Comportamiento del Servicio de Urgencia Estomatológica en tiempos de covid-19. Jagüey Grande, Matanzas, 2020 / Behavior of the Dentistry Emergency Service in the times of COVID-19. Jagüey Grande, Matanzas, 2020

RESUMEN Introducción: en marzo de 2020, la Organización Mundial de la Salud determinó que la covid-19 podía caracterizarse como una pandemia. Desde entonces, Cuba implementó medidas de control sanitario y evita el colapso de los servicios de salud. Por su parte, la atención estomatológica básica quedó sustituida por la de urgencias y es brindada por personal calificado con equipos de protección. Objetivos: describir el comportamiento de la atención a urgencias estomatológicas. Materiales y métodos: se realizó un estudio observacional, descriptivo y transversal (de marzo a agosto de 2020), a un universo constituido por 3 722 pacientes atendidos en dicho período, 32 estomatólogos y 29 licenciados. Se estudiaron las variables edad, sexo y patología de urgencias. Resultados: entre los estomatólogos que atendieron urgencias, predominaron los de 22 a 35 años (68,75 %), el sexo femenino (77,27 %) y licenciadas del grupo de 36 a 50 años (68,96 %). Los pacientes atendidos en Urgencias fueron mayormente de 19 a 59 años (76,03 %) y de sexo masculino (52,76 %). Los motivos más representativos de asistencia allí, fueron la odontalgia (53,68 %), el absceso alveolar agudo (17,35 %), la hiperestesia dentinaria (6,15 %) y la estomatitis aftosa (5,02 %). Conclusiones: la atención estomatológica de urgencia fue brindada fundamentalmente por personal joven, no comprendido dentro del grupo vulnerable, de sexo femenino. Las principales urgencias estomatológicas fueron la odontalgia por estados inflamatorios pulpares, el absceso alveolar agudo, la hiperestesia dentinaria y la estomatitis aftosa, prevaleciendo pacientes adultos del sexo masculino (AU).

ABSTRACT Introduction: in March 2020, the World Health Organization decided that COVID-19 could be characterized as a pandemic. Since then on, Cuba has implemented health control measures and prevents the collapse of the health services. For its part, basic dentist care was replaced by emergency care and is provided by qualified personnel with protective equipment. Objective: to describe the behavior of care to dentistry emergencies. Materials and methods: a cross-sectional, descriptive, observational study was carried out to a universe formed by 3 722 patients, 32 dentists and 29 bachelors. The variables age, gender and emergency pathology were studied. Results: among the dentists who attended the emergency, those aged 22-35 years (68.75 %), who were female (77.27 %), and bachelors from the 36-50 age group (68.96 %) predominated. The patients treated in the Emergencies were mostly 19 to 59 years old (76.03 %) and male (52.76 %). The most representative reasons for care there were toothache (53.68 %), acute alveolar abscess (17.35 %), dental hyperesthesia (6.15 %) and aphthous stomatitis (5.02 %). Conclusions: emergency dentistry care was provided mainly by young female persons, not included within the vulnerable group. The main dentistry emergencies were toothaches by pulpal inflammatory states, acute alveolar abscess, dental hyperesthesia and aphthous stomatitis, prevailing adult male patients (AU).

Impacto académico de la COVID-19 en estudiantes cubanos de Estomatología / Academic impact of the COVID-19 in Cuban dental students

Introducción: La COVID-19 ha impactado en diversos ámbitos de la educación superior, por lo que es necesario generar investigaciones que aporten evidencias sobre el tema. Objetivo: Validar una escala para evaluar las percepciones de los estudiantes cubanos de Estomatología sobre el posible impacto académico a causa de la COVID-19. Métodos: Estudio de tipo instrumental y transversal. A partir de un instrumento en español validado en estudiantes de medicina y otros universitarios peruanos, se realizó el primer paso de la validación mediante el criterio de expertos. Luego se desarrolló un análisis factorial exploratorio (AFE) por mínimos cuadrados no ponderados y se calculó la consistencia interna con el Alpha de Cronbach. Resultados: Se incluyó a 159 participantes de los cuales el 60,38 por ciento fueron hombres y la media de la edad fue 21,86 años. Todos los ítems recibieron una evaluación favorable por parte de los expertos (V > 0,70). De la escala inicial, el análisis preliminar sugirió eliminar el ítem 6. La pertinencia del análisis factorial exploratorio se justificó con el índice KMO (0,801) y la prueba de Bartlett (344,8; gl = 15; p = 0,000) cuyos valores fueron aceptables y significativos. Se obtuvo un coeficiente de Cronbach de 0,915 (IC 95 por ciento = 0,90-0,91), lo cual indica que la consistencia del instrumento es buena. Conclusiones: Se validó una escala de factor único que mide la percepción que tienen los estudiantes cubanos de Estomatología acerca de las posibles repercusiones académicas de la COVID-19(AU)

Introduction: COVID-19 pandemic has impacted in different scopes of higher education, that is why is necessary to generate researches that contribute with evidences on this topic. Aim: To validate a scale for evaluating the Cuban dental students' perceptions on the possible academic impact of the COVID-19. Methods: Instrumental and cross-sectional study. Starting from a Spanish language instrument validated in Peruvian medical and other university students, the first step of the validation through the expert's criteria was performed. After, a factorial exploratory analysis (FEA), by not pondered minima squares, was performed and the internal consistency was measured through Alpha of Cronbach. Results : 159 students were suitable for analysis; 60.38 percent were men and the mean age was 21.86 years. All items were evaluated in a favorable way by the expert's criteria. From the initial scale, the preliminary analysis suggested to eliminate the item 6. The relevance of the FEA was justified with the KMO index (0.801) and Bartlett's test (344.8; gl=15; p=0.000) being acceptable and significant. An Alpha of Cronbach's coefficient of 0.915 with a 95 percent confidence interval of 0.90-0.91 was obtained; indicating that the consistency of the instrument is good. Conclusions : A single factor scale measuring Cuban dental students' perception of the possible academic impact of the COVID-19 was validated(AU)

Percepción de los estudiantes del grado de Odontología sobre la utilización de un sistema de respuesta interactiva (Kahoot) / Perception of students in dentistry degree on the use of an interactive response system (Kahoot)

Introducción: La adquisición de competencia clínica de diagnóstico en el alumnado de grado de Odontología debe potenciarse con metodologías docentes que le permitan realizar un aprendizaje continuo y autónomo de las materias clínicas. Objetivo: El objetivo del presente trabajo es analizar la percepción de los estudiantes sobre la utilización de la herramienta Kahoot® en la asignatura de Medicina Oral (tercer curso del grado) como estrategia educativa para el reconocimiento de lesiones orales mediante la realización de una encuesta de satisfacción sobre su uso. La herramienta Kahoot® permite a los docentes plantear cuestiones de respuesta múltiple o de verdadero-falso que los alumnos deben responder en un tiempo limitado a través de sus ordenadores personales, teléfonos móviles u otros dispositivos electrónicos conectados a la red wifi. Tras cada respuesta, la herramienta registra la opción correcta y los resultados obtenidos por cada alumno/a, así como su puntuación final y la global del grupo. Materiales y método: Empleamos Kahoot® en cinco de las unidades temáticas del programa durante las clases expositivas. Posteriormente, realizamos al alumnado un test de valoración mediante una escala de tipo Likert (1-5) para registrar la facilidad de utilización y la satisfacción de uso. Resultados: Los resultados obtenidos en los ítems facilidad de uso del sistema (4,31 ± 0,74), motivación (4,18 ± 0,75) y capacidad para aclarar conocimientos (4,13 ± 0,61) muestran una valoración positiva por el alumnado. Conclusiones: Esta metodología de aprendizaje a partir de juegos ha favorecido la enseñanza de conceptos teórico-prácticos y la adquisición de competencias transversales y específicas del grado de Odontología, además de fomentar la participación y el aprendizaje en el aula, lo que orienta al alumnado sobre los principales contenidos del programa y permite una evaluación interactiva de su rendimiento.(AU)

Introduction: The acquisition of clinical diagnostic competence in undergraduate Dentistry students must be enhanced with teaching methodologies that allow them to carry out continuous and autonomous learning of clinical subjects. Aim: The objective of this work is to analyze the students’ perception of the use of the Kahoot® tool in the subject of Oral Medicine (3rd year of the Degree) as an educational strategy for the recognition of oral lesions by conducting a satisfaction survey on its use. The Kahoot® tool allows teachers to pose multiple-answer, or true-false, questions that students must answer in a limited time through their personal computers, mobile phones, or other electronic devices connected to the wifi network. After each answer, the tool records the correct option and the results obtained by each student, as well as their final score and the overall score for the group. Materials and methods: We used Kahoot® in 5 of the thematic units of the program during the lectures/expositive classes. Subsequently, we performed an assessment test on the students using a Likert scale (1-5) to record ease of use and satisfaction with use. Results: The results obtained in the items ease of use of the system (4.31 ± 0.74), motivation (4.18 ± 0.75) and ability to clarify knowledge (4.13 ± 0.61) show the assessment positive by the students. Conclusions: This learning methodology based on games has favored the learning of theoretical-practical concepts and the acquisition of transversal and specific competences of the degree of Dentistry in addition to promoting participation and learning in the classroom, guiding the students on the main contents of the program allowing a interactive evaluation of student performance.(AU)

Cuidados en los servicios de Prótesis frente a la pandemia por covid-19 / Cares in the Prosthetic services toward COVID-19 pandemic

RESUMEN La covid-19 es una enfermedad infecciosa causada por el virus SARS-CoV-2, y es capaz de provocar un cuadro clínico variable. Los individuos que están en contacto estrecho con pacientes positivos de esta enfermedad, tienen un mayor riesgo de infección. Así les sucede a los trabajadores de la salud que atienden directamente a pacientes. Al igual que otros servicios de salud, la atención estomatológica requiere del contacto estrecho entre el profesional y el paciente. El objetivo de este trabajo fue describir las principales recomendaciones para la prevención y control de infecciones por SARS-CoV-2 en los servicios de Prótesis. En la práctica dental, la prevención, el control y la reducción de la transmisión de infecciones se realiza a través del uso del equipo de protección personal y de un conjunto de procedimientos de descontaminación, desinfección y esterilización en cualquier superficie o instrumento. La constante actualización científica y la adopción de medidas de protección antes, durante y después de la atención estomatológica, podrán garantizar el éxito de la atención médica con el mínimo riesgo de contagio (AU).

ABSTRACT COVID-19 is an infectious diseases caused by SARS-CoV-2 virus, and it is able to provoke variable clinical characteristics. The individuals that are in close contact with this disease positive patients are at higher infection risk. That is the case of the heath care workers directly caring for patients. As in any health service, dentistry care requires the narrow contact between the professional and the patient. The aim of this paper was describing the main recommendations for preventing and control SARS-CoV-2 in Prosthetic services. In the dental practice, the prevention, control and reduction of infection transmission is achieved using the personal protection equipment and a whole of decontamination, disinfection and sterilization procedures in any surface or device. The constant scientific updating and adopting protection measures before, during and after the dentistry care can ensure the success of health care with the minimal risk of contagion (AU).

Teledentistry in the diagnosis of oral lesions: A systematic review of the literature.

OBJECTIVE: The purpose of this systematic review is to summarize information on the use of teledentistry in the diagnosis of oral lesions. MATERIALS AND METHODS: A systematic literature search conducted in August 2018 included articles published until December 2018 in 4 databases. Two reviewers evaluated the search results separately. If they were uncertain as to whether to include an article, a third reviewer made the final decision. Studies related to the diagnosis of oral lesions using teledentistry were included. The methodological quality of the studies was analyzed using the Quality Assessment of Studies of Diagnostic Accuracy. RESULTS: Eleven articles were included in the study. The selected articles were published between 1999 and 2018, predominantly in developing countries. The professionals acting as patient examiners are dental students and dentists, as well as other health professionals. Most of the patients evaluated in the studies were from rural populations or locations distant from large centers. The tools used to obtain patient data were smartphones, videoconference, email, questionnaires, histopathological exams, and telemedicine applications and systems. Most studies concluded that there is a high level of agreement between teledentistry and clinical consultation and that the use of this resource for diagnostic purposes can reduce costs and the travel time to consult a specialist personally. Nine of the 11 studies were of good quality. CONCLUSIONS: Teledentistry has the potential to improve the care quality related to diagnosis and management of oral lesions, shortening distances between patients who need specialized diagnoses and specialists.

Recent Advances in Cone-beam CT in Oral Medicine.

BACKGROUND: The cone-beam computed tomography (CBCT) technology has continuously evolved since its appearance in oral medicine in the early 2000s. OBJECTIVES: To present recent advances in CBCT in oral medicine: i) selection of recent and consensual evidence-based sources, ii) structured summary of the information based on an iterative framework and iii) compliance with ethical, public health and patient-centered concerns. MAIN FINDINGS: We will focus on technological advances, such as sensors and reconstruction algorithms used to improve the constant quality of the image and dosimetry. CBCT examination is now performed in almost all disciplines of oral medicine: currently, the main clinical disciplines that use CBCT acquisitions are endodontics and oral surgery, with clearly defined indications. Periodontology and ear, nose and throat medicine are more recent fields of application. For a given application and indication, the smallest possible field of view must be used. One of the major challenges in contemporary healthcare is ensuring that technological developments do not take precedence over admitted standards of care. The entire volume should be reviewed in full, with a systematic approach. All findings are noted in the patient's record and explained to the patient, including incidental findings. This presupposes the person reviewing the images is sufficiently trained to interpret such images, inform the patient and organize the clinical pathway, with referrals to other medical or oral medicine specialties as needed. CONCLUSION: A close collaboration between dentists, medical physicists, radiologists, radiographers and engineers is critical for all aspects of CBCT technology.

Referentes sobre la prevención de la COVID-19 en Estomatología / References on the prevention of COVID-19 in the Dental Service

RESUMEN Introducción: La atención estomatológica expone a los sujetos actuantes al riesgo de infectarse y presentar la enfermedad por el coronavirus-2, denominada COVID-19. Objetivo: Ofrecer un referente teórico sobre la COVID-19 que sustente la preparación de los estomatólogos para la percepción del riesgo y la autoprotección en las condiciones actuales de esta pandemia. Método: En el Hospital General Docente "Dr. Agostinho Neto", entre marzo y junio de 2020 se hizo una revisión narrativa sobre este tema a través de una búsqueda en diferentes bases de datos bibliográficas: Pubmed/Medline, Science Direct y SciELO. Resultados: Se encontraron artículos de varios autores que aportan al conocimiento de la prevención del nuevo coronavirus en los servicios de salud. Conclusiones: Tener en cuenta la vía de transmisión del SARS-CoV-2 revela que los estomatólogos son uno de los profesionales de las ciencias de la salud con mayor riesgo de enfermar por la COVID-19, lo que hace necesario se apropien de las bases teóricas esenciales para su prevención y diagnóstico, las que quedan sistematizada en el artículo que se presenta.

ABSTRACT Introduction: Dental care exposes acting personnel to the risk of infection and of acquiring the coronavirus-2 disease, called COVID-19. Objective: To provide a theoretical reference on COVID-19 to support the preparation of stomatologists for risk perception and self-protection in the current conditions of this pandemic. Method: At the General Teaching Hospital "Dr. Agostinho Neto", between March and June 2020 a narrative review was made on this topic through a search in different bibliographic databases: Pubmed/Medline, ScienceDirect and SciELO. Results: It was found articles by several authors that contribute to the knowledge of the prevention of the new coronavirus in the health services. Conclusions: Taking into account the way of transmission of SARS-CoV-2 reveals that oral medicine specialists are one of the health science professionals with the greatest risk of illness from COVID-19, therefore, it is necessary to set up the essential theoretical bases for its prevention and diagnosis, which are reflected in this article.

World Workshop on Oral Medicine VII: What participants perceive as important.

Our objective was to identify which aspects of World Workshop on Oral Medicine (WWOM) participation were perceived as significant for participants' professional development. Online survey was sent to previous WWOM participants. Qualitative analysis of participants' responses to an open-ended question was performed. Fifty-two WWOM participants responded. Nearly three quarters of respondents (72.3%) felt that participation in the WWOM helped their career. A high percentage of respondents (67.3%) provided answers that fell under the domains of international collaboration, followed by personal academic benefits (48%). Overall, the results indicate that WWOM participation played an important role in individual's professional development. We identified aspects of WWOM involvement that the participants perceived as important. This information will be used for the development of an objective instrument for measuring impact of WWOM on participant's professional path.

Circular RNAs: Diversity of Functions and a Regulatory Nova in Oral Medicine: A Pilot Review.

Oral diseases, such as cancers, inflammation, loss of bone/tooth/soft tissues, are serious threats to human health since some can cause systemic disease and effective treatments are limited. Thus, discovering promising biomarkers for physiological and pathological processes in oral medicine, and identifying novel targets for therapy have become a most critical issue. Recently, circular RNAs (circRNAs), which were once thought to be a class of non-coding RNAs (ncRNAs), are found to be of coding potential. CircRNAs are highly present in the cytoplasm of eukaryotic cells and are key elements in the physiological and biological processes of various pathological conditions, and are also reflected in oral development and progress. Previous studies have indicated that circRNAs are involved in the initiation and development of different types of diseases and tissues (e.g., cancers, cardiovascular diseases, neural development, growth and development, wood healing, liver regeneration). Moreover, growing evidence demonstrates that circRNAs play vital roles in oral cancers and osteogenic differentiation of periodontal ligament stem cells (PDLSCs). Here, we focus on the biological characteristics of circRNAs, beginning with an overview of previous studies on the functional roles of circRNAs as diagnostic biomarkers and therapeutic targets in oral medicine. We hope this will give us a promising new comprehension of the underlying mechanisms occurring during related biological and pathological progress, and contribute to the development of effective diagnostic biomarkers and therapeutic targets for oral diseases.

Experiencias de los estudiantes de estomatologia en el control de la conducta de niños. Analisis cualitativo / Experiences of stomatology students in the control of child behavior. Qualitative analysis

Introducción: Uno de los factores que influyen en la atención de los pacientes pediátricos, es la susceptibilidad de los niños a desarrollar con facilidad miedos y temores ante una situación desconocida y sobre todo cuando se trata de la práctica odontológica. Objetivo del estudio es conocer las experiencias de los estudiantes de estomatología en relación al control de la conducta del paciente pediátrico. Metodología: Para ello fue realizado un análisis cualitativo empleado un enfoque fenomenológico de tipo trascendental. Para lo cual se realizó la entrevista a todos los estudiantes que cumplieron los criterios de selección hasta obtener la saturación de la información. El método de recolección de datos fue la entrevista recomendado por Marshall C 1, y la entrevista siguiendo el enfoque de Seidman I 2 que recomienda realizar tres entrevistas por separado a los participantes. Resultados: La información obtenida a través de entrevistas y videos fue analizada a través del programa informático Atlas.Ti. Donde se obtiene como resultados la falta de confianza de los estudiantes al momento de atender pacientes pediátricos. Y como se va adquiriendo esta confianza al momento de realizar sus prácticas pre profesionales orientadas por el docente. Conclusiones: Se concluye que el estudiante no adquiere las habilidades suficientes para lograr el control de la conducta del niño al momento de su atención odontológica, a pesar de tener los conocimientos teóricos. Pero ello se va supliendo siempre y cuando el estudiante toma conciencia y pone en práctica lo aprendido en la teoría

Introduction: One of the factors that influence the care of pediatric patients is the susceptibility of children to easily develop fears and fears in an unknown situation and especially when it comes to dental practice. Objective of the study is to know the experiences of stomatology students in relation to the control of the behavior of the pediatric patient. Methodology: For this, a qualitative analysis was carried out in a transcendental phenomenological approach. Why the interview was conducted to all students who met the selection criteria to obtain the saturation of the information. The method of data collection was approved by Marshall C 1, and the interview following the approach of Seidman I 2 that recommends conducting three separate interviews to participants. Results: The information obtained through interviews and videos was analyzed through the Atlas.Ti computer program. Where the lack of confidence of the students at the time of attending pediatric patients is obtained as results. And how this confidence is acquired at the moment of carrying out their pre-professional practices guided by the teacher. Conclusions: It is concluded that the student cannot acquire sufficient skills to achieve control of the child's behavior at the time of dental care, despite having the theoretical knowledge. But this can be provided as long as the student becomes aware and puts into practice what they have learned in theory

Perioperative intervention by oral medicine team in cardiovascular surgery patients.

In brief, perioperative oral intervention consists of elimination of odontogenic foci and maintenance of oral hygiene in patients undergoing surgery. The importance of oral intervention before, during, and after medical treatments is well-known, especially in cancer patients, because odontogenic foci such as untreated deep dental caries or periodontitis can cause systemic infection in patients with myelosuppression resulting from chemotherapy. Although perioperative oral intervention is currently recommended for patients with cardiovascular disease, its efficacy in this population has not been established. This article consists of three sections: first, we review the current knowledge about the association between dental disease and cardiovascular disease to show the importance of oral hygiene maintenance and the risks of invasive dental procedures in patients with cardiovascular disease; second, we introduce pertinent, but limited evidence concerning the effect of oral care in preventing postoperative pneumonia; and finally, we present the optimal strategy for perioperative oral intervention in cardiovascular surgery patients.

Boosted photoelectrochemical immunosensing of metronidazole in tablet using coral-like g-C3N4 nanoarchitectures.

A simple, facile and sensitive photoelectrochemical (PEC) bioassay protocol for metronidazole (MNZ) detection in common oral medicine samples has been proposed under visible-light irradiation, where novel hierarchical coral-like g-C3N4 nanoarchitectures (cg-C3N4) have been first explored as PEC sensing platform. Featured with the unique nanostructures (e.g., interlaced porous network architecture, and open boundaries), the as-formed cg-C3N4 nanoarchitectures not only efficiently inhibit the recombination of photogenerated electron-hole but also enable the immobilization of capture antibodies as well as the antibody-antigen binding efficiency fluently, thus amplifying the photocurrent response. This newly constructed PEC immunoassay displays excellent performance for MNZ determination with high sensitivity and selectivity. Under the optimal condition, this bioassay protocol exhibits a linear range of 0.01-100 µM with a detection limit of 0.005 µM at signal to noise ratio of 3. The resulting PEC immunoassay has been proved to be applicable for sensing MNZ in common oral medicine samples.

Propuesta de Guía metodológica para evaluar la calidad de un servicio de Estomatología General Integral / Proposal for a methodological guide to evaluate the quality of a General Comprehensive Stomatology service

RESUMEN Fundamentación: Para la evaluación de la calidad de los servicios de salud se necesitan instrumentos que permitan una visión individual e integral de su estructura, procesos y resultados. Objetivo: Proponer una guía metodológica para evaluar la calidad de un servicio de Estomatología General Integral. Metodología: Se utilizó como método del nivel empírico: el análisis documental (documentos, programas, investigaciones relacionadas). La guía metodológica propuesta consta de dos etapas, la primera: constitución y capacitación del equipo de trabajo y la segunda: aplicación de la Guía metodológica para la evaluación de indicadores de tres dimensiones de calidad del servicio (estructura, proceso y resultado) a los que se les da la categoría de bien, regular o mal, según la sumatoria de los puntos. Conclusiones: La Guía metodológica propuesta puede ser un instrumento para la evaluación de la calidad de un servicio de Estomatología General Integral, al permitir la identificación de los problemas, según los componentes estructura, proceso y resultado.

ABSTRACT Background: For the evaluation of the quality of health services, instruments are needed which allow an individual and integral vision of their structure, processes and results. Objective: To propose a methodological guide to evaluate the quality of a General Comprehensive Stomatology service. Methodology: The method of the empirical level was used: documentary analysis (documents, programs, related research). The proposed methodological guide consists of two stages, the first: constitution and training of the work team and the second: application of the Methodological Guide for the evaluation of the three dimensions quality service indicators: structure, process and result, to which they are given the category of good, regular or bad, according to the sum of points. Conclusions: The proposed Methodological Guide can be an instrument for the evaluation of the quality of a General Comprehensive Stomatology service, by allowing the identification of problems, according to the components structure, process and result.

Propuesta de Guía metodológica para evaluar la calidad de un servicio de Estomatología General Integral / Proposal for a methodological guide to evaluate the quality of a General Comprehensive Stomatology service

RESUMEN Fundamentación: Para la evaluación de la calidad de los servicios de salud se necesitan instrumentos que permitan una visión individual e integral de su estructura, procesos y resultados. Objetivo: Proponer una guía metodológica para evaluar la calidad de un servicio de Estomatología General Integral. Metodología: Se utilizó como método del nivel empírico: el análisis documental (documentos, programas, investigaciones relacionadas). La guía metodológica propuesta consta de dos etapas, la primera: constitución y capacitación del equipo de trabajo y la segunda: aplicación de la Guía metodológica para la evaluación de indicadores de tres dimensiones de calidad del servicio (estructura, proceso y resultado) a los que se les da la categoría de bien, regular o mal, según la sumatoria de los puntos. Conclusiones: La Guía metodológica propuesta puede ser un instrumento para la evaluación de la calidad de un servicio de Estomatología General Integral, al permitir la identificación de los problemas, según los componentes estructura, proceso y resultado (AU)

ABSTRACT Background: For the evaluation of the quality of health services, instruments are needed which allow an individual and integral vision of their structure, processes and results. Objective: To propose a methodological guide to evaluate the quality of a General Comprehensive Stomatology service. Methodology: The method of the empirical level was used: documentary analysis (documents, programs, related research). The proposed methodological guide consists of two stages, the first: constitution and training of the work team and the second: application of the Methodological Guide for the evaluation of the three dimensions quality service indicators: structure, process and result, to which they are given the category of good, regular or bad, according to the sum of points. Conclusions: The proposed Methodological Guide can be an instrument for the evaluation of the quality of a General Comprehensive Stomatology service, by allowing the identification of problems, according to the components structure, process and result (AU)

Knowledge, Attitudes, and Practices on Infection Control Measures in Stomatology Students in Lima, Peru.

Introduction: The level of knowledge, attitudes, and practices with respect to infection control measures in undergraduate stomatology students is not well understood; that is why these variables were evaluated in the students of the Universidad Privada San Juan Bautista between September and November of 2017. Methods: A cross-sectional study was carried out. A total of 347 students from the Ica, Lima Norte, and Chorrillos campuses were evaluated. The sample was calculated using the statistical formula of comparison of means. The questionnaire of the CDC (Center of Contagious Diseases) was used to measure the variables described. Results: It was observed that 72.05% of the students preferred to use oral rinsing before starting a treatment, 72.62% used the autoclave as the primary equipment to sterilize their instruments in the dental clinic, 95.10% considered that isolation is important in the control of the infection, 46.40% affirmed that tuberculosis is the most infectious disease, and only 26.51% considered it to be hepatitis B. On the other hand, it was found that the scores of knowledge, attitudes, and practices were 2.74 ± 2.16, 3.59 ± 0.88, and 3.59 ± 1.73, respectively. Conclusions: The level of knowledge was low among the students evaluated; however, as far as the level of practices and attitudes was high, even so, this topic must be reinforced so that stomatology students reflect on the importance of the risks that exist to get infected with any disease inside the dental office, as outside of it.

Errores cognitivos de diagnóstico en medicina bucal / Cognitive errors of diagnosis in oral medicine

La Medicina Bucal, como toda actividad humana, puede ser abordada desde dos sistemas de razonamiento, conocidos como Sistemas Cognitivos. El Sistema 1 es intuitivo, económico y rápido, mientras que el Sistema 2 es analítico, lento, costoso en esfuerzo, pero más confiable. Ambos sistemas interactúan entre sí, de manera que nuestra actividad de diagnóstico emplea a uno y otro. Los errores de diagnóstico en Medicina Bucal pueden basarse en falta de aplicación de reglas sistemáticas del sistema 2, o en errores cognitivos al utilizar exclusivamente el sistema 1. Estos errores derivan generalmente en considerar falso un diagnóstico verdadero, o en considerar verdadero un diagnóstico falso. Existen estrategias para reducir estos errores cognitivos, pero el paso fundamental es conocer cómo pensamos y cuáles son los errores que podemos cometer. El análisis reflexivo de los errores cognitivos de diagnóstico (metacognición) permitiría transformarlos en oportunidades de crecimiento profesional y en una mejor atención para nuestros pacientes. (AU)

Oral Medicine, like all human activity, can be approached from two systems of reasoning, known as Cognitive Systems. System 1 is intuitive, economical and fast, while System 2 is analytical, slow, costly in effort, but more reliable. Both systems interact with each other, so that in our diagnostic activity we use both. Diagnosis errors in Oral Medicine can be based on the lack of application of systematic rules of the system 2, or on cognitive errors when the system 1 is used exclusively. These errors derive generally in false considering a true diagnosis, or in considering true a diagnosis false. There are strategies to reduce these cognitive errors, but the fundamental step is to know how we think and what are the mistakes we can make. The reflexive analysis of cognitive errors of diagnosis (metacognition) would allow transforming them into opportunities for professional growth and better care for our patients. (AU)

Analgesia quirúrgica acupuntural y técnicas bioenergéticas afines en estomatología / Surgical acupunctural analgesia and bioenergetics techniques related in stomatology

Fundamento: la analgesia quirúrgica acupuntural permite realizar el tratamiento quirúrgico sin el uso de anestésicos convencionales, pues la acupuntura y la electroterapia, logran un aumento del umbral doloroso en el paciente, y producen una disminución o pérdida de la percepción del dolor. Este proceder combinado con otras técnicas bioenergéticas afines es más efectivo. Objetivo: divulgar información actualizada sobre el uso de la analgesia quirúrgica acupuntural y las técnicas bioenergéticas afines, en profesionales dela estomatología. Método: se realizó una revisión bibliográfica desde enero hasta marzo de 2017, en las bibliotecas de la facultad de Estomatología y Medicina, de la Universidad de Ciencias Médicas de la provincia Camagüey. Se consultó la bibliografía impresa, libros clásicos revistas y la información disponible en internet, que aparece escrita en los idiomas español, inglés y portugués. La búsqueda se realizó en bases de datos como: Medline, Lilacs, Dialnet, Redalyc, Hinari, Doyma, SciELO. De los 90 artículos encontrados, se incluyen 47 en la investigación, Desarrollo: la revisión bibliográfica muestra la importancia de combinar la acupuntura con técnicas eléctricas, terapias psicológicas, la hipnosis, la homeopatía y la auriculopuntura; al realizar exodoncias. Se mencionan los antecedentes históricos, conceptos, indicaciones, precauciones, contraindicaciones, equipo e instrumental, aspectos que garantizan el éxito del tratamiento. Se señalan los puntos acupunturales más útiles, ventajas de su uso, iatrogenias y eventos adversos frecuentes.Conclusiones: la analgesia quirúrgica acupuntural es un procedimiento con bases científicas en continuo desarrollo. Su indicación para exodoncias en estomatología es favorable y su eficacia es mayor al combinarla con terapias bioenergéticas afines, por tanto es necesario potenciar y desarrollar estudios rigurosos sobre este tema, para estimular y divulgar su uso entre los profesionales de la estomatología(AU)

Background: the surgical acupunctural analgesia allows accomplishing the surgical treatment without the use of conventional anesthetics, because acupuncture and electrotherapy achieve an increase of the painful doorstep in the patient and they produce a decrease or loss of the perception of the pain. This action combined with other techniques related bioenergetics is more effective. Objective: to popularize updated information on the use of the surgical acupunctural analgesia and techniques related to bioenergetics in stomatology. Methods: a bibliographic revision was carried out from January to March 2017, at the libraries of Dentistrys and Medicine´s faculty of Medical Science's University of Camagüey´s province. It was consulted the printed bibliography, classical books, magazines and the available information in internet, which appear written in the Spanish, English and Portuguese languages. The search was carried out in databases like Medline, Lilacs, Dialnet, Redalyc, Hinari, Doyma and SciELO. Of the 90 articles found, 47 are included in the investigation; a high percentage of them were published in the last five years. Development: the bibliographical review shows the importance of combining the acupuncture with electrical techniques, psychological therapies, hypnosis, homeopathy, and auriculopuncture; when performing exodontias. There are mentioned the historic background, concepts, indications, precautions, contraindications. It is pointed out the most useful acupuncture points, advantages of its use, iatrogenic and frequent adverse events. Conclusions: the surgical acupunctural analgesia is a procedure with scientific bases in continuous development. Its indication for exodontias in dentistry is clearly favorable and its efficacy is higher when combining with bioenergetics therapies, therefore it is necessary to encourage and to develop rigorous studies on this theme to stimulate and to promote its use among the professionals of dentistry(AU)

Estrategia curricular de Medicina Natural y Tradicional en la disciplina Estomatología Integral / Curricular strategy of Natural and Traditional Medicine in the Comprehensive Dentistry Discipline

Introducción: La Medicina Natural y Tradicional constituye un área formativa necesaria según el Modelo del Profesional del futuro egresado de la carrera de Estomatología y está definida como estrategia curricular en el actual plan de estudios D, en el cual la disciplina principal integradora Estomatología Integral, es el eje conductor en la formación del estudiante. Objetivo: Describir la estrategia curricular de Medicina Natural y Tradicional en la disciplina Estomatología Integral de la carrera de Estomatología. Material y Métodos: Se realizó una investigación descriptiva, de revisión analítica documental. Los documentos revisados fueron: planes de estudios de la carrera de Estomatología, las estrategias curriculares con énfasis en la de Medicina Natural y Tradicional, las disciplinas de la carrera con mayor profundidad en Estomatología Integral y sus asignaturas. Resultados: Los contenidos sobre MNT fueron incluidos en el programa de estudio de la carrera de Estomatología desde el plan de estudios C. El actual plan D los mantiene y enriquece, al establecer la MNT como una de las estrategias curriculares, la cual establece temas a abordar en 16 de las 20 asignaturas de la disciplina principal Estomatología Integral. Se observó falta de coincidencia entre los documentos vinculados para la ejecución de la estrategia. Conclusiones: La estrategia curricular de MNT de la carrera de Estomatología, establece contenidos a desarrollar en un número elevado de asignaturas de la disciplina principal Estomatología Integral, con carácter integrador con las prácticas estomatológicas convencionales, aunque se percibió falta de coincidencia entre los documentos vinculados para la ejecución de este trabajo(AU)

Introduction: Natural and Traditional Medicine constitutes a necessary formative area according to the Professional Framework of the future graduate students in Dentistry. It is defined as a curricular strategy in the current curriculum according to "D" plan, in which the main integrative discipline, Comprehensive Dentistry, is the focal point in the student´s formation. Objective: To describe the curricular strategy of Natural and Traditional Medicine in the Comprehensive Dentistry Discipline. Material and Methods: A descriptive research, with document analysis was carried out. The documents reviewed were: the curriculum in Dentistry; curricular strategies with an emphasis on Natural and Traditional Medicine; the disciplines of Dentistry, in greater detail of Comprehensive Dentistry, and their subjects. Results: The contents on NTM were included in the dental curriculum according to C plan. The current D plan maintains and improves them, when establishing the NTM as one of the curricular strategies, which presents topics that are expected to be covered in 16 of the 20 subjects of Comprehensive Dentistry as the main discipline. A lack of coincidence among the documents related to the implementation of the strategy was observed. Conclusions: The curricular strategy of NTM in the Comprehensive Dentistry Discipline establishes contents to develop in a high number of subjects of Comprehensive Dentistry as the main discipline, with an integration of conventional dental practices, although a lack of coincidence was perceived among the documents related to the implementation of this work.

Trends in polymeric electrospun fibers and their use as oral biomaterials.

Electrospinning is one of the techniques to produce structured polymeric fibers in the micro or nano scale and to generate novel materials for biomedical proposes. Electrospinning versatility provides fibers that could support different surgical and rehabilitation treatments. However, its diversity in equipment assembly, polymeric materials, and functional molecules to be incorporated in fibers result in profusion of recent biomaterials that are not fully explored, even though the recognized relevance of the technique. The present article describes the main electrospun polymeric materials used in oral applications, and the main aspects and parameters of the technique. Natural and synthetic polymers, blends, and composites were identified from the available literature and recent developments. Main applications of electrospun fibers were focused on drug delivery systems, tissue regeneration, and material reinforcement or modification, although studies require further investigation in order to enable direct use in human. Current and potential usages as biomaterials for oral applications must motivate the development in the use of electrospinning as an efficient method to produce highly innovative biomaterials, over the next few years. Impact statement Nanotechnology is a challenge for many researchers that look for obtaining different materials behaviors by modifying characteristics at a very low scale. Thus, the production of nanostructured materials represents a very important field in bioengineering, in which the electrospinning technique appears as a suitable alternative. This review discusses and provides further explanation on this versatile technique to produce novel polymeric biomaterials for oral applications. The use of electrospun fibers is incipient in oral areas, mainly because of the unfamiliarity with the technique. Provided disclosure, possibilities and state of the art are aimed at supporting interested researchers to better choose proper materials, understand, and design new experiments. This work seeks to encourage many other researchers-Dentists, Biologists, Engineers, Pharmacists-to develop innovative materials from different polymers. We highlight synthetic and natural polymers as trends in treatments to motivate an advance in the worldwide discussion and exploration of this interdisciplinary field.