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Pacientes com artrite reumatoide e a reabilitação com implantes dentários
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Advisor(s)
Abstract(s)
A Artrite Reumatóide é uma doença autoimune inflamatória, de natureza complexa, e apresenta manifestações como dor, edema, osteoartroses, sinovite crónica e rigidez articular, podendo mesmo levar a danos severos nas articulações, causando incapacidade funcional e morbilidade.
Os medicamentos utilizados no tratamento e gestão dos sintomas da artrite reumatóide são AINES (anti-inflamatórios não esteroides), glicocorticóides, e DMARDS (“disease-modifying antirheumatic drugs”, em
inglês). Os últimos medicamentos mencionados, os DMARDS, são agentes imunossupressores e imunomoduladores, atuando, mesmo em doses pequenas, como inibidores potentes da proliferação de osteoblastos e metabolismo mitocondrial in vitro, o que resulta em possíveis efeitos negativos na
regeneração óssea e na osteointegração de implantes dentários.
Existem alguns efeitos dos AINES, glicocorticóides, e DMARDs na osteointegração descritos na literatura, mas pouco se sabe ainda sobre os seus mecanismos em concreto.
O objetivo deste trabalho é atualizar o conhecimento no que concerne aos desafios da reabilitação com implantes dentários em pacientes com Artrite Reumatoide, de forma a possibilitar aos profissionais de saúde gerir os seus efeitos adversos a curto e a longo prazo, as possíveis contraindicações, e adequar as doses dos medicamentos, garantindo assim, a prevenção, o diagnóstico e a gestão dos possíveis efeitos negativos.
Foi realizada uma revisão da literatura científica, com o recurso à pesquisa de fontes obtidas nas bases de dados PubMed, Medline, B-on, LILACS, SciELO, e Google Scholar, através de palavras-chave mencionadas em baixo.
Foi dada preferência aos artigos que estejam completos.
Rheumatoid arthritis is an autoimmune inflammatory disease, complex in its nature, and has manifestations like pain, edema, osteoarthritis, chronic synovitis, and joint stiffness, and can lead to severe joint damage, causing loss of function, functional incapacitation, and morbidity. The medications used in the treatment and management of symptoms caused by rheumatoid arthritis are NSAIDs (“nonsteroidal anti-inflammatory drugs”), glucocorticoids, and DMARDs (“disease-modifying antirheumatic drugs”). DMARDs are immunosuppressant and immunomodulator agents, operating, even in small doses, as potent inhibitors of osteoblastic proliferation and in vitro mitochondrial metabolism, which results in possible negative effects on bone regeneration and osseointegration of dental implants. There are some effects of NSAIDs, glucocorticoids, and DMARDs in osseointegration, described in the literature, but there is still little knowledge about its mechanisms. The objective of this work is to update the knowledge regarding the challenges of rehabilitation with dental implants in patients with Rheumatoid Arthritis, and thus making it possible for health professionals to manage its adverse effects in short and long-term, its possible complications, and establish the adequate doses, thus assuring the prevention, diagnosis and management of its possible negative effects. A review of the scientific literature was performed, by researching the databases of PubMed, Medline, B-on, LILACS, SciELO, and Scholar Google, using the keywords listed below. It was given preference to complete scientific articles.
Rheumatoid arthritis is an autoimmune inflammatory disease, complex in its nature, and has manifestations like pain, edema, osteoarthritis, chronic synovitis, and joint stiffness, and can lead to severe joint damage, causing loss of function, functional incapacitation, and morbidity. The medications used in the treatment and management of symptoms caused by rheumatoid arthritis are NSAIDs (“nonsteroidal anti-inflammatory drugs”), glucocorticoids, and DMARDs (“disease-modifying antirheumatic drugs”). DMARDs are immunosuppressant and immunomodulator agents, operating, even in small doses, as potent inhibitors of osteoblastic proliferation and in vitro mitochondrial metabolism, which results in possible negative effects on bone regeneration and osseointegration of dental implants. There are some effects of NSAIDs, glucocorticoids, and DMARDs in osseointegration, described in the literature, but there is still little knowledge about its mechanisms. The objective of this work is to update the knowledge regarding the challenges of rehabilitation with dental implants in patients with Rheumatoid Arthritis, and thus making it possible for health professionals to manage its adverse effects in short and long-term, its possible complications, and establish the adequate doses, thus assuring the prevention, diagnosis and management of its possible negative effects. A review of the scientific literature was performed, by researching the databases of PubMed, Medline, B-on, LILACS, SciELO, and Scholar Google, using the keywords listed below. It was given preference to complete scientific articles.
Description
Dissertação para obtenção do grau de Mestre no Instituto Universitário Egas Moniz
Keywords
Artrite reumatoide Reabilitação Implantes dentários Osteointegração