Evaluation of the correlation between side effects to oral mucosa, salivary glands, and general health status with quality of life during intensity-modulated radiotherapy for head and neck cancer.

PURPOSE: The aim of this study was to evaluate the distribution of acute clinical complications that involve the oral cavity (oral mucositis and salivary flow), general health status (Karnofsky performance status scale (KPS) and weight), and quality of life using the worst performance throughout radiotherapy treatment by intensity-modulated radiation therapy (IMRT) in the head and neck region and to evaluate the correlation between these variables. METHODS: This prospective, longitudinal study evaluated 32 patients who were undergoing IMRT for head and neck tumors. The measures were collected weekly through standardized protocols and a quality of life questionnaire (UW-QOL version 4). RESULTS: The worst performance for all variables was concentrated in treatment weeks 2 and 5. Regarding quality of life, the emotional dimensions were the most affected (pain 62.86; activity 55; recreation 43.57; mood 49.97; shoulder 57.06; anxiety 42.91). There were a higher number of moderate mucositis correlations with quality of life (mucositis × KPS 0.002; mucositis × weight loss 0.03; mucositis × pain 0.001; mucositis × activity 0.002; mucositis × recreation 0.001; mucositis × swallowing 0.002; mucositis × saliva 0.006; mucositis × mood 0.007; mucositis × anxiety 0.002). CONCLUSIONS: IMRT treatment severely deteriorated the patients' quality of life. There were important correlations between the clinical variables and quality of life, especially mucositis.

Vocal resistance among choir singers.

PURPOSE: The purpose of the present study was to compare the voice of choir singers before and after 60 min of singing and after an absolute rest. METHODS: Twenty-one female choir singers aged on average 26.59 years, with experience in choir singing of at least one year were instructed to emit the vowel /a/ before and after singing and after a vocal rest of 30 min for an analysis of acoustic measures, and for the evaluation of their tactile-kinesthetic self-perception. Vocal warm-up was performed for 10 min. The participants were instructed to sing the "Ave Verum" music continuously for 60 min. RESULTS: f0 (p = 0.0001) and Flo (p = 0.0002) increased after the singing test and were reduced after the vocal rest, in contrast to Fhi (p = 0.001), which continued to be increased compared to the pre-test measure even after the vocal rest. The vAm parameter (p = 0.05) was reduced after continuous singing and rest. All self-evaluation symptoms increased after the continuous singing task and were reduced after the 30 min rest, except for complaints of low voice, pain when swallowing and cough/throat clearing. CONCLUSION: 60 min of continuous use of the singing voice induced signs of vocal fatigue with an increase in f0, with improvement of symptoms and a reduction of f0 occurring after 30 min of vocal rest.

Topical pilocarpine for xerostomia in patients with head and neck cancer treated with radiotherapy.

OBJECTIVE: To evaluate a pilocarpine spray as a treatment for xerostomia in patients treated with radiotherapy (RT) for head and neck cancer (HNC). METHODS: This was a placebo-controlled, double-blind, crossover clinical trial of patients complaining of dry mouth after RT for HNC. Forty patients were randomly assigned to either placebo or pilocarpine (1.54%) spray and instructed to use three times a day for 3 months. After 1-month washout period, patients were crossed over to receive placebo or pilocarpine. The assessments were salivary flow (Stimulated Whole Saliva Flow - SWSF), xerostomia (Xerostomia Inventory - XI), and quality of life (QoL/Oral Health Impact Profile - OHIP-14), assessed at baseline, 1 hr (only SWSF), and at 1, 2, and 3 months of treatment. RESULTS: Posttreatment SWFS was not statistically different between pilocarpine and placebo regardless of the treatment sequence (paired T test; p > .05), except for the SWFS rates at 2 months after therapy. When comparing pilocarpine with placebo in the time points, there was no significant difference (p > .05) for QoL or XI. Significant differences in improvement in QoL and xerostomia experience appeared along time for pilocarpine group. CONCLUSION: The topical application of pilocarpine spray tested was similar to placebo on SWSF assessments in patients treated with RT for HNC.

Correlation of maximum phonation time and vocal intensity with intraluminal esophageal and pharyngoesophageal pressure in total laryngectomees.

OBJECTIVE: This study aimed to correlate maximum phonation time, vocal intensity, and dynamic extension with intraluminal esophageal and pharyngoesophageal segment pressure during tracheoesophageal phonation. DESIGN: Prospective analysis. SETTING: Tertiary academic hospital. METHODS: The study was conducted on 20 total laryngectomees with alaryngeal speech and with secondary insertion of a tracheoesophageal prosthesis who were submitted to vocal recording of maximum phonation time and vocal intensity (minimum, habitual, and maximum). The participants were then submitted to manometry for the determination of the amplitude of intraluminal esophageal (proximal, middle, and distal) and pharyngoesophageal segment pressure during phonation. RESULTS: A significant positive correlation was detected between habitual vocal intensity and the middle (0.004) and distal (0.05) esophagus, in addition to a correlation of maximum intensity with the middle esophageal portion (0.03). Dynamic extension showed correlation with the amplitude of esophageal pressure. There was no significant correlation between the variables studied and pressure of the pharyngoesophageal segment or between maximum phonation time and esophageal pressure amplitude. CONCLUSION: The middle and distal regions of the esophagus were found to be compliant, permitting an adjustment of vocal intensity. There was no correlation between maximum phonation time and the amplitude of esophageal and pharyngoesophageal segment pressure.

Assessment of oral health condition in recipients of allogeneic hematopoietic cell transplantation.

INTRODUCTION: The optimization of oral health before allogeneic hematopoietic cell transplantation (HCT) is important for preventing infectious complications during treatment. OBJECTIVE: The objective of this study was to evaluate the oral health condition and dental treatments performed in patients in pre-allogeneic HCT. METHOD: The records of patients treated during 2018 at a Brazilian HCT service were reviewed. The following oral health data were obtained: 1. Decayed, missing and filled teeth / correlated index for primary dentition (DMFT/dmft); 2. Quality of oral hygiene and 3. Dental pathologies: 3.1 Periodontal infectious focus, 3.2 Endodontic infectious focus and 3.3 Carie incidence. All dental procedures performed were surveyed. RESULTS: Thirty-three patients were included, with a mean age of 28.42 (±16.37), 20 male (60%) and 13 female. The average DMFT/dmft found in this study was 10.24 (± 8.37), similar to the index found in the population in southeastern Brazil. The younger study population presented a DMFT/dmft considered high, when compared to the general population. A total of 27.2% of the patients had active caries lesions, 33.3%, foci of periodontal infection, 15.1%, endodontic infectious focus and 40%, poor oral hygiene. Almost half of the patients (48.4%) had to undergo dental intervention, 24.2% needing periodontal scaling, 21.2%, fillings and 12.1%, tooth extractions. CONCLUSION: We conclude that the studied population had an important incidence of dental pathologies and infectious conditions that could complicate throughout HCT, especially in younger patients, therefore presenting a high demand for dental treatment in the pre-HCT. Studies that assess the impact of dental conditioning on the outcomes of HCT with an emphasis on dental infectious complications, days of hospitalization and survival are necessary."

Intraluminal esophageal pressures in speaking laryngectomees.

OBJECTIVES: The objective of the present study was to evaluate intraluminal esophageal pressure during voice and speech emission in speaking laryngectomees with a tracheoesophageal prosthesis. METHODS: In our prospective analysis in a tertiary-care academic hospital, 25 laryngectomees were divided into 2 groups: 11 speaking individuals with a tracheoesophageal prosthesis and a control group of 14 nonspeaking laryngectomees. All patients were subjected to manometry during voice and speech emission tests. We determined the pressures achieved in the distal, middle, and proximal parts of the esophagus. RESULTS: Statistical analysis revealed that the amplitude of pressure in the distal esophagus during sound emission was higher in speaking laryngectomees; in the middle esophagus, intraluminal pressure during emission of the sentence was higher in speaking subjects, and in the proximal esophagus there was no difference between the groups. CONCLUSIONS: During the manometric evaluation of the distal and middle esophagus in the presence of voice and speech emission, the intraluminal pressure revealed a significant difference for the speaking laryngectomees with a tracheoesophageal prosthesis. The proximal esophagus behaved similarly in the groups of speakers and nonspeakers. Speaking laryngectomees with a tracheoesophageal prosthesis depend on a differentiated performance of the middle and distal parts of the esophagus.

Do foreign bodies migrate through the body towards the heart?

UNLABELLED: Fixation of foreign bodies (FB), in the mucosa, can favor its migration, giving origin to the popular saying: 'FB walk to the heart'. AIM: Describe the mechanisms involved in FB migration and how to diagnose them. METHODOLOGY: From a sample of 3,000 foreign bodies, during 40 years, we analyzed four which had extra-lumen migration. We analyzed clinical, radiologic, endoscopic and ultrasound data collected at the medical documentation service. RESULTS: Three clinical histories are presented, describing two fish bones and one piece of fish cartilage. FB shifting was analyzed in all of them. Migration started in the esophagus in two, one going to the aorta and the other to the neck area. In the other two, migration started in the pharynx, and the FB moved towards the prevertebral fascia and the other externalized in the submandibular region. The mechanisms and the risks posed to the patient, by FB migration, and the way to diagnose them are hereby discussed. CONCLUSIONS: The study allows us to determine that FB can move through the body but not towards the heart. The study also serves as a warning sign: in cases of prolonged histories of FB ingestion, imaging studies are mandatory before endoscopic examination.

Laryngeal Cancer Attributable Factors and the Influence on Survival Rates: A Single Brazilian Institution Experience.

Introduction Epidemiological studies focused on prognostic factors associated with laryngeal cancer in the Brazilian population are poorly reported in the literature. Objective To evaluate the influence of certain risk factors on the survival rates of patients with squamous cell carcinoma (SCC) of the larynx. Methods This retrospective study was conducted on adult patients who were admitted to the outpatient clinic of the head and neck department in a tertiary care hospital. Evaluation of the influence of risk factors on the survival rates of patients registered in the hospital with laryngeal SCC was performed based on age, sex, initial stage, time of evolution, habits, educational levels and relapse and death. Overall survival (OS), disease-free survival (DFS) and clinical-demographic data were analyzed using the Kaplan-Meier method, Log-rank test and Cox regression. Results A total of 107 patients with a mean age of 59.8 years (range 19-81) were included in this study. Stages III and IV were associated with decreased DFS ( p = 0.02) and OS ( p = 0.02). Smoking patients had a greater period of disease evolution than non-smoking patients ( p = 0.003). Alcohol consumption in smokers increased the risk of death by 2.8 ( p = 0.002) compared with non-drinking smokers. Male patients presented lower DFS average when compared with female patients ( p = 0.04). Conclusion Our study confirms that male gender, smoking habit combined with alcohol consumption, and advanced stages were strongly associated with poor prognosis.

SWALLOWING IN PATIENTS WITH LARYNGITIS.

BACKGROUND: Dysphagia is described as a complaint in 32% of patients with laryngitis. OBJECTIVE: The objective of this investigation was to evaluate oral and pharyngeal transit of patients with laryngitis, with the hypothesis that alteration in oral-pharyngeal bolus transit may be involved with dysphagia. METHODS: Videofluoroscopic evaluation of the swallowing of liquid, paste and solid boluses was performed in 21 patients with laryngitis, 10 of them with dysphagia, and 21 normal volunteers of the same age and sex. Two swallows of 5 mL liquid bolus, two swallows of 5 mL paste bolus and two swallows of a solid bolus were evaluated in a random sequence. The liquid bolus was 100% liquid barium sulfate and the paste bolus was prepared with 50 mL of liquid barium and 4 g of food thickener (starch and maltodextrin). The solid bolus was a soft 2.2 g cookie coated with liquid barium. Durations of oral preparation, oral transit, pharyngeal transit, pharyngeal clearance, upper esophageal sphincter opening, hyoid movement and oral-pharyngeal transit were measured. All patients performed 24-hour distal esophageal pH evaluation previous to videofluoroscopy. RESULTS: The evaluation of 24-hour distal esophageal pH showed abnormal gastroesophageal acid reflux in 10 patients. Patients showed longer oral preparation for paste bolus and a faster oral transit time for solid bolus than normal volunteers. Patients with laryngitis and dysphagia had longer preparation for paste and solid boluses, and a faster oral transit time with liquid, paste and solid boluses. CONCLUSION: A longer oral preparation for paste and solid boluses and a faster transit through the mouth are associated with dysphagia in patients with laryngitis.

Magnetic resonance imaging: dynamic contrast enhancement and diffusion-weighted imaging to identify malignant cervical lymph nodes.

OBJECTIVE: To examine the potential of two magnetic resonance imaging (MRI) techniques-dynamic contrast enhancement (DCE) and diffusion-weighted imaging (DWI)-for the detection of malignant cervical lymph nodes. MATERIALS AND METHODS: Using DCE and DWI, we evaluated 33 cervical lymph nodes. For the DCE technique, the maximum relative enhancement, relative enhancement, time to peak enhancement, wash-in rate, wash-out rate, brevity of enhancement, and area under the curve were calculated from a semi-quantitative analysis. For the DWI technique, apparent diffusion coefficients (ADCs) were acquired in the region of interest of each lymph node. Cystic or necrotic parts were excluded. All patients underwent neck dissection or node biopsy. Imaging results were correlated with the histopathological findings. None of the patients underwent neoadjuvant treatment before neck dissection. RESULTS: Relative enhancement, maximum relative enhancement, and the wash-in rate were significantly higher in malignant lymph nodes than in benign lymph nodes (p < 0.009; p < 0.05; and p < 0.03, respectively). The time to peak enhancement was significantly shorter in the malignant lymph nodes (p < 0.02). In the multivariate analysis, the variables identified as being the most capable of distinguishing between benign and malignant lymph nodes were time to peak enhancement (sensitivity, 73.7%; specificity, 69.2%) and relative enhancement (sensitivity, 89.2%; specificity, 69.2%). CONCLUSION: Although DCE was able to differentiate between benign and malignant lymph nodes, there is still no consensus regarding the use of a semi-quantitative analysis, which is difficult to apply in a clinical setting. Low ADCs can predict metastatic disease, although inflammatory processes might lead to false-positive results.

OBJETIVO: Examinar o potencial das imagens de contraste dinâmico (DCE-MRI) e difusão (DW-MRI) em ressonância magnética na detecção de linfonodos cervicais malignos. MATERIAIS E MÉTODOS: Foram realizadas DCE-MRI e DW-MRI em 33 linfonodos cervicais. Os valores de realce relativo máximo, realce relativo, tempo de pico, taxa de realce e lavagem, brevidade do realce e área sob a curva foram avaliados pela análise semiquantitativa (DCE-MRI). Os coeficientes de difusão aparente na DW-MRI foram obtidos na área de interesse. Foram excluídas partes císticas ou necróticas dos nódulos. Todos os pacientes foram submetidos a dissecção cervical ou a biópsia. Os resultados de imagem foram correlacionados com os achados patológicos. Nenhum paciente foi submetido a tratamento neoadjuvante antes da dissecção do pescoço. RESULTADOS: Realce relativo, realce relativo máximo e taxa de realce aumentaram nos nódulos malignos (p < 0,009, p < 0,05 e p < 0,03, respectivamente). O tempo de pico foi reduzido nos nódulos malignos (p < 0,02). A análise multivariada identificou tempo de pico (sensibilidade, 73,7%; especificidade, 69,2%) e realce relativo (sensibilidade, 89,2%; especificidade, 69,2%) como variáveis capazes de distinguir os nódulos benignos e malignos. CONCLUSÃO: Embora o DCE-MRI possa diferenciar os nódulos benignos e malignos, ainda não há consenso sobre a técnica de análise semiquantitativa, em razão de dificuldade de aplicação clínica. Valores baixos do coeficiente de difusão aparente podem predizer nódulo metastático, mas devem-se considerar também resultados falso-positivos, provavelmente secundários ao processo inflamatório.

Alternative products in tropical treatment of radiation induced xerostomia: a systematic review / Produtos alternativos no tratamento tópico da xerostomia radioinduzida: uma revisão sistemática

Xerostomia, a term used to characterize the sensation of dry mouth, it is one of the most common symptoms after radiotherapy treatment of the head and neck region, being also the most expensive, impacting the oral health and quality of life of these patients. We performed a systematic review to identify topical treatments of natural composition in patients with radiation induced xerostomia. Searches were carried out in electronic databases such as the databases consulted were Cochrane library, PubMed (MEDLINE) and Latin American and Caribbean Literature in Health Sciences ­ LILACS. The research was carried out from June to July 2022 the period admitted for the results were from 1990 to 2022. We included trials of topical interventions with natural composition such, medicinal mucilage, sprays, oils and chewing gums for the management of dry mouth symptom. Results: 6 studies fully met the desired criteria, totalizing 336 patients. The therapies based on natural products were compared with placebo or other treatments and the forms of presentation were spray, oil, medicinal mucilage, and gel. In general, there was an improvement in some signs and symptoms of xerostomia and the most described adverse effect was nausea. Natural composition products seem to be a good alternative therapy for the relief of xerostomia symptoms and their consistency and form of application seem to exert influence, as evidence is still scarce, more randomized and placebo-controlled clinical studies are needed.

A xerostomia é o termo utilizado para caracterizar a sensação de boca seca, sendo um dos sintomas mais comuns após o tratamento radioterápico da região de cabeça e pescoço e também o mais oneroso, impactando na saúde bucal e na qualidade de vida desses pacientes. Realizamos uma revisão sistemática para identificar tratamentos tópicos de composição natural em pacientes com xerostomia induzida por radiação. As buscas foram realizadas em bases de dados eletrônicas, sendo que as bases de dados consultadas foram a biblioteca Cochrane, PubMed (MEDLINE) e Literatura Latino-Americana e do Caribe em Ciências da Saúde ­ LILACS. A pesquisa foi realizada de junho a julho de 2022, o período admitido para os resultados foi de 1990 a 2022. Incluímos ensaios de intervenções tópicas com composição natural como mucilagem medicinal, sprays, óleos e gomas de mascar para o manejo do sintoma de boca seca. Nos resultados 6 estudos preencheram totalmente os critérios desejados, totalizando 336 pacientes. As terapias baseadas em produtos naturais foram comparadas com placebo ou outros tratamentos e as formas de apresentação foram spray, óleo, mucilagem e gel. Em geral, houve melhora de alguns sinais e sintomas da xerostomia e o efeito adverso mais descrito foi a náusea. Os produtos de composição natural parecem ser uma boa alternativa terapêutica para o alívio dos sintomas da xerostomia e sua consistência e forma de aplicação parecem exercer influência, como as evidências ainda são escassas, são necessários mais estudos clínicos randomizados e controlados por placebo.

Behavior of the cricopharyngeal segment during esophageal phonation in laryngectomized patients.

BACKGROUND: After total laryngectomy, the interruption of the upper digestive tube and the section of the cricopharyngeal segment alter the high-pressure zone of the pharyngoesophageal transition, which will not only start to have a digestive function, but also be stimulated to take on the production of voice and speech. The pressure observed in the cricopharyngeal segment seems to act as a critical factor for the development of esophageal sound production, and manometry is the procedure capable of quantifying the pressure observed in this region. OBJECTIVE: The objective of the current study was to assess the upper esophageal sphincter pressure in laryngectomized patients who are either successful or unsuccessful esophageal speakers, both at rest and during esophageal phonation, using manometry. METHODS: Twenty laryngectomized persons aged 32 to 83 years (mean, 44.2 years) were submitted to evaluation by a speech pathologist and divided into two groups, ie, successful esophageal speakers (N=12) and unsuccessful esophageal speakers (N=8), according to a scale validated by Wepman et al (1953). The upper esophageal sphincter (UES) pressure was assessed by manometry both at rest and during the following voice emissions in Portuguese: the vowel "a," the monosyllable "pa," and the sentence "papai papou pipoca." The amplitude, the duration of the pressure wave, and the area under the curve were measured. RESULTS: At rest, the mean UES pressure was 11.83 mm Hg for successful esophageal speakers and 9.92 mm Hg for unsuccessful esophageal speakers, with no significant difference between groups; the mean for the two groups as a whole was 11.06 mm Hg. During the voice and speech sequence tests, no significant difference was observed when the emissions in Portuguese of "a," "pa," and the sentence were analyzed separately. CONCLUSION: As the pressure observed at rest did not differ between the successful esophageal speakers and the unsuccessful esophageal speakers, and the amplitude, the duration of the pressure wave, and the area under the amplitude x duration curve were also equal for both groups, we conclude that the cricopharyngeal segment pressure is not a preponderant factor for the acquisition of esophageal voice and speech.

Effect of the tracheoesophageal voice resistance test in total laryngectomees.

OBJECTIVES/HYPOTHESIS: To analyze tracheoesophageal voice resistance in laryngectomized patients by comparing the acoustic, perceptive-auditory and self-evaluation measures before and after the voice resistance test. STUDY DESIGN: An observational, experimental study with a quantitative and descriptive approach. METHODS: Nineteen total laryngectomees were submitted for capture of vocal intensity, self-assessment of signs and symptoms of voice fatigue using a visual analogue scale, and perceptive-auditory and acoustic analysis of the tracheoesophageal voice before and after the voice resistance test, which consisted of continuous repeated counting from one to 100. RESULTS: The mean time of execution of the test was 33.68 minutes. Type II sound signal, voice intensity, voice quality, degree of severity of dysphonia, and the pitch and loudness parameters were maintained after the test. There were no changes in signs and symptoms of vocal fatigue. CONCLUSIONS: Most of the total laryngectomees performed the voice resistance test for less than 30 minutes. However, the voice resistance test did not induce significant changes in the quality of tracheoesophageal voice of total laryngectomees or in the signs and symptoms of vocal fatigue. LEVEL OF EVIDENCE: 4 Laryngoscope, 2016 127:405-410, 2017.

Electrophysiological activity of the pharyngoesophageal transition of total laryngectomees.

OBJECTIVES/HYPOTHESIS: To determine the association of the electrophysiological activity of the pharyngoesophageal transition with tracheoesophageal speech proficiency in total laryngectomees. STUDY DESIGN: An observational (nonexperimental) study of the correlation type with a descriptive approach. METHODS: Thirty-four individuals (26 males), average age 62.5 years, total laryngectomees rehabilitated with the use of a tracheoesophageal prosthesis, were assessed for tracheoesophageal speech proficiency using an adapted protocol and classified as good, moderate, or poor speakers. Next they were submitted to electromyography of the muscles of the pharyngoesophageal transition with a needle electrode. The area to be examined was located by videofluoroscopy. Electromyographic analysis was characterized as normal, neurogenic injury (moderate to severe, severe, severe to total), myopathic injury, or inconclusive. The Fisher exact test was used to determine the association between the speech proficiency variables and electromyography. RESULTS: in the final rating of tracheoesophageal speech proficiency, most laryngectomees were categorized as moderate (n = 24) and a few as good (n = 3). Electromyography revealed neurogenic injury in all laryngectomees, which was severe in most cases (n = 20), followed by severe to total (n = 10), and moderate to severe injury (n = 4). There was no significant association between he electromyographic analyses of neurogenic injuries and tracheoesophageal speech proficiency. CONCLUSIONS: Whether or not the musculature of the pharyngoesophageal transition of tracheoesophageal speakers had a preserved motor unit, did not prevent voice acquisition and was not associated with tracheoesophageal speech proficiency. However, further studies are needed in this area. LEVEL OF EVIDENCE: 4. Laryngoscope, 127:1369-1375, 2017.

Vocal Parameters and Self-Perception in Individuals With Adductor Spasmodic Dysphonia.

OBJECTIVE: The study aimed to compare and correlate perceptual-auditory analysis of vocal parameters and self-perception in individuals with adductor spasmodic dysphonia before and after the application of botulinum toxin. STUDY DESIGN: This is a prospective cohort study. METHODS: Sixteen individuals with a diagnosis of adductor spasmodic dysphonia were submitted to the application of botulinum toxin in the thyroarytenoid muscle, to the recording of a voice signal, and to the Voice Handicap Index (VHI) questionnaire before the application and at two time points after application. Two judges performed a perceptual-auditory analysis of eight vocal parameters with the aid of the Praat software for the visualization of narrow band spectrography, pitch, and intensity contour. RESULTS: Comparison of the vocal parameters before toxin application and on the first return revealed a reduction of oscillation intensity (P = 0.002), voice breaks (P = 0.002), and vocal tremor (P = 0.002). The same parameters increased on the second return. The degree of severity, strained-strangled voice, roughness, breathiness, and asthenia was unchanged. The total score and the emotional domain score of the VHI were reduced on the first return. There was a moderate correlation between the degree of voice severity and the total VHI score before application and on the second return, and a weak correlation on the first return. CONCLUSIONS: Perceptual-auditory analysis and self-perception proved to be efficient in the recognition of vocal changes and of the vocal impact on individuals with adductor spasmodic dysphonia under treatment with botulinum toxin, permitting the quantitation of changes along time.

Assessment of oral health condition in recipients of allogeneic hematopoietic cell transplantation

ABSTRACT Objective: The objective of this study was to evaluate the oral health condition and dental treatments performed in patients in pre-allogeneic HCT. Method: The records of patients treated during 2018 at a Brazilian HCT service were reviewed. The following oral health data were obtained: 1. Decayed, missing and filled teeth / correlated index for primary dentition (DMFT/dmft); 2. Quality of oral hygiene and 3. Dental pathologies: 3.1 Periodontal infectious focus, 3.2 Endodontic infectious focus and 3.3 Carie incidence. All dental procedures performed were surveyed. Results: Thirty-three patients were included, with a mean age of 28.42 (±16.37), 20 male (60%) and 13 female. The average DMFT/dmft found in this study was 10.24 (± 8.37), similar to the index found in the population in southeastern Brazil. The younger study population presented a DMFT/dmft considered high, when compared to the general population. A total of 27.2% of the patients had active caries lesions, 33.3%, foci of periodontal infection, 15.1%, endodontic infectious focus and 40%, poor oral hygiene. Almost half of the patients (48.4%) had to undergo dental intervention, 24.2% needing periodontal scaling, 21.2%, fillings and 12.1%, tooth extractions. Conclusion: We conclude that the studied population had an important incidence of dental pathologies and infectious conditions that could complicate throughout HCT, especially in younger patients, therefore presenting a high demand for dental treatment in the pre-HCT. Studies that assess the impact of dental conditioning on the outcomes of HCT with an emphasis on dental infectious complications, days of hospitalization and survival are necessary."