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Análise dos níveis de IL-1β, TNF-α e PGE2 no fluido crevicular peri-implantar como método auxiliar de diagnóstico da peri-implantite
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Resumo(s)
Atualmente, os implantes dentários são utilizados rotineiramente na prática clínica como uma das principais opções de reabilitação de espaços edêntulos, devido aos seus benefícios funcionais e estéticos a longo prazo. Apesar das elevadas taxas de sucesso e sobrevivência associadas à reabilitação com implantes, podem surgir complicações, nomeadamente a doença peri-implantar, que em última instância leva à falha do implante.
A peri-implantite afeta os tecidos de suporte peri-implantares, ocorrendo inflamação da mucosa e perda de osso de suporte. Os métodos comumente utilizados para diagnosticar esta patologia são complexos na sua aplicação e interpretação, além de não permitirem a especificidade e sensibilidade desejáveis para a deteção precoce da doença. A avaliação e a quantificação dos biomarcadores presentes no fluido crevicular peri-implantar podem complementar este diagnóstico.
Esta revisão narrativa pretendeu analisar a evidência científica existente acerca da associação entre os níveis de interleucina-1 beta (IL-1β), fator de necrose tumoral alfa (TNF-α) e prostaglandina E2 (PGE2) no fluido crevicular peri-implantar e a peri-implantite. Foi realizada uma pesquisa bibliográfica nas bases de dados: PubMed, Cochrane Library, Research Gate e Elsevier.
A análise da literatura mostra que a IL-1β, o TNF-α e a PGE2 desempenham um papel pró-inflamatório fulcral na peri-implantite, sobretudo através da mediação da reabsorção óssea a partir da ativação dos osteoclastos. Por conseguinte, a maioria dos estudos verificou um aumento das suas concentrações no fluido crevicular peri-implantar de localizações afetadas, sendo confirmada a presença de uma associação positiva com a doença, que no futuro deverá ser fortalecida com evidência de mais estudos longitudinais controlados.
A descoberta desta associação e o desenvolvimento de um teste que permita identificá-la no contexto clínico, concede ao Médico Dentista a capacidade de realizar o diagnóstico precoce da peri-implantite, que melhora consideravelmente o prognóstico do seu tratamento.
Currently, dental implants are used as one of the main clinical rehabilitation methods for edentulous spaces due to their long-term functional and aesthetic benefits. Despite the high success and survival rates associated with implant rehabilitation, complications can arise, namely peri-implant disease, which ultimately can lead to implant failure. Peri-implantitis affects the supporting peri-implant tissues, with inflammation of the peri-implant mucosa and loss of supporting bone. The methods commonly used to diagnose this pathology are complex in their application and interpretation, in addition to not allowing the desired specificity and sensitivity for the early detection of the disease. The evaluation and quantification of biomarkers present in the peri-implant crevicular fluid can complement this diagnosis. This narrative review aimed to analyze the existing scientific evidence about the association between the levels of interleukin-1 beta (IL-1β), tumor necrosis factor alpha (TNF-α) and prostaglandin E2 (PGE2) in the peri-implant crevicular fluid and the peri-implantitis. A bibliographic search was carried out in the following databases: PubMed, Cochrane Library, Research Gate and Elsevier. The literature review shows that IL-1β, TNF-α and PGE2 play a key pro-inflammatory role in the establishment of peri-implantitis, mainly from the mediation of bone resorption through activation of osteoclasts. Therefore, most studies have found an increase in their concentrations in the peri-implant crevicular fluid of affected locations, confirming the presence of a positive association with the disease which in the future should be strengthened with additional evidence from controlled longitudinal studies. The discovery of this association and the development of a test that allows it to be identified in the clinical context, gives the Dentist the ability to perform an early diagnosis of peri-implantitis, which considerably improves the prognosis of its treatment.
Currently, dental implants are used as one of the main clinical rehabilitation methods for edentulous spaces due to their long-term functional and aesthetic benefits. Despite the high success and survival rates associated with implant rehabilitation, complications can arise, namely peri-implant disease, which ultimately can lead to implant failure. Peri-implantitis affects the supporting peri-implant tissues, with inflammation of the peri-implant mucosa and loss of supporting bone. The methods commonly used to diagnose this pathology are complex in their application and interpretation, in addition to not allowing the desired specificity and sensitivity for the early detection of the disease. The evaluation and quantification of biomarkers present in the peri-implant crevicular fluid can complement this diagnosis. This narrative review aimed to analyze the existing scientific evidence about the association between the levels of interleukin-1 beta (IL-1β), tumor necrosis factor alpha (TNF-α) and prostaglandin E2 (PGE2) in the peri-implant crevicular fluid and the peri-implantitis. A bibliographic search was carried out in the following databases: PubMed, Cochrane Library, Research Gate and Elsevier. The literature review shows that IL-1β, TNF-α and PGE2 play a key pro-inflammatory role in the establishment of peri-implantitis, mainly from the mediation of bone resorption through activation of osteoclasts. Therefore, most studies have found an increase in their concentrations in the peri-implant crevicular fluid of affected locations, confirming the presence of a positive association with the disease which in the future should be strengthened with additional evidence from controlled longitudinal studies. The discovery of this association and the development of a test that allows it to be identified in the clinical context, gives the Dentist the ability to perform an early diagnosis of peri-implantitis, which considerably improves the prognosis of its treatment.
Descrição
Dissertação para obtenção do grau de Mestre no Instituto Universitário Egas Moniz
Palavras-chave
Interleucina-1 beta Fator de necrose tumoral alfa Prostaglandina E2 Peri-implantite