O que o Cirurgião-Dentista Precisa Saber Sobre a Doença de Crohn? What do Dentists Need to Know About Cronh’s Disease?
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Publicado:
Out 15, 2021
Palavras-chave:
Doença periodontal, Doenças inflamatórias intestinais, Doença de Crohn, Manifestações orais, Inflamação
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Resumo
A doença de Crohn é descrita como uma doença inflamatória intestinal de alta complexidade, caracterizando-se por apresentar lesões e inflamações transmurais que podem acometer todo o trato gastrointestinal. A doença de Crohn pode apresentar manifestações bucais, tais como lesões na mucosa, alterações do fluxo salivar e envolvimento periodontal. Para este artigo de revisão, foi realizada uma busca de literatura nas bases de dados PubMed, Scielo e Academic Google, com espaço temporal de 2010 a 2020, utilizando palavras-chaves obtidas de acordo com o descritor em ciência da saúde. Foi encontrado que as lesões bucais estão presentes em cerca de 46,75% dos pacientes jovens e 22% dos pacientes idosos com doença de Crohn, podendo ser bastante incômodas, persistentes e de difícil tratamento. Apresentam-se com diversos aspectos clínicos como: ulcerações lineares ou aftosas, nodularidades da mucosa e aumento de volume labial. Essas lesões estão diretamente relacionadas com a doença, mas algumas lesões podem surgir de forma indireta, como complicação da doença de Crohn ou como efeitos adversos do tratamento. As manifestações bucais podem ser os primeiros sinais da doença de Crohn, logo, o reconhecimento de seus aspectos clínicos pode contribuir para um diagnóstico precoce. Cabe ao cirurgião-dentista reconhecer, diagnosticar e tratar, junto a uma equipe multiprofissional, as manifestações bucais da doença de Crohn, promovendo melhoras no quadro clínico dos pacientes.
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Como Citar
Fernando Gabriel de Araújo Chagas, Anna Thereza Thomé Leão, & Sandra Regina Torres. (2021). O que o Cirurgião-Dentista Precisa Saber Sobre a Doença de Crohn?. Revista Naval De Odontologia, 48(2), 37-44. https://doi.org/10.29327/25149.48.2-4
Seção
Revisões de Literatura
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
Referências
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5. Neurath MF. Cytokines in inflammatory bowel disease. Nat Rev Immunol. 2014;14(5): 329-42.
6. Dutta AK, Chacko A. Influence of environmental factors on the on set and course of inflammatory bowel disease. World J Gastroenterol. 2016;22(3):1088-100.
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13. Rowland M, Fleming P, Bourke B. Looking in the mouth for Crohn’s disease. Inflamm Bowel Dis. 2010;16(2):332-7.
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20. Docktor MJ, Paster BJ, Abramowicz S, Ingram J, Wang YE,Correll M, et al. Alterations in diversity of the oral microbiome in pediatric inflammatory bowel disease. Inflamm Bowel Dis.
2012;18(5):935-42.
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24. Kim SK, Lee ES. Orofacial granulomatosis associated with Crohn’s disease. Ann Dermatol. 2010;22(2):203-5.
25. Adegun OK, Zou L, Willis A, Fortune F. Facial biometrics: a
novel technique for evaluation of morphological changes in orofacial Crohn’s disease. BMJ Case Rep. 2013; [Acessado em 01 Junho de 2021]. Disponível em: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3841427/.
26. Jennings VC, Williams L, Henson S. Orofacial granulomatosisas a presenting feature of Crohn’s disease. BMJ Case Rep. 2015; [Acessado em 01 Junho de 2021]. Disponível em: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4289786/.
27. Gale G, Ostman S, Saalman R, Telemo E, Jontell M, Hasséus B. Immunophenotype in orofacial granulomatosis with and without Crohn’s disease. Med Oral Patol Oral Cir Bucal. 2014;19(6):584-91.
28. Antunes H, Patraquim C, Baptista V, Silva Monteiro L. Oral manifestations of Crohn’s disease. BMJ Case Rep. 2015; [Acessado em 01 Junho de 2021]. Disponível em:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4636709/.
29. Trikudanathan G, Venkatesh PG, Navaneethan U. Diagnosis and therapeutic management of extra-intestinal manifestations of inflammatory bowel disease. Drugs. 2012;72(18):2333-49.
30. Nico MM, Hussein TP, Aoki V, Lourenço SV. Pyostomatitis vegetans and its relation to inflammatory bowel disease, pyoderma gangrenosum, pyodermatitis vegetans, and pemphigus. J Oral Pathol Med. 2012;41(8):584-8.
31. Gheisari M, Zerehpoosh FB, Zaresharifi S. Pyodermatitis--pyostomatitis vegetans: a case report and review of literature.Dermatol Online J. 2020;26(5)13030/qt5871q750.
32. Pereira MS, Munerato MC. Oral Manifestations of inflammatory bowel diseases: Two Case Reports. Clin Med Res.2016;14(1):46-52.
33. de Vries SAG, Tan CXW, Bouma G, Forouzanfar T, Brand HS, de Boer NK. Salivary function and oral health problems in Crohn’s disease patients. Inflamm Bowel Dis. 2018;24(6):1361-7.
34. Hopcraft MS, Tan C. Xerostomia: an update for clinicians. Aust Dent J. 2010;55(3):238-44.
35. Fernandez-Gutierrez MM, Imangaliyev S, Prodan A, Loos BG, Keijser BJF, Kleerebezem M. A salivary metabolite signature that reflects gingival host-microbe interactions: instability predicts gingivitis susceptibility. Sci Rep. 2020;10(1):3008 [Acessado em 01 Junho de 2021]. Disponível em: https://doi.org/10.1038/
s41598-020-59988-z.
36. Singhal S, Dian D, Keshavarzian A, Fogg L, Fields JZ, Farhadi A. The role of oral hygiene in inflammatory bowel disease. Dig Dis Sci. 2011;56(1):170-5.
37. Caton JG, Armitage G, Berglundh T, Chapple ILC, Jepsen S, Kornman KS, et al. A new classification scheme for periodontal and peri-implant diseases and conditions - Introduction and key changes from the 1999 classification. J Clin Periodontol. 2018;45(20):S1-S8.
38. Hegab MM, Abdelkawy M. Classification of periodontal diseases – old is gold or new is bold? a survey study in Egypt. Perio J. 2020;4(1):11–23.
39. Garlet GP. Destructive and protective roles of cytokines in periodontitis: a re-appraisal from host defense and tissue destruction viewpoints. J Dent Res. 2010;89(12):1349-63.
40. Gasner NS, Schure RS. Periodontal Disease. StatPearls 2020 [Acessado em 01 Junho de 2021]. Disponível em: https://www.ncbi.nlm.nih.gov/books/NBK541126/.
41. Johannsen A, Fored MC, Håkansson J, Ekbom A, Gustafsson A. Consumption of dental treatment in patients with inflammatory bowel disease, a register study. PLoS One. 2015;10(8) [Acessado em 01 Junho de 2021]. Disponível em: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4534207.
2. Wisam S, Anas K, Mahmud M, Hala K, Amir M, Shani T, etal. Oral manifestations of inflammatory bowel disease: the neglected piece of the puzzle. Eur J Gastroenterol Hepatol. 2020;32(11): 1422-31.
3. Hullah EA, Escudier MP. The mouth in inflammatory bowel disease and aspects of orofacial granulomatosis. Periodontol 2000.2019;80(1): 61-76.
4. Lira-Junior R, Figueredo CM. Periodontal and inflammatory bowel diseases: Is there evidence of complex pathogenic interactions?. World J Gastroenterol. 2016;22(35): 7963-72.
5. Neurath MF. Cytokines in inflammatory bowel disease. Nat Rev Immunol. 2014;14(5): 329-42.
6. Dutta AK, Chacko A. Influence of environmental factors on the on set and course of inflammatory bowel disease. World J Gastroenterol. 2016;22(3):1088-100.
7. Barta Z. Apical periodontitis in patients with inflammatory bowel disease: a puppet master?. Inflamm Bowel Dis.2020;26(2):280-2.
8. Brito F, Zaltman C, Carvalho AT, Fischer RG, Persson R, Gustafsson A, et al. Subgingival microflora in inflammatory bowel disease patients with untreated periodontitis. Eur J Gastroenterol Hepatol. 2013;25(2):239-45.
9. Muhvić-Urek M, Tomac-Stojmenović M, Mijandrušić-Sinčić B. Oral pathology in inflammatory bowel disease. World J Gastroenterol. 2016;22(25):5655-67.
10. Hovde Ø, Moum BA. Epidemiology and clinical course of Crohn’s disease: results from observational studies. World J Gastroenterol. 2012;18(15):1723-31.
11. Rosen MJ, Dhawan A, Saeed SA. Inflammatory bowel disease in children and adolescents. JAMA Pediatr.;169(11):1053-60.
12. Salek H, Balouch A, Sedghizadeh PP. Oral manifestation of Crohn’s disease without concomitant gastrointestinal involvement. Odontology. 2014;102(2):336-8.
13. Rowland M, Fleming P, Bourke B. Looking in the mouth for Crohn’s disease. Inflamm Bowel Dis. 2010;16(2):332-7.
14. Stein JM, Lammert F, Zimmer V, Granzow M, Reichert S, Schulz S, et al. Clinical periodontal and microbiologic parameters in patients with Crohn’s disease with consideration of the CARD15 genotype. J Periodontol. 2010;81(4):535-45.
15. Mays JW, Sarmadi M, Moutsopoulos NM. Oral manifestations of systemic autoimmune and inflammatory diseases: diagnosis and clinical management. J Evid Based Dent Pract. 2012;12(3):265-82.
16. Woo VL. Oral manifestations of Crohn’s disease: a case report and review of the literature. Case rep in dentistry. 2015; [Acessado em 01 Junho de 2021]. Disponível em: https://doi.org/10.1155/2015/830472.
17. Padmavathi B, Sharma S, Astekar M, Rajan Y, Sowmya G. OralCrohn’s disease. J Oral Maxillofac Pathol. 2014;18(1):139-42.
18. Dyall-Smith D. Oral manifestations of inflammatory bowel disease. 2015; [Acessado em 01 Junho de 2021]. Disponível em: htpps://dermentz.org/topics/oral.manifestacions-ofinflamatory-bowel-disease
19. Law ST, Li KK. Age-related differences in the clinical course of Crohn’s disease in an Asian population: a retrospective cohortreview. Indian Pediatr. 2013;50(12):1148-52.
20. Docktor MJ, Paster BJ, Abramowicz S, Ingram J, Wang YE,Correll M, et al. Alterations in diversity of the oral microbiome in pediatric inflammatory bowel disease. Inflamm Bowel Dis.
2012;18(5):935-42.
21. Ribaldone DG, Brigo S, Mangia M, Saracco GM, Astegiano M,Pellicano R. Oral manifestations of inflammatory bowel disease and the role of non-invasive surrogate markers of disease activity. Medicines (Basel). 2020;7(6):33.
22. Carolino F, Fernandes M, Plácido JL. Melkersson-Rosenthal syndrome - delay in the diagnosis of an early-onset oligosymptomatic variant. Porto Biomed J. 2016;1(1):43-45.
23. Lankarani KB, Sivandzadeh GR, Hassanpour S. Oral manifestation in inflammatory bowel disease: a review. World J Gastroenterol. 2013;19(46):8571-9.
24. Kim SK, Lee ES. Orofacial granulomatosis associated with Crohn’s disease. Ann Dermatol. 2010;22(2):203-5.
25. Adegun OK, Zou L, Willis A, Fortune F. Facial biometrics: a
novel technique for evaluation of morphological changes in orofacial Crohn’s disease. BMJ Case Rep. 2013; [Acessado em 01 Junho de 2021]. Disponível em: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3841427/.
26. Jennings VC, Williams L, Henson S. Orofacial granulomatosisas a presenting feature of Crohn’s disease. BMJ Case Rep. 2015; [Acessado em 01 Junho de 2021]. Disponível em: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4289786/.
27. Gale G, Ostman S, Saalman R, Telemo E, Jontell M, Hasséus B. Immunophenotype in orofacial granulomatosis with and without Crohn’s disease. Med Oral Patol Oral Cir Bucal. 2014;19(6):584-91.
28. Antunes H, Patraquim C, Baptista V, Silva Monteiro L. Oral manifestations of Crohn’s disease. BMJ Case Rep. 2015; [Acessado em 01 Junho de 2021]. Disponível em:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4636709/.
29. Trikudanathan G, Venkatesh PG, Navaneethan U. Diagnosis and therapeutic management of extra-intestinal manifestations of inflammatory bowel disease. Drugs. 2012;72(18):2333-49.
30. Nico MM, Hussein TP, Aoki V, Lourenço SV. Pyostomatitis vegetans and its relation to inflammatory bowel disease, pyoderma gangrenosum, pyodermatitis vegetans, and pemphigus. J Oral Pathol Med. 2012;41(8):584-8.
31. Gheisari M, Zerehpoosh FB, Zaresharifi S. Pyodermatitis--pyostomatitis vegetans: a case report and review of literature.Dermatol Online J. 2020;26(5)13030/qt5871q750.
32. Pereira MS, Munerato MC. Oral Manifestations of inflammatory bowel diseases: Two Case Reports. Clin Med Res.2016;14(1):46-52.
33. de Vries SAG, Tan CXW, Bouma G, Forouzanfar T, Brand HS, de Boer NK. Salivary function and oral health problems in Crohn’s disease patients. Inflamm Bowel Dis. 2018;24(6):1361-7.
34. Hopcraft MS, Tan C. Xerostomia: an update for clinicians. Aust Dent J. 2010;55(3):238-44.
35. Fernandez-Gutierrez MM, Imangaliyev S, Prodan A, Loos BG, Keijser BJF, Kleerebezem M. A salivary metabolite signature that reflects gingival host-microbe interactions: instability predicts gingivitis susceptibility. Sci Rep. 2020;10(1):3008 [Acessado em 01 Junho de 2021]. Disponível em: https://doi.org/10.1038/
s41598-020-59988-z.
36. Singhal S, Dian D, Keshavarzian A, Fogg L, Fields JZ, Farhadi A. The role of oral hygiene in inflammatory bowel disease. Dig Dis Sci. 2011;56(1):170-5.
37. Caton JG, Armitage G, Berglundh T, Chapple ILC, Jepsen S, Kornman KS, et al. A new classification scheme for periodontal and peri-implant diseases and conditions - Introduction and key changes from the 1999 classification. J Clin Periodontol. 2018;45(20):S1-S8.
38. Hegab MM, Abdelkawy M. Classification of periodontal diseases – old is gold or new is bold? a survey study in Egypt. Perio J. 2020;4(1):11–23.
39. Garlet GP. Destructive and protective roles of cytokines in periodontitis: a re-appraisal from host defense and tissue destruction viewpoints. J Dent Res. 2010;89(12):1349-63.
40. Gasner NS, Schure RS. Periodontal Disease. StatPearls 2020 [Acessado em 01 Junho de 2021]. Disponível em: https://www.ncbi.nlm.nih.gov/books/NBK541126/.
41. Johannsen A, Fored MC, Håkansson J, Ekbom A, Gustafsson A. Consumption of dental treatment in patients with inflammatory bowel disease, a register study. PLoS One. 2015;10(8) [Acessado em 01 Junho de 2021]. Disponível em: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4534207.