Functional recovery time after facial fractures: characteristics and associated factors in a sample of patients from southern Brazil.

Understanding the cause, severity, and elapsed time for the restoration of the functions of maxillofacial injuries can contribute to the establishment of clinical priorities aiming at effective treatment and further prevention of facial trauma. The objective of this study was to understand the factors associated with the restoration of mastication, ocular, and nasal functions in the face of trauma victims, estimating their recovery time after surgical treatment. We analyzed 114 medical records of patients treated at the Hospital Montenegro, who attended follow-up consultations for up to 180 days. For analysis of the recovery time, we performed survival analysis, followed by COX analysis. We observed that half of the patients recovered their functions within 20 days. The average time for recovery from trauma in the zygomatic-orbital-malar-nasal complex was 11 days, and in the maxillary-mandibular complex, 21 days (HR: 1.5 [0.99 2.3], p = 0.055). Although functional reestablishment has reached high rates after the surgical approach, it is necessary to analyze the failing cases, as well as the economic impacts and the prevention strategies associated with facial trauma, to improve the service to the population.

Functional recovery time after facial fractures: characteristics and associated factors in a sample of patients from southern Brazil.

Understanding the cause, severity, and elapsed time for the restoration of the functions of maxillofacial injuries can contribute to the establishment of clinical priorities aiming at effective treatment and further prevention of facial trauma. The objective of this study was to understand the factors associated with the restoration of mastication, ocular, and nasal functions in the face of trauma victims, estimating their recovery time after surgical treatment. We analyzed 114 medical records of patients treated at the Hospital Montenegro, who attended follow-up consultations for up to 180 days. For analysis of the recovery time, we performed survival analysis, followed by COX analysis. We observed that half of the patients recovered their functions within 20 days. The average time for recovery from trauma in the zygomatic-orbital-malar-nasal complex was 11 days, and in the maxillary-mandibular complex, 21 days (HR: 1.5 [0.99 2.3], p = 0.055). Although functional reestablishment has reached high rates after the surgical approach, it is necessary to analyze the failing cases, as well as the economic impacts and the prevention strategies associated with facial trauma, to improve the service to the population.

Functional recovery time after facial fractures: characteristics and associated factors in a sample of patients from southern Brazil / Tempo de recuperação funcional após fraturas faciais: perfil e fatores associados em amostra de pacientes do sul do Brasil

ABSTRACT Understanding the cause, severity, and elapsed time for the restoration of the functions of maxillofacial injuries can contribute to the establishment of clinical priorities aiming at effective treatment and further prevention of facial trauma. The objective of this study was to understand the factors associated with the restoration of mastication, ocular, and nasal functions in the face of trauma victims, estimating their recovery time after surgical treatment. We analyzed 114 medical records of patients treated at the Hospital Montenegro, who attended follow-up consultations for up to 180 days. For analysis of the recovery time, we performed survival analysis, followed by COX analysis. We observed that half of the patients recovered their functions within 20 days. The average time for recovery from trauma in the zygomatic-orbital-malar-nasal complex was 11 days, and in the maxillary-mandibular complex, 21 days (HR: 1.5 [0.99 2.3], p = 0.055). Although functional reestablishment has reached high rates after the surgical approach, it is necessary to analyze the failing cases, as well as the economic impacts and the prevention strategies associated with facial trauma, to improve the service to the population.

RESUMO O entendimento da causa, da gravidade e do tempo decorrido para o restabelecimento das funções de lesões maxilofaciais pode contribuir para o estabelecimento de prioridades clínicas objetivando o efetivo tratamento e prevenção dos traumatismos de face. Assim, o objetivo deste estudo foi compreender quais os fatores associados ao restabelecimento das funções mastigatórias, oculares e nasais em vítimas de trauma de face, estimando o tempo para recuperação das funções, após o tratamento cirúrgico. Foram analisados 114 prontuários de pacientes atendidos no Hospital de Montenegro que compareceram às consultas de acompanhamento por até 180 dias. Para a análise do tempo para a recuperação, foi realizada a análise de sobrevida, seguida da análise de COX. Observou-se que metade dos pacientes recuperaram as funções em até 20 dias, sendo que o tempo médio para recuperação dos traumas no complexo zigomático-orbitário-malar-nasal foi de 11 dias e do complexo maxilo - mandibular de 21 dias (HR: 1,5 (0,99 - 2,3) p=0,055). Embora o restabelecimento das funções tenha atingido taxas elevadas após abordagem cirúrgicas, faz-se necessária a análise dos casos de insucessos bem como os impactos econômicos e as estratégias de prevenção associados aos traumas de face a fim de qualificar o serviço prestado à população.

Impacts of Orthognathic Surgery on Patient Satisfaction, Overall Quality of Life, and Oral Health-Related Quality of Life: A Systematic Literature Review.

Several treatments have been suggested to correct dentofacial abnormalities, including orthognathic surgery. The aim of the present systematic review was to assess the impact of orthognathic surgery on patient satisfaction, overall quality of life, quality of life related to oral health-and to orthognathic surgery in particular-among adult patients. Two investigators independently reviewed the available literature in the databases PubMed/MEDLINE, LILACS, SciELO, EMBASE, Trip, and Google Scholar (gray literature) based on the keywords "orthognathic surgery" and "quality of life." An analysis of bias was performed based on the MINORS (methodological index for nonrandomized studies). A total of 245 relevant studies were retrieved from the databases, and 6 additional studies were located after a manual search of the references. Following selection based on titles, abstracts, and full-text analysis, 30 studies were included in the present systematic review. To evaluate quality of life before and after orthognathic surgery, 12 studies applied the surgery-related Orthognathic Quality of Life Questionnaire (OQLQ), 12 used the Oral Health Impact Profile (OHIP-14), and 4 used the Short Form Health Survey (SF-36). Orthognathic surgery results in improvements in quality of life both physically and psychosocially after surgery and is associated with high rates of patient satisfaction.

Use of Dental Care Among Pregnant Women in the Brazilian Unified Health System.

PURPOSE: To assess the prevalence of and factors associated with the use of public Unified Health System-based dental services by pregnant women and recent mothers. MATERIALS AND METHODS: In this cross-sectional study, face to face interviews were conducted to collect data on the outcome of interest (prevalence of use of dental care) and independent variables (sociodemographic, pregnancy, and prenatal care data). A total of 302 pregnant women seen at public dental services in the municipality of Canoas, southern Brazil, were interviewed. Statistical analysis was performed using the chi-squared test and hierarchical Poisson regression with robust variance (p < 0.05). RESULTS: The prevalence of use of dental care among pregnant women was 50% (n = 151). Pregnant women who initiated prenatal care in the first trimester showed a 34% higher likelihood of using dental care (prevalence ratio [PR] 1.34; 95% confidence interval [95%CI] 1.27-1.61); this likelihood was 12% higher among multiparous women (PR 1.12; 95%CI 1.03-1.23), and 40% higher among women who received guidance to seek dental care (PR 1.40; 95%CI 1.30-1.51). CONCLUSION: The present findings suggest that starting prenatal care in the first trimester, being multiparous, and receiving guidance to seek dental care significantly contributed to the use of public dental services during pregnancy in the population assessed. These factors should be considered when planning public health policies for this population.

Satisfaction of Primary Healthcare Dentists after the Completion of a Distance Learning Course in Pediatric Dentistry.

BACKGROUND: The aim of the present study was to assess the level of satisfaction of dentists working in primary healthcare (PHC) with a Distance learning (DL) course in pediatric dentistry offered by the TeleHealthRS center, and to the investigate possible associations between the variables indicative of their satisfaction and their performance on the questionnaires applied before and after the course. METHODS: The course was offered in 2015 by the Federal University of Rio Grande do Sul (UFRGS) together with the TeleHealthRS center in Brazil. Data were collected on the participants' personal and professional profile, their pre- and post-course knowledge about pediatric dentistry, and their satisfaction with the course. Student's t-test and the ANOVA test were used to assess the possible associations between the variables indicative of their satisfaction and their performance on the questionnaires applied before and after the course. RESULTS: Overall, the participants were satisfied with the course, however, no statistically significant association was found between the variables indicative of their satisfaction and the grades they earned on the pre- and post-course questionnaires. CONCLUSION: The available pediatric dentistry course received positive evaluations from the participants, constituting a possible strategy for the qualification of primary care dentists. Future studies are warranted to further investigate the expectations of DL course participants, aiming to enhance the quality of future editions of this learning modality for pediatric dentistry contents.

An ethnomedicinal survey on phytotherapy with professionals and patients from Basic Care Units in the Brazilian Unified Health System.

ETHNOPHARMACOLOGICAL RELEVANCE: In this study, an ethnomedicinal survey was conducted in the city of Pelotas, Brazil, with professionals and patients in the Unified Health System (SUS). With the approval of the National Policy on Medicinal Plants and Herbal Medicines, and with the adoption of a National Policy on Integrative and Complementary Practices in the SUS in Brazil, there is growing concern regarding Brazilian medicinal plants and their proper use in medicine. The expansion of the therapeutic options offered to the users of the SUS includes access to medicinal plants and herbal drugs, as well as related services, such as phytotherapy. For improving health and for the social inclusion of phytotherapies, safety, efficacy, and quality are important strategies. MATERIALS AND METHODS: Interviews of both professionals and patients were conducted at five Basic Care Units, and a sample size of 393 was obtained. RESULTS: Of the patients attending the Basic Care Units, 91.6% had experienced the use of medicinal plants at least once to treat certain diseases. Of the professionals, 65% had used medicinal plants but only 10% prescribed phytotherapeutics to their patients. Generally, the users were homemakers (26%) of the female gender (71.5%) who were older than 60 years (26%) and had a family income between 1 and 2 Brazilian minimal salaries. The professionals were predominantly female (80%), and a high proportion (80%) believed in the positive effects of phytotherapy (80%), even though these professionals had not been taught phytotherapy as undergraduate students (75%) and had not discussed the topic with their teachers (85%). Patients (81.5%) and professionals (45%) reported that their knowledge of medicinal plants came from their parents or grandparents. From a total of 66 different herbs used by the subjects, mauve (24%) was the most commonly used, often to treat toothaches (24.2%). CONCLUSION: It is concluded that a high proportion of users and professionals made use of medicinal plants, and of the large number of plants mentioned in the questionnaire, mauve was the most commonly used, mainly for the treatment of toothaches. The major source of the transmission of knowledge concerning herbal medicine was parents or grandparents.

Reattachment using a fragment from an extracted tooth to treat complicated coronal fracture.

Reattachment of fragment is the preferred alternative to restore the fractured teeth, offering several advantages. Partial pulpotomy has demonstrated satisfactory results as a conservative treatment for pulp exposures because of trauma. This study reports a case in which the treatment of a complicated coronal fracture was accomplished by partial pulpotomy and reattachment of a dental fragment obtained from an extracted tooth using composite resin. The results show the feasibility of the conservative pulp therapy and the restorative approach.

Demographic, socio-economic, behavioural and clinical variables associated with caries activity.

This study investigated the association between several demographic, socio-economic, behavioural and clinical variables on caries activity. One hundred and two patients were randomly retrieved from the files of the Operative Dentistry Clinic (UFPel-Brazil). The patients gave written consent to participate in the study. They were interviewed reporting demographic (sex and age), socio-economic data (income, educaional level) and oral health behaviours (tooth-brushing frequency, dental floss usage and snacks frequency). Intraoral examination was performed to investigate the clinical variables (presence and quality of biofilm, DMFT and modified DMFT index and bleeding points). Patients were divided between caries-active (n=51) and caries-inactive (n=51), according to the presence of white spot lesions and/or active cavity lesions. Statistical analysis was carried tout using Chi-square or Fischer's exact test, with the confidence level at 95%. Results demonstrated that several conditions (younger subjects, lower educational or income levels, lower tooth-brushing frequency, higher snacks frequency, adherent biofilm, presence of bleeding points and higher modified DMFT index) were associated with caries activity in the studied population. Within the limitations of the experimental design, and considering the population under investigation, it was verified that demographic (age), socio-economic (income and educational levels), behavioural (tooth brushing and snacks frequencies) and clinical (modified DMFT index, presence and quality of biofilm, and bleeding points) variables were associated with caries-active patients.

Avaliação clínica de restaurações de resina condensável em dentes posteriores após um ano / One-year clinical evaluation of condensable composite restoration in posterio teeth

O objetivo deste estudo foi avaliar comparativamente, após o período de um ano, a performance clínica em dentes posteriores de restaurações da resina condensável ALERT (Jeniric-Pentron), de resina composta microhibrida Sculp-It (Jeneric-Pentron) e de amálgama Logic C (SDI). Os pacientes foram selecionados na Clínica de Dentística da Faculdade de Odontologia de Pelotas e foram inseridos no estudo mediante consentimento esclarecido. Cada paciente deveria ter ao menos uma restauração de cada material. Trinta e três restaurações classe I e II foram realizadas em seis pacientes. Após o acabamento e polimento das restaurações, foi realizada a avalição baseline, que tinha como pré-requisito a qualificação Alfa para seguir no estudo. A avaliação foi baseada nos critérios de avaliação clínica USPHS (United States Public Health Service) modificado, para as restaurações de amálgama e USPHS adaptado, para as restaurações de resina. Após um ano as restaurações foram reavaliadas pelo mesmo examinador. Baseados na avaliação clínica, as restaurações foram agrupadas nos critérios clinicamente satisfatórias (maioria dos escore Alfa e Bravo) e insatisfatórias (maioria dos escores Charlie e Delta). A comparação entre as restaurações para os dois critérios convencionados, através do teste exato de Fischer, demonstrou não haver diferença entre os materiais para o tempo de avaliação de um ano (p>0,05). Quando realizada uma comparação mais especifica entre as restaurações de resinas, o teste não paramétrico de Mann-Whitney demonstrou maior rugosidade superficial (p<0,05) e menor estabilidade de cor (p<0,01) da resina condensável, quando comparada com a resina microhibrida.