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(Adnkronos Salute) - "Tendenzialmente il paziente affetto da parodontite è nella quinta decade di vita e, in genere, presenta fattori di rischio, uno dei quali è certamente un'igiene orale insufficiente che ha determinato una condizione che precede quella della parodontite, che è la gengivite, cioè l'infiammazione delle gengive, da cui poi si sviluppa il corteo fisiopatologico che determina la distruzione del tessuto di supporto al dente. L'abitudine al fumo certamente determina un'accelerazione nella distruzione dei tessuti parodontali: tanto più il paziente è fumatore, tanto più rischia tale condizione con progressione più rapida. Altro fattore di rischio fondamentale è il diabete, in particolare, il diabete non controllato". Lo spiega Leonardo Trombelli, presidente eletto Sidp, Società italiana di parodontologia e implantologia, all'Adnkronos Salute in occasione della Giornata nazionale della parodontite. "Nel momento in cui ci troviamo davanti a una condizione di parodontite severa - aggiunge Trombelli - è sempre importante fare una valutazione anche del metabolismo glicemico, della glicemia e dell'emoglobina glicosilata, in modo da accertare che non vi sia una coesistenza di un diabete non diagnosticato. E' altrettanto vero, però, che la parodontite può esacerbare il diabete, nel senso che l'infezione orale potrebbe determinare uno scompenso metabolico nel paziente diabetico". Nel dettaglio, "la parodontite è una condizione infettivo-infiammatoria che è determinata da una disbiosi, cioè da un'alterazione di quella che è la flora orale, che determina una condizione infiammatoria. Inoltre - precisa lo specialista - i batteri possono andare continuamente in circolo filtrando dal margine gengivale ed essere immessi nel torrente circolatorio, anche semplicemente durante le fasi di masticazione. La persistente condizione infiammatoria, d'altro lato, può scatenare delle complicanze anche in organi e distretti corporei diversi, come l'insorgenza di lesioni e placche aterosclerotiche che predispongono poi il paziente a una patologia cardiovascolare". Tecnicamente, la parodontite "è una patologia polifattoriale, in cui entrano sia componenti genetiche che ambientali - rimarca l'esperto - Dal punto di vista genetico è poligenica, per cui ci sono un corredo di geni che sembrano essere sottesi alla suscettibilità nei confronti della parodontite, nessuno dei quali però la determina. Diventa quindi particolarmente complesso identificare dei marker, siano essi legati al microbioma o a fattori e mediatori dell'infiammazione, come del resto fattori di carattere genetico ed epigenetico del paziente a rischio. Per questo è estremamente importante la diagnosi precoce - conclude Trombelli - cioè intercettare quelle che sono le forme precoci di malattia, come ad esempio la gengivite, perché il trattamento della gengivite è la miglior prevenzione primaria per la parodontite". di Adnkronos   09-07-2024 - 19:14 Link copiato Commenti Leggi la Netiquette

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