Prevalence and reasons for referrals to the Endodontics Specialty Clinic at the Piracicaba Dental School

Abstract Dental referrals to the Endodontics Specialty Clinic (ESC) are routine owing to the complexity of endodontic treatments. To obtain a better prognosis for treatment, students/dentists must perceive their technical limits. This study sought to investigate the referrals of patients to the ESC from different clinics of the Piracicaba Dental School, State University of Campinas - SP, Brazil, and check: a) the demographic profile of patients and the most commonly affected tooth; b) the clinic with the largest number of referrals; c) the reasons for referrals; d) the complexity of the cases; e) and the difficulty in assessing the referred cases based on the classification provided by the American Association of Endodontists (AAE) and Souza-Filho. The study sample consisted of patients' electronic dental referral records from February 2015 to June 2019. A total of 1,707 patients were referred to the ESC during the study period, and 62.4% were female. Lower molars were the most frequently involved teeth (34.8%), and 60.7% of the cases were referred due to the presence of root curvature. The AAE classification showed prevalence of highly difficult cases (71.3%), whereas Souza-Filho classification demonstrated a high rate of class III cases (85.8%). This study highlights the difficulties encountered by undergraduate students before or during endodontic treatments, reinforcing the need for clear criteria for selecting cases appropriate for each education level, thus improving endodontic treatment prognosis.

Percepción de la utilidad de los registros dentales como método de identificación humana en profesiones de alto riesgo: el caso de las personas trabajadoras de la Cruz Roja Costarricense / Perception of the usefulness of dental records as a method of human identification in high-risk professions: the case of the Costa Rican Red Cross workers

Introducción: Aquellas personas que brindan atención en situaciones de emergencias están expuestas a un alto riesgo de sufrir lesiones o fallecer durante labores de rescate, sea en accidentes de tránsito, desastres naturales, atentados terroristas o crisis humanitarias generadas por conflictos armados. Esta investigación fue realizada en las personas trabajadoras de la Cruz Roja Costarricense (CRC) para establecer la percepción de la utilidad de los registros dentales como método de identificación y elaborar un formato único de información odontológica antemortem. Materiales y métodos: Un cuestionario piloto fue diseñado y aplicado a 10 personas para ser calibrado y validado. Posteriormente se generó un cuestionario electrónico final en la plataforma Google Forms que fue enviado vía correo electrónico institucional a las personas trabajadoras constituida por 175 individuos, de los cuales 92 respondieron en el período del 20 de noviembre de 2022 al 20 de enero de 2023. Los resultados fueron analizados mediante las distribuciones de frecuencia, cruce de variables, comparación de medias con base en el análisis de variancia. El nivel mínimo de confianza para las comparaciones fue del 95%. Resultados: El cuestionario fue realizado por 92 personas, 75% hombres y 25% mujeres. El rango de edad entre los 36 y 40 años fue el más frecuente (23.9%). El 60,9% labora en la provincia de San José, 58% indica que visitaron al odontólogo hace un año o menos y el 38,6% refiere que nunca les han tomado una radiografía panorámica, un 81,8% dice tener tratamientos dentales como coronas, puentes o implantes; y el 75% considera de gran utilidad los registros dentales como método de identificación, y lo ubican en segundo lugar de conocimiento (89,8%) al compararlo con ADN (97,7%) y dactiloscopia (86,4%). Conclusiones: Las personas trabajadoras de la Cruz Roja Costarricense consideran que los registros odontológicos son útiles en la identificación de seres humanos y cuentan con información antemortem útil para dicho efecto.

Introduction: Those who provide care in emergency situations are exposed to a high risk of injury or death during rescue work, whether in traffic accidents, natural disasters, terrorist attacks, or humanitarian crises generated by armed conflicts. This research was carried out among Costa Rican Red Cross (CRC) workers to establish the perception of the usefulness of dental records as a method of identification and to develop a single format for antemortem dental information. Materials and methods: A pilot questionnaire was designed and applied to 10 persons to be calibrated and validated. Subsequently, a final electronic questionnaire was generated in the Google Forms platform and sent via institutional e-mail to 175 workers, of whom 92 responded during the period from November 20, 2022, to January 20, 2023. The results were analyzed by means of frequency distributions, crossing of variables, and comparison of means based on the analysis of variance. The minimum confidence level for comparisons was 95%. Results: The questionnaire was completed by 92 people, 75% men and 25% women. The age range between 36 and 40 years was the most frequent (23.9%). A total of 60.9% worked in the province of San José, 58% indicated that they had visited the dentist a year ago or less and 38.6% said that they had never had a panoramic X-ray taken, 81.8% said they had dental treatments such as crowns, bridges or implants; and 75% considered dental records to be very useful as a method of identification, and placed it in second place in terms of knowledge (89.8%) when compared with DNA (97.7%) and dactyloscopy (86.4%). Conclusions: Costa Rican Red Cross workers consider dental records to be useful in the identification of human beings and have useful antemortem information for this purpose.

Uma análise sobre o preenchimento do prontuário odontológico em uma universidade brasileira / Dental record filling out analysis at a Brazilian University

Esse estudo tem como objetivo investigar a qualidade do preenchimento do prontuário odontológico na Clínica Escola da Faculdade de Odontologia da Universidade Federal do Maranhão (UFMA) através da análise da percepção dos discentes sobre a temática e a avaliação de uma amostra de prontuários utilizados na instituição de ensino. Um estudo transversal foi conduzido com 67 discentes matriculados no Curso de Odontologia do quarto ao nono período do curso de graduação, representando 48,2% da população alvo. Além disso, foram analisados 73 prontuários preenchidos em atendimentos odontológicos nesta instituição do entre 2020 a 2022. Um questionário com questões abertas e fechadas foi respondido pelos participantes. As medidas de frequência absoluta e relativa foram utilizadas na análise descritiva dos dados. Observou-se que mais de 90% concordaram total ou parcialmente que preenchem corretamente os prontuários, entretanto, a análise dos prontuários revelou a ausência de itens obrigatórios A frequência do preenchimento dos itens obrigatórios está listada a seguir: identificação do paciente (80,8%), assinatura do docente (75,3%), termo de consentimento do paciente (74%), seção anamnese completa (69,9%), radiografias (64,4%), plano de tratamento (34,2%), questionário Covid (13,7%) e identificação dos discentes (60,3%). Os achados deste estudo indicam que é necessário o aperfeiçoamento das orientações pedagógicas sobre preenchimento do prontuário odontológico no intuito de reduzir possíveis inadequações no uso deste documento legal

This study aims to investigate the quality of dental record at the Dental School Clinic of Maranhao Federal University (UFMA) through analyzing the students' perception of the topic and evaluating a sample of records used at the educational institution. A cross-sectional study was conducted with 67 undergraduate dental students from second to fifth year, representing 48.2% of the target population. Additionally, 73 records that were filled out during dental appointments at this institution from 2020 to 2022 were analyzed. Participants responded a questionnaire containing both open-ended and closed-ended questions. Absolute and relative frequency measures were used in the descriptive data analysis. It was observed that over 90% partially or fully agreed that they correctly fill out the records, but the analysis of the records revealed the absence of mandatory items. The frequency of completion for the mandatory items is listed as follows: patient identification (80.8%), faculty signature (75.3%), patient consent form (74%), complete medical history section (69.9%), radiographs (64.4%), treatment plan (34.2%), Covid questionnaire (13.7%), and student identification (60.3%). The findings of this study indicate the need for improvement in pedagogical guidance on dental record completion in order to reduce possible inadequacies in the use of this legal document

Atestado odontológico falso e seu real enquadramento no Código Penal brasileiro / False certificate in Dentistry and its real framework in the Brazilian Penal Code

O atestado odontológico compreende um tipo de documento emitido pelo profissional que expressa a veracidade de um fato relacionado ao paciente constatado durante a prática clínica. O objetivo deste artigo foi apontar e analisar o tipo de crime que incorre o cirurgião-dentista que emite atestado falso. Trata-se de uma pesquisa transversal com abordagem descritiva realizada por meio do levantamento das provas de concursos públicos realizados no Brasil para o cargo de Perito Odontolegista ou nomenclatura correspondente. Foram considerados os concursos realizados nas unidades federativas do Brasil sem distinção quanto ao ano, sendo que a coleta das informações se deu nos meses de janeiro a abril de 2023. Conclui-se que, apesar de ocorrerem discrepâncias de interpretação muito pontuais na literatura odontológica quanto ao condizer entre os Artigos 299 e 302 do Código Penal Brasileiro, não há possibilidade legal de o cirurgião-dentista ser sujeito ativo do crime de falsidade de atestado médico, por ser crime próprio do profissional médico

The dental certificate comprises a kind of document issued by the professional that expresses the veracity of a fact related to the patient verified during clinical practice. The aim of this article was to point out and analyze the type of crime incurred by dentists who issue false certificates. This is a cross-sectional research with a descriptive approach carried out through the survey of public tenders held in Brazil for the position of Forensic Odontologist or corresponding nomenclature. It was considered the contests held in the Brazilian Federative Units without distinction to the year, and the information collection was performed from January to April 2023. It can be concluded that, although there are few interpretation discrepancies in the dental literature regarding articles 299 and 302 of the Brazilian Penal Code, there is no legal possibility for the dentist to be an active subject of the crime of falsity of medical certificate, as it is a crime specific to the professional medical doctor

Audit of dental record-keeping at a university dental hospital

Background: Good record-keeping is fundamental in clinical practice and essential for practising dental practitioners and those in training. Aim: This study aimed to evaluate the level of compliance with clinical record-keeping by undergraduate dental students and staff at a university dental hospital. Setting: The selected study setting was the Admissions and Emergency section at a university dental hospital. Methods: A retrospective, cross-sectional review was undertaken of 257 clinical records. The CRABEL scoring system was used to evaluate 12 variables. The 12 variables included: patient name, patient hospital number, date of examination, patient main complaint, medical history, dental history, proposed treatment, proposed procedure for next visit, patient consent signature, treatment and treatment codes, student name and signature, clinical supervisor name and signature. STATA® 13 was used for descriptive analysis and all tests were conducted at 5% significance level. Results: The median CRABEL score was 87 and interquartile range (IQR: 70­92). A CRABEL score of 100 was achieved by the students in the variable patient main complaint, indicating a 100% compliance with this variable. Other variables such as signature of supervisors showed poor compliance. The CRABEL scores showed no statistically significant difference (p = 0.86) between the students and clinical supervisors. Conclusion: The overall audit showed that there was poor compliance with record-keeping. Contribution: The study highlights the importance of good record keepings so that key information can be accessed for proper diagnosis and treatment of the patient. An electronic filing system presents an alternative manner of documenting medical records.

Prevalence of premature loss of deciduous teeth and its relationship with gender among children from Acapulco, Guerrero: a cross-sectional study / Prevalencia de pérdida prematura de dientes deciduos y su relación con el género en niños de Acapulco, Guerrero: estudio transversal

Abstract Background: Premature loss of deciduous teeth is the exfoliation or extraction before physiological replacement with < 50% or < 75% of the root of the substitute tooth formed or if there is > 1 mm of alveolar bone covering the permanent successor tooth organ. This study aimed to estimate the prevalence of premature tooth loss in children and identify associated factors in a health center in Acapulco, Guerrero. Methods: We conducted a cross-sectional study in which we collected information from 109 clinical records of children examined from January 2019 to August 2021. Sociodemographic data of the children and parents were collected: socioeconomic level, non-pathological personal history, and the history of premature deciduous tooth loss. Multivariate analysis to identify factors associated with premature deciduous tooth loss was performed with CIETmap statistical software. Odds ratio (OR) and 95% confidence interval (CI) were calculated to estimate the strength of the association. Results: The prevalence of premature loss of primary teeth was 40% (43/109). The leading cause was caries (84%, 36/43). The tooth organ with the highest loss occurrence was the lower right second molar (33%, 14/43). Gender was identified as an associated factor, with males having a higher risk of loss (ORa = 2.97; CI95% = 1.33-6.65). Conclusions: Our results were similar to those reported in other studies. Strategies aimed at health promotion directed at parents and children should be reinforced.

Resumen Introducción: Se considera como pérdida prematura de dientes deciduos a la exfoliación o extracción antes del recambio fisiológico con < 50% o < 75% de la raíz del diente sustituto formado, o si existe > 1 mm de hueso alveolar cubriendo al órgano dentario sucesor permanente. El objetivo de este trabajo fue estimar la prevalencia de pérdida prematura dental en niños e identificar factores asociados en un centro de salud de Acapulco, Guerrero. Métodos: Se llevó a cabo un estudio transversal en el que se recopiló información de 109 expedientes clínicos de niños atendidos de enero de 2019 a agosto de 2021. Se recolectaron datos sociodemográficos de los niños y los padres: nivel socioeconómico, antecedentes personales no patológicos y el antecedente de la pérdida prematura del diente deciduo. Se realizó un análisis multivariado para identificar factores asociados con la pérdida prematura de dientes deciduos con el software estadístico CIETmap. Se calcularon la razón de momios (OR) y el intervalo de confianza (IC) del 95% para estimar el grado de la asociación. Resultados: La prevalencia de pérdida prematura de dientes primarios fue del 40% (43/109). La principal causa fue por caries (84%, 36/43). El órgano dentario con más ocurrencia de pérdida fue el segundo molar inferior derecho (33%, 14/43). Se identificó el sexo como factor asociado, y se observó que el sexo masculino presenta mayor riesgo de pérdida (ORa = 2.97; IC95% = 1.33-6.65). Conclusiones: Nuestros resultados fueron similares a lo reportado en otros estudios. Deben reforzarse las estrategias de promoción de la salud dirigidas a los padres de familia y a sus hijos.

Percepción de la utilidad de los registros dentales como método de identificación humana en profesiones de alto riesgo: el caso de las personas investigadoras del OIJ / Perception of the usefulness of dental records as a method of human identification in high-risk professions: the case of the OIJ investigators

Resumen Introducción: Las personas que laboran en investigación criminal se exponen a un alto riesgo de sufrir lesiones o fallecer durante operaciones contra el crimen organizado que pueden provocar condiciones que dificulten su identificación por métodos convencionales. La presente investigación fue realizada en las personas investigadoras del Organismo de Investigación Judicial para establecer la percepción de la utilidad de los registros dentales como método de identificación y elaborar un formato único de información odontológica antemortem. Materiales y métodos: Un cuestionario piloto fue diseñado y aplicado a 10 personas para ser calibrado y validado. Posteriormente se generó un cuestionario electrónico final en la plataforma Google Forms que fue enviado vía correo electrónico institucional a la totalidad de personas investigadoras constituida por 1200 individuos, de los cuales 807 respondieron en el período del 21 de junio al 20 de julio de 2021. Los resultados fueron analizados mediante las distribuciones de frecuencia, cruce de variables, comparación de medias con base en el análisis de variancia. El nivel mínimo de confianza para las comparaciones fue del 95%. Resultados: El cuestionario fue realizado por 807 personas, 79% hombres y 21% mujeres. La edad promedio fue de 37,8 años (IC95%: 37,3 - 38,48) sin que se encontrara diferencia estadísticamente significativa (p=0,419). El 80% labora en la Región Central del país, 78% indica que visitaron al odontólogo hace un año o menos y el 69% refiere que en algún momento les han tomado una radiografía panorámica, un 89% dice tener tratamientos dentales como coronas, puentes o implantes; y el 88% considera de gran utilidad los registros dentales como método de identificación, y lo ubican en tercer lugar de conocimiento (95,5%) al compararlo con ADN (99,6%) y dactiloscopia (98,7%). Conclusiones: Las personas investigadoras del Organismo de Investigación Judicial consideran que los registros odontológicos son útiles en la identificación de seres humanos y cuentan con información antemortem útil para dicho efecto.

Abstract Introduction: People who work in criminal investigations are exposed to a high risk of suffering injuries or dying during operations against organized crime that can cause conditions that make identification difficult by conventional methods. This research was carried out in the investigators of the Organismo de Investigación Judicial (Judicial Investigation Agency) to establish the perception of the usefulness of dental records as a method of identification and to elaborate a unique format of dental information antemortem. Materials and methods: A pilot questionnaire was designed and applied to 10 people to be calibrated and validated. Subsequently, a final electronic questionnaire was generated on the Google Forms platform that was sent via institutional email to all the investigators consisting of 1200 individuals, of which 807 responded in the period of the June 21 to July 20, 2021. The results were analyzed by frequency distributions, crossing of variables, comparison of means based on the analysis of variance. The minimum confidence level for comparisons was 95%. Results: The questionnaire was conducted by 807 people, 79% men and 21% women. The mean age was 37.8 years (95% CI: 37.3 - 38.48) with no statistically significant difference (p=0.419), 80% work in the Central Region of the country, 78% indicate that they visited the dentist a year or less ago and 69% report that at some point they have taken a panoramic X-ray, 89% say they have dental treatments such as crowns, bridges or implants; and 88% consider dental records as a method of identification very useful, and place it in third place in knowledge (95.5%) when compared with DNA (99.6%) and dactyloscopy (98.7%). Conclusions: The investigators of the Judicial Investigation Agency consider that dental records are useful in the identification of human beings and have useful antemortem information for this purpose.

Knowledge and practices of recording and maintaining patients 'dental records among private dental practitioners of Delhi, India

Proper recording and keeping dental records are an important part of any dental practice. It helps in improving patient care, has medico-legal importance and play significant role in human identification during mass disasters or criminal offences. Aim: To assess the knowledge and practices of recording and maintaining patients 'records among private dental practitioners of Delhi, India. Methods: Data for this cross-sectional study was collected from 160 dentists of Delhi using a self-administered questionnaire. The face and content validity as well as reliability of questionnaire was tested before the final data collection. A single trained examiner collected all the necessary information via personal visits or google forms. Chi-square test was applied to check the statistically significant difference between the dichotomous independent variables with respect to study participants' responses to the questionnaire. Results: The mean age of the study participants was 34.5 (SD 7.2) years.Digital method of recording patient's data and x-ray storage was more prevalent than manual method among the study participants. Slightly more than 40% of the dentists were keeping patient's records safe for a period of 6 to 10 years. Younger dentists with lesser years of practice were more explicit in recording and correcting patient records. Conclusion: Results of this study shows that private dental practitioners of Delhi are aware of medico-legal importance of dental records. Most of them were recording important findings and history of their patients. Dentists must be educated in two aspects namely correct method of recording and the ideal duration of storing their patients' dental records

Importância da documentação ortodôntica para análise odontológica e rugoscópica forenses: relato de caso / Importance of orthodontic records for forensic dental and rugoscopic analysis: case report

Introdução: A perícia odontolegal para identificação humana fundamenta-se na grande variedade de caracteres individualizadores dos arcos dentais. Além disso, os elementos dentários são as estruturas mais estáveis, duras e resistentes do corpo humano. Em casos de carbonização, comumente não é viável a coleta de impressões digitais e a Odontologia Legal se torna uma alternativa rápida e de baixo custo, dispensando o exame de DNA para identificação das vítimas. Objetivo: Relatar um caso pericial em que um cadáver carbonizado foi identificado pelo método odontolegal com a utilização de documentação ortodôntica. Relato de caso: Em 2020 uma vítima de acidente automobilístico seguido de incêndio foi examinada para determinação da causa mortis e identificação humana. Exames de reconhecimento facial e papiloscópicos não puderam determinar a identidade do cadáver carbonizado. A análise odontológica permitiu constatar a presença de contenção ortodôntica na cavidade bucal do periciado. Como a Ortodontia é uma especialidade que rotineiramente produz prontuários completos, em virtude da complexidade e duração dos tratamentos, e constituindo-se em uma das melhores documentações odontológicas que o perito pode utilizar para a identificação odontolegal, aguardou-se a procura por eventuais familiares. O exame odontológico confrontou dados postmortem com exames radiográficos e fotografias intrabucais produzidas em 2012, apontando inúmeras similaridades e nenhuma incompatibilidade, o que permitiu a identificação positiva da vítima. Conclusão: A documentação ortodôntica foi de fundamental importância para a identificação rápida, segura e inconteste, tanto pela riqueza de informações contidas nas imagens e modelos de gesso, quanto por estar adequadamente arquivada com o cirurgião-dentista que assistiu a vítima em vida

Introduction: The forensic dentistry expertise for human identification is based on the wide variety of individualizing characteristics of dental arches. In addition, dental elements are the most stable, hard, and resistant structures of the human body. In cases of carbonization, fingerprinting is usually not feasible and Forensic Dentistry becomes a fast and low-cost alternative, dispensing with DNA testing to identify victims. Objective: To report an expert case in which a charred corpse was identified by the forensic dentistry method using orthodontic documentation. Case report: In 2020, a car accident victim followed by fire was examined for cause of death and human identification. Fingerprint analysis and facial recognition tests could not determine the identity of the charred corpse. The dental analysis showed the presence of orthodontic retention in the oral cavity of the expert. As Orthodontics is a specialty that routinely produces complete medical records, due to the complexity and duration of treatments, and constituting one of the best dental documentation that the expert can use for forensic dentistry identification, the search for possible family members was awaited. The dental examination compared postmortem data with radiographic exams and intraoral clinical photographs produced in 2012, pointing out numerous similarities and no incompatibilities, which allowed the positive identification of the victim. Conclusion: The orthodontic documentation was of fundamental importance for the fast, safe, and unchallenged identification, both because of the wealth of information contained in the images and plaster cast, and because it was properly filed with the dental surgeon who assisted the victim in life

Percepción de la utilidad de los registros dentales como método de identificación humana en profesiones de alto riesgo: el caso de Bomberos de Costa Rica / Perception of the usefulness of dental records as a method of human identification in high-risk professions: the case of the Costa Rican firefighters

Resumen Introducción: Las profesiones de alto riesgo como bomberos, rescatistas, policía, paramédicos yaquellas donde existe alta exposición al peligrodurante rescates o intervenciones constituyen poblaciones que requieren adecuada información antemortem con fines de identificación. La presente investigación estableció la percepción de la utilidad de los registros dentales como método de identificación y la presencia de tratamientos dentales del personal de Bomberos de Costa Rica. Materiales y métodos: Se elaboró un cuestionario piloto y se envió a la Dirección General de Bomberos de Costa Rica donde se realizaron observaciones, posteriormente fue calibrado por la experta en estadística. Mediante la plataforma Google Docsfue enviado víacorreo electrónico institucional al personal operativo de Bomberos de Costa Rica. Los resultados fueron analizados mediante las distribuciones de frecuencia, cruce de variables, comparación de medias con base en el análisis de variancia. El nivel mínimo de confianza para las comparaciones fue del 95%. Resultados: El cuestionario fue enviado a un total de 2006 bomberos (personal permanentey voluntario), de los cuales 757 completaron el cuestionario. El 85%de los participantes considera que su profesión tiene un riesgo alto o muy alto, el método de identificaciónmás conocido es el ADN, seguido de la dactiloscopia y luego la identificación odontológica. El 66.7% de los participantes considera que la odontología es útil como método de identificación en bomberos, 58% indica que visitaron al odontólogo hace un año o menos; y 75% en los últimos dos años; no se encontró diferencia estadísticamente significativa por grupo de edad (p=0,400). Conclusiones: el personal de Bomberos de Costa Rica considera que los registros dentales son útiles en la identificación de seres humanos y acuden regularmente a consulta odontológica.

Abstract Introduction: High-risk professions such as firefighters, rescuers, police, paramedics, and those where there is high exposure to danger during rescues or interventions constitute populations that require adequate antemortem information for identification purposes. The present investigation established the perception of the usefulness of dental records as an identification method and the presence of dental treatments of the Costa Rican Fire Department personnel. Materials and methods: A pilot questionnaire was prepared and sent to the General Directorate of Firefighters of Costa Rica where observations were made, later it was calibrated by the statistical expert. Through the Google Docs platform, it was sent via institutional email to the operational personnel of the Costa Rican Fire Department. The results were analyzed through the frequency distributions, crossing of variables, comparison of means based on the analysis of variance. The minimum level of confidence for the comparisons was 95%. Results: The questionnaire was sent to a total of 2006 firefighters (permanent and voluntary personnel), of which 757 completed the questionnaire. 85% of the participants consider that their profession has a high or very high risk, the best-known identification method is DNA, followed by fingerprints and then dental identification. 66.7% of the participants consider that dentistry is useful as an identification method in firefighters, 58% indicate that they visited the dentist a year ago or less; and 75% in the last two years; no statistically significant difference was found by age group (p = 0.400). Conclusions: The Costa Rican Fire Department personnel consider that dental records are useful in the identification of human beings and they regularly attend dental appointments that include dental x-rays.

Determinación de la simbología más utilizada en expedientes odontológicos en Costa Rica en el año 2019 con fines de identificación de seres humanos / Determination of the most common symbology used in dental records in Costa Rica in 2019 for identification of human beings

Resumen Introducción: El objetivo de la investigación fue establecer cuál es la simbología utilizada por los profesionales en odontología para documentar los hallazgos odontológicos más comunes en sus expedientes; con la finalidad de incluirla en un formato único odontológico estandarizado con fines de identificación en Costa Rica. Materiales y métodos: Mediante un cuestionario se identificó y comparó la simbología utilizada por profesionales en odontología generales y especialistas para registrar los hallazgos odontológicos en sus expedientes. Se realizó una fase piloto con 8 cuestionarios y posterior a las correcciones se aplicó a una muestra de 49 odontólogos que incluyó a profesionales en odontología generales y de todas las especialidades. Las técnicas estadísticas utilizadas para el análisis de la información recolectada en las encuestas son las distribuciones de frecuencia, cruce de variables, comparación de medias con base en el análisis de variancia. El nivel mínimo de confianza para las comparaciones fue del 95%. El procesamiento estadístico de los datos se diseñó una base de datos creada en EPI-INFO 6.4, el procesamiento estadístico de los datos se realizó en SPSS versión 13.0 y en Excel. Resultados: De los 49 participantes, 56% fueron hombres y 44% mujeres. La edad varía entre 25 y 65 años; la edad promedio fue de 44,5 años (IC 95%: 41,7 - 47,3) y una edad mediana [1] de 43 años, la cual no tuvo diferencia estadísticamente significativa (p = 0,552) entre la edad promedio entre los hombres y mujeres. El 70% de los odontólogos usan expediente físico, mientras que sólo un 17% usan expediente digital, y el 13% usan ambos; en el expediente digital es en el que se presenta la mayoría de problemas con un 62,5 %, en comparación al físico que tiene una prevalencia de 36,4% donde el principal problema es que no se comprendió la letra en un 86,7%. Conclusiones: El examen clínico odontológico es de extrema utilidad para colaborar en el proceso de identificación de víctimas mortales, sin embargo, se logró identificar, que no todos los profesionales en odontología en Costa Rica realizan una adecuada documentación en sus expedientes clínicos. Se propone una simbología estandararizada para dicha documentación.

Abstract Introduction: The objective of the research was to establish what is the symbology used by dentistry professionals to document the most common dental findings in their records; with the purpose of including it in a single standardized dental format for identification purposes in Costa Rica. Materials and methods: Through a questionnaire the symbology used by general dentists and specialists was identified and compared to record the dental findings in their files. A pilot phase with 8 questionnaires was carried out and after the corrections, it was applied to a sample of 49 dentists that included general and all specialties dentists. The statistical techniques used for the analysis of the information collected in the surveys are frequency distributions, crossing of variables, comparison of means based on the analysis of variance. The minimum level of confidence for the comparisons was 95%. The statistical processing of the data was designed a database created in EPI-INFO 6.4, the statistical processing of the data was performed in SPSS version 13.0 and in Excel. Results: The sample was conformed by 49 participants, 56% were men and 44% women. The age varies between 25 and 65 years; the average age was 44.5 years (95% CI: 41.7 - 47.3) and a median age [1] of 43 years, which had no statistically significant difference (p = 0.552) between the average age between men and women. A 70% of dentists use physical records, while only 17% use digital records, and 13% use both; digital files present the majority of problems with 62.5%, compared to the written format who has a prevalence of 36.4% where the main problem is that the letter was not understood in an 86.7 %. Conclusions: Dental records are extremely useful to collaborate in the process of human identification in fatalities; however, it was possible to identify that not all dental professionals in Costa Rica make adequate documentation in their clinical records. A standardized symbology is proposed for such documentation.

Importância do registro das ausências dentais para a identificação humana: relato de caso / Importance of the registration of dental absences for human identification: case report

Identificar é determinar ou comprovar a identidade de algo, alguém ou de si mesmo, para isso é necessário um conjunto de procedimentos e diligências. O processo de identificação pode ser realizado por diferentes métodos, em casos de cadáveres carbonizados, muitas vezes, o método de escolha para a identificação é o comparativo entre as particularidades odontológicas ante e post mortem. O objetivo deste trabalho é relatar um caso de identificação humana de corpo carbonizado através do método de comparação odontológica. No necrotério do Instituto de Perícias Oficiais local, deram entrada três corpos carbonizados envolvidos em sinistro aeronáutico. O perito odontolegista foi solicitado para participar do processo de identificação de umas das vítimas. O procedimento pericial consistiu na elaboração de um odontograma específico para o corpo não identificado (exame post-mortem) e confronto com os documentos assistenciais (prontuário odontológico) apresentados como sendo da vítima envolvida no acidente (exame ante-mortem). Após a uniformização dos dados Ante Mortem e Post Mortem, os odontogramas foram confrontados gerando o resultado positivo para identificação, destacando-se o registro de várias ausências dentais. Frente ao relato do caso, destaca-se a importância da atuação do cirurgião-dentista no contexto pericial, contribuindo significativamente com a efetividade dos exames realizados, com a celeridade dos resultados, oferecendo uma opção de baixo custo e alta eficiência para a identificação de corpos carbonizados, dispensando outros métodos de identificação

To identify is to determine or prove the identity of something, of someone or of oneself; for this, a set of procedures and diligences are necessary. The identification process can be performed by different methods; in cases of charred corpses, the method of choice for identification is often the comparative between dental and post-mortem dental characteristics. The objective of this work is to report a case of human identification of charred body by means of the method of dental comparison. In the morgue of the local Forensic Institute, three carbonized bodies involved in an aeronautical accident were admitted. A forensic dentist was asked to participate in the process of identifying one of the victims. The expert procedure consisted in the elaboration of a specific dental chart for the unidentified body (post-mortem examination) and confrontation with the assistance documents (dental records) presented as being of the victim involved in the accident (ante-mortem examination). After the standardization of Ante- Mortem and Post-Mortem data, the dental charts were confronted, generating the positive result for identification, highlighting the record of several dental absences. In view of the case report, the importance of the dental surgeon's performance in the expert context is of extreme value, contributing significantly to the effectiveness of the exams performed, with the speed of results, offering a low cost and high efficiency option for the identification of bodies rather than other methods of identification

Planejamento e reestruturação de um serviço de saúde bucal do trabalhador ­ relato de experiência com ênfase na documentação odontológica / Planning and restructuring a workers' dental health service ­ experience report with emphasis in dental records

INTRODUÇÃO: A Odontologia do Trabalho busca seu espaço dentro das empresas públicas e privadas. Pensando em melhorar a condição de vida do empregado e manter a produtividade da empresa, a Odontologia integra a equipe de Saúde Ocupacional das empresas, realizando ações preventivas e de educação em saúde, além dos exames admissionais e periódicos. OBJETIVO: O presente trabalho objetiva relatar a experiência do planejamento e reestruturação de um serviço de saúde bucal do trabalhador em uma empresa do setor elétrico brasileiro, com ênfase na documentação odontológica. RELATO DE CASO: O serviço de saúde bucal foi planejado levando em conta as metas e objetivos da empresa, as condições epidemiológicas dos trabalhadores brasileiros, além das prioridades elencadas pelos empregados e pela equipe de saúde. Um novo prontuário foi desenvolvido e o rol de procedimentos realizados no serviço foi ampliado. CONCLUSÃO: Cabe ao cirurgião-dentista apresentar projeto de implementação ou de readequação do serviço, demonstrando a melhoria dos índices de saúde bucal e geral através da realização de ações odontológicas ocupacionais e preventivas. A presença do cirurgião-dentista do trabalho nas empresas é de grande valia, pois este profissional contribuirá com a redução do absenteísmo, a diminuição dos acidentes de trabalho relacionados a causas odontológicas e a promoção de saúde bucal para todos os trabalhadores

INTRODUCTION: The Occupational Dentistry seeks space within the public and private companies. Thinking about improving the employee's living conditions and maintain the productivity of the company, Dentistry integrates the Occupational Health team, performing preventive actions and health education, in addition to the admission and periodic exams. OBJECTIVE: This paper aims to report the experience of planning and restructuring a Labor Dentistry service in a company in the Brazilian electrical sector, with emphasis on dental documentation. CASE REPORT: The oral health service was planned taking into account the goals and objectives of the company, the epidemiological conditions of Brazilian workers, and the priorities established by the employees and the health team. The new dental record was developed and the list of procedures was updated and expanded. CONCLUSION: The dentist must submit a project for the implementation or the readjustment of the service, demonstrating the improvement of oral and general health indexes through the performance of occupational and preventive dental actions. The presence of the occupational dentist in the companies is of great value, since this professional will contribute with the reduction of absenteeism, the reduction of the accidents of work related to dental causes and the promotion of oral health for all the workers.

Documentação ortodôntica e dentes rosados: a importância da atuação do odontolegista / Orthodontic records and pink teeth: the importance of the forensic dentist's performance

Introdução: A identificação humana por meio dos arcos dentais pode se fazer necessária em diversas situações, tais como acidentes, desastres em massa e em corpos em avançado estado de decomposição, onde a comparação necropapiloscópica ou outros meios tornam-se inviáveis. Relato do Caso: Em 2017, deu entrada um cadáver em adiantado estado de putrefação, em uma capital Nordestina, no qual constava na requisição que o mesmo havia sido encontrado parcialmente inumado. Pela impossibilidade da realização da análise papiloscópica, foi solicitado a família da suposta vítima uma documentação odontológica e a mesma apresentou uma documentação ortodôntica recente. Ao realizar a análise comparativa dos dados ante-mortem (AM) e post-mortem (PM), notou-se a existência de vários pontos positivos de grande relevância, dentre eles a ausência de alguns elementos dentais, aparelho fixo instalado no arco dental superior, cárie e diastema interincisivos, sendo considerados elementos que caracterizavam aquele indivíduo e, ainda, ressaltando a inexistência de qualquer ponto divergente, possibilitando a identificação positiva. Como achados pós-morte também foi evidenciado que todos os dentes estavam rosados. Conclusão: o presente caso ilustra o trabalho do odontolegista e exemplifica a contribuição da Odontologia Legal para o processo de identificação humana, sendo possível elencar como vantagens a confiabilidade, rapidez dos resultados e o baixo custo

Introduction: Human identification by dental arch may be necessary in many situations, such as accidents, mass disasters and decomposing bodies, where a necropapilloscopic comparison or other means become unfeasible. Case Report: In 2017, entering an advanced state of decay in a northeastern capital was not an obligation to say goodbye at once. Due to the impossibility of performing papilloscopic analysis, recent orthodontic diagnosis documentation was requested. To perform a comparative analysis of ante-mortem (AM) and post-mortem (PM) data, noting the existence of several very important positive points, including the absence of some dental elements, the fixed appliance installed in the dental arch. Superior caries and interincisive diastema, being the elements that characterize that individual and also highlighting the absence of any divergent point, enabling a positive identification. As it was also possible to poison all teeth were rosy. Conclusion: the present specific case is the identification and evaluation work of Forensic Dentistry for the human identification process, being possible to grant advantages, speed of results and low cost.

Prontuário do paciente: comentários à lei nº 13787/2018 / Patient's record: comments to Brazilian Federal Law nº 13787/2018

O presente artigo tem como objetivo discutir a Lei nº 13.787/2018 que dispõe sobre a digitalização e a utilização de sistemas informatizados para a guarda, o armazenamento e o manuseio de prontuário de paciente. Inicialmente são apresentadas definições sobre prontuário do paciente, bem como a apresentação e considerações sobre quatro tipos de prontuário do paciente. O texto prossegue analisando individualmente cada um dos sete artigos da Lei nº 13.787/2018, trazendo considerações sobre a digitalização de prontuários em papel, requisitos para digitalização a fim de tornar o documento digitalizado válido como um documento original, sistema de armazenamento do prontuário digitalizado, tempo mínimo de guarda e possibilidade de eliminação do prontuário do paciente. Como conclusão, o artigo evidencia os principais pontos da referida Lei e sua relevância no ordenamento jurídico nacional

The purpose of this article is to discuss the Brazilian Federal Law n. 13.787/2018, which deals with the digitization and use of computerized systems for the custody, storage and handling of patient records. Initially, definitions on patient charts are presented, as well as the presentation and considerations on four types of patient's charts. The text goes on to analyze individually the seven articles of Law 13.787/2018, with considerations on the digitization of medical records, requirements for digitization in order to make the scanned document valid as an original document, minimum guarding time and possibility of elimination of the patient's medical record. As a conclusion, the article highlights the main points of this Law and its relevance in the national legal system

Avaliação da percepção dos cirurgiões-dentistas de São José Dos Campos (SP) sobre a importância legal do prontuário odontológico / Evaluation of the perception of dentists in São José dos Campos (SP) on the legal importance of dental records

A elaboração do prontuário odontológico é uma das principais atividades realizadas pelo cirurgião-dentista, visando a documentação das informações específicas dos pacientes. Este trabalho teve como objetivo a avaliação do conhecimento dos cirurgiões dentistas em relação à elaboração e ao preenchimento correto dos prontuários odontológicos, para que os mesmos sejam úteis em casos de identificação antropológica e em ações de responsabilidade profissional. A população de cirurgiões-dentistas entrevistada foi composta principalmente pelo gênero feminino (59%) com tempo de conclusão de curso de até 10 anos (53%), exercendo a profissão em consultórios particulares próprios (60%) como especialistas (55%). Os cirurgiões-dentistas, afirmaram que receberam instruções sobre o tempo de guarda dos registros, mas 25% destes responderam que os guardariam por até 5 anos apenas. A maioria dos entrevistados (98%) afirmou conhecimento da importância do uso dos prontuários odontológicos no processo de identificação humana e 74% anotavam as condições prévias ao tratamento, mas nem todos tomavam o cuidado de registrar os detalhes, como o tipo de material e as faces já restauradas, o que dificultaria, nesse caso, a identificação de um indivíduo.

The preparation of dental records is one of the main activities carried out by the dentist, in order to document the specific information of patients. The objective of this study was to evaluate the knowledge of dentist in relation to the preparation and correct filling of dental records, this can be useful in cases of anthropological identification and professional responsibility actions. The dentist population interviewed consisted mainly of female gender (59%) with a course completion time up to 10 years (53%), practicing in private dental office (60%) as specialists (55%). The dentists said they were given instructions on how long the records should kept, but 25% said they would keep them for up to 5 years only. The majority of respondents (98%) reported knowledge of the importance of using dental records in the process of human identification, and 74% wrote down the preconditions for treatment, but not everyone took care of recording the details, such as the type of material and the faces already restored, which would make the process of human identification difficult.

Importance of dental records and panoramic radiograph in human identification: a case report / Importância dos registros odontológicos e de radiografia panorâmica na identificação humana: um relato de caso

Forensic dentistry is important in human identification because it analyses individual characteristics present in the teeth of each individual based on comparison. The aim of this work is to highlight the importance of the correct documentation made by the dentist and to present a case solution using panoramic x-ray. To carry out the report, dental charts and panoramic radiography were used for comparison with dental examination of a female body remains. The wrong notation of charts, made by the dentist, almost leaded to an exclusion identification. Due to panoramic x-ray made nine years before the death, a positive identification could be made. That fact emphasized the importance of attention when charts are being filled out.

A odontologia forense é importante na identificação humana porque analisa características individuais presentes nos dentes de cada indivíduo com base na comparação. O objetivo deste trabalho é destacar a importância da documentação correta feita pelo dentista e apresentar uma solução de caso usando radiografia panorâmica. Para realizar o relatório, foram utilizados gráficos dentais e radiografia panorâmica para comparação com o exame dental nos restos de um corpo feminino. A notação errada do prontuário, feita pelo dentista, quase levou a uma identificação de exclusão. Devido à radiografia panorâmica feita nove anos antes da morte, uma identificação positiva pode ser feita. Esse fato enfatizou a importância da atenção quando o prontuário está sendo preenchido.

Uso de una aplicación para registrar información sobre pacientes estomatológicos desde la perspectiva de los cirujanos dentales / The use of an application to record information on Dentistry patients from the perspective of dental surgeons

Dental records are complex documents and not all dental surgeons have been careful to fill them correctly. On the other hand, a number of apps for professional support has been observed on the market aimed at healthcare. The purpose of this study was to show how dental surgeons have noticed the technology of mobile devices and how it would help in their work routine by analysing an application for recording patient information. This study was exploratory, qualitative, descriptive, and transversal, with data obtained through a semi-structured interview with open-ended questions applied to ten dental surgeons who have downloaded the App OdontoExame as study population. The answers were analysed by the content analysis technique. The results showed that this technology could be useful in storing information. Besides, 90 percent of respondents stated that the application would help in clinical practices, while 10 percent considered such a technology still limited to this function(AU)

Los registros estomatológicos son documentos complejos y no todos los cirujanos dentales han sido cuidadosos al llenarlos correctamente. Por otra parte, un conjunto de aplicaciones de apoyo profesional han aparecido en el mercado, las que están dirigidas a la atención médica. El propósito del presente estudio es mostrar cómo los cirujanos dentales han notado la presencia de la tecnología de dispositivos móviles y cómo esta los podría ayudar en su trabajo diario, a partir del análisis de una aplicación para el registro de información de los pacientes. Se trata de un estudio exploratorio, cualitativo, descriptivo y transversal, basado en datos obtenidos mediante una entrevista semiestructurada con preguntas abiertas dirigidas a una población de diez cirujanos dentales que han descargado la aplicación OdontoExame. Las respuestas se analizaron aplicando la técnica de análisis de contenidos. Los resultados mostraron que esa tecnología puede ser útil para almacenar información. El 90 por ciento de los encuestados plantearon que la aplicación podría ser útil en la práctica clínica, mientras que el 10 por ciento consideró que esta aún estaba limitada a esa función(AU)

A importância da documentação odontológica de usuários de drogas institucionalizados para a identificação post mortem: relato de caso / The importance of dental records of institutionalized drug users to post mortem identification: case report

Introdução: No Brasil, houve aumento do número de usuários de drogas, os quais possuem maior risco de morte devido ao confronto com gangues rivais e com a polícia. Muitas vezes, a identificação destas vítimas se faz necessária pelo arco dental, que será possível caso existam registros odontológicos. Objetivo: Demonstrar a importância legal dos registros odontológicos para a identificação de indivíduos com histórico de uso de drogas e que estão acolhidos institucionalmente. Relato de caso: um cadáver do sexo masculino, esqueletizado, foi encaminhado ao Instituto de Medicina Legal (IML) Gerardo Vasconcelos, em Teresina-PI, para exame de identificação humana e determinação da causa da morte. Junto com a ossada, foram encontrados documentos pessoais compatíveis com histórico descrito pelos familiares de uma pessoa do sexo masculino de 19 anos de idade, usuário de drogas, que se encontrou institucionalizado em comunidade terapêutica para tratamento e recuperação. Foram disponibilizados um atestado de saúde bucal usado para admissão na comunidade terapêutica e ficha odontológica com odontograma, o que possibilitou o processo de identificação pelos arcos dentais. Após o confronto odontolegal entre dados ante mortem (AM) e post mortem (PM), a identificação foi realizada com sucesso. A idade foi estimada entre 18 e 30 anos, de acordo com estágios de mineralização dos terceiros molares e suturas cranianas. As lesões ósseas encontradas evidenciam a hipótese de homicídio. Conclusão: A documentação odontológica produzida com finalidade clínica e administrativa de indivíduos usuários de droga e que necessitam de tratamento institucionalizado demonstrou ser eficiente na identificação odontológica pós-morte.

Introduction: In Brazil, there was an increase in the number of drug users, which have a greater risk of death due to confrontation with rival gangs and the police. Often, the identification of these victims is required by the dental arch, which will be possible if there are dental records. Objective: To demonstrate the legal importance of dental records for the identification of individuals with a history of drug use and who are institutionally welcomed. Case report: a skeletonized male cadaver was sent to the Institute of Legal Medicine (IML) Gerardo Vasconcelos, in Teresina-PI, for examination of human identification and determination of the cause of death. Along with the human skeleton, were found personal documents compatible with the history described by the relatives of a 19-year-old male drug user, who was institutionalized in a therapeutic community for treatment and recovery. An oral health certificate was used for admission to the therapeutic community and dental record with odontogram, which allowed the process of identification by the dental arches. After the forensic dental confrontation between ante mortem (AM) and post mortem (PM) data, the identification was successfully performed. Age was estimated between 18 and 30 years, according to stages of mineralization of third molars and cranial sutures. The bone lesions found evidenced the hypothesis of homicide. Conclusion: The dental documentation produced with clinical and administrative purposes of individuals who use drugs and who need institutionalized treatment proved to be efficient in the post mortem dental identification.

Proposta de um instrumento para avaliar eventos adversos em odontologia / Propuesta de un instrumento para evaluar eventos adversos en odontología / Proposal of a trigger tool to assess adverse events in dental care

Resumo: O objetivo deste estudo foi propor um conjunto de rastreadores para a pesquisa de eventos adversos em odontologia ambulatorial no Brasil. O instrumento foi elaborado em duas etapas: (i) para construir um conjunto preliminar de rastreadores foi realizada uma revisão da literatura, a fim de identificar a composição das ferramentas de rastreamento utilizadas nas demais áreas da saúde e os principais eventos adversos encontrados em odontologia; (ii) para validar os rastreadores preliminarmente construídos foi organizado um painel de especialistas empregando o método Delphi modificado. Foram elaborados quatorze rastreadores para compor um instrumento com critérios explícitos para identificar potenciais eventos adversos no cuidado odontológico, essenciais para os estudos de revisão retrospectiva de prontuários. Pesquisas relacionadas à segurança do paciente em odontologia ainda são bastante incipientes em relação às demais áreas da saúde. Este trabalho pretendeu contribuir para a investigação nesse campo. O aporte da literatura e a ajuda da expertise do painel de especialistas permitiram a elaboração de um conjunto de rastreadores para a detecção de eventos adversos odontológicos, no entanto, são necessários estudos adicionais para testar a validade do instrumento.

Resumen: El objetivo de este estudio fue proponer un conjunto de marcadores para la investigación de eventos adversos en odontología ambulatoria en Brasil. El instrumento se elaboró en dos etapas: (i) para construir un conjunto preliminar de marcadores se realizó una revisión de la literatura, a fin de identificar la composición de las herramientas de rastreo utilizadas en las demás áreas de la salud, y los principales eventos adversos encontrados en odontología; (ii) para validar los marcadores preliminarmente construidos se organizó un panel de especialistas, empleando el método Delphi modificado. Se elaboraron catorce marcadores para componer un instrumento con criterios explícitos, con el fin de identificar potenciales eventos adversos en el cuidado odontológico, esenciales para los estudios de revisión retrospectiva de registros médicos. Las investigaciones relacionadas con la seguridad del paciente en odontología todavía son bastante incipientes, en relación con las demás áreas de salud. Este trabajo pretendió contribuir a la investigación en ese campo. El aporte de la literatura y la ayuda de la pericia del panel de especialistas permitieron la elaboración de un conjunto de marcadores para la detección de eventos adversos odontológicos, sin embargo, se necesitan estudios adicionales para probar la validez del instrumento.

Abstract: The aim of this study was to propose a trigger tool for research of adverse events in outpatient dentistry in Brazil. The tool was elaborated in two stages: (i) to build a preliminary set of triggers, a literature review was conducted to identify the composition of trigger tools used in other areas of health and the principal adverse events found in dentistry; (ii) to validate the preliminarily constructed triggers a panel of experts was organized using the modified Delphi method. Fourteen triggers were elaborated in a tool with explicit criteria to identify potential adverse events in dental care, essential for retrospective patient chart reviews. Studies on patient safety in dental care are still incipient when compared to other areas of health care. This study intended to contribute to the research in this field. The contribution by the literature and guidance from the expert panel allowed elaborating a set of triggers to detect adverse events in dental care, but additional studies are needed to test the instrument's validity.