Influência dos bifosfonatos na movimentaçao ortodontica: uma revisão narrativa

Abstract

Bisphosphonates, derived from inorganic pyrophosphate, are drugs commonly prescribed for the treatment/prevention of pathologies, such as osteoporosis and malignant neoplasms such as multiple myeloma and bone metastasis. They are specific for the bone, acting as inhibitors of bone reabsorption through its action on osteoclasts, culminating in their apoptosis. Nowadays, aesthetics is increasingly valued, with a greater demand for treatments that go in that direction. An example of this is orthodontic treatment, increasingly sought after by adult patients (some of them undergoing bisphosphonate therapy), and whose success depends on the phenomenon of bone resorption and apposition. From the narrative review carried out, studies were found reporting the effects of bisphosphonates on orthodontic tooth movement. All studies reported a decrease in the rate of tooth movement, although some authors did not consider it significant. Thickening of the periodontal ligament, sclerotic zones, as well as increased chances of poor root parallelism and incomplete space closure have also been reported. Regarding the effects on root resorption, some of the studies concluded that bisphosphonates prevent root resorption associated with orthodontic treatment. Others have also suggested the use of bisphosphonates as a means of achieving anchoring during treatment, however, requiring greater scientific evidence regarding the risks. It is important to carry out more studies on humans, as one of the gaps in scientific evidence on this topic is that it is supported, for the most part, by studies on animals. The orthodontist must be aware of the possible effects that may occur in patients using this medication.