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A relação entre a doença periodontal e a diabetes mellitus
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Introdução: A associação entre a doença periodontal e a Diabetes mellitus, observa-se uma relação bi-direccional, cujos todos os mecanismos ainda não estão totalmente definidos. Porém, sabe-se que a diabetes atua como agente modificador da resposta inflamatória, causando, uma maior destruição dos tecidos periodontais e um aumento da severidade da doença periodontal. No que diz respeito à doença periodontal, esta pode alterar a resposta à insulina e consequentemente agravar a condição sistémica pré-existente. O seu tratamento pode promover a melhoria do controlo glicémico nos indivíduos diabéticos, contudo em relação a este ainda existe alguma controvérsia. Materiais e métodos: A pesquisa foi realizada nas bases de dados Medline e B-On, no período compreendido entre Outubro de 2012 e Maio de 2013, utilizando como palavras chave: “periodontal diseases”, “diabetes mellitus”, “ periodontal disease + systemic conditions”, periodontal diseases + diabetes” e “relationship between periodontal disease+ diabetes”. Foram definidos como limites à pesquisa de artigos com resumo disponível, restringindo a pesquisa a artigos escritos em português, inglês e castelhano. Objetivo: O objetivo deste trabalho é rever detalhadamente a literatura relativa à relação entre a doença periodontal e a Diabetes mellitus, descrevendo os mecanismos através dos quais estas duas patologias se influenciam. Desenvolvimento: A diabetes mellitus tem a capacidade não só de aumentar a susceptibilidade como também a severidade da doença periodontal por intermédio de um mecanismo central que resulta da superexpressão dos AGEs. Em relação ao impacto da doença periodontal ainda existe controvérsia face à melhoria do controlo glicémico após realização do tratamento. Conclusão: Existe uma forte evidência sobre a existência de uma relação bidirecional entre estas patologias, em que a diabetes e a doença periodontal estão diretamente associadas e que o tratamento periodontal pode proporcionar efeitos benéficos em indivíduos diabéticos. São necessários mais estudos, sobretudo estudos prospectivos de forma a reforçar esta relação.
Introdution: The association between periodontal disease and diabetes mellitus, has been widely investigated. There is a bi-directional relationship, which all the mechanisms are not yet fully clarified. However, it is known that diabetes acts as a modifying agent, thus causing a greater periodontal tissue destruction and increased severity of periodontal disease. About periodontal disease, it can alter the response to insulin and thus exacerbate pre-existing systemic condition. The periodontal treatment may promote the improvement of glycemic control in diabetic patients, however there is still some controversy. Material and Methods: The survey was conducted in Medline and B-On in the period between October 2012 and May 2013, using as keywords: "periodontal diseases", "diabetes", "periodontal disease + systemic conditions", periodontal diseases + diabetes "and" relationship between periodontal disease + diabetes ". Were defined as limits to the survey of articles with abstracts available, restricting the search to articles written in Portuguese, English and Spanish. Objective: The aim of this paper is to review in detail the literature concerning the relationship between periodontal disease and diabetes mellitus, describing the mechanisms by which these two pathologies are influenced. Results: Diabetes mellitus has the ability to increase the susceptibility as well as the severity of periodontal disease through a central mechanism which results from the overexpression of AGEs. Regarding the impact of periodontal disease there is still controversy in the face of improved glycemic control after completion of treatment. Conclusion: A strong evidence exists about a two-way relationship between these pathologies, in that diabetes and periodontal disease are directly associated and that periodontal treatment can provide beneficial effects in diabetic subjects. More studies, especially prospective studies, are needed in order to strengthen this relationship.
Introdution: The association between periodontal disease and diabetes mellitus, has been widely investigated. There is a bi-directional relationship, which all the mechanisms are not yet fully clarified. However, it is known that diabetes acts as a modifying agent, thus causing a greater periodontal tissue destruction and increased severity of periodontal disease. About periodontal disease, it can alter the response to insulin and thus exacerbate pre-existing systemic condition. The periodontal treatment may promote the improvement of glycemic control in diabetic patients, however there is still some controversy. Material and Methods: The survey was conducted in Medline and B-On in the period between October 2012 and May 2013, using as keywords: "periodontal diseases", "diabetes", "periodontal disease + systemic conditions", periodontal diseases + diabetes "and" relationship between periodontal disease + diabetes ". Were defined as limits to the survey of articles with abstracts available, restricting the search to articles written in Portuguese, English and Spanish. Objective: The aim of this paper is to review in detail the literature concerning the relationship between periodontal disease and diabetes mellitus, describing the mechanisms by which these two pathologies are influenced. Results: Diabetes mellitus has the ability to increase the susceptibility as well as the severity of periodontal disease through a central mechanism which results from the overexpression of AGEs. Regarding the impact of periodontal disease there is still controversy in the face of improved glycemic control after completion of treatment. Conclusion: A strong evidence exists about a two-way relationship between these pathologies, in that diabetes and periodontal disease are directly associated and that periodontal treatment can provide beneficial effects in diabetic subjects. More studies, especially prospective studies, are needed in order to strengthen this relationship.
Descrição
Tese de mestrado, Medicina Dentária, Universidade de Lisboa, Faculdade de Medicina Dentária, 2013
Palavras-chave
Periodontologia Teses de mestrado - 2013