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Abstract The aim of this case report is to show the hospital dental approach to a patient with Niemann-Pick disease (NPD) type B. After her caregivers reported poor oral health, a 10-year-old girl was referred to a hospital. She was diagnosed with NPD type B 4 years ago, with involvement of the brain, nerves, liver, spleen, bone marrow, and lungs. A dental physical examination revealed chronic carious lesions in ten teeth, as well as four residual roots and poor oral hygiene. We chose a surgical block treatment based on the altered complementary exams, dental demands, and the systemic compromise caused by NPD type B. All decayed elements were restored with glass ionomer cement, and residual roots were extracted. The patient had no clinical signs of infection or hemorrhage after 20 days of post-surgical follow-up. Although rare, the presence of patients with NPD type B in the dental routine can occur, necessitating the development of an individualized and multidisciplinary treatment plan.

Em março de 2020, a doença causada pelo novo coronavírus (SARS-CoV-2) foi caracterizada como uma pandemia. Em decorrência da magnitude que a doença alcançou e seu caráter inédito, um crescente interesse científico sobre a mesma surgiu, com buscas para se encontrarem novos métodos diagnósticos, aumentando a velocidade para a obtenção dos resultados dos testes e, consequentemente, um melhor mapeamento epidemiológico da doença. Esta revisão integrativa tem como objetivo analisar as principais evidências científicas sobre a utilização da saliva como método diagnóstico da Covid-19. Na presente revisão integrativa, foram realizadas buscas em quatro bases de dados eletrônicas, em março de 2022, sendo elas: PubMed, em que foram inclusos resultados exclusivamente em inglês, e nas plataformas Google acadêmico, SciELO e Biblioteca Virtual de Saúde (BVS), havendo a inclusão dos resultados restritamente em português. Foram utilizadas diferentes palavras-chave de acordo com a linguagem dominante das bases de dados, sendo no PubMed em língua inglesa escolhidos ‘’SARS-CoV-2´´, ‘’saliva’’, ‘’diagnosis’’, ‘’viral load’’ e ‘’coronavirus Covid-19’’ e nas demais plataformas, em língua portuguesa ‘’saliva’’, ‘’covid’’ e ‘’diagnósticos’’. Dentre os 45 artigos incluídos e analisados, mais da metade classificaram a saliva como um método diagnóstico alternativo ou complementar. Ainda, apenas três artigos do número total classificaram a saliva como uma amostra inviável para os testes de diagnóstico. Dessa forma, a saliva mostrou resultados positivos como uma opção de diagnóstico e para o acompanhamento e monitoramento da Covid-19. No entanto, apesar das limitações dos estudos, a amostra salivar em pacientes pediátricos sugere ter baixa sensibilidade.

Abstract The risk of contamination and dissemination by SARS-CoV-2 has a strong link with nasal, oral and pharyngeal cavities. Recently, our research group observed the promising performance of an anionic phthalocyanine derivative (APD) used in a mouthwash protocol without photoexcitation; this protocol improved the general clinical condition of patients infected with SARS-CoV-2. The present two-arm study evaluated in vitro the antiviral activity and cytotoxicity of APD. Additionally, a triple-blind randomized controlled trial was conducted with 41 hospitalized patients who tested positive for COVID-19. All the included patients received World Health Organization standard care hospital treatment (non-intensive care) plus active mouthwash (experimental group AM/n = 20) or nonactive mouthwash (control group NAM/n = 21). The adjunct mouthwash intervention protocol used in both groups consisted one-minute gargling/rinsing / 5 times/day until hospital discharge. Groups were compared considering age, number of comorbidities, duration of symptoms prior admission and length of hospital stay (LOS). The associations between group and sex, age range, presence of comorbidities, admission to Intensive care unit (ICU) and death were also evaluated. The in vitro evaluation demonstrated that APD compound was highly effective for reduction of SARS-CoV-2 viral load in the 1.0 mg/mL (99.96%) to 0.125 mg/mL (92.65%) range without causing cytotoxicity. Regarding the clinical trial, the median LOS of the AM group was significantly shortened (4 days) compared with that of the NAM group (7 days) (p = 0.0314). Additionally, gargling/rinsing with APD was very helpful in reducing the severity of symptoms (no ICU care was needed) compared to not gargling/rinsing with APD (28.6% of the patients in the NAM group needed ICU care, and 50% of this ICU subgroup passed way, p = 0.0207). This study indicated that the mechanical action of the protocol involving mouthwash containing a compound with antiviral effects against SARS-CoV-2 may reduce the symptoms of the patients and the spread of infection. The use of APD in a mouthwash as an adjuvant the hospital COVID-19 treatment presented no contraindication and reduced the hospital stay period. Trial registration: The clinical study was registered at REBEC—Brazilian Clinical Trial Register (RBR-58ftdj).

ABSTRACT BACKGROUND: There is a need for studies that correlate the severity of oral mucositis (OM) with chemotherapy protocols, transient myelosuppression and oral health. OBJECTIVE: To analyze the severity of OM among individuals with solid tumors during hospitalization and its correlation with the type of chemotherapy, myelosuppression and oral health condition. DESIGN AND SETTING: Retrospective study at a public hospital in Bauru, state of São Paulo, Brazil, that is a regional referral center. METHODS: Individuals diagnosed with solid malignant tumors who received chemotherapy during hospitalization for completion of the antineoplastic treatment cycle or who presented complications resulting from this were assessed. RESULTS: Twenty-eight individuals (24.3%) manifested some degree of OM. The most prevalent degrees of OM according to the World Health Organization (WHO) and modified WHO classification were grades 2 (11.3%) and 5 (4.3%), respectively. It was observed that the higher the OM-WHO (P < 0.001; r = 0.306) and modified OM-WHO (P < 0.001; r = 0.295) classifications were, the greater the oral pain reported by the individuals was. Presence of mucositis in the upper lip and buccal mucosa contributed to increased severity of OM and worsening of swallowing during hospitalization. Thus, severe OM was associated with use of the FOLFIRI protocol (folinic acid, fluorouracil and irinotecan). CONCLUSION: Individuals with tumors who presented severe OM had greater severity of oral pain and worse oral health. Use of the FOLFIRI protocol was associated with higher prevalence of severe OM, while use of 5-fluorouracil (5-FU) was correlated with worse oral condition.

Introdução: O município de Pelotas-RS dispõe do Programa de Internação Domiciliar Interdisciplinar (PIDI) implantado no Hospital Escola da Universidade Federal de Pelotas com a presença de cirurgiões-dentistas em sua equipe. O PIDI atende a pacientes oncológicos em cuidados paliativos. Objetivo: Avaliar a prevalência de manifestações bucais em pacientes assistidos por esse programa, as características epidemiológicas da referida população e verificar a associação das manifestações com o tipo de câncer e tratamento antineoplásico recebido. Método: Estudo transversal retrospectivo, com dados secundários coletados dos prontuários odontológicos de pacientes atendidos no período de abril de 2018 a setembro de 2019. O teste qui-quadrado foi aplicado com um nível de 5% de significância (p ≤0,05) atribuído aos resultados significativos. Resultados: As manifestações bucais foram encontradas 47 vezes nos 61 pacientes avaliados, sendo que alguns apresentaram mais de uma ocorrência. Pacientes que apresentavam câncer primário no sistema digestivo foram os mais acometidos por manifestações bucais. As mais prevalentes foram xerostomia (26,2%); candidíase (18%); mucosite (13,1%); disfagia e disgeusia, que apresentaram o mesmo percentual (9,8%); nenhum paciente desenvolveu carie de radiação. A xerostomia mostrou significância estatística (p≤0,05) na associação com o tipo de câncer. Ao correlacionar as manifestações bucais com o tipo de tratamento recebido, estas não apresentaram significância estatística. Conclusão: Este estudo demonstrou alta prevalência de manifestações bucais na população estudada, reafirmando a importância do cirurgião-dentista na equipe multiprofissional de cuidados paliativos.