Proteus syndrome (SP; OMIM #176920) is a rare complex disorder, characterized by the asymmetric postnatal growth of different parts of the body which tends to progress throughout life. Its prevalence is estimated at 1 per 1,000,000 live births. The clinical features are: partial gigantism of extremities, plantar hyperplasia, macrocephaly, cranial hyperostosis and asymmetry of the limbs due to the growth of long bones and soft tissues. Some of those affected may have intellectual impairment. Diagnosis is based on clinical criteria, imaging and genetic exams. The mainstay of treatment is early diagnosis of the disease and medication for symptoms presenting throughout life to improve quality of life. This case report presents a female patient, from 4½ years of age to the present, with asymmetric growth of the face and upper and lower limbs, undergoing dental follow-up at the Dental Service of a Specialist Center for Rehabilitation and Readaptation in Goiânia, Brazil. She presents delay in neuropsychomotor development, pronounced osteopenia, does not speak and is dependent in terms of activities of daily living. The eruption of deciduous teeth began at 4 months and permanent dentition at 4 years of age. During the current clinical examination of the child at 12 years and 2 months we found severe enamel hypoplasia in the teeth on the right side, mandibular prognathism, maxillary atresia, ogival palate, and anterior crossbite. The treatment plan included prevention and maintenance of oral health, monitoring of enamel hypoplasia, rhizolysis of the deciduous dentition and of eruption of permanent dentition, and restoration and extraction of teeth which were causing traumatic lesions on soft tissues. The parents' concerns were the malformations in dental enamel and traumatic lesions in the mucous membranes caused by badly positioned teeth. The interventions performed were composite resin restorations, tooth extractions, oral hygiene guidance and topical application of fluoride. Orthodontic treatment was contraindicated due to the severity of the disease. The dental approach in severe cases of PS must be individualized, with emphasis on oral hygiene and the removal of traumatic factors which damage soft tissues and cause pain. Dental surgeons must be prepared for individualized management.
No contexto da pandemia do Coronavírus, a regulamentação do uso do telemonitoramento e teleorientação em Odontologia foi liberada em junho de 2020 pelo Conselho Federal de Odontologia. O objetivo deste estudo foi avaliar o resultado do telemonitoramento, traçar o perfil sociodemográfico e epidemiológico dos pacientes, verificar as dificuldades empreendidas na execução e as demandas de urgência. A amostra por conveniência consistiu na busca de dados em 1643 prontuários de pacientes que receberam o telemonitoramento no período de julho a outubro de 2020. Foi utilizado um roteiro estruturado na coleta de dados sociodemográficos e epidemiológicos, além de perguntas referentes à satisfação do atendimento na opinião do paciente. A amostra foi composta por 57,9% pessoas do sexo masculino e 42,1% do sexo feminino. A idade média foi de 21 anos (±16,9). O maior número de pacientes que receberam o telemonitoramento eram da clínica de deficiência física (81,6%). Uma pequena parcela de pacientes (2,6%) não recebeu material audiovisual educativo por falta de dispositivo de recebimento como celulares e computadores. Ao avaliar as entregas realizadas, observou-se que houve associação significativa entre os pacientes que não receberam orientações para prevenção contra a COVID-19 (p=0,0001) e que não receberam material audiovisual (p=0,0001). O telemonitoramento é um recurso que permitiu a promoção do cuidado em saúde, além de disseminar informações pertinentes às pessoas com deficiências durante a pandemia, e se firma como um novo artifício de promoção e prevenção à saúde.
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