Simulação Clínica Realística: relato da experiência do laboratório de simulação clínica realística da FOUSP / Simulación clínica realista: informe de la experiencia del laboratorio de simulación clínica realista de la FOUSP / Realistic Clinical Simulation: report of the experience of the realistic clinical simulation laboratory at FOUSP

Apresenta-se a experiência da simulação clínica realística (SCR) efetuada no Laboratório de Simulação Clínica Realística e de Realidade Virtual Aumentada da Faculdade de Odontologia da Universidade de São Paulo (inaugurado em junho de 2022). Essa metodologia contribui significativamente na formação do estudante de Odontologia em todas as áreas do conhecimento odontológico. Sua aplicação deve submeter-se a protocolos corretos construção do problema (briefing), a simulação e discussão posterior (debriefing). Este cenário constitui o presente e o futuro da realidade do ensino odontológico. De fato, sua estratégia possibilita a simulação de uma multiplicidade de situações clínicas. Para tal, impõe-se a estruturação de um ambiente específico (aqui denominado "laboratório"). Este trabalho resume os fundamentos dessa simulação e a avaliação interna de sua aplicabilidade e inequívoca eficácia na nossa Faculdade. De fato, a simulação é uma estratégia facilitadora imprescindível no processo ensino-aprendizagem da Odontologia, cujo papel nesse processo deve delinear-se cada vez mais importante, na medida em que outros centros formadores forem adotando esse recurso e forem progressivamente intercambiando suas experiências e avaliações (AU).

Se presenta la experiencia de simulación clínica realista (SCR) realizada en el Laboratorio de Simulación Clínica Realista y Realidad Virtual Aumentada de la Facultad de Odontología de la Universidad de São Paulo (inaugurado en junio de 2022). Esta metodología contribuye significativamente a la formación de los estudiantes de odontología en todas las áreas del conocimiento odontológico. Su aplicación debe someterse a protocolos correctos para la construcción del problema (briefing), simulación y posterior discusión (debriefing). Este escenario constituye la realidad presente y futura de la educación odontológica. De hecho, su estrategia permite simular una multiplicidad de situaciones clínicas. Para lograrlo, es necesario estructurar un entorno específico (aquí llamado "laboratorio"). Este trabajo resume los fundamentos de esta simulación y la evaluación interna de su aplicabilidad y efectividad inequívoca en nuestra Facultad. De hecho, la simulación es una estrategia facilitadora esencial en el proceso de enseñanza-aprendizaje de la Odontología, cuyo papel en este proceso debe ser cada vez más importante, a medida que otros centros de formación adopten este recurso e intercambien progresivamente sus experiencias y valoraciones (AU).

This report on the experience of realistic clinical simulation (RCS) is linked to the Realistic Clinical Simulation and Augmented Virtual Reality Laboratory, launched in June 2022 at the Faculty of Dentistry of the University of São Paulo (São Paulo). RCS is an active methodology that can significantly contribute to the education of dental students in all areas of dental knowledge. Its application must adhere to correct protocols for problem construction (briefing), the simulation itself, and the subsequent discussion (debriefing). This scenario represents both the present and the future of dental education. Indeed, its strategy enables the simulation of a multitude of clinical situations, for which the establishment of a specific environment (herein referred to as a "laboratory") is needed. The present work summarizes the basis of this simulation and the internal evaluation of its applicability and effectiveness. It is concluded that simulation is a facilitating strategy in the dental teaching-and-learning process. In fact, its role in this process will become increasingly important as far as other educational institutions adopt this resource and progressively exchange their experiences and assessments (AU).

Using information and communication technologies (ICTs) to solve the repressed demand for primary dental care in the Brazilian Unified Health System due to the COVID-19 pandemic: a randomized controlled study protocol nested with a before-and-after study including economic analysis.

BACKGROUND: With the COVID-19 pandemic, thousands of children had their dental care interrupted or postponed, generating a pent-up demand for primary care. To minimize the impact of this outage, information and communication technologies (ICT) could be an alternative. The aim of this study is to elucidate the impact of implementing the ICTs in primary dental care for children on resolving the pent-up demand for primary dental care to children in the national health system service (SUS) due to the COVID-19 pandemic. METHODS: Different research strategies are being proposed to demonstrate such effect and extrapolating findings to a real-world context to guide further research, practice and policies: two clinical trials (one randomized controlled by the waiting list trial (RCT) and a before-and-after study), one simulation study to prospect trial results to a broader population and three economic evaluations using different effects. Children enrolled in a reference dental unit will be invited to participate in the before-and-after study for trials. The first 368 families will be randomized for the RCT to the intervention vs waiting list. All participants will receive the intervention, but the waiting list group will be assessed before the intervention is available for them. The intervention comprises standardized non-face-to-face primary dental care using the V4H platform. The problem-solving and the family's perception will be the primary outcomes set for the before-and-after study and RCT, respectively. They will be measured 2 weeks after randomization. Based on trial findings, we will develop theoretical models to estimate how the intervention could benefit the population included in the national health system.  Three economic evaluations will be carried out considering different trial effects (cost-effectiveness analyses). A societal perspective and the pandemic time horizon will be considered. Possible social impact (inequalities) will also be explored. DISCUSSION: This ongoing trial may be an essential contribution to clarify positive and negative aspects related to the use of technologies for non-face-to-face dental care for children. Trial products may bring relevant contributions to the pandemic context and the post-pandemic period. Potential benefits may be feasible to implement and preserve in the health system even in the post-pandemic period. Trial registration Clinicaltrials.gov registration NCT04798599 (registered March 2021).

O processo de trabalho em saúde bucal coletiva em tempos de pandemia: a contribuição da teleducação com a teleodontologia / The work process in collective oral health in times of a pandemic: the contribution of tele-education with teledentistry

A pandemia da COVID-19 impôs ações assertivas em todos os níveis da sociedade. Aqui se relata o apoio emergencial na Resposta Rápida do Núcleo de Evidências e Análises Econômicas da Faculdade de Odontologia da Universidade de São Paulo (EvipOralHealth) para a coordenadoria estadual de saúde bucal de São Paulo, em prol da tomada de decisão e ressignificação do processo de trabalho. Foram implementadas duas estratégias de teleodontologia para a educação permanente (EP) dos trabalhadores de saúde bucal: 1. Lives com pesquisadores, estudantes, gestores e trabalhadores das diversas áreas da saúde pública e da Odontologia para estabelecer marcos teóricos; 2. Ambulatórios virtuais - via webconferência. Reuniu-se gestores e trabalhadores para a condução de diálogos de políticas sobre o dia a dia do enfrentamento e de adaptações e condições de trabalho de cada região. A experiência revela a importância da relação ensino-serviço-comunidade efetiva, pautada na tradução do conhecimento e na construção de espaços de troca possibilitando a implementação de práticas, programas e políticas. Precisamos repensar as estratégias de EP, sermos mais ágeis, mais flexíveis, menos acadêmicos e capazes de adaptar conteúdos e formatos às necessidades. A teleodontologia e a teleducação podem conferir escala e fazer chegar mais facilmente o conhecimento aos que necessitam.

Comparative in vitro study of intracanal Enterococcus faecalis reduction using photosensitizers in aPDT

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

Teledentistry and the Unified Health System: An Important Tool for the Resumption of Primary Health Care in the Context of the COVID-19 Pandemic

Abstract This paper describes the possibilities of using Teledentistry to expand and qualify health care in oral health care networks. WHO already recommended to its member countries, even before the pandemic, Telehealth as a strategy to improve the quality of services, especially in universal systems, as the Unified Health System (SUS). Teledentistry opens opportunities for oral health to resume the provision of various services, remotely, such as: 1) Tracking, active search, monitoring of priority users, those at risk and with systemic problems, suspicions of COVID-19 and contacts, through Telemonitation; 2) Initial listening, individual or collective educational activities, through Teleorientation; 3) Discussion of clinical cases for the definition of the opportunity / need for operative procedures, matrix support, sharing, solution of doubts among professionals and between these and teaching and research institutions, by Teleconsulting, among others. In addition to a review of Teledentistry in the context of the pandemic, we conceptualized the terms used and possibilities offered to SUS professionals, in addition to specifying the possible protocols for recording these activities to provide safe data for their monitoring and evaluation. Besides, we bring a brief discussion with promising experiences, carried out in the pre- and trans-pandemic contexts, which can be important strategies for the resumption of oral health in the post-pandemic scenario.

Aplicações de Business Intelligence na Saúde: Revisão de Literatura / Business intelligence applications in healthcare: Literature Review / Inteligencia de negocio aplicada a la salud: Revisión de Literatura

Este artigo revisa a literatura publicada entre 2009 e 2014 sobre aplicação de Business Intelligence (BI) na saúde, indexada nas bases de dados Scopus, PubMed, Bireme, Web of Science e Google Scholar. A busca pelos descritores "Business Intelligence" e "saúde" e a sua combinação retornou 339 artigos, sendo selecionados 17 adequados aos critérios estabelecidos. Os artigos foram classificados nas temáticas "cuidados em saúde" e "gestão". Não houve predominância de temáticas. O ano 2010 foi o de maior número de publicações e Portugal, Canadá e EUA os países de origem da maior parte dos autores. Com as práticas de BI a estruturação e análise da informação possibilitou o monitoramento do desempenho do ponto de vista assistencial e gerencial. Confirmou-se que as práticas de Business Intelligence podem ser aplicadas no setor de saúde, com valorização das ações gerenciais estratégicas.

This article reviews literature on Business Intelligence in healthcare (BI), indexed in databases Scopus, PubMed, Bireme, Web of Science and Google Scholar databases between 2009 and 2014. Search using the descriptors "Business Intelligence", "Health" and their combination returned 339 articles, of which 17 matched the established criteria. Articles were classified as either pertaining to the subject "healthcare" or "management". No subject was predominant. The year 2010 yielded the most results. Canada, Portugal and the United States were the countries of origin for the majority of the authors. Structuring and analyzing information that stems from BI practices allowed for monitoring performance from both care and management points of view. The study confirms that Business Intelligence practices may be applied to the health sector, with an increase of strategic management actions.

Este artículo revisa la literatura sobre "Inteligencia de Negocios" en salud, indexadas en bases de datos Scopus, PubMed y Google Scholar, Bireme, Web of Science entre 2009 y 2014. La búsqueda usando los descriptores de inteligencia de negocios, salud y su combinación resultó 339 artículos, de los cuales 17 cumpliran los criterios establecidos. Artículos fueron clasificados como referentes a la "salud del sujeto" o a "gestión". Ningún tema fue predominante. El año 2010 rindió la mayoría de los resultados. Canadá, Portugal y Estados Unidos fueron los países de origen para la mayoría de los autores. Estructuración y análisis de la información que proviene de BI prácticas permitió monitorear el performance tanto del punto de vista de salud como de gestión. El estudio confirma que las prácticas de Inteligencia de Negocios pueden aplicarse al sector de la salud, con las acciones estratégicas de gestión mejoradas.

Influence of final rinse technique on ability of ethylenediaminetetraacetic acid of removing smear layer.

INTRODUCTION: There is ongoing debate regarding the ideal sequence, volume, and concentration of irrigants, length of time for irrigation, and irrigation technique to achieve debridement of the root canal system. The aim of this study was to verify the impact of the final rinse technique on smear layer removal ability of 17% ethylenediaminetetraacetic acid (EDTA). METHODS: Sixteen single-rooted human teeth were instrumented and divided into 2 groups at the final rinse step according to the following final rinse techniques used: continuous rinse group, continuous rinse with EDTA during 3 minutes, and rinse and soaking group, rinse with 1 mL of EDTA, soaking of the canal for 2 minutes and 30 seconds, and rinse completion with the remaining 4 mL for 30 seconds. The specimens were split lengthwise and observed under scanning electron microscope. RESULTS: Data were analyzed with Kruskal-Wallis and Dunn tests. The continuous rinse group presented more debris-free surfaces when compared with the rinse and soaking group (P<.01). When the root canal areas were compared within the groups, no statistical differences were found (P>.05). CONCLUSIONS: It can be concluded that a continuous rinse with 5 mL of EDTA for 3 minutes can more efficiently remove the smear layer from root canal walls.

Desenvolvimento de material didático dinâmico em odontopediatria para utização na teleodontologia: utilização do software Macromedia Flash / Development of pediatric dentistry educational materials for use in teledentistry: use of macromedia flash software

Atualmente, a internet está sendo utilizada como recurso didático de auxílio às aulas presenciais ou para realização de disciplinas à distância. Na Odontologia, assim como em outras áreas, a Teleducação vem avançando e ocupando espaço nos cursos de graduação e pós-graduação. A Teleodontologia amplia as condições de aprendizagem do aluno, facilitando o contato com diferentes materiais e trazendo oportunidade de escolha do momento de estudo. A preparação de material didático pelos tutores deve ser prioridade, como forma de estimular o aprendizado do aluno. Este trabalho descreve a utilização do software Macromedia Flash® para desenvolvimento de material didático dinâmico relativo à progressão da lesão de cárie e traumatismo dentário, executado por duas alunas da turma de pós-graduação em Odontopediatria da Faculdade de Odontologia da USP...

Currently, websites are being widely used as a resource to support traditional teaching lessons or for long distance teaching. In dentistry, as well as in other areas, teleeducation is moving forward and taking up space in undergraduate and graduate courses. Teledentistry extends the student's learning, since it enables contact with different materials and offers the opportunity to study at the most appropriate moment. The development of dynamic educational material by tutors should be a priority, as a way to stimulate student's learning. This paper describes the use of Macromedia Flash® software used to development educational materials on the progression dental carious lesions and dental trauma. These were developed by two pediatric dentistry is graduate students at the Faculty of Dentistry at USP...

Avaliação da superfície dentinária com o microscópio clínico após remoção de retentor intra-radicular utilizando o ultra-som / Evaluation of dentinal surface with clinical microscope after intra-radicularretainer removal using ultrasound

Objetivo: Avaliar o tempo despendido e possíveis linhas de fissura, trincas e outros danos causados na superfície dentinária ao redor do retentor intra-radicular submetido à vibração ultra-sônica para a sua remoção, utilizando o microscópio clínico. Métodos: Foram utilizadas 15 raízes de incisivos centrais inferiores bovinos, portadoras de retentores intra-radiculares Flexi-Post nº 3 cimentados com o cimento resinoso RelyX CRA® e incluídas em um alvéolo artificial, envoltas com uma camada de silicone. Os retentores foram submetidos à vibração ultra-sônica com o aparelho ENAC modelo EO-5 na sua potência máxima e, após a remoção, foi realizada uma avaliação a olho nu e outra com o microscópio clínico nos aumentos de 5, 8, 12,5 e 20 vezes. Resultados: Os resultados mostraram que nenhuma superfície dentinária apresentou linhas de fissura, trincas ou outros danos, e que o tempo médio para remoção dos retentores foi de 13,25 minutos. Conclusão: O ultra-som demonstrou ser um aparelho eficaz e seguro para a remoção de retentores intra-radiculares.

Objective: To evaluate the time spent and possible fissure lines, fractures and other damage caused on the dentinal surface around the intra-radicular retainer submitted to ultrasonic vibration to remove it, using a clinical microscope. Methods: The roots of 15 bovine mandibular central incisors were used. These contained Flexi-Post No. 3 intra-radicular retainers cemented with RelyX CRA® resinous cement and were included in an artificial alveolus, surrounded by a layer of silicone. The retainers were submitted to ultrasonic vibration with the ENAC model EO-5 appliance at maximum power, and after removal, an evaluation was made by the naked eye, and another with a clinical microscope, at magnifications of 5, 8, 12.5 and 20 times. Results: The results showed that no dentinal surface presented fissure lines, cracks or other damage, and that the mean time for removal of the retainers was 13.25 minutes. Conclusion: Ultrasound was shown to be an efficient and safe appliance for intra-radicular retainer removal.

Método de captura e utilizaçäo de imagem digital direta (IDD) com finalidade didática em Odontologia / Method for the capture and utilization of direct digital image (DDI) for didactic purposes in dentistry

Uma técnica simples de digitalizaçäo dos cortes dentais com finalidade didática em Odontologia é apresentada pelos autores. A técnica é de fácil reproduçäo, baixo custo e resultados de alta qualidade