Is the Erich arch bar the best intermaxillary fixation method in maxillofacial fractures? : a systematic review

Background: Intermaxillary fixation is used to achieve proper occlusion during and after oral and maxillofacial fracture surgery. The aim of this systematic review was to compare Erich arch bar fixation with other intermaxillary fixation methods in terms of the operating time, safety during installation, oral health maintenance and occlusal stability. Material and Methods: An electronic online search was conducted of the Scirus, PubMed, Ovid, Cochrane Library and VHL databases. A clinical trial dating from the inception of the data bases until August 2013 was selected. Studies that compared Erich arch bars with other intermaxillary fixation methods in patients older than 18 years-old were included. The studies were assessed by two independent reviewers. The methodological quality of each article was analyzed. Results: Nine hundred and twenty-five manuscripts were found. Seven relevant articles were analyzed in this review. The risk of bias was considered moderate for four studies and high for three clinical trials. Conclusions: There is not enough evidence to conclude that the Erich arch bar is the best intermaxillary fixation method in cases of oral and maxillofacial fracture

Simulação realística como método de ensino no aprendizado de estudantes da área da saúde

Objetivo: Avaliar o conhecimento, a satisfação e autoconfiança de estudantes de cursos de graduação em Enfermagem e Medicina, que participaram da simulação realística. Métodos: Trata-se de estudo quase experimental, exploratório e analítico, sobre a utilização do método de ensino tradicional com aula expositiva e método de ensino com simulação realística. Para coleta dos dados, utilizou-se formulário de caracterização dos participantes, avaliação de conhecimento e Escala de Satisfação dos Estudantes e Autoconfiança na Aprendizagem. Análises descritiva e univariada foram conduzidas. Resultados: A cada método de ensino utilizado houve ganho de conhecimento dos participantes (

Simulação realística como método de ensino no aprendizado de estudantes da área da saúde

Objetivo: Avaliar o conhecimento, a satisfação e autoconfiança de estudantes de cursos de graduação em Enfermagem e Medicina, que participaram da simulação realística. Métodos: Trata-se de estudo quase experimental, exploratório e analítico, sobre a utilização do método de ensino tradicional com aula expositiva e método de ensino com simulação realística. Para coleta dos dados, utilizou-se formulário de caracterização dos participantes, avaliação de conhecimento e Escala de Satisfação dos Estudantes e Autoconfiança na Aprendizagem. Análises descritiva e univariada foram conduzidas. Resultados: A cada método de ensino utilizado houve ganho de conhecimento dos participantes (

Periodontal disease, peri-implant disease and levels of salivary biomarkers IL-1β, IL-10, RANK, OPG, MMP-2, TGF-β and TNF-α: follow-up over 5 years

Objective: The aim of this study was to evaluate the levels of salivary biomarkers IL-1β, IL-10, RANK, OPG, MMP-2, TG-β and TNF-α in individuals with diagnosis of peri-implant mucositis in the absence or presence of periodontal and peri-implant maintenance therapy (TMPP) over 5 years. Material and Methods: Eighty individuals diagnosed with peri-implant mucositis were divided into two groups: one group that underwent periodontal and peri-implant regularly maintenance therapy, called GTP (n=39), and a second group that received no regular maintenance GNTP (n=41). Each participant underwent a complete periodontal and peri-implant clinical examination. Collection of saliva samples and radiographic examination to evaluate peri-implant bone levels were conducted at two times: initial examination (T1) and after 5 years (T2). The salivary samples were evaluated through ELISA for the following markers: IL-1β, IL-10, RANK, OPG, MMP-2, TGF and TNF-α. Results: A higher incidence of peri-implantitis was observed in the GNTP group (43.9%) than in the GTP group (18%) (p=0.000). All individuals (n=12) who presented peri-implant mucositis and had resolution at T2 were in the GTP group. After 5 years, there was an increase in the incidence of periodontitis in the GNTP group compared to the GTP group (p=0.001). The results of the study revealed an increase in the salivary concentration of TNF-α in the GNTP group compared to the GTP group. The other salivary biomarkers that were evaluated did not show statistically significant differences between the two groups. Conclusions: The salivary concentration of TNF-α was increased in individuals with worse periodontal and peri-implant clinical condition and in those with a higher incidence of peri-implantitis, especially in the GNTP group. Longitudinal studies in larger populations are needed to confirm these findings and elucidate the role of this biomarker in peri-implant disease

Effect of Topical Application of Different Substances on Fibroplasia in Cutaneous Surgical Wounds

Background. Fibroblasts on the edges of a surgical wound are induced to synthesize collagen during the healing process which is known as fibroplasia. Objective. The aim of this study was to determine the effect of the application of different substances on fibroplasia of cutaneous surgical wounds on rats. Materials and Methods. 48 Wistar rats were divided into three groups. A surgical wound 1 cm in diameter and 1  mm in depth was created on the dorsum of each animal. The surgical wounds were submitted to the topical application of an alcoholic extract of 30% propolis, 70% alcohol, or 0.001% dexamethasone in a cream base every 12 hours. The animals were sacrificed three, seven, 14, and 28 days postoperatively. The specimens were histologically processed and stained with Masson's trichrome. The assessment of fibroplasia was performed using a scoring system: (1) 5 to 25% collagen deposition; (2) 26 to 50% collagen deposition; (3) 51 to 75% collagen deposition; (4) more than 75% collagen deposition. Results. There were statistically significant differences in collagen deposition between the substances at all postoperative evaluation times. Conclusion. Propolis and alcohol promoted greater collagen deposition in surgical wounds than dexamethasone

O IMPACTO DA PRÓTESE TOTAL NA AUTOPERCEPÇÃO DE SAÚDE BUCAL DO IDOSO

Objetivo: Avaliar por meio do questionário GOHAI o impacto da prótese total na autoestima dos idosos. Métodos: Foi realizado um estudo transversal e quantitativo no Centro Universitário Newton Paiva, utilizando o Índice Geriatric Oral Health Assesment Index (GOHAI) para avaliação da autopercepção de saúde bucal. A amostra foi composta por 22 voluntários idosos, pacientes das clínicas odontológicas do Centro Universitário Newton Paiva, de ambos os gêneros que atenderam aos critérios de inclusão: idade igual ou superior a 60 anos; de ambos os sexos, que concordassem em participar no estudo; capacidade de compreender e assinar o termo de consentimento livre e esclarecido. Para avaliação da autopercepção de saúde bucal utilizou-se o índice GOHAI, composto por 12 perguntas relacionadas à problemas que podem afetar as pessoas nas dimensões: física, psicossocial,dor e desconforto. Todos os dados foram analisados pelo Statistical Package for the Social Sciences (SPSS) na versão 23. Resultados: Quanto à autopercepção da condição de saúde bucal, conforme critérios do Índice GOHAI, obteve-se uma pontuação média geral de 29,18 (dp=4,34). A maior porcentagem observada foi para o grupo com percepção ruim (59,0%), seguido de percepção regular (27,0%) e percepção ótima (14,0%). As pontuações médias por domínio foram: Físico: 11,09±2,52; Psicossocial: 10,54±1,87; Dor e Desconforto: 7,54±1,22. Conclusão: A autopercepção de saúde bucal dos idosos foi coeso com a condição clínica verificada, marcado pelo endentulismo. A maioria dos participantes da pesquisa classifica sua saúde bucal como “ruim” por meio do questionário GOHAI

Cross-cultural adaptation of the Brazilian version of the Dentine Hypersensitivity Experience Questionnaire

Abstract The dentine hypersensitivity (DH) is able to impair the oral health related quality of life (OHRQoL). However, there isn't any specific validated questionnaire to be used in Brazil. The objective was to adapt and to validate the English version of the Dentine Hypersensitivity Experience Questionnaire (DHEQ-15) for use in Brazil. DHEQ-15 was cross-culturally adapted into the Brazilian-Portuguese language and then validated in a cross-sectional study with 100 participants recruited at a University clinic. Study sample comprised 2 groups: 100 individuals with DH, and 100 individuals without. The instrument was self-administered twice 7 to 10 days apart. The participants answered a global rating of oral health. The psychometric properties of the Brazilian version of DHEQ-15 were verified through internal consistency (Cronbach's α) and test-retest reliability (intraclass correlation coefficient - ICC), convergent (Spearman correlation) and discriminant (Mann-Whitney test) validity. The significance threshold was set at p<0.05. Sample comprised 69 men and 131 women, of mean age 30.4y. The Brazilian DHEQ-15 demonstrated very good internal consistency (α = 0.945). Test-retest reliability revealed excellent reproducibility (ICC = 0.959, p < 0.001). There was statistically significant correlation between the scores obtained on all DHEQ-15 domains and the global rating of oral health (p<0.001). Participants with DH scored significantly higher than those without DH (p<0.001). This study provides evidence supporting the cross-cultural validity of the Brazilian version of DHEQ-15 for use in Brazil

Radiolucent image in lower third molar: hidden caries or pre-eruptive resorption?: a case report

ABSTRACT Caries is a multifactorial disease due to the imbalance of the de/re-mineralization process. Complementary radiographic examinations are able to detect hidden caries. The purpose of this short communication was to investigate the radiolucent image suggestive of hidden caries in lower third molar. The extraction of the tooth, decalcification, inclusion and preparation were performed for histological analysis of the lesion. Histological findings revealed a pre-eruptive resorption, and the etiological factors of this coronary resorption were undefined. The professional should be aware of the occurrences of these lesions to early diagnose and propose appropriate treatment to avoid future complications to the patient

Hipersensibilidade dentinária e qualidade de vida relacionada à saúde bucal: adaptação e validação do DHEQ-15, e revisão sistemática sobre o impacto do tratamento

Exportado OPUSMade available in DSpace on 2019-08-13T08:31:26Z (GMT). No. of bitstreams: 1 tese_dhelfeson.pdf: 1689055 bytes, checksum: bc5fcabf675933dd1b6d757489779020 (MD5) Previous issue date: 4A hipersensibilidade dentinária (HD) caracteriza-se por dor aguda, súbita e de curta duração, podendo comprometer a qualidade de vida relacionada à saúde bucal. A presente tese teve 2 propostas de investigação, com objetivos específicos: 1) adaptar transculturalmente e validar a versão curta do questionário Dentine Hypersensitivity Experience Questionnaire (DHEQ-15) para o Português para uso no Brasil; 2) investigar na literatura, através de uma revisão sistemática, se o tratamento da hipersensibilidade dentinária é capaz de melhorar a qualidade de vida dos indivíduos afetados. Para a adaptação transcultural, foi realizado um estudo em 5 etapas seguindo critérios internacionais pré-estabelecidos, sendo: tradução do questionário original para duas versões em português; síntese das versões em português; retrotradução da versão sintetizada para o inglês; pré-teste com um grupo focal; avaliação das propriedades psicométricas do instrumento traduzido. Foi estabelecido um comitê de juízes para acompanhar todo processo e avaliar os relatórios que foram elaborados em cada etapa. O questionário foi aplicado 2 vezes em 100 participantes, com intervalo de 7 a 10 dias, na última etapa. A HD foi estimulada através do jato de ar da seringa tríplice, e o nível de hipersensibilidade foi medido através da escala de Schiff. Os dados foram submetidos a testes de consistência interna e validade, e analisados pelo programa estatístico SPSS. A amostra foi composta de 69 homens e 131 mulheres, com idade média de 30,4 anos. O grupo focal sugeriu duas modificações no questionário traduzido. A versão brasileira do questionário apresentou alfa de Cronbach de 0,945, e coeficiente correlação intraclasse de 0,959. Houve correlação significativa (p<0,001) entre a pontuação do escore do DHEQ-15 e auto-avaliação da saúde bucal. Concluiu-se que a versão brasileira do questionário apresenta boa consistência interna, confiabilidade e validade. Para a revisão sistemática, as seguintes bases eletrônicas de dados foram pesquisadas até maio de 2017: PubMed/MEDLINE, Scopus, Web of Science, Cochrane Library, LILACS, EMBASE e Scielo, com estratégias de buscas adaptadas para cada base. Foram incluídos ensaios clínicos que avaliassem a qualidade de vida antes e após qualquer tipo de tratamento de HD. Três pesquisadores independentemente selecionaram os estudos, extraíram os dados e avaliaram a qualidade metodológica dos artigos. Os desfechos primários investigados foram tipo de tratamento, critério de inclusão, avaliação da HD e qualidade de vida, resultados para HD e qualidade de vida. Foi realizado meta-análise pelo teste I2, e a qualidade de evidência foi averiguada pela ferramenta Grading of Recommendations Assessment, Development, and Evaluation. Foram identificadas 1805 referências, e seis ensaios clínicos foram incluídos nesta revisão. Os estudos foram desenvolvidos na Suécia, Brasil, Estados Unidos e Canadá. Os estudos apresentaram alta heterogeneidade estatística (I2=0.8407) e metodológica. O nível de evidência desta revisão variou de muito baixo a moderado. Concluiu-se que há significante redução de HD e significante melhora na qualidade de vida dos pacientes após tratamento da HD.Dentin hypersensitivity (DH) is characterized by acute, sharp and short pain, and it may compromises the oral health related quality of life. The present thesis had 2 researches proposals, with specific objectives: 1) to adapt and to validate the short version of the Dentine Hypersensitivity Experience Questionnaire (DHEQ-15) into Portuguese for use in Brazil; 2) to investigate in the literature, using a systematic review, if the DH treatment is able to improve the quality of life of affected individuals. For cross-cultural adaptation, it was conducted a study with 5 steps according to preset criteria: translation of the original questionnaire into two Portuguese versions; synthesis of Portuguese versions; back-translation of the synthesized version into English; pre-test in a focus group; psychometric properties test of the translated instrument. An expert panel was set in order to monitor all process and to evaluate the reports from each step. The questionnaire was applied twice in 100 participants, with an interval of 7 to 10 days, in the last step. The DH was stimulated by air blast, and the level of sensitivity was assessed by Schiffs scale. The data were subjected to tests of internal consistency and validity, and they were analyzed by SPSS statistical software. The sample was composed of 69 men and 131 women, with mean age of 30.4 years. The focus group suggested two changes in the translated instrument. The Brazilian version presented Cronbach's alpha of 0.945, intraclass correlation coefficient of 0.959. There was statistically significant correlation (p<0.001) between DHEQ-15 score and oral health self-assessment. It was concluded that the Brazilian version of the instrument has good internal consistency, reliability and validity. For systematic review, the following electronic databases were searched until may 2017: PubMed/MEDLINE, Scopus, Web of Science, Cochrane Library, EMBASE, LILACS and Scielo, search strategies were adapted to each database. It were included clinical trials that assessed quality of life before and after any type of DH treatment. Three researchers independently selected studies, extracted data and assessed the methodological quality of the articles. The primary outcomes investigated were: type of treatment, inclusion criteria, assessment of quality of life and DH, results for DH and quality of life. Meta-analysis was conducted by I2, and the quality of evidence was determined by the Grading of Recommendations Assessment, Development, and Evaluation. It were identified 1805 references, and only six clinical trials were included in this review. The studies were developed in Sweden, Brazil, United States and Canada. The studies showed high statistical (I2=0.8407) and methodological heterogeneity. The level of evidence of this review ranged from very low to moderate. It was concluded that there are significant reduction of DH and significant improvement of quality of life of patients after DH treatment

Clinicamente que tan importante es el Valor-p?

Currently, it has been observed a growing number of publications in all fields of Dentistry. These publications act as scientific evidence, as well as a basis for clinical decision-making in dental care routine. It is important to note that the results and conclusions in articles are based on the p-value that is a purely probabilistic and statistical parameter, and it assists the researcher to accept or reject the null hypothesis being tested. The p-value was proposed by Fisher in 1925, and in Dentistry, it is usual to adopt the p-value stated in 0.05.1 In practical terms, when a statistical test results in p-value less than 0.05, the null hypothesis must be rejected (equality between groups), assuming that there is a difference between the assessed groups.2 In other words, p&lt;0.05 indicates statistically significant difference between groups. Under a critical look, the researcher and reader should keep in mind that a statistical difference is not always reflecting a true clinical importance. In addition, a lack of statistical significance does not necessarily relate to the absence of clinical significance. The clinical importance is far beyond statistical calculations based on the p-value.3 A study presents clinical importance when the one being tested presents clinical effect capable to change the behavior of the dentist in daily routine. This judgment should be done by the researcher based on the results of his/her research, clinical experience and actual&nbsp; knowledge. In addition, estimates of effect sizes should be presented. This facilitates assessment of how large or small the observed effect could actually be in the population of interest, and hence how clinically important it could be. Kassab et al. (2006)4 compared periodontal parameters in groups with and without chemical biomodifciation of the root prior surgical coverage in cases of gingival recession. The group, that used edetic acid, statistically improved the periodontal parameters in relation to the group without surface biomodification. However, this difference was imperceptible to both dentist and patient. That is, the clinical result of root coverage will be the same when using or not acid biomodification of the root. In other words, there was not an important clinical effect of this step, although there was a significant difference. In the above example, it is clear that just because a statistic test is significant doesn't mean the effect it measures is significant or clinically important. Then, researchers should not draw conclusions based solely on the p-value, they should propose alternatives that really evaluate the clinical effect. &nbsp; Dhelfeson Willya Douglas-de-Oliveira Federal University of Jequitinhonha and Mucuri Valleys, Diamantina, Brazil. [email protected], it has been observed a growing number of publications in all fields of Dentistry. These publications act as scientific evidence, as well as a basis for clinical decision-making in dental care routine. It is important to note that the results and conclusions in articles are based on the p-value that is a purely probabilistic and statistical parameter, and it assists the researcher to accept or reject the null hypothesis being tested. The p-value was proposed by Fisher in 1925, and in Dentistry, it is usual to adopt the p-value stated in 0.05.1 In practical terms, when a statistical test results in p-value less than 0.05, the null hypothesis must be rejected (equality between groups), assuming that there is a difference between the assessed groups.2 In other words, p&lt;0.05 indicates statistically significant difference between groups. Under a critical look, the researcher and reader should keep in mind that a statistical difference is not always reflecting a true clinical importance. In addition, a lack of statistical significance does not necessarily relate to the absence of clinical significance. The clinical importance is far beyond statistical calculations based on the p-value.3 A study presents clinical importance when the one being tested presents clinical effect capable to change the behavior of the dentist in daily routine. This judgment should be done by the researcher based on the results of his/her research, clinical experience and actual&nbsp; knowledge. In addition, estimates of effect sizes should be presented. This facilitates assessment of how large or small the observed effect could actually be in the population of interest, and hence how clinically important it could be. Kassab et al. (2006)4 compared periodontal parameters in groups with and without chemical biomodifciation of the root prior surgical coverage in cases of gingival recession. The group, that used edetic acid, statistically improved the periodontal parameters in relation to the group without surface biomodification. However, this difference was imperceptible to both dentist and patient. That is, the clinical result of root coverage will be the same when using or not acid biomodification of the root. In other words, there was not an important clinical effect of this step, although there was a significant difference. In the above example, it is clear that just because a statistic test is significant doesn't mean the effect it measures is significant or clinically important. Then, researchers should not draw conclusions based solely on the p-value, they should propose alternatives that really evaluate the clinical effect. &nbsp; Dhelfeson Willya Douglas-de-Oliveira Federal University of Jequitinhonha and Mucuri Valleys, Diamantina, Brazil. [email protected]