Lesão de riga-fede e manutenção de dentes natais na cavidade bucal: Possibilidades terapêuticas com a terapia fotodinâmica antimicrobiana em relato de caso

Abstract

Riga-Fede disease is a traumatic ulceration on the ventral surface of the tongue in newborns, associated with the presence of natal or neonatal teeth. The objective of this study is to present a clinical case of neonatal teeth preservation in the oral cavity of a newborn, demonstrating therapeutic possibilities for the remission. A female patient, one month old, was referred to the Pediatric Dentistry Clinic at FOUFU due to the presence of neonatal teeth (71 and 81) and a Riga-Fede lesion on the ventral surface of the tongue, with a report of maternal breast pain during breastfeeding. The patient did not present weight loss and was able to breastfeed, despite irritability and pain while nursing. A periapical radiograph showed that the teeth were part of the normal series. Clinically, the teeth exhibited mild mobility, and the lesion on the ventral surface of the tongue was ulcerated, measuring 10 mm in diameter. The initial treatment consisted of restoring the incisal edge of tooth 81 with composite resin to eliminate sharp edges, along with the prescription of VASA for ulcer treatment over seven days. After 15 days, the lesion had regressed in size, and the infant no longer displayed pain sensitivity. Maternal breast pain was resolved, and the infant showed weight gain during follow-ups. At the 21-day follow-up, the patient bit her tongue, causing a fissure in the healing lesion. The treatment of choice was antimicrobial photodynamic therapy with low-level laser application and the use of a photosensitizing agent (0.01% methylene blue). Three applications were performed within the red and infrared spectrum on consecutive days, with an energy density of 2 J/cm², applied to the center of the lesion, combined with VASA application to the lesion for seven days. After this period, the Riga-Fede lesion was healed, with scar tissue appearing whitish and intact, without ulceration or pain sensitivity. Follow-ups were conducted at 3 and 6 months, showing complete remission of the Riga-Fede lesion. The neonatal teeth of the primary dentition remained in the oral cavity, and the treatment of the Riga-Fede lesion with ameloplasty, antimicrobial and analgesic medication, and low-level laser therapy with a photosensitizing agent proved effective in the regression of the lesion