Manifestações bucais e o perfil bioquímico salivar de mulheres com anorexia e bulimia nervosa
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Data
2020-09-25
Autores
Belila, Naiana de Melo [UNESP]
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Universidade Estadual Paulista (Unesp)
Resumo
Introdução: Os distúrbios alimentares são transtornos psiquiátricos graves, com altos níveis de mortalidade, incapacidade e morbidade física e psicológica; o que provoca redução na qualidade de vida. Objetivo: O presente trabalho teve como objetivos realizar uma revisão sistemática com base na análise de publicações nacionais e internacionais presentes na literatura científica sobre a ocorrência de manifestações bucais em pacientes com anorexia e bulimia nervosa; comparar a ocorrência de cárie, erosão dentária e o perfil bioquímico salivar de mulheres com e sem transtornos alimentares; além de relatar a condição de saúde bucal de uma paciente com anorexia nervosa internada em um hospital de psiquiatria pertencente à Faculdade de Medicina de Marília (FAMEMA), São Paulo, Brasil. Metodologia: A tese foi dividida em três partes. No primeiro momento da pesquisa, realizou-se vasto levantamento bibliográfico para a elaboração do primeiro capítulo, que consistiu em uma revisão sistemática sobre o assunto. O segundo capítulo foi composto por um estudo observacional do tipo caso-controle. Realizou-se a coleta de dados com os pacientes diagnosticados com bulimia e anorexia nervosa e que estavam sob tratamento no ambulatório. O grupo controle foi composto por acompanhantes dos doentes, que possuíam características similares. O terceiro capítulo foi composto por um caso clínico de uma paciente que estava hospitalizada com anorexia nervosa no Hospital das Clínicas da FAMEMA (Unidade I), onde foi realizada toda a descrição de suas condições de saúde bucal. Resultados: No capítulo 1, foi obtido um número final de seis trabalhos, onde todos respondiam a questão sobre quais manifestações bucais são encontradas em pacientes com anorexia e bulimia nervosa, e apresentavam validade e poder em sua estrutura metodológica e resultados. No segundo capítulo, podemos observar que, o grupo das pacientes com anorexia e bulimia nervosa apresenta maiores índices de cárie e erosão dentária, assim como alterações nos parâmetros salivares, em especial o fluxo salivar e os marcadores bioquímicos fósforo, cálcio, FRAP e ácido úrico; quando comparados ao grupo controle. E por fim, na terceira parte da presente tese, observamos que a paciente apresentava 11 dentes atacados pela cárie dentária. No exame periodontal, todos os dentes sondados apresentaram sangramento, além de cálculo nos incisivos inferiores e molares superiores pela face lingual; e o fluxo salivar da paciente encontrava-se extremamente reduzido. Quanto aos parâmetros salivares, o valor encontrado para o cálcio e fósforo estavam aumentados, 13,36mg/dL e 6,31mg/dL, respectivamente. Conclusão: Dessa forma, conclui-se que pacientes diagnosticados com anorexia e bulimia nervosa normalmente apresentam lesões cariosas e erosivas nos dentes e gengivas, além de alterações nos parâmetros bioquímicos salivares.
Introduction: Eating disorders are serious psychiatric disorders, with high levels of mortality, disability and physical and psychological morbidity; which causes a reduction in quality of life. Objective: The present study aimed to carry out a systematic review based on the analysis of national and international publications present in the scientific literature on the occurrence of oral manifestations in patients with anorexia and bulimia nervosa; to compare the occurrence of caries, dental erosion and the biochemical salivary profile of women with and without eating disorders; in addition to reporting the oral health condition of a patient with anorexia nervosa admitted to a psychiatric hospital belonging to the Faculty of Medicine of Marília (FAMEMA), São Paulo, Brazil. Methodology: The thesis was divided into three parts. In the first moment of the research, a vast bibliographic survey was carried out for the elaboration of the first chapter, which consisted of a systematic review on the subject. The second chapter consisted of an observational case-control study. Data collection was performed with patients diagnosed with bulimia and anorexia nervosa and who were under treatment at the outpatient clinic. The control group was composed of patients' companions, who had similar characteristics. The third chapter consisted of a clinical case of a patient who was hospitalized with anorexia nervosa at Hospital das Clínicas da FAMEMA (Unit I), where the entire description of her oral health conditions was carried out. Results: In chapter 1, a final number of six studies was obtained, in which all answered the question about which oral manifestations are found in patients with anorexia and bulimia nervosa, and presented validity and power in their methodological structure and results. In the second chapter, we can see that the group of patients with anorexia and bulimia nervosa has higher rates of caries and dental erosion, as well as changes in salivary parameters, especially the salivary flow and the biochemical markers phosphorus, calcium, FRAP and uric acid ; when compared to the control group. Finally, in the third part of this thesis, 13 we observed that the patient had 11 teeth attacked by dental caries. In the periodontal examination, all probed teeth showed bleeding, in addition to calculus in the lower incisors and upper molars through the lingual surface; and the patient's salivary flow was extremely reduced. As for salivary parameters, the values found for calcium and phosphorus were increased, 13.36mg/dL and 6.31mg/dL, respectively. Conclusion: Thus, it is concluded that patients diagnosed with anorexia and bulimia nervosa usually have carious and erosive lesions on the teeth and gums, in addition to changes in the salivary biochemical parameters.
Introduction: Eating disorders are serious psychiatric disorders, with high levels of mortality, disability and physical and psychological morbidity; which causes a reduction in quality of life. Objective: The present study aimed to carry out a systematic review based on the analysis of national and international publications present in the scientific literature on the occurrence of oral manifestations in patients with anorexia and bulimia nervosa; to compare the occurrence of caries, dental erosion and the biochemical salivary profile of women with and without eating disorders; in addition to reporting the oral health condition of a patient with anorexia nervosa admitted to a psychiatric hospital belonging to the Faculty of Medicine of Marília (FAMEMA), São Paulo, Brazil. Methodology: The thesis was divided into three parts. In the first moment of the research, a vast bibliographic survey was carried out for the elaboration of the first chapter, which consisted of a systematic review on the subject. The second chapter consisted of an observational case-control study. Data collection was performed with patients diagnosed with bulimia and anorexia nervosa and who were under treatment at the outpatient clinic. The control group was composed of patients' companions, who had similar characteristics. The third chapter consisted of a clinical case of a patient who was hospitalized with anorexia nervosa at Hospital das Clínicas da FAMEMA (Unit I), where the entire description of her oral health conditions was carried out. Results: In chapter 1, a final number of six studies was obtained, in which all answered the question about which oral manifestations are found in patients with anorexia and bulimia nervosa, and presented validity and power in their methodological structure and results. In the second chapter, we can see that the group of patients with anorexia and bulimia nervosa has higher rates of caries and dental erosion, as well as changes in salivary parameters, especially the salivary flow and the biochemical markers phosphorus, calcium, FRAP and uric acid ; when compared to the control group. Finally, in the third part of this thesis, 13 we observed that the patient had 11 teeth attacked by dental caries. In the periodontal examination, all probed teeth showed bleeding, in addition to calculus in the lower incisors and upper molars through the lingual surface; and the patient's salivary flow was extremely reduced. As for salivary parameters, the values found for calcium and phosphorus were increased, 13.36mg/dL and 6.31mg/dL, respectively. Conclusion: Thus, it is concluded that patients diagnosed with anorexia and bulimia nervosa usually have carious and erosive lesions on the teeth and gums, in addition to changes in the salivary biochemical parameters.
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Palavras-chave
Transtornos da alimentação e da ingestão de alimentos, Manifestações bucais, Bulimia, Anorexia nervosa, Eating disorders and food intake