Low-Level Laser Therapy for Management of Hypersensitivity in Molar-Incisor Hypomineralization and Oral Health-Related Quality of Life: Case Report.

The aim was to report the use low-level laser therapy (LLLT) in the management of hypersensitivity in an adolescent with molar incisor hypomineralization (MIH) and the impact of LLLT on his oral health-related quality of life (OHRQoL). Clinical examination revealed severe MIH with hypersensitivity, in all first permanent molars and incisors. The treatment proposed was desensitization with fluoride and esthetic rehabilitation of the affected teeth. Then, LLLT was applied perpendicularly in a continuous mode (wavelength of 808 nm, power of 100 mW, dose of 1 J, and fluence of 35 J/cm2). The visual analogue scale was applied each session of LLLT. The child perceptions questionnaire (CPQ11-14) was administered at the beginning and the end of the treatment. It was concluded that LLLT can be indicated in the management of hypersensitivity in an adolescent with severe MIH to control pain and to improve his OHRQoL.

Shprintzen-goldberg craniosynostosis: craniofacial and oral characteristics, diagnosis, and clinical management of a very rare syndrome / Craniossinostose de shprintzen-goldberg: características craniofaciais e orais, diagnóstico e manejo clínico de uma síndrome muito rara

ABSTRACT Shprintzen-Goldberg craniosynostosis syndrome, characterized by craniosynostosis and marfanoid habitus, is a very rare entity described in 75 individuals worldwide. This study aimed to present a case report of a 6-year-old female Brazilian child with Shprintzen-Goldberg's craniosynostosis syndrome. We described the craniofacial and oral characteristics and its clinical management, comparing to the existing literature. The patient presented with intellectual disability, craniosynostosis, ocular proptosis, low-set anomalous ears, and other skeletal and connective tissue defects. Oral features included malocclusion, micrognathia, pseudo-cleft palate, dental caries, and inefficient biofilm control. The treatment started with guidance on cariogenic foods, oral hygiene, and an indication to discontinue bottle feeding. Subsequently, the carious lesions were restored with composite resins, and the patient was referred for orthopedic surgery, orthodontic treatment, speech therapy, and nutritional counseling. The patient was followed for 5 years. This case report emphasizes the importance of knowing the craniofacial and oral characteristics for the diagnosis and clinical management of a female child with a rare Shprintzen-Goldberg's craniosynostosis syndrome. The case also highlights the need for oral health care in individuals with intellectual disabilities.

RESUMO A síndrome Shprintzen-Goldberg é uma entidade muito rara descrita em 75 pessoas, caracterizada por craniossinostose e habitus marfanóide. O objetivo deste estudo é apresentar o relato de um caso clínico de uma criança brasileira de 6 anos com síndrome da craniossinostose de Shprintzen-Goldberg, apresentando as características craniofaciais e orais e seu manejo clínico, comparando com a literatura. O paciente apresentava deficiência intelectual, craniossinostose, proptose ocular, orelhas anômalas de implantação baixa e outros defeitos esqueléticos e do tecido conjuntivo. As características orais incluíram má oclusão, micrognatia, pseudo fenda palatina, atividade de cárie e controle ineficiente do biofilme. O tratamento foi iniciado com orientações sobre alimentos cariogênicos, higiene oral e indicação de suspensão do uso de mamadeira. Em seguida, as lesões cariosas foram restauradas com resina composta e o paciente encaminhado para cirurgia ortopédica, tratamento ortodôntico, fonoaudiologia e nutricionista. O paciente foi acompanhado periodicamente por 5 anos. Este relato de caso enfatiza a importância do conhecimento das características craniofaciais e orais para o diagnóstico e manejo clínico de uma criança do sexo feminino com síndrome de craniossinostose de Shprintzen-Goldberg rara, destacando a necessidade de cuidados com a saúde bucal em indivíduos com deficiência intelectual.

Monitoring enamel caries on resin-treated occlusal surfaces using quantitative light-induced fluorescence: an in vitro study.

The aim of this study is to evaluate the ability of quantitative light-induced fluorescence (QLF) to monitor enamel caries lesions of different severity stages located on the occlusal surfaces of permanent teeth before and after treatment with resin infiltrant. Sixty extracted permanent teeth had one occlusal site selected and were categorized according to the International Caries Detection and Assessment System (ICDAS) criteria. The teeth were divided into three groups (n = 20): ICDAS 1, ICDAS 2, and ICDAS 3. The teeth were assessed by a trained examiner using QLF in two phases: (A) before and (B) after treatment with resin infiltrant. The caries lesions were evaluated using the following QLF parameters: area (mm2); ΔF, fluorescence loss (%); and ΔQ, fluorescence loss integrated over the lesion area (%*mm2). The resin infiltrant (Icon™) was applied on the occlusal surface following the manufacturer's recommendations. The teeth were then sectioned and prepared for polarized light microscopy analysis. The penetration of resin infiltrant was measured with ImageJ. The groups showed a statistically significant difference in all QLF parameters before and after caries infiltration, with the reduction of fluorescence values posttreatment (p < 0.05). Infiltrant penetration was observed in all groups, with a statistical difference between all groups (p < 0.05). The reduction in QLF parameters after resin infiltration suggests that QLF is able to monitor enamel caries lesions of different severity stages located on the occlusal surfaces of permanent teeth before and after treatment with resin infiltrant.

Cinco años de seguimiento de tratamiento no invasivo para lesiones auto-infligidas en un niño con parálisis cerebral / Five year follow-up of non-invasive treatment for self-inflicted oral trauma in a child with cerebral palsy

ABSTRACT Introduction: Cerebral palsy involves loss or impairment of motor function attributed to non-progressive disturbances occurring in the developing fetal or infant brain. Self-inflicted oral trauma is a recurrent parafunctional habit in individuals with cerebral palsy. Objective: Describe two treatment modes for self-inflicted oral trauma in a 6-year-old male patient with cerebral palsy over a 5-year follow-up period. Case presentation: The child had been having pain due to injuries to the mouth floor and lingual frenum regions. Initially, low-level laser therapy was applied to accelerate the healing process of the wounds. Five years later, the child started to present worse oral injuries and placement of a fixed oral appliance was proposed. Intraoral examination showed that the wounds had healed completely in response to the oral appliance. Conclusions: Different therapies may be useful to control the recurrence of self-inflicted oral injuries(AU)

RESUMEN Introducción: La parálisis cerebral provoca una pérdida o deterioro de la función motora atribuida a trastornos no progresivos del desarrollo cerebral fetal o infantil. La lesión autoinfligida es un hábito parafuncional recurrente en personas con parálisis cerebral. Objetivo: Describir dos modalidades de tratamiento para las lesiones autoinfligidas en un niño de 6 años de edad con parálisis cerebral durante un periodo de seguimiento de 5 años. Presentación del caso: El niño presentaba dolor debido a lesiones en la región del suelo de la boca y el frenillo lingual. Inicialmente se aplicó terapia con láser de baja intensidad para acelerar el proceso de cicatrización de las heridas. Cinco años más tarde el niño empezó a presentar lesiones bucales más severas, por lo que se propuso la colocación de un dispositivo oral fijo. El examen intraoral mostró que las lesiones habían cicatrizado completamente en respuesta al dispositivo oral instalado. Conclusiones: Diferentes terapias pueden ser útiles para controlar la recurrencia de las lesiones orales autoinfligidas(AU)