{"id":855,"date":"2020-08-20T19:36:54","date_gmt":"2020-08-20T19:36:54","guid":{"rendered":"https:\/\/radiologiajardim.com.br\/?p=855"},"modified":"2022-02-22T09:52:42","modified_gmt":"2022-02-22T12:52:42","slug":"dose-de-sabedoria-9","status":"publish","type":"post","link":"http:\/\/blog.radiologiajardim.com.br\/index.php\/2020\/08\/20\/dose-de-sabedoria-9\/","title":{"rendered":"Dose de Sabedoria #9"},"content":{"rendered":"\t\t<div data-elementor-type=\"wp-post\" data-elementor-id=\"855\" class=\"elementor elementor-855\" data-elementor-settings=\"[]\">\n\t\t\t\t\t\t\t<div class=\"elementor-section-wrap\">\n\t\t\t\t\t\t\t<section class=\"elementor-section elementor-top-section elementor-element elementor-element-88790bd elementor-section-boxed elementor-section-height-default elementor-section-height-default\" data-id=\"88790bd\" data-element_type=\"section\">\n\t\t\t\t\t\t<div class=\"elementor-container elementor-column-gap-default\">\n\t\t\t\t\t<div class=\"elementor-column 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Emphasis\"><\/w:LsdException><br \/>  <w:LsdException Locked=\"false\" Priority=\"21\" SemiHidden=\"false\" UnhideWhenUsed=\"false\" QFormat=\"true\" Name=\"Intense Emphasis\"><\/w:LsdException><br \/>  <w:LsdException Locked=\"false\" Priority=\"31\" SemiHidden=\"false\" UnhideWhenUsed=\"false\" QFormat=\"true\" Name=\"Subtle Reference\"><\/w:LsdException><br \/>  <w:LsdException Locked=\"false\" Priority=\"32\" SemiHidden=\"false\" UnhideWhenUsed=\"false\" QFormat=\"true\" Name=\"Intense Reference\"><\/w:LsdException><br \/>  <w:LsdException Locked=\"false\" Priority=\"33\" SemiHidden=\"false\" UnhideWhenUsed=\"false\" QFormat=\"true\" Name=\"Book Title\"><\/w:LsdException><br \/>  <w:LsdException Locked=\"false\" Priority=\"37\" Name=\"Bibliography\"><\/w:LsdException><br \/>  <w:LsdException Locked=\"false\" Priority=\"39\" QFormat=\"true\" Name=\"TOC Heading\"><\/w:LsdException><br \/> <\/w:LatentStyles><br \/><\/xml><![endif]--><!-- [if gte mso 10]><\/p>\n<style>\n \/* Style Definitions *\/<br \/> table.MsoNormalTable<br \/>\t{mso-style-name:\"Tabela normal\";<br \/>\tmso-tstyle-rowband-size:0;<br \/>\tmso-tstyle-colband-size:0;<br \/>\tmso-style-noshow:yes;<br \/>\tmso-style-priority:99;<br \/>\tmso-style-parent:\"\";<br \/>\tmso-padding-alt:0cm 5.4pt 0cm 5.4pt;<br \/>\tmso-para-margin-top:0cm;<br \/>\tmso-para-margin-right:0cm;<br \/>\tmso-para-margin-bottom:8.0pt;<br \/>\tmso-para-margin-left:0cm;<br \/>\tline-height:107%;<br \/>\tmso-pagination:widow-orphan;<br \/>\tfont-size:11.0pt;<br \/>\tfont-family:\"Calibri\",\"sans-serif\";<br \/>\tmso-ascii-font-family:Calibri;<br \/>\tmso-ascii-theme-font:minor-latin;<br \/>\tmso-hansi-font-family:Calibri;<br \/>\tmso-hansi-theme-font:minor-latin;<br \/>\tmso-bidi-font-family:\"Times New Roman\";<br \/>\tmso-bidi-theme-font:minor-bidi;<br \/>\tmso-fareast-language:EN-US;}<br \/><\/style>\n<p><![endif]--><\/p><h1 align=\"center\">Osteonecrose: o poder da Anamnese<\/h1><p>\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 A elabora\u00e7\u00e3o da anamnese deve ser a primeira conduta a ser adotada em um atendimento odontol\u00f3gico, pois \u00e9 atrav\u00e9s dela que conheceremos o paciente que ser\u00e1 ou n\u00e3o submetido ao tratamento. Sua realiza\u00e7\u00e3o \u00e9 inegoci\u00e1vel, n\u00e3o se tratando de mera liberalidade ou faculdade do Cirurgi\u00e3o-Dentista.<\/p><p>\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 Durante o tratamento, conv\u00e9m que o Cirurgi\u00e3o-Dentista converse com o paciente para saber se houve alguma altera\u00e7\u00e3o cl\u00ednica, uso de medicamentos ou outros fatores que possam modificar as informa\u00e7\u00f5es apresentadas na anamnese inicial. Esse documento deve ser assinado pelo paciente ou por seu respons\u00e1vel legal, o que contribuir\u00e1 para e, minimizar os poss\u00edveis efeitos coletareis ap\u00f3s uma conduta cl\u00ednica.<\/p><p>\u00a0\u00a0 \u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0\u00a0 O caso a ser descrito \u00e9 de paciente encaminhada a cl\u00ednica para avaliar a extens\u00e3o de um poss\u00edvel caso de osteocrenose associada ao uso de medica\u00e7\u00e3o anti reabsortivo. Nos cortes obl\u00edquos (imagem 1) e imagens axiais (imagem 2)(1:1) verificou uma imagem hipodensa, localizada na regi\u00e3o de corpo da mand\u00edbula, subjacente aos molares do lado direito, sem limites definidos, reabsor\u00e7\u00e3o do rebordo alveolar, t\u00e1buas \u00f3sseas vestibular e lingual. H\u00e1 envolvimento do canal mandibular e \u00e1reas de fenestra\u00e7\u00e3o da base da mand\u00edbula. A ressalva neste caso \u00e9 que havia na hist\u00f3ria m\u00e9dica o relato de uso de bisfosfonato. Com aux\u00edlio da reconstru\u00e7\u00e3o 3D no realistic (imagem 3) ilustra-se a destrui\u00e7\u00e3o \u00f3ssea no arqu\u00e9tipo mandibular.<\/p><p><b>Imagem 1 \u2013 Cortes obl\u00edquos 1:1<\/b><\/p><p><b><img loading=\"lazy\" class=\"size-full wp-image-858\" src=\"https:\/\/radiologiajardim.com.br\/wp-content\/uploads\/2020\/08\/a.png\" alt=\"Imagem 1 \u2013 Cortes obl\u00edquos 1:1\" width=\"543\" height=\"459\" \/> I<\/b><\/p><p><b>Imagem 2 \u2013 Imagens axiais 1:1<\/b><\/p><p><b><img loading=\"lazy\" class=\"size-full wp-image-859\" src=\"https:\/\/radiologiajardim.com.br\/wp-content\/uploads\/2020\/08\/02.png\" alt=\"Imagens axiais 1:1\" width=\"537\" height=\"348\" \/><\/b><\/p><p><b>Imagem 3\u00a0 &#8211; Reconstru\u00e7\u00e3o 3D<\/b><\/p><p><img loading=\"lazy\" class=\"alignnone size-full wp-image-868\" src=\"https:\/\/radiologiajardim.com.br\/wp-content\/uploads\/2020\/08\/img-real-1.jpg\" alt=\"\" width=\"937\" height=\"220\" \/> <img loading=\"lazy\" class=\"alignnone size-full wp-image-869\" src=\"https:\/\/radiologiajardim.com.br\/wp-content\/uploads\/2020\/08\/img-real-0.jpg\" alt=\"\" width=\"778\" height=\"349\" \/><\/p><p>\u00a0<\/p><p>Portanto, saber identificar por meio de uma boa anamnese o uso dos medica\u00e7\u00e3o anti reabsortiva (imagem 4) \u00e9 de extrema import\u00e2ncia para evitar quadros de osteonecrose que s\u00e3o considerados efeito colateral quando h\u00e1 manipula\u00e7\u00e3o \u00f3ssea. Esses quadros apresentam dif\u00edcil tratamento e redu\u00e7\u00e3o da qualidade de vida do paciente, apresentando na maioria das vezes dor.<\/p><p><img loading=\"lazy\" class=\"alignnone wp-image-861\" src=\"https:\/\/radiologiajardim.com.br\/wp-content\/uploads\/2020\/08\/4.jpg\" alt=\"Tabela de medica\u00e7\u00f5es anti reabsortivas\" width=\"517\" height=\"411\" \/><\/p><p><b>Imagem 4 \u2013 Tabela de medica\u00e7\u00f5es anti reabsortivas<\/b><\/p><div style=\"box-sizing: border-box; color: #7a7a7a; font-family: Roboto, sans-serif; font-size: 14px; font-style: normal; font-variant-ligatures: normal; font-variant-caps: normal; font-weight: 400; letter-spacing: normal; orphans: 2; text-align: start; text-indent: 0px; text-transform: none; white-space: normal; widows: 2; word-spacing: 0px; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial; background-color: #ffffff;\"><b style=\"box-sizing: border-box; font-weight: bold;\"><i style=\"box-sizing: border-box;\">Dose de Sabedoria por: Dra Ana Luiza Riul, Dr. Luis Fernando Jardim e Dra. Patr\u00edcia Jardim<\/i><\/b><\/div><p><b style=\"box-sizing: border-box; font-weight: bold;\"><i style=\"box-sizing: border-box;\">Siga-nos nas <a style=\"box-sizing: border-box; background-color: transparent; color: #008a8a; text-decoration: none; text-align: center; text-transform: uppercase; box-shadow: none;\" href=\"https:\/\/radiologiajardim.com.br\/dose-de-sabedoria-2\/_wp_link_placeholder\">REDES SOCIAIS<\/a><\/i><\/b><\/p>\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t","protected":false},"excerpt":{"rendered":"<p>Osteonecrose: o poder da Anamnese A elabora\u00e7\u00e3o da anamnese deve ser a primeira conduta a ser adotada em um atendimento odontol\u00f3gico, pois \u00e9 atrav\u00e9s dela que conheceremos o paciente que ser\u00e1 ou n\u00e3o submetido ao tratamento. Sua realiza\u00e7\u00e3o \u00e9 inegoci\u00e1vel, n\u00e3o se tratando de mera liberalidade ou faculdade do Cirurgi\u00e3o-Dentista. Durante o tratamento, conv\u00e9m que &hellip;<\/p>\n<p class=\"read-more\"> <a class=\"\" href=\"http:\/\/blog.radiologiajardim.com.br\/index.php\/2020\/08\/20\/dose-de-sabedoria-9\/\"> <span class=\"screen-reader-text\">Dose de Sabedoria #9<\/span> Read More &raquo;<\/a><\/p>\n","protected":false},"author":1,"featured_media":856,"comment_status":"open","ping_status":"open","sticky":true,"template":"","format":"standard","meta":{"site-sidebar-layout":"default","site-content-layout":"default","ast-main-header-display":"","ast-hfb-above-header-display":"","ast-hfb-below-header-display":"","ast-hfb-mobile-header-display":"","site-post-title":"","ast-breadcrumbs-content":"","ast-featured-img":"","footer-sml-layout":"","theme-transparent-header-meta":"","adv-header-id-meta":"","stick-header-meta":"","header-above-stick-meta":"","header-main-stick-meta":"","header-below-stick-meta":""},"categories":[2],"tags":[],"_links":{"self":[{"href":"http:\/\/blog.radiologiajardim.com.br\/index.php\/wp-json\/wp\/v2\/posts\/855"}],"collection":[{"href":"http:\/\/blog.radiologiajardim.com.br\/index.php\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"http:\/\/blog.radiologiajardim.com.br\/index.php\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"http:\/\/blog.radiologiajardim.com.br\/index.php\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"http:\/\/blog.radiologiajardim.com.br\/index.php\/wp-json\/wp\/v2\/comments?post=855"}],"version-history":[{"count":3,"href":"http:\/\/blog.radiologiajardim.com.br\/index.php\/wp-json\/wp\/v2\/posts\/855\/revisions"}],"predecessor-version":[{"id":2444,"href":"http:\/\/blog.radiologiajardim.com.br\/index.php\/wp-json\/wp\/v2\/posts\/855\/revisions\/2444"}],"wp:featuredmedia":[{"embeddable":true,"href":"http:\/\/blog.radiologiajardim.com.br\/index.php\/wp-json\/"}],"wp:attachment":[{"href":"http:\/\/blog.radiologiajardim.com.br\/index.php\/wp-json\/wp\/v2\/media?parent=855"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"http:\/\/blog.radiologiajardim.com.br\/index.php\/wp-json\/wp\/v2\/categories?post=855"},{"taxonomy":"post_tag","embeddable":true,"href":"http:\/\/blog.radiologiajardim.com.br\/index.php\/wp-json\/wp\/v2\/tags?post=855"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}