Revista de Odontologia da UNESP
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Revista de Odontologia da UNESP
Review Article

Infecção endodôntica como fator de risco para manifestações sistêmicas: revisão da literatura

Endodontic infection as factor of risk for systemic manifestations: review of the literature

Silva, J.M.; Marceliano, M.F.V.; Souza, P.A.R.S.; Lamarão, S.M.S.

Rev. odontol. UNESP, vol.36, n4, p.357-364, 2007
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Resumo

A teoria da infecção focal perdurou por muito tempo, impedindo o progresso científico da Endodontia. Acreditava-se que microrganismos ou toxinas oriundos de infecções orais agiam como foco de infecções, podendo disseminar-se sistemicamente. Essa teoria caiu em descrédito devido à falta de evidências científicas que lhe dessem suporte. Com o desenvolvimento das técnicas de cultivo e isolamento, novas pesquisas foram realizadas. Atualmente, volta-se a questionar a relação entre infecções orais e manifestações sistêmicas, principalmente em relação à endocardite infecciosa. Inúmeros estudos confirmam a presença de bactérias provenientes de canais radiculares infectados, na circulação sanguínea, pela ocorrência da bacteriemia, podendo ser determinante para complicações sistêmicas. O objetivo deste trabalho é revisar criticamente a literatura relacionada às infecções endodônticas como fator de risco à condução de possível manifestação sistêmica. A literatura sugere que a bacteriemia pode estar associada à endotoxinas bacterianas de canais infectados, apresentando riscos para complicações sistêmicas, e que tais riscos podem ser minimizados quando medidas terapêuticas adequadas são aplicadas, como manipulação cuidadosa de canais infectados e antibioticoterapia profilática para pacientes de alto risco.

Palavras-chave

Endocardite infecciosa, infecção focal dentária, bacteriemia

Abstract

The theory of the focal infection has been lasted for a long time, hindering scientific progress of endodontics. They used to believe that microorganisms or toxins of oral infections had a special role as focus of infections, being able to spread systematically. This theory has lost credibility due to lack of support scientific evidences. With the development of culture and isolation techniques, new researches had been carried through. Currently, they started to search again about the relationship between oral infections and systemic manifestations, especially related infectious endocarditic. Innumerable studies confirm the presence of bacteria proceeded from infected root canals in bloody circulation due to the forthcoming of bacteremia, being able to determinate systemic complications. The aim of this study is to revise critically the literature content suggesting that endodontic infections can act as a risk factor and often being able to promote systemic manifestation. The literature suggests that bacteremia can be associated to infected canals bacterial endotoxins and cause potential risk to systemic complications, such risks can be minimized when therapeutical measures are applied (careful manipulation of infected canals and prophylactic antibiotic therapy to high risk patients).

Keywords

Endocarditis, focal infection dental, bacteremia

References

 


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