Manual estadual de odontologia hospitalar de Mato Grosso do Sul / State manual of hospital dentistry of Mato Grosso do Sul

O manual busca orientar a condução dos serviços estaduais de saúde bucal na oferta do atendimento a pacientes que apresentem manifestações em cavidade oral decorrentes da doença ou da terapia presente em âmbito hospitalar, incluindo aqueles internados e os que necessitam de atendimento pré-cirúrgico.

Integrating antimicrobial photodynamic therapy into the adjuvant phototherapeutic approach for orofacial manifestations of toxic epidermal necrolysis and Stevens-Johnson syndrome.

Characterized by an immune reaction to medications, toxic epidermal necrolysis (TEN) and Steven-Johnson Syndrome (SJS) are potentially fatal mucocutaneous reactions, and their management remains challenging. Considering the promising studies regarding the use of laser in managing orofacial lesions, this study aimed to report two cases in which children presenting with TEN and SJS were treated using a combination of antimicrobial photodynamic therapy (aPDT) and photobiomodulation therapy (PBMT) concurrently with conventional supportive care. The treatment proposed herein resulted in significant clinical improvement of the children's oral condition within a few days, enabling the reintroduction of oral feeding. Within the limitations of the study, the cases reported suggest that the adjuvant combination of PBMT and aPDT may be beneficial for improving the oral condition of children afflicted with oral injuries induced by TEN and SJS.

Diagnosis of Epidermoid Carcinoma of the Tongue after Treatment of Epidermoid Carcinoma of the Esophagus.

In the present case report, a patient with esophageal squamous cell carcinoma (SCC) developed a second primary tumor in the tongue at the same time. Stage III middle esophageal SCC was discovered in a 60-year-old Caucasian male patient who was institutionalized, a smoker, and had previously struggled with alcoholism. Following treatment, the patient was admitted to the hospital for 15 days due to dysphagia and malnutrition. According to him, he had mouth pain while in the hospital. An intraoral examination revealed tooth mobility, bacterial plaque, dental calculus, and a 1.3-cm ulcerated lesion on the right lateral edge of the tongue. During the extraoral examination, no palpable lymph nodes were found in the submandibular or cervical regions. The tongue lesion was excisionally biopsied, and the histological evaluation agreed. The patient was advised to seek treatment for tongue SCC. Given that patients with esophageal SCC have a 9.3%-11.4% risk of developing head-and-neck SCC, multiprofessional follow-up of patients with esophageal SCC is critical for early detection of this cancer.

Terapia de fotobiomodulação em lesões por pressão relacionada a dispositivos médicos: relato de caso em lábio de um paciente adulto / Photobiomodulation therapy for medical device-related pressure injuries: a case report of an adult with lip involvement

Lesão por pressão relacionada a dispositivos médicos é uma complicação bastante comum e geralmente oriunda da fixação do dispositivo utilizado na intubação endotraqueal para ventilação mecânica. Desta forma, o presente estudo reportou o caso de um paciente do sexo masculino, 65 anos, leucoderma, internado em uma unidade de terapia intensiva, e que desenvolveu lesão ulcerada na região de fixação do dispositivo utilizado para intubação orotraqueal. Após alívio da pressão local exercida, terapia de fotobiomodulação foi proposta como única estratégia para cicatrização da lesão e diminuição do edema. Após 3 sessões diárias foi possível observar excelente curso de reparação tecidual e remissão dos sinais flogísticos. De acordo com o presente caso, a terapia de fotobiomodulação parece ser bastante eficiente para o tratamento de lesões por pressão relacionada a dispositivos médicos(AU)

Medical device-related pressure injuries are very common complications and usually arise from the fixation of the device used in endotracheal intubation for mechanical ventilation. Thus, the present study reports a case of a Caucasian male patient, 65 years old, who was admitted to an intensive care unit and developed later an ulcerated lesion on the region of fixation of the device used for orotracheal intubation. After relieving the local pressure exerted, photobiomodulation therapy was proposed as the only strategy for wound healing and edema reduction. After 3 daily sessions, it was possible to note an excellent tissue repair course and remission of phlogistic signs. According to the present case, photobiomodulation therapy appears to be a quite efficient treatment strategy for medical device-related pressure injuries(AU)

Adjunctive phototherapies for oral manifestation of HIV-related histoplasmosis and leishmaniasis: An unusual case report.

BACKGROUND: Secondary infections of leishmaniasis and histoplasmosis in patients with advanced HIV are still a concern in low- and middle-income countries. The most common drugs for the treatment of both infections may be problematic mainly due to their toxicity. AIM AND CASE REPORT: The present study aimed to report a case in which a concurrent oral manifestation of leishmaniasis and histoplasmosis in a hospitalized patient with HIV was managed with a combination of photobiomodulation therapy (PBMT) and antimicrobial photodynamic therapy (aPDT) as an adjuvant treatment. In addition to the use of conventional systemic oral drugs, a single aPDT session followed by two PBMT sessions was proposed, which resulted in complete wound healing within four days. CONCLUSION: Given the complexity of the current case, PBMT in combination with aPDT may be considered as an effective adjuvant option for managing oral infectious lesions of histoplasmosis and leishmaniasis in immunocompromised patients.

Phototherapies for the management of a large painful facial cutaneous lesion from human monkeypox infection.

BACKGROUND: The management of patients with Monkeypox (MPX) infection is generally symptomatic as there has been no approved antiviral drug so far. Despite being generally a self-limited disease, some complications may be encountered such as severe pain and the formation of permanent skin scarring. AIM: To present a case report in which a combination of antimicrobial photodynamic therapy (aPDT) and photobiomodulation therapy (PBMT) was used for a large facial cutaneous lesion in an MPX patient. CASE REPORT: A 20-year-old Caucasian man presenting with a large, painful, grayish, rubbery, well-circumscribed, deep-seated, and umbilicated ulcer on his face was treated with four daily sessions of PBMT and two sessions of aPDT every other day. Within a day, the patient's pain complaint was no longer present and a crust central area was visible. On the 4th day of laser treatment, the wound almost completely disappeared, leaving a small reddish area free of inflammation or infection signs and without unaesthetic skin scarring. CONCLUSION: Given the lack of specific strategies for the management of severe MPX-related skin lesions, the current case report suggests that the concomitant use of PMBT and aPDT seems to be a promising therapeutic approach. The most appropriate laser parameters, however, should be further investigated in future studies in order to establish an effective and reliable clinical protocol.

Low-level laser for the management of head-and-neck burn wounds.

Burn injuries are of serious concern worldwide not only because of the physical impact but also because of severe mental and emotional distress and reduced quality of life. The usual management comprises topical and systemic medications, and supportive care; however, conventional therapy may be expensive and insufficient for many cases. Thus, we describe herein a unique case in which a low-level laser was used concomitantly with the conventional approach for the management of head and neck burn wounds and could improve the patient's clinical condition within a short period.

Phototherapies for erythema multiforme secondary to viral infections: A case report of a child.

INTRODUCTION: Erythema multiforme (EM) is a reactive mucocutaneous disorder typically initiated by viral infections. Although the management of EM differs according to the clinical course and trigger factor, it is not clear whether antiviral suppressive therapies may be useful in cases related to such infections. Moreover, the treatment is most often based on supportive care directed towards only the symptoms. AIM: To present a clinical case of a child in which antimicrobial photodynamic therapy (aPDT) and photobiomodulation therapy (PBMT) were used for orofacial manifestations of EM secondary to viral infections. CASE REPORT: A Brazilian 1-year-old boy was admitted to an ICU due to a severe Influenza A H3N2 infection, pneumonia with pleural effusion, and sepsis. About 10 days later, it was noted bleeding lip lesions covered by crusts and bleeding tongue lesions, diagnosed as EM secondary to both H3N2 and herpes simplex virus infections, confirmed by serology tests. A combination of an aPDT session and six PBMT sessions was proposed and resulted in almost complete resolution of the lesion on the 7th day. CONCLUSION: Given the complexity of the present case, the combination of phototherapies seems to be a promising tool for treating acute orofacial mucosal lesions of viruses-induced EM. More studies, however, are needed to reach a definite conclusion.

Accidental aspiration of removable dental prosthesis in a patient with Creutzfeldt-Jacob disease.

Accidents involving dental prostheses are unusual but relevant, which may result in complications in the upper respiratory airways and esophagus. A 47-year-old male patient with Creutzfeldt-Jacob disease (CJD), completely dependent on care, was reported by his family to have a partial obstruction and intraoral bleeding after swallowing his upper Removable Partial Denture (RPD). After difficulties in the endoscopy procedure, a surgical approach by exploratory cervicotomy to remove the prosthetic device was conducted, without postoperative complications. Considering individual impairments and the patients' advanced age, the removal of dental prostheses during sleep or for patients under intensive care is a preventive strategy to reduce comorbidities in patients with unstable health conditions.

Tratamento odontológico em portador da Doença de Huntington: relato de caso / Dental treatment in Huntington's Disease: a case report / Tratamiento dental en la Enfermedad de Huntington: reporte de un caso

Caracterizada por um distúrbio neurodegenerativo progressivo autossômico dominante, a doença de Huntington interfere na capacidade de movimento, interação cognitiva além de causar transtornos comportamentais nos indivíduos diagnosticados com a enfermidade. Dependendo do estadiamento e do grau de comprometimento neuromotor a adesão voluntária à propostas terapêuticas como o tratamento odontológico fica comprometida. Este estudo relata o caso raro de um portador da doença de Huntington do sexo masculino com 23 anos, diagnosticado com a doença desde 2017. A abordagem em âmbito hospitalar sob sedação foi adotada considerando as limitações físicas e segurança para o paciente bem como a complexidade e extensão dos procedimentos odontológicos necessários(AU)

Characterized by a progressive autosomal dominant neurodegenerative disorder, Huntington's disease interferes in the ability to move, cognitive interaction and causes behavioral disorders in individuals diagnosed with the disease. Depending on the staging and the degree of neuromotor damage, willingly adhesion to therapeutic procedures such as a dental treatment could be compromised. This study reports the rare case of a 23-year-old male with Huntington's disease diagnosed since 2017. A hospital approach under sedation was required considering the physical limitations and safety for the patient as well as the complexity and extension of the necessary dental procedures(AU)

Caracterizada por un trastorno neurodegenerativo progresivo autosómico dominante, la enfermedad de Huntington interfiere con la capacidad para moverse, la interacción cognitiva y causa trastornos del comportamiento en individuos diagnosticados con la enfermedad. Según la estadificación y el grado de afectación neuromotora, se compromete la adherencia voluntaria a propuestas terapéuticas como el tratamiento odontológico. Este estudio reporta el caso raro de un varón de 23 años con enfermedad de Huntington diagnosticado con la enfermedad desde 2017. Se adoptó el abordaje hospitalario bajo sedación considerando las limitaciones físicas y la seguridad del paciente, así como la complejidad y extensión de los procedimientos dentales necessários(AU)

Exérese de tumor incomum em região pré-auricular: relato de caso / Exerese of incomum tumor in preauricular region: case report / Exeresis del incomum tumoral en la región pre-auricular: relato de caso

O cilindroma é um tumor de face raro que acomete frequentemente o couro cabeludo e o pescoço podendo ser benigno ou também desenvolver um curso maligno. É objetivo apresentar um caso de paciente de 55 anos de idade com um tumor de pequena dimensão em região pré-auricular a esquerda, com queixas álgicas e presença de discreta equimose. A terapêutica empregada foi a excisão cirúrgica e acompanhamento. A paciente, após 3 meses de controle pós-operatório apresenta-se sem queixas e sem sinais de recidiva. Deste modo, pode-se concluir que o tratamento empregado foi satisfatório com bons resultados. Em virtude da possibilidade de recidiva a paciente segue em acompanhamento(AU)

The cylindroma is a rare-face tumor that often affects the scalp and neck, which may be benign or develop a malignant course. The objective of this study is to present a 55-year-old patient with a small tumor in the preauricular region on the left, with painful complaints and a slight purpura. The therapy used was surgical excision and follow-up. The patient, after 3 months of postoperative control, presented with no complaints and no signs of relapse. In this way, it can be concluded that the treatment used was satisfactory with good results. Due to the possibility of recurrence, the patient is followed up(AU)

El cilindroma es un tumor de cara raro que acomete frecuentemente el cuero cabelludo y el cuello pudiendo ser benigno o también desarrollar un curso maligno. Es objetivo presentar un caso de paciente de 55 años de edad con un tumor de pequeña dimensión en región pre-auricular a la izquierda, con quejas álgicas y levemente enrojecida. La terapia empleada fue la excisión quirúrgica y seguimiento. La paciente, después de 3 meses de control postoperatorio se presenta sin quejas y sin signos de recidiva. De este modo, se puede concluir que el tratamiento empleado fue satisfactorio con buenos resultados. En virtud de la posibilidad de recidiva la paciente sigue en seguimiento(AU)