Influência dos cuidados odontológicos e do uso de laserterapia na prevenção e tratamento de mucosite oral de pacientes submetidos à transplante de medula óssea: um estudo experimental

Abstract

Patients undergoing bone marrow transplantation (BMT) may have oral complications resulting from stomatotoxicity such as mucositis, xerostomia and fungal or viral infections. Oral mucositis (OM) is initially characterized by erythema that progresses to ulceration in the mucous membranes, being one of the most painful complications experienced during this period. Low-intensity laser therapy (LTBI) is a safe, painless, minimally invasive, inexpensive and quick-to-apply method, with studies proving its effectiveness in the prophylaxis and treatment of OM. This study aimed to evaluate the influence of dental care on the implementation of a follow-up protocol for patients undergoing BMT receiving LTBI. This is an experimental research carried out at the University Hospital of Santa Maria (HUSM). The instrument used for data collection was a pre-elaborated questionnaire and the performance of dental follow-up from the moment of pre-BMT until the patient's discharge. During the BMT period, the patients were evaluated, on average, 5 times a week, with technical guidance and monitoring of oral hygiene and maintenance of the mucous membranes with LTBI. 7 patients were followed, 6 of these were treated only with chemotherapy and only 1 underwent chemotherapy and total body irradiation (TBI). TLBI was performed in all patients in a preventive and curative manner. Only 2 patients had OM grade 2 at some time after BMT. No patient had OM grade ≥3, and two patients did not have OM. It can be concluded that the oral cavity is affected by the consequences of BMT associated with chemotherapy and/or TBI, in addition to being a potentially infectious site, of the manifestations, OM was the most frequent, in the patient who received allogeneic BMT, the development of OM grade 2, with a longer duration of the lesion in the oral cavity, however only one of the patients in the study underwent this type of transplant, the elaboration of a protocol pre and post OMT in the follow-up of patients is essential in the support therapy facilitating the dental routine, TLBI in the prevention of OM in patients submitted to BMT was effective and this preventive protocol can be instituted in daily clinical practice collaborating with the quality of life. Therefore, this study showed how necessary the presence of a dentist is in the multidisciplinary team, in order to collaborate with the early diagnosis, management and adequate treatment of oral complications.