Associação entre saúde bucal e aptidão física, funcionalidade e qualidade de vida : uma revisão sistemática e um estudo transversal em indivíduos com acidente vascular cerebral

Abstract

Oral Inflammatory diseases represent a public health problem worldwide. Caries, periodontitis and apical periodontitis (AP) are infectious and/or chronic inflammatory diseases with high prevalence in different populations. The oral inflammatory burden (OIB) has been associated with atherosclerosis, cardiovascular events and with impaired physical fitness. This study aimed to evaluate the association between oral health and physical fitness, disability and quality of life after the occurrence of stroke in humans. For this, this master thesis consists of two articles. Article 1: This systematic review aimed to evaluate the association between the CIB and different parameters of physical fitness and disability in adults. This study followed the PRISMA recommendations. Electronic searches were performed in PubMed, SCOPUS, Embase and Cochrane Library databases, in addition to manual searches. Among the 2,739 studies identified, a total of 23 observational clinical studies were included. The most frequent oral variables analyzed in the primary studies were tooth loss (n = 18) and periodontitis (n = 9). There was great methodological heterogeneity in the parameters related to physical activity and disability. Significant associations between OIB and physical fitness and/or disability were observed in 22 of the 23 studies included. The certainty of evidence is limited, but consistent, and suggest that OIB is a risk indicator for a poorer physical fitness and disability. Article 2: This study aimed to evaluate the association between oral health, disability and quality of life after stroke. Total of 69 patients with a recent history of stroke were included. The oral exposure variables were collected from angiotomography exam, to evaluate the presence of periodontal bone loss (MBL), AP, tooth loss and OIB. Disability and quality of life assessments were obtained using the Self-efficacy scale questionnaires after stroke (SSEQ-B) and Frenchay Activity Index (FAI). Poisson regression models estimated the association between oral parameters and outcomes calculating the prevalence ratio (PR) and confidence intervals (CI) adjusting for sociodemographic and medical variables. The mean age was 62.9 ± 12.7 years, with 53.6% males. The adjusted models revealed significant and independent association between AP (PR = 2.26; 95% CI = 1.07-4.75; p = 0.032), OIB (PR = 2.73; 95% CI = 2.07-6.95; p = 0.035) and poorer scores in SSEQ-B. The results suggest an association between higher OIB and disability and worse post-stroke quality of life.