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Habilitation Thesis
DOI
10.11606/T.25.2012.tde-10022012-154515
Document
Author
Full name
Sebastiao Luiz Aguiar Greghi
Institute/School/College
Knowledge Area
Date of Defense
Published
Bauru, 2012
Committee
Rezende, Maria Lucia Rubo de (President)
Bosco, Alvaro Francisco
Casati, Marcio Zaffalon
Magini, Ricardo de Souza
Romito, Giuseppe Alexandre
Title in Portuguese
Avaliação quantitativa das citocinas IL-4, IL-6, IL-8, IL-10 e do TGF-β, presentes na saliva de pacientes com periodontite, antes e após a submissão à psicoterapia: análise comparativa com pacientes controles
Keywords in Portuguese
Citocinas
Estresse
Etiologia da doença periodontal
Fatores de risco à doença periodontal
Inflamação
Abstract in Portuguese
Considerando a condição multi-fatorial da etiologia da doença periodontal, em particular a influência do estresse, evidente na literatura, esta pesquisa teve como propósito avaliar 2 grupos de indivíduos com doença periodontal, sendo que um grupo foi submetido à psicoterapia (grupo experimental - N=13) por 3 meses, enquanto o outro grupo serviu como controle(N=13); em ambos os grupos nenhuma intervenção periodontal foi realizada nesse período, seja curativa ou preventiva. Os dados obtidos dos indivíduos de ambos os grupos, no "baseline" e no final do experimento (após 3 meses) incluíram: níveis das citocinas IL-4, IL-6, IL-8, IL-10 e TGF- β (salivares), parâmetros periodontais (profundidade de sondagem-PS, nível de inserção- NI, recessão gengival, índice de placa-IP, índice gengival-IG) e o número de dentes perdidos (NDP). Também o nível de cortisol (NC) e análise psicológica do grau de estresse dos indivíduos que compuseram a amostra, foram importados de GREGHI-2009, para análise conjunta com os demais parâmetros. Os pacientes foram triados seguindo vários critérios de exclusão e inclusão. Na análise dos parâmetros periodontais verificou-se que no grupo experimental houve uma melhora significante do IP e do IG, e no grupo controle ocorreu uma piora significante do IP. A análise laboratorial mostrou que o NC diminuiu de forma significativa no grupo experimental e no grupo controle houve um aumento significativo do nível de IL-6. Cabe destacar que, embora as diferenças entre os níveis iniciais e finais das citocinas analisadas, não tenham sido estatisticamente significantes, no grupo experimental houve uma tendência do aumento das citocinas anti-inflamatórias e diminuição das citocinas pró-inflamatórias. Como conclusão final admitiu-se que o estresse pode repercutir negativamente no controle de placa, que o NC elevado pode aumentar os riscos de comprometimento periodontal, que a psicoterapia pode interferir de forma positiva em alguns parâmetros clínicos e laboratoriais, propiciando melhora clínica, e que o estresse como fator de risco à doença periodontal, não pode ser negligenciado.
Title in English
Quantitative evaluation of the cytokines IL-4, IL-6, IL-8, IL-10 and TGF-β presents in the saliva of patients with periodontitis, before and after submission to psychotherapy: comparative analisys with control patients
Keywords in English
Cytokines
Etiology of periodontal disease
Inflammation
Risk factors of periodontal disease
Stress
Abstract in English
Considering the multi-factorial etiology of periodontal disease, particularly the evidence based influence of stress, this research aimed at evaluating two groups of individuals with periodontal disease. One of them was subjected to psychotherapy (experimental group N=13) during 3 months while the other served as control group (N=13); none f the groups received any curative or preventive periodontal intervention in the period. The achieved data from both groups of individuals at baseline and at the end of the experiment (3 months) included: cytokines levels IL-4, IL-6, IL-8, IL-10 and TGF- β (salivary), periodontal parameters (probing depth - PS, attachment level - NI, gingival recession, plaque index - IP, gingival index -IG) and number of lost teeth (NDP). The cortisol level (NC) and the psychological analysis of the stress level in the individuals who constituted the sample were imported from GREGHI-2009 for concurrent analysis with the other parameters. The patients were selected by respecting several inclusion and exclusion criteria. The periodontal parameters analysis showed that there was a significant improvement of IP and IG in the experimental group and there was a significant worsening of IP in the control group. The laboratorial analysis showed that the NC diminished significantly in the experimental group and there was a significant magnification in the level of IL-6 in the control group. It is worthwhile to emphasize that even though the differences between the initial and final levels of the analyzed cytokines were not statistically significant, there was a tendency of augmentation in the anti-inflammatory cytokines levels and decrease in the pro-inflammatory cytokines levels in the experimental group. As a final conclusion, it was accepted that the stress can negatively influence the plaque control, the elevated NC can increase the risk for periodontal breakdown, the psychotherapy can positively interfere in some clinical and laboratorial parameters leading to clinical improvement and the stress may not be neglected as a risk factor for periodontal disease.
 
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Publishing Date
2012-02-10
 
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