RESUMEN
BACKGROUND: This study aims to describe the Libyan oral health care system in terms of its structure, function, workforce, funding, reimbursement and target groups. METHODS: A single descriptive case study approach and multiple sources of data collection were used to provide an in-depth understanding of the Libyan oral health care system. A purposeful sample of the key informants (Managers of oral health centers, dentists of various specialties with experience in the field, dentists, nurses, dental technicians, and officials in the affairs of medical insurance) was recruited. The case and its boundaries were guided by the study's aim. Both qualitative and quantitative analyses were conducted. Descriptive statistics were used for quantitative data. Framework analysis, informed by the study objectives, was used to analyze interviews and documents. RESULTS: The analysis showed that oral health services are integrated into medical services. The provision of dental care is mainly treatment-based, in the private sector. The oral health services in the public sector are mainly emergency care and exodontia. The dental workforce included in the study were mostly dentists (89% General Dental Practitioners (GDPs), 11% specialists), with a marked deficiency in dental technicians and nurses. Around 40% of dentists work in both the private and public sectors. The government provides the funding for the public sector, but the private sector is self-funded. No specific target group(s) nor clear policies were reported. However, the system is built around primary health care as an overarching policy. Dental caries is the most common oral problem among Libyan preschool children affecting around 70% and is the most common cause of tooth loss among adults. CONCLUSION: The oral health care system in Libya is mainly privatized. The public health services are poorly organized and malfunctioning. There is an urgent need to develop policies and plans to improve the oral health care system in Libya.
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Odontólogos , Libia , Humanos , Odontólogos/provisión & distribución , Odontólogos/estadística & datos numéricos , Atención a la Salud , Servicios de Salud Dental/estadística & datos numéricos , Servicios de Salud Dental/organización & administración , Sector Privado , Sector Público , Técnicos Dentales , Atención Odontológica/economía , Niño , Financiación Gubernamental , Especialidades Odontológicas , Salud Bucal , Enfermeras y Enfermeros , Auxiliares Dentales/estadística & datos numéricosRESUMEN
AIM: Implant therapy in partially edentulous patients has become the most adapted and predictable treatment modality. The success rate of implants has been measured in terms of esthetic, biological, and technical factors such as radiographic bone loss, prosthetic complications, and stability. Despite the existence of several indices for the esthetic assessment of implant crowns, a need for functional evaluation of the implant crown with an objective and reproducible score has arisen. The study aims to validate the reproducibility of the functional implant prosthodontic score (FIPS) and the influence exerted by different dental specialties while evaluating posterior single-unit implant crowns. STUDY SETTING AND DESIGN: This was a prospective clinical study. MATERIALS AND METHODS: Fifteen patients with cement-retained single-implant crowns in the posterior region of the jaws were included. Eight examiners, two prosthodontists, two periodontists, two oral surgeons, and two orthodontists evaluated 15 photographs of single-unit implant crowns during the 1-year follow-up examination. The examiners assessed the photographs for FIPS, which includes five parameters for objectively evaluating the single-unit implant crowns. Assessments were performed twice at a gap of 4 weeks. STATISTICAL ANALYSIS USED: Pearson's correlation with a 95% confidence interval was calculated for the intra-examiner and the Kruskal-Wallis test for inter-examiner reproducibility. RESULTS: The mean total FIPS scores for all included examiners were 7.133 for time T1 and 7.074 for time T2, showing a strong Pearson correlation coefficient for intra-examiner reproducibility. No significant difference was analyzed among different specialties with statistically significant values of the Kruskal-Wallis test. CONCLUSION: Intra- and inter-examiner analysis showed very consistent results during the reproducibility assessment of FIPS. The results validated the use of FIPS as a long-term predictive functional evaluation tool for the single-implant crowns in posterior sites irrespective of the effect of different dental specialties. It could be used for risk estimation and prognosis for long-term survival and performance of implant crowns.
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Coronas , Humanos , Estudios Prospectivos , Reproducibilidad de los Resultados , Femenino , Masculino , Especialidades Odontológicas , Implantes Dentales de Diente Único , Estética Dental , Adulto , Persona de Mediana Edad , Prótesis Dental de Soporte Implantado , Prostodoncia/métodosRESUMEN
OBJECTIVE: To investigate the impact of various degrees of white spot lesions (WSLs) of maxillary anterior teeth on the aesthetic perception and treatment satisfaction among orthodontic patients, orthodontists and other dental specialists and to evaluate the differences among the three groups. METHODS: A total of 45 orthodontic patients (OP), 45 orthodontists (OR) and 45 other dental specialists (OS) were recruited. Subjective evaluations of perceived aesthetics and treatment satisfaction were performed towards eight digitally generated photographs of maxillary anterior teeth with incremental degrees of WSLs using a numerical visual analogue scale (VAS) from 0 to 100. Data were collected and analysed with descriptive statistics, repeated one-way analysis of variance and multivariable generalized estimating equations. RESULTS: A total of 135 valid questionnaires were collected. Regarding aesthetic scores for WSLs, OP gave more positive scores than OR and OS (p < .05) towards excessive white spot formation without colouration and were more tolerant than OR (p < .05) towards excessive white spot formation with slight colouration. The level of treatment satisfaction for slight to severe WSLs without cavitation was higher in OP than OR. Patients with higher education levels had more negative scores for aesthetic perception and treatment satisfaction (p < .05). Patients who brushed teeth more frequently scored lower in treatment satisfaction (p < .05). CONCLUSIONS: Orthodontists were the most critical when evaluating aesthetics and treatment satisfaction for slight to severe WSLs without cavitation. For orthodontic patients, better oral hygiene habits and higher education levels were associated with more critical attitudes towards WSLs.
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Estética Dental , Ortodoncistas , Satisfacción del Paciente , Humanos , Femenino , Masculino , Ortodoncistas/psicología , Adulto , Encuestas y Cuestionarios , Adolescente , Especialidades Odontológicas , Adulto Joven , OrtodonciaRESUMEN
This is a protocol for an overview to summarize the findings of Systematic Reviews (SR) dealing with Photodynamic Inactivation (PDI) for control of oral diseases. Specific variables of oral infectious will be considered as outcomes, according to dental specialty. Cochrane Database of Systematic Reviews (CDSR), MEDLINE, LILACS, Embase, and Epistemonikos will be searched, as well as reference lists. A search strategy was developed for each database using only terms related to the intervention (PDI) aiming to maximize sensitivity. After checking for duplicate entries, selection of reviews will be performed in a two-stage technique: two authors will independently screening titles and abstracts, and then full texts will be assessed for inclusion/exclusion criteria. Any disagreement will be resolved through discussion and/or consultation with a third reviewer. Data will be extracted following the recommendations in Chapter V of Cochrane Handbook and using an electronic pre-specified form. The evaluation of the methodological quality and risk of bias (RoB) of the SR included will be carried out using the AMSTAR 2 and ROBIS. Narrative summaries of relevant results from the individual SR will be carried out and displayed in tables and figures. A specific summary will focus on PDI parameters and study designs, such as the type and concentration of photosensitizer, pre-irradiation time, irradiation dosimetry, and infection or microbiological models, to identify the PDI protocols with clinical potential. We will summarize the quantitative results of the SRs narratively.
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Especialidades Odontológicas , Revisiones Sistemáticas como AsuntoRESUMEN
BACKGROUND: The European Economic Area (EEA) is composed of member states with a multitude of different regions. This study aimed to analyse the ratios of general dentists and dental specialists to the total population and the proportion of dental specialists to general dentists in 24 European countries and to explore specific intranational differences within 2 countries: France and Germany. METHODS: Available official documents and webpages from the United Kingdom and 23 of the 30 countries comprising the EEA were analysed. Data were expressed as absolute values, ratios of general dentists and dental specialists in the total of population, and percentages of dental specialists/dentists. The Mann-Whitney U test was used to clarify the main ratios that distinguish France from Germany, and cluster analysis was employed to determine similar areas. RESULTS: Significant differences were found between countries, with Ireland and Austria having the lowest ratio of dentists and Romania and Greece having the highest. The Czech Republic, the Netherlands, France, and Denmark had the lowest ratios of dental specialists to the total population. Lithuania, Sweden, and Germany had the highest number of dental specialists. Orthodontists were the most numerous specialists (5.0% of dentists), followed by oral surgeons (2.7%). In France, differences between departments were pronounced and associated with the presence of dental schools and per capita income. In Germany, only the correlation between per capita income and the density of oral surgeons was significant. CONCLUSIONS: Diverse ratios of general dentists and dental specialists to the total population and the proportion of dental specialists to general dentists were discovered within the examined countries, and their maximum values were 2.5, 5.7, and 4.1 times the minimum values, respectively. Differences were even found within the same country, as was the case in France and, to a lesser extent, in Germany.
Asunto(s)
Odontólogos , Especialidades Odontológicas , Europa (Continente) , Humanos , Especialidades Odontológicas/estadística & datos numéricos , Odontólogos/estadística & datos numéricos , Odontólogos/provisión & distribución , Odontología General/estadística & datos numéricos , Francia , AlemaniaRESUMEN
BACKGROUND: Diagnosis in dentistry begins with the correct reading and interpreting of the dental radiograph. OBJECTIVES: The aim of the present study was to examine the effects of the imaging technique used, the dentistry specialty and the years of experience on the gray-level perception among dentists. MATERIAL AND METHODS: A custom web application was developed. Dentomaxillofacial radiologists (DentRads), endodontists (Ends) and general dental practitioners (GDPs) were invited via e-mail to participate in the study. A total of 46 participants met the requirements of the test. The test comprised 2 webpages. On the 1st page, the participants were asked for information such as gender, specialty, the years of experience, and the imaging techniques they used. Then, on the 2nd page, they were welcomed with instructions and directions, and asked to rearrange 85 gray color tones represented by square bars of equal dimensions. These mixed gray bars were placed in 4 rows according to the principles of the FarnsworthMunsell 100-hue test (FM). Each clinician's test results were recorded in a database. The individual's level of recognition of gray tones was evaluated through the total error score (TES), which was calculated using a web-based independent scoring software program. Lower TES values were a desirable result, indicating fewer misplacement, while higher scores indicated more misplacements of gray tones. The testing time (TT) was recorded automatically. RESULTS: The years of the participants' experience as dentists or specialists did not affect TES or TT. The dentists who used the charge-coupled device-complementary metal oxide semiconductor (CCD-CMOS) had lower TES values than those who used analog radiographs (p < 0.05). CONCLUSIONS: While the specialty and the years of experience did not affect the clinicians' ability to recognize gray tones, the digital imaging techniques (photostimulable phosphor (PSP) and CCD/CMOS) could improve the clinicians' gray-level perception.
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Odontólogos , Radiografía Dental Digital , Humanos , Rol Profesional , Computadores , Especialidades Odontológicas , InternetRESUMEN
PURPOSE: A lack of contemporary dental literature exists on evaluating dental residents in postgraduate education, with no standardized criteria or information on technology adoption. This study aims to understand current evaluation methods in dental residency programs and compare them to existing literature. METHODS: A survey with 22 questions was sent to program directors of 749 ADA/CODA (American Dental Association/Commission on Dental Accreditation)-accredited postgraduate dental residencies. The questions focused on evaluation frequency, faculty involvement, submission methods, and electronic software usage. RESULTS: The survey response rate was 30.2% (226 responses). Results show that 98% of program directors are involved in evaluations, but require more support from auxiliary faculty. Evaluations are typically submitted twice or four times a year, with 12% of programs wanting increased frequency. Face-to-face delivery of feedback is considered crucial. While desktop computers are widely used for evaluation submission, 55% of programs utilize mobile devices, which correlates with higher program director satisfaction. The most popular evaluation software includes New Innovations, MEd Hub, and Qualtrics. Overall, 86.96% of program directors are satisfied with current evaluation practices. Areas needing improvement are non-program director faculty involvement, resident response/feedback, and software navigation. CONCLUSION: This study found that a majority of program directors of the postgraduate dental education system are using electronic technology for their resident evaluation systems and are satisfied with their current mechanism of evaluation.
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Internado y Residencia , Estados Unidos , Humanos , Evaluación de Programas y Proyectos de Salud , Encuestas y Cuestionarios , Docentes , Especialidades Odontológicas , Educación de Postgrado en MedicinaRESUMEN
Objetivo: Determinar los hábitos de medicación sistémica de odontólogos especialistas y no especialistas en endodoncia ante diferentes patologías pulpares previos al tratamiento en- dodóntico en Argentina. Materiales y métodos: Se diseñó una encuesta para evaluar la prescripción de antibióticos, tipo de antibióticos, tiempo de prescripción, indicación de antinflamatorios no es- teroides y esteroides ante diferentes patologías pulpares. Se envió a 635 odontólogos especialistas y no especialistas en endodoncia a través de SurveyMonkey. Por medio de la prue- ba de Chi cuadrado se evaluaron las diferencias de medica- ción entre los grupos estudiados. Resultados: En pulpitis se medicó con antibióticos en el 3,48% de los casos y con antinflamatorios en un 62,60%. En necrosis pulpar sin fístula no se indicó ninguna medica- ción en un 64,47% de los casos, seguido de antibióticos en un 24,56%. En necrosis con fístula, el 52,38% no indicó nin- guna medicación, seguido de medicación con antibióticos en un 35,49%. En periodontitis apical aguda la principal medica- ción fue con antinflamatorios (52,79%), seguido de antibió- ticos (32,87%); y en el absceso alveolar agudo, un 57,10% indicó antibióticos seguido de antinflamatorios. El antibiótico de elección fue la penicilina en un 65,23% de los casos, y en caso de alergia a la misma, el antibiótico elegido fue azitromi- cina (30,12%). El tiempo de prescripción fue de 7 días. En la comparación entre especialistas y no especialistas hubo dife- rencias estadísticamente significativas para pulpitis y necrosis con fístula (p<0,01) y no las hubo entre necrosis sin fístula, periodontitis apical aguda y absceso alveolar agudo (p> 0,05). Conclusiones: La penicilina fue el antibiótico de elec- ción de la mayoría de los odontólogos argentinos encuestados junto al ibuprofeno como anti-inflamatorio. Existiría una so- bremedicación en patologías endodónticas que podría contri- buir a la resistencia microbiana a los antibióticos (AU)
Aim: Determine the systemic medication habits of den- tists specialists and non-specialists in endodontists in differ- ent pulp pathologies prior to root canal treatment in Argen- tina. Materials and methods: A survey was designed to evaluate the prescription of antibiotics, the type of antibiotics, prescription time, indication of non-steroidal anti-inflamma- tory drugs in different pulp pathologies. It was sent to 635 general dentists and endodontic specialists via SurveyMon- key. A Chi-square test was made to evaluate the differences in medication between the studied groups. Results: In pulpitis, antibiotics were prescribed in 3.48% of cases and anti-inflammatories in 62.60%. In pul- pal necrosis without fistula, no medication was indicated in 64.47% of cases, followed by antibiotics in 24.56%. In ne- crosis with fistula, 52.38% did not indicate any medication, followed by medication with antibiotics in 35.49%. In acute apical periodontitis the main medication was anti-inflamma-tories (52.79%), followed by antibiotics (32.87%); and for acute alveolar abscess, 57.10% indicated antibiotics, fol- lowed by anti-inflammatories. The antibiotic of choice was penicillin in 65.23% of the cases, and in case of allergy to it, the chosen antibiotic was azithromycin (30.12%). The prescription time was 7 days. In the comparison between specialists and non-specialists, there were significant dif- ferences for pulpitis and necrosis with fistula (p<0.01) and there were no significant differences between necrosis without fistula, acute apical periodontitis and acute alveo- lar abscess (p>0.05). Conclusions: Penicillin was the antibiotic of choice for the majority of the surveyed Argentine dentists, as well as ibuprofen as an anti-inflammatory drug. These could reflect an overmedication in endodontics pathologies that could con- tribute to microbial resistance to antibiotics (AU)
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Humanos , Masculino , Femenino , Penicilinas/uso terapéutico , Antiinflamatorios no Esteroideos/uso terapéutico , Enfermedades de la Pulpa Dental/tratamiento farmacológico , Antibacterianos/uso terapéutico , Argentina , Facultades de Odontología , Especialidades Odontológicas/normas , Distribución de Chi-Cuadrado , Administración Oral , Encuestas y Cuestionarios , Endodoncia/tendenciasRESUMEN
BACKGROUND: Although the European Economic Space usually acts in a united and organized way, several main differences are found regarding the type and number of dental specialties all around this group of member states. The aim of the study is to analyse the inequalities and similarities existing between 21 European countries, highlighting the number and types of recognized dental specialties. METHODS: Available official documents and webpages from 20 out of the 30 countries of which the European Economic Space is comprised plus the United Kingdom (UK), were analysed to obtain reliable data referred to dental specialties. Differences were tested with the Lorentz curve and Gini test. Additionally, a Cluster analysis was performed to obtain groups of countries with a similar pattern in the number and type of dental specialties. RESULTS: Up to a total of 15 different specialties are officially recognized in all the analysed countries. Orthodontics (90%) and Oral Surgery (81%) are the two most frequently recognized specialties. The total global degree of inequality of the analysed countries was 40.2%. Cluster analysis differentiated three different main groups of countries according to the number and type of dental specialties. CONCLUSIONS: The situation of dental specialties in the area of the EES plus the UK exhibits an unequal organization. Cluster analysis showed 3 main clusters of countries with a similar pattern of dental specialties.
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Ortodoncia , Cirugía Bucal , Humanos , Europa (Continente) , Reino Unido , Atención Odontológica , Especialidades OdontológicasRESUMEN
A pesquisa teve como objetivo verificar a rastreabilidade dos pacientes atendidos no setor de urgência do Núcleo de Acolhimento e Pronto Atendimento da Universidade Federal de Pernambuco (NAPA-UFPE), o tempo decorrido entre seu encaminhamento e a continuidade do tratamento na instituição, além de identificar o perfil dos usuários. Trata-se de estudo observacional descritivo, com coleta de dados a partir dos prontuários físicos e eletrônicos dos pacientes atendidos no segundo semestre de 2014 (2014.2) e no primeiro semestre de 2015 (2015.1). Ao total, foram analisados 373 prontuários. Em ambos os semestres houve maior prevalência do sexo feminino e da faixa etária entre 20 e 59 anos. A rastreabilidade revelou que 40,75% dos pacientes continuaram seus tratamentos na instituição. Nos semestres 2014.2 e2015.1, respectivamente, 31,20% e 82,00% dos pacientes prosseguiram com o tratamento eletivo até 30 dias após a realização do atendimento de urgência. Em conclusão, a rastreabilidade revelou maior prevalência do sexo feminino e da faixa etária adulta. O quantitativo de pacientes que deram continuidade ao tratamento na instituição em até 30 dias após o encaminhamento esteve dentro do previsto, considerando-se as características das clínicas-escola (AU).
El objetivo de la investigación fue verificar la trazabilidad de los pacientes atendidos en el sector de urgencias del Centro de Recepción y Atención de Urgencias de la Universidade Federal de Pernambuco (NAPA-UFPE), el tiempo transcurrido entre su derivación y la continuidad del tratamiento en la institución, además de identificar el perfil de los usuarios. Se trata de un estudio observacional descriptivo, con recolección de datos de los registros físicos y electrónicos de pacientes atendidos en el segundo semestre de 2014 (2014.2) y en el primer semestre de 2015 (2015.1). En total se analizaron 373historias clínicas. En ambos semestres hubo mayor prevalencia del sexo femenino y del grupo de edad entre 20 y 59 años. La trazabilidad reveló que el 40,75% de los pacientes continuaron sus tratamientos en la institución. En los semestres 2014.2 y 2015.1,respectivamente, el 31,20% y el 82,00% de los pacientes continuaron con el tratamiento electivo hasta 30 días después de la atención de emergencia. En conclusión, la trazabilidad reveló una mayor prevalencia del sexo femenino y del grupo etario adulto. Elnúmero de pacientes que continuaron el tratamiento en la institución dentro de los 30 días posteriores a la derivación estuvo dentro del rango esperado, considerando las características de las clínicas docentes (AU).
The objective of this study was to verify the traceability of patients attended in the emergency sector of the Reception and Emergency Care Center of the Federal University of Pernambuco (NAPA-UFPE), the time elapsed between their referral and the continuity of treatment at the institution, in addition to identifying the users' profile. This is a descriptive observational study, with data collection from the physical and electronic medical records of patients treated in the second half of 2014 (2014.2) and in the first half of 2015 (2015.1). A total of 373 medical records were analyzed There was a higher prevalence of females and an age group between 20 and 59 years in both semesters. The traceability revealed that 40.75% of the patients continued their treatments at the institution. Moreover, 31.20% and 82.00% of the patients in the 2014.2 and 2015.1 semesters continued with the elective treatment up to 30 days after the emergency care, respectively. In conclusion, traceability revealed a higher prevalence of females and the adult age group. The number of patients who continued treatment at the institution within 30 days after referral was within the expected range, considering the characteristics of the teaching clinics (AU).
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Humanos , Masculino , Femenino , Adolescente , Adulto , Persona de Mediana Edad , Especialidades Odontológicas , Atención Odontológica , Atención Ambulatoria , Distribución de Chi-Cuadrado , Registros Médicos/estadística & datos numéricos , Interpretación Estadística de Datos , Estadísticas no Paramétricas , Servicios de Salud Dental , Registros Electrónicos de Salud , Estudio ObservacionalRESUMEN
Apart from conventional treatment, dentists are increasingly relying on physical therapy modalities in their clinical practice. The aim of this literature review is to analyze the clinical relevance and potential uses of ozone in modern dentistry. The research question is geared towards detailing the multiple potential applications of ozone therapy in a range of dental specialties. Based on the available literature, accessed via the PubMed, Google Scholar, Scopus, and EBSCO databases, a detailed search of the electronic literature was performed for 2001-2022. Eligible studies were chosen according to inclusion and exclusion criteria, using keywords: ozone, ozone therapy, therapeutic applications, oxidants, dental disinfectants, oral medicine, physical therapy in dentistry. Out of 834 manuscripts, 273 studies were curated. A total of 70 publications were used in the final consideration. After assessing their quality, they were analyzed to determine the relevance and potential use of ozone in the various aspects of modern dentistry. Ozone therapy is used mainly as an adjunct to the primary clinical or pharmacological treatment. In some cases of oral mucosal disease, it has proven effective as a primary therapy. During the literature analysis, it was noted that ozone therapy in dentistry is a subject of ongoing research, and the results are not always consistent. The multitude of studies in the literature on the applications of ozone in dentistry reflects the search for its undiscovered physical therapeutic potential.
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Medicina Oral , Ozono , Ozono/uso terapéutico , Oxidantes , Especialidades OdontológicasRESUMEN
BACKGROUND: The attitudes of dental students to study a particular specialty of dentistry in post-graduation are of great importance as these facilitate workforce planning in the dental sector. AIM AND OBJECTIVE: To assess the attitude of dental students towards choosing periodontology as their future career and to explore demographic variables that affect their choice. MATERIALS AND METHODS: A cross-sectional survey based on a questionnaire was conducted, including students of the third and fourth years and interns of the dental college. Twenty-seven questions, graded on a Likert scale (5-point) were included in the questionnaire, and the responses were categorised via three attitudes: negative (score 0-21), neutral (score 22-44) and positive (score 45-64). The Chi-square test for proportions was used to examine the differences between groups. RESULTS: Among 114 participants, 53 (46.5%) were males and 61 (53.5%) were females. One-third of the respondents had a positive attitude towards selecting periodontology as their future career, and the majority had a neutral perspective, with a few students having a negative attitude (20.2%). Out of the total, 34.2% of respondents had a positive attitude, and 45.6% showed a neutral attitude or perspective. CONCLUSION: Efforts should be intensified, and undergraduate (UG) students should be motivated by broadening the scope of the field in the UG curriculum by the dental council so that the students show considerable interest in pursuing the field as their future career.
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Selección de Profesión , Periodoncia , Estudiantes de Odontología , Humanos , Estudiantes de Odontología/psicología , Femenino , Masculino , Estudios Transversales , Periodoncia/educación , Encuestas y Cuestionarios , Adulto , Especialidades Odontológicas/educación , Adulto Joven , Actitud del Personal de Salud , IndiaRESUMEN
O uso de substâncias para melhorar a prática esportiva ou de trabalho, remonta a própria história, mesmo nas primeiras olimpíadas na Grécia, era tolerado o uso de remédios para melhorar o desempenho dos atletas, enquanto outros tipos de trapaça eram punidos até com a escravidão. Nossos tempos são de consumo de esportes em massa e grandes volumes financeiros como indústria de entretenimento. Tentando manter o jogo o mais justo possível, diversas entidades criaram regras cada vez mais rígidas para preservar a saúde do atleta e não deixar que haja trapaças por meio de substâncias proibidas. Tendo isso em vista, o CD (Cirurgião Dentista) precisa estar preparado para atender esse paciente a fim de não comprometer sua vida profissional no esporte e dar o melhor cuidado possível a ele. Este trabalho se propões a identificar os medicamentos mais utilizados pelos CDs, em suas várias especialidades, e identificar por meio da biotransformação as possíveis substâncias que levem ao doping.
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Humanos , Especialidades Odontológicas , OdontologíaRESUMEN
OBJECTIVE: There is a lack of diversity in the dental workforce. Efforts to enhance underrepresented minority (URM) recruitment and retention within dental school exist, but little effort has been made to track URM providers through education and practice. This study assesses the status of workforce diversity in the dental specialties and the predictors of URM dentist specialization. METHODS: The primary data used were a 2012 national sample survey of Hispanic/Latino (H/L), Black, or American Indian/Alaska Native (AI/AN) dentists in the US, supplemented by publicly available workforce data. Descriptive and multivariate statistical analyses were performed to describe the demographic composition of URM clinical general and specialist dentists and analyze changes in proportions of URMs specializing among age cohorts, differences in specific type of specialization, and racial concordance between specialists and their patients. RESULTS: The pathway continues to winnow with fewer URM dentists in specialty practice. Among all URM clinical dentists being first in his/her family to obtain a college degree, having a strong desire to work in his/her own cultural community or joining a loan repayment program due to debt load independently predicted lower odds of specialization. Alternatively, being initially foreign trained as a dentist and valuing professional training were independently predictive of higher odds of specialization. CONCLUSION: The lack of diversity within the dental specialties is a critical flaw in our education and care delivery systems demanding clear actions toward improving the pathway into residency programs for URM students.
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Grupos Minoritarios , Especialidades Odontológicas , Femenino , Humanos , Masculino , Estados UnidosRESUMEN
We studied the influence of Self-Assessment for Improving Access and Quality (AMAQ) in the production of specialized procedures in the of Dental Specialties Centers (DSC). Data were obtained from the 900 DSC submitted to the external evaluation of the Program for Improving Access and Quality (PMAQ-CEO) and the Outpatient Information System (SIA-SUS). The dependent variable was the monthly average of dental procedures (proc/mon) in the DSC performed in three periods: 1) October 2012 to September 2013; 2) October 2013 to September 2014; and 3) October 2014 to September 2015. The main independent variable was the use of AMAQ/CEO, which occurred during the second period. Type of DSC, average number of dentists with a 20-hour workload, strategies to reduce missing appointments, referral support, clinical protocols and coverage of PHC registered users were used as covariates. Multiple linear regression models were run to estimate adjusted differences. Teams that used AMAQ-CEO had a mean of 515.0 proc/mon, 575.5 proc/mon, and 519.9 proc/mon in the first, second and third periods, respectively. The DSC that used AMAQ-CEO had a higher mean than those that did not, with an adjusted difference of 32.7 proc/mon, 64.7 proc/mon and 27.7 proc/mon for the first, second and third periods, respectively.
Estudou-se a influência da Autoavaliação para Melhoria do Acesso e Qualidade (AMAQ) na produção de procedimentos especializados nos Centros de Especialidades Odontológicas (CEO). Utilizou-se dados da avaliação externa de 900 CEO do primeiro ciclo do Programa para Melhoria do Acesso e Qualidade (PMAQ/CEO) e Sistema de Informação Ambulatorial (SIA/SUS). A variável dependente foi a média mensal de procedimentos (proc/mês) dos CEO entre os três períodos: 1) outubro de 2012 a setembro de 2013; 2) outubro de 2013 a setembro de 2014; e 3) outubro de 2014 a setembro 2015. A principal variável independente foi o uso da AMAQ/CEO no segundo período. Tipo de CEO, média de cirurgiões-dentistas com carga-horária de 20h, estratégias contra absenteísmo, apoio matricial, protocolos clínicos e cobertura de cadastrados na Estratégia de Saúde Bucal das Família foram covariáveis. Utilizou-se modelos de regressão linear múltipla para análises ajustadas. Equipes que utilizaram a AMAQ-CEO apresentaram média de 515,0 proc/mês, 575,5 proc/mês, e 519,9 proc/mês no primeiro, segundo e terceiro períodos, respectivamente. As equipes que utilizaram AMAQ-CEO tiveram uma maior média de produção do que aquelas que não utilizaram, com diferença ajustada de 32,7 proc/mês, 64,7 proc/mês e 27,7 proc/mês no primeiro, segundo e terceiro períodos, respectivamente.
Asunto(s)
Pacientes Ambulatorios , Autoevaluación (Psicología) , Humanos , Especialidades OdontológicasRESUMEN
Resumo Estudou-se a influência da Autoavaliação para Melhoria do Acesso e Qualidade (AMAQ) na produção de procedimentos especializados nos Centros de Especialidades Odontológicas (CEO). Utilizou-se dados da avaliação externa de 900 CEO do primeiro ciclo do Programa para Melhoria do Acesso e Qualidade (PMAQ/CEO) e Sistema de Informação Ambulatorial (SIA/SUS). A variável dependente foi a média mensal de procedimentos (proc/mês) dos CEO entre os três períodos: 1) outubro de 2012 a setembro de 2013; 2) outubro de 2013 a setembro de 2014; e 3) outubro de 2014 a setembro 2015. A principal variável independente foi o uso da AMAQ/CEO no segundo período. Tipo de CEO, média de cirurgiões-dentistas com carga-horária de 20h, estratégias contra absenteísmo, apoio matricial, protocolos clínicos e cobertura de cadastrados na Estratégia de Saúde Bucal das Família foram covariáveis. Utilizou-se modelos de regressão linear múltipla para análises ajustadas. Equipes que utilizaram a AMAQ-CEO apresentaram média de 515,0 proc/mês, 575,5 proc/mês, e 519,9 proc/mês no primeiro, segundo e terceiro períodos, respectivamente. As equipes que utilizaram AMAQ-CEO tiveram uma maior média de produção do que aquelas que não utilizaram, com diferença ajustada de 32,7 proc/mês, 64,7 proc/mês e 27,7 proc/mês no primeiro, segundo e terceiro períodos, respectivamente.
Abstract We studied the influence of Self-Assessment for Improving Access and Quality (AMAQ) in the production of specialized procedures in the of Dental Specialties Centers (DSC). Data were obtained from the 900 DSC submitted to the external evaluation of the Program for Improving Access and Quality (PMAQ-CEO) and the Outpatient Information System (SIA-SUS). The dependent variable was the monthly average of dental procedures (proc/mon) in the DSC performed in three periods: 1) October 2012 to September 2013; 2) October 2013 to September 2014; and 3) October 2014 to September 2015. The main independent variable was the use of AMAQ/CEO, which occurred during the second period. Type of DSC, average number of dentists with a 20-hour workload, strategies to reduce missing appointments, referral support, clinical protocols and coverage of PHC registered users were used as covariates. Multiple linear regression models were run to estimate adjusted differences. Teams that used AMAQ-CEO had a mean of 515.0 proc/mon, 575.5 proc/mon, and 519.9 proc/mon in the first, second and third periods, respectively. The DSC that used AMAQ-CEO had a higher mean than those that did not, with an adjusted difference of 32.7 proc/mon, 64.7 proc/mon and 27.7 proc/mon for the first, second and third periods, respectively.