Alterações clínicas dos pacientes com lesão encefálica adquirida que interferem no tratamento odontológico / Clinical impairments of patients with acquired encephalic lesions that interfere with their dental treatment

Lesão Encefálica Adquirida (LEA) é uma lesão que ocorre no encéfalo após o nascimento e não está relacionada a doenças hereditárias, congênitas, degenerativas ou traumas de parto, podendo causar seqüelas físicas e cognitivas. Pacientes portadores de necessidades especiais estão cada vez mais presentes na prática diária do cirurgião dentista, porém, muitos profissionais ainda encontram dificuldades em atender estes pacientes. O objetivo deste estudo foi detectar alterações clínicas nos pacientes com LEA e relatar como estas podem interferir no atendimento odontológico. Foram avaliados 101 pacientes, com 18 a 87 anos de idade, de ambos os sexos, pertencentes à Clínica de LEA da Associação de Assistência à Criança Deficiente de São Paulo (AACD-SP). As informações foram coletadas através de consulta de prontuários, questionário fechado e exame clínico do paciente. Neste estudo, 70,30% dos pacientes apresentavam espasticidade, 51,49% disfagia, 44,55% convulsão, 75,25% déficit cognitivo, 9,90% limitação de abertura bucal e 40,59% eram dependentes para a higiene oral. O cirurgião dentista deve estar atento às alterações clínicas dos pacientes com LEA, minimizando possíveis intercorrências clínicas por meio de uma anamnese detalhada e planejamento clínico.

The Acquired Encephalic Lesion (AEL) is a lesion that occurs in the encephalon after birth and it is not related to hereditary, congenital, or degenerative diseases or to birth traumas that might be able to cause physical and cognitive after-effects. Patients with special needs are more and more present in the daily practice of a dental surgeon. However, many professionals still find it difficult to attend these patients. The objective of this study was to detect clinical impairments in AEL patients and report how they can interfere with dental treatment. One hundred and one (101) patients were evaluated, ranging from 18 to 87 years of age, of both genders, at the AEL Clinic at the São Paulo Association for Assistance to Disabled Children. The information was collected through consulting patients’medical histories, closed questionnaires, and clinical exams. In this study, 70.30% of the patients showed spasticity, 51.49% dysphagia, 44.55% convulsion, 75.25% cognitive deficit, 9.90% limited mouth opening, and 40.59% were dependent for oral hygiene. The dental surgeon must beaware of the clinical impairments in AEL patients to minimize possible clinical inter-occurrences by a detailed anamnesis and clinical planning.

Occurrence of bruxism in a sample of Brazilian children with cerebral palsy.

Bruxism has been reported to exist in many children with cerebral palsy; however, only a few studies confirm this fact. The objective of this study was to determine the rate of bruxism in children with cerebral palsy and to relate its presence to the following factors: kind of cerebral palsy, gender, age, dentition, degree of malocclusion, oral mucous membrane trauma, trismus, and number of wear facets on specific teeth. The guardians of 121 children with cerebral palsy between the ages of 4 and 9 years were interviewed and the children were clinically examined. Bruxism was detected in 69.4% of the children and reported by 57% of the guardians. In 4- and 5-year-old children, the rate of wear facets was small. Children with athetosis and spastic tetraplegia had a higher rate of bruxism than all others.