org/10.21615/cesodon.29.2.7


Palabras clave


Necrosis ósea, bifosfonatos, reabsorción ósea, remodelado óseo.

Citas


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