الملخص
Abstract Denture biofilm acts as a potential reservoir for respiratory pathogens, considerably increasing the risk of lung infections, specifically aspiration pneumonia, mainly 48h after hospital admission. The establishment of a straightforward, affordable, and applicable hygiene protocol in a hospital environment for the effective control of denture biofilm can be particularly useful to prevent respiratory infections or reduce the course of established lung disease. Objectives To evaluate the anti-biofilm effectiveness of denture cleaning protocols in hospitalized patients. Methodology The maxillary complete dentures (MCDs) of 340 hospitalized participants were randomly cleaned once using one of the following 17 protocols (n=20): brushing with distilled water, toothpaste, or neutral liquid soap (controls); immersion in chemical solutions (1% sodium hypochlorite, alkaline peroxide, 0.12% or 2% chlorhexidine digluconate), or microwave irradiation (650 W for 3 min) combined or not with brushing. Before and after the application of the protocols, the biofilm of the intaglio surface of the MCDs was evaluated using two methods: denture biofilm coverage area (%) and microbiological quantitative cultures on blood agar and Sabouraud Dextrose Agar (CFU/mL). Data were subjected to the Wilcoxon and Kruskal-Wallis tests (α=0.05). Results All 17 protocols significantly reduced the percentage area of denture biofilm and microbial and fungal load (P<0.05). The highest percentage reductions in the area of denture biofilm were observed for 1% hypochlorite solution with or without brushing and for 2% chlorhexidine solution and microwave irradiation only in association with brushing (P<0.05). The greatest reductions in microbial and fungal load were found for the groups that used solutions of 2% chlorhexidine and 1% hypochlorite and microwave irradiation, regardless of the association with brushing (P<0.05). Conclusions A single immersion for 10 min in 1% sodium hypochlorite, even in the absence of brushing, proved to be a straightforward, rapid, low-cost, and effective protocol for cleaning the dentures of hospitalized patients.
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A violência contra as mulheres é um fenômeno complexo, pois se manifesta em diversas formas, classes sociais e contextos, tornando-se responsável por danos capazes de afetar a saúde das vítimas de maneira irreversível. Esta revisão de literatura buscou descrever os principais tipos de trauma dento alveolar que acometem mulheres vítimas de violência doméstica com o intuito de apontar a importância dos cirurgiões dentistas no atendimento inicial e na identificação de possíveis vítimas bem como do diagnóstico das lesões, tratamento e notificação de casos de violências contra as mulheres. Foi realizada uma pesquisa bibliográfica nas bases de dados Scielo, Lilacs, Pubmed e Capes utilizando as palavras-chaves, "Violência contra a Mulher", "Violência", "Odontologia" e "Notificação". Após a leitura de títulos e resumos foram incluídos 39 artigos e utilizados para esta revisão de literatura. Os critérios de inclusão foram artigos nos idiomas português, inglês e espanhol que contivessem achados clínicos das lesões na região da cabeça e pescoço, dados epidemiológicos e legislativos referentes aos aspectos éticos-legais dos profissionais de saúde. Os critérios de exclusão foram artigos incompletos e estudos relacionados à violência contra idosos, adolescentes, crianças e violência sexual. Os estudos apresentaram que profissionais de Odontologia possuem pouco conhecimento sobre o tema, evidenciando falta de preparo na identificação da violência e prevenção de potenciais prejuízos à saúde. Ainda demonstrou a necessidade de maiores esclarecimentos científicos, da inclusão do tema na graduação e em cursos de capacitações aos profissionais já formados. Mesmo em casos de suspeita de violência é indispensável que os cirurgiões-dentistas tenham conhecimento acerca da importância em notificarem e não limitar seu atendimento apenas aos cuidados das lesões físicas, de forma que possam contribuir na prevenção e redução deste fenômeno, por meio de um atendimento integral e humanizado
Violence against women is a complex phenomenon, as it manifests itself in different forms, social classes, and contexts, being it responsible for irreversible damages capable of affecting the health of the victims. This literature review sought to describe the main types of alveolar dento trauma that affect women victims of domestic violence. In order to point out the importance of dentists in the initial care and identification of possible victims as well as the diagnosis of injuries, treatment and notification of cases of violence against women. A bibliographic search was carried out in Scielo, Lilacs, Pubmed, and Capes databases using the keywords, "Violence against Women", "Violence", "Dentistry" and "Notification". After reading titles and abstracts, 39 articles were included and used for this literature review. The inclusion criteria were articles in Portuguese, English, and Spanish that contained clinical findings of lesions in the head and neck region, epidemiological and legislative data regarding the ethical-legal aspects of health professionals. Exclusion criteria were incomplete articles and studies related to violence against elderly people, adolescents, children, and sexual violence. The studies showed that dentistry professionals have little or no knowledge on the subject, evidencing a lack of training in carrying out the diagnosis and preventing potential damage to health. It also demonstrated the need for further scientific clarification, the inclusion of the topic in undergraduate programs, and training courses for professionals who have already graduated. Even in cases of suspected violence, it is essential that dentists are aware of the importance of reporting it and not limit their care only to the care of physical injuries so that they can contribute to the prevention and reduction of this phenomenon, through comprehensive and humanized care
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O objetivo deste estudo foi discutir, por meio de uma revisão de literatura, as indicações, contraindicações, vantagens, desvantagens das alternativas reabilitadoras mais comuns utilizando PPRs e o impacto desses tratamentos na qualidade de vida relacionada à saúde bucal dos pacientes. Foi realizada uma pesquisa ampla na literatura, com a utilização dos termos "Prótese Parcial Removível", "Qualidade de Vida", "Saúde bucal"; "Satisfação do Paciente", no período entre 1990 e 2018, no Medline, Google Scholar, internet e livros didáticos. Foi demonstrado que a reabilitação com PPRs associadas a implantes resultou em melhor qualidade de vida associada à saúde bucal dos usuários, seguida por PPRs retidas por encaixe e PPRs convencionais. Entretanto, o profissional deve considerar as condições sistêmicas, bucais e econômicas de cada paciente, tendo o conhecimento biomecânico bem como a ciência dos benefícios e das desvantagens de cada tipo de tratamento para estabelecer um correto diagnóstico do caso e, assim, indicar o melhor tipo de PPR. Dessa forma, é possível oferecer o melhor tratamento para cada paciente parcialmente edêntulo, devolvendo estética e função de maneira satisfatória de modo a resultar em maior nível de satisfação e qualidade de vida(AU)
The purpose of this study was to discuss, through a review of the literature, indications, contraindications, advantages, disadvantages of the most common rehabilitation alternatives using RPDs and the impact of these treatments on patients' oral health quality of life. A broad research was conducted in the literature, using the terms "Partial Removable Prosthesis", "Quality of Life", "Oral Health"; "Patient Satisfaction" in the period between 1990 and 2018, in Medline, Google Scholar, internet and textbooks. It was demonstrated that rehabilitation with RPDs associated with implants resulted in a better oral health quality of life of users, followed by RPDs with attachments and conventional RPDs. However, the professional should consider the systemic, oral and economic conditions of each patient, based on the biomechanical knowledge, as well as the science of the benefits and disadvantages of each type of treatment to establish a correct diagnosis of the case, and thus, indicate the best type of RPD. In this way, it is possible to offer the best treatment for each partially edentulous patient, returning aesthetics and function in a satisfactory manner in order to result in a higher level of satisfaction and quality of life(AU)
الموضوعات
Quality of Life , Denture, Partial, Removable , Dental Implants , Oral Health , Patient Satisfactionالملخص
ABSTRACT Incorporation of antifungals in temporary denture soft liners has been recommended for denture stomatitis treatment; however, it may affect their properties. Objective: To evaluate the porosity of a tissue conditioner (Softone) and a temporary resilient liner (Trusoft) modified by minimum inhibitory concentrations (MICs) of antifungal agents for Candida albicans biofilm. Material and Methods: The porosity was measured by water absorption, based on exclusion of the plasticizer effect. Initially, it was determined by sorption isotherms that the adequate storage solution for specimens (65×10×3.3 mm) of both materials was 50% anhydrous calcium chloride (S50). Then, the porosity factor (PF) was calculated for the study groups (n=10) formed by specimens without (control) or with drug incorporation at MICs (nystatin: Ny-0.032 g, chlorhexidine diacetate: Chx-0.064 g, or ketoconazole: Ke-0.128 g each per gram of soft liner powder) after storage in distilled water or S50 for 24 h, seven and 14 d. Data were statistically analyzed by 4-way repeated measures ANOVA and Tukey's test (α=.05). Results: Ke resulted in no significant changes in PF for both liners in water over 14 days (p>0.05). Compared with the controls, Softone and Trusoft PFs were increased at 14-day water immersion only after addition of Ny and Chx, and Chx, respectively (p<0.05). Both materials showed no significant changes in PF in up to 14 days of S50 immersion, compared with the controls (p>0.05). In all experimental conditions, Softone and Trusoft PFs were significantly lower when immersed in S50 compared with distilled water (p<0.05). Conclusions: The addition of antifungals at MICs resulted in no harmful effects for the porosity of both temporary soft liners in different periods of water immersion, except for Chx and Ny in Softone and Chx in Trusoft at 14 days. No deleterious effect was observed for the porosity of both soft liners modified by the drugs at MICs over 14 days of S50 immersion.