Efecto de los Fármacos para el control de hipertensión y diabetes tipo II el el movimiento dental: una revisión sistémica
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Agudelo Solano, María José
Delgado Jaimes, Ronald Yair
Estupiñan Alarcón, Jhon Alexander
Vivas Flórez, Jairo Alberto
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Universidad Santo Tomás
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Introducción: La prevalencia de diabetes e hipertensión plantea desafíos en ortodoncia debido a la potencial alteración del movimiento dental ortodóncico (O.T.M) por los medicamentos utilizados para su control. La necesidad de comprender integralmente esta interacción y la limitación de realizar un estudio primario motivó la realización de una revisión sistemática. Objetivo: identificar el efecto de los fármacos para la hipertensión y la diabetes en el movimiento dental ortodóncico, según la evidencia publicada en los últimos diez años. Materiales y métodos: Se realizó una revisión sistemática siguiendo la metodología PRISMA. Se buscaron artículos entre 2014 y 2024 en cinco bases de datos, gestionados con Mendeley y seleccionados en dos etapas cegadas por revisores mediante título/resumen y texto completo (con Rayyan). La calidad metodológica se evaluó con la herramienta JBI. La investigación se clasificó sin riesgo, respetando la propiedad intelectual, conforme a la Ley 1915 de 2018 y la 1032 de 2006. Resultados: De 1834 artículos, se incluyeron 10 estudios (60% de Google Scholar, 100% en inglés, 40% de Japón). Los estudios, con experimentación de 3 a 21 días, analizaron principalmente fármacos para diabetes (60%) e hipertensión (40%). En diabetes, la condición no controlada aumentó el O.T.M, mientras que insulina, metformina, IGF-1, exendina-4 y la proteína quinasa activada por monofosfato de adenosina tendieron a normalizarlo; la linagliptina lo inhibió. En hipertensión, el captopril aumentó el O.T.M, mientras que losartán (después de 12 días), butoxamina y propanolol lo redujeron. Conclusión: En pacientes diabéticos, insulina, metformina, IGF-1 y exendina-4 favorecen el O.T.M, mientras que la linagliptina lo inhibe. En hipertensos, el captopril lo aumenta, y losartán, propanolol y butoxamina lo disminuyen. Sin embargo, la necesidad de estudios clínicos en humanos es crucial para confirmar cómo estos medicamentos afectan el tratamiento ortodóncico en pacientes con enfermedades concurrentes, permitiendo así establecer guías de práctica clínica confiables.
Abstract
Introduction:The prevalence of diabetes and hypertension poses challenges in orthodontics due to the potential alteration of orthodontic tooth movement (OTM) by medications used for their control. The need for a comprehensive understanding of this interaction and the limitations in conducting a primary study motivated the completion of a systematic review. Objective: To identify the effect of medications for hypertension and diabetes on orthodontic tooth movement, based on evidence published over the last ten years. Materials and Methods: A systematic review was conducted following the PRISMA methodology. Articles published between 2014 and 2024 were searched across five databases, managed with Mendeley, and selected in two blinded stages by reviewers—first by title/abstract and then by full text (using Rayyan). Methodological quality was assessed using the JBI tool. The research was classified as risk-free, respecting intellectual property in accordance with Law 1915 of 2018 and Law 1032 of 2006. Results: Out of 1,834 articles, 10 studies were included (60% from Google Scholar, 100% in English, 40% from Japan). The studies, with experimental durations ranging from 3 to 21 days, mainly analyzed drugs for diabetes (60%) and hypertension (40%). In diabetes, the uncontrolled condition increased OTM, while insulin, metformin, IGF-1, exendin-4, and AMP-activated protein kinase tended to normalize it; linagliptin inhibited it. In hypertension, captopril increased OTM, while losartan (after 12 days), butoxamine, and propranolol reduced it. Conclusion: In diabetic patients, insulin, metformin, IGF-1, and exendin-4 promote OTM, while linagliptin inhibits it. In hypertensive patients, captopril increases OTM, whereas losartan, propranolol, and butoxamine decrease it. However, clinical studies in humans are essential to confirm how these medications affect orthodontic treatment in patients with comorbidities, thereby enabling the establishment of reliable clinical practice guidelines.
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Agudelos Solano, M.J., Delgado Jaimes, R.Y., Estupiñan Alarcón, J. A. y Vivas Florez, J. A.(2025)Introduction:The prevalence of diabetes and hypertension poses challenges in orthodontics due to the potential alteration of orthodontic tooth movement (OTM) by medications used for their control. The need for a comprehensive understanding of this interaction and the limitations in conducting a primary study motivated the completion of a systematic review. Objective: To identify the effect of medications for hypertension and diabetes on orthodontic tooth movement, based on evidence published over the last ten years. Materials and Methods: A systematic review was conducted following the PRISMA methodology. Articles published between 2014 and 2024 were searched across five databases, managed with Mendeley, and selected in two blinded stages by reviewers—first by title/abstract and then by full text (using Rayyan). Methodological quality was assessed using the JBI tool. The research was classified as risk-free, respecting intellectual property in accordance with Law 1915 of 2018 and Law 1032 of 2006. Results: Out of 1,834 articles, 10 studies were included (60% from Google Scholar, 100% in English, 40% from Japan). The studies, with experimental durations ranging from 3 to 21 days, mainly analyzed drugs for diabetes (60%) and hypertension (40%). In diabetes, the uncontrolled condition increased OTM, while insulin, metformin, IGF-1, exendin-4, and AMP-activated protein kinase tended to normalize it; linagliptin inhibited it. In hypertension, captopril increased OTM, while losartan (after 12 days), butoxamine, and propranolol reduced it. Conclusion: In diabetic patients, insulin, metformin, IGF-1, and exendin-4 promote OTM, while linagliptin inhibits it. In hypertensive patients, captopril increases OTM, whereas losartan, propranolol, and butoxamine decrease it. However, clinical studies in humans are essential to confirm how these medications affect orthodontic treatment in patients with comorbidities, thereby enabling the establishment of reliable clinical practice guidelines.[Tesis de posgrado]. Universidad Santo Tomas, Bucaramanga, colombia.
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