Manutenção preventiva na clínica integrada: necessidades de tratamento e ontervalo do retorno / Preventive maintenance at the integrated clinic: treatment needs and recall interval

RESUMO

Objetivo: Caracterizar os pacientes atendidos no programa de manutencao preventiva (MP) e relacionar as necessidades de tratamento apresentadas com os intervalos de retorno prescritos. Metodo: Foram coletados dados secundarios de prontuarios de pacientes da MP, no ano de 2008, relativos a idade, genero, e intervalo de tempo decorrido desde a ultima consulta. Registrou-se a presenca ou ausencia de alteracoes sistemicas, uso de medicamentos, dor ou desconforto bucal, desordem oclusal e lesoes de mucosa. Foram comparados os dois ultimos Indices Periodontais Comunitarios (CPI) e Indices de Placa Visivel (IPV). As variaveis necessidade de tratamento e tempo decorrido desde a ultima consulta foram comparadas pelo teste-t, com nivel de significancia de 5%. Resultados: A amostra consisti u de 115 individuos, 60,9% do genero feminino e 39,1% do masculino, com media de idade de 25,40 (ñ13,34) anos. A porcentagem dos que faziam uso regular de medicamentos (22,61%) foi maior que a observada para a presenca de alteracoes sistemicas (19,13%). Dos 67,83% que apresentaram necessidade de tratamento, 52,56% tinham necessidade de atencao primaria, 6,41% somente secundaria e 41,03% em ambos os niveis de atencao. O intervalo medio de tempo decorrido desde a ultima consulta (12,76 ñ 6,62 meses) apresentou baixa correlacao com as variaveis alteracoes sistemicas (r= 0,0174), uso de medicamentos (r= 0,0714), dor e desconforto bucal (r= 0,0357), lesoes de mucosa (r= 0,0357), necessidade de tratamento (r= 0,0368). Nao houve diferenca estatistica significativa entre os intervalos de retorno prescritos para individuos que tinham ou nao necessidade de tratamento (p=0,6958). Conclusao: Existe uma falta de sistematizacao na determinacao de intervalos de MP, ressaltando a necessidade de estudos prospectivos para estabelecer criterios baseados na classificacao de risco individual, que possam ser aplicados ao ensino da disciplina e a pratica profissional.

ABSTRACT

Objective: To characterize the patients enrolled in a preventive maintenance (PM) program, and to correlate their treatment needs with the prescribed and recall intervals. Method: Secondary data - age, gender and time interval elapsed since the last dental appointment - were collected from the charts of patients attending the PM program in 2008. The presence or absence of systemic alterations, use of medications, oral pain or discomfort, oclusal disorder and mucosal lesions was recorded. The last two Community Periodontal Indexes (CPI) and Visible Plaque Indexs (VPI) were compared. The variables treatment needs and time interval elapsed since the last dental appointment were compared by the t-test at 5% significance level. Results: The sample was composed by 115 individuals, 60.9% were females and 39.1% were males with mean age of 25.40 (ñ 13.34) years. The percentage of those who made regular use of medications (22.61%) was higher than that observed for the presence of systemic alterations (19.13%). From the 67.83% that had treatment needs, 52.56% needed primary attention, 6.41% only secondary attention and 41.03% needed both levels of attention. The mean time interval elapsed since the last appointment (12.76 ñ 6.62 months) had a low correlation with the variables systemic alterations (r= 0.0174), use of medications (r= 0.0714), oral pain and discomfort (r= 0.0357), mucosal lesions (r= 0.0357) and treatment needs (r= 0.0368). There was no statistically significant difference among the recall intervals prescribed for individuals who had or not treatment needs (p=0.6958). Conclusion: There is a lack of systematization in the determination of PM intervals, reinforcing the need for prospective studies to reestablish criteria based on the classification of individual risks that can be applied to the teaching of Integrated Clinic discipline and professional practice.