ABSTRACT
As alterações nos níveis dos hormônios sexuais (estrógeno e progesterona) na mulher, durante a puberdade, gravidez, ciclo menstrual, climatério e uso de anticoncepcionais orais, além de atuar em outros orgãos, também agem na cavidade bucal, em especial nos tecidos periodontais, como fator modificador de vários tipos de manifestações patológicas pré-existentes. Este desequilíbrio hormonal altera a resposta tecidual ao biofilme dental, influenciando na composição da sua microbiota e estimulando a síntese de citocinas inflamatórias, em especial das prostaglandinas. O caso clínico apresentado reporta-se a uma paciente com 49 anos, na fase do climatério, que procurou atendimento na Clínica de Periodontia da FOP/UPE, após várias tentativas de tratamento mal sucedido, em função da presença de um aumento gengival localizado na região palatina, envolvendo os dentes 15 e 16. Realizaram-se sessões de orientação sobre higiene bucal e raspagem/alisamento corono-radicular, encaminhamento para um médico ginecologista para equilíbrio das taxas hormonais, com posterior ressecção da lesão. Os resultados da terapêutica periodontal e ginecológica foram efetivos, evitando a recidiva da lesão. Conclui-se, ressaltando a importância de uma terapia integrada para condições como esta ora apresentada, minimizando, dessa forma, maiores danos em níveis bucais e sistêmicos à paciente.
Changes in levels of sex hormones (estrogen and progesterone) in women during puberty, pregnancy, menstrual cycle, menopause and oral contraceptives use, in addition to acting in other organs, also act in the oral cavity, particularly in the periodontal tissues, as modifying factor of various types of pre-existing pathologies. This hormonal imbalance modifies the tissue response to plaque, influencing the flora composition and stimulating the synthesis of inflammatory cytokines, especially prostaglandins. A case report of a localized gingival overgrowth in the palate region in a 49-year-old female patient in the climacteric period is described. The patient was referred to the Periodontics Clinic, Faculty of Dentistry of Pernambuco - FOP / UPE, after repeated unsuccessful attempts at treatment. Treatment consisted of a therapy with oral hygiene instruction, scaling and planing root surface, and referred to a gynecologist for hormone replacement, followed by resection of the lesion. The results of periodontal and gynecological therapy were effective in preventing recurrence. This study concluded the importance of an integrated therapy for conditions such as presented, providing less damage to oral and systemic levels of the patient.
ABSTRACT
PURPOSE: Endocrine abnormalities are common feature of chronic renal failure. The purpose of this study is to understand women's hormonal changes in connection with renal transplantation and to verify improved quality of life of recipient by comparing level of sexual hormone between renal transplant recipients and dialyzed patients. METHODS: To evaluate the level of hormones before and after female renal transplantation, we measured FSH, LH, estradiol, progesterone and prolactin (PRL) in 10 renal transplant recipients (RTR), 10 chronic renal failure patients (CRF) undergoing dialysis (hemodialysis or peritoneal dialysis) and 10 healthy, regularly menstruating women (controls). RESULTS: All 30 females' mean age was 37.83 years. All 10 RTR were menstruating and mean age was 38.6 years and mean serum creatinine (sCr) level was 1.09 mg/dL. Of ten dialyzed patients (6 hemodialysis and 4 peritoneal dialysis), nine of ten dialyzed patients had menstrual disturbance and their mean age was 37.5 years and mean sCr level was 9.8 mg/dL. In RTR, serum PRL and LH level were reduced compared with CRF patients, but these hormones were increased compared with controls. In RTR, progesterone level was significantly lower compared with controls, whereas slightly decreased compared with CRF patients. Estradiol level in dialyzed patients was significantly higher compared with RTR or controls and in RTR was increased compared with controls. CONCLUSION: Following successful renal transplantation, uremic hormonal abnormalities were ameliorated. However, these hormonal changes are not always fully restored which can be attributed to renal insufficiency grade or result from the administered immunosuppressive treatment.