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1.
Br Dent J ; 231(5): 303-304, 2021 09.
Artigo em Inglês | MEDLINE | ID: mdl-34508208

RESUMO

This article looks at some of the issues around providing and receiving dental care for autistic children and adults in the shadow of COVID-19 and suggests management approaches. COVID-19 represents yet another barrier to accessing dental care for some individuals with ASD.Dental professionals need to specifically ask families at recall about how the pandemic has,and continues to affect the individual concerned. Dental management may consequently need to be adapted to reflect this information.


Assuntos
Transtorno Autístico , COVID-19 , Adulto , Criança , Odontologia , Humanos , Pandemias , SARS-CoV-2
2.
Artigo em Inglês | MEDLINE | ID: mdl-34501710

RESUMO

This work evaluates the impact of the COVID-19 pandemic on Czech dentistry from March 2020 to March 2021. The assessment was based on questionnaires filled out by 3674 Czech dentists representing 42.6% of practicing dentists in the country. During March-May, 2020 (the first COVID-19 wave), 90.7% of dental practices remained open; however, only 22.8% of the practices continued to operate with no changes, 46.5% had fewer patients, 21.4% treated only acute cases, and 3.8% were closed. During September 2020-May 2021 (the second wave of COVID-19), 96.1% of dental practices remained open, 60.8% operated with no changes, 34.5% had fewer patients, 0.8% treated only acute cases, and 0.5% were closed. The reasons leading to the closure of Czech dental practices during the whole pandemic were a shortage of personal protective equipment (50.5%), a COVID-19 outbreak in the workplace (24.5%), fear of a possible self-infection (24.0%), and quarantine (20.5%). The time range of Czech dental practices closure during the whole pandemic was: 1-2 weeks (49.9%), 2-4 weeks (21.2%), and >1 month (0.8%). The greatest professional difficulties of Czech dentists during the pandemic were crisis operating management (55%), health safety and hygiene concerns (21%), shortage of personal protective equipment (21%), and difficulty working with the protective equipment (15%). In addition, 47.3% of dentists also observed a declining interest in preventive dental care, and 16.9% of them observed worse oral care of patients. These results show that despite the lack of protective equipment, dental care was maintained throughout the pandemic. Additionally, the pandemic negatively affected the patients' approach to dental care, indicating a deterioration in oral health as a possible delayed outcome of the COVID-19 pandemic.


Assuntos
COVID-19 , Pandemias , Estudos Transversais , República Tcheca/epidemiologia , Odontologia , Odontólogos , Humanos , SARS-CoV-2
3.
BMC Health Serv Res ; 21(1): 972, 2021 Sep 15.
Artigo em Inglês | MEDLINE | ID: mdl-34526032

RESUMO

BACKGROUND: The demand for more flexible and person-centered models of oral healthcare delivery is increasing and while mobile and domiciliary dental services have the potential to increase access to oral healthcare among dependent elderly and people with disabilities; the uptake of this service model by dentists remains low. Therefore, the aim of this study was to understand how existing domiciliary dental services operate within a particular context. METHODS: We used a qualitative descriptive multiple case study design. We studied three independent domiciliary dentistry clinics in the province of Quebec, Canada. We completed observations of 27 domiciliary visits, four of which were in private homes and the remaining 23 in LTCFs. We also conducted semi-structured interviews with dental professionals, patients, and caregivers. We performed a qualitative content analysis using a deductive/inductive coding framework. RESULTS: We presented a detailed description of the physical and service features of the studied cases. Physical features included the set-up of the mobile clinics, the portable equipment used, and the domiciliary locations of visits. For service features, we described the roles, attitudes, and interactions among those involved on both the providers' and recipients' sides, as well as, the logistical and financial aspect of the domiciliary dental services. CONCLUSIONS: Despite variations in setup and years of practice, the three mobile clinics had similar physical and service features. They also faced common logistic challenges but were able to provide services and respond to the high demand for domiciliary dental services. Additional research in different contexts would further contribute to building evidence-based models to help increase the uptake of this type of practice by current and future dental professionals.


Assuntos
Atenção à Saúde , Unidades Móveis de Saúde , Idoso , Canadá , Odontologia , Acesso aos Serviços de Saúde , Humanos , Quebeque
4.
Head Face Med ; 17(1): 39, 2021 Sep 04.
Artigo em Inglês | MEDLINE | ID: mdl-34481505

RESUMO

INTRODUCTION: The COVID-19 pandemic poses a continued challenge for all parties involved especially for the dentist as routine operation must be resumed. Rapid Antigen Tests (RATs) are actually recommended to identify and minimize infectious risks. However, there is still no guideline on the implementation of RATs in a dental or medical setting. METHODS: Based on data and an extensive literature research regarding rapid antigen testing and reflecting the recommendations given by the various professional societies a task force was formed to determine a specific testing and treatment strategy. RESULTS: A comprehensive test and treatment strategy and risk analysis was developed with practical suggestions for a wide range of typical activities in dental and medical offices. The transmission of SARS-CoV-2 and its variants via aerosols and droplets as well as the difficulties to maintain the minimum distance form special challenges to the dental routine. RATs might in addition to optimal and necessary hygienic standards in combination with the use of adequate personal protection equipment be an important instrument in managing the challenges. CONCLUSIONS: The present work gives recommendations for dental routine operation (dental practices, outpatient clinics) to provide the necessary dental care for the population while protecting the doctor, practice team and patient at the same time.


Assuntos
COVID-19 , Odontologia , Controle de Infecções , COVID-19/diagnóstico , COVID-19/prevenção & controle , Teste para COVID-19 , Humanos , Pandemias
5.
Br Dent J ; 231(4): 221-224, 2021 08.
Artigo em Inglês | MEDLINE | ID: mdl-34446892

RESUMO

COVID-19 has dominated our lives since the start of the pandemic in 2020, as well as greatly impacting dentistry, its patients and the dental profession. A new and potentially further problematic phenomenon is that of long COVID, a term used to describe the effects of COVID-19 that continue for weeks, or even months, beyond the initial illness. It is characterised by debilitating symptoms including extreme fatigue, shortness of breath, insomnia, heart palpitations and prolonged high temperature. With one in ten people in the UK suffering from long COVID, there will undoubtedly be a considerable impact on dentistry provision; there will be ramifications not only for patients, but also the workforce, both physically and mentally. The aim of this article is to explore the obstacles we will face due to long COVID, examining possible challenges but also possible solutions.


Assuntos
COVID-19 , COVID-19/complicações , Odontologia , Humanos , SARS-CoV-2 , Recursos Humanos
6.
Br Dent J ; 231(4): 243-248, 2021 08.
Artigo em Inglês | MEDLINE | ID: mdl-34446899

RESUMO

Introduction The COVID-19 pandemic resulted in substantial global disruptions, with many universities restructuring their examinations to open-book assessments. In this format, learners are allowed to use revision notes, textbooks and other permitted material during their examination. Traditionally, dentistry is assessed using closed-book examinations where the use of such materials is prohibited. Learners will have limited or no prior experience of open-book examinations in dentistry, hence this educational evaluation aimed to explore their experiences and assess suitability for continuity of this examination.Methods A retrospective anonymous survey was conducted on all undergraduate dentistry and oral health sciences learners on completion of their examination and once they received their results. The questionnaire was designed to contain both qualitative and quantitative data items, validated through previous published studies. All authors independently analysed the data through tallying quantitative parameters and thematically analysing qualitative free text.Results In total, 210 learners participated in the survey, with 52.4% strongly agreeing a preference for open-book examinations. In addition, 42.9% of learners either agreed or strongly agreed that less preparation was required for open-book examinations; however, 80.5% reported learning new information. Furthermore, 85.2% disagreed or strongly disagreed that open-book examinations were stressful. Thematic analysis highlighted four core themes: stress, memorisation of facts, motivation to learn and unfairness.Conclusions There were several learning points for both educators and learners that can be actioned for future open-book examinations, including tailoring exam questions to foster application of knowledge rather than resource-searching skills, intended learning objective mapping against curriculum requirements and learner preparation.


Assuntos
COVID-19 , Pandemias , Odontologia , Avaliação Educacional , Humanos , Estudos Retrospectivos , SARS-CoV-2
7.
Br Dent J ; 231(4): 206-207, 2021 08.
Artigo em Inglês | MEDLINE | ID: mdl-34446872

Assuntos
Odontologia
8.
Trials ; 22(1): 562, 2021 Aug 23.
Artigo em Inglês | MEDLINE | ID: mdl-34425901

RESUMO

BACKGROUND: Due to the inherent characteristics of immersion, imagination, and interactivity in virtual reality (VR), it might be suitable for non-drug behavior management of children in dental clinics. The purpose of this trial was to measure the role of VR distraction on behavior management in short-term dental procedures in children. METHODS: A randomized clinical trial design was carried out on 120 children aged between 4 and 8 years to identify the comparative efficacy of VR and tell-show-do (TSD) to improve behavioral management during dental procedures. The primary outcomes were evaluated anxiety, pain, and compliance scores in perioperative children. The levels of operative anxiety and pain were assessed using the Children's Fear Survey Schedule-Dental Subscale (CFSS-DS) and Wong Baker FACES Pain Rating Scale (WBFS), respectively. The Frankl Behavior Rating Scale (FBRS) was tested before and during dental procedures. The length of the dental procedure was compared between both groups after treatment. RESULTS: The average anxiety and behavioral scores of the VR group significantly reduced compared with the control. The decreased anxiety score for the VR group and control group were 8 (7, 11) and 5 (5, 7), p < 0.05. The compliance scores of the control group during treatment were 3 (2, 3), and the same in the VR intervention were 3 (3, 4), p = 0.02. A significant reduction in pain was observed when using VR distraction (p < 0.05). Comparing the length of the dental procedure, the VR group (19.0 2 ± 5.32 min) had a shorter treatment time than the control group (27.80 ± 10.40 min). CONCLUSION: The use of VR significantly reduced the anxiety and pain of children and the length of the dental procedure and improved the compliance of children that underwent short-term dental procedures without an adverse reaction. TRIAL REGISTRATION: Chinese Clinical Trial Registry, ChiCTR2000029802 . Registered on February 14, 2020.


Assuntos
Realidade Virtual , Transtornos de Ansiedade , Criança , Pré-Escolar , Odontologia , Humanos , Dor , Medição da Dor
9.
J Can Dent Assoc ; 87: l7, 2021 05.
Artigo em Inglês | MEDLINE | ID: mdl-34343070

RESUMO

The field of artificial intelligence (AI) has experienced spectacular development and growth over the past two decades. With recent progress in digitized data acquisition, machine learning and computing infrastructure, AI applications are expanding into areas that were previously thought to be reserved for human experts. When applied to medicine and dentistry, AI has tremendous potential to improve patient care and revolutionize the health care field. In dentistry, AI is being investigated for a variety of purposes, specifically identification of normal and abnormal structures, diagnosis of diseases and prediction of treatment outcomes. This review describes some current and future applications of AI in dentistry.


Assuntos
Inteligência Artificial , Aprendizado de Máquina , Odontologia , Previsões , Humanos
10.
J Indian Soc Pedod Prev Dent ; 39(2): 120-131, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34341230

RESUMO

COVID-19 was first reported in China, in November 2019 and since then the spread of this disease was so rapid that on March 11, 2020, it was declared a pandemic by the World Health Organization. Due to the high transmissibility of the COVID virus and the associated morbidity and mortality, various International and National health authorities released different guidelines for day-to-day living, laying down "new norms" which has impacted our lives enormously. Although these guidelines seem to be convoluted but owing to some differences in the guidelines, it raises an ambiguity in the minds of dentists. Hence, we felt the need of this review to summarize different guidelines issued by various National health authorities for catering emergency and routine dental care. We included guidelines from CDC, ADA, NHS, India, UAE, Egypt, and Tunisia and compared and consolidated to reach a consensus that teledentistry is a good alternative to face-to-face management for nonemergency patients. Triage should be done for all patients coming to the health-care facility. Temperature and other vital parameters should be recorded in our daily practice. Antibacterial mouth rinses before the dental procedure can reduce the microbial load and therefore can alleviate transmission. To reduce indirect transmission through fomites on inanimate objects various waiting area changes must be ensured. Air conditioners can be used in well-serviced conditions with due care given to ventilation of the operatory after each patient. Strict disinfection protocols and personal protective equipment for dentist safety are mandatory.


Assuntos
COVID-19 , SARS-CoV-2 , Odontologia , Humanos , Índia , Pandemias
11.
Cien Saude Colet ; 26(8): 3323-3334, 2021 Aug.
Artigo em Português, Inglês | MEDLINE | ID: mdl-34378719

RESUMO

The training directed at the Unified Health System (SUS) has been one of the most challenging assumptions in the development of Dentistry courses in Brazil. In this regard, public health educated teachers play a fundamental role in the curricular proposition favoring such an approach. This study aimed to identify the possible advances achieved in Dentistry courses and the challenges in training for the SUS. This is a quantitative, cross-sectional research with a sample of 119 teachers employing the probabilistic Snowball technique. Participants responded to a validated criteria matrix, and an exploratory factor analysis was performed for data analysis, which defined five factors responsible for training for the SUS: Primary Care; Social Responsibility and Teamwork; Health Management; Information Systems, and Continuing Education/Humanization. The study allowed identifying significant advances in the perspective of greater adequacy of the training proposal aimed at the SUS. However, some challenges to teachers require expanding the prospect to face the barriers still imposed by traditional health training.


Assuntos
Educação em Saúde , Saúde Pública , Brasil , Estudos Transversais , Odontologia , Humanos
12.
Artigo em Inglês | MEDLINE | ID: mdl-34360209

RESUMO

Due to the rising popularity of Dental Operating Microscopes, the issue of their ergonomic use has become an important topic. To verify its impact on dental teams' ergonomics, the aspect of working in two distinct environments was examined. The research was performed on a group of 82 dentists regarding the number and character of shifts from the microscopic environment to the macroscopic one. The results revealed the shifts constitute a significant part of an inexperienced DOM operator's work. Because such shifts, when performed repeatedly and in short succession, may influence the operator's vision and comfort, they should be considered ergonomically detrimental. Having indicated the problem, the article puts forth a solution in the form of an instrument transfer methodology. The proposed adjustment has the potential of improving the quality of work for DOM operators quickly and efficiently by significantly reducing the number of shifts between the environments.


Assuntos
Odontologia , Ergonomia , Humanos
13.
Braz Oral Res ; 35: e094, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34406309

RESUMO

Artificial intelligence (AI) is a general term used to describe the development of computer systems which can perform tasks that normally require human cognition. Machine learning (ML) is one subfield of AI, where computers learn rules from data, capturing its intrinsic statistical patterns and structures. Neural networks (NNs) have been increasingly employed for ML complex data. The application of multilayered NN is referred to as "deep learning", which has been recently investigated in dentistry. Convolutional neural networks (CNNs) are mainly used for processing large and complex imagery data, as they are able to extract image features like edges, corners, shapes, and macroscopic patterns using layers of filters. CNN algorithms allow to perform tasks like image classification, object detection and segmentation. The literature involving AI in dentistry has increased rapidly, so a methodological guidance for designing, conducting and reporting studies must be rigorously followed, including the improvement of datasets. The limited interaction between the dental field and the technical disciplines, however, remains a hurdle for applicable dental AI. Similarly, dental users must understand why and how AI applications work and decide to appraise their decisions critically. Generalizable and robust AI applications will eventually prove helpful for clinicians and patients alike.


Assuntos
Inteligência Artificial , Aprendizado Profundo , Odontologia , Humanos , Aprendizado de Máquina , Redes Neurais de Computação
14.
Prim Dent J ; 10(2): 41-46, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-34353157

RESUMO

This paper highlights the process of transition to a female majority for dentistry, examines various influences on this trajectory, and considers the implications for the profession, health systems and patients, as well as individual dentists.This celebratory transition has been facilitated by educational systems that provide both males and females with equal opportunities and is supported by legislation, as well as societal change that has spanned decades. In crossing this gender representation threshold, we have outperformed doctors nationally.In order to embrace our highly educated workforce and support them to better serve their patients and the population, urgent debate and action aimed at reshaping current systems of dental care provision are required. In this regard, flexible working arrangements, together with reshaping professional leadership to better represent the workforce, as well as changes in terminology can all play their part; however, we will need careful discussions about how this might happen effectively.A collaborative effort between the dental profession and wider health systems is required to ensure that there are opportunities for everyone to flourish and contribute back to the profession and society. Our medical counterparts have been considering how healthcare should be shaped creatively, particularly in relation to working patterns, economic models and quality patient care: we need to catch up.


Assuntos
Odontologia , Liderança , Feminino , Humanos , Masculino , Reino Unido , Recursos Humanos
15.
Artigo em Inglês | MEDLINE | ID: mdl-34444548

RESUMO

The number of medically compromised dental patients is increasing every year with the increase in the super-aged population. Many of these patients have underlying psychiatric problems and diseases, which need to be recognized by dental professionals for better treatment outcomes. The aim of this narrative review article is to summarize the psychological and psychiatric backgrounds of medically compromised patients who are frequently visited and taken care of by dentists using findings from recent systematic reviews and meta-analyses. Anxiety and symptoms of depression, post-traumatic stress disorders, panic disorders, poor cognitive functions, and poor quality of life were some of the common psychological backgrounds in medically compromised patients. Additionally, the consequences of these psychological problems and the considerations that need to be taken by the dentist while treating these patients have been discussed. Dental professionals should be aware of and recognize the different psychological backgrounds of medically compromised dental patients in order to provide appropriate dental treatment and to prevent oral conditions from worsening.


Assuntos
Doenças da Boca , Transtornos de Estresse Pós-Traumáticos , Idoso , Transtornos de Ansiedade , Odontologia , Humanos , Doenças da Boca/terapia , Qualidade de Vida
16.
Artigo em Inglês | MEDLINE | ID: mdl-34444634

RESUMO

The coronavirus disease 2019 (COVID-19), which is mainly transmitted through droplets without overlooking other sources of transmission, rendered attention on the air quality in indoor areas and more specifically in healthcare settings. The improvement of indoor air quality (IAQ) is ensured by frequent changes of the air that must be carried out in healthcare areas and with assistance from special devices that undertake the filtration of the air and its purification through special filters and lamps. In this research, the performance of air purifiers is assessed in terms of the limitation of PM2.5, PM10, VOCs and CO2 in a postgraduate clinic of the Dentistry School of the National and Kapodistrian University of Athens in parallel with mechanical ventilation. Our findings indicate that the use of mechanical ventilation plays a key role on the results, retaining good IAQ levels within the clinic and that air purifiers show a positive impact on IAQ by mainly reducing the levels of PM2.5 and secondly of TVOC.


Assuntos
Filtros de Ar , Poluição do Ar em Ambientes Fechados , COVID-19 , Poluição do Ar em Ambientes Fechados/análise , Odontologia , Grécia/epidemiologia , Humanos , Pandemias , Material Particulado/análise , Respiração Artificial , SARS-CoV-2
17.
Sensors (Basel) ; 21(13)2021 Jul 02.
Artigo em Inglês | MEDLINE | ID: mdl-34283107

RESUMO

The most common imaging technique for dental diagnoses and treatment monitoring is X-ray imaging, which evolved from the first intraoral radiographs to high-quality three-dimensional (3D) Cone Beam Computed Tomography (CBCT). Other imaging techniques have shown potential, such as Optical Coherence Tomography (OCT). We have recently reported on the boundaries of these two types of techniques, regarding. the dental fields where each one is more appropriate or where they should be both used. The aim of the present study is to explore the unique capabilities of the OCT technique to optimize X-ray units imaging (i.e., in terms of image resolution, radiation dose, or contrast). Two types of commercially available and widely used X-ray units are considered. To adjust their parameters, a protocol is developed to employ OCT images of dental conditions that are documented on high (i.e., less than 10 µm) resolution OCT images (both B-scans/cross sections and 3D reconstructions) but are hardly identified on the 200 to 75 µm resolution panoramic or CBCT radiographs. The optimized calibration of the X-ray unit includes choosing appropriate values for the anode voltage and current intensity of the X-ray tube, as well as the patient's positioning, in order to reach the highest possible X-rays resolution at a radiation dose that is safe for the patient. The optimization protocol is developed in vitro on OCT images of extracted teeth and is further applied in vivo for each type of dental investigation. Optimized radiographic results are compared with un-optimized previously performed radiographs. Also, we show that OCT can permit a rigorous comparison between two (types of) X-ray units. In conclusion, high-quality dental images are possible using low radiation doses if an optimized protocol, developed using OCT, is applied for each type of dental investigation. Also, there are situations when the X-ray technology has drawbacks for dental diagnosis or treatment assessment. In such situations, OCT proves capable to provide qualitative images.


Assuntos
Tomografia Computadorizada de Feixe Cônico , Tomografia de Coerência Óptica , Odontologia , Humanos , Imageamento Tridimensional , Imagens de Fantasmas , Raios X
18.
J Biol Regul Homeost Agents ; 35(3 Suppl. 1): 7-12, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34289659

RESUMO

Stem cells of dental pulp (SCDPs) are multipotent stem cells with the potential to differentiate into various cell types. For this reason, they have been proposed as an alternative source for mesenchymal stem cells. Somatostatin (ST) is a peptide hormone with an inhibitory effect on several endogenous hormones. The aim of our study is to investigate whether somatostatin can promote or inhibit differentiation of SCDPs in osteoblasts and bone tissue. SCDPs were extracted from third molars of healthy subjects and were treated with ST at the concentration of 100 ng/ml for 24 and 48 h. Gene expression in treated SCDPs was compared with untreated cells (control) to check the effect of somatostatin on stem cell differentiation. After 24 h of treatment many genes investigated were downregulated in treated SCDPs vs untreated SCDPs. Significantly up-regulated gene (Fold change >2) was the Bone Morphogenetic Protein BMP4. On the contrary ST induced the over-expression of bone related genes after 48 h of treatment. TGFB family genes and their receptors were also significantly upregulated after 48 h of treatment. ST demonstrated to promote the self-renewal of SCDPs: in our experiments somatostatin mainly acted on TGFB family genes. Further studies are needed to explore this new way of creating bone tissue.


Assuntos
Células-Tronco Mesenquimais , Osteogênese , Diferenciação Celular , Células Cultivadas , Polpa Dentária , Odontologia , Hormônios , Osteoblastos
19.
J Biol Regul Homeost Agents ; 35(3 Suppl. 1): 13-18, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34289660

RESUMO

The purpose of this paper is to evaluate the role of hyaluronic acid in bio-revitalization (HABR) by testing several extracellular matrix biological parameters in cultured dermal fibroblasts. To this aim, fibroblastic expressed genes after exposition to three HABR medical devices were evaluated. Cells were seeded on a layer of three different medical devices containing 6.2, 10 and 20 mg/ml of HABR for 24 h. Real Time Polymerase Chain Reaction was performed to investigate gene expressions. Genes encoding HABR synthesis and degradation, Metalloproteinases 2 and 3 and Desmoplakin production as well as GDF6, and IGF1 were activated by hyaluronic acid products. The in vitro study showed similar effects on tested genes despite a different concentration of hyaluronic acid contained in the medical devices and the simultaneous presence of other additives. Based on the reported data, gene activations are an aspect of metabolic modulation of signalling pathways rather than the proportional production of a specific connective tissue molecule. Indeed, different HABR concentration and the presence of other additives did not change the overall effect on the studied genes. We believe that the optimization of extracellular matrix micro-environment, obtained by enhanced structural support with HABR, leads to functional and metabolic improvement.


Assuntos
Fibroblastos , Ácido Hialurônico , Células Cultivadas , Odontologia , Matriz Extracelular , Expressão Gênica
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