Aptidão e conduta dos estudantes de odontologia sobre atendimento de pacientes com deficiência visual e auditiva / Aptitude and conduct of dental students on the care of patients with visual and hearing impairments

Avaliar a aptidão e conduta de estudantes de Odontologia sobre atendimento de pacientes com de deficiência visual e auditiva. Trata-se de um estudo observacional, do tipo transversal. A coleta de dados foi realizada a partir de um questionário estruturado e a amostra foi constituída por 88 estudantes do 5º, 7º e 9º período, matriculados em alguma disciplina clínica, do curso de Odontologia de uma instituição privada do estado de Pernambuco. Os dados coletados foram tabulados e analisados através de estatística descritiva e inferencial com um nível de significância de 5%. Menos da metade dos estudantes se sente aptos para atender pacientes com essas necessidades, independente do período avaliado. Uma pequena parcela tem algum tipo de contato social/familiar com deficientes visuais e auditivos, mas o fato de possuírem contato, não alterou significativamente a aptidão deste para realizar a consulta. Da mesma forma, possuir informação prévia sobre o tema não influenciou significativamente na aptidão dos estudantes durante o atendimento odontológico. A maioria dos estudantes não se sentem aptos e seguros ao atendimento de pacientes com deficiências visuais e auditivas e que o fato de possuir familiar e/ou parente com esse tipo de deficiência e ter recebido informação prévia sobre o tema não aumenta a segurança dos estudantes.

To evaluate the aptitude and conduct of dentistry students regarding the care of patients with visual and hearing impairments. This is an observational, cross-sectional study. Data collection was carried out using a structured questionnaire and the sample consisted of 88 students from the 5th, 7th and 9th period, enrolled in some clinical discipline, of the Dentistry course at a private institution in the state of Pernambuco. The collected data were tabulated and analyzed using descriptive and inferential statistics with a significance level of 5%. Less than half of the students feel able to care for patients with these needs, regardless of the period evaluated. A small portion has some kind of social/family contact with the visually and hearing impaired, but the fact that they have contact did not significantly change their ability to carry out the consultation. Likewise, having prior information on the subject did not significantly influence the students' aptitude during dental care. Most students do not feel able and safe to care for patients with visual and hearing impairments and that the fact of having a family member and/or relative with this type of disability and having received prior information on the subject does not increase the safety of the students. students.

Restauração indireta em resina composta: um relato de prontuário / Indirect resin composite restoration: a dental record report

Restaurações diretas em resina composta são amplamente utilizadas em odontologia para restaurar dentes posteriores. Todavia, quando há grande destruição coronária, onde a distância do istmo excede dois terços da distância intercuspídea, as restaurações indiretas em resina composta são indicadas. O presente estudo teve como objetivo relatar a análise de um prontuário de um paciente que recebeu uma restauração indireta em resina composta em dente posterior amplamente destruído. Através da análise de prontuários de pacientes atendidos nas disciplinas de Estágios Supervisionados do Curso de Odontologia da FSG Centro Universitário no ano de 2023, foi selecionado um prontuário de um paciente que compareceu a clínica odontológica da FSG com uma restauração em amálgama fraturada com reparo em resina composta que apresentou sintomatologia dolorosa. O procedimento diagnóstico ocorreu através de exame clínico e radiográfico, que constatou a indicação de substituição da restauração insatisfatória e realização de uma restauração indireta em resina composta. Os resultados estéticos e funcionais apresentados demostraram a viabilidade da técnica restauradora indireta em resina composta para reabilitar dentes posteriores com ampla destruição coronária(AU)

Direct composite resin restoration are widely used in dentistry to restore posterior teeth. However, when there is large coronary destruction, that the distance from the isthmus exceeds two- thirds of the intercuspal distance, indirect composite resin restorations are indicated. This study aimed to report the analysis of a dental record of a patient who received an indirect restoration in composite resin in a badly destroyed posterior tooth. Through the analysis of dental records of patients seen in the disciplines of Supervised Internship of the Dentistry Course at FSG Centro Universitário in the year 2023, the dental record of a patient who attended the FSG dental clinic with fractured amalgam restoration with composite resin repair was selected who had painful symptoms. The diagnostic procedure took place through clinical and radiographic examination, which revealed the indication of replacing the unsatisfactory restoration and carrying out an indirect restoration in composite resin.The aesthetic and functional results presented demonstrated the viability of the indirect composite resin restoration technique for rehabilitating posterior teeth with extensive coronal destruction(AU)

Atuação do cirurgião-dentista na atenção primária à saúde: experiências a partir da residência multiprofissional / Performance of the dentist in primary health care: experiences from the multiprofissional residency program / El rol del cirujano dentista en laatención primaria de salud: experiencias del programade residencia multiprofesional

Introdução:A inserção das equipes de saúde bucal na Estratégia Saúde da Família, embora tardia, representa um avanço significativo para a ampliação da cobertura e da qualidade dos serviços odontológicos no Brasil. No entanto, aindaexistem muitosdesafiosnas práticas do cirurgião-dentista na Estratégia Saúde da Família. A atuação majoritariamente clínica prejudica a realização deum trabalho humanístico, resolutivo, interdisciplinar e multiprofissional. Objetivo:Relatar a experiência de atuação de uma cirurgiã-dentista residente na Atenção Primária em Saúde no município de Santo Estêvão, Bahia, Brasil, durante o Programa de Residência Multiprofissional em Saúde da Família da Universidade Estadual de Feira de Santana. Metodologia:Trata-se de um estudo qualitativo, do tipo relato de experiência, que visa descrever as atividades desenvolvidas durante o Programa de Residência Multiprofissional em Saúde da Família, da Universidade Estadual de Feira de Santana, no município de Santo Estêvão, Bahia, Brasil, no período de março de 2022 a novembro de 2023. Resultados:As atividades descritas abrangem as diferentes possibilidades de trabalho do cirurgião-dentista na Atenção Primária, envolvendo ações assistenciais através das consultas individuais e levantamento epidemiológico, educação permanente e em saúde com atuação nos grupos operativos e capacitações com os profissionais da rede e as ações de planejamento e gestão, através do desenvolvimento de estratégias para fortalecer a rede de atenção à saúde. Conclusões:É preciso motivar os profissionais de saúde bucal a repensarem suas práticas, tendo como ponto de partida o investimento e o estímulo à educação permanente e continuada. A especialização em saúde da família permite que cirurgiões-dentistas que atuam ou têminteresse em trabalhar no serviço público desenvolvam habilidades e práticas voltadas para uma assistência integral e multiprofissional da saúde, contribuindo para a consolidação do Sistema Único de Saúde (AU).

Introduction:The oral health team inclusion in the Family Health Strategy represents a significant advance in expanding the coverage and quality of dental services in Brazil. However, there arestill many challenges in the dental surgeons practices in the Family Health Strategy. The ppredominantly clinical approach hinders the achievement of ahumanistic, problem-solving, and interdisciplinary and multidisciplinary. Objective:To report the experience of a dental surgeon resident in Primary Health Care in the city of Santo Estêvão, Bahia, Brazil, during the Multidisciplinary Residency Program in Family Health at the Universidade Estadual de Feira de Santana. Methodology:This is a qualitative study, experience report type, which aims to describe the activities developed during the Multidisciplinary Residency Program in Family Health at the Universidade Estadual de Feira de Santana, in the city of Santo Estêvão, Bahia, Brazil, from March 2022 to November 2023. Results:The activities described cover the different work possibilities of dental surgeons in Primary Care, involving assistance actions through individual consultations and epidemiological surveys, ongoing health education with work in operative groups and training with network professionals, and planning and management actions through the development of strategies to strengthen the health care network. Conclusion:It is necessary to motivate oral health professionals to rethink their practices, with investment and encouragement for permanent and continuing education as a starting point. Specialization in family health allows dental surgeons who work or are interested in working in the public service to develop skills and practices aimed at comprehensive and multidisciplinary health care, contributing to the consolidation of the Unified Health System (AU).

Introducción: La inclusión de los equipos de salud dental en la Estrategia de Salud Familiar, aunque tardía, representa un avance significativo en la ampliación de la cobertura y la calidad de los servicios dentales en Brasil. Sin embargo, los cirujanos dentistas siguen enfrentándose a muchos retos em la Estrategia de Salud Familiar. El enfoque mayoritariamente clínico obstacualiza la realización de um enfoque humanista, resolutivo, interdisciplinario y multiprofesional.Objetivo:Reportar la experiencia de un cirujano dentista residente en Atención Primaria de Salud en el ayuntamiento de Santo Estêvão, Bahía, Brasil, durante el Programa de Residencia Multiprofesional en Salud Familiar de la Universidad Estadual de Feira de Santana.Metodología:Se trata de un estudio cualitativo, del tipoinforme de experiencia, que tiene como objetivo describir las actividades desarrolladas durante el Programa de Residencia Multiprofesional en Salud Familiar de la Universidad Estadual de Feira de Santana, en el ayuntamiento de Santo Estêvão, Bahía, Brasil, de marzo de 2022 a noviembre de 2023. Resultados:Las actividades descritas abarcan las diferentes posibilidades de trabajo del cirujano dentista en la Atención Primaria, implicando actividades asistenciales mediante consultas individuales y encuestas epidemiológicas, educación sanitaria continuada con actuación en los grupos operativos y capacitaciones con los profesionales de la red y actividades de planificación y gestión mediante el desarrollo de estrategias de fortalecimiento de la red de atención sanitaria.Conclusiones:Es necesario motivar a los profesionales de la salud dental a replantear sus prácticas, con la inversión y el fomento de la formación permanente y continua como punto de partida. La especialización en salud familiar permite a los cirujanos dentistas que trabajan o están interesados en trabajar en el servicio público desarrollar competencias y prácticas dirigidas a la atención sanitaria integral y multiprofesional, contribuyendo a la consolidación del Sistema Único de Salud (AU).

SMART Monitoring computer program for oral and skin lesions measurements: analysis through clinical photography

Lesion evaluation through photographs is a common clinical practice and its performance using computational tools is encouraged. Objective: To assess the reliability of the computer program SMART Monitoring (SM) in giving adequate lesion measurements through clinical photography. Materials and methods: A cross-sectional study was conducted with 28 patients diagnosed with oral or skin flat lesions. Each lesion was measured twice: clinically and by photographic image. Photographs were taken using a 3D-printed scale as a reference for SM measurements of the total lesional area (mm²) and the two longest axes (length and width) by two different operators. The agreement was evaluated between the axis's measurements of the two operators with the clinic measurements by the Bland-Altman plot. Results: Both operators revealed excellent agreement (ICC=0.98) regarding measurements of the lesion's axes and the total lesional area with no difference between operators. Comparison of the axes' values from SM to clinical measurements were also not different (p=0.82 and p=0.43). The Bland-Altman plot revealed that most mean differences were within the 95% confidence interval. Conclusion: SMART Monitoring proved to be a reliable tool for measuring oral or skin flat lesions on clinical photographs, regarding length, width, and total area measurements. The values obtained using SMART Monitoring presented an excellent agreement with the clinical measurements. (AU)

Comparación de la microfiltración apical de cuatro tipos de cementos endodónticos: Endofill, mtaFillapex, Adseal y Roeko Seal / Comparison of the Apical Microleakage of Four Types Of Endodontic Cements: Endofill, mta Fillapex, Adseal and Roeko Seal / Comparação da microinfiltração apical de quatro tipos de cimentos endodônticos: Endofill, mta Fillapex, Adseal e Roeko seal

Introducción: La microfiltración apical es uno de los principales causantes de fracasos endodónticos donde hay invasión de bacterias y líquidos periapicales a la parte interna del conducto radicular y material de relleno. Materiales y Métodos: La muestra estuvo conformada por 60 dientes premolares unirradiculares que fueron seccionados en la unión amelocementaria, la instrumentación biomecánica se realizó con técnica rotatoria e irrigación con hipoclorito de sodio al 5.25% y EDTA 17%, se dividió aleatoriamente en 4 grupos (n=15) para cada tipo de cemento, la obturación se realizó con la técnica de condensación lateral, a nivel coronal se obturó con Ionómero vidrio base y resina, se colocaron en una incubadora a 37° sumergidos en NaCL 0.9% por 5 días hasta el fraguado de los cementos, para observar la microfiltración se utilizó el método filtración de tinta china y la diafanización con la técnica de Robertson. Las medidas de microfiltración apical se observaron utilizando el Estereomicroscopio. Resultados: El valor promedio fue menor para el cemento Adseal 0,33mm, seguido por los cementos Fillapex 0,87mm, Roeko seal 1,00mm y Endofill 1,30mm respectivamente. Hubo diferencias estadísticamente significativas en la microfiltración apical de los cuatro cementos endodónticos (p=0.00) Conclusiones: El cemento Adseal presentó menor microfiltración en comparación a los cementos Fillapex, Roeko seal y Endofill.

Introduction: Apical microleakage is one of the main causes of endodontic failure, either due to invasion of microorganisms or periapical fluids into the canal, and only the composition of the type of obturator cement favors its reduction. The objective of this research was to compare the apical microleakage of four types of endodontic cements Endofill, MTA Fillapex, Adseal and Roeko Seal. Materials and methods: The sample consisted of 60 single root premolar teeth that were sectioned at the cement- enamel junction, the biomechanical instrumentation was performed with a rotary technique and irrigation with sodium hypochlorite and edta, randomly divided into 4 groups (n = 15) for each type of cement, the obturation was performed with the lateral condensation technique, at the coronal level it was obturated with base glass ionomer and resin, they were placed in an incubator at 37° submerged in NaCL 0.9% for 5 days until setting. of the cements, to observe the microleakage the India ink filtration method was used and diaph-anization with the Robertson technique. Apical microleakage measurements were observed using the Stereomicroscope. Results: The average value was lower for the Adseal 0.33 mm cement, followed by the Fillapex 0.87 mm, Roeko Seal 1.00 mm and Endofill 1.30 mm cements respectively. There were sta-tistically significant differences in the apical microleakage of the four endodontic cements (p = 0.00) Conclusions: Adseal cement presented less microfiltration compared to Fillapex, Roeko Seal and Endofill cements

Introdução: a microinfiltração apical é uma das principais causas de falhas endodônticas onde há inva-são de microrganismos e líquidos periapicais ao interior do conducto e só a composição do tipo de cimento obturador favorece sua disminuição. O objetivo desta pesquisa foi comparar a microinfiltração apical de quatro tipos de cimentos endodônticos Endofill, MTA Fillapex, Adseal e Roeko Seal. Materiais e métodos: a amostra foi composta por 60 dentes pré-molares uniradiculares que foram seccionados na junção amelocementária. A instrumentação biomecânica foi realizada com técnica rotatória e irrigação com hipoclorito e edta, sendo dividida aleatoriamente em 4 grupos (n = 15) para cada tipo de cimento. A obturação foi realizada pela técnica de condensação lateral, no nível coronal foi obturado com base de ionômero de vidro e resina, foram colocados em incubadora a 37° submersos em NaCl 0,9% por 5 dias até a pega dos cimentos. Para observar a microfiltração utilizou-se o método de filtração em tinta nan-quim e diafanização pela técnica de Robertson. As medidas de microinfiltração apical foram observadas utilizando o estereomicroscópio. Resultados: o valor médio foi menor para o cimento Adseal (0,33 mm), seguido pelos cimentos Fillapex (0,87 mm), Roeko Seal (1,00 mm) e Endofill (1,30 mm), respectivamente. Houve diferenças estatisticamente significativas na microinfiltração apical dos quatro cimentos endo-dônticos (p = 0,00). Conclusões: o cimento Adseal apresentou menor microinfiltração comparado aos cimentos Fillapex, Roeko seal e Endofill.

Orientações de manutenção e higienização de prótese fixa total implantossuportada: revisão de literatura / Guidelines for maintenance and cleaning of implantssupported total fixed prosthesis: literature review

A evolução dos tratamentos em implantodontia possibilitou uma mudança nos tratamentos reabilitadores para pacientes edêntulos, tornando possível a colocação de próteses fixas, que proporcionam maior qualidade de vida para estes pacientes. Para que estas próteses tenham bom desempenho e longevidade satisfatórios é essencial que se mantenha um padrão adequado de higienização bucal e manutenção profissional. Assim, o objetivo deste trabalho foi realizar uma revisão de literatura a respeito dos principais recursos disponíveis para higienização e manutenção das próteses totais fixas sobre implante (protocolo de Branemark), tanto nos cuidados domiciliares dos pacientes quanto no atendimento profissional do cirurgião dentista. Foi realizada uma busca eletrônica, não sistemática, nas bases de dados Lilacs, Pubmed/Medline, Scielo e ScienceDirect, cruzando-se os seguintes descritores: "Higiene Oral"; "Implantes Dentários"; "Implantação Dentária"; "Manutenção"; "Prótese Dentária Fixada por Implante" e "Prótese Dentária". Foram consultados artigos de revisão de literatura, revisão sistemática, meta-análise, estudos clínicos randomizados, além de livros pertinentes ao assunto, publicados no período de 1995 a 2022.Verificou-se na literatura disponível que os principais instrumentos indicados para uso domiciliar são escova dental, fio dental, escova interdental, irrigador oral, dentifrício e enxaguatório. No atendimento profissional em consultório odontológico deve ser dispendida atenção especial às instruções passadas ao paciente e também fazer o possível para motivar e encorajar o seu engajamento na rotina de higienização, além do acompanhamento periodontal, possíveis substituições de parafusos e instalação de placa oclusal estabilizadora, quando necessário. Manter uma higiene oral adequada é essencial para o sucesso das próteses fixas sobre implantes e o cirurgião dentista desempenha um papel crucial não apenas ao realizar o acompanhamento periódico do paciente, mas também ao sugerir os instrumentos mais apropriados, instruir sobre a higiene oral adequada e motivar o paciente a manter a saúde bucal satisfatória(AU)

The evolution of treatments in implantology has enable a change in rehabilitation treatments for edentulous patients, making it possible to place fixed prostheses that provide a better quality of life for these patients. In order to ensure good performance and satisfactory longevity, it is essential to maintain an appropriate standard of oral hygiene and professional maintenance. Thus, the objective of this work was to conduct a literature review on the main resources available for cleaning and maintenance of complete fixed prostheses on implants (Branemark protocol), both in the patients' home care and in the professional care provided by the dentist. A nonsystematic electronic search was carried out in the Lilacs, Pubmed/Medline, Scielo, and ScienceDirect databases, crossing the following descriptors: "Oral Hygiene"; "Dental Implants"; "Dental Implantation"; "Maintenance"; "Dental Prosthesis, ImplantSupported"; and "Prosthodontics". Literature review articles, systematic reviews, meta-analyses, randomized clinical studies, and relevant books on the subject published from 1995 to 2022 were consulted. The literature available indicates that the main instruments recommended for home care are toothbrush, dental floss, interdental brush, oral irrigator, toothpaste, and mouthwash. In the professional dental office, special attention should be given to the instructions given to the patient, as well as to motivate and encourage their engagement in the hygiene routine, in addition to periodontal monitoring, possible screw replacements, and installation of an occlusal splint when necessary. Maintaining adequate oral hygiene is essential for the success of fixed prostheses on implants, and the dentist plays a crucial role, not only in providing periodic patient follow-up, but also in suggesting the most appropriate instruments, instructing on adequate oral hygiene, and motivating the patient to maintain satisfactory oral health(AU)

Knowledge, attitudes and practices related to oral health in participants of the institutional program for the inclusion of people with cognitive disabilities in higher education at the University of Costa Rica / Conocimientos, actitudes y prácticas relacionadas con la salud oral en participantes del Programa Institucional de Inclusión de Personas con Discapacidad Cognitiva a la Educación Superior de la Universidad de Costa Rica

Abstract People with cognitive disabilities face multiple challenges concerning oral health and frequently show oral tissue decay because of the barriers society imposes upon them, and due to financial issues, professional and family lack of knowledge, limitations regarding access to services, lack of empowering-driven actions, among others. Positive knowledge, attitudes and practices regarding oral health, developed during the course of a lifetime, help in preserving good health. The aim of the current study is to describe oral health knowledge, attitudes and practices in people with cognitive disabilities participating in the Institutional Program for the Inclusion of People with Cognitive Disabilities in Higher Education at the University of Costa Rica (PROIN, in Spanish), during 2021. A descriptive study with mixed focus was performed; a representative sample comprised of 86 students enrolled in PROIN was used for the quantitative approach, while the qualitative approach used a criteria sample along with an opinion sample, limiting size due to information overload. The survey, along with its corresponding questionnaire and the semi-structured interview, were used as data gathering techniques. It was evidenced that certain issues need to be readdressed, such as bleeding gums, the importance of preserving dental pieces, as well, the practice of flossing, which many students expressed difficulties doing. Good attitudes were found, such as dentist visits; however, access barriers for this population must be overthrown. This article showed the importance of training professionals in disabilities as well as developing oral health promotion programs aimed at people with cognitive disabilities.

Resumen La población con discapacidad cognitiva enfrenta múltiples retos en cuanto a la salud oral, presentado comúnmente un deterioro de los tejidos orales; esto como consecuencia a las barreras impuestas por la sociedad, factores económicos, desconocimiento de los profesionales y familiares, limitaciones en el acceso a la atención, falta de acciones para fomentar su autonomía, entre otras. Los conocimientos, actitudes y prácticas favorables en salud oral ayudan a conservar una buena salud, los cuales se desarrollan a lo largo de la vida. El objetivo del presente estudio es describir los conocimientos, actitudes y prácticas de salud oral en las personas con discapacidad cognitiva que participaron en el Programa Institucional de Inclusión de Personas con Discapacidad Cognitiva a la Educación Superior de la Universidad de Costa Rica (PROIN) durante el año 2021. Se realizó un estudio descriptivo con un enfoque mixto, para el enfoque cuantitativo se utilizó una muestra representativa de 86 estudiantes matriculados en PROIN y para la parte cualitativa se utilizó una muestra por criterio con un muestreo opinático, estableciendo el tamaño por saturación de la información. Se utilizaron como técnicas de recolección de datos la encuesta con su respectivo cuestionario y la entrevista semiestructurada. Se evidenció que existen temas que se deben reforzar, como lo es el sangrado de encías, la importancia de conservar las piezas dentales, así como la práctica de uso de hilo dental, donde la mayoría de los estudiantes expresaron tener dificultades para su utilización. Además, se encontró buenas actitudes con respecto a la visita al odontólogo, sin embargo, se debe derribar barreras de acceso que se presentan para esta población. Este estudio demostró la necesidad de capacitar a los profesionales en el tema de discapacidad y desarrollar programas de promoción de la salud oral específicos para personas con discapacidad cognitiva.

Los servicios de odontología en los tiempos del COVID- 19 en Colombia: análisis de país / Oral and dental services in times of COVID-19 in Colombia: a national analysis

Se desconoce el impacto que produjo la pandemia por el COVID-19 en la prestación y en la consulta de los servicios odontológicos y analizados según el sistema integrado de protección social o SISPRO en Colombia. El objetivo fue Determinar los cambios en la cobertura y los patrones de atención odontológica, entre los años pre pandemia (2017-2019) y los años de pandemia (2020-2021). Se analizaron los registros de las atenciones odontológicas reportadas en el sistema SISPRO del Ministerio de Salud de Colombia en periodos prepandemia y postpandemia por el COVID-19. En el año 2019 la tasa de cobertura por cada 100 habitantes en el estudio era de 31,14; sin embargo, la cobertura de atención odontológica se redujo al 17% en el 2020 y al 9% en el 2021 y las atenciones de urgencias disminuyeron drásticamente en los años 2020 y en el 2021. Se requiere que los tomadores de decisión promuevan los servicios de odontología para recuperar los niveles de cobertura previos a la pandemia. Se identificó una disminución en la cobertura odontológica asociada a la pandemia de la COVID-19 en los años 2020 y 2021 y desconocen cuales son los posibles efectos en la morbilidad bucal de los Colombianos.

Introduction. The COVID-19 pandemic affected Colombian dental services from March 2019 to now, but its magnitude is unknown. Objective. To determine dental care coverage in Colombia during the pandemic period and compare these data with the pre-pandemic period 2017-2019. Methods. Dental coverage and consultation services registered in the "Sistema Integrado de Protección Social" or SISPRO from 2017 to 2021 were analyzed. Results. The whole dental service coverage rate was nearly 20% before Covid-19 pandemic and even registered a slight increase from 2017 to 2018 at national and at department levels. This dental national coverage was 31,14% for every 100 habitants in 2019. However, there was a sharp reduction to 17% in 2020 and to 9% in 2021, revealing a clear and negative impact of the pandemic in dental coverage services and in dental emergency services. Conclusion. A decrease in dental coverage during to the COVID-19 pandemic is revealed, with a concomitant reduction in dental emergency consultations during 2020 and 2021 at country level. The consequences of this disruption on the oral and dental epidemiological profile of Colombians is still unknown and might require urgent preventive, promotional and curative care actions to recover the pre-pandemic dental coverage levels.

Complicações odontológicas em indivíduos com insuficiência renal crônica: estudo retrospectivo / Dental complications in chronic renal failure individuals: a retrospective study

A doença renal crônica em estágio terminal pode levar a alterações sistêmicas que tornam o manejo clínico odontológico desses indivíduos desafiador, especialmente se os procedimentos forem invasivos. As preocupações incluem alteração do metabolismo de drogas, da resposta imunológica e do metabolismo ósseo, além do risco aumentado de sangramento e discussão sobre risco aumentado para endocardite infecciosa. O objetivo deste estudo retrospectivo foi conhecer a frequência e o tipo de complicações durante e após execução de procedimentos odontológicos em indivíduos com insuficiência renal crônica em diálise (IRC-D), atendidos no Centro de Atendimento a Pacientes Especiais (CAPE) da Faculdade de Odontologia da USP (FOUSP). Adicionalmente, comparamos a quantidade e o tipo de complicações entre os indivíduos que usaram antibiótico profilático e aqueles que não usaram, antes dos procedimentos odontológicos. Para tanto desenvolvemos um formulário específico para este estudo, no qual compilamos as informações relativas aos períodos trans e pós-operatórios de procedimentos odontológicos realizados nos pacientes com IRC em diálise. Nossa hipótese era a de que a prevalência de complicações durante e após os procedimentos odontológicos de indivíduos com IRC em diálise fosse baixa, e que ouso do antibiótico prescrito profilaticamente não interferiria na qualidade dareparação ou na incidência de complicações relacionadas aos procedimentos odontológicos. Analisamos retrospectivamente 225 prontuários de pacientes com IRC em diálise atendidos no CAPE-FOUSP desde 1990 até os dias atuais. Desse total, 130 eram pacientes do sexo masculino e do 95 do feminino. A idade média destes indivíduos foi de 48,4 anos. As principais doenças de base que levaram a ocorrência da IRC-HD foram a hipertensão arterial sistêmica (48 pacientes) e o diabetes mellitus (23 pacientes). Nos 225 pacientes, 1.390 procedimentos odontológicos foram realizados, dos quais 856 foram não invasivos, 443 invasivos e 91 tratamentos endodônticos. Dentre os procedimentos invasivos, houve 259 exodontias. Antes de 80 das 259 intervenções cirúrgicas (31%) houve a prescrição de antibiótico profilático em diferentes posologias; em 29 exodontias (11%) foram utilizados hemostáticos locais no momento da realização da sutura. Foram descritos nos prontuários 16 casos de sangramento transoperatório (6%), 5 casos de sangramento pós-operatório (2%) e 2 casos de complicação pós-operatória (0,8%), definidos como uma alveolite e uma infecção alveolar. Nossos resultados permitiram nos concluir que a incidência de complicações após exodontias é baixa e que o uso de antibiótico profilático (AP) não interferiu nessa incidência.

Avaliação do protocolo de biossegurança na pandemia em uma clínica odontológica de ensino na perspectiva do paciente / Evaluación del protocolo de bioseguridad en la pandemia en una clínica de enseñanza odontológica desde la perspectiva del paciente / Evaluation of the pandemic biosafety protocol in a dental clinic from the patient's perspective

This study aimed to assess whether patients feel safe or anxious when receiving dental care at a teaching clinic; the study was carried out from the perspective of patients, given the biosafety protocol during the 2019 Coronavirus (COVID-19) pandemic. Thiscross-sectional study was carried out with 217 patients assisted by students in the Dental Clinic of the Pontifícia Universidade Católica do Paraná. A semi-structured questionnaire was used to collect sociodemographic data, humanization and the safety protocols followed during care. Multivariate analysis was performed using Poisson regression (PR), and p values ≤0.05 were understood. Around 90% of patients reported that students were attentive, communicative, welcoming and confident during treatment about the risk of contracting COVID-19 during care. Patients who showed anxiety during treatment were 32.2%. Some patients were unable to keep their distance in the waiting room (PR 3.439) and did not feel safe during the appointment (PR 2.64) had a higher prevalence of anxiety during dental care. Anxiety about care was associated with the individual's color or ethnicity, ability to maintain social distancing in the waiting room, and feeling safe when receiving care (AU).

El objetivo de este estudio fue evaluar si los pacientes se sienten seguros o ansiosos al recibir atención odontológica en una clínica docente; el estudio se realizó desde la perspectiva de los pacientes, teniendo en cuenta el protocolo de bioseguridad durante la pandemia del Coronavirus 2019 (COVID-19). Se trata de un estudio transversal realizado con 217 pacientes atendidos por estudiantes de la Clínica Odontológica de la Pontificia Universidad Católica de Paraná. Se utilizó un cuestionario semiestructurado para recolectar datos sociodemográficos, humanización y protocolos de seguridad seguidos durante la atención. El análisis multivariado se realizó mediante regresión de Poisson (RP), con valores de p ≤0,05. Alrededor del 90% de los pacientes informaron que los estudiantes se mostraron atentos, comunicativos, acogedores y confiados durante el tratamiento sobre el riesgo de contraer COVID-19 durante el tratamiento. Los pacientes que demostraron ansiedad durante el tratamiento fueron el 32,2%. Algunos pacientes no pudieron mantener la distancia en la sala de espera (RP 3.439) y no se sintieron seguros durante la consulta (RP 2.64) y tuvieron mayor prevalencia de ansiedad durante la atención odontológica. La ansiedad con respecto a la atención se asoció con elcolor o el origen étnico del individuo, la capacidad de mantener el distanciamiento social en la sala de espera y sentirse seguro al recibir atención (AU).

O objetivo deste estudo foi avaliar se os pacientes se sentem seguros ou ansiosos ao receber atendimento odontológico em uma clínica-escola; o estudo foi realizado sob a perspectiva dos pacientes, tendo em vista o protocolo de biossegurança durante a pandemia do Coronavírus 2019 (COVID-19). Trata-se de um estudo transversal realizado com 217 pacientes atendidos por estudantes da Clínica Odontológica da Pontifícia Universidade Católica do Paraná. Foi utilizado questionário semiestruturado para coletar dados sociodemográficos, sobre humanização e protocolos de segurança seguidos durante o atendimento. A análise multivariada foi realizada por meio de regressão de Poisson (RP), sendo compreendidos valores de p ≤0,05. Cerca de 90% dos pacientes relataram que os estudantes se mostraram atentos, comunicativos, acolhedores e confiantes durante o tratamento sobre o risco de contrair a COVID-19 durante o atendimento. Os pacientes que demonstraram ansiedade durante o tratamento foram 32,2%. Alguns pacientes não conseguiram manter distância na sala de espera (RP 3,439) e não se sentiram seguros durante a consulta (RP 2,64) tiveram maior prevalência de ansiedade durante o atendimento odontológico. A ansiedade em relação ao atendimento esteve associada à cor ou etnia do indivíduo, capacidade de manter distanciamento social na sala de espera e sentir-se seguro ao receber atendimento (AU).

Perfil de saúde bucal dos pacientes pediátricos internados no Hospital e Pronto Socorro da Criança Zona Sul (PSC) / Oral health profile of pediatric patients admitted to the South Zone Children's Hospital and First Aid Station

A pesquisa propõe conhecer a saúde bucal, analisando o perfil epidemiológico, identificando a prevalência e necessidade de tratamento dos pacientes pediátricos internados na enfermaria do Hospital e Pronto Socorro da Criança Zona Sul em Manaus (PSC), no Amazonas. Este estudo transversal e observacional descritivo foi realizado com pacientes internados atendidos no PSC no período de setembro de 2022 a fevereiro de 2023. A coleta de dados foi realizada presencialmente nos dias semanais através análise dos prontuários, utilização de uma ficha odontológica e avaliação clínica. Observou-se a presença de pacientes do gênero masculino, superior ao gênero feminino e com faixa etária maior entre 2 a 9 anos de idade. Obteve-se resultados positivos acerca da condição bucal dos pacientes, sendo 44,26% considerada no critério Boa. A doença mais prevalente entre os pacientes internados nas enfermarias, corresponde à Síndrome Nefrótica com 25,35%. Conclui-se que a condição bucal mais prevalente entre os pacientes que se encontram internados na enfermaria é a condição bucal Boa. Isto justifica-se devido a presença de um projeto de extensão completado no hospital, que evidencia que a presença do cirurgião dentista na equipe multidisciplinar nas enfermarias dos hospitais é indispensável, pois ele é o profissional capacitado a manter e restabelecer a saúde bucal.

The research aims to investigate oral health by analyzing the epidemiological profile, identifying the prevalence and treatment needs of pediatric patients admitted to the ward of the South Zone Children's Hospital and First Aid Station in the city of Manaus, in the state of Amazonas. This cross-sectional and descriptive observational study was conducted with admitted patients treated at the South Zone Children's Hospital and First Aid Station between September 2022 and February 2023. The data collection was conducted in person on weekly days through the analysis of medical records, the use of a dental form, and clinical evaluation. It was observed that male patients were more numerous than female patients, and that the age range of 2 to 9 years old had a higher representation. Positive results were obtained regarding the oral condition of the patients, with 44.26% considered to be in the Good category. The most prevalent disease among the patients admitted to the wards is Nephrotic Syndrome, accounting for 25.35%. It is concluded that the most prevalent oral condition among patients admitted to the ward is the Good oral condition. This is justified by the presence of an extension project conducted in the hospital, which shows that the presence of the dental surgeon in the multidisciplinary team in the hospital wards is essential, as they are the professionals capable of maintaining and restoring oral health.

A atenção e as condições de saúde bucal na população brasileira em situação de privação de liberdade / Oral health care and conditions of brazilian population in a liberty privation situation

A população em situação de privação de liberdade por motivos judiciais no Brasil é composta por homens e mulheres adultos inseridos no sistema prisional e jovens que cumprem medidas socioeducativas. O direito à saúde dessa população é garantido por políticas ministeriais regulamentadas por portarias normativas, que integram esta parcela da população ao Sistema Único de Saúde (SUS), com foco no cuidado integral, resolutividade e atenção contínua e de qualidade. No entanto, existem expressivos fatores que obstaculizam a promoção efetiva de saúde, como a deficiência estrutural, superlotação, ambientes insalubres e estressantes, má alimentação e hábitos não saudáveis. Diante disso, o presente estudo se propôs a analisar, através de uma revisão narrativa da literatura, o panorama da saúde bucal dessa população. A pesquisa para compor essa revisão foi realizada nas bases de dados bibliográficos PubMed, Biblioteca Virtual em Saúde, contemplando LILACS, Periódicos CAPES e SciELO. Foram utilizados critérios de inclusão como parâmetro linguístico (inglês e português), temático e cronológico, publicados entre 2010 e 2020, abrangendo estudos qualitativos e quantitativos, e revisões de literatura, totalizando ao final 12 artigos. Foi possível observar uma alta demanda por atenção à saúde bucal neste grupo, tanto na assistência como na promoção e prevenção, e déficit na oferta dos serviços, expresso pelas limitações na infraestrutura, fragilidades nos recursos humanos, e pelo perfil curativista da assistência, evidenciando a necessidade da reformulação e fortalecimento da oferta de serviços odontológicos a esses indivíduos.

The population in a liberty privation situation, for legal reasons in Brazil, it's composed of men and women adults in the prisional system and young people in educational measures. The right to health of this population is guaranteed by ministerial policies regulated by normative ordinances, which integrate this part of population to the Sistema Único de Saúde (SUS), with focus on comprehensive, resolutive and continuous quality care. However, there are significant factors that hinder the effective promotion of health, such as structural deficiency, overcrowding, unhealthy and stressful environments, poor diet and unhealthy habits. Therefore, the present study proposed to verify, through a narrative review of the literature, the oral health panorama of this population. The research to compose this review was made in the bibliographic databases PubMed, Biblioteca Virtual em Saúde, including LILACS, Periódicos CAPES and SciELO. Inclusion criteria were used as a linguistic (English and Portuguese), thematic and chronological parameter, published between 2010 and 2020, covering qualitative and quantitative studies, and literature reviews, totalizing 12 articles. It was possible to observe a high demand for oral health care in this group, in promotion and prevention, and a deficit in the provision of services, expressed by limitations in infrastructure, weaknesses in human resources, and by the curative profile of care, evidencing the need to reformulate and strengthen the offer of dental services to these individuals.

COVID-19 and Personal Protective Equipment-Related Challenges Faced by Pediatric Dentists during patient care: A Qualitative Study

Abstract Objective: To describe the challenges pediatric dentists face while caring for their patients during the pandemic. Material and Methods: A descriptive qualitative study was conducted with purposefully sampled pediatric dentists. Data were collected through in-depth, semi-structured interviews until the content of the collected data reached theoretical saturation. Data were transcribed verbatim, coded, and analyzed using content analyses. Results: Seven participants (four females and three males) between 29 and 50 years participated in the study. Three themes emerged from the analyses: Anxiety and fear; PPE (Personal Protective Equipment) and its impact on care delivery; and 3) Behavior management. Conclusion: Dental care delivery was challenging for pediatric dentists. They experienced high anxiety levels and modified their services according to the recommended guidelines while making accommodations to lessen patients' COVID-19-related anxiety. The additional mandated PPE use affected the communication between the dentists and their patients, affecting their dentist-patient bonding.

Differences in dental care for pregnant women in the public sector after the creation of Previne Brasil

Aim: To compare performance differences among dental surgeons in the public sector of the state of Minas Gerais regarding prenatal dental care before and after the establishment of Previne Brasil. Methods: A cross-sectional study was conducted, gathering data through a structured questionnaire. The sample consisted of dental surgeons working in the public sector of municipalities in MG and utilizing the snowball effect. Data analysis was performed using the IBM-SPSS® version 29.0, employing Pearson's Chi-square statistical test (P<0.05). Results: Out of the 28 State Health System (SRS) present in MG. A total of 1696 responses were collected, but after applying the exclusion criteria, 1001 responses remained, specifically related to dental surgeons working in MG public sector. 78.6% comprised professionals who graduated before 2019, while 20.1% graduated after that year. The morning and the second or other gestational trimesters were the most common periods considered optimal for caring for pregnant women. A significant portion of the professionals had not undergone any specific courses or training on this topic, reporting an average satisfaction level of 5.52 regarding the accessibility of information during their education aimed at this audience. Conclusion: Variances were observed in the care provided to pregnant women by dental surgeons working in the public sector of Minas Gerais, distinguishing those trained before and after the implementation of Previne Brasil. The debunking of myths and taboos stands as crucial for enhancing the acceptance of prenatal dentistry

Impacto da COVID-19 nos procedimentos odontológicos do Sistema Único de Saúde em Manhuaçu: estudo transversal baseado em dados extraídos do sistema Sidim Saúde Pública entre 2018 e 2021 / Impact of COVID-19 on dental procedures in the Unified Health System in Manhuaçu: Cross-sectional study with data extracted from the Sidim - Saúde Pública system between 2018 and 2021

Objetivo: Analisar o impacto da pandemia da COVID-19 no atendimento odontológico do município de Manhuaçu/MG.Métodos: Coletou-se dados secundários por meio do software Sidim Saúde Pública dos procedimentos realizados antes e durante a pandemia. Realizou-se análise descritiva (porcentagens e médias) dos dados obtidos. Resultados: Os atendimentos de urgência e agendados diminuíram, respectivamente, cerca de 19% e 85%. Antes da pandemia, a média de procedimentos realizados referentes as especialidades dentística (103,4) e periodontia (97,4) eram os mais frequentemente realizados diariamente. No entanto, durante a pandemia, os procedimentos agrupados na categoria "outros" foram mais realizados, seguido por procedimentos de dentística e endodontia. Os procedimentos das especialidades de saúde coletiva, periodontia e dentística tiveram maior redução 100%, 97% e 95% respectivamente. Conclusão: A COVID-19 causou impacto significante nos atendimentos e procedimentos preventivos e curativos de eleição realizados pela equipe de saúde bucal em Manhuaçu.

Aim: To analyze the impact of the COVID-19 pandemic on dental care in Manhuaçu, MG. Methods: Secondary data were extracted from the Sidim database of Public Health. The procedures performed by dentists before and during the pandemic were collected. A descriptive analysis was performed (percentages and averages).Results: A decrease in emergency procedures and routine care of approximately 19% and 85%, respectively, was found. Before the pandemic, the average number of procedures performed on a daily basis was around 103.4 dental specialties and 97.4 periodontal procedures. However, during the pandemic, the most performed procedures were rapid testing for SARS-COVID-2 detection, temperature measurement, and blood pressure, followed by dental and endodontic procedures. A maximum decline in procedures was observed in public health specialties (100%), periodontics (97%), and dentistry (95%). Conclusion:COVID-19 had a significant impact on the dental care and preventive and curative procedures in the public health system of Manhuaçu.

Drug Hypersensitivity Associated with Dental Treatments

ABSTRACT Objective: To characterize drug hypersensitivity associated with dental treatments. Material and Methods: Data from 5,302 dental patients extracted from the Faculty of Dental Medicine were used to investigate drug use history, drug hypersensitivity, and associations with oral health outcomes. The chi-square test was used, and values of p ≤ 0.05 were considered statistically significant. Results: The frequency of patients' self-reported drug hypersensitivity was 26.42% (n = 1,401). The highest frequencies were for opioid/narcotic analgesics (20.84%, n = 292), antibiotics (18.13%, n = 961), and non-steroidal anti-inflammatory drugs (10.46%, n = 141). Most of the patients (68.65%, n = 3,640) reported using medications, mostly for cardiovascular disease (43.1%, n = 1,569), for psychiatric/neurological disorders (39.75%, n = 1,447), drugs that affect the endocrine system (32.55%, n= 1,185), and drugs for pain (24.92%, n = 907). Higher drug hypersensitivity frequencies were associated with older White female subjects (p<0.0001). Associations were also identified between drug hypersensitivity and history of the following dental procedures: tooth extractions (p=0.003), root canal treatment (p=0.0004), prosthodontic treatments (p<0.0001), and orthodontic treatments (p=0.007). Conclusion: A high frequency of self-reported drug hypersensitivity in dental patients was found, with a higher occurrence in older White women and those with a history of more extensive and invasive dental care.

Treatment Trends in Paediatric Dentistry with Evolving Training and Education of Postgraduate Students in India: A Retrospective Study

ABSTRACT Objective: To assess and analyse the pattern of dental treatment services and their characteristics provided to children by evaluating the clinical use of materials and prevalence in material research in a major postgraduate paediatric tertiary care hospital in India over three years. Material and Methods: Institutionally approved retrospective analysis was conducted by auditing the clinical records of 2644 patients who visited and had treatment in the Outpatient and Inpatient Department of Paedodontics and Preventive Dentistry from January 2017 to December 2019. Clinical logbooks of postgraduate students were analysed by crosschecking with the department's data warehouse. Results: Out of the 2644 children who had treatment, more than two-thirds of them were in the age group of 4-7 years old. Around 5.6% of the patients were specially-abled children. Extraction (33.5%) was the most common treatment, followed by restorative treatment (29.1%). Endodontic treatment had a prevalence of 19.8%, with a reduced prevalence of preventive treatment care (0.5%). Patients who had traumatic tooth management included 2.8% of the study population. The prevalence of preventive care was found to be 2.1%. The teaching curriculum with theoretical and clinical skill practices was under the country's assigned authority. Conclusion: Despite advancements in paediatric dentistry, more children had extraction treatment with less observed utilization of preventive care. The widening of the training prospectus includes comprehensive care and an amplified focus on preventive care in the academic curriculum of paediatric postgraduates, which is the need of the hour.

Compliance Analysis of the Dental Care Service Provided to Pregnant Women in Primary Health Care

ABSTRACT Objective: To analyze oral health services for pregnant women in the primary health care of a Brazilian metropolis, based on the performance of dentists who integrate these services. Material and Methods: Exploratory, descriptive and cross-sectional study was conducted through qualitative and quantitative approaches. A semi-structured questionnaire was used for data collection. This study was conducted in a Brazilian metropolis and included all dentists working in primary health care. The compliance analysis was performed considering access, adherence, group activity and individual dental care dimensions. Open questions were analyzed using the content analysis method and the closed questions were performed using frequency estimates. Bivariate statistics (Chi-square, Fisher's Exact Test, α<0.05) were analyzed through STATA. Results: 260 dentists agreed to participate in this study. Strategies to facilitate the scheduling of pregnant women to dental treatment occur in 93.9% of oral health teams, the main one being the scheduling and/or referral performed by the family health team. In terms of access and adherence to treatment, all variables in these dimensions showed relevant compliance results. The group activity dimension presented moderate compliance percentages, whereas individual care obtained high results, except for referral to radiography. Conclusion: The oral health service was compliant regarding access and adherence to treatment, but showed limitations in individual care and collective activities. Recommendations include improving oral health team coverage and permanent education programs.

Model Proposal for Equity Production in Access to Dental Specialty Centers

ABSTRACT Objective: To address disparities in oral healthcare to allow prioritization of individuals with higher vulnerability. The model seeks to develop a methodology for identifying and classifying vulnerability among CEO users using socioeconomic indicators. Additionally, it aims to establish criteria for access prioritization based on vulnerability profiles, ultimately ensuring that those in greater need receive the specialized oral healthcare they require. Material and Methods: The proposed method leverages two key indicators: the Municipal Social Vulnerability Index (IVS) and the CEO Social Vulnerability Indicator (CEO IVS). CEO IVS is calculated based on CEO user socioeconomic data and compared to the municipality's IVS. The model utilizes a scoring system to classify users' vulnerability levels, allowing for the identification of those most in need of specialized care. The Equality Production Trend Indicator (ITPE-CEO) assesses the alignment between CEO and municipal vulnerability levels, aiding access prioritization. Conclusion: This equity-focused model offers a practical approach to address disparities in oral healthcare access. Vulnerability profiles and socioeconomic factors empower local managers to allocate resources effectively, ensuring that individuals with higher vulnerability receive timely and specialized care. The proposed model promotes inclusivity and responsiveness to community needs, contributing to achieving equitable oral healthcare for all.

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