Phytotherapy: knowledge, experience and prescription in oral healthcare. A cross-sectional survey of dental practitioners / Conhecimento, experiência e prescrição de fitoterapia em saúde bucal: Um levantamento transversal com dentistas clínicos

ABSTRACT Herbal medicine is widely used as an integrative complementary treatment for common chronic diseases, yet potential risks include adverse effects and coprescription Aim This exploratory survey assessed Brazilian dentists' knowledge, attitudes, and practices regarding phytotherapy Material and Method This study used a consecutive sample of registered dentists who were active in clinical practice and attending advanced training for complex oral rehabilitation at a leading dental school in Latin America. Participants responded to a semi-structured 38-item instrument designed to collect data on sociodemographic, professional and health variables, and on their knowledge, use, prescription and opinions of phytotherapy. Quantitative data were analyzed with descriptive and inferential statistics. Qualitative data were described and analyzed with a thematic approach Results A total 53 dentists responded the survey (88.3% response rate). Six dentists reported formal education in phytotherapy and 33 had informal knowledge. Twenty-one dentists (39.6%) reported using herbal medicine, and 17 (32.1%) prescribed phytotherapy to their patients, mostly traditional medicinal plants. A logistic regression model showed that post-graduate degree and personal use of phytotherapy were associated with phytotherapy prescription. Opinions on how to improve the rational use of phytotherapy included the need for research evidence, specific academic education, and knowledge dissemination to clinicians. As a clinical recommendation, it was proposed that questions on herbal medicine should be asked during the dental patient's anamnesis Conclusions Dentists with post-graduate degrees and personal use of phytotherapy prescribe herbal medicines for their patients in real-world clinics, regardless of formal education on the subject. Qualitative findings indicate the need to implement scientific initiatives.

RESUMO A fitoterapia é amplamente utilizada como um tratamento integrativo e complementar para doenças crônicas comuns, mas os riscos potenciais incluem efeitos adversos e co-prescrição Objetivo Esta pesquisa exploratória avaliou o conhecimento, as atitudes e as práticas de cirurgiões-dentistas brasileiros sobre fitoterapia Materiais e Método Uma amostra consecutiva foi composta por dentistas com registro profissional, que eram ativos em prática clínica e frequentavam treinamento avançado para reabilitação oral complexa em uma das principais escolas de odontologia da América Latina. Os participantes responderam a um instrumento semiestruturado de 38 itens para coletar dados sobre variáveis sociodemográficas, profissionais e de saúde, bem como conhecimento, uso, prescrição e opiniões sobre fitoterapia. Os dados quantitativos foram analisados com estatística descritiva e inferencial. Os dados qualitativos foram descritos e analisados com abordagem temática Resultados Um total de 53 dentistas respondeu à pesquisa (taxa de resposta de 88,3%). Seis cirurgiões-dentistas relataram formação em fitoterapia e 33 possuíam conhecimento informal. Vinte e um dentistas (39,6%) relataram o uso de fitoterápicos e 17 (32,1%) prescreveram fitoterapia para seus pacientes, principalmente plantas medicinais tradicionais. Um modelo de regressão logística mostrou que pós-graduação e uso pessoal de fitoterapia estiveram associados à prescrição de fitoterapia. As opiniões para melhorar o uso racional da fitoterapia incluíram a necessidade de evidências de pesquisa, formação acadêmica específica e disseminação do conhecimento para os clínicos. Como recomendação clínica, foram propostas questões sobre fitoterapia para a anamnese odontológica do paciente Conclusões Cirurgiões-dentistas com pós-graduação e uso pessoal de fitoterapia prescrevem mais medicamentos fitoterápicos para seus pacientes em clínicas do mundo real, independentemente da educação formal sobre o assunto. Os resultados qualitativos indicam a necessidade de iniciativas de implementação científica.

Phytotherapy: knowledge, experience and prescription in oral healthcare. A cross-sectional survey of dental practitioners.

Herbal medicine is widely used as an integrative complementary treatment for common chronic diseases, yet potential risks include adverse effects and coprescription. Aim: This exploratory survey assessed Brazilian dentists' knowledge, attitudes, and practices regarding phytotherapy. Material and Method: This study used a consecutive sample of registered dentists who were active in clinical practice and attending advanced training for complex oral rehabilitation at a leading dental school in Latin America. Participants responded to a semi-structured 38-item instrument designed to collect data on sociodemographic, professional and health variables, and on their knowledge, use, prescription and opinions of phytotherapy. Quantitative data were analyzed with descriptive and inferential statistics. Qualitative data were described and analyzed with a thematic approach. Results: A total 53 dentists responded the survey (88.3% response rate). Six dentists reported formal education in phytotherapy and 33 had informal knowledge. Twenty-one dentists (39.6%) reported using herbal medicine, and 17 (32.1%) prescribed phytotherapy to their patients, mostly traditional medicinal plants. A logistic regression model showed that post-graduate degree and personal use of phytotherapy were associated with phytotherapy prescription. Opinions on how to improve the rational use of phytotherapy included the need for research evidence, specific academic education, and knowledge dissemination to clinicians. As a clinical recommendation, it was proposed that questions on herbal medicine should be asked during the dental patient's anamnesis. Conclusions: Dentists with post-graduate degrees and personal use of phytotherapy prescribe herbal medicines for their patients in real-world clinics, regardless of formal education on the subject. Qualitative findings indicate the need to implement scientific initiatives.

A fitoterapia é amplamente utilizada como um tratamento integrativo e complementar para doenças crônicas comuns, mas os riscos potenciais incluem efeitos adversos e co-prescrição. Objetivo: Esta pesquisa exploratória avaliou o conhecimento, as atitudes e as práticas de cirurgiões-dentistas brasileiros sobre fitoterapia. Materiais e Método: Uma amostra consecutiva foi composta por dentistas com registro profissional, que eram ativos em prática clínica e frequentavam treinamento avançado para reabilitação oral complexa em uma das principais escolas de odontologia da América Latina. Os participantes responderam a um instrumento semiestruturado de 38 itens para coletar dados sobre variáveis sociodemográficas, profissionais e de saúde, bem como conhecimento, uso, prescrição e opiniões sobre fitoterapia. Os dados quantitativos foram analisados com estatística descritiva e inferencial. Os dados qualitativos foram descritos e analisados com abordagem temática. Resultados: Um total de 53 dentistas respondeu à pesquisa (taxa de resposta de 88,3%). Seis cirurgiões-dentistas relataram formação em fitoterapia e 33 possuíam conhecimento informal. Vinte e um dentistas (39,6%) relataram o uso de fitoterápicos e 17 (32,1%) prescreveram fitoterapia para seus pacientes, principalmente plantas medicinais tradicionais. Um modelo de regressão logística mostrou que pós-graduação e uso pessoal de fitoterapia estiveram associados à prescrição de fitoterapia. As opiniões para melhorar o uso racional da fitoterapia incluíram a necessidade de evidências de pesquisa, formação acadêmica específica e disseminação do conhecimento para os clínicos. Como recomendação clínica, foram propostas questões sobre fitoterapia para a anamnese odontológica do paciente. Conclusões: Cirurgiões-dentistas com pós-graduação e uso pessoal de fitoterapia prescrevem mais medicamentos fitoterápicos para seus pacientes em clínicas do mundo real, independentemente da educação formal sobre o assunto. Os resultados qualitativos indicam a necessidade de iniciativas de implementação científica.

Acupuncture applied at local or distal acupoints reduces pain related to temporomandibular disorders in female patients.

PURPOSE: To evaluate the efficacy of two traditional acupuncture protocols on pain relief in temporomandibular disorder (TMD) patients using either local or distal acupoints for mechanical needle stimulation. MATERIALS AND METHODS: The sample was selected from female TMD patients with chronic pain from a specialized referral center. Clinical charts were retrieved to select patients treated by traditional acupuncture following either a protocol for application of needles in local acupoints (head, neck) or a protocol for application in distal acupoints (hands, legs, feet). Pain intensity was recorded before and after each acupuncture session by using an instrumental question with a 10-point visual analog scale (VAS). A control group consisted of nontreated patients from the waiting list for TMD treatment. Data were analyzed using descriptive statistics, paired t test, analysis of variance, and Tukey test, at a significance level of .05. RESULTS: Out of 102 TMD patients, 32 were treated with acupuncture at local points, 22 were treated with acupuncture at distal points, and 48 were controls. A significant decrease of mean VAS score (approximately 70%) was found after acupuncture treatments in both the local- and distal-point groups. The final VAS of each acupuncture group was lower than the control group, but the acupuncture groups showed no difference. CONCLUSION: It can be concluded that acupuncture treatment reduces chronic pain in TMD patients, and the application of needle stimulation at local or distal acupoints has similar effects.

Implant Inclination and Cantilever Length Are Not Associated with Bone Loss in Fixed Complete Dentures: A Prospective Study.

PURPOSE: To investigate whether the inclination of the most distal implant and the cantilever length influence marginal bone loss in implant-supported fixed complete dentures (ISFCDs). MATERIALS AND METHODS: A novel method using computed tomography images was developed to measure the mesiodistal implant inclination. The cantilever length was measured during ISFCD fabrication. Radiographs were obtained after ISFCD installation at 1 and 3 years after loading. RESULTS: A total of 30 subjects with 62 implants were included. Accumulated marginal bone loss was 0.35 ± 0.49 mm. No significant association was found between marginal bone loss and cantilever length or implant inclination. CONCLUSION: Implant inclination and cantilever length do not seem to affect marginal bone loss.

Impact of Prosthetic Rehabilitation on Quality of Life in Patients with Significant Dental and Orofacial Tissue Loss: A Mixed-Methods Study.

PURPOSE: To assess the impact of prosthetic rehabilitation on quality of life (QoL) in patients with cleft lip and palate (CLP) and in edentulous patients with implant-supported complete dentures (ICD). MATERIALS AND METHODS: CLP (n = 20) and ICD (n = 26) patients completed the Oral Health Impact Profile (OHIP-14). Nine patients with an OHIP-14 score above the 75th percentile were interviewed. Data were interpreted using inductive content analysis and triangulation. RESULTS: ICD patients scored higher than CLP patients in overall OHIP-14 score and in most domains (P < .05). After rehabilitation, CLP patients reported improvement in psychosocial functions but worsening in physical functions. ICD patients had improvement in all domains, but were less satisfied. CONCLUSION: The mixed-methods study design can detect the origins and interactions of factors in treated patients with complex problems.

Marginal fit analysis of premachined and castable UCLA abutments

This study evaluated the fit between implants and premachined and castable UCLA abutments. All plastic specimens were cast using the conventional technique in accordance with the manufacturer's instructions. Five specimens of each experimental group were measured for vertical and horizontal gaps by scanning electronic microscopy (Phillips XL 30 model, Holland). Gold UCLA (vertical gap: 2.15 μm, horizontal gap: 11.30 μm) and castable rotational UCLA (vertical gap: 14.91 μm, horizontal gap: 59.41 μm) groups showed the lowest and highest mean values, respectively (Neodent, Curitiba, Parana, Brazil). In general, the castable UCLA abutments showed poorer marginal fit than the premachined abutments.

Esse estudo avaliou a adaptacao entre implantes pilares UCLA usinados e fundidos. Todos os corpos de prova de plastico foram fundidos usando tecnica de fundicao convencional de acordo com o fabricante. Cinco corpos de prova foram avaliados em relacao a desadaptacao vertical e horizontal utilizando um Microscopio Eletronico de Varredura. Os grupos UCLA Ouro (desadaptacao vertical: 2.15 μm, horizontal : 11.30 μm) e UCLA rotacional fundido (desadaptacao vertical: 14.91 μm, horizontal: 59.41 μm) mostraram as medias mais baixas e mais altas, respectivamente. De uma maneira geral, os pilares UCLA fundidos mostraram adaptacao menor do que os pilares UCLA usinados.