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L’Endocrinologo

, Volume 10, Issue 2, pp 74–80 | Cite as

Rischio di osteonecrosi della mandibola/mascella associata ai bisfosfonati nell’osteoporosi

  • Francesco Bertoldo
  • Silvano Adami
Article
  • 21 Downloads

Riassunto

L’osteonecrosi della mandibola (ONJ) è un raro evento avverso in corso di trattamento con bisfosfonati (BP). L’incidenza è estremamente rara tra gli osteoporotici (0,7-1/100.000/pazienti/anno) rispetto ai pazienti oncologici (111%). L’elemento che maggiormente caratterizza il rischio di osteonecrosi da bisfosfonati (ONJBP) è la dose cumulativa dei BP. Essa è particolarmente elevata in oncologia rispetto a quella nell’osteoporosi. Il tipo di BP e la via di somministrazione (rispetto alla dose e alla frequenza) non sembrano per ora elementi determinanti per un maggior rischio di ONJ. Apparentemente i BP per via endovenosa sembrano determinare più frequentemente ONJ. Ciò in realtà è legato al fatto che la formulazione endovenosa è utilizzata prevalentemente ad alte dosi in oncologia. I maggiori fattori di rischio legati al paziente sono la suscettibilià alle infezioni (diabete, immunosoppressione, cortisone), il fumo, l’alcool e l’età (tutti elementi che influenzano la velocità di guarigione delle lesioni orali e predispongono altresì alla parodontosi). Il quadro clinico di esordio della ONJ nell’osteoporosi appare meno esteso, meno grave e più facilmente gestibile dal punto di vista terapeutico.

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Copyright information

© Springer International Publishing AG 2009

Authors and Affiliations

  • Francesco Bertoldo
    • 1
  • Silvano Adami
    • 2
  1. 1.Medicina Interna DPoliclinico GB RossiVeronaItalia
  2. 2.Reumatologia, Dipartimento di Scienze Biomediche e ChirurgicheUniversità degli Studi di VeronaVeronaItalia

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