A Doença periodontal associada a artrite reumatoide, diabetes e doenças cardiovasculares: Revisão de literatura
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A Organização Mundial da Saúde estima que doenças periodontais graves afetam cerca de 14% da população adulta global, representando mais de um bilhão de casos no mundo. A doença periodontal (DP) é desencadeada pela resposta imune do hospedeiro contra microrganismos patogênicos do biofilme dental e é caracterizada pela destruição do tecido gengival, osso alveolar e tecidos conjuntivos que sustentam o dente. O biofilme, composto por bactérias, estimula o processo de inflamação local gerado pelo aumento de citocinas, células inflamatórias como macrófagos, células B e T. O equilíbrio entre a virulência do biofilme local e a resposta imune do hospedeiro influenciam na progressão e gravidade da doença periodontal. Diversos fatores e condições sistêmicas podem interferir e modular a resposta do hospedeiro, e a relação entre doença periodontal e doença sistêmica é bidirecional, ou seja, a doença periodontal pode levar a resultados sistêmicos adversos, e certas doenças sistêmicas predispõem os indivíduos à doença periodontal. Existem diversas espécies de patógenos abundantes na cavidade oral, principalmente bactérias anaeróbicas Gram-negativas, que produzem endotoxinas que contribuem diretamente com doenças sistêmicas. Estudos recentes demonstraram possíveis mecanismos pelos quais a periodontite pode aumentar a suscetibilidade a doenças sistêmicas. Esta revisão de literatura buscou apresentar a possível relação da doença periodontal com artrite reumatoide, diabetes mellitus e doenças cardiovasculares por meio de levantamento bibliográfico realizado nas bases de dados: PubMed, PERIÓDICOS CAPES, MEDLINE, LILACS e Biblioteca Virtual em Saúde. Diante dessa pesquisa, pode-se concluir que a doença periodontal e a saúde sistêmica têm uma associação bidirecional.
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