Efeito da gastrostomia na saúde oral e na composição salivar de crianças com paralisia cerebral

Abstract

Non-progressive chronic childhood encephalopathy, also called cerebral palsy (CP), is a consequence of a brain injury that occurred during the prenatal, perinatal or postnatal period, causing sensory and / or motor changes. Due to impairment of motor functions, such as difficulty in swallowing, choking and pulmonary aspiration, some patients with CP are submitted to gastrostomy (GTT). Knowing and identifying the salivary properties and salivary changes of individuals with cerebral palsy (CP), associated or not with gastrostomy, and correlating the salivary composition with caries indexes of these individuals is fundamental in order to contribute to the planning of effective actions for improvement of the oral and systemic health of these patients. The aim of this study was to evaluate the effect of gastrostomy on oral health and salivary composition of children with Cerebral Palsy. This was a cross-sectional, descriptive and analytical study that evaluated 23 children with CP divided into: patients with Cerebral Palsy Without Gastrostomy (PCSG, n = 12) and patients with Cerebral Palsy With Gastrostomy (PCCG, n = 11) age group from 5 to 12 years. Oral health was evaluated by the index of decayed and decayed teeth (CPO-D / ceo-d) and the salivary composition analyzed by Fourier Transform Infrared Spectroscopy (FTIR). For this analysis, 1ml of saliva was collected using a vacuum suction pump. Statistical analyzes were performed using the Mann-Whitney test or unpaired t-test. CPO-D / ceo-d was reduced (p = 0.0034) in PCCG children compared to PCSG. The spectral profile of FTIR in PCCG and PCSG saliva presented 12 vibrational modes described in lipids, carbohydrates, proteins and nucleic acids. The salivary concentration of thiocyanate (2057 cm -1, SCN-) was increased in PCCG patients compared to PCSG. However, no correlation (p> 0.05) was found between the salivary concentration of SCN- and CPO-D / ceo-d. Patients with PCCG showed an increase in the salivary concentration of SCN- compared to PCSG. Although they also presented lower CPO-D / ceo-d indexes in relation to PCSG, no correlation of this with SCN-concentration in saliva was observed.