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O papel do metabolismo do biofilme oral na doença cárie : dados actuais
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Advisor(s)
Abstract(s)
A atividade metabólica do biofilme na superfície da lesão cariosa é a força motriz por detrás desta lesão. A desmineralização do esmalte e da dentina pode, portanto, ser vista como um reflexo direto da atividade metabólica do biofilme na superfície. O controlo desta atividade metabólica permite controlar a evolução da lesão cariosa e, consequentemente, o seu prognóstico.
Esta tese reúne os conhecimentos actuais da bioquímica metabólica e as perspectivas terapêuticas que ela pode abrir. As técnicas ultraconservadoras (selagem cariostática, técnica de hall, etc.) baseiam-se na interrupção da cadeia metabólica da cárie, desligando a lesão cariosa do seu "motor". Os agentes preventivos permitem igualmente controlar a atividade metabólica do biofilme nas fases iniciais da lesão de cárie. Este
conhecimento permite igualmente desenvolver técnicas baseadas nas diferenças de propriedades entre os tecidos afectados e os tecidos sãos: é este o princípio da quimioexcavação.
A bioquímica metabólica permite compreender melhor a ação dos agentes preventivos. Embora estas técnicas tenham sido objeto de numerosos estudos clínicos, a sua utilização ainda não é generalizada. O objetivo é, portanto, fazer uma revisão crítica da literatura sobre esta abordagem da doença e do tratamento das lesões cariosas.
The metabolic activity of the biofilm on the surface of the carious lesion is the driving force behind this lesion. The demineralization of enamel and dentin can, therefore, be seen as a direct reflection of the metabolic activity of the biofilm on the surface. Controlling this metabolic activity allows for controlling the progression of the carious lesion and, consequently, its prognosis. This thesis brings together current knowledge of metabolic biochemistry and the therapeutic perspectives it can open. Ultraconservative techniques (caries sealing, Hall technique, etc.) are based on interrupting the metabolic chain of caries, disconnecting the carious lesion from its "engine." Preventive agents also allow for controlling the metabolic activity of the biofilm in the initial stages of carious lesion development. This knowledge also enables the development of techniques based on the differences in properties between affected tissues and healthy tissues: this is the principle of chemoexcavation. Metabolic biochemistry allows for a better understanding of the action of preventive agents. Although these techniques have been the subject of numerous clinical studies, their use is still not widespread. The objective is, therefore, to provide a critical review of the literature on this approach to the disease and the treatment of carious lesions.
The metabolic activity of the biofilm on the surface of the carious lesion is the driving force behind this lesion. The demineralization of enamel and dentin can, therefore, be seen as a direct reflection of the metabolic activity of the biofilm on the surface. Controlling this metabolic activity allows for controlling the progression of the carious lesion and, consequently, its prognosis. This thesis brings together current knowledge of metabolic biochemistry and the therapeutic perspectives it can open. Ultraconservative techniques (caries sealing, Hall technique, etc.) are based on interrupting the metabolic chain of caries, disconnecting the carious lesion from its "engine." Preventive agents also allow for controlling the metabolic activity of the biofilm in the initial stages of carious lesion development. This knowledge also enables the development of techniques based on the differences in properties between affected tissues and healthy tissues: this is the principle of chemoexcavation. Metabolic biochemistry allows for a better understanding of the action of preventive agents. Although these techniques have been the subject of numerous clinical studies, their use is still not widespread. The objective is, therefore, to provide a critical review of the literature on this approach to the disease and the treatment of carious lesions.
Description
Dissertação para obtenção do grau de Mestre no Instituto Universitário Egas Moniz
Keywords
Cárie Cariostático Biofilme Bactérias Escavação Técnica ultraconservadora Selagem cariostática