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Rev Clin Periodoncia Implantol Rehabil Oral 2009;2:23-6
REVISIÓN BIBLIOGRÁFICA
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MMPs en la Patogenia de la Periodontitis Apical Crónica: ¿Destrucción o Protección de los Tejidos Periapicales?
MMPs in the Pathogenesis of Chronic Apical Periodontitis: Destructive or Protective Role of Apical Tissues?
R.M. Hernández1,4, G.M. Saldaña2, P.A. Dezerega3,4
1Profesor Asistente, Departamento de Patología, Facultad de Odontología, Universidad de Chile. Chile
2Cirujano Dentista, HOSCAR, Hospital de Carabineros de Chile. Chile
3Instructor, Área de Endodoncia, Departamento de Odontología Conservadora, Facultad de Odontología, Universidad de Chile. Chile
4Laboratorio de Biología Periodontal, Facultad de Odontología, Universidad de Chile. Chile
Resumen
La periodontitis apical crónica corresponde una patología de alta prevalencia en la población chilena y constituye una causa frecuente de pérdida dentaria. Se produce como una manifestación de injuria tisular localizada, que presenta signos bien defhidosde inflamación crónica con destrucción del periodonto apical, reabsord ón ósea y la formación de un granuloma apical o qüste radicular inflamatorio.
Las metaloproteinasas de matriz extracelular (MMPs) degradan los componentesde la matriz y adicionalmente son capaces de potenciar I os procesos sroteoliticose inflamatorios mecíante el procesamiento de sustratos bioacti vos, que incluyen citoquinas, quimioquinas, factores de crecimiento y activación de otras MMPs.’varias MMPs se han identificado en lesiones apicales y red ertem ente, nuestro grupo de trabajo demostró su presencia en el fluido crevicular gingival (FCG) de dientes con lesiones apicales.
A pesar de que tradicionalmente se ha atribuido a las MMPs un papel destructivo en las enfermedades inflamatorias, evidencia reciente sugiere que podrían desempeñar un papel protector Trente a los procesos osteolíticos, proponiendo un nuevo enfoque sobre la función de las MMPs en estas lesiones. Un mayor conocí miento de las interacciones existentes entre las MMPs, sus sustratos bioactivosy los tejidos perirradiculares en la periodontitis apical y su análisis en el FCG, podrían eventualmente conducir a un mejoramiento de los métodos de diagnóstico, tratamiento y monitoreo clínico de esta patología; cuyo desarrollo se ha visto limitado, en parte, por la falta de métodos de estudio adecuados.
Palabras clave
MMPs, periodontitis apical crónica
Abstract
Chronic apical periodortitis is a prevalent disease among Chilean population and a frequent cause of tooth loss. It represents a manifestation of ocalized tissue injury with well-defhed signs of chronic inflammation, destruction of apical periodontium, bone nesorption and formation of an apical granuloma or cyst.
ViMPs degrade extracellular matrix, and further potentiate proteolysisand inflammation by processing of bioactive substrates ascytokines, chemok-ines, growth factors and by activating other MMPs. MMPs have been previously demonstrated in apical lesions and recently, our group demonstrated ts presence also in gingival crevicular fluid (GCF) of associated teeth. Despite MMPs have been traditionally assumed to play a destructive role in nflammatory diseases, recent evidence suggests a protective role of some MMPs over bone resorptive process. These studies open up newinsights to the significance of MMP activity in the pathogenesis of chronic apical periodontitis. Thus, a deeper knowledge of the interactions between MMPs and their substrates in apical periodontitis and associated GCF changes, can eventually lead to improved diagnosis, treatment modalities and clinical monitoring, which have been hampered by the lack of proper methods to study these lesions.
Keywords
MMPs, chronic apical periodontitis
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Recibido 16 enero 2009, Aceptado 04 marzo 2009
Correspondencia autor
Laboratorio de Biología Periodontal, Departamento de Patología, Facultad de Odontología, Universidad de Chile.
Olivos 943 - Independencia. Santiago, Chile.
Fono: (56-2) 978 18 33. Fax: (56-2) 978 18 39.
Copyright © 2009.
Sociedad de Periodoncia de Chile, Sociedad de Implantología Oral de Chile y Sociedad de Prótesis y Rehabilitación Oral de Chile.
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