INTER-RELAÇÃO DA DOENÇA PERIODONTAL E DIABETES MELLITUS: REVISÃO INTEGRATIVA

Autores

DOI:

https://doi.org/10.47820/recima21.v4i11.4441

Palavras-chave:

Diabetes mellitus, Periodontite, Complicações diabéticas, Inflamação, Citocinas.

Resumo

Introdução: A Doença periodontal (DP) e o Diabetes mellitus (DM) são patologias não transmissíveis intimamente relacionadas que apresentam alta prevalência no mundo, comprometendo seriamente a qualidade de vida dos indivíduos acometidos, além de compartilharem características comuns em termos de respostas inflamatórias. O DM e a DP têm uma relação bidirecional que tem sido amplamente documentada na literatura. Alguns estudos identificam que a terapia periodontal pode melhorar o controle glicêmico no diabético, em contrapartida, outros trabalhos relatam contradições nessa assertiva. Objetivo: Através de uma revisão integrativa da literatura, avaliar a inter-relação entre Doença periodontal e Diabetes mellitus. Metodologia: Foi realizada uma pesquisa bibliográfica nas bases de dados MEDLINE (PubMed), sem restrição de data, com texto completo nos idiomas inglês e português, aplicando os descritores “Diabetes mellitus”, “Periodontite”, “Complicações diabéticas”, “Inflamação”, “Citocinas”. “Diabetes mellitus”. Discussão: Algumas pesquisas têm demonstrado que o tratamento bem-sucedido da infecção periodontal pode contribuir para aprimorar o controle glicêmico em pessoas com diabetes, resultando na redução dos níveis de mediadores inflamatórios associados à resistência à insulina no sangue. Conclusão: o tratamento periodontal é associado à melhoria do controle glicêmico em pessoas com DM, além de melhorar o controle metabólico e reduzir a inflamação sistêmica, reduzindo os níveis séricos de HbA1c e PCR.

Downloads

Não há dados estatísticos.

Biografias Autor

Maria Eduarda Ribeiro da Silva

Graduanda do Curso de Odontologia da Faculdade Independente do Nordeste -FAINOR.

Iana Batista Gaviao

Graduanda do Curso de Odontologia da Faculdade Independente do Nordeste -FAINOR.

Antenor Martins Dias Vieira

Graduando do Curso de Odontologia da Faculdade Independente do Nordeste -FAINOR

Adilson dos Santos Damascena Júnior

Graduando no Curso de Odontologia na Faculdade Independente do Nordeste - FAINOR.

Janilson Souza Figueiredo Júnior

Graduando no Curso de Odontologia na Faculdade Independente do Nordeste -FAINOR.

Francisco Augusto da Silva Filho

Graduando no Curso de Odontologia na Faculdade Independente do Nordeste - FAINOR.

Edson Vinicius Santos Almeida

Graduando no Curso de Odontologia na Faculdade Independente do Nordeste - FAINOR.

Karina Sarno Paes Alves Dias.

Mestre em Periodontia; Especialista em Implantodontia; Professora da Faculdade Independente do Nordeste - FAINOR.

Referências

ACHARYA, A. B. et al. Systemic cytokines in type 2 diabetes mellitus and chronic periodontitis. Current diabetes reviews, v. 14, n. 2, p. 182-188, 2018. Disponível em: https://pubmed.ncbi.nlm.nih.gov/28000545/.

ALBA-LOUREIRO, Tatiana Carolina et al. Diabetes causes marked changes in function and metabolism of rat neutrophils. Journal of endocrinology, v. 188, n. 2, p. 295-303, 2006. doi: 10.1677/joe.1.06438. Disponível em: https://pubmed.ncbi.nlm.nih.gov/16461555/.

ALBA-LOUREIRO, Tatiana Carolina et al. Neutrophil function and metabolism in individuals with diabetes mellitus. Brazilian Journal of Medical and Biological Research, v. 40, p. 1037-1044, 2007. Disponível em: https://pubmed.ncbi.nlm.nih.gov/17665039/.

ARTESE, Hilana Paula Carillo et al. Periodontal therapy and systemic inflammation in type 2 diabetes mellitus: a meta-analysis. PloS one, v. 10, n. 5, p. e0128344, 2015. Disponível em: https://pubmed.ncbi.nlm.nih.gov/26010492/.

BAEZA, Mauricio et al. Effect of periodontal treatment in patients with periodontitis and diabetes: systematic review and meta-analysis. Journal of Applied Oral Science, v. 28, 2020. doi: 10.1590/1678-7757-2019-0248. PMID: 31939522; PMCID: PMC6919200. Disponível em: https://pubmed.ncbi.nlm.nih.gov/31939522/.

BASCONES-MARTINEZ, A.; MUNOZ-CORCUERA, M.; BASCONES-ILUNDAIN, J. Diabetes and periodontitis: A bidirectional relationship. Medicina Clínica (English Edition), v. 145, n. 1, p. 31-35, 2015. Disponível em: https://pubmed.ncbi.nlm.nih.gov/25192582/.

BATCHELOR, P. Is periodontal disease a public health problem?. British dental journal, v. 217, n. 8, p. 405-409, 2014. Disponível em: https://pubmed.ncbi.nlm.nih.gov/25342346/.

BORGNAKKE, Wenche S. “Non-modifiable” risk factors for periodontitis and diabetes. Current oral health reports, v. 3, p. 270-281, 2016. Disponível em: https://link.springer.com/article/10.1007/s40496-016-0098-7.

BORGNAKKE, Wenche S. Modifiable risk factors for periodontitis and diabetes. Current Oral Health Reports, v. 3, p. 254-269, 2016. Disponível em: https://link.springer.com/article/10.1007/s40496-016-0099-6

CALLE, M. C.; FERNANDEZ, M. L. Inflammation and type 2 diabetes. Dia- betes Metab., v. 38, n. 3, p. 183‐191, 2012. Disponível em: https://pubmed.ncbi.nlm.nih.gov/22252015/.

CASANOVA, L.; HUGHES, F. J.; PRESHAW, P. M. Diabetes and periodontal disease: a two-way relationship. British dental journal, v. 217, n. 8, p. 433-437, 2014. Disponível em: https://pubmed.ncbi.nlm.nih.gov/25342350/

CHÁVARRY, N. G. M. et al. The relationship between diabetes mellitus and destructive periodontal disease: a meta-analysis. Oral health & preventive dentistry, v. 7, n. 2, 2009. Disponível em: https://pubmed.ncbi.nlm.nih.gov/19583037/.

CHEE, B.; PARK, B.; BARTOLD, P. M. Periodontitis and type II diabetes: a two‐way relationship. International Journal of Evidence‐based Healthcare, v. 11, n. 4, p. 317-329, 2013. Disponível em: https://pubmed.ncbi.nlm.nih.gov/24298927/.

D'AIUTO, F. et al. Systemic effects of periodontitis treatment in patients with type 2 diabetes: a 12 month, single-cen tre, investigator-masked, randomised trial. The lancet Diabetes & endocrinology, v. 6, n. 12, p. 954-965, 2018. Disponível em: https://pubmed.ncbi.nlm.nih.gov/30472992/.

DARRÉ, L. et al. Efficacy of periodontal treatment on glycaemic control in diabetic patients: a meta-analysis of interventional studies. Diabetes & metabolism, v. 34, n. 5, p. 497-506, 2008. Disponível em: https://pubmed.ncbi.nlm.nih.gov/18948050/.

DEDOV, I. I. et al. Standards of specialized diabetes care. Edited by Dedov II, Shestakova MV, Mayorov A. Yu. Diabetes mellitus, v. 22, n. 1S1, p. 1-144, 2019. Disponível em: https://www.dia-endojournals.ru/jour/article/view/12211/en_US?locale=en_US.

DEMMER, Ryan T. et al. The influence of type 1 and type 2 diabetes on periodontal disease progression: prospective results from the Study of Health in Pomerania (SHIP). Diabetes care, v. 35, n. 10, p. 2036-2042, 2012. Disponível em: https://pubmed.ncbi.nlm.nih.gov/22855731/.

EKE, Paul I. et al. Periodontitis prevalence in adults≥ 65 years of age, in the USA. Periodontology 2000, v. 72, n. 1, p. 76-95, 2016. Disponível em: https://pubmed.ncbi.nlm.nih.gov/27501492/.

ENGEBRETSON, S.; KOCHER, T. Evidence that periodontal treatment improves diabetes outcomes: a systematic review and meta‐analysis. Journal of clinical periodontology, v. 40, p. S153-S163, 2013. Disponível em: https://doi.org/10.1111/jcpe.12084.

FERNÁNDEZ-REAL, J. M.; RICART, W. Insulin resistance and chronic cardiovascular inflammatory syndrome. Endocrine reviews, v. 24, n. 3, p. 278-301, 2003. Disponível em: https://pubmed.ncbi.nlm.nih.gov/12788800/.

GENCO, R. J. et al. Um modelo proposto ligando a inflamação à obesidade, diabetes e infecções periodontais. Jornal de periodontologia, v. 76, p. 2075-2084, 2005. Disponível em: https://aap.onlinelibrary.wiley.com/doi/abs/10.1902/jop.2005.76.11-S.2075.

GENCO, R. J.; BORGNAKKE, W. S. Risk factors for periodontal disease. Periodontology 2000, v. 62, n. 1, p. 59-94, 2013. Disponível em: https://pubmed.ncbi.nlm.nih.gov/23574464/.

GRAVES, D. T. et al. Diabetes-enhanced inflammation and apoptosis—impact on periodontal pathology. Journal of dental research, v. 85, n. 1, p. 15-21, 2006. doi: 10.1177/154405910608500103. Disponível em: https://pubmed.ncbi.nlm.nih.gov/16373675/.

GRAZIANI, F. et al. A systematic review and meta‐analysis of epidemiologic observational evidence on the effect of periodontitis on diabetes An update of the EFP‐AAP review. Journal of Clinical Periodontology, v. 45, n. 2, p. 167-187, 2018. Disponível em: https://doi.org/10.1111/jcpe.12837.

HARDING, Jessica L. et al. Global trends in diabetes complications: a review of current evidence. Diabetologia, v. 62, p. 3-16, 2019. doi: 10.1007/s00125- 018-4711-2. Disponível em: https://pubmed.ncbi.nlm.nih.gov/30171279/.

HONG, J. W.; NOH, J. H.; KIM, D. J. The prevalence and associated factors of periodontitis according to fasting plasma glucose in the Korean adults: The 2012–2013 Korea National Health and Nutrition Examination Survey. Medicine, v. 95, n. 14, 2016. Disponível em: DOI: http://dx.doi.org/10.1097/md.0000000000003226.

JIALAL, I.; DEVARAJ, S.; VENUGOPAL, S. K. C-reactive protein: risk marker or mediator in atherothrombosis?. Hypertension, v. 44, n. 1, p. 6-11, 2004. Disponível em: https://pubmed.ncbi.nlm.nih.gov/15148294/.

JUNIOR, R. L. et al. Effects on HbA1c in diabetic patients of adjunctive use of systemic antibiotics in nonsurgical periodontal treatment: A systematic review. Journal of dentistry, v. 66, p. 1-7, 2017. Disponível em: https://doi.org/10.1016/j.jdent.2017.08.001.

KNIGHT, Ellie T. et al. Risk factors that may modify the innate and adaptive immune responses in periodontal diseases. Periodontology 2000, v. 71, n. 1, p. 22-51, 2016. Disponível em: https://pubmed.ncbi.nlm.nih.gov/27045429/.

KOROMANTZOS, Panagiotis A. et al. Effect of non‐surgical periodontal therapy on C‐reactive protein, oxidative stress, and matrix metalloproteinase (MMP)‐9 and MMP‐2 levels in patients with type 2 diabetes: a randomized controlled study. Journal of periodontology, v. 83, n. 1, p. 3-10, 2012. Disponível em: https://pubmed.ncbi.nlm.nih.gov/21627458/.

KUME, N. et al. Lysophosphatidylcholine, a component of atherogenic lipoproteins, induces mononuclear leukocyte adhesion molecules in cultured human and rabbit arterial endothelial cells. The Journal of clinical investigation, v. 90, n. 3, p. 1138-1144, 1992. Disponível em: https://pubmed.ncbi.nlm.nih.gov/1381720/.

LALLA, E.; PAPAPANOU, P. N. Diabetes mellitus and periodontitis: a tale of two common interrelated diseases. Nature Reviews Endocrinology, v. 7, n. 12, p. 738-748, 2011. Disponível em: https://doi.org/10.1038/nrendo.2011.106.

LALLA, Evanthia et al. Receptor for advanced glycation end products, inflammation, and accelerated periodontal disease in diabetes: mechanisms and insights into therapeutic modalities. Annals of Periodontology, v. 6, n. 1, p. 113-118, 2001. doi: 10.1902/annals.2001.6.1.113. Disponível em: https://pubmed.ncbi.nlm.nih.gov/11887453/.

LIU, Chenxiao et al. Adiponectin, TNF-α and inflammatory cytokines and risk of type 2 diabetes: a systematic review and meta-analysis. cytokine, v. 86, p. 100-109, 2016. Disponível em: https://pubmed.ncbi.nlm.nih.gov/27498215/.

LIU, Rongkun et al. Diabetes alters the response to bacteria by enhancing fibroblast apoptosis. Endocrinology, v. 145, n. 6, p. 2997-3003, 2004. doi: 10.1210/en.2003-1601. Disponível em: https://pubmed.ncbi.nlm.nih.gov/15033911/.

MANOUCHEHR-POUR, M. et al. Impaired neutrophil chemotaxis in diabetic patients with severe periodontitis. Journal of dental research, v. 60, n. 3, p. 729-730, 1981. doi: 10.1177/00220345810600031101. Disponível em: https://pubmed.ncbi.nlm.nih.gov/6937506/.

MARCACCINI, Andrea M. et al. Circulating interleukin‐6 and high‐sensitivity C‐reactive protein decrease after periodontal therapy in otherwise healthy subjects. Journal of periodontology, v. 80, n. 4, p. 594-602, 2009. doi: 10.1902/jop.2009.080561. Disponível em: https://pubmed.ncbi.nlm.nih.gov/19335079/.

MEALEY, B. L.; OATES, T. W. Diabetes mellitus and periodontal diseases. Journal of periodontology, v. 77, n. 8, p. 1289-1303, 2006. Disponível em: doi:10.1902/jop.2006.050459.

MEALEY, B. L.; ROSE, L. F. Diabetes mellitus and inflammatory periodontal diseases. Current Opinion in Endocrinology, Diabetes and Obesity, v. 15, n. 2, p. 135-141, 2008. Disponível em: doi:10.1097/MED.0b013e3282f824b7.

MESIA, R. et al. Systemic inflammatory responses in patients with type 2 diabetes with chronic periodontitis. BMJ Open Diabetes Research and Care, v. 4, n. 1, p. e000260, 2016. Disponível em: https://drc.bmj.com/content/4/1/e000260.short.

MIRANDA, T. S. et al. Metronidazole and amoxicillin as adjuncts to scaling and root planing for the treatment of type 2 diabetic subjects with periodontitis: 1‐year outcomes of a randomized placebo‐controlled clinical trial. Journal of clinical periodontology, v. 41, n. 9, p. 890-899, 2014. Disponível em: https://doi.org/10.1111/jcpe.12282.

MOURÃO, L. et al. Homeopathy and periodontal treatment in type II diabetic patients: a 1-year randomized clinical trial. Brazilian dental journal, v. 30, p. 139-145, 2019. Disponível em: https://www.scielo.br/j/bdj/a/JMCzzBQh6yBhPC77q5pMtCz/abstract/?lang=en.

NAGUIB, Ghada et al. Diabetes prolongs the inflammatory response to a bacterial stimulus through cytokine dysregulation. Journal of Investigative Dermatology, v. 123, n. 1, p. 87-92, 2004. doi: 10.1111/j.0022-202X.2004.22711.x. Disponível em: https://pubmed.ncbi.nlm.nih.gov/15191547/.

NEGISHI, Jun et al. Effect of lifestyle on periodontal disease status in diabetic patients. Journal-International Academy Of Periodontology, v. 6, n. 4, p. 120-124, 2004. Disponível em: https://pubmed.ncbi.nlm.nih.gov/15553978/.

NITTA, Hiroshi et al. The number of microvascular complications is associated with an increased risk for severity of periodontitis in type 2 diabetes patients: Results of a multicenter hospital‐based cross‐sectional study. Journal of diabetes investigation, v. 8, n. 5, p. 677-686, 2017. Disponível em: https://pubmed.ncbi.nlm.nih.gov/28129466/.

NOTSU, M.; YAMAGUCHI, T.; OKAZAKI, K.; TANAKA, K.; OGAWA, N.; KANAZAWA, I. et al. Advanced glycation end products inhibit the mineralization of mouse stromal ST2 cells by binding the receptor for ages and increasing TGF-β expression and secretion. J Bone Miner Res., v. 28, n. 2402, p. 10, 2013. Disponível em: https://pubmed.ncbi.nlm.nih.gov/24758301/.

NYENWE, Ebenezer A. et al. Management of type 2 diabetes: evolving strategies for the treatment of patients with type 2 diabetes. Metabolism, v. 60, n. 1, p. 1-23, 2011. doi: 10.1016/j.metabol. 2010.09.010. Disponível em: https://pubmed.ncbi.nlm.nih.gov/21134520.

OLIVEIRA, Luciano Santos et al. Self-reported periodontitis and complications in type 1 diabetes patients: A Brazilian nationwide survey. Brazilian dental journal, v. 27, p. 599-603, 2016. https://doi.org/10.1590/0103-6440201601054. Disponível em: https://pubmed.ncbi.nlm.nih.gov/27982241/.

PAGE, M. J. et al. PRISMA 2020 explanation and elaboration: updated guidance and exemplars for reporting systematic reviews. BMJ, v. 372, 2021. Disponível em: https://doi.org/10.1136/bmj.n160.

PAPAPANOU, P. N. et al. Periodontitis: Consensus report of workgroup 2 of the 2017 World Workshop on the Classification of Periodontal and Peri‐Implant Diseases and Conditions. Journal of periodontology, v. 89, p. S173-S182, 2018. Disponível em: https://doi.org/10.1002/JPER.17-0721.

PARASKEVAS, S; HUIZINGA, J D.; LOOS, B G. A systematic review and meta‐analyses on C‐reactive protein in relation to periodontitis. Journal of clinical periodontology, v. 35, n. 4, p. 277-290, 2008. doi: 10.1111/j.1600-051X.2007.01173.x. Disponível em: https://pubmed.ncbi.nlm.nih.gov/18294231/.

POLEPALLE, Tejaswin et al. Acute phase proteins and their role in periodontitis: a review. Journal of clinical and diagnostic research: JCDR, v. 9, n. 11, p. ZE01, 2015. Disponível em: https://pubmed.ncbi.nlm.nih.gov/26674303/.

PRESHAW, P M.; Taylor, J J. How has research into cytokine interactions and their role in driving immune responses impacted our understanding of periodontitis?. Journal of clinical periodontology, v. 38, p. 60-84, 2011. doi: 10.1111/j.1600-051X.2010.01671.x.

PRESHAW, P. M. et al. Periodontitis and diabetes: a two-way relationship. Diabetologia, v. 55, p. 21-31, 2012. doi: 10.1007/s00125-011-2342-y. Epub 2011 Nov 6. PMID: 22057194; PMCID: PMC3228943. Disponível em: https://pubmed.ncbi.nlm.nih.gov/22057194/.

PRESHAW, P. M. et al. Periodontitis and diabetes: a two-way relationship. Diabetologia, v. 55, p. 21-31, 2012. Disponível em: https://link.springer.com/article/10.1007/s00125-011-2342-y.

QUINTERO, A. J. et al. Effect of two periodontal treatment modalities in patients with uncontrolled type 2 diabetes mellitus: A randomized clinical trial. Journal of clinical periodontology, v. 45, n. 9, p. 1098-1106, 2018. Disponível em: https://doi.org/10.1111/jcpe.12991 .

ROGLIC, G. Global Report on Diabetes. Geneva, Switzerland: World Health Organization, 2016.

SAITO, T.; SHIMAZAKI, Y. Metabolic disorders related to obesity and periodontal disease. Periodontology 2000, v. 43, n. 1, p. 254-266, 2007. Disponível em: https://citeseerx.ist.psu.edu/document?repid=rep1&type=pdf&doi=8d2bb1c59f088c76963f5388d3bec59fcedffbb5.

SELVIN, E.; JURASCHEK, S. P. Diabetes epidemiology in the COVID-19 pandemic. Diabetes care, v. 43, n. 8, p. 1690-1694, 2020. Disponível em: https://diabetesjournals.org/care/article/43/8/1690/35599/Diabetes-Epidemiology-in-the-COVID-19-Pandemic.

SOLOWIEJ‐WEDDERBURN, J.; IDE, M.; PENNINGTON, M. Cost‐effectiveness of non‐surgical periodontal therapy for patients with type 2 diabetes in the UK. Journal of clinical periodontology, v. 44, n. 7, p. 700-707, 2017. Disponível em: https://doi.org/10.1111/jcpe.12746.

SOSKOLNE, W. A.; KLINGER, A. The relationship between periodontal diseases and diabetes: an overview. Annals of Periodontology, v. 6, n. 1, p. 91-98, 2001. Disponível em: doi:10.1902/annals.2001.6.1.91.

SOUTHERLAND, Janet H. et al. Commonality in chronic inflammatory diseases: periodontitis, diabetes, and coronary artery disease. Periodontology 2000, v. 40, n. 1, p. 130-143, 2006. Disponível em: https://pubmed.ncbi.nlm.nih.gov/16398690/.

STANKO, P. et al. Bidirectional association between diabetes mellitus and inflammatory periodontal disease. A review. Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub, v. 158, n. 1, p. 35-8, 2014. Disponível em: http://biomed.papers.upol.cz/pdfs/bio/2014/01/05.pdf

STEWART, James E. et al. The effect of periodontal treatment on glycemic control in patients with type 2 diabetes mellitus. Journal of clinical periodontology, v. 28, n. 4, p. 306-310, 2001.

TAYLOR, G. W. Bidirectional interrelationships between diabetes and periodontal diseases: an epidemiologic perspective. Annals of periodontology, v. 6, n. 1, p. 99-112, 2001. Disponível em: https://aap.onlinelibrary.wiley.com/doi/abs/10.1902/annals.2001.6.1.99.

TAYLOR, George W. et al. Severe periodontitis and risk for poor glycemic control in patients with non‐insulin‐dependent diabetes mellitus. Journal of periodontology, v. 67, p. 1085-1093, 1996. Disponível em: https://pubmed.ncbi.nlm.nih.gov/29539790/.

TEEUW, W. J.; GERDES, V. E. A.; LOOS, B. G. Effect of periodontal treatment on glycemic control of diabetic patients: a systematic review and meta-analysis. Diabetes care, v. 33, n. 2, p. 421-427, 2010. Disponível em: https://doi.org/10.2337/dc09-1378.

TESHOME, Amare. The efficacy of chlorhexidine gel in the prevention of alveolar osteitis after mandibular third molar extraction: a systematic review and meta-analysis. BMC oral health, v. 17, n. 1, p. 1-8, 2017. Disponível em: https://pubmed.ncbi.nlm.nih.gov/28526078/.

TORRUNGRUANG, Kitti et al. Periodontitis is associated with elevated serum levels of cardiac biomarkers—Soluble ST2 and C‐reactive protein. Journal of clinical periodontology, v. 46, n. 8, p. 809-818, 2019. Disponível em: https://pubmed.ncbi.nlm.nih.gov/31125449/.

TSAI, Carlene; HAYES, Catherine; TAYLOR, George W. Glycemic control of type 2 diabetes and severe periodontal disease in the US adult population. Community dentistry and oral epidemiology, v. 30, n. 3, p. 182-192, 2002. https://doi.org/10.1034/j.1600-0528.2002.300304.x. Disponível em: https://pubmed.ncbi.nlm.nih.gov/12000341/.

VERNILLO, Anthony T. Dental considerations for the treatment of patients with diabetes mellitus. The Journal of the American Dental Association, v. 134, p. 24S-33S, 2003. Disponível em: https://pubmed.ncbi.nlm.nih.gov/18196670/.

VLASSARA, Helen. The AGE‐receptor in the pathogenesis of diabetic complications. Diabetes/metabolism research and reviews, v. 17, n. 6, p. 436-443, 2001. Disponível em: https://pubmed.ncbi.nlm.nih.gov/11757079/.

Downloads

Publicado

24/11/2023

Como Citar

Ribeiro da Silva, M. E., Batista Gaviao, I., Martins Dias Vieira, A., dos Santos Damascena Júnior, A., Souza Figueiredo Júnior, J., Augusto da Silva Filho, F., … Sarno Paes Alves Dias., K. (2023). INTER-RELAÇÃO DA DOENÇA PERIODONTAL E DIABETES MELLITUS: REVISÃO INTEGRATIVA. RECIMA21 -Revista Científica Multidisciplinar - ISSN 2675-6218, 4(11), e4114441. https://doi.org/10.47820/recima21.v4i11.4441

Edição

Vol. 4 N.º 11 (2023): CLIQUE AQUI PARA ACESSAR OS ARTIGOS

Secção

ARTIGOS

Categorias

Licença

Direitos de Autor (c) 2023 RECIMA21 - Revista Científica Multidisciplinar - ISSN 2675-6218

Creative Commons License

Este trabalho encontra-se publicado com a Licença Internacional Creative Commons Atribuição 4.0.

Os direitos autorais dos artigos/resenhas/TCCs publicados pertecem à revista RECIMA21, e seguem o padrão Creative Commons (CC BY 4.0), permitindo a cópia ou reprodução, desde que cite a fonte e respeite os direitos dos autores  e contenham menção aos mesmos nos créditos. Toda e qualquer obra publicada na revista, seu conteúdo é de responsabilidade dos autores, cabendo a RECIMA21 apenas ser o veículo de divulgação, seguindo os padrões nacionais e internacionais de publicação.