Is there an association between head and neck cancer diagnosis and self-reported dental fear? A dual-center cross-sectional study.

Introduction: Mental distress is highly reported in cancer patients, resulting in anxiety and depression most of the time. Both conditions, in turn, are recognized to be related to dental fear in adults; however, there are no studies on patients suffering from head and neck cancer. Thus, the present study aimed to investigate whether newly diagnosed patients with head and neck cancer are more prone to self-reported dental fear. Material and Methods: This dual-center cross-sectional study was conducted with 25 healthy outpatients and 25 patients with a recent diagnosis of head and neck cancer, all requiring dental care. The patients were informed at the first appointment about their dental therapy planning and the Brazilian Portuguese Version of the Dental Fear Survey (DFS) questionnaire was then applied after appropriate instructions. Results: The DFS total scores did not differ statistically between the groups (Mann-Whitney U test, P = 0,120) but the Cancer Group presented a slightly higher mean score (32.2 ± 10.0) than the Control Group (30.0 ± 14.2). Conclusion: Within the limitations of this study, newly diagnosed patients with head and neck cancer and healthy individuals seem to experience similar self-reported dental fear.

Surgical outcomes of the surgical techniques following management of iatrogenic trigeminal nerve injuries: A systematic review.

Objective: To investigate the effectiveness of the microsurgical treatment in restoring full sensory recovery following trigeminal nerve injuries caused by iatrogenic oral and maxillofacial surgical interventions. Methods: A detailed search was conducted on the Cochrane central register of controlled trials, Medline and Embase. Clinical studies with at least twelve months of follow up were included and assessment of risks of bias was made using the Robbin I assessment tool. Results: Six studies were identified in the searches which include 227 patients. The lingual nerve was the most common injured nerve, followed by the inferior alveolar nerve. Third molar removal was the most frequent cause of nerve injury, followed by root canal treatment, pathology excision, coronectomy, orthognathic surgery, dental implants and then local anaesthetic injections. Overall, surgical interventions for nerve injuries showed neurosensory improvement postoperatively in the majority of patients. Conclusion: Direct neurorrhaphy is still the gold-standard technique when the tension at the surgical site is minimal. Promising results have been noted on conduit applications following traditional repair or grafting. Further research is needed on the efficacy of allografting and conduit applications in nerve repair.

Dental robotics: a groundbreaking technology with disruptive potential - review article.

Dental Robotics represent a groundbreaking technological frontier with the potential to disrupt traditional paradigms in oral healthcare. This abstract explores the transformative impact of robotic applications in dentistry, focussing on precision, reproducibility, and reliability. A comprehensive search was conducted on the PubMed database, Dental and Oral Science, and CINAHL to identify pertinent studies exploring the implications of robotics in dentistry. Studies incorporated in this analysis highlighted the significance of broadening the research scope beyond implantology. This review underscores the importance of integrating robotic dentistry into educational frameworks and advancing technological preparedness. As we navigate these challenges, the abstract underscores the pivotal role of robotic dentistry in shaping the future of oral healthcare. Robotic dentistry promises transformative advancements in oral healthcare with precision and reliability. Challenges like limited system availability and expertise highlight the need for increased dentist-engineer collaboration. Diversifying research, emphasizing non-invasive technologies, and integrating robotic dentistry into education are crucial for wider acceptance. Public awareness and regulatory clarity are pivotal for seamless integration, unlocking the vast potential of robotic technologies in the future of dental care.

Prospective Cohort Study Identifies Medical Predictors of Treatment-Related Oral Toxicities in Oral and Oropharyngeal Cancer Patients.

The dental treatment of patients with oral cavity and oropharyngeal squamous cell carcinoma (OOPSCC) may be challenging for dentists. This study aimed to characterize systemic changes in patients with OOPSCC undergoing dental treatment prior to cancer therapy, with a specific focus on laboratory assessments. The primary objectives included identifying potential adverse events, such as infections or bleeding, resulting from dental procedures. Additionally, the study aimed to correlate baseline patient characteristics with treatment-related toxicities. This was a prospective cohort study that included 110 OOPSCC patients referred to the Dental Oncology Service at São Paulo State Cancer Institute, Brazil, between November/2019 and December/2020. Comorbidities, sociodemographic data, medication in use, cancer treatment-related toxicities, and altered laboratory tests results were correlated. The most common comorbidities and altered laboratory results were hypertension, dyslipidemia, diabetes, as well as elevated levels of C-reactive protein, hemoglobin, and hematocrit. Toxicities exhibited a progressive pattern over time, encompassing oral mucositis (OM), xerostomia, dysphagia, dysgeusia, trismus, and radiodermatitis. No correlation between comorbidities and cancer treatment-related toxicities, a positive correlation between medications in use and OM, and a negative correlation between medications and dysgeusia were found. OM was associated with altered thyroxine (T4) and free thyroxine (FT4), calcium, urea, creatinine, alkaline phosphatase, and syphilis. Family income and housing were OM predictors. Altered T4/FT4/urea/calcium/alkaline phosphatase/creatinine/syphilis may be useful clinical predictors of OM. Despite the elevated prevalence of comorbidities and abnormal laboratory findings, dental treatment prior to cancer treatment yielded no adverse events.

The hypotheses of oral disease-associated perioprosthetic joint infections to understand the role of oral health for endoprostheses - a narrative review.

AIMS: Periprosthetic infections are a severe complication, causing enormous morbidity. The role of oral diseases in the development of such infections has been discussed controversially, showing a large discrepancy between prevalence of oral foci and infections of endoprostheses (EP). This narrative review aimed in explaining and discussing two hypotheses for the occurrence of oral disease-associated EP infections. METHODS AND RESULTS: The hypotheses include two mechanisms. (1) In case of an acute exacerbation during the early healingperiod after EP surgery (first 3 months). (2) Coincidental in the context of late EP infections (after successful initial healing), where an initial periprosthetic inflammation can be colonized secondarily by oral microorganisms. In both settings,oral foci are not primarily causative for EP infection, but represent an important reservoir for EP colonization, while the immunological conditions (locally and systemically) are crucial for the onset of an EP infection. As potential consequence, patients with risk factors should be orally rehabilitated prior to EP surgery. Usage of antibiotic prophylaxis during the first 3 months after EP implantation (initial healing period) might be considered, but has no reliable evidence. To avoid morbidity of patients, radical dental clearance is unfavorable for the respective patients. CONCLUSION: Altogether, patients with EP should receive increased attention from the dental perspective alongside with dental preventive measures, because they show a high dental and periodontal treatment need.

An Aspirated Tooth Masquerading As Lung Cancer: A Unique Case Report.

Tooth aspiration, while commonly linked to predisposing conditions such as loose teeth, facial surgeries, or injuries, can also affect patients without apparent risk factors. Such small foreign body aspirations may go undiagnosed for many months as patients often tolerate the symptoms, such as chronic cough. However, the protracted course of unaddressed foreign body aspiration has the potential to resemble symptoms of malignancy, including persistent hemoptysis, weight loss, and fatigue. In this report, we detail the case of a 51-year-old man with underlying chronic obstructive pulmonary disease (COPD) whose history and symptoms initially suggested lung carcinoma. Further investigation uncovered an aspirated tooth as the culprit. The sequelae of pulmonary complications arising from endobronchial obstruction, such as post-obstructive pneumonia and atelectasis, as demonstrated in our case, further emphasize the importance of prompt detection and management of tooth aspiration.

Oral Health in Patients with History of Head and Neck Cancer: Complexity and Benefits of a Targeted Oral Healthcare Pathway.

PURPOSE OF REVIEW: This work consists in a literature review on the current state of knowledge regarding the oral management of patients with a history of head and neck cancer (HNC), corroborated by clinical cases and illustrated by clear infographic summaries. It aims to provide healthcare professionals with a comprehensive overview of the oral health status of HCN patients. RECENT FINDINGS: Head and neck cancers (HNCs) represent the seventh most common type of cancer worldwide, with over 660,000 annual new cases. Despite the significant negative impact of HNCs on oral health, patients often receive no or inappropriate oral care while the significant impact of oral pathologies on cancer prognosis is commonly underestimated. This work (i) describes the oral cavity during and after HNC through the prism of care complexity and (ii) highlights several potential key factors that could worsen long-time patients' prognosis and quality of life. By investigating the biological, microbiological, functional, and psychological dimensions of the interrelationships between HNCs and oral health, the authors explored the barriers and benefits of a targeted oral healthcare pathway. This article emphasizes the importance of multidisciplinary care and highlights the need for further research elucidating the intricate relationships between oral health and HNCs, particularly through the microbiota.

Awareness of Medication-Related Osteonecrosis of the Jaws Amongst Patients on Antiresorptive and Antiangiogenic Medications.

Background Medication-related osteonecrosis of the jaws (MRONJ) is a rare but severe condition that has garnered increasing attention in recent years. It primarily affects individuals undergoing treatment with antiresorptive and antiangiogenic medications, such as bisphosphonates and denosumab, commonly prescribed for osteoporosis and cancer-related bone metastases. Therefore, the present study aimed to assess awareness and understanding of MRONJ among patients receiving antiresorptive and antiangiogenic medications. Methods A cross-sectional survey was conducted among 110 patients receiving antiresorptive and antiangiogenic medications in a clinical setting. Participants were given a structured questionnaire to assess their awareness of MRONJ. The questionnaire covered aspects such as MRONJ, bisphosphonate usage, and awareness of the condition's potential complications. Demographic information was also collected. Chi-square and Fisher's tests were performed using SPSS statistical software. Results In terms of gender distribution, 63.6% of the participants were female. Concerning age distribution, the majority (43.6%) fell within the 21 to 40 age group, whereas only 5.5% were aged over 60. Regarding educational attainment, a substantial majority (58.2%) of the participants held a bachelor's degree. The study findings reveal that a considerable proportion (35.5%) of participants possess awareness regarding jaw osteonecrosis, and this association is statistically significant (p=0.002). A substantial number of participants administered the medication orally (30.9%), while others utilized various administration routes, including injection (IV and others) (40%), and this difference was also statistically significant (p=0.001). Most participants took bisphosphonates for osteoporosis (41.8%) or cancer (13.6%), both statistically significant (p<0.01). Gender had no significant impact (p>0.01), but age showed potential associations (p=0.07 for awareness, p=0.003 for medication use). Educational backgrounds had no significant link, except for bisphosphonate usage (p<0.01) and side effects reporting (p<0.01). Conclusion Notably, a small percentage of participants demonstrated awareness of this condition, indicating a need for continued education and awareness campaigns. Further research and interventions may be warranted to address the specific needs of different age groups and educational backgrounds in promoting safe and effective medication management.

Changes in oral home care and smoking habits during COVID-19 pandemic: A cross-sectional study.

OBJECTIVES: The coronavirus disease-19 (COVID-19) pandemic has caused disruption in the health behavior in many aspects of life. While hand hygiene was promoted as one of the precautionary measures to mitigate and contain COVID-19, oral health and smoking might have received less attention in the media campaigns. The aim of this study was to examine health behavioral changes in terms of oral home care habits, smoking, and perception of dental care during the COVID-19 pandemic. MATERIAL AND METHODS: An online survey was designed to assess oral home care, smoking habits, and attitude toward dental services of participants aged 18 years and older. The data were collected between September and November 2021. The strength of association between changes in oral home care habits, smoking, and attitude toward invasive/long dental procedures and each variable was measured by χ2 analysis. Estimates of relative risk were also calculated for all variables. Predictors of avoiding dental procedures were estimated by a binary logistic regression. RESULTS: A total of 532 participants, based in the United Arab Emirates, took part in this online survey with a response rate of 88.7%. The age of the participants ranged between 18 and 67 with mean age of 34.9 ± 9.0 years. The majority of the participants have adopted changes in their routine oral home care habits, with 82.1% of them changing the toothbrush more frequently. Participants who changed their oral home care habits were more likely to have received sufficient information on the importance of maintaining oral health. Likewise, the changes in smoking habits were significantly associated with receiving information on the relationship between smoking and the severity of the COVID-19 (p < 0.001). CONCLUSIONS: The findings showed that positive behavior toward oral home care and smoking was noticed during the pandemic particularly when public receives sufficient and up-to-date information.

Oral health inequalities in Swedish older adults over 25 years of follow-up.

OBJECTIVES: The aim of this study was to describe inequalities in tooth loss and dissatisfaction with teeth related to time-invariant and time-variant socio-demographic characteristics and use of dental care across the middle and older life course and to assess whether oral health inequalities remain stable, widen or narrow from age 50 to 75. MATERIALS AND METHODS: In 1992, 6346 residents, aged 50, consented to participate in a prospective cohort study including postal questionnaire follow-ups every fifth year until age 75. Tooth loss and dissatisfaction with teeth were assessed at each survey wave in addition to socio-demographic factors and use of dental care. Multivariable logistic regression, generalised estimating equations, GEE, and random intercept logistic mixed models were used for estimation of population-averaged and person-specific odds ratio. Interaction terms of each covariate with the time indicator were added to test whether inequalities changed across time. RESULTS: Person-specific OR and 95% CI estimates for tooth loss varied from 1.29 (1.09-1.53) (unmarried vs married) to 9.20 (6.07-13.94) (foreign country vs native). Estimated ORs for tooth dissatisfaction ranged from 1.33 (1.15-1.55) (unmarried vs married) to 2.59 (2.15-3.11) (smoking vs no smoking). Inequalities in tooth loss according to sex, educational level and country of birth were smaller in magnitude in 2017 than in 1992. Inequality estimates in dissatisfaction with teeth according to use of dental care and perceived health were, respectively, smaller and greater at older than at younger age. CONCLUSION: Socio-demographic inequalities in oral health persisted from age 50 to 75 and varied in magnitude across time. Both convergence and widening of disparities in oral health occurred towards older ages.

Dental needs and conditions of individuals with Lowe syndrome: An observational study.

INTRODUCTION: Lowe syndrome (LS) is an uncommon condition that affects the brain, kidneys, nervous system, and eyes, predominantly in males. The aim of this study was to examine dental conditions, dental treatments, and access and/or barriers to care for those with LS compared to healthy individuals. METHODS: Surveys assessing dental conditions, dental treatments, and access and/or barriers to care were administered to families in the Lowe Syndrome Association and families with healthy children who had dental appointments at the Tufts University School of Dental Medicine (TUSDM) pediatric dental clinic. One parent or a guardian of pediatric patients with LS or not at TUSDM was asked to complete an online survey. RESULTS: One hundred and eight surveys were obtained (n:58 from the LS group and n:50 from the healthy group). The LS group was significantly more likely (p < .05) to report "crooked/misaligned teeth," "difficult time chewing," "bad breath," and "mouth cysts" and was significantly less likely to report 6-month examination, "cleaning," and "filling." The LS group reported significantly greater difficulty locating a dentist. CONCLUSION: The findings of this study indicate that individuals with LS are more vulnerable to developing severe dental conditions and experiencing difficulties in accessing dental care than healthy individuals. Additionally, those who present with this syndrome may be less likely to receive specific necessary dental treatments. As a result, it is essential to offer appropriate dental care and support to individuals with LS to guarantee they achieve optimal oral health.

Patients with inflammatory bowel disease have more oral health problems and higher costs of professional dental care than healthy controls: The Periodontitis Prevalence in ulcerative Colitis and Crohn disease (PPCC) case-control study.

BACKGROUND: To describe the frequency and impact of oral lesions and professional dental care costs in patients with inflammatory bowel disease (IBD) (i.e., Crohn disease [CD] or ulcerative colitis [UC]) compared to matched controls). METHODS: IBD patients and matched controls were surveyed on general anamnestic information, eating and drinking habits, and oral health- and dental care-related questions; IBD patients were additionally surveyed on oral lesions. Problems related to oral lesions and the amount of money spent for professional dental care in the past 12 months were defined as primary outcome parameters. RESULTS: Answers from 1108 IBD patients and 3429 controls were analyzed. About 30% of the patients indicated having had problems with oral lesions, with CD patients having 46% higher odds and having them more often in a generalized form compared to UC patients. Further, self-reported severe periodontitis increased the odds of having oral lesions by almost 2.3-times. However, only about 12.5% of IBD patients were informed by their physician about oral lesions and about 10% indicated receiving treatment for them. Compared to controls, IBD patients required more often dental treatment and spent more money; specifically, UC and CD patients had 27 and 89% higher odds, respectively, for having spent ≥3000 DKK (ca. 440 USD) at the dentist compared to controls. CONCLUSIONS: IBD patients have more often oral health problems and higher expenses for professional dental care compared to matched controls. This included problems with IBD-related oral lesions, but these are rarely addressed by the medical or dental team.

Oral conditions of children with microcephaly associated with congenital Zika syndrome: a cross-sectional study

Abstract The aim of the present study was to compare the oral conditions of children with congenital Zika syndrome (CZS)-associated microcephaly, non-CZS-associated microcephaly, and normotypical children, as well as to characterize their sociodemographic aspects and medical history. A paired cross-sectional study was carried out on 14 children with CZS-associated microcephaly and 24 age-matched controls, in Belo Horizonte, in southeastern Brazil. Children's oral conditions were assessed: dental caries experience (dmft/DMFT indices); developmental defects of enamel (DDE) index; dental anomalies; mucosal changes; lip sealing, and malocclusion (overjet, overbite, and/or posterior crossbite alterations). The quality of oral hygiene was analyzed by the simplified oral hygiene index. The children's mothers also answered a questionnaire about sociodemographic and medical history data. The variables were analyzed descriptively. Female participants were more prevalent (60.5%), and the mean age of the participants was 4.9 years (±1.4) (range: 2-8 years) and 92.1% of their exhibited some oral condition. All participants with CZS-associated microcephaly showed absence of lip sealing and had malocclusion (100.0%). When compared to the other groups, children with CZS had a higher percentage of dental anomalies (35.7%), mucosal changes (71.4%), and unsatisfactory oral hygiene (64.3%). In a sample composed mainly of female participants aged less than 5 years, the prevalence of oral conditions and unsatisfactory oral hygiene was higher in the group with CZS-associated microcephaly, followed by the group with non-CZS-associated microcephaly. Normotypical children had the highest percentage of dental caries experience.

Resumption of brazilian oral medicine health care during the second period of the COVID-19 pandemic

Aim: This present study aims to compare the data from the Brazilian Unified Health System on the number of clinical consultations of Oral Medicine from the first 6 months (March-August 2020) of the COVID-19 pandemic in Brazil with the last 6 months (September-February 2020/2021) to update the data, verify the measures' effectiveness to return clinical activities in the following months. Methods: perform a literature review of recent articles that report the impact of the COVID-19 pandemic on Oral Medicine. Results: There was an increase in the number of Oral Medicine clinical consultations in the second half of the pandemic throughout Brazil (+64.2%), representing over 9,235 appointments in this period. Conclusion: measures for the return of health assistance and the practice of Telemedicine proved to be effective after the second period of the pandemic. Even so, strengthening security measures against the coronavirus is essential to ward off a new wave since the Omicron variant emerged in the country and, consequently, possible new lockdowns that might affect healthcare in Brazil

The Role of Socioeconomic and Health Services Organizational Factors on Infection Control Structure Score, Brazil / O Papel dos Fatores Socioeconômicos e de Organização dos Serviços de Saúde sobre o Escore da Estrutura de Controle de Infecção, Brasil

Abstract This study aimed to analyze possible associations between the Infection Control Structure Score (ICSS), health services, and social characteristics of the municipalities in Brazil. Secondary data from the third cycle 2017-2018 of the Brazilian National Program for Improving Primary Care Access and Quality (PMAQ) was analyzed. Six independent variables - FIRJAN Index of Municipal Development, number of inhabitants, number of family health teams receiving a financial incentive from the federal government, healthcare expenditure per capita, and number of Oral Health Teams modalities 1 and 2 - were included to assess their influence on ICSS, measured for each Brazilian town. Data analysis used the Classification and Regression Tree model performed with IBM SPSS 25. A total of 4,900 municipalities were included, and the mean ICSS was 0.905 (±0.092). A positive relationship was observed between healthcare expenditure per capita, municipal development, and the outcome. Conversely, towns with a higher number of family health teams receiving a financial incentive from the federal government showed lower mean ICSS. The findings suggest that inequalities in the infection control structures exist within the country, and they were related to the health services and social characteristics of the municipalities.

Resumo Este estudo objetivou analisar as possíveis associações entre o Escore da Estrutura de Controle de Infecção (EECI), os serviços de saúde e características sociais dos municípios brasileiros. Foram analisados dados secundários do terceiro ciclo 2017-2018 do Programa Nacional de Melhoria do Acesso e Qualidade da Atenção Básica (PMAQ). Seis variáveis independentes - Índice FIRJAN de Desenvolvimento Municipal, número de habitantes, número de Equipes de Saúde da Família que recebiam incentivo financeiro do governo federal, gasto com saúde per capita e número de Equipes de Saúde Bucal modalidades 1 e 2 - foram incluídas para avaliar a influência sobre o EECI, medido para cada município brasileiro. Para a análise dos dados, foi utilizado o modelo de Árvore de Classificação e Regressão no IBM SPSS 25. Foram incluídos 4.900 municípios, e o EECI médio foi de 0,905 (±0,092). Observou-se uma associação positiva entre o gasto com saúde per capita, o desenvolvimento municipal e o desfecho. Por outro lado, municípios com maior número de Equipes de Saúde da Família com incentivo financeiro do governo federal apresentaram menor média do EECI. Os achados sugerem que existem desigualdades nas estruturas de controle de infecções no país, relacionadas aos serviços de saúde e às características sociais dos municípios.

Atendimento odontológico de pacientes com necessidades especiais na atenção secundária em um estado do nordeste do Brasil / Dental care of special needs patients in secondary care in a northeastern state of Brazil / Atención odontológica a pacientes con necesidades especiales en la atención secundaria en un estado del nordeste de Brasil

O objetivo desse estudo foi descrever a produção dos atendimentos oferecidos aos pacientes com necessidades especiais nos Centros de Especialidades Odontológicas (CEO) da Paraíba (Brasil) e sua relação com o cumprimento das metas de produtividade, entre o período de 2019 e 2022. Trata-se de um estudo descritivo e ecológico em que foram coletados dados secundários do Sistema de Informações Ambulatoriais do SUS (SIA/SUS), através da captação da produção ambulatorial individualizada (BPA-I), por meio da ferramenta TabWin, dos 98 CEO operantes na Paraíba. Realizou-se análise descritiva e analítica, por meio dos testes Qui-Quadrado de Pearson e Exato de Fisher entre a variável dependente "alcance da meta" e a variável independente "adesão à Rede de Cuidados à Pessoa com Deficiência (RCPD)". Em todos os anos, a porcentagem de CEO cumpridores da meta (15,3% em 2019; 1% em 2020; 12,2% em 2021; e 11,2% em 2022) foi substancialmente menor que os números expressados por aqueles que não alcançaram a produção mínima. Os resultados também apontaram maior realização de procedimentos restauradores (29,6% em 2019; 28,6% em 2020; 32,7% em 2021; e 37,8% em 2022) em detrimento aos periodontais, cirúrgicos e preventivos. No que concerne a estar aderido à RCPD, no ano de 2022, 90,9% dos CEO que alcançaram a meta estavam aderidos à Rede (p<0,05). Concluiu-se que uma baixa frequência de CEO alcançou o cumprimento da meta de produtividade da especialidade de Odontologia para Pacientes com Necessidades Especiais nos CEO. No entanto, a adesão à RCPD manifestou-se como elemento influenciador para aqueles que cumpriram suas metas mensais e anuais.

The objective of this study was to describe the production of care provided to special needs patients in the Dental Specialties Centers (CEO) of Paraíba (Brazil) and its relationship with the achievement of productivity goals, between the period 2019 and 2022. This is a descriptive and ecological study in which secondary data were collected from the SUS Outpatient Information System (SIA/SUS), by capturing the individualized outpatient production (BPA-I), through the TabWin tool, of the 98 operating CEOs in Paraíba. We carried out descriptive and analytical analysis, using Pearson's Chi-square and Fisher's Exact tests between the dependent variable "goal attainment" and the independent variable "adherence to the Care Network for People with Disabilities (RCPD)". In all years, the percentage of CEOs meeting the goal (15.3% in 2019; 1% in 2020; 12.2% in 2021; and 11.2% in 2022) was substantially lower than the numbers expressed by those who did not meet the minimum output. The results also indicated greater performance of restorative procedures (29.6% in 2019; 28.6% in 2020; 32.7% in 2021; and 37.8% in 2022) to the detriment of periodontal, surgical, and preventive procedures. Regarding being adhered to the RCPD, in the year 2022, 90.9% of the CEOs who reached the goal were adhered to the Network (p<0.05). It was concluded that a low frequency of CEOs achieved compliance with the productivity target of the specialty of Dentistry for Special Needs Patients in CEOs. However, adherence to the RCPD manifested itself as an influential element for those who met their monthly and annual goals.

El objetivo de este estudio fue describir la producción de la atención prestada a pacientes con necesidades especiales en los Centros de Especialidades Odontológicas (CEO) de Paraíba (Brasil) y su relación con el alcance de las metas de productividad, entre el período de 2019 y 2022. Se trata de un estudio descriptivo y ecológico en el que se recogieron datos secundarios del Sistema de Información Ambulatoria del SUS (SIA/SUS), mediante la captura de la producción ambulatoria individualizada (BPA-I), a través de la herramienta TabWin, de los 98 CEOs en funcionamiento en Paraíba. Se realizaron análisis descriptivos y analíticos, utilizando las pruebas Chi-cuadrado de Pearson y Exacta de Fisher entre la variable dependiente "cumplimiento de metas" y la variable independiente "adhesión a la Red de Atención a Personas con Discapacidad (RCPD)". En todos los años, el porcentaje de directores generales que cumplieron el objetivo (15,3% en 2019; 1% en 2020; 12,2% en 2021; y 11,2% en 2022) fue sustancialmente inferior a las cifras expresadas por los que no alcanzaron el rendimiento mínimo. Los resultados también indicaron una mayor realización de procedimientos restauradores (29,6% en 2019; 28,6% en 2020; 32,7% en 2021; y 37,8% en 2022) en detrimento de los procedimientos periodontales, quirúrgicos y preventivos. Respecto a estar adherido a la RCPD, en el año 2022, el 90,9% de los CEOs que alcanzaron el objetivo estaban adheridos a la Red (p<0,05). Se concluyó que una baja frecuencia de CEOs alcanzó el cumplimiento de la meta de productividad de la especialidad de Odontología para Pacientes con Necesidades Especiales en CEOs. Sin embargo, la adhesión al RCPD se manifestó como un elemento influyente para aquellos que cumplieron sus objetivos mensuales y anuales.

Potential Use of ChatGPT for Patient Information in Periodontology: A Descriptive Pilot Study.

Objectives The aim of this study is to evaluate the accuracy and completeness of the answers given by Chat Generative Pre-trained Transformer (ChatGPT) (OpenAI OpCo, LLC, San Francisco, CA), to the most frequently asked questions on different topics in the field of periodontology. Methods The 10 most frequently asked questions by patients about seven different topics (periodontal diseases, peri-implant diseases, tooth sensitivity, gingival recessions, halitosis, dental implants, and periodontal surgery) in periodontology were created by ChatGPT. To obtain responses, a set of 70 questions was submitted to ChatGPT, with an allocation of 10 questions per subject. The responses that were documented were assessed using two distinct Likert scales by professionals specializing in the subject of periodontology. The accuracy of the responses was rated on a Likert scale ranging from one to six, while the completeness of the responses was rated on a scale ranging from one to three. Results The median accuracy score for all responses was six, while the completeness score was two. The mean scores for accuracy and completeness were 5.50 ± 0.23 and 2.34 ± 0.24, respectively. It was observed that ChatGPT's responses to the most frequently asked questions by patients for information purposes in periodontology were at least "nearly completely correct" in terms of accuracy and "adequate" in terms of completeness. There was a statistically significant difference between subjects in terms of accuracy and completeness (P<0.05). The highest and lowest accuracy scores were peri-implant diseases and gingival recession, respectively, while the highest and lowest completeness scores were gingival recession and dental implants, respectively. Conclusions The utilization of large language models has become increasingly prevalent, extending its applicability to patients within the healthcare domain. While ChatGPT may not offer absolute precision and comprehensive results without expert supervision, it is apparent that those within the field of periodontology can utilize it as an informational resource, albeit acknowledging the potential for inaccuracies.

Manejo odontológico del paciente en tratamiento de anticoagulante oral sometido a cirugía oral: una revisión narrativa / Stomatological management of anticoagulated patients undergoing oral surgery: a narrative review

Resumen Los pacientes que se encuentran bajo tratamiento de anticoagulantes orales, presentan alteraciones en distintas etapas de la hemostasia, lo que conlleva a tener implicancias y consideraciones médico/quirúrgicas durante su atención. En la actualidad, no existe un consenso en relación con el manejo odontológico de estos pacientes que serán sometidos a procedimientos quirúrgicos, llevando a protocolos clínicos que siguen diversas posturas, como la de disminuir la ingesta farmacológica del anticoagulante, sustituir con heparina y la de mantener el tratamiento bajo control. Objetivo Establecer el manejo estomatológico del paciente que se encuentra en tratamiento de anticoagulante oral mediante una revisión profunda de la literatura Materiales y método Se realizó una búsqueda de revisión bibliográfica manualmente de artículos indexados a las bases de datos de PUBMED y EBSCO que correspondiesen a las palabras "cirugía bucal", "anticoagulantes", "atención dental" y "hemorragia oral". En cuanto a los criterios de inclusión, se consideraron revisiones bibliográficas, estudios observacionales, ensayos clínicos, guías, revisiones sistemáticas y metaanálisis publicados entre noviembre de 2005 y 2022, en idiomas inglés o español. Conclusiones Existen múltiples protocolos para la atención del paciente anticoagulado que será sometido bajo procedimiento de cirugía oral menor. Es importante considerar el anticoagulante utilizado, motivo, control de este, el procedimiento a realizar en el paciente y medidas hemostáticas tanto intra como postoperatorias por realizar, tras analizar lo anterior, se advierte que disminuir la ingesta del fármaco para realizar el procedimiento, puede ser más perjudicial al paciente como al clínico, por lo tanto se sugiere mantener el tratamiento antitrombótico y realizar un correcto manejo médico/quirúrgico.

Abstract Patients undertaking oral anticoagulant treatment may experience alterations in different stages of hemostasis, which lead to medical/surgical implications and considerations during their care. Currently, there is no consensus regarding the dental management of these patients, as they go through surgical procedures. This leads to clinical protocols that follow numerous approaches, such as reducing the pharmacological intake of the anticoagulant, replacing it with heparin, and maintaining the controlled treatment. Objective: To establish the stomatological management of the patient undergoing oral anticoagulant treatment through an in depth review of the literature. Materials and Method: A manual bibliographic review search of articles indexed to the PUBMED and EBSCO databases corresponding to the words "oral surgery", "oral bleeding", "anticoagulants" and "dental management" was performed. Regarding the inclusion criteria: bibliographic reviews, observational studies, clinical trials, guidelines, systematic reviews, and meta-analyses published between November 2005 and 2022, in English or Spanish, were considered. Conclusion: There are multiple protocols for the care of the anticoagulated patient who will undergo a minor oral surgery procedure. It is important to reflect on the anticoagulant used, the reason for it, its supervision, the surgical procedure that will be undertaken by the patient, and both intraoperative and postoperative hemostatic measures to be implemented. After analyzing the above, it is noted that reducing the intake of the drug to perform the surgical procedure may be harmful to the patient and to the clinician, therefore it is suggested to maintain the antithrombotic treatment and carry out a correct medical/surgical management.

Access to dental care is still complex in 2022 for patients living with HIV despite the need for careful monitoring of pathologies of the oral mucosa. Results of a monocentric cross-sectional study in the Infectious Diseases Department of Clermont-Ferrand University Hospital.

OBJECTIVES: Describe the dental care pathway of people living with HIV (PLHIV) and their oral pathologies. MATERIALS AND METHODS: A monocentric cross-sectional study involving adult PLHIVs followed (October 2021/April 2022) in our department. Socio-demographic and medical data, course of dental care, and presence of pathologies of the oral mucosa were recorded. RESULTS: 112 PLHIV (71% men, 54 ± 14 years) were included. Of the 112, 96% had already consulted a dentist, and 78% had a referring dentist; 73% had disclosed their seropositivity; for 84%, the visit proceeded normally, 7% refused treatment; for 8%, the dentist was not comfortable, and for 4% the dentist's attitude became negative; 21% of the PLHIV had already encountered difficulties in finding a dentist including 37% because of their viral status. Among the oral pathologies listed, 23 lesions were identified: 15 (65%) were unrelated to HIV, 4 (17%) were classified stages B/C (1 Kaposi's sarcoma, 1 oral villous leukoplakia, 2 chronic candidiasis), and 4 (17%) were lesions with evolution specifically due to HIV (2 inhomogeneous leukoplakias, 1 cancer, 1 verrucous papilloma). CONCLUSION: Although 78% of the PLHIV included had a referring dentist, discrimination by dentists toward PLHIV still persists (16% of the PLHIV concerned). CLINICAL RELEVANCE: 27% of participants did not feel ready to disclose their infection. The resulting lack of follow-up is also a loss of opportunity because while most of the small number of oral lesions diagnosed in this population are related to age or comorbidities, some are serious and need to be identified.