Dental trauma in Brazilian children and adolescents with cerebral palsy.

BACKGROUND: Assessing the frequency and factors associated with dental trauma in pediatric populations with cerebral palsy is important for the planning and implementation of prevention and health promotion programs. The aim of this study was to determine the prevalence and factors associated with dental trauma in children and adolescents with cerebral palsy. MATERIAL AND METHODS: Cross-sectional study with a non-probabilistic sample of 80 patients aged 2-18 years was treated in a rehabilitation institution in northeastern Brazil. Caregivers completed a socioeconomic questionnaire, while oral exams were performed by a calibrated investigator (K = 0.75-1.00), with record of the Dental Trauma Index, DMFT and dmft, and Dental Aesthetics and malocclusion indices. Bivariate and multivariate Poisson regression analyses (α = 0.05) were performed with the Statistical Package for Social Sciences, version 17. RESULTS: The prevalence of dental trauma was 36.3%, enamel fracture was the most common trauma (89.1%), and the upper central incisors were the most affected dental elements (63.0%). Patients with dental trauma were male, aged 7-18 years, with family income more than one minimum wage, caregiver's education over 4 years, increased overjet, lip hypotonia, quadriplegia, epilepsy, oral breathing, and severe communication skills. The presence of dental trauma was not associated with socioeconomic characteristics (gender, age, family income, and caregiver's educational level), oral health perception, and systemic and oral conditions (dental caries, malocclusion, and lip hypotonia) were evaluated (P > 0.05). CONCLUSION: The prevalence of dental trauma was high, but not associated with clinical variables and evaluated socioeconomic indicators.

Factors associated with health and oral health-related quality of life of children and adolescents with cerebral palsy.

AIMS: To verify factors associated with impact on Health-Related Quality of Life (HRQoL) and Oral Health-Related Quality of Life (OHRQoL) of children and adolescents with cerebral palsy (CP). METHODS AND RESULTS: Sample of 149 individuals with CP aged 2 to 18 years and their caregivers, who provided information regarding HRQoL (PedsQL 4.0), OHRQoL (PedsQL 3.0 Oral Health, and socioeconomic factors. A calibrated investigator performed dental examinations, with dental caries, traumatic dental injury, periodontal, and occlusal evaluation. HRQoL and OHRQoL scores were transformed into a 0 to 100 scale, dichotomized in absence or presence of impact (score < 50) and analyzed by Mann-Whitney test and Poisson regression (α = .05). The mean HRQoL score was 50.3 ± 10.2. Impact on HRQoL was observed in 51.7% and associated with gender, general health perception, and communication skills. The mean OHRQoL score was 78.0 ± 24.6. The presence of impact on OHRQoL (12.1%) was associated with age, presence of gastroesophageal reflux, dental caries, and periodontal diseases. CONCLUSION: Individuals with CP had low HRQoL and OHRQoL scores. The impact on HRQoL was shown to be associated with gender, health perception. and communication skills. Regarding OHRQoL, the presence of impact was associated with age, gastroesophageal reflux, dental caries. and periodontal diseases.

Factors Associated with the Caregivers' Perception of the Oral Health of Individuals with Cerebral Palsy

Abstract Objective: To evaluate factors associated with the caregivers' perception of the oral health of children and adolescents with cerebral palsy. Material and Methods: A cross-sectional study was carried out with 80 children and adolescents with cerebral palsy aged 2-18 years, registered at a reference institution and their respective caregivers. Caregivers provided socioeconomic, systemic and health perception and access to dental services data. A calibrated researcher (Kappa=0.75-0.98) performed oral examinations using DMF-T, dmf-t, dental trauma, gingival bleeding index, community periodontal index, malocclusion index and the dental aesthetic index. The Poisson Regression was used (α=0.05) Results: According to the caregivers' perception, the oral health reports of children and adolescents with cerebral palsy considered good and poor was 73.8% and 26.3%, respectively. The poor oral health perception is associated with the presence of dental caries in anterior teeth (PR 1.34, 95% CI=1.11-1.63) and bleeding during tooth brushing (PR 1.20, 95% CI=1.04-1.40) Conclusion: Children and adolescents with cerebral palsy who presented lesions of caries in the anterior teeth and gingival bleeding during tooth brushing, more frequently, had poor oral health by their caregivers.

Abordagem sistêmica do pênfigo vulgar com acometimento oral / Systemic approach of the vulgar penfigure with oral accomplishment

O termo "pênfigo" remete a um grupo de doenças autoimunes raras, caracterizadas pela formação de bolhas, que afetam o epitélio escamoso estratificado da pele, mucosa ou ambos. Cinco tipos principais de pênfigo foram descritos: vulgar (PV), vegetante, eritematoso, foliáceo e paraneoplásico. O PV é a variante mais comum e frequentemente acomete a mucosa oral. Este artigo relata um caso de Pênfigo Vulgar, com acometimento da mucosa oral e com 10 anos de evolução. Paciente de gênero masculino, 70 anos, procurou o serviço, queixando-se de úlceras na mucosa que causavam ardência e não cicatrizavam. Foi realizada uma biópsia incisional da lesão e, após exame histopatológico, estabelecido o diagnóstico de PV, sendo instituído um regime terapêutico com 60 mg de prednisona por via oral, até a remissão dos sintomas. O PV é uma doença sistêmica de caráter imunológico, de grande importância para a odontologia, tendo em vista que geralmente as manifestações orais antecedem as sistêmicas. Essa doença não tem cura, mas pode ser controlada, como no referido caso. Embora o diagnóstico nesse caso não tenha sido precoce, o prognóstico foi favorável... (AU)

The term "pemphigus" refers to a group of rare autoimmune diseases, characterized by the formation of blisters that affect the squamous epithelium stratified of the skin, oral mucosa or both. Five main types of pemphigus were described: pemphigus vulgaris (PV), vegetative, erythematous, foliaceous and paraneoplastic pemphigus. PV is a more common variant and often affects an oral mucosa. This article reports a case of Pemphigus vulgaris, with involvement of the oral mucosa and 10 years of evolution. A male patient, 70 years old, sought the service complaining of ulcers in the mucosa that caused burning and did not heal. An incisional biopsy of the lesion was performed and after histopathological examination, the diagnosis of PV was established, a therapeutic regimen with oral prednisone 60 mg was instituted util remission of symptoms. PV is a systemic disease of immunological character that has great importance for dentistry, since oral manifestations usually precede the systemic ones. This disease has no cure, can be controlled, as in this case, although the diagnosis in this case was not early, the prognosis was favorable... (AU)