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Lesões periodontais associadas à infeção pelo vírus da imunodeficiência humana
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As doenças periodontais e a infeção pelo vírus da imunodeficiência humana representam dois importantes problemas de saúde mundial. A sua relação tem sido especulada há décadas, contudo, uma eventual relação permanece controversa entre os diversos estudos epidemiológicos realizados até à data. A doença periodontal é uma doença infecciosa multifatorial que resulta de uma resposta inflamatória induzida por microrganismos e envolve a participação do sistema imunitário do hospedeiro. A infeção pelo vírus da imunodeficiência humana é um processo crónico e progressivo que conduz à imunossupressão severa do hospedeiro. Associadas à infeção, existem diversas lesões orais, nomeadamente a candidíase oral, a leucoplasia pilosa oral e as lesões periodontais. Tem sido referido um papel possível da infeção pelo vírus na iniciação e progressão das lesões periodontais. As lesões que parecem estar mais frequentemente associadas incluem o eritema gengival linear, as lesões periodontais necrosantes e a periodontite crónica de progressão acelerada. No entanto, estas parecem ser as mesmas lesões que ocorrem na população não infetada. Os estudos realizados em relação ao tema apresentam diversas limitações, nomeadamente quanto à sua metodologia e amostras analisadas. Estudos mais recentes mostram uma relação menos evidente em comparação com os estudos anteriores. São necessários estudos longitudinais que permitam esclarecer esta aparente relação, bem como os cuidados que o médico dentista deve adotar aquando do tratamento periodontal de um paciente infetado pelo vírus.
Periodontal diseases and infection by human immunodeficiency virus represent two important worldwide health problems. Their relationship has been speculated for decades, however, a possible relationship remains controversial among the many epidemiological studies conducted to date. Periodontal disease is a multifactorial infectious disease resulting from an inflammatory response induced by microrganisms and involves the participation of the host immune system. The infection by the human immunodeficiency virus is a chronic and progressive process that leads to the host severe immunosuppression. Associated with infection, there are several oral lesions, including oral candidiasis, oral hairy leukoplakia and periodontal lesions. Has been referred a possible role of virus infection in the initiation and progression of periodontal lesions. Lesions that appear to be most frequently associated include linear gingival erythema, necrotizing periodontal lesions and accelerated progression of chronic periodontitis. However, these seem to be the same lesions that occurr in non-infected population. The studies on the subject have several limitations, particularly regarding its methodology and samples. More recent studies show a less evident relationship in comparison with previous studies. Longitudinal studies are needed to clarify this apparent relationship, as well as the care that dentist should adopt when periodontal treatment of a patient infected with the virus.
Periodontal diseases and infection by human immunodeficiency virus represent two important worldwide health problems. Their relationship has been speculated for decades, however, a possible relationship remains controversial among the many epidemiological studies conducted to date. Periodontal disease is a multifactorial infectious disease resulting from an inflammatory response induced by microrganisms and involves the participation of the host immune system. The infection by the human immunodeficiency virus is a chronic and progressive process that leads to the host severe immunosuppression. Associated with infection, there are several oral lesions, including oral candidiasis, oral hairy leukoplakia and periodontal lesions. Has been referred a possible role of virus infection in the initiation and progression of periodontal lesions. Lesions that appear to be most frequently associated include linear gingival erythema, necrotizing periodontal lesions and accelerated progression of chronic periodontitis. However, these seem to be the same lesions that occurr in non-infected population. The studies on the subject have several limitations, particularly regarding its methodology and samples. More recent studies show a less evident relationship in comparison with previous studies. Longitudinal studies are needed to clarify this apparent relationship, as well as the care that dentist should adopt when periodontal treatment of a patient infected with the virus.
Descrição
Tese de mestrado, Medicina Dentária, Universidade de Lisboa, Faculdade de Medicina Dentária, 2013
Palavras-chave
Periodontia Teses de mestrado - 2013