Study and analysis of information technology in dentistry in Latin American countries / Estudio y análisis de la informática odontológica en países de Latinoamérica

Dentistry increasingly uses Information and CommunicationTechnology (ICT), which has impact on teaching, research, the profession and dental care in general. However, there is alack of valid information on ICT resources and use in LatinAmerica. This was a descriptive, cross-sectional, multi-center,interdisciplinary study, the aim of which was to conduct asurvey on how extensively ICT is used in Dentistry in LatinAmerican countries by enquiring into two primary components:1) use of ICT in student training and 2) use of ICT by professionalsin consulting rooms and services. Two questionnaires on ICTwere prepared: one for teachers/researchers and another for students/professionals. We received 94 answers fromteachers/researchers at universities in the region providinginformation on ICT resources for teaching (type andimplementation) and 221 answers from professionals (personaluse and use in healthcare). Data are presented as absoluterelative frequencies and analyzed quantitatively as percentages.Results: 1) Teachers highlight ICT as an instrument fordevelopment, democratization and fairness in access toknowledge for higher education. 2) ICT supports collaborativelearning and generates other innovative resources (e.g.simulators). 3) Innovations in telemedicine and experienceswith electronic clinical history were identified in Brazil,Uruguay and Colombia. These results are a basis upon whichto reach a consensus regarding a set of ICT indicators whichare comparable at regional level and serve as input to unifythe design and implementation of ICTs experiences in bothteaching and dental care in Latin America.

La Odontología utiliza en forma creciente las Tecnologías de la Información y la Comunicación (TIC) impactando en la enseñanza, la investigación, la profesión y la atenciónodontológica en general. Sin embargo, no se cuenta con información válida sobre los recursos e utilización de las TIC en latinoamérica. La investigación representó un estudio descriptivo, de corte transversal, multicéntrico e interdisciplinario, cuyo objetivo fue realizar un relevamiento del gradode informatización en Odontología en países latinoamericanos indagando dos componentes principales en el empleo de las TIC: 1) en la formación de estudiantes y 2) por parte de losprofesionales en consultorios y servicios. Se realizaron cuestionarios a referentes TIC: uno para docentes/investigadores y otro para estudiantes /profesionales. Se recibieron 94 respuestas de docentes /investigadores de universidades de la región dando cuenta de los recursos TIC para la enseñanza (tipo e implementación) y 221 de profesionales (personal y en la asistencia clínica). Los datos recogidos fueron analizados cuantitativamente con tabulación en porcentaje y se presentan en frecuencia relativa absoluta. Resultados: 1) Los docentes enfatizan a las TIC como instrumento de desarrollo, democra tiza ción y equidad en el acceso al conocimiento en educación superior. 2) Las TIC apoyan el aprendizaje colaborativo y generan otros recursos innovadores (ej: simuladores). 3) Se identificaron innovaciones en telemedicina y experiencias con historia clínica electrónica en Brasil, Uruguay y Colombia. Los resultados constituyenuna base para consensuar un conjunto de indicadores TIC comparables a nivel regional y sirven como insumo paraunificar el diseño e implementación de las experiencias TIC tanto en enseñanza como en la asistencia odontológica enLatinoamérica.

The awareness and attitudes of students of one indian dental school toward information technology and its use to improve patient care.

BACKGROUND: Many obstacles need to be overcome if digital and electronic technologies are to be fully integrated in the operation of dental clinics in some countries. These obstacles may be physical, technical, or psychosocial barriers in the form of perceptions and attitudes related to software incompatibilities, patient privacy, and interference with the patient-practitioner relationship. The objectives of the study are to assess the perceptions of Indian dental students of one school toward the usefulness of digital technologies in improving dental practice; their willingness to use digital and electronic technologies; the perceived obstacles to the use of digital and electronic technologies in dental care setups; and their attitudes toward Internet privacy issues. METHODS: The study population consisted of 186 final year undergraduate dental students from the A. B. Shetty Memorial institute of Dental Sciences, Rajiv Gandhi University of Health Sciences, Mangalore, India. Survey data were analyzed descriptively . RESULTS: Most students indicated that information technology enhances patient satisfaction, the quality of dental record, diagnosis, treatment planning, and doctor-doctor communication. Cost of equipment and need for technical training were regarded as major obstacles by substantial proportions of respondents. DISCUSSION: Most dental students at our school feel that the information technology will support their decision making in diagnoses and devising effective treatment plans, which in turn increase patient satisfaction and quality of care. Students also perceived that lack of technical knowledge and the high cost of implementation are major barriers to developing information technology in India.

Personal identification using QR Code incorporated in dentures / Identificação pessoal usando código QR incorporado em próteses totais

Forensic dentistry is finding increased application in identifying deceased individuals. Incorporating patient identification system in dentures is one of the measures taken in this regard. There are several denture identification measures, each having their own merits and demerits. This article describes a new denture identification system using Quick Response Code incorporated in dentures. This identification system can be very cost-effective, store lot of patient-related information and be easily accessible to the dentist...

A identificação de indivíduos falecidos é uma demanda crescente em Odontologia. A incorporação de sistemas de identificação na prótese total de pacientes é um procedimento de possível. Existem vários sistemas de identificação em próteses totais, cada um com seus próprios méritos e deméritos. Este artigo descreve um novo sistema de identificação de dentadura utilizando o código QR incorporado em próteses totais. Este sistema de identificação é de baixo custo, armazena grande quantidade de informações relacionadas ao paciente e é de fácil acesso ao dentista...

An initial, qualitative investigation of patient-centered education in dentistry.

Patient education plays an important role in the delivery of dental care. Current evidence suggests that the emergence of the Internet and other electronic resources are significantly influencing how patients learn about their healthcare. We conducted a qualitative inquiry using a combination of interviews with patients and clinicians, and direct observation of patient education episodes, to begin identifying requirements for customized, patient-centered approaches to education at the point of care. Most patients in our study felt comfortable with the amount and method of education during the dental visit, but 38% sought additional information on the Internet. Dentists and their team members provided patient education mostly verbally, supported by media such as radiographs, images and models. Electronic means, especially the Internet, were little used. Patient education occupied a significant portion of the time of initial comprehensive examination (29%) and routine (7%) dental visits. A deeper understanding of patient knowledge deficits and information needs will be needed to design effective educational interventions. Patient education should be meaningfully integrated into the workflow shared by dentists, their team members and patients, in order to maximize its outcomes.

Sequential software processing of micro-XCT dental-images for 3D-FE analysis.

OBJECTIVES: The aim was to describe a sequential software processing of mu-XCT molar-images for 3D-FE tooth/restoration model geometries based on a representative molar tooth, giving attention on each step of data-processing. This paper first gives an overview of a sequential processing and then applies the resulting model to the particular case. METHODS: An intact mandibular molar was scanned using a micro-XCT instrument (1072, SkyScan, Belgium) in which 960 slices were obtained. Sixty-three non-adjacent bitmap slices were then optimally selected for model-creation. Enamel/dentin boundaries were clarified, for each slice, using image control-system software (ScanIP, Simpleware), generated a file which was sequentially converted into a mesh in a reconstruction software (ScanFE, Simpleware) and posteriorly converted into a STL-file (triangulated-2D-stereolithography). This was imported into a FE-software package (Patran, MSC.Software, USA) and all elements were re-meshed. From these elements, surfaces were created and exported to another FE-software (Hypermesh, Altair Hyperworks) to build the dental-cavities. Finally, the volumetric-mesh was created and the model was imported back to FE-software to apply the boundary-conditions, material-properties and initiate post-processing (using Patran and Marc, MSC Software). To demonstrate the use of the resulting model, this was applied to the particular case of a Class I restoration subjected to distributed loading. The analysis was performed as linear and structural and outputs of maximum principal (MP) and maximum shear (MS) stresses were then evaluated. RESULTS: A 3D-model of a mandibular molar was processed without generating errors in the FE-package used. The maximum deviation between the tooth and the model was less than 0.1%. Stress concentrations were found at the surface where the load was applied and in the vicinity of the tooth-composite interface. SIGNIFICANCE: The described procedure is a successful method able to produce a highly detailed 3D finite element model of restored molar teeth with any cavity configuration and combination of restorative materials and this method can also be used for other biological or biomaterials applications.

Web services modeling for electronic dental records.

A Service-Oriented Architecture (SOA) is an ideal, promising paradigm for health information systems. In this study, we demonstrate how to apply SOA to dentistry and develop a web-service model for electronic dental records.

SmartConsent: a computerized informed consent for dental patients.

Communicating personalized information to patients about the risks, benefits and other critical information about dental disease and treatment is often difficult for providers. In this research we developed a novel informed consent prototype that can accurately translate and communicate information to patients in a standardized and effective manner based on their diagnosis and prescribed treatment. In future work, we aim to integrate SmartConsent into the institutional electronic patient record (EPR) and determine its effectiveness in a randomized controlled study.

A preliminary comparison of speech recognition functionality in dental practice management systems.

In this study, we examined speech recognition functionality in four leading dental practice management systems. Twenty dental students used voice to chart a simulated patient with 18 findings in each system. Results show it can take over a minute to chart one finding and that users frequently have to repeat commands. Limited functionality, poor usability and a high error rate appear to retard adoption of speech recognition in dentistry.

A nonsurgical endodontics relational research database: the initial six years of experience.

The purpose of this study was to report results of the initial six years of experience utilizing a nonsurgical root canal treatment (NSRCT) database; to compare patient characteristics, operative procedures, and patient outcomes observed in the database to those observed in other studies; and to discuss the potential benefits of a clinical endodontic database. A total of 7,372 NSRCT cases performed by endodontic residents at the University of Pennsylvania from 2000 to 2006 were evaluated. The odds ratio (OR) for caries and trauma being causative agents for NSRCT in

Automatic mining of the literature to generate new hypotheses for the possible link between periodontitis and atherosclerosis: lipopolysaccharide as a case study.

AIM: The aim of the current report was to generate and explore new hypotheses into how, in a pathophysiological sense, atherosclerosis and periodontitis could be linked. MATERIAL AND METHODS: Two different biomedical informatics techniques were used: an association-based technique that generated a ranked list of genes associated with the diseases, and a natural language processing tool that extracted the relationships between the retrieved genes and lipopolysaccharide (LPS). RESULTS: This combined approach of association-based and natural language processing-based literature mining identified a hit list of 16 candidate genes, with PON1 as the primary candidate. CONCLUSIONS: Further study of the literature prompted the hypothesis that PON1 might connect periodontitis with atherosclerosis in both an LPS-dependent and a non-LPS-dependent manner. Furthermore, the resulting genes not only confirmed already known associations between the two diseases, but also provided genes or gene products that have only been investigated separately in the two disease states, and genes or gene products previously reported to be involved in atherosclerosis. These findings remain to be investigated through clinical studies. This example of multidisciplinary research illustrates how collaborative efforts of investigators from different fields of expertise can result in the discovery of new hypotheses.

The feasibility of a three-dimensional charting interface for general dentistry.

BACKGROUND: Most current paper- and computer-based formats for patient documentation use a two-dimensional dental chart, a design that originated almost 150 years ago in the United States. No studies have investigated the inclusion of a three-dimensional (3-D) charting interface in a general dental record. METHODS: A multidisciplinary research team with expertise in human-computer interaction, dental informatics and computer science conducted a 14-week project to develop and evaluate a proof of concept for a 3-D dental record. Through several iterations of paper- and computer-based prototypes, the project produced a high-fidelity (hi-fi) prototype that was evaluated by two dentists and two dental students. RESULTS: The project implemented a prototypical patient record built around a 3-D model of a patient's maxillofacial structures. Novel features include automatic retrieval of images and radiographs; a flexible view of teeth, soft tissue and bone; access to historical patient data through a timeline; and the ability to focus on a single tooth. CONCLUSIONS: Users tests demonstrated acceptance for the basic design of the prototype, but also identified several challenges in developing intuitive, easy-to-use navigation methods and hi-fi representations in a 3-D record. CLINICAL IMPLICATIONS: Test participants in this project accepted the preliminary design of a 3-D dental record. Significant further research must be conducted before the concept can be applied and evaluated in clinical practice.

Confiabilidade do uso de modelos digitais tridimensionais como exame auxiliar ao diagnóstico ortodôntico: um estudo piloto / Reliability of three-dimensional digital casts as a diagnostic tool for orthodontic treatment planning: a pilot study

OBJETIVO: os rápidos e contínuos avanços nas Ciências da Computação resultaram no aumento significativo do emprego de novas tecnologias em todos os níveis da sociedade. Na Ortodontia, radiografias e fotografias digitais já são usadas de forma rotineira. A utilização de modelos de estudo digitais vem sendo anunciada como o novo componente da documentação ortodôntica computadorizada. Como acontece quando uma nova tecnologia se torna disponível, o uso de modelos ortodônticos digitais tem gerado controvérsias. Alguns ortodontistas questionam a aplicabilidade de imagens tridimensionais em substituição aos modelos tradicionais de gesso, pois não há na literatura número relevante de estudos que tenham testado adequadamente tal tecnologia. Diante disso, o objetivo desse estudo foi testar a confiabilidade do uso de modelos dentários digitais como exame complementar ao diagnóstico ortodôntico. METODOLOGIA: três examinadores mediram a largura dos dentes permanentes, quatro segmentos dos arcos superiores e inferiores, distâncias intercaninos, distâncias intermolares, trespasses horizontal e vertical em modelos de gesso e em seus correspondentes digitais de seis pacientes, utilizando um paquímetro digital e o programa eModel, respectivamente. RESULTADOS E CONCLUSÕES: diante dos resultados, observou-se que todas as medidas avaliadas foram estatisticamente semelhantes nos dois tipos de modelos testados, com exceção das médias encontradas para a largura do dente 45 (p<0,05). Entretanto essa diferença é considerada clinicamente aceitável. Comprova-se com esse estudo a confiabilidade do uso dos modelos dentários digitais como exame complementar ao diagnóstico ortodôntico. Além disso, a facilidade de armazenamento de informações, o menor risco de perda de dados durante sua manipulação e transporte, bem como a diminuição do tempo gasto para realizar as medições foram considerados vantagens do uso dessa nova tecnologia na Ortodontia.

AIM: the fast and continuous advances in computer sciences have resulted in an increased usage of new technologies in all levels of the modern society. Orthodontics has also been influenced by this phenomenon. Digital radiographs and photographs have been commonly used in Orthodontics offices. Recently, digital study models have been advertised as the latest component of fully digitized orthodontic records. When a new diagnostic technology becomes available it may initially generate controversy, and with digital orthodontic casts it has not been different. Some orthodontists may question the reliability of this new diagnostic tool since there is not enough literature to support the substitution from traditional stone casts to digital models. Therefore, the aim of the present study was to compare the reliability of digital orthodontic models and stone casts as a diagnostic aid. METHODS: three examiners measured the width of the permanent teeth, intercanine and intermolar distances, overbite and overjet of stone and the corresponding digital casts from six patients. A digital caliper was used for measuring the stone casts and the eModel software to evaluate the digital models. RESULTS AND CONCLUSIONS: the results of this study showed no statistically significant difference among any of the measurements tested, except by the width of the lower second right premolar (p<0.05). However, these differences were not considered clinically relevant. These findings show that digital orthodontic casts are as reliable as stone study models as a diagnostic tool for orthodontic treatment planning. The easy data storage, the lower risk of breakage during its handling and transportation, and also the shorter time needed to obtain the diagnostic information were considered additional advantages of this new technology.

Search and selection methodology of systematic reviews in orthodontics (2000-2004).

INTRODUCTION: More systematic reviews related to orthodontic topics are published each year, although little has been done to evaluate their search and selection methodologies. METHODS: Systematic reviews related to orthodontics published between January 1, 2000, and December 31, 2004, were searched for their use of multiple electronic databases and secondary searches. The search and selection methods of identified systematic reviews were evaluated against the Cochrane Handbook's guidelines. RESULTS: Sixteen orthodontic systematic reviews were identified in this period. The percentage of reviews documenting and using each criterion of article searching has changed over the last 5 years, with no recognizable directional trend. On average, most systematic reviews documented their electronic search terms (88%) and inclusion-exclusion criteria (100%), and used secondary searching (75%). Many still failed to search more than MEDLINE (56%), failed to document the database names and search dates (37%), failed to document the search strategy (62%), did not use several reviewers for selecting studies (75%), and did not include all languages (81%). CONCLUSIONS: The methodology of systematic reviews in orthodontics is still limited, with key methodological components frequently absent or not appropriately described.

Conhecimento e utilização da informática pelo cirurgião-dentista como ferramenta de trabalho / Knowledge and aplication of information technology as a working toll by dentists

O presente trabalho teve por objetivos verificar e analisar os conhecimentos de informática dos cirurgiões-dentistas, forma de aquisição de tais conhecimentos e efetiva utilização. Foi aplicado um questionário para 203 cirurgiões-dentistas participantes de congressos e jornadas odontológicas, previamente elaborado, com respostas múltiplas, e realizado um estudo piloto que permitiu um ajuste da metodologia com a inclusão e alteração de algumas perguntas pertencentes ao questionário inicial. Foi possível concluir que apesar da grande utilização da Internet o profissional ainda não a utiliza para o aprendizado específico da informática e sim para o específico de odontologia. A procura pela informatização do consultório cresce a cada dia e a maioria, 77,06% dos profissionais que não possuem seu consultório informatizado pretendem informatizá-lo. No que se refere a sistemas aplicativos odontológicos, foi possível verificar que 46,81 % utilizam algum tipo de sistema. Quando se trata de ferramentas para captura de imagens (14,29%), radiografias digitais (12,81%) e outros tipos de ferramentas automatizadas (6,89%), foi possível notar uma pequena utilização, talvez devido ao alto custo e por muitas vezes pela dificuldade de seu manuseio, porém é interessante ressaltar que já está presente nas atividades diárias do profissional. Certamente com as novas configurações de microcomputadores, com a redução e aumento de vantagens, os sistemas aplicativos ocuparão uma parte maior para o controle também de dados clínicos. Novas versões e novos equipamentos têm surgido numa velocidade cada vez maior, o que reforça a necessidade do profissional estar sempre atualizado com o que aparece no mercado.

Avaliação do uso da informática pelo CD e acadêmico em odontologia / Evaluation of the use of informatics for the dental surgeons and academics in dentistry

A utilização de computadores na clínica odontológica trouxe muitos benefícios ao cirurgião dentista, auxiliando-o na administração do consultório, no diagnóstico clínico, e até mesmo para o marketing pessoal do profissional. Contudo não são todos os profissionais que conseguem usufruir completamente os benefícios oferecidos pelo computador. Com o objetivo de avaliar a condição do cirurgião dentista frente aos avanços tecnológicos, foi elaborada uma pesquisa destinando-se a fazer um panorama do conhecimento do profissional na área da informática, bem como a utilização de computadores, visando identificar habilidades e deficiências em áreas críticas de aplicação desta tecnologia. Para tal elaborou-se um questionário que foi respondido por cirurgiões dentistas e acadêmicos durante o Curso de Férias, julho de 2005, da Escola de Aperfeiçoamento Profissional (EAP) da APCD, São Paulo. Concluiu-se que a grande maioria dos profissionais tem acesso ao computador e não consegue usufruir os recursos que esta tecnologia pode oferecer, talvez por desconhecimento ou descrédito na mesma.