Occurrence and Severity of Oral Mucositis in Brazilian Pediatric Cancer Patients

Abstract Objective: To determine the occurrence and severity of oral mucositis (OM) and the factors associated with the onset of severe oral mucositis (SOM) in pediatric cancer patients. Material and Methods: This was a longitudinal and prospective study with 85 children and adolescents (aged 0 to 19 years) admitted to the Pediatric Oncology Sector of Napoleão Laureano Hospital between November 2016 and July 2019. The patients' sociodemographic and epidemiological information, as well as hematological and biochemical parameters, were obtained from their medical charts. The oral mucosa of study participants was assessed through the modified Oral Assessment Guide (OAG) at baseline and after the 2nd, 5th and 10th week of antineoplastic treatment. Data were analyzed by Chi-square test to determine the factors associated with the occurrence of SOM (p<0.05). Results: The occurrence of OM was more frequent in the 2nd (60%), 5th (40.9%) and 10th week (43.2%) of antineoplastic treatment. During the follow-up period, SOM was more frequent in the 5th week (34.7%), followed by the 2nd (32.3%) and 10th weeks (29.7%). There was no association between the occurrence of SOM and the patient's age, type of tumor, chemotherapy regimen, and hematological and biochemical parameters. Conclusion: The occurrence of oral mucositis in pediatric cancer patients was significant, especially in the 2nd week of antineoplastic treatment. Severe oral mucositis was more prevalent in the 5th week of treatment and was not associated with any of the study variables.

Panorama do ensino da terapia pulpar em dentes decíduos nos cursos de graduação em odontologia / An overview of teaching of pulp therapy in primary teeth in undergraduate dental courses

Objetivo: Verificar as abordagens terapêuticas endodônticas em dentes decíduos adotadas nas disciplinas de Odontopediatria dos cursos de graduação em Odontologia no Brasil. Método: Foi realizado um estudo transversal, no qual foram enviados questionários, por correio eletrônico, aos coordenadores das disciplinas de Odontopediatria dos cursos de graduação em Odontologia (N = 162), com questões referentes às condutas terapêuticas adotadas nas pulpotomias e pulpectomias de dentes decíduos. Para análise dos dados, foram obtidas distribuições absolutas e percentuais, assim como técnicas de estatística descritiva. Resultados: Dos 162 questionários enviados, 83 (51,2%) retornaram. Para a realização da técnica da pulpotomia, o formocresol diluído foi o medicamento mais indicado (42,2%), o óxido de zinco e eugenol foi o material mais indicado como proteção do remanescente pulpar (54,2%) enquanto a resina composta foi o material restaurador escolhido para emprego definitivo em dentes anteriores (86,7%) e posteriores (77,1%). Para a realização da técnica da pulpectomia, a solução irrigadora mais usada foi o hipoclorito de sódio a 0,5% associado a outras substâncias (32,5%), a pasta Guedes-Pinto foi a substância mais usada como curativo de demora nos casos de biopulpectomia (24,1%) e o formocresol diluído nas necropulpectomias (28,9%). Para obturação dos canais radiculares, a pasta Guedes-Pinto foi o material de escolha (55,6%). A guta-percha associada ao cimento de ionômero de vidro foi o material mais indicado (33,7%) como sub-base e base da cavidade após obturação dos canais radiculares. O emprego do isolamento absoluto para terapia endodôntica é ensinado por 55 (66,2%) das instituições. Conclusão: A análise dos dados mostrou um consenso entre as condutas terapêuticas pulpares adotadas pelas instituições das diversas regiões, percebendo-se a tendência na redução do uso de medicamentos que agridem ao tecido pulpar e aumento do uso de substâncias biocompatíveis.

Objective: To verify the endodontic therapeutic approaches in primary teeth adopted in the Pediatric Dentistry discipline of undergraduate dental courses in Brazil. Method: A cross-sectional study was performed in which questionnaires were emailed to the coordinators of the Pediatric Dentistry discipline of Brazilian undergraduate dental courses (N = 162), with questions referring to the therapeutic approach adopted in pulpotomies and pulpectomies in primary teeth. For analysis of data, the absolute and percent distributions were obtained and descriptive statistics was used. Results: From the 162 questionnaires sent by email, 83 (51.2%) were returned. In the pulpotomy technique, diluted formocresol was the most frequently indicated medication (42.2%), zinc oxide and eugenol was the most frequently indicated pulp capping material (54.2%), and composite resin was the definitive restorative material of choice for anterior (86.7%) and posterior (77.1%) teeth. For the pulpectomy technique, 0.5% sodium hypochlorite was the most used irrigating solution combined with other substances (32.5%), the Guedes-Pinto paste was the most frequently used intracanal dressing for cases of biopulpectomy (24.1%) and diluted formocresol for cases of necropulpectomy (28.9%). The Guedes-Pinto paste was material of choice for root canal filling (55.6%). Gutta-percha combined with glass ionomer cement was the most indicated material (33.7%) as sub-base and base to cover the cavity floor after root canal filling. The use of rubber dam isolation for endodontic therapy is taught in 55 (66.2%) of the evaluated institutions. Conclusion: The analysis of the results showed a consensus among the pulp therapy approaches adopted by dental schools of diverse regions, revealing a tendency of reducing the use of harmful medications to the pulp tissue, and increasing the use of biocompatible substances.