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Implantologia dentária em doentes com síndroma de Sjögren : revisão bibliográfica
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Abstract(s)
Introdução: O Síndroma de Sjögren é uma doença crônica, autoimune, inflamatória do tecido conjuntivo, associada com infiltrados inflamatórios que afetam predominantemente as glândulas exócrinas, particularmente as glândulas salivares e lacrimais. As membranas mucosas e as glândulas secretoras de humidade dos olhos e da boca são usualmente as primeiras a serem afetadas, resultando no decréscimo na produção de lágrimas e saliva, e caracterizando o Síndroma de Sjögren primário (pSS). A associação desta doença com outras patologias autoimunes, tais como artrite reumatóide (AR), lúpus eritematoso sistêmico (LES), ou esclerose sistêmica (ES) define o Síndroma de Sjögren secundário (sSS).
Objetivo: o objetivo deste estudo foi apresentar uma visão geral, por meio de uma revisão literária, da fisiopatologia do SS, bem como ter acesso a resultados clínicos de investigações sobre taxa de sucesso do tratamento por meio de implantes dentários nos pacientes acometidos por esta doença.
Métodos: para alcançar o objetivo, efetuou-se uma consulta a artigos indexados nas bases de dados da plataforma pubMed/MEDLINE, adotando-se os seguintes descritores: síndroma de Sjögren, qualidade de vida, perda óssea marginal e implantes dentários. O estudo foi subdividido em epidemiologia do SS e análise e registo de casos clínicos. O critério de elegibilidade incluiu estudos prospetivos, retrospetivos e relatos de casos clínicos.
Resultados: para a revisão da epidemiologia foram identificados 37 estudos, enquanto a pesquisa e o processo de seleção de casos clínicos resultaram em 18 estudos, publicados entre 1997 e 2021. Em todos os estudos de casos clínicos foram observadas significativas melhorias na qualidade de vida dos pacientes que foram reabilitados e com base nos resultados obtidos, a terapia de implante nos pacientes com SS apresentou uma elevada taxa de sobrevivência com baixo índice de perda óssea marginal (POM), mucosites e peri-implantites.
Conclusão após análise dos estudos selecionados conclui-se que a etiologia do SS é ainda indefinida e os métodos de diagnóstico persistem com lacunas de informação. A reabilitação dos pacientes com síndroma de Sjögren é um desafio complicado, uma vez que o tratamento consiste apenas no alívio da sintomatologia e, por ser administrada a longo prazo, acarreta efeitos secundários adversos. Contudo, os implantes dentários devem ser considerados pelos médicos dentistas como uma opção viável para o tratamento dos pacientes com SS pelo baixo índice de insucesso e a grande melhoria na qualidade de vida dos pacientes.
Introduction: The Sjogrën’s Syndrome is a chronic autoimmune inflammatory disease of the connective tissue, associated with inflammatory infiltrates that affects, predominately, the exocrine glands, particularly salivary and lacrimal glands. The mucosal membranes and the moisture-secreting glands of the eyes and the mouth are, usually, the first ones to be affected, resulting on decrease production of tear and saliva, characterizing the primary Sjögren’s Syndrome (pSS). The association of this disease with others autoimmune pathology, such as, rheumatoid arthritis (RA), systemic lupus erythematosus (SLE), or systemic sclerosis (SE) defines the secondary Sjögren’s Syndrome (sSS). Objective: the aim of this study was to present a general view, by means of a literature review, of the physiopathology of the SS, as well as, access clinical results of investigations related to the success rate of the treatment with dental implants in patients affected by this disease. Methods: to reach the objective, it was carried out a research on articles indexed in the platform databases pubMed/MEDLINE, adopting the following descriptors: Sjögren’s Syndrome; quality of life; marginal bone loss, and dental implants. This study was subdivided into epidemiology of the SS and analysis and clinical reports. Results: for the epidemiological review it was identified 37 studies, while the research and the selection process of the clinical reports resulted on 18 studies, published between 1997 and 2021. In all clinical reports studies were observed significant improvement in the quality of life of the SS rehabilitated patients and based on the results obtained, the therapy of implant in patients with SS showed high rate of survival with low index of marginal bone loss (MBL), mucosites and periimplantites. Conclusion: after the analysis of the selected studies it was concluded that the etiology of SS is still undefined and the methods of diagnosis remain as information gap. The rehabilitation of patients with Sjögren’s Syndrome is a complicated challenge, once the treatment consists only on the relief of symptoms and, for being administrated in the long run, it brings about several secondary effects. However, the dental implants should be considered by the dentists as a viable option for the treatment of these patients with SS for its low rate of failure and the great improvement in their quality of life.
Introduction: The Sjogrën’s Syndrome is a chronic autoimmune inflammatory disease of the connective tissue, associated with inflammatory infiltrates that affects, predominately, the exocrine glands, particularly salivary and lacrimal glands. The mucosal membranes and the moisture-secreting glands of the eyes and the mouth are, usually, the first ones to be affected, resulting on decrease production of tear and saliva, characterizing the primary Sjögren’s Syndrome (pSS). The association of this disease with others autoimmune pathology, such as, rheumatoid arthritis (RA), systemic lupus erythematosus (SLE), or systemic sclerosis (SE) defines the secondary Sjögren’s Syndrome (sSS). Objective: the aim of this study was to present a general view, by means of a literature review, of the physiopathology of the SS, as well as, access clinical results of investigations related to the success rate of the treatment with dental implants in patients affected by this disease. Methods: to reach the objective, it was carried out a research on articles indexed in the platform databases pubMed/MEDLINE, adopting the following descriptors: Sjögren’s Syndrome; quality of life; marginal bone loss, and dental implants. This study was subdivided into epidemiology of the SS and analysis and clinical reports. Results: for the epidemiological review it was identified 37 studies, while the research and the selection process of the clinical reports resulted on 18 studies, published between 1997 and 2021. In all clinical reports studies were observed significant improvement in the quality of life of the SS rehabilitated patients and based on the results obtained, the therapy of implant in patients with SS showed high rate of survival with low index of marginal bone loss (MBL), mucosites and periimplantites. Conclusion: after the analysis of the selected studies it was concluded that the etiology of SS is still undefined and the methods of diagnosis remain as information gap. The rehabilitation of patients with Sjögren’s Syndrome is a complicated challenge, once the treatment consists only on the relief of symptoms and, for being administrated in the long run, it brings about several secondary effects. However, the dental implants should be considered by the dentists as a viable option for the treatment of these patients with SS for its low rate of failure and the great improvement in their quality of life.
Description
Dissertação para obtenção do grau de Mestre no Instituto Universitário Egas Moniz
Keywords
Síndroma de Sjögren Xerostomia Implantes dentários