RESUMO

BACKGROUND: We investigated the efficacy of hyperbaric oxygen (HBO), low-intensity laser (LIL), and platelet-rich plasma (PRP) in the management of medication-related osteonecrosis of the jaws (MRONJ). METHODS: A literature search was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. Two examiners independently assessed eligibility and risk of bias and extracted data. RESULTS: There was improvement in 75.6% of the 41 patients submitted to HBO, with positive effects on pain relief and decreased size and number of lesions at a faster rate, with better effects when the drug was discontinued. For LIL, 158 (64.2%) of the 246 patients/sites improved the symptoms and 98 (39.8%) healed completely. Fourteen (17.3%) of the 81 patients treated with PRP significantly improved the symptoms and 65 (80.2%) completely healed. CONCLUSIONS: These therapies served as safe and effective adjuvant modalities for MRONJ treatment. The lack of randomized clinical trials evidences the need for more high-quality investigations on the subject.

Assuntos

Osteonecrose da Arcada Osseodentária Associada a Difosfonatos/terapia , Oxigenoterapia Hiperbárica/métodos , Terapia a Laser/métodos , Plasma Rico em Plaquetas , Idoso , Idoso de 80 Anos ou mais , Osteonecrose da Arcada Osseodentária Associada a Difosfonatos/patologia , Conservadores da Densidade Óssea/efeitos adversos , Terapia Combinada , Denosumab/efeitos adversos , Difosfonatos/efeitos adversos , Feminino , Humanos , Doenças Maxilomandibulares/induzido quimicamente , Doenças Maxilomandibulares/terapia , Masculino , Pessoa de Meia-Idade , Osteonecrose/induzido quimicamente , Osteonecrose/terapia , Manejo da Dor , Pamidronato/efeitos adversos , Ensaios Clínicos Controlados Aleatórios como Assunto

RESUMO

OBJECTIVES: The aim of this study is to evaluate the accuracy of linear measurements on cone-beam computed tomography (CBCT) images using three software programs and different voxel sizes. METHODS: Ten human mandibles with 25 silica markers were scanned for 0.250-, 0.300-, and 0.400-mm voxels in the i-CAT New Generation (Imaging Sciences International, Hatfield, PA, USA). Thirty-five linear measurements were carried out by two examiners two times on the multiplanar reconstructions in the following software programs: XoranCat version 3.1.62 (Xoran Technologies, Ann Arbor, MI, USA), RadiAnt DICOM 2.2.9 Viewer (Medixant, Poznan- Poland) and InVesalius 3.0.0 (Centro de Tecnologia da Informação Renato Archer, Campinas, SP, Brazil). The physical measurements were made by another observer two times using a digital caliper on the macerated mandibles. ANOVA test was used to compare voxels and software programs. Pearson correlation and the Bland-atman tests were used to compare physical and virtual measurements and to evaluate the accuracy of the software programs, respectively (P < 0.05). RESULTS: There was no statistically significant difference when the measurements were compared in acquisitions with different voxel sizes analyzed in the three software programs. There was also no difference when the measurements were compared between the software programs and the digital caliper. Excellent intra- and inter-observer reliability for the markers, physical measurements, and multiplanar reconstructions were found. CONCLUSION: Linear measurements in the XoranCat, Radiant, and InVesalius software programs are reliable and accurate compared with physical measurements. The different acquisition protocols using different voxel sizes did not influence the accuracy of linear measurements in CBCT images.