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ABSTRACT Caries is a multifactorial disease due to the imbalance of the de/re-mineralization process. Complementary radiographic examinations are able to detect hidden caries. The purpose of this short communication was to investigate the radiolucent image suggestive of hidden caries in lower third molar. The extraction of the tooth, decalcification, inclusion and preparation were performed for histological analysis of the lesion. Histological findings revealed a pre-eruptive resorption, and the etiological factors of this coronary resorption were undefined. The professional should be aware of the occurrences of these lesions to early diagnose and propose appropriate treatment to avoid future complications to the patient.
RESUMO A cárie é conceituada como uma doença multifatorial condicionada ao desequilíbrio no processo de desmineralização e remineralização das estruturas dentárias. O propósito desse trabalho foi investigar a imagem radiolúcida sugestiva de cárie oculta em terceiro molar. Foi realizado a exodontia do elemento dentário, descalcificação e confecção de lâminas para posterior estudo histológico da lesão. O achado histológico conclui-se tratar de uma reabsorção pré-eruptiva. O profissional deve estar atento às ocorrências dessas lesões para diagnosticar precocemente e propor o tratamento adequado, evitando complicações futuras ao paciente.
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ABSTRACT Objective: This study aimed to review the psychometric properties of oral health-related quality of life (OHRQoL) questionnaires for the Brazilian adult population. Methods: A systematic review was performed based on the COSMIN guidelines (PROSPERO CRD42022300018). The studies were obtained through electronic searches in the PubMed/MEDLINE, Web of Science, Lilacs, VHL (BIREME), SciELO, and Embase databases. Results: The search was performed in December 2022. Articles on OHRQoL that reported the cross-cultural adaptation of instruments into Portuguese (Brazil) and evaluated the psychometric properties of measuring instruments in adult patients were included. Those about the development of a novel instrument and participants under 18 years of age were excluded. Information was collected on the country, type of instrument validated, psychometric tests, and adaptation process. The certainty of the evidence was assessed using GRADEpro program. The search returned 6,556 articles, and 14 were considered for this review. However, two studies did not report the cross-cultural adaptation process. Content validity, internal consistency, criterion validity, construct validity, reliability, general discriminant validity, Cronbach's alpha value, and general intraclass correlation coefficient value were confirmed in 12 studies. Cronbach's alpha ranged from 0.69 to 0.96. The certainty of the evidence was considered moderate and low. This study has some limitations, such as the lack of information in some reviewed studies, the unavailability of Brazilian instruments, and absence of longitudinal validation of some instruments. Conclusions: In conclusion, there are 14 OHRQoL instruments adapted for Brazilian adults that can be used with caution by researchers and clinicians, since they presented moderate to low certainty of the evidence.
RESUMO Objetivo: Este estudo teve como objetivo revisar as propriedades psicométricas dos questionários de qualidade de vida relacionada à saúde bucal (OHRQoL) para a população adulta brasileira. Métodos: Foi realizada uma revisão sistemática com base nas diretrizes Consensus-based standards for the selection of health measurement instruments - COSMIN (International Prospective Register of Systematic Reviews - PROSPERO CRD42022300018). Os estudos foram obtidos por meio de buscas eletrônicas nas bases de dados United States National Library of Medicine (PubMed)/ Medical Literature Analysis and Retrieval System Online (MEDLINE), Web of Science, Literatura Latino-Americana e do Caribe em Ciências da Saúde (Lilacs), Biblioteca Virtual em Saúde - BVS (Centro Latino-Americano e do Caribe de Informação em Ciências da Saúde - BIREME), Scientific Electronic Library Online (SciELO) e Embase. A busca foi realizada em dezembro de 2022. Foram incluídos artigos que relatavam a adaptação transcultural de instrumentos (QVRSB) para o português (Brasil) e que avaliavam as propriedades psicométricas de mensuração de instrumentos (QVRSB) em pacientes adultos. Foram excluídos aqueles sobre o desenvolvimento de um novo instrumento e com participantes menores de 18 anos. Foram coletadas informações sobre país, tipo de instrumento validado, testes psicométricos e processo de adaptação. A certeza da evidência foi avaliada usando GRADE. Resultados: A pesquisa retornou 6556 artigos, e 14 foram incluídos nesta revisão. Dois estudos não relataram o processo de adaptação transcultural. A validade de conteúdo, consistência interna, validade de critério, validade de constructo, confiabilidade, validade discriminante geral, valor alfa de Cronbach e valor geral do coeficiente de correlação intraclasse foram confirmadas em 12 estudos. O alfa de Cronbach variou de 0,69 a 0,96. A certeza da evidência foi considerada moderada e baixa. Esta pesquisa apresenta algumas limitações, como falta de informação em alguns estudos revisados; indisponibilidade de instrumentos brasileiros; ausência de validação longitudinal de alguns instrumentos. Conclusões: Em conclusão, existem 14 instrumentos de QVRSB adaptados para adultos brasileiros que podem ser utilizados com cautela por pesquisadores e clínicos, uma vez que apresentam moderada a baixa certeza de evidência.
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Contexto:O cimento cirúrgico é um material alternativo no pós operatório de gengivoplastia e gengivectomia, que proporciona conforto ao paciente. Porém, existem controvérsias sobre sua utilização, sendo relatado por alguns especialistas o surgimento do processo inflamatório agudo, sendo classificado como desnecessário.Objetivo: Identificar evidências na literatura acerca do efeito do cimento cirúrgico no pós-operatório do tecido gengival após gengivectomia e gengivoplastia. Materiais e métodos: Foi realizada uma revisão crítica de literatura por meio de buscas nas bases de dadosPubmed, Scielo, Lilacs, Cochrane, Scopus e na literatura cinzenta (Periódicos Capes, Google Scholar). Foram incluídos ensaios clínicos randomizados que testaram o cimento cirúrgico em casos de gengivectomias. Os artigos foram selecionados inicialmente pelo título e resumo, seguido de análise do texto na íntegra. Os estudos incluídos tiveram o nível de evidência avaliado por parâmetros do CONSORT. Resultados:Foram levantados 1458 estudos, sendo 16 escolhidos para leitura na íntegra e, destes, 3 foram incluídos na revisão. A amostra teve idade variando de dezessete a setenta e um anos. Foi utilizado cimento cirúrgico sem eugenol comparado com o bochecho de clorexidina 0,2% e a escovação mecânica precoce no pós-cirúrgico. Um estudo relatou menor índice de dor com o uso de cimento cirúrgico. O tempo de acompanhamento dos estudos foi de 30 dias. Dois estudos tiveram nível de evidência III.Conclusão: Os artigos apresentaram baixa evidência científica e quenão há consenso na literatura quanto ao efeito de cimento cirúrgico após gengivectomias.
Aim:To identify evidence in the literature about the effect of periodontal dressing on the healing of gingival tissue after gingivectomy and gingivoplasty. Materials and methods: A critical literature review was carried out through electronic searches in thePubmed, Scielo, Lilacs, Cochrane, Scopus databases and in the gray literature (Periódicos Capes, Google Scholar). Randomized clinical trials evaluating periodontal dressing in gingivectomies were included. The articles were selected by title and abstract,followed by analysis of the full text. The included studies have the level of evidence determined by CONSORT parameters. Results: A total of 1458 studies were surveyed, 16 were selected for full reading and, of these, 3 were included in the review. The age sample ranged from seventeen to seventy-one years old. A periodontal dressing without eugenol was used compared to a 0.2% chlorhexidine mouthwash and an early mechanical brushing after surgery. One study reported less pain with the use of periodontal dressing. The follow-up of the studies was 30 days. Two studies had Level of Evidence III.Conclusion:It was concluded that the articles had low scientific evidence and that there is no consensus in the literature regarding the effect of periodontal dressing after gingivectomies.
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Objetivo:Realizar uma comparação entre a prevalência de infecções hospitalares pelo período de 13 meses entre dois grupos: pacientes internados sem assistência odontológica e com assistência odontológica. Métodos:O estudo é considerado do tipo transversal descritivo, através de dados referentes às taxas de infecções hospitalares obtidas em dois grupos, sem e com acompanhamento odontológico, considerando mais especificamente os setores: Centro de Terapia Intensiva (CTI) e Clínica Neurológica. Foram incluídos na amostra pacientes com idade superior a 16 anos, de ambos os gêneros e que apresentaram diagnóstico de infecção hospitalar após o período de 48 horas de internação ou 48 horas após a alta. Resultados:Entre março de 2016 à março de 2017, observou-se uma prevalência de infecção hospitalarde 3.14% em pacientes sem assistência odontológica e no período de março de 2017 à março de 2018, a prevalência foi de 2.85% nos pacientes que tiveram assistência odontológica. Conclusão: O CTI foi o setor de maior ocorrência das infecções. A assistência odontológica não se mostrou associada com as ocorrências de infecções.
Aim: To make a comparison between the prevalence of hospital infections over a period of 13 months between two groups: patients hospitalized without dental care and with dental care. Methods:This was a descriptive cross-sectional study, through data regarding the rates of hospital infections obtained in two groups: with and without dental care, considering more specifically the sectors: Intensive care unit (ICU) and neruological clinic. Patients over 16 years-old, of both genders and who were diagnosed withhospital infection after 48 hours of hospitalization or 48 hours after discharge, were included in the sample. Results: Between March 2016 and March 2017, a prevalence of hospital infection was observed of 3. 14% in patients without dental care and from March 2017 to March 2018, the prevalence was 2. 85% in patients who had dental care. Conclusion: The ICU was the sector with the highest occurrence of infections. Dental care was not associated with the occurrence of infections.
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Fundamento: O estado de saúde bucal pode ter influência física e psicológica sobre a vida dos indivíduos. Pode afetar simultaneamente o prazer na vida devido a interferência nas condições bucais, na fala, mastigação, sabor e deglutição, nos domínios sociais, sobre a aparência e autoconfiança dos indivíduos. Objetivo:Verificar se o tratamento protético odontológico é capaz de gerar melhoria na qualidade de vida e na autoestima de pacientes idosos submetidos a hemodiálise. Materiais e Métodos: Realizou-se um estudo intervencional com 26 pacientes submetidos à hemodiálise na cidade de Diamantina, Brasil. Os pacientes foram divididos em dois grupos de acordo com a realização do tratamento; com e sem tratamento. O grupo tratamento recebeu ajustes ou confecção de uma nova prótese odontológica, já o grupo sem tratamento recebeu apenas avaliação clínica e orientações sobre higiene bucal. A qualidade de vida foi avaliada através do instrumento Medical Outcomes Study 36-Item Short Form Health Questionnaire (SF-36) e Oral Health Impact Profile (OHIP) na sua versão 14. Já para a autoestima utilizou-se a Escala de Autoestima de Rosenberg. Resultados: A média de idade foi 69,08 anos (±05,90) e o índice CPO-D médio foi de 29,65 (±01,35). Houve significância estatística na dimensão aspecto emocional do SF-36 nos dois grupos. O grupo que recebeu tratamento apresentou significância na incapacidade física do OHIP-14 e melhora da autoestima. Conclusão: O tratamento protético odontológico gerou melhoria na qualidadede vida e impactou na autoestima de pacientes idosos submetidos à hemodiálise, sendo o impacto maior nos pacientes que realizaram tratamento protético
Background: Oral health status can have a physical and psychological influence on individuals' lives. It can simultaneously affect the pleasure in life due to interference in oral conditions, speech, chewing, taste and swallowing, in social domains, on the appearance and self-confidence of individuals. Objective:To verify whether dental prosthetic treatment is able to improve the quality of life and self-esteem of elderly patients undergoing hemodialysis. Materials and Methods: An interventional study was carried out with 26 patients undergoing hemodialysis in the city of Diamantina, Brazil. Patients were divided into two groups according to treatment completion; with and without treatment. The treatment group received adjustments or made a new dental prosthesis, while the group without treatment received only clinical evaluation and guidance on oral hygiene. Quality of life was assessed using the instrument Medical Outcomes Study 36-Item Short Form Health Questionnaire (SF-36) and Oral Health Impact Profile (OHIP) in its version 14. For self-esteem, the Rosenberg Self-Esteem Scale was used. Results:The mean age was 69.08 years (±05.90) and the mean DMFT index was 29.65 (±01.35). There was statistical significance in the emotional aspect dimension of the SF-36 in both groups. The group that received treatment showed significance in the physical disability of the OHIP-14 and improvement in self-esteem. Conclusion:Dental prosthetic treatment improved the quality of life and impacted the self-esteem of elderly patients undergoing hemodialysis, with the greatest impact on patients who underwent prosthetic treatment.
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Background: Bruxism is defined as repetitive masticatory muscle activity characterized by clenching or grinding of the teeth and it has been related to psychological factors, such as personality traits, anxiety and stress. Objective: To investigate association between stress and bruxism among university students. Materials and methods:Lipp's Stress Symptoms Inventory for Adults (LSSI) was applied to 253 university students in Diamantina, Brazil. The y were clinically evaluated to verify dental wear. The non-instrumental evaluation of probable bruxism was determined by the patients' reports. Sociodemographic variables and self-reported stress data were collected by usi ng the questionnaire. The chi-square test was used, and significance level of 5% ( p<0.05) was adopted. Results: The prevalence of bruxism was 45.8% and stress, 37.9%. There was no significant association between the presence of stress diagnosed by ISSL and bruxism (p = 0.815). Among the students diagnosed as stressed, 31.6% were in the resistance phase. Self-reported stress was associated with the habit of tooth grinding (p < 0.001). Conclusions: No association was found between stress and bruxism. Nevertheless, the prevalence of bruxism among these students was considered high.
Fundamento: O bruxismo é definido como atividade muscular repetitiva da mastigação caracterizada pelo ranger dos dentes e tem sido relacionado a fatores psicológicos, como traços de personalidade, ansiedade e estresse. Objetivo: Verificar a associação entre estresse e bruxismo em universitários. Materiais e métodos:O Inventário de Sintomas de Stress para Adultos de Lipp (ISSL) foi aplicado a 253 estudantes universitários em Diamantina, Brasil. Eles foram avaliados clinicamente para verificar o desgaste dentário. A avaliação não instrumental de provável bruxismo foi determinada pelos relatos dos pacientes. Variáveis sociodemográficas e dados de estresse autorreferido foram coletados por meio do questionário. Foi utilizado o teste do qui-quadrado e adotado nível de significância de 5% (p <0,05). Resultados: A prevalência de bruxismo foi 45,8% e estresse, 37,9%. Não houve associação significativa entre a presença de estresse diagnosticado pelo ISSL e bruxismo (p = 0,815). Entre os alunos com diagnóstico de estresse, 31,6% encontravam-se na fase de resistência. O estresse autorreferido foi associado ao hábito de ranger os dentes (p <0,001). Conclusões: Não foi encontrada associação entre estresse e bruxismo. Apesar disso, a prevalência de bruxismo entre esses estudantes foi considerada alta.
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Contexto: a insuficiência renal crônica dá-se quando os rins deixam de desenvolver suas multitarefas com eficácia, levando o paciente à hemodiálise ou transplante renal e a um progressivo desgaste emocionalObjetivo:avaliar percepção da qualidade de vida relacionada à saúde bucal e autoestima de pacientes submetidos à hemodiálise, após intervenções odontológicas e transplantes renais. Materiais e Métodos: Oitenta e dois pacientes responderam aos questionários SF-36, OHIP-14 e Escala de Autoestima de Rosenberg. Destes, 76 passaram por intervenções odontológicas e responderam aos questionários novamente. Após 3 anos, apenas 33 deram continuidade ao estudo. Doze foram transplantados e 10 responderam aos questionários ao final. Resultados:Apenas a autoestima mostrou melhora, com alterações estatisticamente significativas. Conclusão:Tratamento odontológico e transplante renal melhoraram a autoestima dos pacientes. Houve uma tendência de melhora no aspecto social.
Background: Chronic kidney failure occurs when the kidneys fail to perform their multitasking effectively, leading the patient to hemodialysis or kidney transplantation and progressive emotional exhaustionObjective:to evaluate the perception of quality of life related to oral health and self-esteem of patients undergoing hemodialysis, after dental interventions and kidney transplants. Materials and Methods:Eighty-two patients answered the SF-36, OHIP-14 and Rosenberg Self-Esteem Scale questionnaires. Of these, 76 underwent dental interventions and answered the questionnaires again. After 3 years, only 33 continued the study. Twelve were transplanted and 10 completed the questionnaires. Results:Only self-esteem showed improvement, with statistically significant changes. Conclusion:Dental treatment and kidney transplantation improved patients' self-esteem. There was a trend towards improvement in the social aspect.
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Background: Patients undergoing dialysis treatment have a worse quality of life and have higher rates of malnutrition, inflammation and hospitalization than the general population. Objective: This study aimed to evaluate the influence of dental treatment on the quality of life and self-esteem of hemodialysis-therapy patients. Materials and Methods: An interventional study was developed with 27 patients undergoing hemodialysis in Diamantina, Brazil. Initially, patients received a clinical evaluation of a dentist and responded to questionnaires to estimate the quality of life (Medical Outcomes Study 36-Item Short Form Health Questionnaire (SF-36) and Oral Health Impact Profile (OHIP) version 14) and self-esteem (Scale Self-Esteem of Rosenberg). After 45 days, the questionnaires were reapplied, and the patients received dental treatment to adapt the oral environment. After the treatment, 45 days were awaited to reapply the questionnaires. Descriptive analyzes were performed, Wilcoxon and Friedman tests were done. The level of significance was set at 5% (p <0.05). Results: Twenty-seven low-income and educated individuals participated in the study, most of whom were men. Hypertension and diabetes were not widely reported systemic diseases. There was statistical significance in SF-36 and OHIP-14 dimensions and improvement of self-esteem. Conclusion: Dental treatment interfered positively with the quality of life and self-esteem of patients undergoing hemodialysis.
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Background: The implementation of the self-cleaning practice is of fundamental importance for the maintenance of oral health and to remove the human dental biofilm which is considered the main etiological factor for the development of caries and periodontal diseases. Objective: This study aimed to evaluate the use of chewing gum, Rolly Brush® and apples as forms of mechanical control and removal of the dental biofilm in the absence of brushing. Materials and Methods: Eighteen volunteers were submitted to plaque index evaluation after a period of 24 hours of no oral hygiene. Then, they would use one of the methods: chewing gum, Rolly Brush®, apple or tooth brushing, chosen by a draw, for one minute, and then, plaque index was evaluated again. This stage was repeated until all participants were submitted to all selected methods, in periods of 24 hours each. Results: Dental brushing was more effective when compared to each of the other methods applied and there was a statistically significant reduction of dental plaque index after apllying all methods of cleaning in all groups. Conclusion: Chewing gum, Rolly Brush® and apple may be used as auxiliary to dental brushing or when such method is impossible to be performed. Clinicaltrials.gov: number of protocol NCT 03.601.585.
Fundamento: A implementação da prática de autolimpeza é de fundamental importância para a manutenção da saúde bucal e remoção do biofilme dental humano que é considerado o principal fator etiológico para o desenvolvimento de cáries e doenças periodontais. Objetivo: Este estudo teve como objetivo avaliar a utilização de goma de mascar, Rolly Brush® e maçã como formas de controle mecânico e remoção do biofilme dental na ausência de escovação. Materiais e Métodos: Dezoito voluntários foram submetidos à avaliação do índice de placa após um período de 24 horas sem higiene bucal. Em seguida, utilizariam um dos métodos: goma de mascar, Rolly Brush®, ingerir uma maçã e escovar os dentes, escolhida por sorteio, por um minuto, e então, o índice de placa era novamente avaliado. Essa etapa foi repetida até que todos os participantes fossem submetidos a todos os métodos selecionados, em períodos de 24 horas cada. Resultados: A escovação dentária foi mais eficaz quando comparada a cada um dos outros métodos aplicados e houve redução estatisticamente significativa do índice de placa dentária após a aplicação do método de limpeza em todos os grupos. Conclusão: Goma de mascar, Rolly Brush® e maçã podem ser utilizados como auxiliares da escovação dentária ou quando tal método for impossível de ser realizado. Clinicaltrials.gov: Número do protocolo NCT 03.601.585.
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Introduction: Chronic kidney failure is a serious public health problem worldwide and it is considered an alarmingly epidemic. Patients undergoing hemodialysis treatment require dental attention, and perioperative management in this population is challenging. Aim:To evaluate the procedure of tooth extraction in anticoagulated patients undergoing hemodialysis, detecting possible complications during and after surgery. Material and Method:Eleven patients, from the hemodialysis sector of the Santa Casa de Caridade de Diamantina -MG, who needed tooth extractions, with medical clearance, previously undergoing periodontal treatment, were selected at the Clinic of Surgery and Periodontics of the Department of Dentistry of the Federal University of Jequitinhonha and Mucuri Valleys. Postoperative questionnaires were applied for the proposed evaluations. Results:A total of 8 patients were treated and 14 teeth were extracted. Only one patient reported mild pain, and presented mild bleeding, most patients used the recommended pain killer, and there were no alveolar infections. Conclusion:The entire sample obtained satisfactory results with the proposed treatment during and after dental surgery. There is no reason to neglect their dental needs due to the apprehension of complications.
Introdução: A insuficiência renal crônica emerge como um sério problema de saúde pública em todo o mundo, sendo considerada uma epidemia de crescimento alarmante. Pacientes em tratamento hemodialítico requerem atenção odontológica e o manejo perioperatório nesta população é desafiador e importante. Objetivo:Avaliar clinicamente o procedimento cirúrgico de exodontia em pacientes anticoagulados submetidos à hemodiálise, observando possíveis complicações no trans e no pós-operatório. Materiais e métodos:Foram selecionados 11 pacientes do setor de hemodiálise da Santa Casa de Caridade de Diamantina MG, que necessitavam de exodontias, com liberação médica, passando previamente por adequação periodontal, na Clínica de Cirurgia e Periodontia do Departamento de Odontologia da Universidade Federal dos Vales do Jequitinhonha e Mucuri. Questionários pós cirúrgicos foram aplicados para as avaliações propostas. Resultados:Um total de 8 pacientes foram atendidos e 14 dentes extraídos. Apenas um paciente relatou dor classificada como leve, quadros de hemorragia leve ocorreram sem complicações, a maioria dos pacientes fez uso da analgesia recomendada e não houve infecções alveolares. Conclusão:Respeitando os protocolos, toda a amostra obteve resultado satisfatório com o tratamento proposto no trans e pós cirúrgico, não havendo motivos para negligenciar suas necessidades odontológicas por apreensão de complicações e intercorrências
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Abstract Background Currently, different pain scales are used extensively to measure clinical pain, especially in dental practice. Objective This study aims to compare pain scales used in clinical research and dental practice, identifying the easiest to understand by patients with Cervical Dentin Hypersensitivity. Method Seventy-four patients with Cervical Dentin Hypersensitivity were stimulated by a thermic test of the sensitive tooth, followed by application of different pain measurement scales (Visual Analogue Scale, Faces Pain Scales, Numeric Rating Scale, and Verbal Rating Scale) and by a questionnaire to evaluate the patient's perception regarding the ease of understanding scales. The statistic tests used were the Wilcoxon, Spearman correlation, and Chi-Square tests. Results The results founded a strong positive correlation between the scales (r = 0.798 to 0.960 p <0.001). The was easiest scale to understand according to the patients was the Verbal Rating Scale (52.7%). Conclusion The pain measurement scales evaluated provide similar information about pain reported in the Cervical Dentin Hypersensitivity allowing the comparison between studies that used them to measure pain. The affinity of the patient with the pain scale can guide the clinical dental practice in the different levels of health care.
Resumo Introdução Atualmente, diferentes escalas têm sido utilizadas para medir a dor no contexto clínico, especialmente na prática odontológica. Objetivo O objetivo deste estudo foi comparar as escalas de dor comumente utilizadas em pesquisas clínicas e na prática clínica odontológica, identificando as mais fáceis de serem compreendidas pelos pacientes com hipersensibilidade dentinária cervical. Método Setenta e quatro pacientes com hipersensibilidade dentinária cervical foram estimulados por um teste térmico para avaliação do dente sensível, seguido pela aplicação de diferentes escalas para avaliação de dor (Escala Visual Analógica, Faces de Dor, Escala Numérica e Escala Verbal) e de um questionário complementar para avaliar a percepção do paciente em relação à facilidade de compreensão das escalas. Os resultados foram submetidos aos testes de correlação de Wilcoxon, Spearman e Qui-Quadrado. Resultados Uma forte correlação positiva foi encontrada entre as quatro escalas avaliadas (r = 0,798 a 0,960; p < 0,001). De acordo com os pacientes, a escala de mais fácil compreensão foi a Escala Verbal (52,7%). Conclusão As escalas para mensuração da dor fornecem informações semelhantes sobre a dor relatada na hipersensibilidade dentinária cervical. A afinidade do paciente pela escala de dor pode direcionar a escolha da escala a ser utilizada na prática clínica odontológica nos diversos níveis de atenção à saúde.
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Abstract The aim of the present study was to compare the sensitivity and specificity of pain scales used to assess dentin hypersensitivity (DH). The preferred scale, and toothbrushing habits of participants were also investigated. This cross-sectional study was conducted with students and employees of a Brazilian Federal University who presented DH. The participants answered a questionnaire about their toothbrushing and drinking habits. Hypersensitive and non-sensitive teeth were submitted to tactile and ice stick stimuli. Then, the subjects marked their pain level in the visual analogue (VAS), numeric scale (NS), faces pain scale (FPS) and verbal evaluation scale (VES). DH was also assessed by Schiff scale (SS). The data were analyzed by Wilcoxon and Chi-Square tests, as well as by ROC curve. The mean age of the sample (56 women, 16 men) was 27.8 years. The most prevalent acidic beverage was coffee (36.0%) and the most preferred scale was the NS (47.2%). The pain level was statistically higher in teeth with DH compared to teeth without DH (p < 0.05). The accuracy ranged from 0.729 (SS) to 0.750 (NS). The highest sensitivity value was 81.9% for NS. The SS presented the highest specificity (91%). The visual analog, numerical, verbal evaluation, faces pain, and Schiff scales were accurate for DH diagnosis. The Schiff scale was the preferred scale for DH assessment.
Subject(s)
Humans , Male , Female , Adolescent , Adult , Young Adult , Pain Measurement/methods , Dentin Sensitivity/diagnosis , Toothbrushing/adverse effects , Beverages/adverse effects , Severity of Illness Index , Cross-Sectional Studies , Surveys and Questionnaires , Reproducibility of Results , Sensitivity and Specificity , Statistics, Nonparametric , Facial ExpressionABSTRACT
Objetivo: Verificar a prevalência de infecções bucais em ambiente hospitalar no período de 13 meses. Materiais e métodos: Estudo transversal, realizado no Centro de Terapia Intensiva (CTI) e na Clínica Neurológica da Santa Casa de Caridade de Diamantina, Minas Gerais, Brasil. Foram analisados todos os dados referentes às infecções bucais e hospitalares, ocorridas no período de março de 2017 a março de 2018, obtidos pela Comissão de Controle de Infecção Hospitalar da instituição. A população estudada compreendeu todos os pacientes desses setores, com idade acima de 16 anos, de ambos os sexos e que tiveram infecção bucal após 48 horas de internação. Resultados: Dentro do total de 2.703 pacientes a prevalência de infecção bucal foi de 1,15% (n=31) dentro do período de 13 meses, sendo a candidíase de maior ocorrência. A prevalência de infecção hospitalar foi de 2,85%. Conclusão: A prevalência das infecções bucais foi maior no CTI, em comparação à Clínica Neurológica, sendo a infecção mais prevalente a candidíase oral. Sugere-se maior atenção à saúde bucal dos pacientes hospitalizados, diante da maior vulnerabilidade dosmesmos às infecções bucais
Aim: To verify the oral infections prevalence in a hospital environment within a period of 13 months. Materials and methods: A cross-sectional study was carried out at the Intensive Care Center and Neurological Clinic of Santa Casa de Caridade, in Diamantina,Minas Gerais, Brasil. All data referring to oral and hospital infections occurred in the period from March 2017 to March 2018 were obtained. The research source was the Hospital Infection Control Committee of the institution. The sample comprised all the patients of these sectors, aged over 16 years, of both genders and who had oral infection after 48 hours of hospitalization. Results: Within 2703 patients, the oral infection prevalence was 1.15% (n=31) within 13 months, being candidiasis the most frequent. The prevalence of nosocomial infection was 2.85%. Conclusion:The prevalence of oral infections was higher in the Intensive Care Center compared to Neurological Clinic, being candidiasis the most common oral infection. More attention should be given tothe hospitalized patients's oral health, considering their greater vulnerability to oral infections
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Abstract Objective The aim of this study was to evaluate the levels of salivary biomarkers IL-1β, IL-10, RANK, OPG, MMP-2, TG-β and TNF-α in individuals with diagnosis of peri-implant mucositis in the absence or presence of periodontal and peri-implant maintenance therapy (TMPP) over 5 years. Material and Methods Eighty individuals diagnosed with peri-implant mucositis were divided into two groups: one group that underwent periodontal and peri-implant regularly maintenance therapy, called GTP (n=39), and a second group that received no regular maintenance GNTP (n=41). Each participant underwent a complete periodontal and peri-implant clinical examination. Collection of saliva samples and radiographic examination to evaluate peri-implant bone levels were conducted at two times: initial examination (T1) and after 5 years (T2). The salivary samples were evaluated through ELISA for the following markers: IL-1β, IL-10, RANK, OPG, MMP-2, TGF and TNF-α. Results A higher incidence of peri-implantitis was observed in the GNTP group (43.9%) than in the GTP group (18%) (p=0.000). All individuals (n=12) who presented peri-implant mucositis and had resolution at T2 were in the GTP group. After 5 years, there was an increase in the incidence of periodontitis in the GNTP group compared to the GTP group (p=0.001). The results of the study revealed an increase in the salivary concentration of TNF-α in the GNTP group compared to the GTP group. The other salivary biomarkers that were evaluated did not show statistically significant differences between the two groups. Conclusions The salivary concentration of TNF-α was increased in individuals with worse periodontal and peri-implant clinical condition and in those with a higher incidence of peri-implantitis, especially in the GNTP group. Longitudinal studies in larger populations are needed to confirm these findings and elucidate the role of this biomarker in peri-implant disease.
Subject(s)
Humans , Periodontitis/pathology , Saliva/chemistry , Stomatitis/pathology , Dental Implants/adverse effects , Cytokines/analysis , Receptor Activator of Nuclear Factor-kappa B/analysis , Osteoprotegerin/analysis , Periodontitis/diagnosis , Reference Values , Stomatitis/diagnosis , Enzyme-Linked Immunosorbent Assay , Biomarkers/analysis , Case-Control Studies , Risk Factors , Follow-Up Studies , Statistics, Nonparametric , Disease ProgressionABSTRACT
Currently, it has been observed a growing number of publications in all fields of Dentistry. These publications act as scientific evidence, as well as a basis for clinical decision-making in dental care routine. It is important to note that the results and conclusions in articles are based on the p-value that is a purely probabilistic and statistical parameter, and it assists the researcher to accept or reject the null hypothesis being tested. The p-value was proposed by Fisher in 1925, and in Dentistry, it is usual to adopt the p-value stated in 0.05.1 In practical terms, when a statistical test results in p-value less than 0.05, the null hypothesis must be rejected (equality between groups), assuming that there is a difference between the assessed groups.2 In other words, p<0.05 indicates statistically significant difference between groups. Under a critical look, the researcher and reader should keep in mind that a statistical difference is not always reflecting a true clinical importance. In addition, a lack of statistical significance does not necessarily relate to the absence of clinical significance. The clinical importance is far beyond statistical calculations based on the p-value.3 A study presents clinical importance when the one being tested presents clinical effect capable to change the behavior of the dentist in daily routine. This judgment should be done by the researcher based on the results of his/her research, clinical experience and actual knowledge. In addition, estimates of effect sizes should be presented. This facilitates assessment of how large or small the observed effect could actually be in the population of interest, and hence how clinically important it could be. Kassab et al. (2006)4 compared periodontal parameters in groups with and without chemical biomodifciation of the root prior surgical coverage in cases of gingival recession. The group, that used edetic acid, statistically improved the periodontal parameters in relation to the group without surface biomodification. However, this difference was imperceptible to both dentist and patient. That is, the clinical result of root coverage will be the same when using or not acid biomodification of the root. In other words, there was not an important clinical effect of this step, although there was a significant difference. In the above example, it is clear that just because a statistic test is significant doesn't mean the effect it measures is significant or clinically important. Then, researchers
Subject(s)
Humans , Editorial , Dentistry , Orthodontics , Periodontics , Prosthodontics , Surgery, Oral , Biostatistics , Probability , Epidemiology and Biostatistics , Pediatric Dentistry , Statistics , Endodontics , Geriatric DentistryABSTRACT
Abstract The dentine hypersensitivity (DH) is able to impair the oral health related quality of life (OHRQoL). However, there isn't any specific validated questionnaire to be used in Brazil. The objective was to adapt and to validate the English version of the Dentine Hypersensitivity Experience Questionnaire (DHEQ-15) for use in Brazil. DHEQ-15 was cross-culturally adapted into the Brazilian-Portuguese language and then validated in a cross-sectional study with 100 participants recruited at a University clinic. Study sample comprised 2 groups: 100 individuals with DH, and 100 individuals without. The instrument was self-administered twice 7 to 10 days apart. The participants answered a global rating of oral health. The psychometric properties of the Brazilian version of DHEQ-15 were verified through internal consistency (Cronbach's α) and test-retest reliability (intraclass correlation coefficient - ICC), convergent (Spearman correlation) and discriminant (Mann-Whitney test) validity. The significance threshold was set at p<0.05. Sample comprised 69 men and 131 women, of mean age 30.4y. The Brazilian DHEQ-15 demonstrated very good internal consistency (α = 0.945). Test-retest reliability revealed excellent reproducibility (ICC = 0.959, p < 0.001). There was statistically significant correlation between the scores obtained on all DHEQ-15 domains and the global rating of oral health (p<0.001). Participants with DH scored significantly higher than those without DH (p<0.001). This study provides evidence supporting the cross-cultural validity of the Brazilian version of DHEQ-15 for use in Brazil.
Subject(s)
Humans , Male , Female , Adolescent , Adult , Middle Aged , Aged , Young Adult , Dentin Sensitivity/physiopathology , Quality of Life , Surveys and Questionnaires/standards , Translations , Brazil , Cross-Cultural Comparison , Cross-Sectional Studies , Dentin Sensitivity/diagnosis , Psychometrics , Reproducibility of Results , Statistics, NonparametricABSTRACT
AIM: The aim was to compare the immunoexpression of extracellular matrix proteins in squamous cell carcinomas of tongue (SCCTo) and lower lip (SCCLi). METHODS: Eleven SCCTo and 11 SCCLi were selected and examined according to Bryne's method (1998). For immunohistochemical study utilized antibodies to fibronectin, tenascin and type I collagen. Histopathologic and immunohistochemical analysis were performed on the tumor invasive front. RESULTS: All SCCTo were classified in high score malignant grade and all SCCLi in lower score. Fibronectin showed strong immunorreactivity in the peritumoral basement membrane (BM) in 91% of SCCTo and all cases of SCCLi, while in the tumor stroma (TS) all cases of SCCTo and SCCLi had strong intensity. Tenascin had strong expression in BM of 91% cases of SCCTo and 63.4% of SCCLi and in TS had strong expression in 91% cases of SCCTo and 54.6% of SCCLi. Type I collagen demonstrated weak immunoreactivity in the TS of 72.7% cases of SCCTo and 63.4% of SCCLi. CONCLUSION: These results may suggest that the strong expression of fibronectin and tenascin proteins and the weak expression of type I collagen could play a role in the invasive process of oral SCC (AU)
Subject(s)
Collagen Type I , Fibronectins , Immunohistochemistry , Mouth Neoplasms , TenascinABSTRACT
Introdução: A hipersensibilidade dentinária (HD) é definida como dor aguda originada em dentina exposta ao meio bucal. O tratamento da HD depende do conhecimento do profissional, e existem diversos aspectos propedêuticos e terapêuticos relacionados com esta condição clínica. Objetivo: Revisar a literatura quanto à etiologia, teorias do mecanismo de ação, epidemiologia e tratamento de casos de hipersensibilidade dentinária. Materiais e Métodos: Foi realizada busca eletrônica nas bases de dados Pubmed/Medline e Web of Science. Utilizou-se as palavras-chave: "dentin(e) sensitivity", "dentin(e) hipersensitivity", "etiology", "epidemiology" e "treatment". Os artigos relevantes foram lidos na íntegra, sem restrição de data ou idioma. Revisão de literatura: A exposição dos túbulos dentinários ao meio bucal geralmente ocorre na região cervical do dente e envolve fatores como retração gengival, perda de esmalte e periodontite. Algumas teorias foram propostas para explicar a HD e a mais aceita mundialmente é a teoria hidrodinâmica. A prevalência de HD varia de 4 a 74%, sendo mais comum em mulheres e dentes pré-molares. Muitos tratamentos têm sido empregados nos casos de HD, entretanto, nenhum tratamento totalmente eficaz e confiável foi identificado. Os tratamentos podem ser caseiros ou de consultório, e estão baseados na obliteração dos túbulos dentinários ou ação neural. Conclusões: Os principais fatores etiológicos para HD são erosão e retração gengival. Esta condição clínica apresenta alta prevalência na população brasileira. A teoria hidrodinâmica é a mais aceita para explicar HD. Não há nenhum tratamento considerado padrão-ouro, e uma combinação de tratamentos caseiro e profissional pode ser necessário para tratar o problema. (AU)
Introduction: The dentin hypersensitivity (DH) is defined as acute pain originated from dentin exposed into oral environment. The DH treatment depends on professional knowledge, and there are several aspects regarding this clinical condition. Aim: This study aimed to review the literature about the etiology, mechanism of action theories, epidemiology and treatment of dentin hypersensitivity. Materials and Methods: Electronic search was performed in Pubmed/Medline and Web of Science databases. It was used the keywords: dentin sensitivity, dentin hipersensitivity, etiology, epidemiology and treatment. The relevant articles were fully read, without date or language restriction. Literature review: the exposure of the dentinal tubules to the oral cavity usually occurs in the cervical region of the tooth, and it involves factors such as gingival recession, loss of enamel and periodontal disease. Some theories have been proposed to explain the DH, the most accepted worldwide is the hydrodynamic theory. The prevalence of DHranges from 4 to 74%, being more common in women and premolars teeth. Many treatments have been used in cases of DH, however, no totally effective and reliable treatment was identified. The treatments can be in-home or in-office, and they are based on obliterating dentinal tubules or neural action. Conclusions: The main etiological factors for DH are erosion and gingival recession. This clinical condition presents high prevalence in Brazilian. The hydrodynamic theory is the most widely accepted to explain DH. There is no gold standard treatment for DH, and a combination of in-office and in-home treatments may be necessary to treat the problem. (AU)