Lesiones orales en el paciente con síndrome de Sjögren primario
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2021
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21/01/2021
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Universidad Complutense de Madrid
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Abstract
El síndrome de Sjögren es una enfermedad sistémica, crónica y autoinmune que se caracteriza por un infiltrado linfocitario y una destrucción subsecuente de las glándulas exocrinas, lo que conlleva a una disminución del flujo lacrimal y salival. Su etiología es desconocida, aunque se considera de base multifactorial. Se clasifica en síndrome de Sjögren primario cuando aparece como una enfermedad aislada y secundario cuando dichas alteraciones se asocian a otras enfermedades autoinmunes como la artritis reumatoide, el lupus eritematoso sistémico o la esclerodermia. La evidencia científica acerca de las manifestaciones orales en el síndrome de Sjögren primario se ha centrado en estudiar la xerostomía e hiposialia, sin embargo, hay pocos datos acerca de la prevalencia, tipo y factores predisponentes de las lesiones de la mucosa oral. Hasta la fecha, no existía una visión global de cuáles eran las lesiones orales más comunes en estos pacientes ni si dichas lesiones aparecían con mayor frecuencia que en la población general. Del mismo modo no se habían estudiado los posibles factores de riesgo asociados a las mismas.
Objetivos: El objetivo general de esta tesis doctoral es valorar la presencia de lesiones orales en los pacientes con síndrome de Sjögren primario. Los objetivos específicos son: realizar una revisión sistemática de la presencia de lesiones orales en pacientes con síndrome de Sjögren y compararlas (cuando estaba disponible) con un grupo control (estudio 1); comparar la presencia de lesiones orales en pacientes con síndrome de Sjögren primario respecto a un grupo control y estudiar los factores predisponentes para la aparición de dichas lesiones en estos pacientes (estudio 2); e investigar la asociación entre la presencia de Candida albicans y lesiones clínicas de candidiasis oral con los niveles de flujo y pH salival y determinar los factores de riesgo asociados a sufrir candidiasis oral en estos pacientes (estudio 3)...
Sjögren’s syndrome is a systemic, chronic, and autoimmune disease characterized by lymphocytic infiltration of the salivary and lacrimal glands, which leads to a decreased salivary and lacrimal flow. Although it is considered a multifactorial disease, its aetiology is yet unknown. Sjögren’s syndrome is classified as primary Sjögren’s syndrome, when it appears as an isolated disease, or secondary when it is associated with another autoimmune condition, such as rheumatoid arthritis, systemic erythematous lupus, or scleroderma. The scientific evidence about oral manifestations in primary Sjögren’s syndrome has focused on xerostomia and hiposialia. There are only few studies about prevalence, type, and risk factors of oral mucosal lesions. To date, there had not been a global overview of which were the most common oral lesions in these patients, or whether these lesions appeared more frequently than in the general population. Similarly, the possible risk factors associated with them had not been studied. Objectives: The general objective of this doctoral thesis is to assess the presence of oral lesions in patients with primary Sjögren's syndrome. The specific objectives are: to carry out a systematic review of the presence of oral lesions in patients with Sjögren's syndrome and to compare them (when available) with a control group (study 1); to compare the presence of oral lesions in patients with primary Sjögren's syndrome with a control group and to study the predisposing factors for the appearance of these lesions in these patients (study 2); to investigate the association between the presence of Candida albicans and clinical lesions of oral candidiasis with salivary flow and pH levels and to determine the risk factors associated with suffering from oral candidiasis in these patients (study 3)...
Sjögren’s syndrome is a systemic, chronic, and autoimmune disease characterized by lymphocytic infiltration of the salivary and lacrimal glands, which leads to a decreased salivary and lacrimal flow. Although it is considered a multifactorial disease, its aetiology is yet unknown. Sjögren’s syndrome is classified as primary Sjögren’s syndrome, when it appears as an isolated disease, or secondary when it is associated with another autoimmune condition, such as rheumatoid arthritis, systemic erythematous lupus, or scleroderma. The scientific evidence about oral manifestations in primary Sjögren’s syndrome has focused on xerostomia and hiposialia. There are only few studies about prevalence, type, and risk factors of oral mucosal lesions. To date, there had not been a global overview of which were the most common oral lesions in these patients, or whether these lesions appeared more frequently than in the general population. Similarly, the possible risk factors associated with them had not been studied. Objectives: The general objective of this doctoral thesis is to assess the presence of oral lesions in patients with primary Sjögren's syndrome. The specific objectives are: to carry out a systematic review of the presence of oral lesions in patients with Sjögren's syndrome and to compare them (when available) with a control group (study 1); to compare the presence of oral lesions in patients with primary Sjögren's syndrome with a control group and to study the predisposing factors for the appearance of these lesions in these patients (study 2); to investigate the association between the presence of Candida albicans and clinical lesions of oral candidiasis with salivary flow and pH levels and to determine the risk factors associated with suffering from oral candidiasis in these patients (study 3)...
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Tesis inédita de la Universidad Complutense de Madrid, Facultad de Odontología, Departamento de Especialidades Clínicas Odontológicas, leída el 21/01/2021. Tesis formato europeo (compendio de artículos)