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O papel dos herpesvírus na etiopatogenia da doença periodontal
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Introdução: A associação entre bactérias e a etiologia da doença periodontal é irrefutável, no entanto, tem sido amplamente sugerido na literatura a existência de um papel dos herpesvírus na etiopatogenia da mesma. Objetivo: Rever a literatura existente desde o ano 2000 de modo a depreender o papel dos herpesvírus na etiopatogenia da doença periodontal descrevendo os mecanismos específicos de tal correlação e apresentando os argumentos a favor e as limitações da hipótese. Materiais e Métodos: A pesquisa foi realizada entre Outubro de 2014 e Janeiro de 2015 nas bases de dados secundárias (Cochrane Database of Systematic Reviews e Evidence Based Dentistry) e primárias (LILACS e Medline- através do motor de busca Pubmed) com os seguintes limites: artigos em Inglês, Português ou Espanhol desde 01/01/2000 até 31/01/2015 aplicados somente em humanos. Foram utilizadas combinações dos termos “Herpes vírus”, “Doença Periodontal”, “herpes vírus”, “periodontal disease” e “periodontitis”. Os artigos considerados adequados com base nos seus títulos e abstracts foram sujeitos a uma leitura aprofundada do seu conteúdo; os artigos foram excluídos segundo os seguintes critérios: desadequação ao tema, referência ao vírus da imunodeficiência humana, referência a peri-implantite e metodologias pouco explícitas. A bibliografia dos artigos incluídos foi consultada e os autores dos artigos sem acesso foram contactados de modo a obter artigos considerados adequados. Um total de 64 artigos foi revisto. Evidência científica: O EBV,CMV e HSV são detetados com elevada frequência na placa subgengival, saliva e fluido crevicular. Estes vírus possuem mecanismos patogénicos que interferem com a resposta imunológica do hospedeiro diminuindo-a. Os herpesvírus parecem aumentar o número e a patogenicidade de bactérias periodontopatógenas. Conclusão: Não é possível estabelecer a existência de uma associação entre os herpesvírus e a etiopatogenia da doença periodontal. São necessários mais estudos, longitudinais e com protocolos homogéneos entre si.
Introduction: Although the association between bacteria and the etiology of periodontal disease is irrefutable, it has been suggested in the literature that herpesviruses play a role in the etiopathogenesis of periodontitis. Purpose: To review the existing literature after the year 2000 to perceive the role of herpesviruses in the etiopathogenesis of periodontal disease, describing the specific mechanisms of such correlation and the arguments forward as well the limitations of the hypothesis. Material and Methods: Searches were conducted between October 2014 and January 2015 in secondary databases (Cochrane Database of Systematic Reviews and Evidence Based Dentistry) and primary databases (LILACS e MEDLINE - through Pubmed) restricting the search to articles in English, Portuguese and Spanish from 01/01/2000 to 31/01/2015, only applied in humans. It was applied a combination of the keywords “Herpes vírus” “Doença Periodontal”, “herpes vírus”, “periodontal disease” and “periodontitis”. The encountered articles considered relevant through their titles and abstracts were subjected further reading; articles were excluded through specific criteria: no relevance to the subject matter, mention to the human immunodeficiency virus, mention to peri-implantitis and articles without clear methodologies. The bibliography of the included articles and the authors of the articles without free access were consulted in order to obtain relevant articles. A total of 64 articles were reviewed. Scientific evidence: EBV, HCMV and HSV are commonly detected with high rates in subgengival samples, saliva and crevicular fluid. These viruses have pathogenic mechanisms that intervene and diminish the immunologic response of the host. Herpesviruses seem to increase the number and pathogenicity of periodontopathic bacteria. Conclusion: It is not possible to affirm with certainty that there is an association between herpesviruses and the etiopathogenesis of periodontal disease. More longitudinal studies with homogeneous protocols are needed.
Introduction: Although the association between bacteria and the etiology of periodontal disease is irrefutable, it has been suggested in the literature that herpesviruses play a role in the etiopathogenesis of periodontitis. Purpose: To review the existing literature after the year 2000 to perceive the role of herpesviruses in the etiopathogenesis of periodontal disease, describing the specific mechanisms of such correlation and the arguments forward as well the limitations of the hypothesis. Material and Methods: Searches were conducted between October 2014 and January 2015 in secondary databases (Cochrane Database of Systematic Reviews and Evidence Based Dentistry) and primary databases (LILACS e MEDLINE - through Pubmed) restricting the search to articles in English, Portuguese and Spanish from 01/01/2000 to 31/01/2015, only applied in humans. It was applied a combination of the keywords “Herpes vírus” “Doença Periodontal”, “herpes vírus”, “periodontal disease” and “periodontitis”. The encountered articles considered relevant through their titles and abstracts were subjected further reading; articles were excluded through specific criteria: no relevance to the subject matter, mention to the human immunodeficiency virus, mention to peri-implantitis and articles without clear methodologies. The bibliography of the included articles and the authors of the articles without free access were consulted in order to obtain relevant articles. A total of 64 articles were reviewed. Scientific evidence: EBV, HCMV and HSV are commonly detected with high rates in subgengival samples, saliva and crevicular fluid. These viruses have pathogenic mechanisms that intervene and diminish the immunologic response of the host. Herpesviruses seem to increase the number and pathogenicity of periodontopathic bacteria. Conclusion: It is not possible to affirm with certainty that there is an association between herpesviruses and the etiopathogenesis of periodontal disease. More longitudinal studies with homogeneous protocols are needed.
Descrição
Tese de mestrado, Medicina Dentária, Universidade de Lisboa, Faculdade de Medicina Dentária, 2015
Palavras-chave
Doença periodontal Herpes Teses de mestrado - 2015