Conexão entre o Mal de Alzheimer e a Doença Periodontal

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Palabras clave:

Doenças Periodontais, Periodontite, Doença de Alzheimer, Demência

Resumen

O Mal de Alzheimer, principal forma de demência em idosos, tem sido estudado quanto aos seus mecanismos e conexões sistêmicas, sendo investigada em relação à possível conexão com a Doença Periodontal, condição infecto-inflamatória dos tecidos periodontais. Esta revisão integrativa da literatura objetiva sumarizar a literatura atual sobre a relação entre a Doença Periodontal e o Mal de Alzheimer. Para tal, foram revisados artigos em inglês, português e espanhol dos últimos 5 anos das bases Medline, Scielo, LILACS e Web of Science, selecionados a partir de perguntas norteadoras com base na estratégia PECO e cuja busca utilizou descritores em inglês indexados no Decs/Mesh. Os resultados revelam associações entre as condições, com a presença de patógenos periodontais no cérebro de pacientes com Alzheimer, demonstrando a possibilidade da ação direta e indireta dos patógenos nos tecidos nervosos, gerando uma resposta inflamatória que, se cronificada, se exacerba e é neurotóxica. Embora a causalidade não seja inferida, a abordagem periodontal emerge como uma possível estratégia de prevenção e controle do Alzheimer, especialmente em casos periodontais graves. Conclui-se que associação entre o Mal de Alzheimer e a Doença Periodontal é demonstrado no impacto das limitações cognitivas na prática da higiene oral devido à perda da perícia mecânica e intelectual na condução do autocuidado geral e bucal, o que, ao ver odontológico, pode potencializar a chance de complicações periodontais.   Alzheimer's Disease, the main form of dementia in the elderly, has been studied in terms of its mechanisms and systemic connections, and has been investigated in relation to the possible connection with periodontal disease, an infectious-inflammatory condition of the periodontal tissues. This integrative literature review aims to summarize the current literature on the relationship between periodontal disease and Alzheimer's disease. To this end, articles in English, Portuguese and Spanish from the last 5 years were reviewed from the Medline, Scielo, LILACS and Web of Science databases, selected from guiding questions based on the PECO strategy and whose search used English descriptors indexed in Decs/Mesh. The results reveal associations between the conditions and the presence of periodontal pathogens in the brains of Alzheimer's patients, demonstrating the possibility of direct and indirect action of the pathogens on nerve tissue, generating an inflammatory response which, if chronic, is exacerbated and neurotoxic. Although causality is not inferred, the periodontal approach emerges as a possible strategy for preventing and controlling Alzheimer's, especially in severe periodontal cases. It is concluded that the association between Alzheimer's disease and periodontal disease is demonstrated in the impact of cognitive limitations on oral hygiene practice due to the loss of mechanical and intellectual expertise in conducting general and oral self-care, which, when viewed dentally, can increase the chance of periodontal complications.

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2024-09-19

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Artigos de revisão