Información del artículo
Resumo
Evidências recentes sugerem que a periodontite é um potencial factor de risco para as doenças induzidas por aterosclerose, nomeadamente o acidente vascular cerebral (AVC). Assim sendo, este trabalho tem como objectivo determinar a existência de uma associação entre a periodontite, a segunda maior patologia dentária e o AVC, a primeira causa de morte em Portugal.
Os possíveis mecanismos fisiopatológicos que estão na base desta possível associação são a acção directa dos microorganismos, a predisposição genética, o mimetismo molecular e a hiperlipidémia.
Contudo, mais estudos são necessários de forma a identificar a verdadeira natureza desta possível associação.
Palavras-chave:
Periodontite
Acidente Vascular Cerebral
Aterosclerose
Mecanismos fisiopatológicos
Infecção
Bactérias periodontais
Abstract
Recent evidence suggests that periodontitis is a potential risk factor for atherosclerosis induced diseases, namely stroke. This way, the study's objective is to determine the existence of association between periodontitis, the second most dental's pathology and stroke, Portugal's primary cause of death.
The possible pathophysiological mechanisms under this association are the direct role of microorganisms, the genetic predisposition, the molecular mimicry and the hyperlipidaemia. However, more studies are needed to identify the true nature of this association.
Keywords:
Periodontitis
Stroke
Atherosclerosis
Pathophysiological mechanisms
Infection
Periodontal pathogens
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Bibliografia
[1.]
L. Humphrey, R. Fu, D. Buckley, M. Freeman, M. Helfand.
Periodontal disease and coronary heart disease incidence: a systemic review and meta-analysis.
J Gen Intern Med, 23 (2008), pp. 2079-2086
[2.]
R. Genco, et al.
Risk factors for periodontal disease.
Periodontal medicine, pp. 11-34
[3.]
J. Lindhe, T. Karring.
Anatomia do periodonto.
Tratado de periodontia clínica e implantologia oral, 3.ª ed.,
[4.]
S. Socransky, A. Haffajee.
Microbiologia da doença periodontal.
Tratado de periodontia clínica e implantologia oral, 3. ª ed., pp. 92-126
[5.]
D. Kinane, J. Lindhe.
Patogénese da periodontite.
Tratado de periodontia clínica e implantologia oral, 3. ª edição, pp. 127-152
[6.]
P. Libby, et al.
The Pathogenesis, Prevention, and Treatment of Atherosclerosis.
Harrison's Principles of Internal Medicine, 17th ed., pp. 1501-1509
[7.]
P. Marques da Silva.
Compreender a aterosclerose para prevenir.
Revista Clube Rei Coração, 7 (2008), pp. 1-20
[8.]
R. Cotran, V. Kumar, T. Collins, S. Robbins.
Atherosclerosis and other forms of atherosclerosis.
Em: Robbins Pathologic Basis of Disease, 5.ª ed., Saunders, (1994),
[9.]
J. Madureira.
Diagnóstico imagiológico da aterosclerose.
Revista Factores de Risco, 9 (2008), pp. 24-29
[10.]
A. Mello e Silva.
Aterosclerose. Doença sistémica com manifestações focais. Território e manifestações clínicas.
Revista Factores de Risco, 6 (2007), pp. 40-45
[11.]
J. Carvalho de Sousa.
A inflamação no processo aterosclerótico.
Revista Factores de Risco, 9 (2008), pp. 56-61
[12.]
M. Correia, M. Silva, I. Matos, R. Magalhães, J. Lopes, J. Ferro, C. Silva.
Prospective community-based study of stroke in northern Portugal. Incidence and case fatality in rural and urban populations.
Stroke, 35 (2004), pp. 2048-2053
[13.]
R. Cotran, V. Kumar, T. Collins, S. Robbins.
Cerebrovascular diseases.
Robbins Pathologic Basis of Disease, 5.ª ed., Saunders, (1994),
[14.]
J. Ferro.
Acidentes Vasculares Cerebrais.
Neurologia Princípios. Diagnóstico e Tratamento, Lidel, (2006),
[15.]
F. Scannapieco, R. Bush, S. Paju.
Associations between periodontal disease and risk for atherosclerosis, cardiovascular disease and stroke – A systematic review.
Ann Periodontol, 8 (2003), pp. 38-53
[16.]
J. Easton, J. Saver, G. Albers, M. Albers, S. Chaturvedi, E. Feldmann, T. Hatsukami, R. Higashida, C. Johnston, C. Kidwell, H. Lutsep, E. Miller, R. Sacco.
Definition and evaluation of transient ischemic attack: a scientific statement for healthcare professionals from the American Heart Association. American Stroke Association Councial; Council on cardiovascular surgery and anesthesia; Councial on cardiovascular cardiology and interventation; Council on cardiovascular nursing; and the interdisciplinary council on peripheral vascular disease: the American academy of neurology affirms the value of this statement as an educational tool for neurologistas.
Stroke, 40 (2009), pp. 2276-2293
[17.]
T. Howell, P. Ridker, U. Ajani, C. Hennekens, W. Christen.
Periodontal disease and risk of subsequent cardiovascular disease in US male physicians.
J Am Coll Cardiol, 37 (2001), pp. 445-450
[18.]
J. Beck, R. Garcia, G. Heiss, P. Vokonas, S. Offenbacher.
Periodontal disease and cardiovascular disease.
J Periodontol, 67 (1996), pp. 1123-1137
[19.]
H. Morrison, L. Elison, G. Taylor.
Periodontal disease and risk of fatal coronary heart disease and cerebrovascular diseases.
J Cardiovasc Risk, 6 (1999), pp. 7-11
[20.]
T. Wu, T. Maurizio, R. Genco, J. Dorn, K. Falkner, C. Sempos.
Periodontal disease and risk of cerebrovascular disease. The first national health and nutrition examination survey and its follow-up study.
Arch Intern Med, 160 (2000), pp. 2749-2755
[21.]
J. Syrjänen, J. Peltola, V. Valtonen, M. Iivanainen, M. Kaste, J. Huttunen.
Dental infections in association with cerebral infarction in young middle-aged men.
J Intern Med, 255 (1989), pp. 179-184
[22.]
A. Grau, F. Buggle, C. Ziegler, W. Schwarz, J. Meuser, A. Tasman, A. Buhler, C. Benesch, H. Becher, W. Hacke.
Association between acute cerebrovascular ischemia and chronic and recurrent infection.
Stroke, 28 (1997), pp. 1724-1729
[23.]
C. Dörfer, H. Becher, C. Ziegler, C. Kaiser, R. Lutz, D. Jörb, C. Lichy, F. Buggle, S. Bültmann, M. Preusch, A. Grau.
The association of gingivitis and periodontitis with ischemic stroke.
J Clin Periodontol, 31 (2004), pp. 396-401
[24.]
H. Lee, R. Garcia, S. Janket, J. Jones, A. Mascarenhas, T. Scott, M. Nunn.
The association between cumulative periodontal disease and stroke history in older adults.
J Periodontol, 77 (2006), pp. 1744-1754
[25.]
S. Janket, A. Baird, S. Chuang, J. Jones.
Meta-analysis of periodontal disease and risk of coronary heart disease and stroke.
Oral Surg Oral Med Pathol Oral Radiol Endod, 95 (2003), pp. 559-569
[26.]
M. Meurman, M. Sanz, S. Janket.
Oral health, atherosclerosis and cardiovascular disease.
Ver Oral Biol Med, 15 (2004), pp. 403-413
[27.]
A. Fardi, D. Papadimitriou.
Periodontal and atherosclerosisinduced diseases.
Int Angiol, 26 (2007), pp. 197-205
[28.]
Y. Khader, Z. Albashaireh, M. Alomari.
Periodontal diseases and the risk of coronary heart and cerebrovascular diseases: a meta-analysis.
J Periodontol, 75 (2004), pp. 1046-1053
[29.]
K. Joshipura.
The relationship between oral conditions and ischemic stroke and peripheral vascular disease.
J Am Dent Assoc, 133 (2002), pp. 23S-30S
[30.]
G. Seymour, P. Ford, M. Cullinan, S. Leishman, K. Yamazaki.
Relationship between periodontal infections and systemic disease.
Clin Microbiol Infect, 13 (2007), pp. 3-10
[31.]
R. Faria Almeida, M. Morado Pinho, S. Lima, I. Faria, P. Santos, C. Bordalo.
Associação entre doença periodontal e patologias sistémicas.
Rev Port Clin Geral, 22 (2006), pp. 379-390
[32.]
J. Behle, P. Papapanou.
Periodontal infections and atherosclerotic vascular disease: an update.
Int Dent J, 56 (2006), pp. 256-262
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