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7520-Revista V.7-n.3.indd - CLINICA DE ESTOMATOLOGIA ...

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Conclusão<br />

A radioterapia leva a danos ósseos, tanto em vascularidade,<br />

em perfusão de oxigênio, quanto em celularidade.<br />

Porém, ainda não há um consenso sobre como ocorrem<br />

estes danos.<br />

O risco de falhas de implantes dentais em osso irradiado<br />

parece ser duas a três vezes maior no osso maxilar do que<br />

na mandíbula.<br />

Doses de irradiação baixas (50 Gy).<br />

Referências bibliográfi cas<br />

1. Ministério da Saúde. Secretaria de Atenção à Saúde. Instituto Nacional de Câncer.<br />

Coordenação de Prevenção e Vigilância de Câncer. Estimativas 2008: Incidência de Câncer<br />

no Brasil. Rio de Janeiro: Inca; 2007. p. 94.<br />

2. Wang X, Ding I, Xie H, Wu T, Wersto N, Huang K et al. Hyperbaric oxygen and basic<br />

fi broblast growth of irradiated bone. Int J Radiation Biol Phys 1997;40(1):189-96.<br />

3. Nishimura RD, Roumanas E, Beumer J, Moy PK, Shimizu KT. Restoration of irradiated patients<br />

using osseointegrated implants: current perspectives. J Prosthet Dent 1998;79:641-7.<br />

4. Abu-Serriah MM, McGowan DA, Moos KF, Bagg J. Extra-oral endosseous craniofacial<br />

implants and radiotherapy. Int J Oral Maxillofac Surg 2003;32:585-92.<br />

5. Aitasalo K. Bone tissue response to irradiation and treatment model of mandibular irradiation<br />

injury. Acta Otolaryngol 1986; Suppl 428:7-24.<br />

6. Moroz A, Crane MC, Smith G, Wimpenny DI. Phenomenological model of bone remodeling<br />

cycle containig ostocyte regulation loop. Biosystems 2005. Article in press.<br />

7. Baker D. The radiobiological basis for tissue reactions in the oral cavity following therapeutic<br />

x-irradiation. Arch Otolaringol 1992;108:21-4.<br />

8. Marx RE, Johnson RP. Studies in the radiobiology of osteoradionecrosis and their clinical<br />

signifi cance. Oral Surg Oral Med Oral Pathol 1987;64:379-90.<br />

9. Muhonen A, Haaparanta M, Grönroos T, Bergman J, Knuuti J, Hinkka S et al. Osteoblastic<br />

activity and neoangiogenesis in distracted bone of irradiated rabbit mandible with or without<br />

hyperbaric oxygen treatment. Int J Oral Maxillofac Surg 2004;33:173-8.<br />

10. Chen NT, Glowacki J, Bucky LP, Hong HZ, Kim WK, Yaremchuk MJ. The roles of<br />

revascularization and resorption on endurance of craniofacial onlay bone grafts in the<br />

rabbit. Plast Reconstr Surg 1994;93(4):714-22.<br />

11. Carmeliet P. Angiogenesis in life, disease and medicine. Nature. 2005 Dec 15;438(7070):932-6.<br />

12. Klagsbrun M, D’Amore PA. Vascular endothelial growth factor and its receptors. Cytokine<br />

Growth Factor Rev 1996;7(3):259-70.<br />

13. Okunieff P, Wang X, Rubin P, Finkelstein JN, Contine LS, Ding I. Radiation-induced changes<br />

in bone perfusion and angiogenesis. Int J Radiation Oncology Biol Phys 1998;42(4):885-9.<br />

14. Dudziak ME, Saadeh PB, Mehrara BJ, Steinbrech DS, Greenwald JA, Gittes GK et al. The<br />

effects of ionizing radiation on osteoblast-like cells in vitro. Plast Reconstr Surg 106(5):1049-<br />

61.<br />

15. Toi M, Matsumoto T, Bando H. Vascular endothelial grwth factor: its prognostic, predictive,<br />

and terapeutic implications. Lancet Oncol 2001;2:667-73.<br />

16. Brogniez V, Nyssen-Behets C, Grégoire V, Reychler H, Lengelé B. Implant osseointegration<br />

Revisão da Literatura<br />

Caderno Científi co<br />

Estudos comparando o momento da colocação do implante<br />

(antes ou depois da radioterapia) não demonstraram<br />

nenhuma diferença.<br />

Um melhor entendimento sobre as mudanças fenotípicas<br />

e celulares pela radioterapia ainda se faz necessário.<br />

Recebido em: mar/2010<br />

Aprovado em: abr/2010<br />

Endereço para correspondência:<br />

Ronaldo Antônio Leite<br />

Av. Dr. Ismael Alonso y Alonso, 1.560<br />

14403-000 - Franca - SP<br />

Tel.: (16) 3724-7777<br />

dr.ronaldoleite@gmail.com<br />

in the irradiated mandible. Clin Oral Impl Res 2002;13:234-42.<br />

17. Muhonen A, Muhonen J, Lindholm TC, Minn H, Klossner J, Kulmala J et al. Osteodistraction<br />

of a previously irradiated mandible with or without adjunctive hyperbaric oxygenation: an<br />

experimental study in rabbits. Int J Oral Maxillofac Surg 2002;31:519-24.<br />

18. Assael LA. New foundations in understanding osteonecrosis of the jaws. J Oral Maxillofac<br />

Surg 2004;62(2):125-6.<br />

19. Marx RE. A new concept in the treatment of osteoradionecrosis. J Oral Maxillfac Surg<br />

1983;41:351-7.<br />

20. Al-Nawas B, Duchener H, Grötz KA. Early celular alterations in bone after irradiation<br />

therapy and its relation to osteoradionecrosis [letter]. J Oral Maxillofac Surg 2004;64:1045-8.<br />

21. Ohrnell LO, Brånemark R, Nyman J, Nilsson P, Thomsen P. Effects of irradiation on the<br />

biomechanics of osseointegration. An experimental in vivo study in rats. Scand J Plast<br />

Reconstr Surg Hand Surg 1997;31:281-93.<br />

22. Johnsson AA, Sawaii T, Jacobsson M, Granstrom G, Turesson I. A histomorphometric and<br />

biomechanical study of the effect of delayed titanium implant placement in irradiated rabbit<br />

bone. Clin Implant Dent Relat Res 2000;2:42-9.<br />

23. Roumanas ED, Freymiller EG, Chang TL, Aghaloo T, Beumer J, third: Implant-retained<br />

prostheses for facial defects: an up to 14-year follow-up report on the survival rates of<br />

implants at UCLA Int J Prosthodont 2002;15:325-32<br />

24. Albrektsson T, Brånemark PI, Jacobsson M, Tjellstrom A. Present clinical applications of<br />

osseointegrated percutaneous implants. Plast Reconstr Surg 1987;79:721-31.<br />

25. Visch LL, van Waas MA, Schmitz PI, Levendag PC. A clinical evaluation of implants in<br />

irradiated oral cancer patients. J Dent Res 2002;81:856-9.<br />

26. Ryu JK, Stern RL, Robinson MG, Bowers MK, Kubo HD, Donald PJ et al. Mandibular<br />

reconstruction using a titanium plate: the impact of radiation therapy on plate preservation.<br />

Int J Radiat Oncol Biol Phys 1995;32:627-34.<br />

27. Cao Y, Weischer T. Comparison of maxillary implant-supported prosthesis in irradiated<br />

and nonirradiated patients. J Huazhong Univ Sci Technolog Med Sci 2003;23:209-12.<br />

28. Moy PK, Medina D, Shetty V, Aghaloo TL. Dental implant failure rates and associated risk<br />

factors. Int J Oral Maxillofac Implants 2005;20:569-77.<br />

29. Takahashi S, Sugimoto M, Kotoura Y, Saai K, Oka M, Yamamuro T. Long-term changes in<br />

the Haversian systems following high-dose irradiation. J Bone Joint Surg 1994;76:722-38.<br />

30. Teng MS, Futran ND. Osteoradionecrosis of the mandible. Curr Opin Otalaryngol Head<br />

Neck Surg 2005;13:217-21.<br />

REVISTA IMPLANTNEWS 2010;7(3):411-5<br />

415

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