Efectividad de los distintos tratamientos de la osteonecrosis de los maxilares asociada a fármacos

  1. González Muñoz, María
  2. Rodríguez-Archilla, Alberto
Revista:
Actualidad médica

ISSN: 0365-7965

Año de publicación: 2021

Tomo: 106

Número: 812

Páginas: 66-77

Tipo: Artículo

DOI: 10.15568/AM.2021.812.REV02 DIALNET GOOGLE SCHOLAR lock_openAcceso abierto editor

Otras publicaciones en: Actualidad médica

Resumen

Antecedentes. La osteonecrosis de los maxilares asociada a fármacos (ONMAF) es una complicación grave de pacientes oncológicos o con osteoporosis, en tratamiento con fármacos antirresortivos. En el momento actual, no existe evidencia científica ni consenso sobre el enfoque de tratamiento más adecuado en función de las etapas de la ONMAF. Objetivo. Analizar la efectividad de las diferentes opciones terapéuticas en el tratamiento de la ONMAF. Métodos de búsqueda. Se realizó una búsqueda de estudios en las siguientes bases de datos: PubMed (MEDLINE, Cochrane Library), Web of Science (WoS) e índice médico español (IME). Criterios de selección. Estudios con resultados sobre tratamiento de la ONMAF. Análisis de datos. Se realizó una estadística descriptiva considerando medias y porcentajes. Resultados. 52 estudios sobre tratamiento de la ONMAF fueron incluidos en esta revisión. La resolución completa de casos de ONMAF se observó en 205 de 257 pacientes (79.8%) tratados con cirugía más colgajos; 202 de 253 (otro 79.8%) con la suspensión del fármaco antirresortivo (“drug holiday”); 512 de 648 (79.0%) con la cirugía extensa; 41 de 59 (69.5%) con la terapia coadyuvante con oxígeno hiperbárico; 462 de 680 (67.9%) con la cirugía conservadora; 55 de 119 (46.2%) con terapia láser y, finalmente, 100 de los 346 pacientes (28.9%) consiguieron la resolución completa con el tratamiento médico (antibióticos+antisépticos). Conclusiones. Dependiendo de la severidad de las exposiciones óseas, el tratamiento quirúrgico combinado con colgajos, parece ser la mejor opción terapéutica para el tratamiento de la ONMAF.

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Fuente de los datos: Dialnet