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1.
Quintessence Int ; 51(9): 763-774, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32901237

RESUMO

When dental trauma occurs, initial management on the day of injury has a determining influence on healing and thus on the prognosis of the affected teeth. Improper, delayed, and/or inconsistent treatment often has far-reaching consequences that cannot be reversed later, even with great effort, especially in children and adolescents. In most cases, it is unrealistic or impossible for the patient to get to a specialized dental trauma facility in time. Therefore, it is every dental practitioner's duty to provide adequate initial diagnosis and treatment of dental trauma at their dental practice, even if they do not have routine experience in this area. This article serves as a guide to the initial management of dental trauma. It utilizes a three-tiered approach to illustrate which initial management measures are absolutely essential (MUSTS), which should ideally be performed (SHOULDS), and which are not top priorities but can be performed (CANS) if the necessary time, training and experience, and equipment and facilities are available. For further treatment, dental practitioners should realistically assess the limits of their ability to treat complex dental trauma cases and, if necessary, they should refer the patient to a specialist or specialized treatment center. (Quintessence Int 2020;51:763-774; doi: 10.3290/j.qi.a45103; modified from a previously published article (in German) Quintessenz 2019;70(9):990-1002).


Assuntos
Avulsão Dentária , Traumatismos Dentários , Adolescente , Criança , Odontólogos , Humanos , Papel Profissional , Prognóstico
2.
Quintessence Int ; 51(9): 732-740, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32901235

RESUMO

OBJECTIVE: The present study compared the efficacy of preoperative administration of paracetamol and placebo in reducing postoperative pain after routine dental treatment in children. The primary objective was to compare postoperative pain level between the groups. The secondary objective was to identify other factors that can influence postoperative pain. METHOD AND MATERIALS: A prospective, placebo-controlled parallel-group trial was conducted on two groups of children aged 5 to 12 years. One hundred and two children participated in the study, 51 in each group, 58 boys (56.9%) and 44 girls (43.1%). The average age was 7 ± 1.72 years, with no difference in age and sex between the groups. The study group received paracetamol (15 mg/kg) and the control group received placebo 15 minutes before dental treatment. Pretreatment baseline anxiety was recorded. Postoperative data were collected immediately at the end of the treatment, and by phone 2.5 hours after taking the remedy. RESULTS: The groups showed no difference in postoperative pain immediately after the treatment and 1.5 hours after treatment. The pain score was higher among children who received stainless steel crowns and combinations of crowns, pulpectomy, and extractions. CONCLUSION: Preoperative use of paracetamol has the same preemptive analgesic effect as placebo in pediatric patients who receive routine dental treatment. CLINICAL RELEVANCE: Postoperative pain can influence the willingness of children to receive consecutive treatments. Dental practitioners should prevent postoperative pain and recommend analgesia when necessary. Pain is expected after performing stainless steel crowns, pulpectomies, and extractions. The current study confirms that preoperative paracetamol has no beneficial effect.


Assuntos
Acetaminofen , Odontólogos , Manejo da Dor , Criança , Pré-Escolar , Método Duplo-Cego , Feminino , Humanos , Masculino , Papel Profissional , Estudos Prospectivos
3.
Indian J Dent Res ; 31(3): 354-357, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32769266

RESUMO

Background: Work-related musculoskeletal pain (MSPs) is not uncommon among dentist and often limits their work efficiency impacting their quality of life. Aim: The present research was conducted to identify site-specific pain resulting from musculoskeletal disorders (MSDs) among practicing dentists and determine its impact on their quality of life. Setting and Design: A cross-sectional questionnaire study conducted among practicing dentists of Puducherry Taluk, Puducherry, India. Method and Materials: A closed-ended, self-administered questionnaire was distributed to 95 practicing dentists to identify site-specific MSP from the study subjects. Data on pain due to MSDs, frequency of pain, its impact on quality of life, relieving factors, patients attended per day, working hours per day, and awareness on ergonomics were also recorded. Statistical Analyses: The data were analyzed for descriptive statistics, and Chi-square tests was used for proportions. Results: Almost all respondents experienced pain due to MSDs. Approximately, 11.1% "always" experienced elbow pain; 5.6% "always" experienced pain in neck and back. Approximately, 83% "sometimes" experienced pain in the back. Pain in elbow was significantly associated with gender (P = 0.036), qualification (P = 0.029), and years of practice (P = 0.032). Approximately, 36% reported having an impact on their life. Conclusion: The magnitude of the problem is slowly shifting from "sometimes" to "always." Although small in proportion, pain due to MSDs has an impact on dental practitioners' quality of life, and elbow pain was reportedly higher in the study setting. Measures need to be implemented before MSD becomes a career limiting occupational hazard.


Assuntos
Doenças Musculoesqueléticas , Dor Musculoesquelética , Doenças Profissionais , Estudos Transversais , Odontólogos , Humanos , Índia , Postura , Prevalência , Papel Profissional , Qualidade de Vida , Fatores de Risco , Autorrelato
4.
Indian J Dent Res ; 31(3): 358-362, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32769267

RESUMO

Introduction: The literature on women in dentistry clearly shows the evolution and elevation of women in academic as well as clinical dentistry. Female dentists in India continue to face the need to balance their careers with the competing social and personal responsibilities of marriage, homemaking, and child rearing. Aim: To assess Indian Women Dentists perspectives towards balancing professional, personal, and social responsibilities. Methodology: This cross-sectional study was conducted for 1 month among 159 female dental professionals comprising all the female dental practitioners in Rajahmundry city and all the female interns, postgraduates, and academicians from 2 dental institutions in Rajahmundry city. A 23-item pretested questionnaire was distributed to the participants on the first day and collected after 1 day. The results were analyzed using SPSS software (V.22). The categorical data were analyzed using the χ2 test and P ≤ 0.05 was considered as statistically significant. Results: Among the study participants, 79.2% of study participants agreed that family commitments were not obstacles for their career (P = 0.02), 86.2% responded that women should be successful in both home-making and career and 89.9% of participants reported as not regretting being women and this finding was found to be statistically significant. Conclusion: Majority of the women perceived that women ought to balance professional, personal, and social responsibilities equally.


Assuntos
Odontólogas , Odontólogos , Criança , Estudos Transversais , Feminino , Humanos , Índia , Papel Profissional , Responsabilidade Social , Inquéritos e Questionários
5.
Nihon Koshu Eisei Zasshi ; 67(7): 442-451, 2020.
Artigo em Japonês | MEDLINE | ID: mdl-32741875

RESUMO

Objectives The purpose of this study was to identify elements that cancer peer supporters working in Japanese hospitals consider to be important in helping them perform their role.Methods A qualitative inductive research was conducted. Introductions to potential participants were obtained from a patient association that agreed to help with the study. Interviews were conducted from July through October 2014, using an interview guide, with cancer peer supporters who consented to participate in the study. Elements they perceived as important to the performance of their role were inductively identified from interview transcripts. The analysis consisted of coding phrases in the text and organizing the codes generated into categories and subcategories.Results The study participants consisted of 10 cancer peer supporters (2 men, 8 women), in the age range of 40 to 70 years, who provided private counseling and worked in cancer support groups in hospitals. The analysis generated 129 codes, 11 subcategories, and 5 categories. These 5 categories were: [1.Help service users determine their own paths by listening to and accepting what they say with a non-judgmental attitude]; [2.Offer a perspective distinct from that of the medical staff]; [3.Think of ways to achieve a good balance between one's personal life and cancer peer support work while maintaining a stable state of mind]; [4.Ensure that one maintains the necessary knowledge and skills, and continually improve oneself]; and [5.Build relationships of trust with medical staff and the hospital].Conclusion Category [1] and category [2] were behaviors regarded as important when interacting with users. They were "matters regarded as important during the practice of cancer peer support working for users," and comprised the core of matters that were regarded as important. Next, as for matters regarded as important in relation to the supporters themselves, the categories were [3] and [4]. These were "matters regarded as important for continuity and qualitative improvement of cancer peer support working." Areas that call for improvement in relation to this are preparation of support systems and learning environments. Another matter regarded as important was category [5]. This was a "matter regarded as important to smoothen and facilitate cancer peer support working." Placing importance on relationships of trust with medical staff and hospitals could be considered a distinctive characteristic of cancer peer supporters working at hospitals.


Assuntos
Pessoal Técnico de Saúde/psicologia , Institutos de Câncer , Aconselhamento , Hospitais , Sistemas de Apoio Psicossocial , Adulto , Idoso , Estudos de Avaliação como Assunto , Feminino , Humanos , Japão , Masculino , Corpo Clínico , Pessoa de Meia-Idade , Papel Profissional , Inquéritos e Questionários , Confiança
6.
Front Health Serv Manage ; 37(1): 27-32, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32842086

RESUMO

As community transmission of COVID-19 first emerged in the United States and then quickly spread, America's military accepted an important role in responding to the growing pandemic. The Department of Defense (DOD) rapidly mobilized and deployed personnel, expeditionary medical capabilities, supplies, and equipment to hot spots across the country. How does a military with an expeditionary focus and armed for war abroad quickly pivot to support national response efforts to a public health crisis here at home? Coinciding with the DOD's established flexible response methodology, the US Army adapted a three-pronged approach to prevent, detect, and treat COVID-19 while protecting the force and safeguarding the American people. This approach is providing strategic and operational lessons for improving healthcare delivery, informing public health decisions, and allocating healthcare resources for future pandemic response and civil emergency support efforts.


Assuntos
Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/terapia , Assistência à Saúde/organização & administração , Serviços Médicos de Emergência/organização & administração , Medicina Militar/organização & administração , Militares , Pandemias/prevenção & controle , Pneumonia Viral/diagnóstico , Pneumonia Viral/terapia , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Papel Profissional , Estados Unidos
9.
J Ambul Care Manage ; 43(4): 301-305, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32858729

RESUMO

Over 100 Community Health Representatives (CHRs) as part of the oldest and largest Community Health Worker (CHW) program in the United States serve the Dine People on the Navajo Nation. The CHRs work under a tribally determined scope of practice that embraces the importance of self-determination of tribal nations, a philosophy central to the CHW field nationally. Navajo CHRs are the epitome of frontline workers, as they extend their traditional role to encompass long-term emergency response during coronavirus disease-2019 (COVID-19). This article describes the Navajo CHR role in the pandemic through the lens of an interview with the program's director, Mae-Gilene Begay.


Assuntos
Agentes Comunitários de Saúde , Infecções por Coronavirus/etnologia , Infecções por Coronavirus/epidemiologia , Índios Norte-Americanos , Pneumonia Viral/etnologia , Pneumonia Viral/epidemiologia , Papel Profissional , United States Indian Health Service/organização & administração , Betacoronavirus , Humanos , Pandemias , Estados Unidos/epidemiologia
10.
J Ambul Care Manage ; 43(4): 312-316, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32858732

RESUMO

The ongoing pandemic has disrupted the health care system, creating challenges for health care workers and patients alike. As workflows and job responsibilities have been adapted to provide care to coronavirus-infected patients, many primary care services have been postponed. This change has led to significant financial impacts that will be difficult to overcome. Ambulatory care pharmacists can help fill gaps both in access to primary care services and in the financial deficit, if given the opportunity to practice at the top of their skillset and bill for their face-to-face and telehealth services both during and after the pandemic.


Assuntos
Infecções por Coronavirus/epidemiologia , Farmacêuticos , Pneumonia Viral/epidemiologia , Atenção Primária à Saúde/organização & administração , Papel Profissional , Betacoronavirus , Acesso aos Serviços de Saúde , Humanos , Pandemias , Estados Unidos/epidemiologia
12.
Sr Care Pharm ; 35(7): 286-291, 2020 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-32600505

RESUMO

Pharmacists across various practice settings are joining the fight against COVID-19, empowered by the resources available through national, governmental and professional organizations. Long-term care pharmacists are instrumental in optimizing medication management and developing policies to reduce the risk of COVID-19 transmission among vulnerable residents.


Assuntos
Infecções por Coronavirus/prevenção & controle , Infecções por Coronavirus/terapia , Pandemias/prevenção & controle , Farmacêuticos , Pneumonia Viral/prevenção & controle , Pneumonia Viral/terapia , Papel Profissional , Betacoronavirus , Humanos
13.
Oral Health Prev Dent ; 18(2): 277-285, 2020 Apr 01.
Artigo em Inglês | MEDLINE | ID: mdl-32618451

RESUMO

PURPOSE: Ergonomics in dentistry poses some challenges to dentists and may require considerable concentration and attention to detail. This research enables early recognition and prevention of common ergonomic-related conditions, such as carpel tunnel syndrome, back pain and neck pain. The purpose of this study was to determine the prevalence of ergonomic-related problems concerning carpel tunnel syndrome (CTS) and to know the efficacy of independent and combined clinical tests used in diagnosing it. MATERIALS AND METHODS: Initially the participants were instructed to complete a self-administered questionnaire regarding the severity of symptoms of their hands on a hand-wrist diagram and a visual analogue scale. The principle investigator evaluated all questionnaires independently and four clinical tests were used on both hands in a systematic (non-randomised) order for subjects who had symptoms. Those with residual symptoms that exceeded beyond 1 min interval were identified and controlled for the statistical analyses. RESULTS: The most common symptom noted in the study group was tingling and numbness of fingers (66.46%) followed by neck pain (66.34%). 29.26% of subjects reported moderate difficulty in typing and driving vehicles, whereas 26.82% subjects felt moderate difficulty in grasping and carrying shopping bags. 61.94% of subjects with symptoms spent more than 1 h daily of their free time on mobile phones or other smart devices. Individually, in our study the Tinsel's sign stood out as ineffective in ruling out CTS when compared with Phalen's test. Combination tests like Phalen's test and compression tests are confirmatory to CTS diagnosis and 66.34 % of the research group were hence diagnosed for CTS. CONCLUSIONS: A positive criteria for CTS, neck and shoulder pain is identified in our study as being due to long-term use of mobile devices. Further, combination tests like Phalen's with pressure provocation tests proved accurate in conforming CTS. Future research is needed to confirm the diagnostic utility of these independent and combined clinical tests in less prevalent settings, including general dental practitioners and occupational worksites. TRIAL REGISTRATION: The current study is registered in King Khalid University, College of dentistry ethical committee SRC/REG/2016-17/107.


Assuntos
Síndrome do Túnel Carpal , Odontólogos , Ergonomia , Universidades , Odontologia , Humanos , Incidência , Papel Profissional , Arábia Saudita
14.
Am J Pharm Educ ; 84(6): ajpe8146, 2020 06.
Artigo em Inglês | MEDLINE | ID: mdl-32665721

RESUMO

This commentary, written primarily by a recent pharmacy graduate, discusses the impact of COVID-19 on the class of 2020. Everyone has been impacted by COVID-19, but pharmacy students have been affected by and experienced COVID-19 in unique ways. This was the first class to complete pharmacy practice experiences in an online format, miss out on milestone events including graduation, and face uncertainty about becoming licensed and entering the job market in the midst of a pandemic. However, instead of discouraging them, these events have in many ways strengthened the resilience of the class of 2020. Additionally, COVID-19 has highlighted the importance of continued advocacy for the profession and articulation of the pharmacist's expanded role and value to the health care team, and inspired the class of 2020 to join the ranks of colleagues nationwide in raising awareness in these areas. Nevertheless, uncertainty over their future and that of their peers lingers as COVID-19 has forever changed pharmacy education and practice.


Assuntos
Infecções por Coronavirus/epidemiologia , Educação em Farmácia/organização & administração , Pneumonia Viral/epidemiologia , Estudantes de Farmácia/psicologia , Betacoronavirus , Educação a Distância/organização & administração , Humanos , Pandemias , Papel Profissional , Resiliência Psicológica
16.
Isr Med Assoc J ; 7(22): 343-348, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32692494

RESUMO

BACKGROUND: Emergency department (ED) overcrowding is associated with worse patient outcomes. OBJECTIVES: To determine whether physician assistants (PAs), fairly recently integrated into the Israeli healthcare system, improve patient outcomes and ED timings. METHODS: We compared patients seen by physicians with patients seen by PAs and then by physicians between January and December 2018 using propensity matching. Patients were matched for age, gender, triage level, and decision to hospitalize. Primary endpoints included patient mortality, re-admittance. and leaving on own accord rates. Secondary endpoints were ED timing landmarks. RESULTS: Patients first seen by PAs were less likely to leave on their own accord (MD1 1.5%, PA 1.0%, P = 0.015), had lower rates of readmission within 48 hours (MD1 2.1%, PA 1.5%, P= 0.028), and were quicker to be seen, to have medications prescribed, and to undergo imaging without differences in timings until decisions were made or total length of stay. Patients seen by a physician with the assistance of a PA were attended to quicker (MD2 47.79 minutes, range 27.70-78.82 vs. MD + PA 30.59 minutes, range 15.77-54.85; P < 0.001) without statistically significant differences in primary outcomes. Mortality rates were similar for all comparisons. CONCLUSIONS: Patients first seen by PAs had lower rates of re-admittance or leaving on their own accord and enjoyed shorter waiting times. Pending proper integration into healthcare teams, PAs can further improve outcomes in EDs and patient satisfaction.


Assuntos
Serviço Hospitalar de Emergência/organização & administração , Readmissão do Paciente/estatística & dados numéricos , Assistentes Médicos/estatística & dados numéricos , Médicos/estatística & dados numéricos , Adulto , Idoso , Idoso de 80 Anos ou mais , Serviço Hospitalar de Emergência/estatística & dados numéricos , Feminino , Mortalidade Hospitalar , Humanos , Israel , Masculino , Pessoa de Meia-Idade , Papel Profissional , Estudos Retrospectivos , Fatores de Tempo , Listas de Espera
17.
J Contemp Dent Pract ; 21(5): 568-574, 2020 May 01.
Artigo em Inglês | MEDLINE | ID: mdl-32690842

RESUMO

AIM: To investigate and evaluate current knowledge and habits in prescribing preoperative antibiotic, and toward specific practice situations, in a subset of dental practitioners performing routine dental implant surgery in Saudi Arabia. MATERIALS AND METHODS: A cross-sectional questionnaire-based study was developed, and relevant information was gathered through a web-based survey from a dentist who performed surgical implant placement. Participant demographics, clinical experience, and educational background were obtained. Factors related to knowledge and practice of preoperative antibiotics prescription and relevant information were collected. Descriptive statistics (frequencies and percentages) were used to describe the categorical variables. Pearson's Chi-square test was used to compare the distribution of the categorical responses across specific survey variables. A p value of ≤ 0.05 was used to report the statistical significance of the responses relative to prescription habits. RESULTS: A total of 156 dentists participated in this study. Majority of the study sample was periodontists (70.5%, n = 110). About 63.5% of the study subjects do not prescribe prophylactic antibiotics. Private practitioners prescribed more antibiotics preoperatively (p = 0.019), while public and academic practitioners were in favor of developing guidelines toward antibiotics prescriptions (p = 0.009). Furthermore, a statistically significant difference was found between private and no private practitioners toward possible adverse complications when prescribing multidose antibiotics (p = 0.014). CONCLUSION: Various factors influence the knowledge and prescription habits toward prophylactic antibiotics among dental practitioners in routine dental implant procedures. The variability and conflicting practices require the attention of healthcare legislations and stakeholders, locally and globally, to improve antibiotics prescription habits. Furthermore, large-scale interventions, prescription stewardship programs, and collaborative work between professional and scientific organizations may be beneficial to address areas of concern. CLINICAL SIGNIFICANCE: Strategic policies and stewardship programs toward antibiotic prescription among dental practitioners may benefit in reducing the unjustified or misuse of these medications. Subsequently, this could minimize the potential development of bacterial resistance and unwanted events that might complicate the management of straightforward dental implant cases.


Assuntos
Antibacterianos/uso terapêutico , Odontólogos , Estudos Transversais , Hábitos , Humanos , Padrões de Prática Odontológica , Papel Profissional , Arábia Saudita , Inquéritos e Questionários
18.
Artigo em Inglês | MEDLINE | ID: mdl-32630735

RESUMO

COVID-19 is the disease supported by SARS-CoV-2 infection, which causes a severe form of pneumonia. Due to the pathophysiological characteristics of the COVID-19 syndrome, the particular transmissibility of SARS-CoV-2, and the high globalization of our era, the epidemic emergency from China has spread rapidly all over the world. Human-to-human transmission seems to occur mainly through close contact with symptomatic people affected by COVID-19, and the main way of contagion is via the inhalation of respiratory droplets, for example when patients talk, sneeze or cough. The ability of the virus to survive outside living organisms, in aerosol or on fomites has also been recognized. The dental practitioners are particularly exposed to a high risk of SARS-CoV-2 infection because they cannot always respect the interpersonal distance of more than a meter and are exposed to saliva, blood, and other body fluids during surgical procedures. Moreover, many dental surgeries can generate aerosol, and the risk of airborne infection is to be considered higher. The aim of this paper is to provide practical advice for dentists based on the recent literature, which may be useful in reducing the risk of spreading COVID-19 during clinical practice.


Assuntos
Infecções por Coronavirus/prevenção & controle , Assistência Odontológica/métodos , Controle de Infecções/métodos , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Padrões de Prática Odontológica/normas , Betacoronavirus , Assistência Odontológica/normas , Odontólogos , Humanos , Controle de Infecções/normas , Programas de Rastreamento , Equipamento de Proteção Individual , Papel Profissional
19.
Int J Prosthodont ; 33(4): 393-400, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32639699

RESUMO

PURPOSE: To evaluate the first-choice treatment options proposed to edentulous patients and the rationale behind them using an internet-based survey conducted among a sample of French dental clinicians. MATERIALS AND METHODS: From July to December 2018, an internet-based survey was conducted among a sample of 2,000 dental practitioners in order to assess first-choice treatment options proposed to edentulous patients. A total of 349 responses were received, and 310 questionnaires were included for analysis. RESULTS: The majority of clinicians proposed a maxillary complete denture (CD) (59.7%) and mandibular implant overdenture (45.2%) for edentulous patients. Almost 30% of practitioners proposed a CD as the first-choice option for mandibular edentulous patients. Binary logistic regression showed that the likelihood of proposing implant therapy in the maxilla was significantly increased for male practitioners (OR = 2.041, 95% CI = 1.231 to 3.385, P < .05) and for clinicians who had further training in implantology (OR = 2.301, 95% CI = 1.354 to 3.917, P < .05). In the mandible, the likelihood was significantly increased for clinicians who graduated 10 to 19 years ago (OR = 5.312, 95% CI = 1.331 to 21.208, P < .05), had further training in implantology (OR = 2.246, 95% CI = 1.121 to 4.500, P < .05), had expectations of comfort and stability (OR = 11.810, 95% CI =5.289 to 26.372, P < .001), and proposed the treatment according to national and international recommendations (OR = 3.252, 95% CI = 1.208 to 8.755, P < .05). CONCLUSION: The research results suggest that proposing either a CD or implant restorations for treatment of edentulous patients depends on training and specific skills in implantology.


Assuntos
Implantes Dentários , Arcada Edêntula , Prótese Dentária Fixada por Implante , Odontólogos , Revestimento de Dentadura , Humanos , Internet , Masculino , Mandíbula , Papel Profissional , Inquéritos e Questionários
20.
Prim Dent J ; 9(2): 56-61, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32643567

RESUMO

When faced with an anxious patient with complex needs who requires dental care, it can be difficult to decide on the most appropriate method to manage their pain and anxiety. There are a range of conscious sedation techniques that may be used, and on some occasions, general anaesthesia may be required. This paper describes the methods available and the factors influencing the decision-making process. The general dental practitioner (GDP) may not be able to offer care in their setting, but knowing more about the decision-making process and the information required to make that decision can help them guide patients and their families.


Assuntos
Anestesia Dentária , Anestésicos Gerais , Anestesia Geral , Sedação Consciente , Ansiedade ao Tratamento Odontológico , Odontólogos , Humanos , Papel Profissional
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