Manifestações bucais da anemia de células falciformes em gêmeos heterozigóticos

Ferreira, Helena Carla Gomes; Guaré, Renata de Oliveira; Gomes, Ana Maria Martins

doi:10.21722/rbps.v18i2.15095

Cited by 2 publications

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“…As complicações sistêmicas da (DF) incluem os sistemas musculoesquelético, nervoso, cardiopulmonar, hepatobiliar, genitourinário, endócrino, craniofaciais, orofaciais e dentárias que são comumente conhecidos e descritos na literatura (GOMES et al, 2016).…”

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Necessidades odontológicas de adultos e crianças com anemia falciforme de um centro de referência de Alagoas

et al. 2019

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RESUMO:A Doença falciforme é uma hemoglobinopatia genética de alta prevalência no Brasil, caracterizada pelo afoiçamento das hemácias, gerando quadros de infarto tecidual e isquemia nos diversos tecidos e órgão do organismo. Este estudo, transversal observacional, analisou 53 pacientes, 27 crianças e 26 adultos, atendidos no Hemocentro de Alagoas, com o objetivo de realizar o levantamento do diagnóstico e das necessidades de tratamento odontológico, bem como descrever o perfil epidemiológico desses pacientes. Os dados foram registrados de acordo com a ficha de avaliação da saúde bucal da Organização Mundial de Saúde. Os dados foram armazenados e analisados através do software SPSS® 17. O gênero feminino foi o mais frequente entre os adultos e o masculino entre as crianças. Adultos com cor da pele negra e crianças pardas foram os mais freqüentes. Palidez da mucosa estava presente em todos os casos. Embora bem orientados em relação à higiene bucal houve um alto percentual de dentes com cárie e ceo-d e CPO-D altos. A má oclusão se apresentou, pela alta freqüência e severidade, como um problema importante para estes pacientes. Os achados apontam para a necessidade de tratamento da cárie dentária e das oclusopatias de grande importância neste grupo de pacientes demonstrando a necessidade de um planejamento adequado de tratamento que previnam e tratem estas patologias. PALAVRAS-CHAVE: anemia falciforme, má oclusão, cárie dentária. ABSTRACT:Sickle cell disease is a genetic hemoglobinopathy of high prevalence in Brazil, characterized by the erythema of red blood cells, generating pictures of tissue infarction and ischemia in the various tissues and organs of the organism, including the dento-maxillofacial region. This observational crosssectional study analyzed 53 patients, 27 children and 26 adults, attended at the Alagoas Blood Center, in order to carry out a survey of the diagnosis and needs of dental treatment, as well as to describe the epidemiological profile of these patients. Data were recorded according to the World Health Organization oral health assessment form. Data were stored and analyzed using SPSS® software. 17 The female gender was the most frequent among the adults and the male among the children. Adults with black skin color and brown children were the most frequent. Pallor of the mucosa was present in all cases. Although well oriented in relation to oral hygiene, there was a high percentage of teeth with high caries and ceo-d and high CPO-D. Malocclusion presented high frequency and severity as an important problem for these patients. The findings point to the need to treat dental caries and major occlusions in this group of patients demonstrating the need for adequate treatment planning to prevent and treat these pathologies.

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Necessidades odontológicas de adultos e crianças com anemia falciforme de um centro de referência de Alagoas

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“…Além disso, os eritrócitos modificados apresentam menor capacidade de transporte de oxigênio para os tecidos, o que torna os pacientes mais susceptíveis à infecção e a um processo reparativo deficitário. Os indivíduos portadores apresentam períodos de crises agudas, as quais ocorrem por obstrução de pequenos vasos sanguíneos, o que impede a circulação local, levando hipóxia, necrose e dor severa (Gomes et al, 2016). As complicações crônicas estão relacionadas a vasculopatia, lesão isquêmica progressiva e hemólise crônica, tais como doença cerebrovascular, retinopatia, hipertensão pulmonar, insuficiência renal, doença óssea e morte prematura (Zivot et al, 2018).…”

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Mucosite oral em pacientes pediátricos submetidos a transplante de células hematopoiéticas

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Castro FG. Oral mucositis in pediatric patients undergoing hematopoietic cell transplantation [thesis]. São Paulo: Universidade de São Paulo, Faculdade de Odontologia; 2019. Versão Corrigida. Oral mucositis (OM) is one of the main morbidities in immediate periods after hematopoietic cell transplantation (HCT). In pediatric patients, OM is poorly described in the literature and there are no specific protocols for prevention and treatment of these lesions. The aim of this study was to characterize OM in pediatric patients before and during the periods after HCT, and also verify which patient and transplant-related factors may be associated with the duration and severity of these lesions. It was also analyzed the impact of OM on body mass changes, opioid prescription and artificial nutrition, as well as overall survival. For this, 115 medical records were selected from patients up to 18 years old, who underwent HCT, collecting information about the patient, transplantation and toxicity in gastrointestinal tract, from the conditioning period up to 10 days after the neutrophil engraftment. Patients were divided into age groups from 0 to 2, 3 to 6, 7 to 12, and 13 to 18 years old. There was a higher frequency of patients indicated to HCT due to primary immunodeficiencies (34.78%), followed by patients with hematologic malignancies (24.34%) and anemia (18.26%). There was a high frequency of patients from 0 to 2 years old (n=35 patients) and 7 to 12 years old (n=38). These patients were mainly submitted to allogeneic transplantation (87.93%) and conditioning containing bussulfan (57.40%). A higher frequency of OM grades 3 and 4 was observed in patients from 7 to 12 years old compared to other age groups (26.32%, p = 0.019). Longer duration of swallowing pain was also observed in this age group and in 13 to 18 years old group (p = 0.024). In general, at all ages, OM was not restricted to the neutropenia period, manifesting before or extending beyond that period. The prescription of artificial nutrition (71.30%) and opioids (84.16%) was high in all the sample. Patients from 0 to 2 years old needed artificial nutrition for longer period (p = 0.002). Prophylaxis for graft versus host disease (GVHD) with methotrexate was a significant risk factor for OM. Both OM grade 2 (OR = 12.6, p = 0.017) and duration of swallowing pain ³ 3 days (OR=6.5, p<0.001) significantly impacted opioid prescription. Swallowing pain also impacted the prescription of artificial nutrition (OR = 2.7, p = 0.018), but OM did not. None factors related to mucositis in the digestive tract was significantly associated with loss or gain of body mass, nor with overall survival. It was concluded that pediatric patients who underwent HCT exhibited different OM profiles according to age group, with variations in the period of manifestation severity and duration of these lesions. Specific oral care protocols for these age groups should be instituted, focusing mainly on the control of OM regarding to analgesia.

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Manifestações bucais da anemia de células falciformes em gêmeos heterozigóticos

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Cited by 2 publications

References 16 publications

Necessidades odontológicas de adultos e crianças com anemia falciforme de um centro de referência de Alagoas

Necessidades odontológicas de adultos e crianças com anemia falciforme de um centro de referência de Alagoas

Mucosite oral em pacientes pediátricos submetidos a transplante de células hematopoiéticas

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