Parâmetros salivares e experiência de cárie dentária em indivíduos com paralisia cerebral / Salivary parameters and dental caries experience in individuals with cerebral palsy

Alterações no fluxo e na composição da saliva têm sido descritas em indivíduos com paralisia cerebral (PC), e estas podem ser consideradas de risco para o desenvolvimento de doenças bucais. O objetivo deste estudo foi investigar a influência das alterações de osmolaridade e fluxo salivar na experiência da cárie dentária em indivíduos com PC. A amostra era composta por 63 crianças com PC (GE) e 50 crianças normorreativas (GC), de ambos os sexos, na faixa etária de 5 a 16 anos de idade. Para o GE foram coletados dos prontuários médicos … desordem do movimento, o tipo clínico da PC, uso de medicações e nível do Gross Motor Funnction Classification System (GMFCS). Ambos os grupos foram avaliados quanto … experiência de cárie, sendo registrado o número total de dentes cariados, perdidos e obturados para a dentição dec¡dua e permanente (ceo-d e CPO-D). A saliva de repouso foi coletada para a determinação do fluxo e da osmolaridade salivar com o emprego do Salivette© (Sarstedt, Nmbrecht, Alemanha). Os grupos GE e GC diferiram significantemente para as variáveis CPOD (p<0,001), osmolaridade (p<0,001) e fluxo salivar (p<0,001), apresentando o GE maiores valores de CPOD e osmolaridade e menores de fluxo salivar quando comparado a GC. A severidade do dano neurológico representado pelo padrão clínico tetraparesia, a falta de controle cervical e o uso de anticonvulsivante são fatores que influenciam negativamente nos parâmetros salivares e experiência de cárie e indivíduos com PC

Changes in the flow and composition of saliva have been described in patients with cerebral palsy (CP), what can be considered as a risk factor that may result on the development of oral diseases. The aim of this study was to investigate the influence of changes in osmolarity and salivary flow in dental caries experience in individuals with CP. The sample consisted of 63 children with CP (GE) and 50 normoreactive children (GC) of both sexes, aged 5-16 years old. For GE group information regarding movement disorder, the clinical type of PC, use of medications, and level of Function Gross Motor Classification System (GMFCS) were obtained through medical records. Both groups were assessed for caries experience, and were recorded the total number of decayed and lost teeth for deciduous and permanent dentition (dmft and DMFT). To determine the salivary flow and osmolality the resting saliva was collected using Salivette© (Sarstedt, Nmbrecht, Germany). The EG and CG have differed significantly for variables DMFT (p <0.001), osmolality (p <0.001), and salivary flow rate (p <0.001). GE has presented higher values of DMFT and osmolarity and inferior salivary flow when compared to GC. The severity of neurological injury represented by standard clinical tetraplegia, lack of neck control, and anticonvulsants are factors that influence negatively salivary parameters and caries in individuals with CP

Increased salivary immunoglobulin A and reduced α-amylase activity in whole saliva from spastic cerebral palsy individuals.

BACKGROUND: Salivary immunoglobulin A (SIgA) together with innate defenses such as α-amylase, provides the 'first line of defense' against pathogens present at mucosal surfaces. This study aimed to evaluate salivary α-amylase and immunoglobulin A (IgA) in whole saliva of spastic cerebral palsy (CP) individuals. METHODS: Whole saliva was collected from 22 CP and 24 sibling volunteers with no neurological damage control groups (CG) (aged 7-14 years). The salivary flow rate, total protein and SIgA concentrations, and α-amylase activity were determined. RESULTS: The CP group presented higher salivary flow rate (35%) and lower total protein concentration (18%) compared with the CG (P ≤ 0.05). CPG had higher absolute (68%, µg SIgA/ml) and relative (55%, µg SIgA/mg prot and 108%, µg SIgA/min) concentrations of IgA compared with the CG (P ≤ 0.05). CPG had lower relative α-amylase activity (15% mg malt/mg prot and 33%, mg malt/min) compared with the CG (P ≤ 0.05). CONCLUSION: This study concluded that CP individuals presented alterations in the profile of salivary proteins involved in the defense system of the oral cavity.

Salivary osmolality and hydration status in children with cerebral palsy.

BACKGROUND: Unstimulated whole salivary parameters have been identified as potential markers of hydration status. Reduced salivary flow rate and increased salivary osmolality have been shown to be useful to identify dehydration, even when minimal loss of body water occurs. This study aimed to evaluate whether unstimulated salivary flow rate and salivary osmolality from individuals with cerebral palsy correlate with plasma and urine osmolality. METHODS: Thirty-five male and female children, aged 9-13 years old, diagnosed with cerebral palsy were compared to 27 nondisabled children (10-12 years old). Unstimulated whole saliva was collected under slight suction and salivary flow rate (ml/min) was calculated. Plasma without venostasis and urine were also collected. Salivary, plasma and urine osmolality were measured using a freezing point depression osmometer. RESULTS: Cerebral palsy children presented a reduction in salivary flow rate (50%) compared to the control group (P < 0.01). Moreover, an increase in salivary (50%), plasma (3%), and urine osmolality (20%) was also observed in the cerebral palsy children compared to the control group (P < 0.01). Salivary flow rate was negatively correlated with the salivary, plasma and urine osmolality (P < 0.01). Salivary osmolality correlated positively with plasma and urine osmolality (P < 0.01). CONCLUSION: Cerebral palsy children seem to present impaired adequate hydration status. Since the possible hypohydration condition may be reflected in saliva fluid, which could compromise the protective function exerted by saliva, the earlier this condition is identified the greater the chances of administering preventive measures. Moreover, salivary osmolality is a reliable parameter that reflects changes in plasma and urine.

Salivary osmolality in individuals with cerebral palsy.

OBJECTIVE: To measure the salivary flow rate, osmolality, electrolyte and total protein concentrations in individuals with cerebral palsy (CP). DESIGN: Thirty-eight individuals with CP were divided according to the neuromotor abnormality type (total, spastic and dyskinectic) and compared to 22 nondisabled children (control group). Whole saliva was collected under slight suction. The salivary parameters studied were salivary flow rate, osmolality, sodium, potassium, chloride and total protein concentrations. RESULTS: CP individuals, with both neuromotor abnormality types (spastic and dyskinectic), presented an increase in salivary osmolality, total protein, potassium and chloride concentrations compared to the control group (p<0.05). Moreover, a reduction in salivary flow rate was verified in spastic individuals (p<0.05). CONCLUSION: The reduction in salivary flow rate and increase in osmolality, total protein and electrolyte concentrations of saliva from cerebral palsy individuals could be caused by hypohydration status.

Tradução, adaptação e validação Non-Communicating Children´s Pain Checklist / Translation, adaptation and validation Non-Communicating Children´s Checklist

O objetivo deste estudo foi traduzir adaptar e validar o questionário Non-Communicating Children´s Pain Checklist Revised para o português. Foi utilizada a metodologia proposta por GUILLEMIN, BOMBARDIER, BEATON (7). Encontrou-se forte associação (p<0,01) entre todas as medidas aplicadas dentro do instrumento para a primeira e segunda avaliação. Encontrou-se também forte associação (p<0,01) para coeficiente de correlação de Pearson entre a escala de Barthell e o Non-Communicating Children´s Pain Checklist-Revised (NC-CPC-R). Concluiu-se que o Brasil-Non-Communicating Children´s Pain Checklist-Revised foi traduzido e adaptado com sucesso para aplicação em pacientes brasileiros sem comunicação verbal ou suplementar alternativa