Orientações de manutenção e higienização de prótese fixa total implantossuportada: revisão de literatura / Guidelines for maintenance and cleaning of implantssupported total fixed prosthesis: literature review

A evolução dos tratamentos em implantodontia possibilitou uma mudança nos tratamentos reabilitadores para pacientes edêntulos, tornando possível a colocação de próteses fixas, que proporcionam maior qualidade de vida para estes pacientes. Para que estas próteses tenham bom desempenho e longevidade satisfatórios é essencial que se mantenha um padrão adequado de higienização bucal e manutenção profissional. Assim, o objetivo deste trabalho foi realizar uma revisão de literatura a respeito dos principais recursos disponíveis para higienização e manutenção das próteses totais fixas sobre implante (protocolo de Branemark), tanto nos cuidados domiciliares dos pacientes quanto no atendimento profissional do cirurgião dentista. Foi realizada uma busca eletrônica, não sistemática, nas bases de dados Lilacs, Pubmed/Medline, Scielo e ScienceDirect, cruzando-se os seguintes descritores: "Higiene Oral"; "Implantes Dentários"; "Implantação Dentária"; "Manutenção"; "Prótese Dentária Fixada por Implante" e "Prótese Dentária". Foram consultados artigos de revisão de literatura, revisão sistemática, meta-análise, estudos clínicos randomizados, além de livros pertinentes ao assunto, publicados no período de 1995 a 2022.Verificou-se na literatura disponível que os principais instrumentos indicados para uso domiciliar são escova dental, fio dental, escova interdental, irrigador oral, dentifrício e enxaguatório. No atendimento profissional em consultório odontológico deve ser dispendida atenção especial às instruções passadas ao paciente e também fazer o possível para motivar e encorajar o seu engajamento na rotina de higienização, além do acompanhamento periodontal, possíveis substituições de parafusos e instalação de placa oclusal estabilizadora, quando necessário. Manter uma higiene oral adequada é essencial para o sucesso das próteses fixas sobre implantes e o cirurgião dentista desempenha um papel crucial não apenas ao realizar o acompanhamento periódico do paciente, mas também ao sugerir os instrumentos mais apropriados, instruir sobre a higiene oral adequada e motivar o paciente a manter a saúde bucal satisfatória(AU)

The evolution of treatments in implantology has enable a change in rehabilitation treatments for edentulous patients, making it possible to place fixed prostheses that provide a better quality of life for these patients. In order to ensure good performance and satisfactory longevity, it is essential to maintain an appropriate standard of oral hygiene and professional maintenance. Thus, the objective of this work was to conduct a literature review on the main resources available for cleaning and maintenance of complete fixed prostheses on implants (Branemark protocol), both in the patients' home care and in the professional care provided by the dentist. A nonsystematic electronic search was carried out in the Lilacs, Pubmed/Medline, Scielo, and ScienceDirect databases, crossing the following descriptors: "Oral Hygiene"; "Dental Implants"; "Dental Implantation"; "Maintenance"; "Dental Prosthesis, ImplantSupported"; and "Prosthodontics". Literature review articles, systematic reviews, meta-analyses, randomized clinical studies, and relevant books on the subject published from 1995 to 2022 were consulted. The literature available indicates that the main instruments recommended for home care are toothbrush, dental floss, interdental brush, oral irrigator, toothpaste, and mouthwash. In the professional dental office, special attention should be given to the instructions given to the patient, as well as to motivate and encourage their engagement in the hygiene routine, in addition to periodontal monitoring, possible screw replacements, and installation of an occlusal splint when necessary. Maintaining adequate oral hygiene is essential for the success of fixed prostheses on implants, and the dentist plays a crucial role, not only in providing periodic patient follow-up, but also in suggesting the most appropriate instruments, instructing on adequate oral hygiene, and motivating the patient to maintain satisfactory oral health(AU)

Consideraciones en la Renovación Curricular de la Carrera de Odontología en la Universidad de La Frontera, Chile / Considerations in Curriculum Renewal of the Dentistry Program of the Universidad de La Frontera, Chile

Dentro de la carrera de Odontología de la Universidad de La Frontera surge la necesidad de pasar por un proceso de renovación curricular. Para esto, se deben considerar tres ejes: la Mención en Prevención con la que cuenta el plan de estudios de Odontología, la coherencia con la legislación chilena y el Modelo Educativo de la Universidad en la formación y gestión de la carrera, y las metodologías de formación actualizadas. La Mención en Prevención se debe fortalecer para entregar una formación integral a los estudiantes, con énfasis en la responsabilidad social. La legislación chilena actualmente exige una revisión sistemática al plan de estudios de Odontología para cumplir con los estándares de calidad, y paralelamente la Universidad propone un Modelo Educativo que entrega un sello de calidad al trabajo de la casa de estudios, con el cual la carrera también debe alinearse. Por otra parte, la constante actualización de conocimientos disciplinares y pedagógicos en Odontología deben ser considerados y estudiados para un óptimo resultado en el proceso de renovación curricular, como así también la inclusión de las nuevas herramientas tecnológicas que se han desarrollado. Estos son ejes esenciales a considerar para generar impacto en educación en Odontología.

Within the dentistry program of the University of La Frontera, there is a need to undergo a process of curricular renewal. For this, three axes must be considered: Mention in Prevention in the Dentistry curriculum, the coherence with the Chilean legislation and the Educational Model of the University in the training and management of the program, and the updated training methodologies. The Mention in Prevention should be strengthened to provide comprehensive training to students, with emphasis on social responsibility. Chilean legislation currently requires a systematic review of the dentistry curriculum to comply with quality standards, and at the same time the University proposes an Educational Model that provides a quality seal for the work of the university, with which the program must also be aligned. On the other hand, the constant updating of disciplinary and pedagogical knowledge in Dentistry must be considered and studied for an optimal result in the process of curricular renovation, as well as the inclusion of new technological tools that have been developed. These are essential axes to consider in order to generate impact on education in dentistry.

Preventive dental service use and oral health-related quality of life in Brazilian older adults.

BACKGROUND: Information on the use of preventive dental services and associated variables is needed to guide policy for the old adult population and consequently promote better oral health-related quality of life (OHRQoL). OBJECTIVE: To investigate the association between preventive dental service use and OHRQoL by older Brazilians. MATERIALS AND METHODS: This cross-sectional study was carried out using the baseline data of participants of the Brazilian Longitudinal Stud of Aging (ELSEI-Brazil) who were aged 60 years or more. Associations with the use of preventive dental services were carried out using Poisson regression models with robust variance, adjusting for confounders. RESULTS: The final sample consisted of 5432 older adults. Almost all (90.7%) participants reported not having sought preventive dental services in the last year. Individuals who used dental services for prevention had fewer impacts on their OHRQoL (RR: 0.74; [95% CI: 0.57-0.97]). CONCLUSION: Preventive dental service use is associated with a better OHRQoL in older Brazilians. Policies to improve access to preventive dental services may result in improved OHRQoL in this age group.

Pré-teste de protocolo de entrevista motivacional para prevenção da cárie dentária na primeira infância / Pre-test of motivational interview protocol for prevention of dental caries in early childhood

A cárie dentária na primeira infância representa um problema crônico e de relevância para a saúde pública. Sendo uma condição clínica evitável, promover a prevenção se faz necessário. Apesar disso, a prevenção tradicional utilizada na Odontologia não tem apresentado resultados favoráveis devido a forma impositiva e prescritiva. A visão multifatorial das doenças considerando os determinantes sociais, econômicos e culturais envolvidos neste processo, tem demandado novas abordagens preventivas no contexto da saúde, incluindo também a cárie dentária na primeira infância. Assim, uma estratégia de comunicação direcionada aos pais, que são a referência da criança no seu processo formativo, tem se mostrado ser efetiva em vários estudos. Essa abordagem com origem na psicoterapia é conhecida como Entrevista Motivacional (EM). Na Odontologia brasileira o assunto ainda é pouco explorado e a EM pouco aplicada pelas equipes de saúde bucal. A explicação pode ser a inexistência de um roteiro direcionador e a falta de capacitação das equipes. Portanto, o objetivo desse estudo foi realizar pré-teste do protocolo proposto por Weinstein, Harrison e Benton e ofertar curso de introdução à teoria da EM. Com base no protocolo de EM direcionado à abordagem de fatores relacionados à cárie dentária na primeira infância, que foi traduzido e validado no Brasil em 2020, foi realizado pré-teste em amostra de 23 participantes com características da população-alvo do protocolo, para verificar o entendimento das questões. A pesquisadora passou por treinamento prévio, com o objetivo de adquirir habilidades para empregar os princípios da EM antes de ir a campo. O estudo metodológico foi realizado com pais/responsáveis por crianças em atendimento na Faculdade de Odontologia da Universidade Federal de Minas Gerais e na Atenção Primária à Saúde de Betim/MG, sendo em sua totalidade mães, a maioria jovens entre 20-30 anos, com ensino médio completo e renda entre 501 e 3.000. Os áudios das entrevistas foram gravados e transcritos, para certificar que a abordagem da entrevistadora seguia os princípios da EM. Também foi utilizado caderno de campo para anotar aspectos importantes da coleta de dados. O protocolo passou no préteste por adaptações estruturais que possibilitaram fluidez e coerência para seu uso no serviço público, foi bem compreendido em grande parte por todos os perfis socioeconômicos entrevistados, apresentou apenas duas questões com maior número de participantes que não compreenderam (n=7). O estudo resultou no Protocolo de Weinstein testado em indivíduos brasileiros, para ser disponibilizado às equipes de saúde bucal como instrumento orientador que possibilite treinamento na abordagem pela EM, para prevenção da cárie dentária na primeira infância. Como produto técnico desse estudo foi ofertado um curso introdutório sobre EM na saúde bucal. O público-alvo do curso foi composto pelos profissionais de saúde bucal do município de Betim (cirurgiões-dentistas, auxiliares e técnicos de saúde bucal), alunos de graduação da FAO-UFMG e demais interessados externos. A carga horária foi de 8h, divididas em dois dias. Houve 47 inscrições, com participação efetiva de 16 e 20 participantes no primeiro e segundo dia, respectivamente. A avaliação global do curso pelos participantes foi bom (29,4%) e excelente (70,6%).

Early childhood caries represent a chronic and relevant problem for public health. Since it is a preventable medical condition, promoting prevention is necessary. Nevertheless, the traditional prevention in Dentistry has not shown favorable outcomes due to its imposing and prescriptive approach. The multifactorial view of diseases, considering the social, economic and cultural determinants involved in this process, has demanded new preventive approaches in the health context, also including early childhood caries.Thus, a communication strategy aimed at parents, who are the child's reference point in their formative process, has been shown to be effective in several studies. This approach, originated in psychotherapy, is known as Motivational Interviewing (MI). In Brazilian Dentistry, the subject is still little exploresand MI is little apllied by oral health teams. The explanation may be the lack of a guiding roadmap and the lack of training of the teams. Therefore, the aim of this study was to pre-test the protocol proposed by Weinstein, Harrison and Benton and to offer an introductory course on MI theory. Based on the MI protocol aimed at addressing factors related to dental caries in early childhood, which was translated and validates in Brazil in 2020, a pre-tes was carried out on a sample of 23 participants with caracteristics of the protocol's target population, to check their understanding of the questions .The researcher previously underwent Training that enable her to acquire skills to employ the principles of MI before entering the field. The methodological study was carried out with parents/guardians of children medically assisted by the Dentistry School of the Federal University of Minas Gerais and the Primary Healthcare in Betim/MG, being mothers between 20 and 30 years old, with high school education and income between 501 and 3,000. The interview audios were recorded and transcribed to ensure that the approach of the interviewer followed the principles of MI. A field notebook was also used to record important aspects of data collection.The protocol underwent structural adaptations in the pretest which enabled fluidity and coherence for its use in public service, was largely well understood by all socioeconomic profiles interviewed, displayed only two questions with a greater number of participants who did not understand (n=7). The study resulted in the Weinstein Protocol, tested on Brazilian individuals, to be made available to oral health teams as a guiding instrument that enables training in the MI approach to prevent early childhood caries. As a techical product of this study, an a introductory course on MI in oralhealth was offered. The course's target audience was oral health profissionals from the municipality of Betim (dental surgeons, oral health assistants and technicians), FAO-UFMG ubdergraduate students and the other external sakholders. The course lasted 8 hours, divided into two days. There were 47 registrations, with 16 and 20 participants actually taking part on the first and second day, respectively. The participant' s overall assessment of the course was good (29,4%) and excellent (70,6%).

Odontología sostenible y sustentable / Sustainable dentistry

Introducción: la periodontitis es una enfermedad infecciosa multifactorial asociada a un biofilm de microorganismos patógenos. Objetivo: el objetivo del trabajo fue establecer la prevalencia de Porphyromonas gingivalis en pacientes con periodontitis y relacionarla con la severidad de la enfermedad. Material y métodos: participaron 45 pacientes, sistémicamente saludables, con edades entre 35 y 65 años. El grado de periodontitis se definió según los criterios de Papapanou y colaboradores. Como grupo control, se incluyeron 20 sujetos de ambos sexos sin periodontitis y sin enfermedades sistémicas. Se tomaron muestras de fluido gingival en dos sitios más profundos. Porphyromonas gingivalis se detectó por PCR (reacción en cadena de la polimerasa). Resultados: la frecuencia relativa de periodontitis fue de 13.3% grado I, 46.7% grado II y 40% grado III. El sexo masculino presentó periodontitis grado III 72.2% y grado II 52.3%. El grado I se registró con mayor frecuencia en el sexo femenino, 66.7%. La prevalencia de Porphyromonas gingivalis en la población con periodontitis fue de 44.4%. Se obtuvieron diferencias estadísticamente significativas entre los grados de severidad de periodontitis y la presencia de Porphyromonas gingivalis (p = 0.0002, α = 5%). Conclusión: la periodontitis predominó en el sexo masculino. La prevalencia de Porphyromonas gingivalis en la población con periodontitis crónica fue de 44.4% y su presencia está relacionada con la severidad (AU)

Introduction: periodontitis is a multifactorial infectious disease associated with a biofilm of pathogenic microorganisms. Objective: the objective of the work was to establish the prevalence of Porphyromonas gingivalis in patients with periodontitis and relate it to the severity of the disease. Material and methods: 45 systemically healthy patients, aged between 35 and 65 years old, participated. The degree of periodontitis was defined according to the criteria of Papapanou et al. As a control group, 20 patients of both sexes without periodontitis and without systemic diseases were included. Gingival fluid samples were taken from two deeper sites. Porphyromonas gingivalis was detected by PCR (polymerase chain reaction). Results: the relative frequency of periodontitis was 13.3% grade I, 46.7% grade II and 40% grade III. The male sex presented periodontitis grade III 72.2% and grade II 52.3%. Grade I was recorded more frequently in the female sex, 66.7%. The prevalence of Porphyromonas gingivalis in the population with periodontitis was 44.4%. Statistically significant differences were obtained between the degrees of severity of periodontitis and the presence of Porphyromonas gingivalis (p = 0.0002, α = 5%). Conclusion: periodontitis predominated in males. The prevalence of Porphyromonas gingivalis in the population with chronic periodontitis was 44.4% and its presence is related to severity (AU)

Preventive program based on multiple intelligences to promote oral health in disabled children from Chiclayo, Peru / Programa preventivo basado en inteligencias múltiples para promover la salud bucal en niños discapacitados de Chiclayo, Perú

Introduction: Children with physical disabilities often present deficient oral hygiene and eating habits that threaten optimal oral health. Objective: To evaluate the result of a preventive program based on multiple intelligences to pro-mote oral health care in children with physical disabilities in Chiclayo - Peru. Materials and Methods: A quasi-experimental, quan-titative, prospective and longitudinal study was carried out from the year 2020, to test a preventive intervention based on multiple intelligences (MI), comparing it with an intervention with traditional methodology, whose purpose was in both cases promote preventive oral health care in 167 boys and girls with physical disabilities from four Special Basic Education Centers (CEBES) in Chiclayo. For the pre- and post-test evaluation using a dental record of oral hygiene practices, oral hygiene index and dietary exposure to sugary carbohydrates, the Mann Whitney U test was required, with a confidence level of 95%. Results: After not very encouraging findings in the pretest for both groups, significant changes were observed in the posttest in favor of the IM-based program, for which 58% of schoolchildren registered an adequate oral hygiene index, 69.2% brushed twice to three times a day and that only 35.8% present regular exposure to carbohydrates. Statistical significance was evidenced in favor of the MI-based intervention for the three indicated variables (p= 0.000). Conclusions: The application of the IM-based program achieved better results in the significant promotion of oral hygiene practices with a favorable record of the IHO and by reducing the exposure to carbohydrates in a vulnerable population.Keywords: Health promotion; Oral health; Preventive dentistry; Health education; Children with disabilities.

Efecto del tratamiento de la morfología oclusal con materiales para restauraciones preventivas / Effect of treating occlusal morphology with materials for preventive restorations

Introducción: las fosas y fisuras son áreas formadas por delgadas irregularidades de la capa del esmalte de la superficie oclusal. La compleja morfología en dientes posteriores es un determinante biológico asociado al desarrollo de caries. Objetivo: evaluar el efecto de diversas formas de tratar la morfología oclusal en la adaptación y penetración de materiales utilizados en restauraciones preventivas. Material y métodos: diseño experimental e in vitro. Sesenta terceros molares fueron distribuidos aleatoriamente en dos grupos: surco sin ameloplastia y con ameloplastia; además, contaban con acondicionamiento del esmalte que se subdividió en tres subgrupos: 1) sellador de fosas y fisuras, 2) adhesivo/sellador de fosas y fisuras y 3) adhesivo/ resina Flow. Resultados: los subgrupos adhesivo/sellador y adhesivo/ Flow alcanzaron mayores valores de adaptación íntima a las paredes del surco. Las diferencias fueron significativas entre los materiales (p = 0.0009). Las mayores zonas de desadaptación resultaron para el sellador sin y con ameloplastia. La penetración de los materiales fue mayor en los surcos con ameloplastia. En los surcos tratados con ameloplastia, el adhesivo/Flow reveló el mayor porcentaje de penetración y la mejor adaptación a las paredes del surco. Conclusiones: la penetración del material está positivamente correlacionada con la profundidad del surco. El sellador con y sin ameloplastia mostró pobre adaptación a las paredes del surco (AU)

Introduction: pits and fissures are areas formed by fine irregularities in the enamel layer of the occlusal surface. The complex morphology in posterior teeth are biological determinants associated with the development of caries. Objective: to evaluate the effect of various ways of treating occlusal morphology on the adaptation and penetration of materials used in preventive restorations. Material and methods: experimental design, in vitro. Sixty third molars were randomly distributed into two groups: groove without ameloplasty and with ameloplasty, with enamel conditioning with three subgroups: 1) pit and fissure sealer, 2) adhesive/pit and fissure sealer, 3) adhesive/resin flow. Results: the adhesive/sealant and adhesive/flow subgroups reached higher values of intimate adaptation to the furrow walls. The differences were significant between the materials (p = 0.0009). The largest areas of maladjustment were found for the sealant without and with ameloplasty. The penetration of the materials was greater in the grooves with ameloplasty. In the grooves treated with ameloplasty, the adhesive/flow revealed the highest percentage of penetration and the best adaptation to the walls of the groove. Conclusions: the penetration of the material is positively correlated with the depth of the furrow. The sealant with and without ameloplasty showed poor adaptation to the sulcus walls (AU)

Bathroom Behaviors Regarding Oral Hygiene Items During COVID-19 Home Isolation: A Cross-Sectional Study in Southern Brazil

ABSTRACT Objective: To describe behaviors with oral hygiene items in single-bathroom households during the domiciliary isolation of individuals with positive 'Reverse transcriptase polymerase chain reaction' (RTPCR+) in southern Brazil. Material and Methods: Cross-sectional study was conducted with Research and Monitoring Sector of COVID-19 data from Palhoça, Brazil, of individuals aged ≥18 years, living in a singlebathroom household, who had an RT-PCR positive. A link of Google Forms was used. Socio-demographic information, characteristics during the home isolation, oral hygiene, and behaviors with oral hygiene items in the bathroom were collected. Descriptive stratified analyses according to age were conducted (<40 and ≥40 years). Results: Among 524 individuals, 36% were aged ≥40 years. During isolation, according to the behaviors with oral hygiene items in the household single-bathroom, 70% (95%CI 64.9-75.5) of the youngest participants reported sharing toothbrushes in the same container and 30% (95%CI 24.4-35.1) of the oldest; use of the same toothpaste was reported by 67% (95%CI 62.8-71.7) of the youngest and 33% (95%CI 28.337.3) of the oldest participants. For the outcome of sharing the same toothpaste, the chances for the youngest and the oldest to share the same toothbrush container was 11 times and 6 times more, respectively. Conclusion: The individuals related good oral hygiene habits; however, behaviors with oral hygiene items in the bathroom were neglected, especially by the younger individuals.

Oral Condition of Adolescents who Participated in an Oral Health Program During the First Decade of Life

ABSTRACT Objective: To evaluate the oral health of adolescents who participated in an oral health preventive program during the first decade of life. Material and Methods: For the evaluation of dental caries and gingival condition, DMFT and Community Periodontal Index were used, both recommended by the World Health Organization. To verify the occurrence of dental fluorosis, the Dean index was used. Results: Data collection was obtained from 252 patients aged 12 to 16 years. The average DMFT index was 1.14; in relation to the gingival condition, the index of healthy gingival tissue prevailed and the average of this value was 84%, with code 0 being more registered in tooth 11, code 1, more frequently in teeth 16/17 and 36/37 and for last, code 2, in tooth 31 most frequently. Dean's index showed a percentage of 89% of patients without clinical signs of dental fluorosis. Conclusion: Adolescents participating in an oral health preventive program in the first decade of life exhibited very satisfactory results regarding the prevention of caries disease, healthy periodontal condition and reduced prevalence of dental fluorosis.

Prevención cuaternaria desde la visión odontológica / Quaternary prevention from a dental point of view

Introducción: El personal de salud debe comprender que el paciente es la figura central en el proceso salud-enfermedad, por lo que, para pro- teger su salud y atender de manera eficaz la enfermedad, se debe partir desde los principios básicos de prevención. La frase «prevenir es mejor que curar¼ debe ser considerada una máxima en salud y una metodología para atender enfermedades desde factores de riesgo, hacer partícipe a los pacientes y a la población en general a llevar a cabo estilos de vida saludables, con actividades preventivas que incrementen su importancia en la atención médica. Conclusiones: La prevención cuaternaria es una forma nueva para llamar al viejo principio de la medicina «lo primero es no hacer daño¼, que da origen al principio bioético de la no male- ficencia, este concepto se refiere a todas aquellas valoraciones que se deben hacer ante cualquier tipo de intervención diagnóstica, terapéutica y preventiva. Esto tiene especial importancia en la población sana, en la cual la prevención será siempre la mejor herramienta, pero se debe siempre tener presente la prevención cuaternaria (AU)

Introduction: Health personnel should understand that the patient is the central figure in the health-disease process and that to protect their health and effectively treat the disease starting from the basic principle of prevention. The phrase «prevention is better than cure¼ from being considered a maxim in health and a methodology to address diseases from risk factors, involving patients and the general population to carry out healthy lifestyles, with preventive activities that increase its importance in medical care. Conclusions: Quaternary prevention is a new way to call the old principle of medicine «first do no harm¼, which gives rise to the bioethical principle of non-maleficence, this concept refers to all those assessments that should be made before any type of diagnostic, therapeutic and preventive intervention. This is especially important in the healthy population, in which prevention will always be the best tool, but quaternary prevention should always be kept in mind (AU)

Comparación del desempeño técnico-asistencial en programas escolares con diferentes modalidades de implementación / Comparison of technical-assisstance performance in school programs with different implementation modalities

Se comparó el desempeño técnico-asistencial de 2 programas de atención odontológica con iguales protocolos de atención y diferente modalidad de implementación. Ambos programas se caracterizaron por un perfil preventivo-promocional; uso de protocolos validados según riesgo biológico, atención odontológica adaptada a sedes no convencionales, recursos asignados por método de necesidades; ejecución por recurso humano pre-profesional supervisado y modulación por altas. La modalidad de implementación difirió en la densidad/concentración de las actividades realizadas: en el Programa Extensivo (PE) las acciones se implementaron con frecuencia semanal; en el Programa Intensivo (PI) las acciones se concentraron en una semana en el año. Cobertura anual: PE = 120 escolares de 6 a 9 años de edad; PI = 180 escolares y preescolares de 3 a 12 años de edad. Se midió la cantidad de prestaciones, sesiones y tiempo -en minutos- hasta alcanzar el Alta Básica Operativa (ABO). Para comparar grupos (PI y PE) se utilizaron los tests: U de Mann Whitney, t de Student para mues-tras independientes, chi cuadrado y comparación de proporciones. La razón de prestaciones/sesión fue significativamente mayor (p=0,000) en el programa intensivo. El número de prestaciones hasta el alta (ABO) y la razón tiempo/sesión no mostraron diferencias entre programas (p=0,8 p=0,087), mientras que se evidenció una mayor razón tiempo/prestación y tiempo en alcanzar el alta (ABO) en la modalidad extensiva (p=0,000). La modalidad intensiva mostró mayor eficiencia en el desempeño técnico asistencial que la extensiva (AU)

Aim: To compare technical-care performance of 2 dental care programs with the same care protocols and different implementation modalities. Both programs shared the following features: preventive-promotional profile; use of validated clinical protocols according to biological risk, dental care adapted to non-conventional settings, allocation of resources by needs method; supervised pre-professional human resource and modulation by discharges. The implementation mode differed in the density/concentration of the activities: in the extensive program (EP) the actions were implemented on a weekly basis along the year; in the intensive program (IP) the actions were concentrated in one week in the year. Annual coverage of the programs: 180 schoolchildren and preschoolers (3 -12 years old); EP = 120 schoolchildren (6 - 9 years old). We measured the following variables: the number of dental services performed, the number of sessions and the time, in minutes, to reach the basic operating discharge (BOD). We used the following tests to compare groups (IP and EP): Mann Whitney U; Student's t for independent samples, chi square and comparison of proportions test. The action per session ratio was significantly higher (p=0.000) in the intensive program. The number of actions performed until discharge (BOD) and the time per session ratio did not show differences between programs (p=0.8 p=0.087). In the extensive mode, compared to intensive mode, it took longer to reach discharge (BOD) (p=0.000) The program implemented with intensive modality (PI) showed greater efficiency regarding technical-care performance when compared to the extensive mode (AU)

Malocclusion indices and their applications in public health: a review study / Índices de oclusopatia e suas aplicações em saúde pública: estudo de revisão / Indicaciones de maloclusión y sus aplicaciones en salud pública: un estudio de revisión

Health indices are important to measurement of the presence and severity of diseases. The objective of this study was to perform a literature review about malocclusion indices and analyze their applications in the public health field. The research was performed by consulting Pubmed, SciELO, Web of Science, Scopus, Bireme and Embase databases, using the following terms: public health, epidemiological methods, indices, epidemiological surveys, preventive dentistry, malocclusion, and orthodontics. Publications on the development and use of malocclusion indices in clinical and epidemiological studies were included, without restrictions of methodology and language. Fifty-two indices and their variations were identified. Of these, most were intended for individual assessments and their use in public health was difficult due to the requirements for their application, including the need for specialists, plaster models analysis, complementary exams such as cephalometric radiographs and photographs, specific equipment, the need for longitudinal monitoring of cases, and exclusively objective orsubjective assessments. Some malocclusion indices present positive aspects and partially evaluate physical, functional, psychological, and social conditions. However, it is still challenging to find a unanimous index that fulfills the requirements for assessing the severity, treatment need, and impact of malocclusions on the individual's quality of life with applicability in public health(AU)

Os índices de saúde são importantes para mensurar a presença e a severidade das doenças. O objetivo neste estudo foi realizar uma revisão da literatura sobre índices de oclusopatia e analisar suas aplicações na saúde pública. A pesquisa foi realizada por meio de consulta às bases de dados Pubmed, SciELO, Web of Science, Scopus, Bireme e Embase, utilizando os termos: saúde pública, métodos epidemiológicos, índices, levantamentos epidemiológicos, odontologia preventiva, má oclusão e ortodontia. Foram incluídas publicações sobre o desenvolvimento e uso de índices de oclusopatia em estudos clínicos e epidemiológicos, sem restrições de metodologia e idioma. Cinquenta e dois índices e suas variações foram identificados. Destes, a maioria destinava-se a avaliações individuais e sua utilização em saúde pública era limitada pelos requisitos de sua aplicação, como necessidade de especialistas, análise de modelos de gesso, exames complementares como radiografias cefalométricas e fotografias, equipamentos específicos, necessidade de acompanhamento longitudinal, e avaliações exclusivamente objetivas ou subjetivas. Alguns índices de maloclusão apresentam aspectos positivos e avaliam parcialmente as condições físicas, funcionais, psicológicas e sociais, entretanto, ainda é um desafio identificar um índice unânime para avaliação da severidade, necessidade de tratamento e impacto das oclusopatias na qualidade de vida do indivíduo, com aplicabilidade na saúde pública(AU)

Los índices de salud son importantes para medir la presencia y gravedad de enfermedades. El objetivo de este estudio fue realizar una revisión de la literatura sobre índices de maloclusión y analizar sus aplicaciones en salud pública. La investigación se llevó a cabo consultando las bases de datos Pubmed, SciELO, Web of Science, Scopus, Bireme y Embase, utilizando los términos: salud pública, métodos epidemiológicos, índices, encuestas epidemiológicas, odontología preventiva, maloclusión yortodoncia. Se incluyeron publicaciones sobre el desarrollo y uso de índices de maloclusión en estudios clínicos y epidemiológicos, sin restricciones de metodología y lenguaje. Se han identificado cincuenta y dos índices y sus variaciones. De estos, la mayoría estaban destinados a evaluaciones individuales y su uso en salud pública estaba limitado por los requisitos de su aplicación, como la necesidad de especialistas, análisis de modelos de yeso, exámenes complementarios como radiografías y fotografías cefalométricas, equipos específicos, la necesidad de seguimiento longitudinal. , y evaluaciones exclusivamente objetivas o subjetivas. Algunos índices de maloclusión tienen aspectos positivos y evalúan parcialmente las condiciones físicas, funcionales, psicológicas y sociales, sin embargo, aún es un desafío identificar un índice unánime para evaluar la gravedad, necesidad de tratamiento e impacto de las maloclusiones en la calidad de vida del individuo, con aplicabilidad en salud pública(AU)

Conocimientos y prácticas de odontología preventiva en odontólogos en México.

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Effectiveness and Legitimacy of the Motivational Interviewing With Caregivers on the Oral Health of Special Patients / Eficacia y Legitimidad de la Entrevista Motivacional con los Cuidadores sobre la Salud Oral de Pacientes Especiales

Difficulty of caregivers in performing oral hygiene for Patients with Special Needs, usually leads to demotivation and negligence. In order to adhere to healthy habits, an intervention model was created: Motivational Interview (MI). It consists of a collaborative conversation to strengthen motivation and commitment to change. Objective: To evaluate the effectiveness and legitimacy of MI in a single session on the oral health of children with special needs, unable to perform the ir hygiene. Methods: Exploratory study with paired randomization, double-blind, including caregivers of patients aged 2 to 19 years treated at the Physical and Motor Rehabilitation Center of IMIP/Recife-Brazil. Caregivers were allocated to a test (Motiv ational Interview) or control (Traditional Counseling) group. In t0, they answered questionnaires, and the child's dental chart and Vis ible Plaque Index (VPI) were filled. MI group participated in a 10 min Motivational Interview involving guidance on brushing techniq ues and making mouth openers. TC group attended a lecture addressing the same theme. In t1, questionnaires were reapplied, followed by a new VPI and dental chart, in addition to a satisfaction survey regarding the methodology used. Results: After 30 days, the MI group showed a decrease in VPI when comparing the medians (14.70 vs. 10.71) and an increase in the frequency of daily brushing to 03 x or more (44.4 % vs. 77.8 %), while the TC group remained practically stable (8.75 vs. 10.71 and 28.6), but with no statistically significant difference between groups (p = 5 %). Both legitimized the workshop as a pleasurable activity (100 %) and felt motivated after completion (TC = 85.7 %, MI = 100 %). Conclusion: A single session of MI reduced VPI from disabled children, however, without proving to be more effective than Traditional Counseling.

La dificultad de los cuidadores para realizar la higiene oral en pacientes con necesidades especiales, generalmente conduce a la desmotivación y negligencia. Con el objetivo de adherirse a los hábitos saludables, se creó un modelo de intervención a partir de una conversación colaborativa: Entrevista Motivacional (EM). El objetivo de este trabajo fue evaluar la eficacia y la legitimidad de la EM en la salud oral para los PNE infantiles. Estudio exploratorio con aleatorización pareada, doble ciego, que incluye cuidadores de pacientes de 2 a 19 años tratados en el Centro de Rehabilitación Física y Motora del IMIP/Recife- Brasil. Los cuidadores fueron asignados en dos grupos: prueba (Entrevista Motivacional - EM) y control (Consejería Tradicional - CT). En t0, se respondieron los cuestionarios y se realizó el Odontograma y el Índice de Placa Visible (IPV) del niño. Grupo EM participó en una entrevista motivacional de 10 minutos que incluyó orientación sobre las técnicas de cepillado y la apertura de la cavidad oral. Grupo CT asistió a una conferencia sobre el mismo tema. En t1, se volvieron a aplicar los cuestionarios, seguidos de una nueva IPV y un odontograma, además de una encuesta de satisfacción sobre la metodología utilizada. Después de 30 días, el grupo EM mostró una disminución en IPV al comparar las media- nas (14,70 vs. 10,71) y un aumento en la frecuencia diaria de cepillado a 03x o más (44,4 % vs. 77,8 %), mientras que el grupo CT permaneció prácticamente estable (8,75 vs. 8,92 y 28,6), pero sin diferencias estadísticamente significativas entre los grupos (p = 5 %). Ambos legitimaron el taller como una actividad placentera (100 %) y se sintieron motivados después de la finalización (AT = 85,7 %, EM = 100 %). Una sola sesión de EM redujo la IPV de las PNE, sin demostrar que es más efectiva que la asesoría tradicional.

Methods for Caries Prevention in Children Reported by Dentists from a Brazilian Community

ABSTRACT Objective: To describe the dental practice patterns related to caries prevention in children aged 6-18 years and associated factors. Material and Methods: Dentists (n=162) from Araraquara, Brazil, completed two paper questionnaires: (1) one about characteristics of their practice and their patient population; and (2) a translated version of the "Assessment of Caries Diagnosis and Caries Treatment" Questionnaire from the National Dental Practice-Based Research Network. Regression analyses were used for data analysis (p<0.05). Results: Dentists reported using in-office fluoride (IOF) and dental sealants (DS) in 74.2% and 45.1% of their pediatric patients, respectively. Regression analysis showed that female dentists (p=0.035 for DS; p=0.044 for IOF; p=0.011 for non-prescription fluoride rinse), those with advanced degrees (p=0.032 for prescription of fluoride), those who graduated from a private dental school (p=0.018 for chlorhexidine rinse), those who provided caries prevention regimens (p<0.001 for DS; p=0.004 for IOF; p=0.013 for non-prescription fluoride rinse), those with a greater percentage of patients interested in a caries prevention regimen (p=0.007 for non-prescription fluoride rinse), those working in a private practice model (p=0.047 for prescription of fluoride) were more likely to recommend some type of preventive methods to their pediatric patients. Conclusion: Dentists reported recommending IOF to most of their pediatric patients. Certain dentists', practices', and patients' characteristics were associated to some caries prevention regimens recommended by dentists.