Perfil Dental de Pacientes que Utilizan Bisfosfonatos en un Hospital Oncológico
DOI:
https://doi.org/10.32635/2176-9745.RBC.2024v70n3.4731Palabras clave:
Neoplasias de la Boca/tratamiento farmacológico, Disfosfonatos/efectos adversos, Atención Odontológica, Perfil de SaludResumen
Introducción: Los bifosfonatos se utilizan en el tratamiento de condiciones
óseas como las metástasis óseas de tumores sólidos y el mieloma múltiple.
Pueden causar osteonecrosis de los maxilares, un efecto adverso poco común
que afecta la calidad de vida de los pacientes. Objetivo: Describir el perfil
clínico-epidemiológico de los pacientes que utilizan bifosfonatos en el Instituto Nacional del Cáncer. Método: Estudio transversal retrospectivo basado en registros de pacientes de la Sección de Odontología entre 2018 y 2022. Resultados: De los 108 pacientes incluidos según los criterios del estudio, la mayoría eran hombres (56,5%), mayores de 50 años (82,4%) y con mieloma múltiple (76,9%). El pamidronato disódico fue el bifosfonato más recetado (37,0%), en dosis de 90 mg (94,7%), administrado mensualmente (74,3%), principalmente para el tratamiento del mieloma múltiple (77,8%). Las consultas odontológicas ocurrieron predominantemente antes y durante el uso de bifosfonatos, aunque hubo un mayor número de consultas después del inicio del tratamiento. Los pacientes con dientes y los usuarios de prótesis inadecuadas eran la mayoría. La movilidad dental fue más común antes de iniciar el tratamiento con bifosfonatos (60,9%), siendo la extracción dental el procedimiento más demandado en ese momento (45,8%). Posteriormente y en adelante, los procedimientos más realizados fueron los raspados dentales (51,3%). Las lesiones periapicales fueron los hallazgos radiográficos más comunes antes y durante el tratamiento, mientras que la rarefacción ósea se observó posteriormente. Dos pacientes (1,85%) desarrollaron osteonecrosis de mandíbula. Conclusión: Estos resultados subrayan una alta demanda de atención dental invasiva antes del tratamiento, una pérdida de seguimiento posterior y una mayor necesidad de procedimientos conservadores para mantener la salud bucal.
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