ABSTRACT
The bisphosphonates are synthetic drugs used for treatment of neoplasms and bone, Pagets disease and more reason for excitement in cases of postmenopausal osteoporosis. These drugs present some known side effects, however, a new complication with oral manifestation was recently identified, called Osteonecrosis. When this necrosis of the bone bases is associated to the use of Bisphosphonates, it is named Osteonecrosis by Bisphosphonates. The type of bisphosphonate, route of administration, and duration of treatment with these drugs seem to have direct relation with the incidence of osteonecrosis associated with bisphosphonates. The aim of this work was to present a review of the last five years about the use of bisphosphonates, the available bisphosphonate groups in the Brazilian market emphasizing those used in the treatment of Osteonecrosis, and exploring possible diagnostic aspects of the disease from image Diagnostics. It is concluded the impact of current world life stimulates new research areas focusing on important illnesses, their manifestations, and on searching for better treatment protocols and faster diagnosis protocols, aiming reduce possible treatment unwanted side effects
Os bisfosfonatos são drogas sintéticas usadas no tratamento de neoplasias de osso, doença de Paget e nos casos de osteoporose pós-menopáusica. Estas drogas apresentam alguns efeitos colaterais conhecidos, no entanto, uma nova complicação com manifestação oral foi recentemente identificada, chamada osteonecrose. Quando a necrose das bases ósseas está associada à utilização de bisfosfonatos, é nomeada osteonecrose por bisfosfonatos. O tipo de Bisfosfonato, a via de administração e duração do tratamento com estes medicamentos parecem ter uma relação direta com a incidência da osteonecrose. O objetivo deste trabalho foi apresentar uma revisão dos últimos cinco anos sobre o uso de Bisfosfonatos e os grupos de Bifosfonatos disponíveis no mercado brasileiro, enfatizando aqueles usados no tratamento da osteonecrose, além de explorar possíveis aspectos de diagnóstico da doença por meio de imagem. Conclui-se que novas áreas de pesquisa, com foco em doenças importantes e as suas manifestações, estão buscando melhores protocolos no tratamento e diagnóstico rápido, visando reduzir possíveis efeitos colaterais indesejados
Subject(s)
Diphosphonates , Osteonecrosis , Radiography, DentalABSTRACT
The quality of the radiographic image is essential for the diagnosis and conservation of x-rays in archive. However, there are some Dental specialties that, for force of the execution, require the attainment of x-rays with bigger brevity, being common professionals and students exist to appeal the procedures that cause the damage of its quality with the justification of time profit. Because of this, this work had the intention to emphasize the optimization importance of the radiographic image through the analysis of imperfections in x-rays taken by students. For such, 572 x-rays, proceeding from archives of patients taken care by the students of the ninth period of the 1999 first semester at the Polyclinic of Pernambuco Dental School -UPE, were analyzed simultaneously by two observers and out of these, 75% presented imperfections. Related to the type of imperfection, the execution of the technique had prevalence in the referring errors (58%), followed by the processing errors (19%). Framing of the exposed region (35%) and elongation of the image (35,7%) were the most prevalent errors in the phase of execution of the technique, while yellowish images (33%) and lacerated x-rays (23%) demonstrated to be the occurred imperfections most frequent during processing.
La calidad de la imagen radiográfica es esencial para el diagnóstico y conservación de radiografías en archivo. Así mismo, hay especialidades odontológicas que, por fuerza de la ejecución, necesitan obtener radiografías con mayor brevedad, siendo común que profesionales y alumnos recurran a procedimientos que perjudican su calidad con la justificación de ganar tiempo. De esta forma, este trabajo tuvo el propósito de enfatizar la importancia de optimizar la imagen radiográfica a través del análisis de errores en radiografías obtenidas por alumnos. Con este propósito fueron analizadas 572 radiografías provenientes de archivos de pacientes atendidos por los alumnos del 9º semestre de 1999, de la Clínica Integrada de la Facultad de Odontología de Pernambuco-UPE. Las radiografías fueron analizadas simultáneamente por dos observadores y de esas, 75% presentaron errores. Los errores asociados a la técnica radiográfica correspondieron a 58%, siendo de mayor prevalencia los errores de elongación de la imagen (35,7%) y encuadramiento de la región radiografiada (35%). Los errores que más ocurrieron durante el procesamiento fueron imágenes "amarillentas" (33%) y radiografías rasguñada (23%).