Oral health-related quality of life of older adults living in long-term care facilities and its association with dental prosthesis use and condition / Qualidade de vida relacionada à saúde bucal de idosos residentes em instituições de longa permanência: associação com o uso e condição da prótese

OBJECTIVE: This cross-sectional study aimed to evaluate the association of oral health-related quality of life with prosthetic rehabilitation status and dental prosthesis condition in residents of Brazilian long-term care facilities. METHODS: The oral health-related quality of life of older adults (n = 194; mean [standard deviation] age = 78.93 [9.10]) was assessed by the Geriatric Oral Health Assessment Index and the Oral Health Impact Profile questionnaires. Prosthetic rehabilitation status was recorded according to the absence of teeth and use of dental prostheses. Dental prosthesis condition was considered good or poor based on stability, retention, occlusion, vertical dimension, and defects. Poisson regression models were plotted to analyze the data (α = 0.05). RESULTS: Lower Geriatric Oral Health Assessment Index scores were associated with edentulism with denture use only on one jaw (B = -0.05) and poor dental prosthesis stability (B = -0.04). Similarly, edentulous participants with denture only on one jaw (B = 0.59) and those wearing dental prostheses with poor stability (B = 0.36) are more likely to achieve higher Oral Health Impact Profile scores. Also, lower Oral Health Impact Profile scores were associated with denture defects (B = -0.34). CONCLUSION: In summary, the oral health-related quality of life of older adults living in long-term care facilities is negatively impacted by edentulism with denture only on one jaw and use of dental prostheses with poor stability. Therefore, long-term care facilities should provide oral health training to caregivers, include dental professionals in the staff, and articulate demands with oral health teams in the primary care system. (AU)

OBJETIVO: Este estudo transversal objetivou avaliar a associação da qualidade de vida relacionada à saúde bucal com o status de reabilitação protética e a condição da prótese em residentes de instituições de longa permanência no Brasil. METODOLOGIA: A qualidade de vida relacionada à saúde bucal dos idosos (n = 194; média [desvio padrão] idade = 78,93 [9,10]) foi avaliada pelos questionários Geriatric Oral Health Assessment Index e Oral Health Impact Profile. O status de reabilitação protética foi registrado de acordo com a ausência de dentes e uso de próteses dentárias. A condição da prótese foi considerada boa ou ruim com base na estabilidade, retenção, oclusão, dimensão vertical e defeitos. Modelos de regressão de Poisson foram plotados para analisar os dados (α = 0,05). RESULTADOS: Como resultado, menores escores no Geriatric Oral Health Assessment Index foram associados ao edentulismo com o uso de dentadura em apenas uma arcada (B = -0,05) e ao uso de próteses com estabilidade ruim (B = -0,04). De forma similar, participantes edêntulos que usavam dentadura em apenas uma arcada (B = 0,59) e aqueles que portavam prótese com estabilidade ruim (B = 0,36) são mais propensos a ter maiores escores no Oral Health Impact Profile. Além disso, menores escores no Oral Health Impact Profile foram associados a defeitos na prótese (B = -0,34). CONCLUSÃO: Sumarizando, a qualidade de vida relacionada à saúde bucal de idosos residentes em instituições de longa permanência é negativamente impactada pelo edentulismo com o uso de dentadura em apenas uma arcada e uso de prótese com estabilidade ruim. Assim, instituições de longa permanência devem promover capacitação em saúde bucal aos cuidadores, incluir dentistas no quadro de funcionários e articular com as equipes de saúde bucal da Atenção Primária à Saúde. (AU)

Association of sociodemographic characteristics, mental health, and sleep quality with COVID-19 fear in an elderly Brazilian population

Aim: This study determined whether COVID-19 fear is correlated with sociodemographic characteristics, general health, mental health, and sleep quality in an elderly Brazilians. Methods: Elderly people aged ≥ 60 years replied to an online survey containing questions about their sociodemographic characteristics; general health; levels of stress, anxiety, and depression; sleep quality; and COVID fear. Results: Data were statistically analyzed using descriptive statistics (α = 5%). In total, 705 elderly people with mean age of 66 ± 5 years, and most (82.7%) respondents were women, graduated and from southeastern Brazil. COVID-19 fear correlated positively and moderately with sleep quality and symptoms of depression, anxiety, and stress (all p < 0.001). It was associated with females. Elderly people from northern and northeastern Brazil and diabetics had increased COVID-19 fear (all p < 0.05). Conclusion: The fear of COVID-19 exists among Brazilian female old people, diabetics, increases anxiety and stress symptoms, and worsen sleep quality in elderly people

Academic perspectives and psychosocial aspects of final-year dental students during COVID-19 pandemic

Aim: This cross-sectional observational study aimed to evaluate the influence of the Universities lockdown measures on academic perspectives and psychosocial aspects of Brazilian finalyear dental students. Methods: 268 undergraduate students regularly enrolled in a Dentistry course at public universities were asked about anxiety, depression, stress sensitivity, and their academic perspectives by using an online survey. The Hospital Anxiety and Depression Scale (HADS) was used to measure anxiety and depression, while the Perceived Stress Scale (PSS) evaluated stress levels. The academic perspective was evaluated by five affirmatives regarding possible difficulties that will be faced when school reopens and after graduation. The possible association between fear of having COVID-19 with psychosocial outcomes and COVID-19 association with academic perspectives were analyzed by ANOVA and chisquare tests, respectively, considering a significance level of 5%. Results: Considering possible associations between the fear of having COVID-19 and psychosocial aspects, significant values were found for anxiety (P = 0.018) and stress sensitivity (P = 0.002). Regarding students' academic perspectives, COVID-19 had significant impact on less opportunity to perform procedures (P = 0.023), additional expenses with personal protective equipment (P = 0.007), and concerns of consulting elderly people (P = 0.012). Conclusion: The COVID-19 pandemic led to increased psychological impairments and enlarged concerns with learning and biosecurity, which might impact academic perspectives. Thus, being aware of these apprehensions, university professors and staff can improve the clinical training of final-year dental students in an empathetic way

Effect of frozen storage on preservation of a silicone-based test food material

Aim: This study aimed to evaluate the effect of frozen storage on the physical properties of a silicone-based test food material, highly used to evaluate the masticatory performance in research settings. Methods: A total of 1,666 silicone cubes of Optosil Comfort® with 5.6-mm edges were shaped and stored at -18°C. The cubes were subsequently tested for flexural strength (maximum force, displacement, stress, and strain) before breaking (n = 136), changes in weight and size (n = 170), and masticatory performance (n = 1360) at eight timepoints: immediately after cube preparation (baseline, no freezing), and 1, 2, 3 and 4 weeks, and 2, 4 and 6 months after frozen storage. The cubes were thawed 8 h before each assessment. Results: The maximum force, stress, maximum displacement, and deformation values for the cubes were not affected by freezing (P > 0.05). At all of the time points, the cubes exhibited similar weight (P = 0.366) and size (identical values). The masticatory performance for the cubes also showed no differences from baseline through 6 months (P = 0.061). Conclusion: Freezing Optosil Comfort® silicone cubes did not alter the physical and mechanical properties of the material, being suitable to optimize the assessment of masticatory parameters for research purposes

Modificación de la composición corporal con la terapia hormonal parenteral y oral en la menopausia / Changes in body composition with the use of parenteral and oral hormone therapy in the menopause

Resumen Antecedentes: La menopausia se relaciona con cambios en la composición corporal que el uso de terapia hormonal (TH) puede revertir. Objetivo: Determinar el efecto de la TH parenteral y oral sobre la composición corporal en la menopausia. Material y métodos: Se realizó un estudio retrolectivo que incluyó a 86 mujeres de 45 a 55 años, con FSH > 20 Ul/ml, antecedente de histerectomía y sintomatología vasomotora, a las cuales se les administró TH por vía oral (44 pacientes) o parenteral (42 pacientes) durante seis meses. Se les realizó impedancia bioeléctrica antes y después del tratamiento. Resultados: La TH por vía oral se asoció con una disminución de diferentes parámetros de la composición corporal entre los que destaca la disminución de la grasa visceral (p < 0.05). La TH parenteral no mostró modificación en la composición corporal. Conclusión: La TH por vía oral modifica de manera positiva la composición corporal, lo cual puede contribuir a regular el estado metabólico.

Abstract Background: Menopause is associated with changes in body composition that the use of hormone therapy (HT) can reverse. Objective: To determine the effect of parenteral and oral HT on body composition in menopause. Material and methods: A retrolective study was carried out in 86 women aged 45 to 55 years old, with FSH > 20 Ul/ml, a history of hysterectomy and vasomotor symptoms. The participants received oral HT (44 patients) or parenteral (42 patients) for six months. Bioelectrical impedance was performed before and after treatment. Results: Oral HT was associated with a decrease in different parameters of body composition, among which the decrease in visceral fat stands out (p < 0.05). Parenteral HT did not show changes in body composition. Conclusion: Oral HT positively modifies body composition, which can help regulate the metabolic state.

Masticatory Function and Nutritional Status in Brazilian Institutionalized Elders: Influence of Denture Use

ABSTRACT Objective: To evaluate the influence of tooth loss and the use of removable dentures on chewing function and nutritional status of institutionalized elders. Material and Methods: Cross-sectional study with 155 elders from seven long-stay institutions in João Pessoa, Brazil. The participants were classified according to the presence of reminiscent teeth and use of dentures in four levels: toothless, without denture (1); toothless with a complete denture (2); partial toothless without denture (3) and partial toothless with a partial denture (4). Nutritional status was assessed using the Mini-Nutritional Assessment (MNA) instrument and the Body Mass Index (BMI). Swallowing threshold was used for the assessment of masticatory function, using a portion of roasted peanuts (3.7 g). Comparisons among groups were performed using Kruskal-Wallis test with Bonferroni adjustment, considering p<0.05. Results: MNA (p=0.702) and BMI (p=0.884) were not modified in relation to the presence of teeth and denture use. Toothless individuals without dentures had a lower swallowing threshold (p<0.001), whilst partial toothless with dentures had better masticatory function (p>0.05). Conclusion: The presence of reminiscent teeth and the use of dentures do not influence the nutritional status of the elders but interfere with the masticatory function. Prosthetic rehabilitation is desirable for complete toothless individuals.

Factors associated with oral health-related quality of life of institutionalized elders

Abstract This study aimed to evaluate the correlation between two Oral Health-Related Quality of Life (OHRQoL) questionnaires (the Oral Health Impact Profile (OHIP-14) and the Geriatric Oral Health Assessment Index (GOHAI)) and to investigate the factors associated with the OHRQoL of institutionalized elderly individuals. A cross-sectional multicenter study was performed with 344 institutionalized elderly individuals residing in two Brazilian cities. Six trained researchers interviewed the elderly individuals. Sociodemographic data were collected from medical records. Dental caries experience and the use of and need for dentures were recorded through oral examination performed by two trained examiners. A Likert scale (1-5 points) was used to assess general health and self-perceived oral health. The number of chewing cycles needed to chew a portion of peanuts was used to assess the swallowing threshold. The OHIP-14 and GOHAI were used to evaluate OHRQoL, and statistically significant correlations were assessed using Spearman's correlation test (p < 0.05). Poisson regression (p < 0.05) was used to investigate the association of OHRQoL with independent variables. Scores on the OHIP-14 (7.57 ± 8.63) and GOHAI (32.46 ± 3.85) were strongly and inversely correlated (r2 = -0.671, p < 0.001), although these measures were associated with different factors. A higher OHIP-14 total score (worse OHRQoL) was associated with female gender, a greater number of healthy teeth, worse self-perceived general health and oral health, and a lower swallowing threshold (p < 0.05). A higher GOHAI total score (better OHRQoL) was associated with a greater number of filled teeth, better self-perceived oral health and a greater swallowing threshold (p < 0.05). In conclusion, worse OHRQoL among institutionalized elderly individuals is associated with worse self-perceived oral health and a greater swallowing threshold.

Botulinum toxin type A and acupuncture for masticatory myofascial pain: a randomized clinical trial

Abstract BoNT-A has been widely used for TMD therapy. However, the potential benefits compared to dry needling techniques are not clear. Objective this study aimed to compare the immediate effects of botulinum toxin type A (BoNT-A) injections and Acupuncture in myofascial temporomandibular disorders (TMD) patients. Methodology 54 women were divided into three groups (n=18). AC patients received four sessions of traditional acupuncture, being one session/week during 20-min. BoNT-A patients were bilaterally injected with 30U and 10U in masseter and anterior temporal muscles, respectively. Moreover, a control group received saline solution (SS) in the same muscles. Self-perceived pain was assessed by visual analog scale, while pressure pain threshold (PPT) was verified by a digital algometer. Electromyographic evaluations (EMG) of anterior temporal and masseter muscles were also measured. All variables were assessed before and 1-month after therapies. The mixed-design two-way repeated measures ANOVA and Tukey's post-hoc tests were used for analysis, considering a=0.05. Results Self-perceived pain decreased in all groups after one month of therapy (P<.001). BoNT-A was not better than AC in pain reduction (P=0.05), but both therapies were more effective in reducing pain than SS (P<0.05). BoNT-A was the only treatment able to improve PPT values (P<0.05); however, a severe decrease of EMG activity was also found in this group, which is considered an adverse effect. Conclusion after one month of follow-up, all therapies reduced the self-perceived pain in myofascial TMD patients, but only BoNT-A enhanced PPT yet decreased EMG.

Obesidad materna como factor de riesgo de obesidad infantil / Maternal obesity as a risk factor for childhood obesity

Introducción: diversos factores ambientales se han relacionado con el incremento en la frecuencia de obesidad infantil en los últimos años. Objetivo: determinar los factores maternos, socioeconómicos y de estilo de vida asociados al sobrepeso/obesidad en niños de 5 a 10 años. Metodología: se realizó un estudio transversal analítico en 153 niños de ambos sexos a los que se les midió peso, talla, índice de masa corporal, presión arterial, glucosa capilar y la presencia de acantosis nigricans. Se compararon los factores entre niños eutróficos y niños con sobrepeso/obesidad a través de Chi cuadrada o t de Student y se realizó una regresión logística para determinar los factores asociados al sobrepeso/obesidad del niño. Resultados: el 30.7% de los niños presentó sobrepeso/obesidad, en ellos se encontró mayor frecuencia de acantosis nigricans y mayores cifras de presión arterial sistólica. El predictor de obesidad infantil fue la obesidad materna, el riesgo de obesidad entre niños de madre con obesidad fue OR: 1.261 (IC95%: 1.047-1.518). Conclusiones: la obesidad materna incrementa el riesgo de obesidad infantil.

Introduction: Several environmental factors have been related to the increase in the frequency of childhood obesity in recent years. Objective: To determine maternal, socioeconomic and lifestyle factors associated with overweight/obesity in children 5 to 10 years oíd. Methods: A cross-sectional analytical study was performed with 153 children of both sexes, measuring weight, height, body mass índex, blood pressure, casual capillary glucose and the presence of acantosis nigricans. Factors were compared between eutrophic children and those with overweight/obesity through Chi-square test or Student's t test, and logistic regression was performed to determine the factors associated with the child's overweight/obesity. Results: 30.7% of the children presented overweight/obesity. In them acantosis nigrica higher systolic blood pressure were found more frequently. The predictor of childhood was maternal obesity; the risk of obesity among children with mothers with obesity it \a 1.261 (95%CI: 1.047-1.518). Condusions: Maternal obesity increases the risk of childhood obesity.

Gestalt-terapia e Empoderamento Feminino na Relação Terapêutica: Reverberações a partir do Atendimento Psicoterápico entre Mulheres / Gestalt Therapy and Female Empowerment in the Therapeutic Relationship: Reverberations from Psychotherapy among Women / Terapia Gestalt y Empoderamiento Femenino en la Relación Terapéutica: Reverberaciones de la Atención Psicoterapéutica entre Mujeres

Este artigo tem por objetivo compartilhar possíveis reverberações da relação terapêutica, dentro da abordagem gestáltica, no processo de empoderamento feminino em psicoterapia. Partindo da ênfase relacional dada pela proposta teórica da Gestalt-terapia, este texto surge das vivências das autoras em seus consultórios de psicologia, refletindo sobre os desdobramentos dos encontros. Neste contexto, uma escuta atenta revela que os reflexos da cultura patriarcal são notórios nas demandas trazidas pelas mulheres que chegam ao setting terapêutico. Desde as insatisfações com o próprio corpo às dúvidas sobre escolha profissional; das relações conjugais às experiências (ou não) de maternidade, entre outras questões, observamos as exigências de uma sociedade machista ecoando sobre corpos femininos que, muitas vezes, incapazes de dar conta do "você deveria/não deveria", adoecem. Na contramão dos "deverias", a Gestalt-terapia nos instrumentaliza, através da relação terapêutica, a buscar, com cada mulher, seu modo próprio de existir-no-mundo, reconhecendo suas necessidades e construindo formas de atendê-las. Com isso, testemunhamos movimentos singulares de empoderamento feminino, os quais podem reverberar coletivamente nos contextos em que essas mulheres se posicionam e tecem novos encontros. (AU)

This article aims to share possible reflections about the therapeutic relationship, within the gestalt approach, in the process of female empowerment in psychotherapy. Considering the relational emphasis given by the theoretical proposal of Gestalt-therapy, this text emerges from the authors' experiences in their psychology offices, reflecting about the impact of the encounters. In this context, a careful listening reveals that the reflexes of patriarchal culture are notorious in the demands brought by women who reach the therapeutic setting. From dissatisfaction with one's body to doubts about professional choice; from marital relationships to (or not) experiences of motherhood, among other issues, we observe the demands of a chauvinistic society echoing over female bodies that, frequently, are unable to cope with the "you should / shouldn't" and get sick. Contrary to the "shoulds", Gestalt-therapy instructs us, through the therapeutic relationship, to seek with each woman their own way of existing, recognizing their needs and constructing ways to take care of them. Thus, we witness unique movements of female empowerment that can collectively reverberate in the contexts in which these women stand for themselves and meet other people. (AU)

Este artículo tiene como objetivo compartir las posibles reverberaciones de la relación terapéutica, dentro del enfoque gestáltico, en el proceso de empoderamiento femenino en psicoterapia. Partiendo del énfasis relacional dado por la propuesta teórica de la terapia Gestalt, este trabajo emerge de las experiencias de las autoras en sus consultorios de psicología, reflexionando sobre el desarrollo de los atendimientos. En este contexto, una escucha cuidadosa revela que los reflejos de la cultura patriarcal son notorios en las demandas presentadas por las mujeres que llegan al entorno terapéutico. Desde la insatisfacción con el cuerpo hasta las dudas sobre la elección profesional; desde relaciones matrimoniales hasta (o no) experiencias de maternidad, entre otros problemas, observamos las demandas de una sociedad chovinista que resuena sobre los cuerpos femeninos que, a menudo incapaces de hacer frente al "deberías / no deberías" se enferman. Contrariamente a los "deberes", la terapia Gestalt nos instruye, através de la relación terapéutica, para buscar, con cada mujer, su propia manera de existir en el mundo, reconociendo sus necesidades y construyendo formas de satisfacerlas. Por lo tanto, fuimos testigos de movimientos singulares de empoderamiento femenino, que pueden reverberar colectivamente en los contextos en los que estas mujeres se posicionan y tejen nuevos encuentros. (AU)

Removable prostheses improve oral health-related quality of life and satisfaction of elderly people with rheumatoid arthritis

Rheumatoid arthritis (RA) is an autoimmune disease that affects joint tissues and causes severe physical and functional impairments on quality of life due to muscular and articular pain. The involvement of temporomandibular joint in RA interferes with mouth opening and masticatory process. However, no studies addressed the impact of RA on oral health-related quality of life (OHRQoL) and satisfaction with prostheses use in elderly people. Aim: This study assessed the impact of oral rehabilitation with conventional dentures on the OHRQoL and prostheses satisfaction in elderly patients with RA, associated or not with temporomandibular disorder (TMD). Methods: Forty-five elderly were enrolled and divided into three groups: (1) RA and TMD (n=15, experimental), (2) RA without TMD (n=15, experimental), and (3) without RA and without TMD (n=15, control). The OHRQoL and the prostheses satisfaction were evaluated before and after new oral rehabilitation with partial and/or complete dentures. The OHRQoL and prosthesis satisfaction were assessed and verified through OHIP-14 questionnaire and visual analogue scale, respectively. Results: TMD group exhibited the worst mean values (P<0.05) for all OHIP-14 domains before insertion of new dentures. Group 2 showed worst means (P<0.05) compared to controls for functional limitation and physical pain domains of the OHIP-14, but not in the general score. Patients showed better outcomes of satisfaction with prostheses use only after the new rehabilitation. Conclusion: The use of new and well-fitted dentures improves all domains of OHRQoL in patients with RA and TMD and all groups were satisfied with prostheses use after the new rehabilitation with conventional dentures

Mandibular single-implant overdenture as an alternative for full arch rehabilitations: a literature review

Oral rehabilitation with mandibular single-implant overdentures (SIO) has been characterized as a solution to improve retention and stability of conventional complete dentures (CD). Among the benefits of this therapy, it can be mentioned minimally invasive surgery, simple prosthetic technique, better retention, and significantly reduced costs. However, the application of this protocol in daily clinic is still not widespread. Aim: Thus, this study aimed to perform a literature review to address the clinical characteristics of this rehabilitation, when compared to two-implant mandibular overdentures and CD. Methods: For this, a search was conducted in the PubMed database, considering articles published in English language, without date limitation. Results: It was found 243 manuscripts, of which 20 were compatible with the aim of this study after title/abstract reading. The selected papers focused on masticatory muscles function, satisfaction levels and self-reported quality of life, as well as surgical and prosthetic outcomes, such as maintenance, repair and implant failure rates. All evaluated manuscripts showed similar masticatory function and patient's satisfaction with SIO and two-implant overdenture, while results for a SIO were greater when compared to rehabilitations with CD. In addition, SIO have proven to do not damage the implant, being implant loss close to zero. However, the prosthesis fracture adjacent to the implant was a recurrent clinical outcome, which requires further studies to solve this impairment. Conclusion: Thus, it can be concluded that SIO represents an alternative treatment for frail elders or low-income patients, leading to higher masticatory function, as well as improved quality of life

Qualidade da informação em saúde: um estudo sobre o vírus do papilomahumano (HPV) em websites brasileiros / Quality of health information: a study of human papillomavirus (HPV) on Brazilian websites / Calidad de la información en salud: un estudio sobre el virus del papiloma humano (HPV) en sitios web brasileños

A internet vem se tornando para a população uma fonte comum de busca de informações sobre temas ligados à saúde, inclusive sobre o vírus do papiloma humano (HPV). Este artigo apresenta uma avaliação da qualidade da informação sobre o tema HPV disponibilizada em websites sobre saúde e um ranking elaborado com base nos resultados obtidos. Para a avaliação foram aplicados 61 indicadores, divididos entre os critérios de conteúdo, usabilidade e legibilidade. No que se refere ao conteúdo, os websites em questão apresentaram informações sobre exames de diagnóstico, prevenção, tratamento e patologias que podem ser desenvolvidas.Quanto à usabilidade, todos os websites avaliados dispõem de um menu principal e possuem um layout agradável. Os indicadores da legibilidade foram atendidos em sua grande maioria, uma vez que todos os submetidos a essa avaliação apresentaram uso de cores, tamanho e formato de fontes aprazíveis. Observou-se um nível expressivo de qualidade das informações sobre o HPV disponibilizadas nos websites avaliados.(AU)

The internet has become for the population a common source of search for information about issues related to health, including the human papillomavirus (HPV). This article presents an evaluation of the quality ofthe information about the HPV available on health websites and a ranking based on its results. 61 indicators were used to do the evaluation, divided into content, usability and readability criteria. In regard to content,the websites under evaluation presented information about diagnostic exams, prevention, treatment and the pathologies that can be developed. All those websites have a main menu and a pleasant layout. The indicators of readability, for the most part, were satisfied, since the websites showed attractive use of colors,size and format of fonts. It can be observed a significant level of quality of information about HPV available on the websites evaluated.

La internet se ha convertido en una fuente común de búsqueda de temas relacionados con la salud,incluso sobre el virus del papiloma humano (HPV). Este artículo presenta una evaluación de la calidadde la información disponible en sitios web sobre el tema del HPV y un ranking elaborado con base en los resultados obtenidos. Para la evaluación se aplicaron 61 indicadores, divididos entre los criterios de contenido, usabilidad y legibilidad. En lo que respecta al contenido, los sitios web presentan información sobre exámenes de diagnóstico, prevención, tratamiento, y sobre las patologías que pueden ser desarrolladas.En lo que concierne a la usabilidad, todos los sitios web evaluados disponen de un menú principal y tienen un diseño gráfico agradable. Los indicadores de legibilidad fueron atendidos en su gran mayoría, en vista de todos los sitios web evaluados hayan presentado uso de colores, tamaño y formato de fuentes agradables. Se observó un nivel expresivo de calidad de la información sobre el HPV disponible en los sitios web evaluados.

A prática da avaliação psicológica em contextos esportivos / The practice of psychological assessment in sport settings / La práctica de la evaluación psicológica en el ámbito deportivo

RESUMO O presente trabalho tem por objetivo discutir a utilização da avaliação psicológica na prática da psicologia do esporte no Brasil. Para tanto, foram entrevistados seis psicólogos esportivos no intuito de verificar suas opiniões a respeito da avaliação psicológica em sua rotina de trabalho. Foi utilizado um questionário contendo cinco perguntas semi-dirigidas contemplando a compreensão pessoal acerca da avaliação psicológica no esporte, a importância atribuída à sua realização no início do trabalho, os procedimentos adotados, o uso de testes psicológicos e as dificuldades encontradas. A partir dos relatos, discutidos com base na literatura de ambas as áreas - Psicologia do Esporte e Avaliação Psicológica, pode-se observar a relevância da utilização da avaliação psicológica em contextos esportivos para o conhecimento do atleta, de suas relações e de seu contexto, além de sua importância como norteadora das intervenções do psicólogo. A respeito dos procedimentos utilizados, aparecem majoritariamente as entrevistas, a observação e a aplicação de testes psicológicos. Estes últimos são referidos, ainda, como uma das maiores dificuldades encontradas pelos entrevistados, dada a inexistência de instrumentos como estes, específicos para a realidade esportiva, devidamente validados e adaptados à população brasileira.

ABSTRACT The following paper has the goal to discuss the role of psychological evaluation in the exercise of sports psychology in Brazil. Therefore, six sports psychologists were interviewed in order to bring forth their opinions about psychological evaluation in their daily work. A survey containing five semi-directed questions, regarding the personal comprehension about psychological evaluation in sports, the importance given to its application at the beginning of the work, the adopted procedures, the usage of psychological evaluation and the hardships found. The reports were discussed in light of the literature of both areas - Sports Psychology and Psychological Evaluation. The relevance of the psychological evaluation in sports' context to the athlete knowledge of its relations and its context has been observed, as well as its importance as guide to psychological interventions. Interviews, observation and application of the psychological tests show themselves as majority, regarding the adopted procedures in the psychological evaluations. The latter are referred as the most difficult by the reports given by the interviewed, given to the inexistence of specific psychological tests to the sportive reality thoroughly proved and adapted to the Brazilian population.

RESUMEN Este trabajo tiene como finalidad analizar el papel de la evaluación psicológica en la práctica de la psicología deportiva en Brasil. Para esto, se entrevistaron a seis psicólogos especializados en deporte y se analizaron sus opiniones sobre la evaluación psicológica en su rutina laboral. Se les hizo un cuestionario que constaba de cinco preguntas semiestructuradas a su opinión personal sobre la evaluación psicológica deportiva, a la importancia que le dan a su realización en el inicio del trabajo, a los procedimientos adoptados, el uso de test psicológicos y a las dificultades encontradas. Los resultados fueron analizados en base a las literaturas de ambas áreas (psicología deportiva y evaluación psicológica). Se observó la importancia de la evaluación psicológica en el ámbito deportivo para el conocimiento del atleta de sus relaciones y de su contexto, además de la importancia que tiene como guía de las intervenciones psicológicas. Sobre los procedimientos aplicados en las evaluaciones psicológicas, Los resultados dictan que mayormente se utilizan entrevistas y la observación y aplicación de test psicológicos, los cuales fueron reportados como una de las mayores dificultades según los entrevistados, debido a la inexistencia de test psicológicos especificos sobre la realidad deportiva ni debidamente adaptados a la población brasileña.

Craniofacial Morphology Affects Bite Force in Patients with Painful Temporomandibular Disorders

Abstract Craniofacial morphology affects masticatory performance in healthy dentate subjects, but little is known about its effects in patients with painful temporomandibular disorders (TMDs). Forty-eight female patients (mean age of 28±5.8 years) with painful TMDs underwent lateral cephalometric radiography. Using Ricketts' cephalometric analysis and the Vert method, subjects were assigned to three groups according to their craniofacial morphology: brachyfacial (n=22), mesofacial (n=13), and dolichofacial (n=13). Research diagnostic criteria for TMD were used to confirm the TMD diagnosis for each patient. Pain intensity was reported by each patient based on a visual analog scale (VAS). Maximum bite force (MBF) was measured with pressure sensors placed on the first molar site. Masticatory performance (MP) was assessed by chewing a silicone-based artificial material and determining the resulting particle size by the sieve method. Chewing ability (CA) was evaluated for seven food types and analyzed by a VAS questionnaire. Data were analyzed by one-way ANOVA followed by a Tukey-Kramer test (p<0.05). MBF differed in each group, with brachyfacial patients having the highest MBF values. There was no difference in MP among the groups. The groups differed only in their ability to chew one of the seven evaluated food types. In summary, craniofacial morphology affects the MBF without impairing MP or CA in patients with painful TMDs.

Resumo A morfologia craniofacial afeta a performance mastigatória em individuos dentados saudáveis, mas pouco é conhecido sobre seus efeitos em pacientes com desordens temporomandibulares (DTMs) com sintomatologia dolorosa. Quarenta e oito pacientes do gênero feminino (idade média de 28±5,8 anos) com DTM e sintomatologia dolorosa foram submetidas à radiografia cefalométrica lateral. Por meio da análise cefalométrica de Ricketts e método Vert, as voluntárias foram divididas segundo a morfologia crabiofacial em: braquifaciais (n=22), mesofaciais (n=13) ou dolicofaciais (n=13). O Research Diagnostic Criteria for TMD (RDC/TMD) foi utilizado para diagnosticar a presença de DTM em cada paciente. A intensidade de dor foi reportada por cada paciente usando a escala visual analógica (EVA). A força máxima de mordida (FMM) foi medida com sensores de pressão colocados na região de primeiros molares. A performance mastigatória (PM) foi avaliada por meio da mastigação de material artificial confeccionado à base de silicone e determinada pelo tamanho da partícula, usando o método de fracionamento em peneiras. A habilidade mastigatória (HM) foi avaliada por meio de sete tipos de alimento e analisada por meio de EVA. Os dados foram analisados por ANOVA, seguido por teste de Tukey-Kramer (p<0,05). A FMM foi diferente entre cada grupo, sendo que as pacientes braquifaciais apresentaram os maiores valores. Não houve diferença na PM entre os grupos. Os grupos somente diferiram quanto à HM para mastigar apenas um dos sete tipos de alimentos avaliados. Em resumo, a morfologia craniofacial afeta a FMM sem prejudicar a PM ou HM em pacientes com DTM e sintomatologia dolorosa.

Oral Health in Elders with Parkinson's Disease

Abstract This study aimed to evaluate objectively and subjectively the oral health of elders with Parkinson's disease (PD), using clinical oral assessments and the General Oral Health Assessment Index (GOHAI). Subjects included 37 removable prosthesis wearers, 17 with PD (mean age 69.59±5.09 years) and 20 without PD (mean age 72.00±5.69 years). The objective assessment included an evaluation of oral characteristics, including the number of remaining teeth, decayed, missing and filled teeth (DMFT), visible plaque index (VPI), salivary flow rate and removable prosthesis conditions. The subjective assessment included self-perception of oral health collected using the GOHAI index. The number of remaining teeth, DMFT, VPI, salivary flow rate and GOHAI data were compared between the groups using t-tests. Removable prosthesis conditions were analyzed using χ2 tests (p<0.05). There were no group differences in the number of remaining teeth, DMFT, VPI or salivary flow rate (p>0.05). Greater maxillary prosthesis defects were observed in the control group (p=0.037). GOHAI scores were low for the PD group and moderate for controls, yielding a group difference (p=0.04). In conclusion, elders with PD have similar oral health to controls. Although all elders had few remaining teeth, high DMFT and high VPI, PD elders had more negative self-perceptions of their oral health than did the controls.

Resumo Este estudo teve como objetivo avaliar objetiva e subjetivamente a saúde bucal em idosos com doença de Parkinson (DP), usando avaliações clínicas bucais e do General Oral Health Assessment Index (GOHAI). Os participantes foram 37 indivíduos usuários de prótese removível, 17 com DP (idade média 69,59±5,09 anos) e 20 sem DP (idade média 72,00±5,69 anos). A avaliação objetiva incluiu avaliação de características bucais,incluindo número de dentes remanescentes; dentes cariados, perdidos e obturados (CPOD); índice de placa visível (IPV), a taxa de fluxo salivar e as condições das próteses removíveis. A avaliação subjetiva incluiu autopercepção da saúde bucal, coletada usando o índice GOHAI. O número de dentes remanescentes, CPOD, IPV, fluxo salivar e os dados GOHAI foram comparadas entre os grupos utilizando o teste t . As condições das próteses removíveis foram analisadas utilizando o teste χ2 (p<0,05). Não houve diferenças entre os grupos no número de dentes remanescentes, CPOD, IPV ou fluxo salivar (p>0,05). Maiores defeitos na prótese superior foi observada no grupo controle (p=0,037). As pontuações do GOHAI foram baixa para o grupo DP e moderada para os controles, com diferença entre os grupos (p=0,04). Como conclusão, os idosos com doença de Parkinson tem saúde bucal semelhante aos controles. Embora todos os idosos tenham poucos dentes remanescentes, alto CPOD e alto IPV, os idosos com DP apresentaram autopercepção mais negativa da sua saúde bucal em relação aos controles.

Implant-Supported Removable Partial Denture Improves the Quality of Life of Patients with Extreme Tooth Loss

Abstract: This study aimed to evaluate oral health-related quality of life (OHRQoL) in partially dentate subjects, presenting extreme tooth loss in posterior region with missing post-canines, comparing the use of conventional removable partial dentures (RPDs) and implant-supported RPDs. OHRQoL was measured using the Brazilian version of the Oral Health Impact Profile. Twelve subjects presenting maxillary total and mandibular Kennedy Class I edentulism (mean age 62.6±7.8 years) first received complete maxillary dentures and conventional mandibular free-end RPDs. After two months, the subjects had their OHRQoL assessed. Osseointegrated implants were inserted bilaterally in the mandibular first molar regions, and after four months ball abutments were placed to support the free-end RPD. Two months later, the patients had their OHRQoL reassessed. Wilcoxon signed-rank test was used to evaluate differences in OHRQoL (α=0.05). Results showed improvement in all OHIP-49 domains (p<0.05) after associating implants to the RPD. The mandibular implant-supported free-end RPD significantly improved OHRQoL.

Resumo: Este estudo avaliou a qualidade de vida relacionada à saúde bucal (QVRSB) em indivíduos parcialmente dentados, apresentando perda extrema de dentes na região posterior com ausência de dentes pós-caninos, comparando a reabilitação por meio de próteses parciais removíveis convencionais (PPRs) e PPRs implanto-suportadas. A QVRSB foi mensurada utilizando a versão brasileira do Oral Health Impact Profile (OHIP-49). Doze indivíduos apresentando edentulismo total maxilar e Classe I de Kennedy mandibular (idade média 62,6±7,8 anos) receberam primeiramente próteses totais maxilares e PPRs mandibulares convencionais de extremidade livre. Após dois meses de uso destas próteses, a QVRSB dos voluntários foi avaliada. Implantes osseointegrados foram bilateralmente instalados na região de primeiros molares inferiores e, após quatro meses, pilares do tipo bola foram instalados para suportar a extremidade livre da PPR. Após dois meses a QVRSB dos voluntários foi reavaliada. O teste pareado de Wilcoxon foi utilizado para avaliar as diferenças de QVRSB (α=0,05). Os resultados mostraram melhora em todos os domínios do OHIP-49 (p<0,05) após a associação dos implantes à PPR. PPRs de extremidade livre mandibulares implanto-suportadas melhorou significativamente a QVRSB.

Long-term Short Implants Performance: Systematic Review and Meta-Analysis of the Essential Assessment Parameters

Lack of standard criteria in the outcome assessment makes it difficult to draw conclusions on the clinical performance of short implants and, under these circumstances, determine the reasons for implant failure. This study evaluated, through a systematic review of the literature and meta-analysis, the essential parameters required to assess the long-term clinical performance of short and extra-short implants. Electronic databases (Pubmed-MEDLINE, Cochrane Library Database, Embase, and Lilacs) were searched by two independent reviewers, without language limitation, to identify eligible papers. References from the selected articles were also reviewed. The review included clinical trials involving short dental implants placed in humans, published between January 2000 and March 2014, which described the parameters applied for outcome's measurements and provided data on survival rates. Thirteen methodologically acceptable studies were selected and 24 parameters were identified. The most frequent parameters assessed were the marginal bone loss and the cumulative implant survival rate, followed by implant failure rate and biological complications such as bleeding on probing and probing pocket depths. Only cumulative implant survival rate data allows meta-analysis revealing a positive effect size (from 0.052 (fixed) to 0.042 (random)), which means that short implant appears to be a successful treatment option. Mechanical complications and crown-to-implant (C/I) ratio measurement were also commonly described, however, considering the available evidence; no strong conclusions could be drawn since different methods were used to assess each parameter. By means of this literature review, a standard evaluation scheme is proposed, being helpful to regiment further investigations and comparisons on future studies.

A falta de critérios padronizados para a avaliação dos resultados faz com que seja difícil tirar conclusões sobre o desempenho clínico dos implantes curtos e, nestas circunstâncias, determinar as razões para o fracasso do implante. Este estudo avaliou, através de uma revisão sistemática da literatura, os parâmetros essenciais necessários para avaliar o desempenho clínico em longo prazo de implantes curtos e extra-curtos. Bases de dados eletrônicas (PubMed-MEDLINE, Base de dados da Biblioteca Cochrane, Embase e Lilacs) foram avaliadas por dois revisores independentes, sem limitação da linguagem, de modo a identificar artigos elegíveis. As referências dos artigos selecionados foram também analisadas. A revisão incluiu estudos clínicos, publicados entre janeiro de 2000 e março de 2014, envolvendo implantes dentais curtos, instalados em seres humanos, nos quais foram descritos os parâmetros utilizados para mensuração dos resultados e fornecidos dados sobre as taxas de sobrevivência. Treze estudos metodologicamente aceitáveis foram selecionados, sendo identificados 24 parâmetros. Os parâmetros avaliados com maior frequencia foram a perda óssea marginal e a taxa cumulativa de sobrevivência do implante, seguida pela taxa de falha dos implantes e complicações biológicas, tais como sangramento à sondagem e profundidade de sondagem. Apenas a taxa cumulativa de sobrevivência dos implantes permitiu a meta-análise revelando efeito positivo (variação de 0.052 (efeito fixo) até 0.042 (efeito aleatório)), demonstrando que os implantes curtos parecem ser uma opção de tratamento bem sucedida. Complicações mecânicas e a mensuração da proporção coroa-implante foram também referidas, entretanto, considerando-se as evidências disponíveis, não se pode chegar a fortes conclusões, pois diferentes métodos foram utilizados para avaliar cada parâmetro. Por meio desta revisão da literatura, um esquema padronizado de avaliação é proposto, sendo útil para arregimentar ...

Multidisciplinary Therapy of Extensive Oligodontia: A Case Report

Oligodontia is a rare congenital disorder consisting in the absence of six or more teeth. This case report describes a multidisciplinary treatment approach for a 12-year-old male with absence of 11 permanent teeth. Prior to any procedure, all primary teeth were scheduled for extraction due to poor crown-to-root ratio. The treatment plan comprised two phases: 1. orthodontic and speech therapy aimed at overbite and anterior open bite adjustment, as well as tongue position improvement; and 2. prosthetic treatment by insertion of removable temporary partial dentures. The multidisciplinary treatment involving orthodontics, speech and prosthetic therapies have reestablished the masticatory function and aesthetics, allowing the patient to achieve greater self-esteem and better social acceptance.

Resumo A oligodontia é uma doença rara, congênita, caracterizada pela ausência de seis ou mais dentes. Este relato de caso descreve uma abordagem terapêutica multidisciplinar de um adolescente de 12 anos de idade com ausência de 11 dentes permanentes. Antes de qualquer procedimento, todos os dentes decíduos foram extraídos devido à pobre relação coroa-raiz. O plano de tratamento foi constituído por duas fases: 1. terapia ortodôntica e fonoaudiológica com o objetivo de ajuste de sobre-mordida e mordida aberta anterior, bem como melhoria da posição da língua, e 2. tratamento reabilitador protético através da instalação de próteses parciais removíveis provisórias. A abordagem multidisciplinar envolvendo os tratamentos ortodônticos, fonoaudiológico e protético reestabeleceram a função mastigatória e a estética, melhorando a autoestima e aceitação social do paciente. .