Lesão oral associado a paciente sistemicamente comprometido assistido em unidade de terapia intensiva: relato de caso

Abstract

INTRODUCTION: Muscle control poses a challenging task for neurologically compromised patients. In certain circumstances, tongue protrusion combined with limited mouth opening can lead to severe intraoral injuries, particularly when the patient is in a coma and unable to consciously perform oral protection and hygiene. OBJECTIVE: To report a case of tongue self-mutilation in a patient with a stroke. CASE REPORT: A 60-year-old female patient with a medical history of diabetes, systemic hypertension, and stroke, being treated in the intensive care unit, presented with an ulcerated lesion and erythematous halo on the underside of the tongue caused by adjacent teeth. A low-cost intraoral device was fabricated using thermoplastic impression material (Aquaplast 3.2 mm, Aquaplast Corp. Wyckoff, NJ, USA). Twenty-one days after using the intraoral device, the patient showed excellent healing of the lingual tissue, with no signs of new self-mutilation. DISCUSSION: Thermoplastic impression material is commonly used for orthopedic appliances and can adapt to the patient without the need for laboratory procedures. Additionally, the material has moderate strength, complete memory, and good remodeling for dynamic conditions, allowing its use in the fabrication of intraoral devices, as demonstrated in this case. CONCLUSION: The device developed in this case proved highly effective in protecting teeth and soft tissues, preventing further episodes of self-mutilation. Further studies are needed to test this device and alternative materials for the protection of intraoral hard and soft tissues.