Revista de Odontologia da UNESP
https://www.revodontolunesp.com.br/article/doi/10.1590/S1807-25772013000600009
Revista de Odontologia da UNESP
Original Article

Experiência de cárie e osmolaridade salivar em crianças com paralisia cerebral

Caries experience and salivary osmolality in cerebral palsy children

Santos, Maria Teresa B. T.; Guaré, Renata de Oliveira; Diniz, Michele Baffi; Ferreira, Maria Cristina D.

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Resumo

Introdução: Estudos têm demonstrado que quanto maior a severidade do dano neurológico em crianças com paralisia cerebral (PC), maior é o risco de doenças orais. Objetivo: Correlacionar a experiência de cárie com a osmolaridade salivar em crianças com PC. Material e método: Participaram do estudo 99 crianças (9,2±2,3 anos) com PC, em tratamento reabilitacional. A saliva de repouso foi coletada no período matutino, utilizando rolos absorventes (Salivette) por cinco minutos. A osmolaridade salivar foi medida por depressão do ponto de congelamento em osmômetro. As avaliações incluíram a experiência de cárie pelo índice de dentes cariados, perdidos e obturados (CPOD), e o motor oral durante o processo de alimentação da criança. Foram utilizados os testes Qui-quadrado, t de Student, Correlação de Spearman e razão de chances (OR), com nível de significância de 5%. Resultado: O grupo 1 (G1) foi composto por 41 crianças livres de cárie e o grupo 2 (G2), por 58 crianças com cárie (CPOD=3,5±2,7). Os grupos foram homogêneos para gênero (p=0,884) e idade (p=0,174). Entretanto, diferiram significantemente com relação à motricidade oral, apresentando G2 maiores porcentagens de crianças com motor oral subfuncional (p<0,001) e tetraparéticos (p=0,001). O G2 apresentou valores significantemente maiores (p<0,001) para osmolaridade (99,6±36,7mOsml) quando comparado ao G1 (76,7±15,9mOsml). Observou-se uma correlação significante entre osmolaridade e experiência de cárie (p<0,001). Apresentar osmolaridade superior a 76,7 (OR=5,18; 1,85 a 14,83) foi determinante individual de maior probabilidade de apresentar risco de cárie (CPOD>0). Conclusão: Maiores valores de osmolaridade salivar aumentam o risco de cárie em crianças com PC.

Palavras-chave

Paralisia cerebral, saliva, cárie dentária, concentração osmolar, destreza motora

Abstract

Introduction: Studies have shown that the greater the severity of neurological damage in children with cerebral palsy (CP), the greater risk of oral diseases. Objective: To correlate the caries experience with salivary osmolality in children with CP. Material and method: 99 CP children (9.2±2.3 years) in rehabilitation treatment participated of this study. Unstimulated whole saliva was collected in the morning using cotton roll (Salivette) for 5 minutes. The salivar osmolality was measured using a freezing point depression osmometer. Caries experience index for decayed, missing and filled teeth (DMFT) and oral motor were assessed during the feeding process. It was used the chi-square test, t Student test, Spearman correlation and odds ratio (OR) with a significance level of 5%. Result: Group 1 (G1) consisted of 41 caries-free children, and group 2 (G2) of 58 children with caries (DMFT=3.5±2.7). The groups were homogeneous for gender (p=0.884) and age (p=0.174). However, they differed significantly with respect to the oral motor, with G2 showing higher percentages of children with sub-functional (p<0.001) and tetraparetic (p=0.001) oral motor. Group 2 showed significantly higher values (p<0.001) for salivar osmolarity (99.6±36.7 mOsml) compared to G1 (76.7±15.9 mOsml). There was a significant correlation between osmolality and caries experience (p<0.001). Presenting osmolality greater than 76.7 (OR=5.18, 1.85 to 14.83) was a individual determinant of higher probability for caries risk (DMFT>0). Conclusion: Higher values of salivary osmolality increase the risk of caries in CP children.

Keywords

Cerebral palsy, saliva, dental caries, osmolar concentration, motor skills

References

 


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