ABSTRACT
Data on clinical management options for sleep bruxism in the primary dentition are inconclusive. This umbrella review aimed to synthesize the available evidence from systematic reviews (SRs) on the associated factors and treatment approaches for clinical management of sleep bruxism in children. A search was conducted in the MEDLINE/PubMed, Web of Science, Embase, and OpenGrey databases up to March 2022. SRs published on sleep bruxism in children containing data on associated factors or treatment outcomes were included. The AMSTAR-2 tool was used to assess the methodological quality of SRs. The search identified 444 articles, of which six were included. Sleep conditions, respiratory changes, personality traits, and psychosocial factors were the associated factors commonly identified. Treatments included psychological and pharmacological therapies, occlusal devices, physical therapy, and surgical therapy. All SRs included presented a high risk of bias. Overlapping of the included studies was considered very high. The best evidence available to date for the management of sleep bruxism in children is based on associated factors, with sleep duration and conditions, respiratory changes, as well as personality traits and psychosocial factors being the most important factors commonly reported by studies. However, there is currently insufficient evidence to make recommendations for specific treatment options.
Subject(s)
Bruxism , Sleep Bruxism , Child , Humans , Sleep Bruxism/therapy , Sleep Bruxism/psychology , Treatment OutcomeABSTRACT
Abstract Data on clinical management options for sleep bruxism in the primary dentition are inconclusive. This umbrella review aimed to synthesize the available evidence from systematic reviews (SRs) on the associated factors and treatment approaches for clinical management of sleep bruxism in children. A search was conducted in the MEDLINE/PubMed, Web of Science, Embase, and OpenGrey databases up to March 2022. SRs published on sleep bruxism in children containing data on associated factors or treatment outcomes were included. The AMSTAR-2 tool was used to assess the methodological quality of SRs. The search identified 444 articles, of which six were included. Sleep conditions, respiratory changes, personality traits, and psychosocial factors were the associated factors commonly identified. Treatments included psychological and pharmacological therapies, occlusal devices, physical therapy, and surgical therapy. All SRs included presented a high risk of bias. Overlapping of the included studies was considered very high. The best evidence available to date for the management of sleep bruxism in children is based on associated factors, with sleep duration and conditions, respiratory changes, as well as personality traits and psychosocial factors being the most important factors commonly reported by studies. However, there is currently insufficient evidence to make recommendations for specific treatment options.
ABSTRACT
O objetivo do estudo foi caracterizar o perfil dos endodontistas do estado de São Paulo, Brasil em relação ao tratamento odontológico depacientes com necessidades especiais (PNE). Um questionário onlinesobre capacitação do profissional e dados sobre o atendimento odontológico de PNEfoi enviado para 3.500 endodontistas registrados no Conselho Regional de Odontologia de São Paulo. Dentre os 138 profissionais que retornaram, 57,2% eram do sexo feminino; 34,8% estavam na faixa etária entre 31e 40 anos; 42,8% tinham entre 11 e20 anos de formados; e 38,4% possuíam 11 a 20 anos de especialidade. Apenas 22,5% eram capacitados para o atendimento de PNE, sendo que desses, 58,1% tiveram apenas aula teórica. Dos que não receberam capacitação na pós-graduação, 80,4% gostariam de ter recebido. Com relação ao interesse em cursos de atendimento a PNE após a especialização, observou-se que apenas 15,9% realizaram algum tipo de curso, a maioria apenas teórico. Em relação às dificuldades durante o atendimento de PNEa "falta de colaboração do paciente durante o atendimento" foi citada por 74,6%, a "insegurança devido àfalta de preparo profissional" por 55,0%. A análise da associação das variáveis pelo teste Qui-quadrado apontou que quanto maior o tempo de formação, menor essa dificuldade (p=0,0415). Os especialistas encontram mais dificuldades comparados aos que tem formação associada (mestrado e doutorado) (p=0,0369). Não houve associação significativa entre as dificuldades e o tipo de instituição de formação(pública ou privada) (p>0,05). O panorama atual da formação do endodontista não contempla o atendimento as pessoas com necessidades especiais (AU).
The aim of this study was to characterize the profile of endodontic professionals from the state of São Paulo, Brazil in relation to dental treatment for patients with special needs (PSN). An online questionnaire on professional training and data on PSN dental care was sent to 3,500 endodontic professionals registered with the São Paulo Regional Dental Council in 2017. Of the 138 returning professionals, 57.2% were female; 34.8% aged 31-40 years; 42.8% had 11-20 years since graduation; 38.4% had 11-20 years of endodontic specialization. Only 22.5% were trained to provide dental care to PSNs and of these, 58.1% had only theoretical classes. Of those who did not receive post-graduation training, 80.4% would like to have received it. Regarding the interest in PSN care courses after specialization, it was observed that only 15.9% performed some type of course, most of them theoretical only. Regarding difficulties during PSN care, "lack of patient collaboration during care" was mentioned by 74.6%, and "insecurity due to lack of professional preparation" by 55.0%. The analysis of the association of variables by the Chi-square test showed that the longer the training time, the lower the difficulty during PSN care (p=0.0415). Specialists find more difficulties compared to those with associated training (masters and doctorate) (p=0.0369). There was no significant association between difficulties in PSN care and typeof HEI (public or private) (p> 0.05). The current panorama of endodontic professional training does not seem to include care for patients with special needs (AU).
Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Dental Care for Disabled/psychology , Education, Dental, Graduate/methods , Professional Training , Endodontists , Health Services Accessibility , Health Profile , Brazil/epidemiology , Chi-Square Distribution , Cross-Sectional Studies/methods , Surveys and Questionnaires , Data Interpretation, StatisticalABSTRACT
Aim: To compare Enterococcus faecalis reduction after antimicrobial photodynamic therapy (aPDT) used with methylene blue, toluidine blue, tannin, and curcumin as photosensitizers, an adjunct to endodontic chemomechanical preparation (CMP) in root canals of human teeth. Methods: A total of 120 single-rooted teeth were divided into 6 groups (n = 20): G1- CMP and 2.5% sodium hypochlorite (NaOCl); G2- CMP and saline solution; G3- CMP, 2.5% NaOCl, and aPDT with 0.005% methylene blue; G4- CMP, 2.5% NaOCl, and aPDT with 0.005% toluidine blue; G5- CMP, 2.5% NaOCl, and aPDT with 0.005% tannin; and G6- CMP, 2.5% NaOCl, and aPDT with 0.005% curcumin. A portable semiconductor laser was used (660 nm, 100 mW, 1.8 J, 180s) in groups 1, 2, 3, 4, 5, and a blue LED light-curing (420-480 nm, 1200 mV/cm2 ) in G6. For all groups, a 5 min pre-irradiation time was applied. Samples were collected before (initial collection), immediately after (intermediate collection) and 7 days after CMP (final collection) for colony-forming unit (CFU) counting. The Kruskal-Wallis test and analysis of variance (ANOVA) were performed (p < 0.05; 95% confidence interval). Results: In between-group comparisons, there was no significant difference observed in the number of CFUs at the initial (p >< 0.001) and final collections (p >< 0.001) for G2 and G3. In within-group comparisons, the number of CFUs showed a decreasing trend in G4 (p = 0.007) and G5 (p = 0.001). Conclusion: Photosensitizers promoted E. faecalis reduction, with better results for tannin and curcumin. Alternative photosensitizers should be the focus of further studies.>< 0.05; 95% confidence interval). Results: In between-group comparisons, there was no significant difference observed in the number of CFUs at the initial (p < 0.001) and final collections (p >< 0.001) for G2 and G3. In within-group comparisons, the number of CFUs showed a decreasing trend in G4 (p = 0.007) and G5 (p = 0.001). Conclusion: Photosensitizers promoted E. faecalis reduction, with better results for tannin and curcumin. Alternative photosensitizers should be the focus of further studies.>< 0.001) and final collections (p < 0.001) for G2 and G3. In within-group comparisons, the number of CFUs showed a decreasing trend in G4 (p = 0.007) and G5 (p = 0.001). Conclusion: Photosensitizers promoted E. faecalis reduction, with better results for tannin and curcumin. Alternative photosensitizers should be the focus of further studies>< 0.001) for G2 and G3. In within-group comparisons, the number of CFUs showed a decreasing trend in G4 (p = 0.007) and G5 (p = 0.001). Conclusion: Photosensitizers promoted E. faecalis reduction, with better results for tannin and curcumin. Alternative photosensitizers should be the focus of further studies
