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O efeito do lúpus eritematoso sistémico na osteointegração de implantes dentários : uma revisão de literatura atualizada
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Abstract(s)
O Lúpus Eritematoso Sistémico (LES) é uma doença autoimune crónica e multissistémica que afeta predominantemente mulheres em idade fértil, caracterizando-se por episódios inflamatórios intercalados com períodos de remissão. A terapêutica de controlo, frequentemente baseada em corticoides, imunossupressores e antiinflamatórios não esteroides (AINES), pode comprometer a qualidade e a remodelação
óssea, interferindo potencialmente com o processo de osteointegração. A reabilitação oral com implantes dentários constitui atualmente uma solução previsível e eficaz para substituir dentes perdidos, com impacto positivo na mastigação, estética e qualidade de vida. Contudo, o sucesso dos implantes depende não só do material e da técnica cirúrgica, mas também da resposta biológica e do estado sistémico do doente.
Esta dissertação teve como objetivo rever e analisar criticamente a literatura científica sobre o efeito do LES na osteointegração de implantes dentários, identificando mecanismos fisiopatológicos e fatores clínicos que possam afetar o prognóstico implantológico. A revisão narrativa revelou que a evidência disponível é limitada e
baseada essencialmente em relatos de caso e pequenos estudos observacionais. Os resultados sugerem que, sob controlo rigoroso da doença e em períodos de remissão, os implantes apresentam taxas de sobrevivência semelhantes às observadas em indivíduos saudáveis. O sucesso do tratamento depende do acompanhamento interdisciplinar, da gestão farmacológica adequada e da implementação de protocolos cirúrgicos individualizados.
Conclui-se que o LES não representa uma contraindicação absoluta para a colocação de implantes dentários, mas requer avaliação médica cuidadosa e planeamento personalizado. São necessários ensaios clínicos prospetivos e estudos de longa duração para determinar com maior precisão o impacto da doença e das terapêuticas imunossupressoras na osteointegração.
Systemic Lupus Erythematosus (SLE) is a chronic, multisystem autoimmune disease that predominantly affects women of reproductive age and is characterized by recurrent inflammatory episodes interspersed with periods of remission. The therapeutic regimen, often based on corticosteroids, immunosuppressants, and nonsteroidal antiinflammatory drugs, can compromise bone quality and remodeling, potentially interfering with the osseointegration process. Oral rehabilitation through dental implants is currently regarded as a predictable and effective solution for replacing missing teeth, with a significant positive impact on mastication, aesthetics, and quality of life. However, implant success depends not only on the material and surgical technique but also on the patient’s biological response and systemic condition. This dissertation aimed to critically review and analyze the scientific literature on the effect of SLE on the osseointegration of dental implants, identifying the underlying pathophysiological mechanisms and clinical factors that may influence implant prognosis. The narrative review revealed that the available evidence remains limited and is primarily based on case reports and small observational studies. The findings suggest that, under strict disease control and during remission periods, implants demonstrate survival rates comparable to those observed in healthy individuals. Treatment success fundamentally relies on interdisciplinary management, appropriate pharmacological control, and the implementation of individualized surgical protocols. It is concluded that SLE does not represent an absolute contraindication for dental implant placement; however, careful medical evaluation and personalized treatment planning are essential. Prospective clinical trials and long-term follow-up studies are needed to more precisely determine the impact of SLE and immunosuppressive therapies on osseointegration.
Systemic Lupus Erythematosus (SLE) is a chronic, multisystem autoimmune disease that predominantly affects women of reproductive age and is characterized by recurrent inflammatory episodes interspersed with periods of remission. The therapeutic regimen, often based on corticosteroids, immunosuppressants, and nonsteroidal antiinflammatory drugs, can compromise bone quality and remodeling, potentially interfering with the osseointegration process. Oral rehabilitation through dental implants is currently regarded as a predictable and effective solution for replacing missing teeth, with a significant positive impact on mastication, aesthetics, and quality of life. However, implant success depends not only on the material and surgical technique but also on the patient’s biological response and systemic condition. This dissertation aimed to critically review and analyze the scientific literature on the effect of SLE on the osseointegration of dental implants, identifying the underlying pathophysiological mechanisms and clinical factors that may influence implant prognosis. The narrative review revealed that the available evidence remains limited and is primarily based on case reports and small observational studies. The findings suggest that, under strict disease control and during remission periods, implants demonstrate survival rates comparable to those observed in healthy individuals. Treatment success fundamentally relies on interdisciplinary management, appropriate pharmacological control, and the implementation of individualized surgical protocols. It is concluded that SLE does not represent an absolute contraindication for dental implant placement; however, careful medical evaluation and personalized treatment planning are essential. Prospective clinical trials and long-term follow-up studies are needed to more precisely determine the impact of SLE and immunosuppressive therapies on osseointegration.
Description
Dissertação para obtenção do grau de Mestre no Instituto Universitário Egas Moniz
Keywords
Lúpus Eritematoso Sistémico (LES Osteointegração Implantes dentários Doenças autoimunes