Uso de Bifosfonatos e Osteonecrose medicamentosa – revisão de literatura

Abstract

INTRODUCTION: Bisphosphonates are drugs widely used in the treatment of diseases that affect bone metabolism, such as osteoporosis and bone metastases. However, their prolonged use has been associated with dental complications, the most relevant being drug-related osteonecrosis (DRO), especially in patients undergoing

invasive procedures. OBJECTIVE: To conduct a narrative review of the literature on the use of bisphosphonates and drug-related osteonecrosis in patients undergoing invasive treatments, in addition to proposing management and prevention strategies to minimize the risks of this complication. METHODOLOGY: This is a narrative review carried out by searching for scientific articles in the Google Scholar, Virtual Health Library (VHL) and Latin American and Caribbean Literature in Health Sciences (LILACS) databases, considering publications between 2020 and 2025. Complete studies, freely available, related to dental complications in bisphosphonate users, especially in invasive procedures, were included. RESULTS: The review included 13 studies that showed that, although the risk of OMAM is relatively low in patients with osteoporosis, it became significant in cancer patients undergoing intravenous therapy. Factors such as duration of medication use, comorbidities, oral infection and concomitant use of other drugs are indicated as aggravating factors. Strategies such as antibiotic therapy, use of minimally invasive surgical techniques, pre-treatment dental planning and use of biomaterials such as L-PRF have shown efficacy in the prevention and treatment of OMAM. CONCLUSION: Drug-induced osteonecrosis is a serious and multifactorial complication associated with the use of bisphosphonates, requiring preventive care and individualized clinical management. Interdisciplinary action and early diagnosis are essential to mitigate risks and promote safety in invasive dental procedures.