Ozonioterapia associada ao tratamento cirúrgico da osteonecrose dos maxilares induzida por medicamentos: relato de caso

Abstract

The medication related osteonecrosis of the jaws (MRONJ) is a complication of the use of antiresorptive and antiogiogenic medication and appears like a necrotic tissue exposed or not on oral cavity. Treatment does not have a gold standard and involves a conservative or surgical approach, associated or not with adjuvant therapies. The ozone therapy is beneficial on analgesia, inflammation modulator, antioxidant capability, improve of healing process and immunity performance. The objective of this manuscript is to report the case of a female pacient, 73 years-old, who presented at the Hospital de Clínicas da Universidade Federal de Uberlândia with exposure of necrotic bone tissue on the oral cavity second quadrant, pain and purulent drainage, with history of antiresorptive use for the osteoporosis treatment for more than three years. The diagnostic revealed stage 3 of MRONJ following the American Association of Oral and Maxillofacial Surgeons concept, demanded surgical treatment to extensive debridement resultant in bucosinusal communication and after the surgery, the patient received ozone therapy. It was used injection of ozone gas and irrigation with ozonated water. There was no complete healing of bucosinusal communication, although it was observed significant reduction of the size and no sintomatology or infection was seen then. The communication was filled with help of a temporary removable partial denture. The association between surgical therapy and ozone therapy was efficient for MRONJ treatment and helped improve the clinical condition.