Relato de experiência no ensino da Dentística com base em metodologias ativas de ensino-aprendizagem: gamificação e práticas lúdicas / Experience report in teaching Dentistry based on active teaching-learning methodologies: gamification and ludic practices

O presente estudotem por objetivo demonstrar umprocesso de ensino-aprendizagemna graduação odontológica de cunho lúdicoe engajamento do estudante, no momentoem que ocorre a transição no ensino dasdisciplinas, destacando-se:do ciclo básico;percorrendo oambiente laboratorial;até o atendimento clínico aospacientes, para além do mero treinamento técnico.Prevalece noensino superioro aprendizadofragmentadopordisciplinas e áreas de especializaçãoenota-se uma ausência de conexãoentre ospropósitoslaboratorialeclínico. A aplicação de duas ferramentas, com o aporte dasMetodologias Ativas de Ensino-Aprendizagem(MAEA), converteu-seem umrelato de experiência de ensino da exitosoda Dentística,a saber: (1) demonstração tridimensional da formação de cavidades com materiaisacessíveis, com base napinturacom tinta guache das paredes cavitáriase ângulos de macromodelos de gesso,representando preparosintracoronário e extracoronárioparcial (onlay);e(2) gamificação, por meio de quebra-cabeçadeprojeçãodeimagem dos diferentestipos de preparos cavitários.O uso de recursos com basenas MAEAdemonstrou resultados promissores, interconectandoáreas de ensino da dentística, vistas como dicotômicas, teórica e prática, ensinosbásico e clínico, assimcomo promovendoo despertar, a adesão e o desenvolvimento de habilidades manuaisdo estudante (AU).

The aim of this study was to demonstrate a teaching-learning process of a ludic nature and student engagement, in a dental graduation course, at a time when the transition in the teaching of subjects is taking place. The basic cycle will be highlighted by walking through the laboratoryenvironment. Even the clinical care of patients will be considered beyond the level of mere technical training. In higher education, learning fragmented by subjects and areas of specialization prevails, and there is no connection between laboratory and clinical purposes. The application of two tools, with the contribution of Active Methods of Teaching and Learning (AMTL), became a report of successful teaching experience in Dentistry, namely: (1) three-dimensional demonstration of the formation of cavities with accessible materials, based on painting the cavity walls and angles of plaster macromodels with gouache paint, representing intracoronal and partial extracoronal (onlay) preparations; and (2) gamification, by means of projecting the images of puzzle of different types of cavity preparations. The use of resources based on the AMTL has shown promising results, by interconnecting areas of teaching dentistry, seen as dichotomous, theoretical and practical, basic and clinical teaching, as well as promoting the awakening, adherence and development of students' manual skills (AU).

Dental dam utilization by dentists in an intramural faculty practice.

Objectives: From casual observation of our colleagues, only a few individuals use the dental dam for operative procedures in their faculty practice. The purpose of this study was to obtain faculty perceptions of the dental dam, quantify its utilization in their intramural faculty practice, and determine the factors that influence dental dam usage. Material and Methods: A survey containing 11 questions was sent to 19 faculty members who teach full time and maintain an intramural dental practice involving operative dentistry. Thirty electronic dental health records of the 19 providers were reviewed to gather the following information from restorative procedures they completed: isolation methods, tooth location and involved surfaces, and dental restorative material. Results: Overall, dental dam was utilized for 30% of all restorative procedures and was used less than 20% of the time for placement of class II and class III composite resins. Dental dam utilization rate by general dentists was 37% and 17.6% for prosthodontists. Those general dentists with prior history of military dental practice had a utilization rate of 78.6% and nonmilitary dentists only 7.6%. Eight faculty members responded to the questionnaire for a 42% return rate. Those who practiced dentistry in the military strongly agreed that the dental dam is the standard of care, improves their quality of restorative work, and should be documented in the dental record. Conclusions: There were significantly different dental dam utilization rates between general dentists and prosthodontists and between dentists with prior military experience and those without.

Has the implementation of the Minamata convention had an impact on the practice of operative dentistry in Jordan?

OBJECTIVE: To assess Jordanian dentists' current perception and attitudes towards amalgam and composite restorations four years after the Minamata treaty was endorsed and suggest decision making factors that may influence the type of restoration requested by patients. METHODS: The cross-sectional study was conducted through structured questionnaires distributed to dentists in Amman, Jordan from June 2017 to February 2018. RESULTS: Of the 1686 dentists who were contacted 758 dentists (response rate 45%) responded to the questionnaire either by email or via field visits. Jordanian dentists used more composite restorations than amalgam. Recurrent caries followed by fracture of the restoration were the main reasons for replacement of both fillings by dentists. However, dentists suggested that the main reason patients requested replacement of amalgam was for 'staining'. In addition, a large proportion of the dentists had experienced patients who had asked either for replacement of amalgam (77%) or refused an amalgam filling (99%) for aesthetic reasons. In the opinion of the dentists, only 20% patients requested replacement of amalgam because of the mercury content. CONCLUSION: The findings of this survey suggest that a 'phase-down' of dental amalgam is being implemented in Jordan's dental clinics but it is not associated with commitment to the Minamata Convention, rather to current dental practice trends and patients' aesthetic demands.

Development of a dental handpiece angle correction device.

BACKGROUND: Preparation of a uniform angle of walls is essential for making an ideal convergence angle in fixed prosthodontics. We developed a de novo detachable angle-correction apparatus for dental handpiece drills that could help the ideal tooth preparation. METHODS: We utilized a gyro sensor to measure the angular velocities to calculate the slope of an object by integrating the values, acceleration sensor to calculate the slope of an object by measuring the acceleration relative to gravity, and Kalman filter algorithm. Converting the angulation of the handpiece body to its drill part could be performed by a specific matrix formulation set on two reference points (2° and 6°). A flexible printed circuit board was used to minimize the size of the device. For convergence angle investigation, 16 volunteers were divided randomly into two groups for performing tooth preparation on a mandibular first molar resin tooth. All abutments were scanned by a 3D scanner (D700®, 3Shape Co., Japan), the convergence angle and tooth axis deviation were analyzed by a CAD program (SolidWorks 2013®, Dassault Systems Co., USA) with statistical analysis by Wilcoxon signed-rank test (α = 0.05) using SPSS statistical software (Version 16.0, SPSS Inc.). RESULTS: This device successfully maintained the stable zero point (less than 1° deviation) at different angles (0°, 30°, 60°, 80°) for the first 30 min. In single tooth preparation, without this apparatus, the average bucco-lingual convergence angle was 20.26° (SD 7.85), and the average mesio-distal (MD) convergence angle was 17.88° (SD 7.64). However, the use of this apparatus improved the average BL convergence angle to 13.21° (SD 4.77) and the average MD convergence angle to 10.79° (SD 4.48). The angle correction device showed a statistically significant effect on reducing the convergence angle of both directions regardless of the order of the directions. CONCLUSIONS: The angle correction device developed in this study is capable of guiding practitioners with high accuracy comparable to that of commercial navigation surgery. The volume of the angle correction device is much smaller than that of any other commercial navigation surgery system. This device is expected to be widely utilized in various fields of orofacial surgery.

The Effect of Magnification Loupes on Dental Hygienists' Posture while Exploring.

Purpose: The purpose of this study was to determine the effects of dental magnification loupes on posture during instrumentation.Methods: A convenience sample of 27 right-handed dental hygienists, with no prior history of injuries or disabilities of the head, neck, or trunk region, enrolled in the study. Baseline posture calibration was taken and tri-axial accelerometers were placed on four locations of the head and trunk (occipital region of head; cervical vertebrae C5; thoracic vertebrae T5; lumbar vertebrae L1) to measure acceleration and the orientation of the body to gravity. Participants were randomly assigned to wear self-supplied magnification loupes during either the first or second half of the session. Dental chair mounted typodonts, prepared with artificial calculus, were used to represent a simulated oral environment. Participants were asked to explore all areas of the mouth using an ODU 11/12 explorer. Mean accelerations of the three axes were used to compute average forward/backward (AP) and side to side (ML) tilt of each accelerometer recorded during the instrumentation sessions. An end-user opinion survey was completed by each participant at the conclusion of the session.Results: No statistically significant differences in posture were revealed between the sessions with the participants wearing their loupes and not wearing loupes. However, data from the end-user survey indicate that 74% of all the participants strongly agreed that magnification loupes made exploring easier and 67% strongly agreed that they felt that magnification loupes improved their posture.Conclusion: While the majority of participants perceived that their magnification loupes enhanced their posture and made exploring easier, data from this study provided little evidence to suggest that wearing loupes leads to improved body orientation. Future research needs to examine the declination angle of ergonomic loupes and its relationship to neck and trunk flexion.

Regional Nerve Blocks for Equine Dentistry.

Regional nerve blocks are necessary to facilitate equine oral surgery in the standing sedated patient. Step-by-step instruction on how to perform common regional nerve blocks are discussed, including infraorbital, maxillary, middle mental, and inferior alveolar nerve blocks. Regional nerve blocks are critical when performing dental procedures in the standing horse.1 The infraorbital and maxillary nerve blocks provide anesthesia of the infraorbital nerve, which is a branch of the maxillary nerve. Both nerve blocks provide adequate anesthesia for all maxillary dental procedures.1 When the infraorbital nerve block is utilized, care must be taken to advance the needle into the infraorbital foramen in order to appropriately anesthetize the caudal maxillary teeth. Mandibular dental procedures require anesthesia of the inferior alveolar nerve, which is a branch of the mandibular nerve. Local anesthesia at the level of the mental foramen will result in anesthesia of ipsilateral incisors and canines, while anesthesia at the level of the mandibular foramen will anesthetize the entire ipsilateral mandibular dental quadrant. All nerve blocks should have the injection site aseptically prepared prior to the procedure. The 4 most common dental nerve blocks are described step by step.

Uso de resina bulk-fill e novo sistema de matriz seccional para otimizar restaurações Classe II / The use of a bulk-fill composite and a new sectional matrix system for optimization for Class II restorations

Novas tecnologias aliadas a novos materiais vêm de encontro à filosofia de facilitar a clínica diária, diminuindo o número de passos, consequentemente diminuindo a chance de erro se utilizando menos tempo clínico para obter bons resultados. Paciente do gênero masculino,38 anos, apresentava uma restauração classe II OD deficiente no elemento 36. Foi realizado oexame clínico, radiográfico e seleção de cor. Sobre isolamento absoluto, a restauração antiga e a lesão de cárie foram removidas. Para a realização da nova restauração foi utilizado um sistema de matriz seccional e uma resina composta de baixa tensão de contração de polimerização e baixa viscosidade com a técnica bulk-fill, seguida por uma resina convencional como é preconizado.Pode-se observar que a técnica bulk-fill é bastante simples quando comparada à técnica incremental tradicional e aliada ao uso do sistema de matrizes seccionais otimizam ainda mais o dia-a-dia na clínica.

New technologies associated with new materials have been introduced to facilitate the dailyclinical procedures, reducing the number of steps, thus reducing the chance of mistakes andchair time for clinical procedures. Male patient, 38 years old, had a deficient OD class II restorationin the lower left first molar. Clinical examination, x-ray and color selection were performed.Using rubber dam isolation, the old restoration and caries were removed. For the new restorationa sectional matrix system and a low-stress flowable bulk-fill composite were used, followedby a conventional nanohybrid composite as recommended. It can be seen that the bulk-fill techniqueis quite simple compared to the traditional incremental technique and combined withthe system of sectional matrix system further optimize the restorative procedures.

Introducing loupes to clinical practice: dental hygienists experiences and opinions.

OBJECTIVES: Recent literature has identified a number of potential advantages in wearing loupes for dental hygienists, including improved quality of care and ergonomics. The aim of the study was to determine dental hygienists' opinions about wearing loupes. METHODS: A short online survey was distributed to all dental hygienists who had recently participated in a study investigating the efficacy of loupes on musculoskeletal disorders; all had only worn loupes for a 6-month period, and prior to the study had not worn loupes. All of those invited completed the survey (n = 12), achieving a 100% response rate. RESULTS: The majority of respondents noted that the loupes were adaptable to wear; however, only one-quarter of hygienists surveyed were wearing them often following the study. Respondents identified that the biggest advantage to loupes was calculus removal (91.7%), and most indicated that they felt the quality of their work increased when wearing loupes (75%). The biggest disadvantage to wearing loupes was the adjustment period (50%), with limited depth of vision, headache, vertigo and infection control noted by at least one-third of respondents. CONCLUSIONS: This study revealed that hygienists identify both benefits and limitations to wearing loupes, and therefore, ongoing support may be required for hygienists adopting their use in clinical practice.

Influence of the operatory field isolation technique on tooth-colored direct dental restorations.

PURPOSE: To evaluate, through a systematic review, the influence of the operatory field isolation technique on the longevity of dental restorations performed with tooth-colored materials. METHODS: An electronic search of the scientific databases (MEDLINE, SCIRUS, VHL and SIGLE) and reference lists of the selected articles was conducted to identify randomized controlled clinical trials with a follow-up period of at least 12 months. The selected articles evaluated the effects of the operatory field isolation techniques (rubber dam or cotton rolls/saliva ejector) on the longevity of direct restorations performed with tooth-colored materials (e.g. resin composites, compomers and glass-ionomer cements) in primary or permanent posterior teeth. The selected studies were analyzed and categorized using a checklist proposed by the National Institute for Health and Clinical Excellence of the United Kingdom. RESULTS: 484 studies were identified on the scientific databases. After applying the exclusion criteria and removal of duplicates, a total of nine studies were considered as potentially eligible. From these, five studies were included in the final analysis by two evaluators. In four studies analyzed, the use of rubber dam did not influence the longevity of restorations in comparison to cotton rolls/saliva ejector. Only two studies were considered as low risk of bias.

[Comparative analysis and clinical experience with osteoplastic materials materials based on non-demineralized bone collagen and artificial hydroxylapatite at the close of bone defects in ambulatory surgical dentistry].

BACKGROUND: In the presence of bone defects during surgery is not always performed osteoptastic material replenishment defect that leads to a lengthening of the timing healing, bone regeneration, and treatment outcome. Application of osteoplastic materials allows for faster treatment outcomes, accelerate the regeneration of bone tissue in the area of the defect. AIM: To examine the effectiveness of materials based on non-demineralized bone collagen and artificial hydroxylapatite when filling bone defects in outpatient surgical practice dentistry. PATIENTS AND METHODS: 22 patients with bone defects of various localization using osteoplastic materials were examined and treated. In our study, two groups were allocated on the etiology of bone loss: radicular cysts and chronic generalized periodontitis. Basic methods of diagnosis and monitoring of treatment in the work presented with the cone-beam computed tomography and digital orthopantomography. RESULTS: Application of the testing osteoplastic materials resulted in faster recovery times with a combination of bone defects using resorbable membranes or gel enriched fibrin. In all 22 patients both tested materials were well tolerated, allergic reactions were not identified. However, five patients with a history of endocrinological history, during which treatment material is applied on the basis non-demineralized bone collagen, the degree of osseointegration has been reduced by 25% compared to the somatic healthy patients. In 3 patients with a history of hematological history, during which the treatment was applied material on the basis of artificial hydroxyapatite, the regeneration of the bone defect was reduced by 20%, which suggests the influence of somatic condition of the patient on the regeneration of bone tissue. Currently, all patients are on dynamic monitoring, recurrence has been detected. CONCLUSION: Materials based on non-demineralized bone collagen and hydroxyapatite artificial equally successful during the replacement of the bone defect during surgery. However, the degree of regeneration may be different if the patient has a history of aggeravated that should be considered when planning treatment.

Sedative effects of oral midazolam, intravenous midazolam and oral diazepam in the dental treatment of children.

OBJECTIVE: To evaluate and compare the behavioral changes and effect of sedative techniques in pediatric dental patients using Oral Midazolam, Intravenous Midazolam and Oral Diazepam as sedative agents. METHOD: Triple blind randomized control trial with 40 patients aged between 2-10 years, exhibiting definitely negative behavior was considered. Patients were randomly assigned to one of the four treatment groups. Group I received midazolam 0.5 mg/kg orally, Group II received 0.5 mg/kg diazepam orally, Group III received 0.06 mg/kg midazolam intravenously and Group IV received oral placebo. Behavioral changes (sleep, crying, movement, and overall behavior) and effect of sedative techniques on pediatric patients were assessed. RESULTS: All the patients in group 3 were significantly better in post administrative behavior viz. sleep, crying and movement. Over all behavior scores for group 3 patients were significantly better than other three groups (p < 0.001). Positive behavior of patients in group 2 and 3 did not show significant difference but positive behavior in group 3 was significantly (p < 0.05) more than group 2. Placebo group showed the highest negative behavior CONCLUSION: Sedative effects of oral midazolam and oral diazepam were comparable, where as intravenous midazolam produced more sedation. Anxiolysis was found to be more in both the midazolam groups than the diazepam group. Most number of positive changes were observed in midazolam groups as compared to diazepam group.

Are friends electric?: A review of the electric handpiece in clinical dental practice.

UNLABELLED: Contemporary restorative procedures demand precise detail in tooth preparation to achieve optimal results. Inadequate tooth preparation is a frequent cause of failure. This review considers the electric high-speed, high-torque handpiece and how it may assist clinicians in achieving greater accuracy in tooth preparation. CLINICAL RELEVANCE: The electric handpiece provides a satisfactory alternative to the air-turbine and may be considered by clinicians who wish greater control with operative procedures.