Tele-odontology in Brazil: Strategies and Challenges for the Training of the Healthcare Network

Different initiatives have been undertaken to guide the telehealth process in the Brazil. The Ministry of Health structured and implemented the Telehealth Brazil Programme initially to cover nine state centres. Later, it expanded the programme to take in the whole country, at which time it became known as the Telehealth Brazil Network. Among the goals of the Telehealth Brazil Network is the development of strategies for clinical training, health education, and training for management, planning and assessment skills, designed for the Family Health Strategy teams. In this context, this paper aims to presents the potential of and difficulties in implementing tele-odontology in Brazil, focusing on teleconsulting, tele-education and telediagnostic experiences developed to date. It will also present the legal and financial support aspects established in the country, as well as the results found so far in relation to the impacts of strategies and user satisfaction. Finally, suggestions for future perspectives are presented. Related to the strategies implemented in Brazil, it is necessary to analyse the data obtained regarding the successes and failures observed over the years. The positive results obtained with tele-education showed that the Telehealth Programme presents as an efficient tool for the training of the health care network. However, points like the limited use by professionals, some technical limitations and the impact on health indicators should still be better studied

O emprego de acupuntura versus agulhamento seco no tratamento da disfunção temporomandibular miofascial

BACKGROUND AND OBJECTIVES: Orofacial pain is the pain felt in the oral cavity and the face, with a multifactorial etiology, being a representative of the temporomandibular dysfunction. Among the various possibilities for treatment are acupuncture and the dry needling. The objective of this study was to compare the effectiveness of these two therapies in the cases of myogenic temporomandibular dysfunction. CONTENTS: A review of articles relating to the topic was conducted on the LILACS, Medline, Scielo and Pubmed database, cross-referencing the following descriptors: “acupuncture” OR “electroacupuncture” OR “dry needling” AND “orofacial pain syndrome” OR “orofacial pain” OR “temporomandibular dysfunction” OR “temporomandibular disorders”, myofascial temporomandibular dysfunction or trigger points in last the 16 years. Clinical trials, systematic reviews, metanalysis, case studies involving human beings were included. The selected languages were English and Portuguese. Twenty-one articles were found that were carefully evaluated and tabulated. The present study identified that both acupuncture and dry needling were significantly important in the resolution of the signs and symptoms of the myogenous temporomandibular dysfunction, with adequate effectiveness. CONCLUSION: It can be pointed out that dry needling seems to be more effective in the resolution of local pain on the myofascial trigger points than just using of acupuncture points at a distance. Acupuncture demonstrated positive influences in the general health quality and pain of patients with myofascial temporomandibular dysfunction. Therefore, the therapy of choice will depend on the professional’s assessment of the clinical conditions of the patient and the therapeutic goals to be achieved.JUSTIFICATIVA E OBJETIVOS: A dor orofacial é aquela que é experimentada na cavidade bucal e na face, e que apresenta uma etiologia multifatorial, sendo um representante a disfunção da articulação temporomandibular. Dentre as várias formas de tratamento, tem-se a acupuntura e o agulhamento seco. O objetivo deste estudo foi comparar a efetividade dessas duas terapias nos casos de disfunção da articulação temporomandibular miogênica. CONTEÚDO: Foi realizado um levantamento bibliográfico nas bases de dados LILACS, Medline, Scielo e Pubmed a partir do cruzamento dos seguintes descritores: “acupuncture” OR “electroacupunture” OR “dry needling” AND “orofacial pain syndrome” OR “orofacial pain” OR “temporomandibular dysfunction” OR “temporomandibular disorders”, disfunção temporomandibular ou pontos-gatilho miofasciais nos últimos 16 anos. Foram incluídos ensaios clínicos, revisões sistemáticas, meta-análises, estudos de caso, envolvendo seres humanos. Os idiomas selecionados foram o inglês e o português. Foram encontrados 21 artigos que, posteriormente, foram criteriosamente avaliados e tabelados. O presente trabalho pode identificar que tanto a acupuntura, como o agulhamento seco, foram significativamente importantes na resolução dos sinais e sintomas da disfunção da articulação temporomandibular de caráter miogênico, com adequada eficácia. CONCLUSÃO: Pode-se salientar que o agulhamento seco parece ser mais eficaz na resolução da dor local sobre o ponto-gatilho miofascial do que somente a utilização de pontos de acupuntura à distância. A acupuntura demonstrou influências positivas na qualidade de saúde geral e dor dos pacientes com disfunção da articulação temporomandibular miofascial. Dessa forma, a escolha da terapêutica a ser aplicada dependerá da avaliação do profissional sobre as condições clínicas do paciente e dos objetivos terapêuticos a serem atingidos

Conhecendo a realidade dos catadores de materiais recicláveis da Vila Dique: visões sobre os processos de saúde e doença = Knowing the reality of the recyclers material collectors in Dique´s Slum: visions concerning sickness and health processes

Considerando as transformações ocorridas no mundo do trabalho e o crescimento expressivo do desemprego, muitos trabalhadores encontraram na reciclagem a possibilidade de garantir o sustento de suas famílias. Vista a precariedade do processo de trabalho e a situação de exclusão social em que se encontram, muitos são os aspectos que perpassam o processo de saúde/doença destes trabalhadores. Portanto, se faz necessário que os profissionais dos serviços de saúde, especificamente da atenção primária, se apropriem desta realidade e conheçam a visão destes sujeitos sobre a produção de saúde/doença, para evidenciá-la e proporcionar um olhar ressignificado, qualificando as ações em saúde. Este artigo está baseado na pesquisa realizada com os catadores de materiais recicláveis da Vila Dique, comunidade localizada na região noroeste de Porto Alegre, território de abrangência da Unidade de Saúde Santíssima Trindade, que teve como objetivo principal conhecer a visão destes trabalhadores, sem vínculos previdenciários, com relação a aspectos do processo de saúde e doença. Dos 10 entrevistados, todos relataram situações de doença, violência e acidentes de trabalho, muitas relacionadas diretamente à situação degradante de trabalho que realiza

Impact of teleconsultations on the conduct of oral health teams in the Telehealth Brazil Networks Programme

Telehealth has been applied in the Unified Health System (SUS) as a tool for qualifying professionals and improving the healthcare provided to the population served by the system. The aim of the present study was to evaluate the impact of teleconsultations on the qualifications of the clinical approach of the oral health teams involved in primary health care (PHC) in the state of Rio Grande do Sul under the Telehealth Brazil Networks Programme. The sample population of the study was composed of 285 dentists and 132 oral health assistants belonging to the Family Health Teams. A chi-square test was used to investigate possible associations between the absolute number of teleconsultations performed and several independent variables, namely, gender, age, dental specialty, time since graduation, time working in the Family Health Strategy (FHS), employment status, type of training institution, familiarity with information technology, and work satisfaction at the health facility. The level of significance was p < 0.05. Use of the oral health teleconsultation service led to a reduction of more than 45% in the number of referrals to other levels of care. However, no significant association was found between the number of teleconsultations and the independent variables analysed. The use of teleconsultations proved to be a powerful tool for professional training, for increasing the effectiveness of PHC, and for improving the oral healthcare provided

Administração intra-estrial de hipoxantina reduz a atividade da Na+, K+-ATPase e induz o estresse oxidativo em ratos

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Lateral periodontal cyst: An unusual case report / Cisto periodontal lateral: Relato de caso incomum

Introduction: Lateral periodontal cysts are odontogenic cysts with very unusual development. According to the literature, they account for less than 0.4% of cases of odontogenic cysts. Presentation of Case: The present report describes a 34-year-old patient referred to the maxillofacial surgery and traumatology department of Montenegro Hospital due to swelling of the face with asymptomatic evolution for approximately 1 year. Based on clinical and tomographic examinations, the diagnostic hypothesis was odontogenic cyst, and the surgical plan involved complete enucleation of the cystic lesion. Complete removal was performed, and the material removed was sent for histopathological analysis. The examination revealed an irregular cystic cavity covered by epithelial tissue with few cuboidal layers that showed clear cells in the basal layer in some areas and the formation of nodular epithelial structures that protruded into the cavity. Discussion: The histopathological characteristics described in the literature are consistent with the histopathological description of the enucleated cyst in this case, confirming the diagnosis of lateral periodontal cyst. Conclusion: The patient is currently under follow-up, and evaluations have been normal

Alternativas de tratamentos para pacientes com luxação de ATM: revisão integrativa

Patologias musculares e articulares podem acometer a articulação temporomandibular (ATM), a luxação sendo uma delas. Caracteriza-se pelo deslocamento do côndilo mandibular em relação à localização anatômica normal na cavidade glenóide, podendo ser anterior, posterior, inferior ou superior a esta, e que acaba por comprometer o bem estar físico e psíquico do indivíduo. Apresenta diversos tratamentos: cirúrgicos, não cirúrgicos e a combinação de ambos. Este trabalho teve por objetivo revisar a literatura acerca das terapias não cirúrgicas para o tratamento da luxação de ATM. Foi realizada uma busca nas bases de dados PubMed e LilacS, onde 16 artigos foram selecionados após critérios de inclusão e de exclusão definidos. O estudo pode observar que as terapias não cirúrgicas que incluem toxina botulínica, ácido hialurônico, proloterapia, injeções de sangue autólogo e artrocentese são eficazes para o tratamento de deslocamento de disco e luxação de ATM, sendo que a artrocentese isolada ou associada ao ácido hialurônico se mostrou com efeito prolongado para a prevenção de futuras luxações, bem como mínimos efeitos adversos. Apesar das leituras, não houve um consenso sobre a melhor abordagem terapêutica, sugerindo-se a realização de mais estudos acerca do tema

Association Between Early Admission at School and Oral Health and Nutritional Status of Children in the City of São Paulo, Brazil

Objective: To investigate the possible relationship between early admission to the school of children in early childhood and oral health conditions (OH) and nutritional status (NS). Material and Methods: Cross-sectional study conducted with 140 children aged 3-4 years, selected for convenience, in 4 public schools in the city of São Paulo, Brazil, during 2016, divided into children with early (IE) and late (IL) admission at school. Comparisons between groups were performed for the presence of overweight / obesity (OW / OB), caries lesions (CL), malocclusion (MO) and dental biofilm (DB), in addition to socioeconomic and dietary data. Multiple regression analysis was applied to determine the association between age of admission at school and OH and NS. Results: Children with IE had CL = 28.1%; DB = 46.9%; MO = 54.7% and OW / OB = 25.9%. Children with IE had IL = 29.8%; DB = 35.1%; MO = 61.4% and OW / OB = 30.8%. No significant association was found between age of admission at school and CL: 1.40 (0.53-3.73) 0.490; DB: 0.51 (0.22-1.16) 0.112; MO: 1.77 (0.77-4.05) 0.173 and OW / OB: 1.27 (0.55-2.92) 0.568, [OR (95% CI) p]. Conclusion: The age of admission at school of children in early childhood did not show a significant association with OH and NS