Ácido hialurônico e reabsorção óssea: uma revisão de literatura

Abstract

Facial aging involves loss of bone volume and tissue sagging, affecting aesthetics and self-esteem. Hyaluronic acid (HA) is one of the main fillers of orofacial harmonization, effective in restoring volumes and contours. Despite its safe use, recent studies report bone resorption in treated areas, especially in the chin and middle face, generating questions about long-term effects. This study investigated the association between AH and bone resorption through an integrative literature review. The search, guided by the acronym PECO (P-adults submitted to facial filling, E-application of AH, C-individuals without exposure, O-bone resorption), was carried out in the PubMed and SciELO databases, in addition to manual references. Of the 168 articles identified, 5 were selected. Clinical cases, case series and prospective and retrospective studies showed an association between AH and reabsorption, especially in areas of fine cortical such as ment, suborbital and paranasal region. The suggested mechanisms include mechanical compression, osteoclastic stimulus and anatomical susceptibility. Although the aesthetic result remains, imaging tests revealed relevant bone losses, reinforcing the need for radiographic follow-up in patients with multiple applications or large volumes. It is concluded that there is a probable association between HA and reabsorption, although limited evidence by small samples and heterogeneous methodologies indicate the need for new longitudinal and controlled studies for safer clinical protocols.