Autopsy and Case Reports
https://autopsyandcasereports.org/article/doi/10.4322/acr.2020.220
Autopsy and Case Reports
Clinical Case Report

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

Analú Barros de Oliveira; Túlio Morandin Ferrisse; Karina Borges Salomão; Marina Lins Miranda; Andreia Bufalino; Fernanda Lourenção Brighenti

Downloads: 1
Views: 372

Abstract

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.

Keywords

scleroderma, systemic, low-level light therapy, pediatrics, laser therapy, xerostomia

References

1 Fett N. Scleroderma: nomenclature, etiology, pathogenesis, prognosis, and treatments: facts and controversies. Clin Dermatol. 2013;31(4):432-7. http://dx.doi.org/10.1016/j.clindermatol.2013.01.010. PMid:23806160.

2 LeRoy EC, Black C, Fleischmajer R, et al. Scleroderma (systemic sclerosis): classification, subsets and pathogenesis. J Rheumatol. 1988;15(2):202-5. PMid:3361530.

3 Katsambas A, Stefanaki C. Life-threatening dermatoses due to connective tissue disorders. Clin Dermatol. 2005;23(3):238-48. http://dx.doi.org/10.1016/j.clindermatol.2004.06.004. PMid:15896538.

4 Herrick AL, Ennis H, Bhushan M, Silman AJ, Baildam EM. Incidence of childhood linear scleroderma and systemic sclerosis in the UK and Ireland. Arthritis Care Res. 2010;62(2):213-8. http://dx.doi.org/10.1002/acr.20070. PMid:20191520.

5 Smirani R, Truchetet ME, Poursac N, Naveau A, Schaeverbeke T, Devillard R. Impact of systemic sclerosis oral manifestations on patients’ health-related quality of life: a systematic review. J Oral Pathol Med. 2018;47(9):808-15. http://dx.doi.org/10.1111/jop.12739. PMid:29855076.

6 Dixit S, Kalkur C, Sattur AP, Bornstein MM, Melton F. Scleroderma and dentistry: two case reports. J Med Case Rep. 2016;10(1):297. http://dx.doi.org/10.1186/s13256-016-1086-1. PMid:27776552.

7 Sreebny LM. Saliva in health and disease: an appraisal and update. Int Dent J. 2000;50(3):140-61. http://dx.doi.org/10.1111/j.1875-595X.2000.tb00554.x. PMid:10967766.

8 Navazesh M. Methods for collecting saliva. Ann N Y Acad Sci. 1993;694(1):72-7. http://dx.doi.org/10.1111/j.1749-6632.1993.tb18343.x. PMid:8215087.

9 Fidelix T, Czapkowski A, Azjen S, Andriolo A, Neto PH, Trevisani V. Low-level laser therapy for xerostomia in primary Sjögren’s syndrome: a randomized trial. Clin Rheumatol. 2018;37(3):729-36. http://dx.doi.org/10.1007/s10067-017-3898-9. PMid:29119483.

10 Biswas R, Ahn JC, Moon JH, et al. Low-level laser therapy with 850 nm recovers salivary function via membrane redistribution of aquaporin 5 by reducing intracellular Ca(2+) overload and ER stress during hyperglycemia. Biochim Biophys Acta Gen Subj. 2018;1862(8):1770-80. http://dx.doi.org/10.1016/j.bbagen.2018.05.008. PMid:29751100.

11 Lončar B, Stipetić MM, Baričević M, Risović D. The effect of low-level laser therapy on salivary glands in patients with xerostomia. Photomed Laser Surg. 2011;29(3):171-5. http://dx.doi.org/10.1089/pho.2010.2792. PMid:21054200.

12 Brzak BL, Cigić L, Baričević M, Sabol I, Mravak-Stipetić M, Risović D. different protocols of photobiomodulation therapy of hyposalivation. Photomed Laser Surg. 2018;36(2):78-82. http://dx.doi.org/10.1089/pho.2017.4325. PMid:29022754.

13 Millsop JW, Wang EA, Fazel N. Etiology, evaluation, and management of xerostomia. Clin Dermatol. 2017;35(5):468-76. http://dx.doi.org/10.1016/j.clindermatol.2017.06.010. PMid:28916028.

14 Crincoli V, Fatone L, Fanelli M, et al. Orofacial manifestations and temporomandibular disorders of systemic scleroderma: an observational study. Int J Mol Sci. 2016;17(7):E1189. http://dx.doi.org/10.3390/ijms17071189. PMid:27455250.

15 Steen VD, Medsger TA. Changes in causes of death in systemic sclerosis, 1972-2002. Ann Rheum Dis. 2007;66(7):940-4. http://dx.doi.org/10.1136/ard.2006.066068. PMid:17329309.

16 Lima DP, Diniz DG, Moimaz SA, Sumida DH, Okamoto AC. Saliva: reflection of the body. Int J Infect Dis. 2010;14(3):e184-8. http://dx.doi.org/10.1016/j.ijid.2009.04.022. PMid:19726214.
 


Submitted date:
11/19/2019

Accepted date:
06/30/2020

Publication date:
12/08/2020

5fcfbb9c0e88257f764ac229 autopsy Articles
Links & Downloads

Autops Case Rep

Share this page
Page Sections