{"id":43729,"date":"2016-12-09T14:11:03","date_gmt":"2016-12-09T18:41:03","guid":{"rendered":"http:\/\/piel-l.org\/blog\/?p=43729"},"modified":"2016-12-09T15:21:28","modified_gmt":"2016-12-09T19:51:28","slug":"caso-fundacion-ortopedico-infantil-caracas","status":"publish","type":"post","link":"https:\/\/piel-l.org\/blog\/43729","title":{"rendered":"Caso Fundaci\u00f3n Ortop\u00e9dico Infantil, Caracas"},"content":{"rendered":"<p>Henry Garc\u00eda, Mariana Villarroel Dorrego<\/p>\n<p>Las osteonecrosis del complejo maxilar-mand\u00edbula no s\u00f3lo est\u00e1n asociadas a bifosfonatos (tal como en este caso que se muestra imagen tomogr\u00e1fica, abordaje quir\u00fargico e histopatolog\u00eda).<\/p>\n<p>Tambi\u00e9n pueden estar asociados a DENOSUMAB. Se trata de un medicamento usado para el metabolismo \u00f3seo como los bifosfonatos. Es un anticuerpo monoclonal anti-RANKL (bloquea el ligando de RANK inhibiendo la acci\u00f3n osteocl\u00e1stica).<\/p>\n<p>Algunas revisiones sistem\u00e1ticas ya muestran que el riesgo de osteonecrosis en pacientes oncol\u00f3gicos es mucho mayor usando denosumab que bifosfonatos, as\u00ed que es un problema que seguir\u00e1 creciendo y que debemos conocer y estar sumamente atentos.<\/p>\n<p>\u00bfCu\u00e1les son los signos cl\u00ednicos de alerta de osteonecrosis asociada a medicamentos (bifosfonatos y denosumab)?<\/p>\n<ol>\n<li>Zonas de exposici\u00f3n \u00f3sea que cursan con dolor.<\/li>\n<li>\u00dalceras persistentes en la mucosa que recubre el hueso.<\/li>\n<li>\u00c1reas que no cicatrizan especialmente despu\u00e9s de extracciones dentales.<\/li>\n<\/ol>\n<p>Referencia: Boquete-Castro A, G\u00f3mez-Moreno G, Calvo-Guirado JL, Aguilar-Salvatierra A, Delgado-Ruiz RA. Denosumab and osteonecrosis of the jaw. A systematic analysis of events reported in clinical trials. Clin Oral Implants Res. 2016 Mar;27(3):367-75.<\/p>\n<p><img loading=\"lazy\" decoding=\"async\" class=\"aligncenter size-full wp-image-43730\" src=\"http:\/\/piel-l.org\/blog\/wp-content\/uploads\/\/2016\/12\/boca-ed-402.jpg\" alt=\"\" width=\"720\" height=\"540\" srcset=\"https:\/\/piel-l.org\/blog\/wp-content\/uploads\/2016\/12\/boca-ed-402.jpg 720w, https:\/\/piel-l.org\/blog\/wp-content\/uploads\/2016\/12\/boca-ed-402-390x293.jpg 390w\" sizes=\"auto, (max-width: 720px) 100vw, 720px\" \/><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Riesgo de osteonecrosis en pacientes oncol\u00f3gicos es mucho mayor usando denosumab que bifosfonatos<\/p>\n","protected":false},"author":80,"featured_media":43730,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[598],"tags":[],"class_list":["post-43729","post","type-post","status-publish","format-standard","has-post-thumbnail","","category-enfermedades-de-la-boca"],"_links":{"self":[{"href":"https:\/\/piel-l.org\/blog\/wp-json\/wp\/v2\/posts\/43729","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/piel-l.org\/blog\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/piel-l.org\/blog\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/piel-l.org\/blog\/wp-json\/wp\/v2\/users\/80"}],"replies":[{"embeddable":true,"href":"https:\/\/piel-l.org\/blog\/wp-json\/wp\/v2\/comments?post=43729"}],"version-history":[{"count":0,"href":"https:\/\/piel-l.org\/blog\/wp-json\/wp\/v2\/posts\/43729\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/piel-l.org\/blog\/wp-json\/wp\/v2\/media\/43730"}],"wp:attachment":[{"href":"https:\/\/piel-l.org\/blog\/wp-json\/wp\/v2\/media?parent=43729"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/piel-l.org\/blog\/wp-json\/wp\/v2\/categories?post=43729"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/piel-l.org\/blog\/wp-json\/wp\/v2\/tags?post=43729"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}