Estado de ánimo en adultos mayores previo a un procedimiento odontológico de primer nivel. Estudio exploratorio

Introducción: La investigación de estados de ánimo en la consulta odontológica se ha centrado principalmente en edades pediátricas; sin embargo, es importante conocer qué sucede en otros grupos etarios. Objetivo: Evaluar el estado de ánimo de los adultos mayores previo a un procedimiento odontológico de primer nivel en la Clínica Universitaria de Atención a la Salud Zaragoza. Materiales y métodos: Se realizó un estudio de tipo exploratorio observacional transversal, con una muestra de 34 adultos mayores (22 mujeres y 12 hombres), con una media de edad de 69,2. La selección de la muestra fue no probabilística por conveniencia. Se utilizó la Escala de Valoración del Estado de Ánimo, que es un instrumento de autorreporte, validado en población adulta para condiciones clínicas y no clínicas. Resultados: Se encontró un puntaje alto en la subescala de Alegría, con una media de 6,63 y una desviación típica de 2,7. Para las subescalas de estado de ánimo consideradas negativas, como Ansiedad, se obtuvo una media de 3,5 y una desviación típica de 2,5. Para Tristeza-Depresión se obtuvo una media de 3,1 y una desviación típica de 3,0 y, finalmente, para la subescala de Ira-Hostilidad, se obtuvo una media de 2,7 y una desviación típica de 3,1. Conclusiones: Se encontraron niveles bajos en los estados de ánimo negativos para las subescalas de Ansiedad, Tristeza-Depresión e Ira-Hostilidad. Por su parte, en los estados de ánimo positivos hay un nivel alto, tanto por ítem como en la subescala de Alegría.

Introduction: The research on mood states in dental consultation has focused mainly on pediatric ages; however, it is important to know what happens in other age groups. Objective: To evaluate the mood of older adults prior to a first-level dental procedure at the Zaragoza University Health Care Clinic. Materials and methods: An exploratory, observational, cross-sectional study was carried out with a sample of 34 older adults (22 women and 12 men) with an average age of 69.2. The sample selection was non-probabilistic for convenience. The Mood Assessment Scale was used, which is a self-report instrument, validated in the adult population, for clinical and non-clinical conditions. Results: A high score was found in the joy subscale with a mean of 6.63 and a standard deviation of 2.7. For the mood subscales considered negative such as Anxiety, a mean of 3.5 and a standard deviation of 2.5 was obtained. For Sadness -Depression, a mean of 3.1 and a standard deviation of 3.0 were obtained; and finally for the Anger-Hostility subscale, a mean of 2.7 and a standard deviation of 3.1 were obtained. Conclusion: Low levels were found in negative mood states for the subscales of Anxiety, Sadness-Depression and Anger-Hostility. Meanwhile, in positive mood states there is a high level, both in item and in the subscale of Joy.

Prevalencia de endocarditis infecciosa a partir de procedimientos odontológicos / Prevalence of infective endocarditis from dental procedures

Resumen Introducción: Los procedimientos dentales han sido asociados a bacteriemia y endocarditis infecciosa. Objetivo: Determinar la prevalencia de endocarditis infecciosa a partir de procedimientos odontológicos. Materiales y métodos: Se realizó un estudio descriptivo de tipo retrospectivo cuantitativo. Se incluyeron historias clínicas de pacientes con endocarditis infecciosa a los cuales se les registró identificación general, sexo, edad, estrato socioeconómico, reporte de procedimiento odontológico, tipo de procedimiento odontológico, endocarditis infecciosa no especificada y reporte de procedimiento médico-quirúrgico. Adicionalmente, se registró información sobre el tipo de procedimiento médico-quirúrgico o condición médica relacionada. Los datos fueron compilados en hoja de cálculo para su procesamiento en software estadístico (SPSS ver. 25). Resultados: De 154 casos de endocarditis infecciosa registrados, solo en uno (0.7%) se reportó procedimiento odontológico del tipo endodoncia previo a la hospitalización. La causa relacionada más comúnmente reportada fue cateterismo para hemodiálisis (37%) seguido de bacteriemia no específica (22%) y condición cardiovascular asociada a válvulas cardíacas y marcapasos (18.8%). En el 15.6% de los casos se reportó como endocarditis infecciosa no especificada. Los microorganismos más comúnmente aislados pertenecen al género Staphylococcus, seguido de Streptococcus. Conclusiones: La frecuencia de endocarditis bacteriana relacionada con procedimientos odontológicos fue menor del 1%. Los procedimientos médico-quirúrgicos siguen siendo la causa más común de endocarditis bacteriana.

Abstract Introduction: Dental procedures have been associated with bacteriemia and infective endocarditis. Objective: To determine the prevalence of infective endocarditis from dental procedures. Materials and methods: A descriptive, retrospective quantitative study was carried out. Records of infective endocarditis of which the general identification, sex, age, socioeconomic status, dental procedure report, type of dental procedure and non-specified infective endocarditis information was collected. Additionally, information was recorded on the type of medical/surgical procedure or medical condition that was associated. Categorical variables are presented as absolute and relative frequencies. The data were compiled in a spreadsheet for processing in statistical software (SPSS ver. 25). Results: Of the 154 cases of infective endocarditis registered, only 1 case (0.7%) reported an endodontic-type dental procedure prior to hospitalization. The most reported related cause was catheterization for hemodialysis (37%) followed by unspecified bacteriemia (22%) and cardiovascular condition associated with heart valves and pacemakers (18.8%). In 15.6% of the cases, it was reported as non-specific infective endocarditis. The most isolated microorganisms belonged to the genus Staphylococcus followed by Streptococcus. Conclusions: The frequency of bacterial endocarditis related to dental procedures was less than 1%. Medical-surgical procedures remain the most common cause of bacterial endocarditis.

Ambulatory Sedation for Dental Procedures-Case of Cuenca, Ecuador.

In recent years, the dental treatment of children under sedation and/or general anesthesia on an outpatient basis has been developed as a behavioral management model in pediatric dentistry. The objective of this study was to establish the percentage of pediatric patients who required deep sedation on an outpatient basis in dental offices in the city of Cuenca, Ecuador. An observational study was conducted with a sample of 450 records of school- and preschool-age patients, where the variables were type and time of treatment, age, and sex. Statistical data were analyzed using the statistical program SPSS V.27 (IBM, Armonk, NY, USA). The highest percentage of children who received sedation were of preschool age. In general, there were three types of procedures per session, the most frequent being restorations (67%), followed by pulp treatment (49.8%) and, less frequently, minor surgery. The need for sedation for dental procedures is high in preschool patients, and ambulatory sedation has contributed to meeting this need. However, a regulation for its use is required at a national level.

Unilateral visual impairment after a dental procedure: Case report.

The use of intra-oral local anaesthetics for dental procedures is a widely extended practice that may cause side effects. As such, in rare cases it may cause ocular complications such as diplopia, ptosis, blurry vision, miosis, vision loss, or amaurosis. (Most of them are transient, recovering after several hours or days). A case is presented of a 26 year-old male patient who had visual impairment in the right eye 2 days after a dental procedure was performed. Six months later he had a complete restoration of the previous visual acuity, despite the fact that he had not received any treatment. Several ways have been proposed in the literature that may explain the appearance of ocular complications following these kinds of procedures. In this case, inadvertent intravenous injection is believed to have been the cause.

Unilateral visual impairment after a dental procedure: Case report. / Disminución de la agudeza visual tras un procedimiento odontológico: A propósito de un caso.

The use of intra-oral local anaesthetics for dental procedures is a widely extended practice that may cause side effects. As such, in rare cases it may cause ocular complications such as diplopia, ptosis, blurry vision, miosis, vision loss, or amaurosis. (Most of them are transient, recovering after several hours or days). A case is presented of a 26 year-old male patient who had visual impairment in the right eye 2 days after a dental procedure was performed. Six months later he had a complete restoration of the previous visual acuity, despite the fact that he had not received any treatment. Several ways have been proposed in the literature that may explain the appearance of ocular complications following these kinds of procedures. In this case, inadvertent intravenous injection is believed to have been the cause.

Is there a Role for Antibiotic Prophylaxis Prior to Dental Procedures in Patients with Total Joint Arthroplasty? A Systematic Review of the Literature.

Background: The indication of prophylactic antibiotics prior to dental procedures for non-infected causes in order to reduce the risk of haematogenous periprosthetic joint infection (PJI) remains as controversial. We performed a systematic review of the literature assessing the relationship between PJI and invasive dental procedures and whether there is evidence to support the use of antibiotic prophylaxis. Methods: This review was conducted in accordance with the 2009 Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) statement. MEDLINE, EMBASE and the Cochrane Database of Systematic Reviews were searched for studies focusing on dental procedures after TJA, reporting on PJI as an outcome. The methodological quality was assessed with the Newcastle-Ottawa quality assessment scale for case-control and cohort studies and by the tool proposed by Murad et al. for observational studies. Results: Our systematic literature review yielded 90 individual studies, of which 9 met the inclusion criteria. The overall infection rate ranged from 0.26% to 2.12%. Of these, cases associated with a dental procedure ranged from 0% to 15.9%. Five of the studies described cases in which antibiotic prophylaxis was administered; however, no clear algorithm regarding type and dosage of antibiotic was mentioned. When assessing the methodological quality of the evidence, all studies had an overall low to moderate quality. Conclusion: The current systematic review, mostly composed of low-quality studies, suggests that there is no direct evidence to indicate prophylactic antibiotics prior to dental procedures in patients with TJA. In line with the current guidelines, no prophylaxis should be used on interventions for non-infected causes, except for occasional unusual situations, which can then be judged individually.

Sinais vitais em crianças e adolescentes submetidos à diferentes tratamentos em Odontopediatria / Vital signs in children and adolescents subjected to different treatments in pediatric dentistry

O objetivo do presente estudo foi monitorar os sinais vitais em crianças e adolescentes submetidos aos diferentes tratamentos na Odontopediatria. Inicialmente foi realizada uma revisão sistemática da literatura para avaliar se procedimentos odontológicos em crianças são capazes de provocar mudanças na pressão sanguínea. Com relação a revisão sistemática, cinco artigos preencheram os critérios de inclusão, na busca eletrônica nas bases Lilacs, PubMed, Web of Science, e Scopus, e concluiu-se que existe evidencia moderada para suportar as mudanças na pressão sanguínea em crianças submetidas a procedimentos odontológicos. Posteriormente, foi elaborado a pesquisa que gerou o segundo artigo da Tese denominado Aferição das alterações nos sinais vitais em crianças frente aos procedimentos em Odontopediatria e o seu perfil social foi dividido em duas fases. A fase I: clínica e a fase II: questionários. A fase I examinou 64 crianças e adolescentes atendidos na clínica de Odontopediatria da Faculdade de Odontologia da Universidade Federal do Rio de Janeiro divididos em 2 grupos: 32 pacientes compareceram para Revisão (Grupo R) com aferição da pressão arterial (PA), frequência cardíaca e saturação periférica de oxigênio antes e depois do procedimento odontológico. O outro Grupo A, também com 32 pacientes foram submetidos a anestesia para o tratamento, sendo aferido a pressão arterial, frequência cardíaca e oximetria, no início do tratamento, após a anestesia e no final do tratamento. Os responsáveis pelos pacientes dos dois grupos receberam o questionário para obter dados da saúde, hábitos alimentares, atividade física e nível socioeconômico. A frequência cardíaca mostrou diferença significativa (p<0,001) entre o início e o final dos tratamentos nos dois grupos. Houve elevação da pressão sistólica e diastólica em 28,8% dos pacientes do grupo R e em 38,4% dos do Grupo A, tendo retornado ao normal em 96,8% dos pacientes. As alterações de elevação da pressão arterial ocorreram na fase inicial dos procedimentos. Podemos supor que o fator ansiedade e medo iniciais contribuem para esta alteração. Na fase II (questionário) a elevada ingestão de biscoitos (79,7%) e de refrigerantes (84,4%) durante a semana pelos participantes do estudo além da prática de atividade física (37,5%) apenas uma vez por semana, foram achados relevantes e preocupantes nesta pesquisa. O presente estudo demonstrou pequenas alterações nos parâmetros cardíacos avaliados nos dois grupos, sendo que o retorno à normalidade após o final dos procedimentos foi verificado. Uma atenção maior aos hábitos alimentares não saudáveis capazes de produzir alterações cardíacas nas crianças e adolescentes em longo prazo e a falta da prática de atividades físicas regulares devem ser mais bem divulgadas e discutidas nas mídias sociais e nos consultórios odontopediátricos. (AU)

The research underscores the fact that little is known about the influence of cardiac alterations on the child's health and its implications on dental treatment. Primary factors such as, Obesity, sodium concentrations in food, inadequate diet and idleness in the present day, are generating a new lifestyle. The objective of the present study was to monitor the vital signs in children and adolescents submitted to different treatments in Pediatric Dentistry. A systematic review of the literature was carried out to evaluate whether dental procedures in children are capable of causing changes in blood pressure. Regarding the systematic review, five articles met the criteria for inclusion in the electronic search in the databases: Lilacs, PubMed, Web of Science, and Scopus, and concluded that there is moderate evidence to support changes in blood pressure in children undergoing dental procedures. Article 2, titled Measurement of changes in the body in children in relation to procedures in Pediatric Dentistry and its social profile was divided into two phases. Phase I: clinical and phase II: questionnaires. Phase I examined 64 children and adolescents attending the Pediatric Dentistry Clinic of the Faculty of Dentistry of the Federal University of Rio de Janeiro. Subjects were divided into two groups: 32 patients attended for Revision (Group R) for gauging blood pressure, heart rate and peripheral saturation of Oxygen before and after the dental procedure. The other group, A, also with 32 patients underwent anesthesia for the treatment, being measured arterial pressure, heart rate and oximetry, at the beginning of treatment, after anesthesia and at the end of the treatment. Patients in both groups received the questionnaire to obtain health data, eating habits, physical activity and socioeconomic status. The heart rate showed a significant difference (p <0.001) between the beginning and the end of treatments in both groups. There was an increase in systolic and diastolic pressure in 28.8% of patients in-group R and in 38.4% of patients in-group A, and returned to normal in 96.8% of patients. Changes in blood pressure occurred in the initial phase of the procedures. We may assume that the initial anxiety and fear factors contribute to this change. In phase II (questionnaire) the high intake of biscuits (79.7%) and soft drinks (84.4%) during the week by study participants beyond practice of physical activity (37.5%) only once a week were found to be relevant and worrying in this study. The present study showed small changes in the cardiac parameters evaluated in both groups, and the return to normal after the end of the procedures was verified. Greater attention to unhealthy eating habits capable of producing cardiac changes in children and adolescents in the long term and lack of regular physical activity should be better publicized and discussed in social media and pediatric dental care. (AU)

La encuesta pone de relieve la atención sobre el hecho de que se sabe poco acerca de la influencia de los cambios cardíacos en la salud del niño y sus implicaciones para el tratamiento dental. factores primarios tales como la obesidad, las concentraciones de sodio en los alimentos, la dieta poco saludable y la inactividad en estos días, la creación de un nuevo estilo de vida. El propósito de este estudio fue monitorear los signos vitales en niños y adolescentes sometidos a distintos tratamientos en odontología pediátrica. Una revisión sistemática de la literatura se realizó para evaluar si los procedimientos dentales en los niños son capaces de provocar cambios en la presión arterial.. En cuanto a la revisión sistemática cinco artículos cumplieron los criterios de inclusión, la búsqueda electrónica en las bases de datos: lilas, PubMed, Web of Science y Scopus, y resulta que hay evidencia moderada de cambios en la presión arterial en niños sometidos a procedimientos dentales. Posteriormente fue elaborado um segundo artículo medición de los cambios en el cuerpo en frente de los niños en los procedimientos de odontología pediátrica y su perfil social, dividido en dos fases. Fase I: Clinica y fase II cuestionarios. Em La fase de exame clínico fueron examinados 64 niños y adolescentes en atendidos em La clínica de odontología pediátrica de la Faculadad de Odontología de la Universidad Federal de Río de Janeiro.divididos en 2 grupos: 32 pacientes procedían de Revisión (Grupo R) con la presión arterial, la frecuencia cardíaca y la saturación periférica de oxígeno antes y después del procedimiento dental. El otro (grupo A), de 32 pacientes también se sometió a anestesia para el tratamiento, y se mide la presión arteriall, ritmo cardíaco y oximetría de pulso al comienzo del tratamiento, después de la anestesia y el final de tratamento.Os responsable de los pacientes de ambos grupos recibido el cuestionario para los datos de salud, hábitos alimenticios, actividad física y el estatus socioeconómico. La frecuencia cardíaca fue significativamente diferente (p <0,001) entre el inicio y el final del tratamiento en ambos grupos. No hubo aumento en la presión arterial sistólica y diastólica en 28,8% del grupo R y el 38,4% del grupo A, retornando a la normalidad en 96,8% de los pacientes. Los cambios de elevación de la presión arterial se producen en la etapa inicial del procedimiento. Podemos suponer que la ansiedad inicial y factor miedo que contribuye a esta fase alteração. En la fase II (cuestionario) alto consumo de galletas (79,7%) y bebidas no alcohólicas (84,4%) durante la semana por los participantes en el estudio y la práctica actividad física (37,5%) una vez por semana, fueron hallazgos relevantes y preocupantes en esta investigación. El presente estudio demostró pequeños cambios en parámetros cardíacos evaluados en dos grupos, con el retorno a la normalidad después de que el final del procedimiento fueron verificados. Una mayor atención a los malos hábitos alimenticios pueden producir anomalías cardíacas en niños y adolescentes en el largo plazo y la falta de actividad física regular debería estar mejor difusión y debate en los medios de comunicación y consultorios Odontopediatricos. (AU)