Os bisfosfonatos são medicamentos amplamente e efetivamente utilizados para o tratamento de doenças osteolíticas. Entretanto, na cavidade oral, é de particular relevância, pois possuem como efeito adverso a osteonecrose dos maxilares induzida pelo uso de bisfosfonatos. Sua etiopatogenia ainda não é bem estabelecida, os métodos de detecção são insatisfatórios e as terapias recomendadas são por vezes, medidas paliativas e ineficazes. Pouco ainda é sabido sobre o efeito do Ácido Zoledrônico na microestrutura óssea, portanto, propusemo-nos a realizar um estudo em modelo animal que analisasse o trabeculado ósseo da mandíbula através da Micro-CT. Foram utilizados 24 ratos machos (Rattus novergicus, albinus, Wistar), com 12 semanas de vida, divididos em 2 grupos: grupo controle (cloreto de sódio 0,9%) e grupo ácido zoledrônico (ácido zoledrônico 0,6mg/kg). As substâncias foram administradas via intraperitoneal a cada 28 dias em um total de 5 doses. Após 150 dias do início do experimento, foi realizada a eutanásia dos animais e então as amostras foram preparadas e escaneadas (Skyscan 1174) para análise da microestrutura óssea através da Micro- CT. O teste t-student demonstrou diferença estatisticamente significativa (p<0,05) em todos os fatores: volume ósseo, densidade óssea, fator de padrão trabecular, índice de modelo estrutural, espessura trabecular, separação trabecular, porosidade total exceção de número de trabéculas e volume tecidual, demonstrando que há alterações significativas na estrutura trabecular pelo uso de bisfosfonatos. O grupo medicado com ácido zoledrônico comparado ao grupo controle demonstrou trabéculas mais espessas, menos separadas e com menores ligações. / Bisphosphonates are widely and effectively drugs used for the treatment of osteolytic disorders. However, in the oral cavity, this situation is of particular relevance as it can lead to bisphosphonate related osteonecrosis of the jaws. Its etiopathogenesis is still not established, detection methods are unsatisfactory and recommended therapies are sometimes palliative and often ineffective. Little is known about the effect of zoledronic acid on the quality of trabecular bone, therefore, we proposed to conduct a study in an animal model to examine the trabecular bone of the jaw through the Micro-CT. 24 male rats were used (Rattus norvegicus, Albinus, Wistar), with 12 weeks old, divided into 2 groups: control group (sodium chloride 0.9%) and group with zoledronic acid (zoledronic acid 0.6 mg / kg). The substances were administered intraperitoneally every 28 days for a total of 5 doses. After 150 days from the beginning of the experiment, the animals were sacrificed and then the samples were prepared and scanned (Skyscan 1174) for analysis of the bone microstructure through Micro-CT. The \"t-student\" test demonstrated statistically significant differences (p<0.05) in all factors: bone volume, osseous density, trabecular pattern, structure model index, trabecular thickness, trabecular separation, total porosity except trabecular number and tissue volume, demonstrating that there are significant changes in the trabecular structure of the bisphosphonates. Zoledronic Acid compared to control group shows thicker, less separate and lower connected trabeculae.

Dans le cadre d'une étude transversale menée sur 202 patientes ménopausées et non ménopausées,les objectifs sont de démontrer l'existence d'un lien entre ménopause et altération de l'état de santé buccodentaire. D'évaluer l'action du THM sur la morbidité dentaire et «in fine» sur la mortalité dentaire.De préciser les liens entre santé bucco-dentaire et diverses pathologies générales et d'apprécier les liens entre psychisme et soma chez les femmes ménopausées. D'apprécier l'influence des biphosphonates sur l'état de santé parodontal.De placer l'étude des liens état bucco-dentaire- ménopause dans une optique sociétale et anthropologique.La ménopause a pour conséquence une altération du parodonte (p=0,003).Le THM a une action bénéfique sur le parodonte.L'effet biologique du diabète est drastique quant à la perte des organes dentaires (p=0,050).L'étude souligne l'influence «per se» d'un mauvais état bucco-dentaire pour la pathologie coronarienne (OR=1,214). De plus,évènements stressants,sècheresse buccale,pathologies ostéo articulaires,carence hormonale sont des facteurs diversement liés de la mortalité dentaire durant cette période. Par ailleurs, il est apparu que les femmes ayant été récemment traitées pour un cancer du sein développaient plus de caries dentaires (p=0,031 OR=2,161). L'étude met en évidence les effets des biphosphonates sur l'altération du parodonte (p=0,011) malgré la prise d'un THM (p=0,020).Un milieu socioculturel aisé contribueraient à la médicalisation du phénomène physiologique.Le fait de vivre seule influerait sur la perte des organes dentaires (p=0,035). Enfin,la pratique régulière d'un sport améliorerait l'état de santé orale (p=0,036). / In a cross-sectional study of 202 postmenopausal and premenopausal women,the objectives of this study are to demonstrate a link between menopause and altered state of oral health.To evaluate the action of HRT on dental disease and finally on the tooth mortality. To assess and clarify the relationship between oral health and various general diseases and links between psyche and soma in postmenopausal women.Also discussed was the influence of bisphosphonates on the state of periodontal health.Finally,it was decided to place the study links oral menopausal status in a social and anthropological perspective.It appears then that menopause results in an altered state of oral health,(p = 0.003).HRT has a beneficial effect on the periodontal disease.The biological effects of diabetes are related to dental mortality (p = 0.050). This study emphasize the influence "per se" a bad oral health status for coronary artery disease (OR = 1.214).In postmenopausal women, stressful events, dry mouth, joint and bone diseases, hormonal deficiency are factors variously related dental mortality during this period. Moreover, it was found that women who have recently been treated for breast cancer developed more dental caries (p = 0.031 OR = 2.161).The study related the effects of bisphosphonates on the alteration of periodontal (p = 0.011), despite taking HRT (p = 0.020).In addition,background socio-economic favored contribute to the medicalization of physiological phenomenon. The fact of living alone would affect the loss of dental organs (p = 0.035). Finally, the regular practice of a sport improve the state of oral health (p = 0.036).