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Aspectos bioquímicos da doença periodontal : uma revisão narrativa
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Abstract(s)
A periodontite é uma doença inflamatória crónica dos tecidos de suporte dos dentes, incluindo a gengiva, o ligamento periodontal e o osso alveolar. Atualmente, é a sexta doença mais prevalente no mundo e a principal causa de perda dentária em adultos. A sua etiologia é complexa e multifatorial, envolvendo a formação de um biofilme bacteriano subgengival e uma resposta imunitária exacerbada do hospedeiro, que resultam na destruição progressiva dos tecidos periodontais.
A progressão da periodontite é impulsionada por interações entre agentes bacterianos, diferentes populações celulares e mediadores inflamatórios. Entre estes, citocinas próinflamatórias como IL-1, IL-6 e TNF-α desempenham um papel crítico na destruição dos tecidos. As metaloproteinases da matriz (MMPs) contribuem para a degradação da matriz extracelular, enquanto o eixo RANKL/OPG regula a atividade osteoclástica e a reabsorção óssea. O stress oxidativo amplifica ainda mais a inflamação, aumentando a produção de espécies reativas de oxigénio (ROS).
A periodontite também está associada bidireccionalmente a várias doenças sistémicas, incluindo diabetes mellitus e distúrbios cardiovasculares, que podem exacerbar a inflamação periodontal e modular os níveis de biomarcadores.
O objetivo desta revisão narrativa é analisar os principais biomarcadores bioquímicos associados à progressão da periodontite, enfatizando a sua relevância para o diagnóstico, monitorização e tratamento. Este trabalho também destaca o papel potencial desses biomarcadores no tratamento individualizado dos pacientes e aponta para futuras direções na pesquisa periodontal com o objetivo de identificar novos alvos terapêuticos.
Periodontitis is a chronic inflammatory disease of the supporting tissues of the teeth, including the gingiva, periodontal ligament and alveolar bone. It is currently the sixth most prevalent disease worldwide and the leading cause of tooth loss in adults. Its etiology is complex and multifactorial, involving the formation of a subgingival bacterial biofilm and an exacerbated host immune response, which result in the progressive destruction of periodontal tissues. The progression of periodontitis is driven by interactions between bacterial agents, different cell populations and inflammatory mediators. Among these, pro-inflammatory cytokines such as IL-1, IL-6 and TNF-α play a critical role in tissue destruction. Matrix metalloproteinases (MMPs) contribute to extracellular matrix degradation, while the RANKL/OPG axis regulates osteoclastic activity and bone resorption. Oxidative stress further amplifies inflammation by increasing the production of reactive oxygen species. Periodontitis is also bidirectionally associated with several systemic diseases, including diabetes mellitus and cardiovascular disorders, which can exacerbate periodontal inflammation and modulate biomarker levels. The aim of this narrative review is to analyse the main biochemical biomarkers associated with the progression of periodontitis, emphasizing their relevance for diagnosis, monitoring and treatment. This work also highlights the potential role of these biomarkers in individualized patient management and points towards future directions in periodontal research aimed at identifying novel therapeutic targets.
Periodontitis is a chronic inflammatory disease of the supporting tissues of the teeth, including the gingiva, periodontal ligament and alveolar bone. It is currently the sixth most prevalent disease worldwide and the leading cause of tooth loss in adults. Its etiology is complex and multifactorial, involving the formation of a subgingival bacterial biofilm and an exacerbated host immune response, which result in the progressive destruction of periodontal tissues. The progression of periodontitis is driven by interactions between bacterial agents, different cell populations and inflammatory mediators. Among these, pro-inflammatory cytokines such as IL-1, IL-6 and TNF-α play a critical role in tissue destruction. Matrix metalloproteinases (MMPs) contribute to extracellular matrix degradation, while the RANKL/OPG axis regulates osteoclastic activity and bone resorption. Oxidative stress further amplifies inflammation by increasing the production of reactive oxygen species. Periodontitis is also bidirectionally associated with several systemic diseases, including diabetes mellitus and cardiovascular disorders, which can exacerbate periodontal inflammation and modulate biomarker levels. The aim of this narrative review is to analyse the main biochemical biomarkers associated with the progression of periodontitis, emphasizing their relevance for diagnosis, monitoring and treatment. This work also highlights the potential role of these biomarkers in individualized patient management and points towards future directions in periodontal research aimed at identifying novel therapeutic targets.
Description
Dissertação para obtenção do grau de Mestre no Instituto Universitário Egas Moniz
Keywords
Periodontite Biomarcadores Inflamação Stress oxidativo