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Abstract(s)
Introdução: A doença periodontal (DP) é uma doença inflamatória crónica de etiologia multifatorial, originada pela disbiose do biofilme bacteriano nas gengivas, afetando os tecidos moles, os ligamentos periodontais e o osso alveolar. A DP é um desafio significativo para a saúde pública, devido à sua prevalência e impacto negativo na saúde sistémica, sendo uma das principais causas de perda dentária em adultos. Fatores de risco para o desenvolvimento da DP incluem a diabetes, a genética, o tabagismo, a resposta inflamatória gengival e periodontal descontrolada, o stress e uma dieta não saudável. Esta dissertação propõe a análise molecular e a validação de biomarcadores, em conjunto com a adoção de novos critérios de estratificação, como uma nova estratégia para a prática de medicina dentária de precisão. Objetivos: Quantificação de biomarcadores moleculares em amostras de saliva e/ou biofilme de pacientes com saúde periodontal, gengivite ou DP, de forma a melhorar a estratificação dos pacientes através da integração dos resultados moleculares obtidos com os respetivos dados clínicos. Materiais e Métodos: Estudo observacional transversal com 82 pacientes. Incluiu questionários, sondagem periodontal, diagnóstico e recolha de saliva e biofilme. As amostras foram analisadas pelo laboratório Salivatec. Foi efetuada a quantificação do número de cópias de DNA de espécies periodontopatogénicas por qPCR, de um grupo representativo de cada um dos diagnósticos da DP (incluindo saúde periodontal e gengivite), perfazendo um total de 34 amostras. Resultados: A análise dos resultados de qPCR revelou que a T. denticola foi mais prevalente em estadios avançados da DP (III e IV) e em casos de gengivite, indicando a sua relevância tanto em processos inflamatórios iniciais quanto em estadios severos da doença. A F. fastidiosum apresentou uma variação muito significativa entre diagnósticos da DP, sugerindo uma forte associação com estadios graves da doença. A M. timidum demonstrou uma associação com estadios moderados e avançados na DP. Conclusão: A integração de biomarcadores moleculares específicos no diagnóstico, como F. fastidiosum e T. denticola, no tratamento da DP, pode proporcionar uma abordagem de precisão, melhorando a gestão clínica e a monitorização do estado de saúde periodontal dos pacientes.
Introduction: Periodontal disease (PD) is a chronic inflammatory disease of multifactorial etiology, caused by dysbiosis of the bacterial biofilm on the gums, affecting the soft tissues, periodontal ligaments and alveolar bone. PD is a significant public health challenge due to its prevalence and negative impact on systemic health, being one of the main causes of tooth loss in adults. Risk factors for the development of PD include diabetes, genetics, smoking, uncontrolled gingival and periodontal inflammatory response, stress and an unhealthy diet. This dissertation proposes the molecular analysis and validation of biomarkers, together with the adoption of new stratification criteria, as a new strategy for the practice of precision dentistry. Objective: Quantification of molecular biomarkers in saliva and/or biofilm samples from patients with periodontal health, gingivitis or PD, to improve patient stratification by integrating the molecular results obtained with the respective clinical data. Materials and methods: Cross-sectional observational study with 82 patients. It included questionnaires, periodontal probing, diagnosis and collection of saliva and bioflm. The samples were analyzed by the Salivatec laboratory. The number of DNA copies of periodontopathogenic species was quantified by qPCR, from a representative group of each of the PD diagnoses (including periodontal health and gingivitis), totaling 34 samples. Results: Analysis of the samples revealed that T. denticola was more prevalent in advanced stages of PD (III and IV) and in cases of gingivitis, indicating its relevance in both initial inflammatory processes and severe stages of the disease. F.fastidiosum showed a very significant variation between PD diagnoses, suggesting a strong association with severe stages of the disease. M.timidum showed an association with moderate and advanced stages of PD. Conclusion: The integration of specific molecular biomarkers in the diagnosis, such as F. fastidiosum and T. denticola, in the treatment of PD can provide a precision approach, improving clinical management and the monitoring of patients' periodontal health status.
Introduction: Periodontal disease (PD) is a chronic inflammatory disease of multifactorial etiology, caused by dysbiosis of the bacterial biofilm on the gums, affecting the soft tissues, periodontal ligaments and alveolar bone. PD is a significant public health challenge due to its prevalence and negative impact on systemic health, being one of the main causes of tooth loss in adults. Risk factors for the development of PD include diabetes, genetics, smoking, uncontrolled gingival and periodontal inflammatory response, stress and an unhealthy diet. This dissertation proposes the molecular analysis and validation of biomarkers, together with the adoption of new stratification criteria, as a new strategy for the practice of precision dentistry. Objective: Quantification of molecular biomarkers in saliva and/or biofilm samples from patients with periodontal health, gingivitis or PD, to improve patient stratification by integrating the molecular results obtained with the respective clinical data. Materials and methods: Cross-sectional observational study with 82 patients. It included questionnaires, periodontal probing, diagnosis and collection of saliva and bioflm. The samples were analyzed by the Salivatec laboratory. The number of DNA copies of periodontopathogenic species was quantified by qPCR, from a representative group of each of the PD diagnoses (including periodontal health and gingivitis), totaling 34 samples. Results: Analysis of the samples revealed that T. denticola was more prevalent in advanced stages of PD (III and IV) and in cases of gingivitis, indicating its relevance in both initial inflammatory processes and severe stages of the disease. F.fastidiosum showed a very significant variation between PD diagnoses, suggesting a strong association with severe stages of the disease. M.timidum showed an association with moderate and advanced stages of PD. Conclusion: The integration of specific molecular biomarkers in the diagnosis, such as F. fastidiosum and T. denticola, in the treatment of PD can provide a precision approach, improving clinical management and the monitoring of patients' periodontal health status.
Description
Keywords
Doença periodontal Disbiose Bactérias periodontopatogénicas Biomarcadores moleculares Medicina dentária de precisão Periodontal disease Dysbiosis Periodontopathogenic bacteria Molecular biomarkers Precision dentistry