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Photobiomodulation in the treatment of xerostomia associated with hyposalivation in a pediatric pt

Photobiomodulation in the treatment of xerostomia associated with hyposalivation in a pediatric patient with systemic scleroderma DOWNLOAD HERE

Oliveira AB, Ferrisse TM, Salomão KB, Miranda ML, Bufalino A, Brighenti FL. Photobiomodulation in the treatment of xerostomia associated with hyposalivation in a pediatric patient with systemic scleroderma. Autops Case Rep [Internet]. 2021;11:e2020220.

ABSTRACT

Scleroderma is a rare autoimmune disease characterized by excessive collagen production. The oral manifestations of the patient with scleroderma can include microstomia, xerostomia, and changes in the resorption teeth. We report the case of a 7-year-old female patient diagnosed with systemic scleroderma where photobiomodulation therapy was used to treat xerostomia associated with hyposalivation. She attended a pediatric clinic and presented with dry and rigid facial skin, trismus, xerostomia, malocclusion, and difficulty swallowing. Stimulated salivary flow was assessed before, during, and after treatment. Photobiomodulation therapy was conducted at four points at the sublingual glands with 660 nm, 100 mW, and 0.8 J/cm2 to each point; eight points at the parotid glands; and six points at the submandibular glands with 808 nm, 100 mW, and 0.8 J/cm2 for 8 seconds at each point. After this therapy, an increase in salivary flow, remission of the xerostomia, and an improvement in mastication and swallowing were observed. Photobiomodulation therapy was effective in controlling xerostomia in this pediatric patient, resulting in increased salivary flow and an improvement in her quality of life.


Scleroderma (Sc) is a rare autoimmune disease that causes excessive production of collagen, leading to hardening of the skin. It affects the joints, muscles, blood vessels, and some internal organs such as the lungs and heart. Until now the etiology and pathogenesis of Sc are poorly understood, possibly due to the rarity of this disease.1

Sc is divided into two types, systemic (SSc) or localized (LSc).2 LSc is the most common form of Sc; it occurs in about 90% of cases and classically presents a benign and self-limiting evolution, and is confined to the skin and/or underlying tissues. SSc is the rarest and severe form of Sc, affecting skin and some internal organs.3 Sc presents slow, progressive, and incapacitating evolution, but it can also occur rapidly and lead to death due to the involvement of the internal organs.1

According to the literature, Sc can manifest at any age, but it is more commonly reported in women over 30 years old.1 Herrick et al.4 evaluated the annual incidence of SSc in childhood in the United Kingdom, and concluded that involvement in children under 16 years old is extremely rare.

Oral manifestations may include tongue stiffness, microstomia, and hyposalivation followed by xerostomia and different degrees of bone and teeth resorption.5,6 Non-stimulated salivary flow is considered to be hyposalivation with values lower than 0.29 mL/min and 1.0 mL/min for stimulated salivary flow.7,8 Hyposalivation can lead to poor oral health and cause adverse impacts on daily life, such as discomfort and pain. Thus, the aim of this article is to report successful treatment with photobiomodulation therapy (PBMt) for xerostomia followed by hyposalivation in a pediatric patient diagnosed with Sc.



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