Como a artrite danifica a ATM.

12 nov Como a artrite danifica a ATM.

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As articulações são conexões naturais entre dois ou mais ossos. Elas são revestidas por uma cartilagem que reveste também as extremidades dos ossos, sendo que a ATM (articulação temporomandibular) apresenta uma cartilagem adicional que tem por objetivo realizar o amortecimento entre os ossos.

Bioquimicamente falando, a cartilagem é composta por fibras de colágeno, glicoproteínas e proteoglicanos.

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O que é artrite?

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A artrite é a inflamação de uma ou mais articulações. Conhecida como “dor nas juntas”.

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Infecção da ATM

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Sendo assim, a ATM pode ser infeccionada como resultado da extensão direta de uma infecção já existente no organismo, tais como a artrite infecciosa aguda, devido à distribuição de microrganismos através do sangue.

A integridade estrutural da cartilagem da ATM ocorre através de um ciclo constante de destruição e reparo. Em outras palavras, o corpo precisa repor cartilagem na mesma velocidade em que a destrói.

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Uma vez que a área da ATM está inflamada, são percebidos os seguintes sintomas:

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Os movimentos mandibulares passam a ser limitados e dolorosos;

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Dores de cabeça;

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Dor nos ombros;

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Dificuldade em abrir e fechar a boca;

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Dor no ouvido.

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Como diagnosticar a artrite da ATM?

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Em estágios precoces, os exames radiográficos apresentam resultados negativos, entretanto depois de algum tempo podem apresentar destruição óssea.

Sendo assim, para diagnosticar a inflamação da ATM precocemente é preciso realizar uma ressonância nuclear magnética a fim de se avaliar o tamanho da lesão.

Exames de sangue para avaliar marcadores inflamatórios, e anticorpos também são necessários no diagnóstico diferencial, bem como o exame clínico.

Veja post no site do portal : patologia da ATM sobre artrite reativa da ATM induzida por bactéria.

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O equilíbrio é o segredo

Quando uma articulação começa a se desgastar, pode-se dizer que ou a destruição aumentou ou o reparo diminuiu.

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Já se perguntou o que exatamente causa a inflamação?

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Como a inflamação resulta em danos a cartilagem?

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Para estas perguntas, não há uma única resposta, visto que existem várias causas de inflamações das articulações. Sendo assim, veja a seguir quais são as principais causas destas inflamações.

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Causas de inflamações na articulações

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Citocinas:

São proteínas que conduzem mensagens entre as células, cuja função é regular a imunidade e a inflamação. As duas principais citocinas são: o fator de necrose tumoral (TNF-alfa) e a interleucina e beta (IL-1Beta).

Em articulações com osteoartrite estas proteínas se encontram em grande quantidade.

Proteases:

São enzimas que provocam a ruptura das proteínas, e que podem gerar inflamação nas articulações.

As proteases estão sob o controle das citocinas. Algumas tem propriedades anti-inflamatórias e outras tem propriedades pró-inflamatórias (causam inflamação).

Na artrite as proteases pró-inflamatórias estão em prevalência.[/fusion_text][/fusion_builder_column][fusion_builder_column type=”1_1″ layout=”1_1″ spacing=”” center_content=”no” link=”” target=”_self” min_height=”” hide_on_mobile=”small-visibility,medium-visibility,large-visibility” class=”” id=”” hover_type=”none” border_size=”0″ border_color=”” border_style=”solid” border_position=”all” border_radius=”” box_shadow=”no” dimension_box_shadow=”” box_shadow_blur=”0″ box_shadow_spread=”0″ box_shadow_color=”” box_shadow_style=”” padding_top=”” padding_right=”” padding_bottom=”” padding_left=”” margin_top=”” margin_bottom=”” background_type=”single” gradient_start_color=”” gradient_end_color=”” gradient_start_position=”0″ gradient_end_position=”100″ gradient_type=”linear” radial_direction=”center center” linear_angle=”180″ background_color=”” background_image=”” background_image_id=”” background_position=”left top” background_repeat=”no-repeat” background_blend_mode=”none” animation_type=”” animation_direction=”left” animation_speed=”0.3″ animation_offset=”” filter_type=”regular” filter_hue=”0″ filter_saturation=”100″ filter_brightness=”100″ filter_contrast=”100″ filter_invert=”0″ filter_sepia=”0″ filter_opacity=”100″ filter_blur=”0″ filter_hue_hover=”0″ filter_saturation_hover=”100″ filter_brightness_hover=”100″ filter_contrast_hover=”100″ filter_invert_hover=”0″ filter_sepia_hover=”0″ filter_opacity_hover=”100″ filter_blur_hover=”0″ last=”true” first=”true”][fusion_text columns=”” column_min_width=”” column_spacing=”” rule_style=”default” rule_size=”” rule_color=”” hide_on_mobile=”small-visibility,medium-visibility,large-visibility” class=”” id=”” animation_type=”” animation_direction=”left” animation_speed=”0.3″ animation_offset=””]

Mecanismo de inflamação das artrites.

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Os fagócitos são atraídos até a articulação na tentativa de sanar essa reação e evitar danos a cartilagem e ao revestimento da articulação temporomandibular. Mas esta resposta inflamatória nem sempre é favorável. Os neutrófilos exercendo sua função de proteção, podem causar mais inflamação e destruição na articulação.

Estes processos causam uma produção excessiva de radicais livres, que por sua vez, sobrecarregam o sistema de defesa antioxidante e provocam o estresse oxidativo. Quando o sistema de defesa antioxidante se sobrecarrega, o estresse oxidativo da articulação provoca danos a cartilagem da articulação temporomandibular.

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Quando o organismo não consegue repor a destruição causada a articulação começa a se deteriorar.

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Na ATM consegue-se realizar manobras que devolvem a harmonia estrutural diminuindo lesões e proporcionando condições de reparo das estruturas.

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Na artrite as proteases pró-inflamatórias estão em prevalência.

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Um outro processo que gera radicais livres e consequentemente a destruição da articulação temporomandibular é um processo que denominado isquemia-perfusão.

Isquemia-perfusão da articulação é um processo simples de lubrificação e hidratação da articulação temporomandibular (e outras articulações que suportam peso).

A ATM está sujeita a tremendas pressões e a isquemia-perfusão está relacionada com o balanço hídrico (hidratação) da articulação. A hidratação é o segredo da resistência desta articulação as pressões.

A ATM está dividida em duas cavidades e quando o disco articular se desloca (travamento/limitação em abrir a boca e estalos no maxilar) compromete a lubrificação da articulação temporomandibular gerando acúmulo de resíduos e um processo degenerativo.

Neste caso, pode-se dizer que foi a artrite que desencadeou a infecção na ATM, sendo assim, cabe ao cirurgião dentista, sempre realizar uma avaliação sistêmica de seu paciente, uma vez que lesões na articulação temporomandibular e bucais, podem ser resultados de outras doenças preexistentes. Então, a fim de se devolver a saúde plena do paciente, deve-se devolver o equilíbrio e a condição de reparo do próprio organismo.

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