Identificação da ausência de sensibilidade pulpar em dentes permanentes hígidos de paciente com doença falciforme do município de Macapá, Amapá: estudo de caso

Abstract

The sickle cell disease is a type of genetic haematological disorder caused by mutation in the beta gene of the hemoglobin molecule. This mutation gives rise to a changed hemoglobin called hemoglobin S (HbS), instead of a normal hemoglobin (HbA) which can polymerize by promoting a change in the structure of the red blood cells, sickling them. The homozygous shape of sickle cell disease (HbSHbS) is called Sickle Cell Anaemia, and for it to occur, the person should get each parent a gene for hemoglobin S. The sickling process of red blood cells results in a scenario of constriction of blood vessels and hemolytic anaemia, that are responsible for various clinical and orofacial manifestations, including asymptomatic and aseptic pulp necrosis. Thus, the aim of this study was to identify the absence of pulp sensitivity in healthy permanent teeth of a patient with sickle cell disease, given that the absence of pulp sensitivity indicates a possible diagnosis of pulp necrosis. We conducted a case study with 01 voluntary patient, female, 15 years old, with clinical and laboratory diagnosis of sickle cell anaemia. For data collection was made the anamnesis and were conducted the oral clinical tests of visual inspection, palpation and percussion, diagnostic tests of pulp sensitivity, x-ray examinations of selected dental elements, computerized tomographic examination of the maxilla and mandible and face examination with infrared thermography. The cold sensitivity test was performed in 28 healthy permanent teeth present and the results showed only 8 incisors teeth with positive response to pulp sensitivity testing. The response of the other was negative to the test. The results of all other examinations were within normal limits. Given the results, it is concluded that the teeth showed no other reason to have absence of pulp sensibility that were not the crises of constriction of blood vessels that occur in the person with sickle cell anaemia, which were associated with a response pattern suggesting a possible pulp necrosis