Osteonecrosis de los maxilares por consumo de antirresortivos: bifosfonatos y denosumab. Revisión de literatura

Abstract

Maxillary and mandibular osteonecrosis is attributed to consuming antiresorptive drugs, such as bisphosphonates and denosumab, manifesting as necrotic tissue persisting for over eight weeks. This article aims to determine which antiresorptive drug—bisphosphonate or denosumab—poses a higher risk of developing maxillary and/or mandibular osteonecrosis using clinical case reports from the past five years for preventive purposes. Materials and Methods: Observational and descriptive, involving the analysis of 29 clinical case files from an initial 163 articles that met the eligibility criteria. The most notable findings regarding drug-induced osteonecrosis were identified in the mandibular region (69%, n=20), followed by the maxillary region (28%, n=8), and both maxillary and mandibular regions (3%, n=1). Among these cases, 66% (n=19) were observed in females, predominantly associated with bisphosphonate consumption (72%, n=21) as opposed to denosumab (28%, n=8). This condition was most frequently observed in individuals aged 70 to 79 years. In conclusion, drug- induced maxillary and mandibular osteonecrosis can lead to significant loss of bone tissue in the oral cavity. Therefore, early prevention and collaborative efforts between dentists and treating physicians are important for maximizing therapeutic success.