Currently, investigations have focused on the identification of Single Nucleotide Polymorphisms (SNP) involved in host response and its ability to generate an immunity deficiency. The aim of this study was to perform a systematic review (SR) and metaanalysis to evaluate the association between TNF-α -308 G>A polymorphism and apical periodontitis (AP) phenotypes. A broad search for studies was conducted. The following databases were used: PubMed, Scopus, Web of Science, and VHL (Medline, SciELO, Ibecs, and Lilacs). The MeSH terms "Periapical Periodontitis," "Periapical Abscess," "Polymorphism, Genetic," and "Polymorphism, Single Nucleotide" were used. MeSH synonyms, related terms, and free terms were included. Clinical investigations of individuals with different AP phenotypes in permanent teeth were selected. After application of the eligibility criteria, selected studies were qualified by assessing their methodological quality. A fixed effect model was used for the meta-analysis. The initial search identified 71 references. After excluding duplicate abstracts, 33 were selected. From these, two were eligible for quality assessment and were classified as being of moderate evidence. The included studies did not demonstrate association between AP and TNF-α -308 G>A SNP. However, the meta-analysis demonstrated an association between the genotype distribution and AP phenotype (OR= 0.49; confidence interval= 0.25, 0.96; p=0.04). The role of TNF-α -308 G>A SNP in AP phenotypes is debatable. Further studies are needed to confirm and understand the underlying mechanisms of the identified association.
O objetivo do presente estudo foi revisar a literatura para avaliar a doença periodontal como fator de risco para a pneumonia nosocomial. A metodologia usada resultou numa busca as bases de dados Medline, PubMed, Lilacs, SciELO e Portal Capes, através dos artigos publicados entre o período de janeiro de 2000 a janeiro de 2017. A pneumonia nosocomial é uma infecção do parênquima pulmonar que se desenvolve nas 48-72 horas após a internação hospitalar, e que não está presente ou incubada no paciente no momento da sua admissão no hospital, representando um dos principais problemas de controle de infecção hospitalar atualmente devido à sua elevada incidência, altas taxas de mortalidade e altos custos. A colonização do biofilme dental e a doença periodontal podem ter um importante papel como reservatório de microrganismos causadores dessa infecção, uma vez que a pneumonia nosocomial resulta da aspiração da flora da cavidade oral e orofaringe para o trato respiratório inferior. A conclusão desta revisão é que a literatura estudada mostra uma relação da doença periodontal no estabelecimento da pneumonia nosocomial. Porém, são necessários mais estudos clínicos controlados randomizados para a confirmação desta associação.ABSTRACT: The aim of this study was to review the literature to evaluate periodontal disease as a risk factor for nosocomial pneumonia. The methodology used resulted in a search of the databases Medline, PubMed, Lilacs, SciELO and Portal Capes, through the works published between January 2000 and January 2017. Nosocomial pneumonia is a pulmonary parenchymal infection that develops within 48-72 hours after hospitalization and is not present or incubated in the patient at the time of admission to the hospital, representing one of the main problems of hospital infection control currently due their high incidence, high mortality rates and high costs. Colonization of the dental biofilm and periodontal disease may play an important role as a reservoir of microorganisms that cause this infection, since nosocomial pneumonia results from aspiration of the flora from the oral cavity and oropharynx to the lower respiratory tract . The conclusion of this review is that the literature studied shows a relationship of periodontal disease in the establishment of nosocomial pneumonia. However, further randomized controlled clinical trials are required to confirm this association.KEYWORDS: Periodontal Disease, Risk Factor, Oral Biofilm, Nosocomial Pneumonia, Intensive Care Units.PALAVRAS-CHAVE: Doença Periodontal, Fator de Risco, Biofilme Dental, Unidade de Terapia Intensiva.
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