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Índice inflamatório da alimentação e doença periodontal
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Abstract(s)
A doença periodontal pode ser definida como uma doença inflamatória crónica, multifatorial, dinâmica e que é desencadeada pela resposta imune-inflamatória do hospedeiro, mediada pela presença de biofilme e sendo caracterizada, em última instância, pela destruição dos tecidos de suporte dentário. A complexidade dessa doença deve-se à presença de infeção polimicrobiana, havendo desequilíbrio entre a libertação de citocinas pró e anti-inflamatórias e aumento da presença de periodontopatógenos, levando à perda da homeostase local e culminando com a disbiose microbiana. Assim, é plausível que indicadores e/ou fatores modificadores possam contribuir para o aumento de marcadores inflamatórios sistémicos e contribuir para a etiopatogénese e progressão da doença, onde durante os últimos anos se tem incluído como fatores tanto o perfil como os hábitos da dieta alimentar. Com o objetivo de estabelecer um índice que avalie todos os componentes da dieta, de uma forma mais ampla e completa, bem como seu potencial de modulação do sistema imune, foi criado o Dietary Inflammatory Index (DII) ou índice inflamatório da dieta. O DII foi delineado com base em diversos parâmetros alimentares, consistindo em alimentos integrais, nutrientes e outros compostos bioativos, sendo considerado atualmente uma base consolidada de literatura científica e representando valores globais de referências, sendo utilizado em uma ampla variedade de estudos epidemiológicos na área de saúde. Desta forma, o objetivo do trabalho foi avaliar o impacto do padrão inflamatório dietético na condição periodontal. Assim, realizou-se um estudo de revisão narrativa, tendo por base 62 artigos publicados em inglês e português, no período de 2013 a 2024, através das bases de dados: PubMed, ScienceDirect e Google Académico com a combinação das seguintes palavras-chave: “periodontitis”, “gengival blending”, “dietary inflammatory índex” e “periodontal disease”. Dos vários estudos selecionados, apesar dos resultados serem escassos na literatura em relação à influência do índice inflamatório da alimentação na doença periodontal, verifica-se que os índices mais elevados, correspondentes a dietas mais pró-inflamatórias estão associados a maiores danos a nível periodontal e a doenças periodontais. Além do tratamento periodontal convencional, os médicos dentistas poderão recomendar uma dieta anti-inflamatória (por exemplo, redução da ingestão de gorduras, carne vermelha e alimentos processados e, consequentemente, aumento do consumo de vegetais de folhas verdes, frutas, grãos integrais e peixe) para os seus doentes com vista a melhoria da saúde oral.
Periodontal disease can be defined as a chronic, multifactorial, dynamic inflammatory disease that is triggered by the host's immune-inflammatory response, mediated by the presence of biofilm and ultimately characterized by the destruction of dental support tissues. The complexity of this disease is due to the presence of polymicrobial infection, with an imbalance between the release of pro- and anti-inflammatory cytokines and an increase in the presence of periodontopathogens, leading to the loss of local homeostasis and culminating in microbial dysbiosis. Thus, it is plausible that indicators and/or modifying factors may contribute to the increase of systemic inflammatory markers and contribute to the etiopathogenesis and progression of the disease, where in recent years both the profile and the habits of the diet have been included as factors. In order to establish an index that evaluates all the components of the diet, in a broader and more complete way, as well as its potential to modulate the immune system, it was created the Dietary Inflammatory Index (DII). The DII was designed based on several dietary parameters, consisting of whole foods, nutrients and other bioactive compounds, and is currently considered a consolidated database of scientific literature and represents global reference values, being used in a wide variety of epidemiological studies in the health area. Thus, the objective of this study was to evaluate the impact of dietary inflammatory pattern on periodontal condition. Thus, a narrative review study was carried out, based on 62 articles published in English and Portuguese, in the period from 2013 to 2024, through the databases: PubMed, ScienceDirect and Google Scholar with the combination of the following keywords: “periodontitis”, “gingival blending”, “dietary inflammatory index” and “periodontal disease”. Of the various studies selected, although the results are scarce in the literature regarding the influence of the inflammatory index of the diet on periodontal disease, it is verified that higher indexes, corresponding to more pro-inflammatory diets, are associated with greater damage at the periodontal level and periodontal diseases. In addition to conventional periodontal treatment, dentists could recommend an anti-inflammatory diet (e.g., reducing the intake of fats, red meat, and processed foods, and consequently increasing the consumption of green leafy vegetables, fruits, whole grains, and fish) to their patients to improved oral health.
Periodontal disease can be defined as a chronic, multifactorial, dynamic inflammatory disease that is triggered by the host's immune-inflammatory response, mediated by the presence of biofilm and ultimately characterized by the destruction of dental support tissues. The complexity of this disease is due to the presence of polymicrobial infection, with an imbalance between the release of pro- and anti-inflammatory cytokines and an increase in the presence of periodontopathogens, leading to the loss of local homeostasis and culminating in microbial dysbiosis. Thus, it is plausible that indicators and/or modifying factors may contribute to the increase of systemic inflammatory markers and contribute to the etiopathogenesis and progression of the disease, where in recent years both the profile and the habits of the diet have been included as factors. In order to establish an index that evaluates all the components of the diet, in a broader and more complete way, as well as its potential to modulate the immune system, it was created the Dietary Inflammatory Index (DII). The DII was designed based on several dietary parameters, consisting of whole foods, nutrients and other bioactive compounds, and is currently considered a consolidated database of scientific literature and represents global reference values, being used in a wide variety of epidemiological studies in the health area. Thus, the objective of this study was to evaluate the impact of dietary inflammatory pattern on periodontal condition. Thus, a narrative review study was carried out, based on 62 articles published in English and Portuguese, in the period from 2013 to 2024, through the databases: PubMed, ScienceDirect and Google Scholar with the combination of the following keywords: “periodontitis”, “gingival blending”, “dietary inflammatory index” and “periodontal disease”. Of the various studies selected, although the results are scarce in the literature regarding the influence of the inflammatory index of the diet on periodontal disease, it is verified that higher indexes, corresponding to more pro-inflammatory diets, are associated with greater damage at the periodontal level and periodontal diseases. In addition to conventional periodontal treatment, dentists could recommend an anti-inflammatory diet (e.g., reducing the intake of fats, red meat, and processed foods, and consequently increasing the consumption of green leafy vegetables, fruits, whole grains, and fish) to their patients to improved oral health.
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Keywords
Índice inflamatório da dieta Doença periodontal Sangramento gengival Alimentação Citoquinas inflamatórias Inflammatory index of the diet Periodontal disease Bleeding gums Feeding Inflammatory cytokines