Avaliação de Cursos de Aperfeiçoamento Profissional em Diagnóstico por Imagem na Odontologia: Formatos On-line e Híbrido

With all the major changes imposed by the COVID-19 pandemic, new challenges have emerged for educational institutions to instruct health professionals. Consequently, they started to look for alternative ways to maintain the teaching-learning process. This study aims to assess the acceptability of a group of 42 students to change the teaching methodology applied in two professional development courses with different formats, one with fully on-line content (Digital Dentistry: Diagnostic Imaging) and the other hybrid (on-line and face to-face) (Computed Tomography: Knowing, indicating and interpreting). This work also proposed to evaluate the learning methodology, adaptations and changes in teaching methods during and after the critical period of the COVID 19 pandemic, as well as the impact on the productivity of courses. The present work was conducted through a cross-sectional observational study. Data were collected through the application of questionnaires. The results showed that remote and hybrid teaching are well consolidated, as they do not provide great interference in their routines and maintain the quality of teaching. It was concluded the importance of approximation in real time (synchronous activities) and in person regarding the content of practical activities and emphasizing the interaction of the educator and the student, in the information of the objectives to be achieved, contents and methods. Keywords: Blended learn. Distance education. Virtual learning environment. Diagnostic imaging.Com todas as grandes mudanças impostas pela pandemia de COVID-19, novos desafios surgiram para as instituições de ensino de formação e capacitação de profissionais de saúde. Consequentemente, estas passaram a buscar formas alternativas de manter o processo de ensino-aprendizagem. Este estudo tem como objetivo avaliar a aceitabilidade de um grupo de 42 alunos a mudança na metodologia de ensino aplicadas em dois cursos de aperfeiçoamento profissional na FFO-USP, com formatos diferentes, um com conteúdo totalmente online (Odontologia Digital: Diagnóstico por imagem) e outro híbrido (online e presencial) (Tomografia computadorizada: Conhecer, indicar e interpretar). Este trabalho também propôs avaliar a metodologia de aprendizado, as adaptações e mudanças de métodos de ensino durante e após o período crítico da pandemia COVID 19, assim como o impacto na produtividade dos cursos. O presente trabalho foi conduzido através de um estudo observacional com delimitação transversal. Os dados foram coletados através da aplicação de questionários. Os resultados encontrados demonstraram que o ensino remoto e o híbrido formam bem consolidados, por não proporcionarem grandes interferências em suas rotinas e manter a qualidade do ensino. Concluiu-se a importância da aproximação em tempo real (atividades síncronas) e presencial quando ao conteúdo de atividades práticas e ressaltando a interação do educador e o educando, na informação dos objetivos a serem atingidos, conteúdos e métodos. Palavras-chave: Ensino híbrido. Educação a distância. Ambiente virtual de aprendizagem. Diagnóstico por imagem

Management of deep caries lesions with or without pulp involvement in primary teeth: a systematic review and network meta-analysis

There is a lack of evidence about the best approach for cavitated caries lesions with the possibility of pulpal involvement in primary teeth. Thus, the present authors aimed to verify the best treatment for deep caries lesions with or without pulp involvement in primary teeth. The search was conducted in MEDLINE/Pubmed and Web of Science databases until May 2020. Studies that compared techniques to manage deep caries lesions with at least 12 months of follow-up were included. The risk of bias was evaluated using the RoB tool. Network meta-analysis and pairwise meta-analyses were conducted considering the treatment clinical success as an outcome, according to the pulp health condition. From 491 potentially eligible studies, 9 were included. For deep caries lesions with pulp vitality, the Hall Technique presented the highest probability of success (78%). In the event of accidental pulp exposure, pulpectomy presented a 76% chance of providing the best clinical results. For pulp necrosis, no difference was observed between a pulpectomy and non-instrumented endodontic treatment (RR = 0.69; 95%CI: 0.21–2.33) Thus, it was concluded that the Hall Technique may be a better option for deep caries lesions with pulp vitality. In cases of accidental pulp exposure of vital teeth during caries removal, a pulpectomy may be considered the best option. However, there are insuficient studies to build up evidence about the best treatment option when irreversible pulpitis or pulp necrosis is present.info:eu-repo/semantics/publishedVersio

História das ideias sobre evolução em um curso de formação continuada para professores de Biologia

A evolução biológica é um tema considerado central na Biologia, uma vez que a sua compreensão é fundamental para que outros conceitos da área possam ser entendidos. Entretanto, o que se observa é uma dificuldade docente em abordar a temática em sala de aula, devido às lacunas decorrentes de sua formação inicial. Frente a isso, foi elaborado um encontro de formação continuada para professores de Biologia, em uma parceria entre a universidade e a rede pública estadual de ensino, com a temática "A História das ideias sobre evolução biológica". O objetivo do presente trabalho é analisar os resultados dessa formação. A análise mostrou que os professores participantes consideraram pertinente a discussão sobre o tema evolução biológica, dada a sua complexidade para o trabalho em sala de aula, assim como as estratégias de ensino utilizadas

Patient-reported outcomes associated with different restorative techniques in pediatric dentistry: A systematic review and MTC meta-analysis

Background Despite the increasing number of studies evaluating patient reported outcome measures (PROs), there is no clearness regarding which restorative treatment offers major benefits based on the pediatric patient perspective. Aim To compare different restorative techniques in pediatric dentistry regarding patient-reported outcomes. Design Literature searching was carried out on prospective studies indexed in PubMed, Scopus and OpenGrey. A Mixed Treatment Comparisons (MTC) meta-analysis was undertaken considering the results from reviewed studies. Anxiety, pain and quality of life were extracted as mean with standard deviation, percentage of pain, and mean difference of scores with standard deviation, respectively. For direct comparisons, data were combined using a random-effect model. Heterogeneity was assessed with the I2 statistic. For indirect comparisons, fixed and random effects were chosen through comparison of competing models based on the Deviance Information Criteria (DIC). The expected efficacy ranking based on the posterior probabilities of all treatment rankings was also calculated. Results An initial search resulted in 4,322 articles, of which 17 were finally selected. Due to unavailability of data, only pain, anxiety and oral health related quality of life (OHRQoL) were statistically analyzed. The difference in means (95% CI) of anxiety between treatments using only hand instruments with or without chemomechanical agents were -5.35 (-6.42 to -4.20) and -5.79 (-7.77 to -3.79) respectively when compared to conventional treatment using rotary instruments and/or local anesthesia. Regarding pain, there was a trend for treatments without rotary instruments and local anesthesia to be less frequently reported as painful. No statistical difference was found intragroup nor among treatments for OHRQoL. Conclusions Anxiety and pain are directly related with more invasive restorative treatments. On the other hand, quality of life is not improved regardless of the restorative technique used. Further well-designed prospective studies regarding PROs in children are still necessary

Enfermeiro escolar: a percepção dos professores sobre as atividades desenvolvidas

The aim was to understand the perception of elementary and high school teachers from public and private networks about the presence and actions of school nurses. This is a descriptive, cross-sectional field research of a quantitative nature, where an interview was carried out with teachers who work in elementary and secondary education at different public and private educational institutions about the perception of teachers regarding the role of school nurses. As a result, the survey showed that 100% of teachers believe the presence of a nurse in the school is important, even though many did not have the opportunity to work with him. It is concluded that this study points to the importance of school nurses, as through them we manage to have a longitudinally in care, seeking to bring knowledge to students at this stage of life, so that they can reduce illnesses and injuries in adulthood. A negative point is the lack of schools that have the program.Objetivou-se conhecer a percepção de professores de ensino fundamental e médio de redes públicas e privadas sobre a presença e as ações do enfermeiro escolar. Trata-se de pesquisa de campo, descritiva, transversal de natureza quantitativa, onde foi realizada uma entrevista com professores que atuam no ensino fundamental e médio de instituições de ensino públicas e privadas diversas sobre a percepção dos professores frente o papel do enfermeiro escolar. Resulta-se que a pesquisa mostrou que 100% dos professores acreditam ser importante a presença de um enfermeiro na escola, mesmo que muitos não tiveram a oportunidade de trabalhar com ele. Conclui-se que esse estudo aponta para a importância do enfermeiro escolar, pois através dele conseguimos ter uma longitudinalidade no cuidado, buscando trazer conhecimentos aos estudantes nessa fase da vida, para que reduza as doenças e agravos na vida adulta. Um ponto negativo é a carência de escola que possuem o programa

Survival rate of the Hall technique compared with resin composite restoration in multi-surface cavities in primary teeth: a 1-year randomized clinical trial

Background: Hall technique (HT) has been indicated for teeth with dentinal caries lesion; however, extensive cavities, with more than two surfaces still seem challenging for restorative treatment in pediatric dentistry, resulting in a higher failure rate and an increased need for retreatment. Objectives: To compare the survival rate of the Hall technique preformed metal crown (HT) with resin composite restoration (RC) for multi-surface cavitated caries lesions in primary molars. Methodology: In this multicenter two-arm randomized clinical trial, children between 4 and 9 years of age with at least one primary molar with cavitated caries lesion involving more than two surfaces, including one buccal or palatal/lingual surface, were selected from 17 Brazilian cities. A total of 364 teeth were allocated into two groups: (1) teeth treated with selective caries removal and RC and (2) treated with the HT. The survival rate was assessed at 6 and 12 months after the interventions. Survival analysis was performed with the Kaplan‒Meier method. Cox regression was used to determine the influence of explanatory variables on the survival rate (α=5%). Results: After 12 months, 292 teeth were re-evaluated. A total of 358 teeth were re-evaluated at least once during the study and included in the survival analysis. The HT (87.8%) resulted in a higher survival rate than RC restoration (75.7%) (p=0.004). Conclusion: HT has a higher survival rate than RC as a treatment for multi-surface cavitated caries lesions in primary teeth. ClinicalTrials.gov: NCT0278239

Enfermeiro escolar: a percepção dos professores sobre as atividades desenvolvidas

The aim was to understand the perception of elementary and high school teachers from public and private networks about the presence and actions of school nurses. This is a descriptive, cross-sectional field research of a quantitative nature, where an interview was carried out with teachers who work in elementary and secondary education at different public and private educational institutions about the perception of teachers regarding the role of school nurses. As a result, the survey showed that 100% of teachers believe the presence of a nurse in the school is important, even though many did not have the opportunity to work with him. It is concluded that this study points to the importance of school nurses, as through them we manage to have a longitudinally in care, seeking to bring knowledge to students at this stage of life, so that they can reduce illnesses and injuries in adulthood. A negative point is the lack of schools that have the program.Objetivou-se conhecer a percepção de professores de ensino fundamental e médio de redes públicas e privadas sobre a presença e as ações do enfermeiro escolar. Trata-se de pesquisa de campo, descritiva, transversal de natureza quantitativa, onde foi realizada uma entrevista com professores que atuam no ensino fundamental e médio de instituições de ensino públicas e privadas diversas sobre a percepção dos professores frente o papel do enfermeiro escolar. Resulta-se que a pesquisa mostrou que 100% dos professores acreditam ser importante a presença de um enfermeiro na escola, mesmo que muitos não tiveram a oportunidade de trabalhar com ele. Conclui-se que esse estudo aponta para a importância do enfermeiro escolar, pois através dele conseguimos ter uma longitudinalidade no cuidado, buscando trazer conhecimentos aos estudantes nessa fase da vida, para que reduza as doenças e agravos na vida adulta. Um ponto negativo é a carência de escola que possuem o programa

Visual and radiographic caries detection:a tailored meta-analysis for two different settings, Egypt and Germany

Abstract\ud \ud Background\ud Diagnostic meta-analyses on caries detection methods should assist practitioners in their daily practice. However, conventional meta-analysis estimates may be inapplicable due to differences in test conduct, applied thresholds and assessed population between settings. Our aim was to demonstrate the impact of tailored meta-analysis of visual and radiographic caries detection to different settings using setting-specific routine data.\ud \ud \ud Methods\ud Published systematic reviews and meta-analyses on the accuracy of visual and radiographic caries detection were used. In two settings (a private practice in Germany and a public health clinic in Egypt), routine data of a total of 100 (n = 50/practice) consecutive 12–14 year-olds were collected. Test-positive rates of visual and radiographic detection for initial and advanced carious lesions on occlusal or proximal surfaces of molars were used to tailor meta-analyses. If prevalence data were available, these were also used for tailoring.\ud \ud \ud Results\ud From the original reviews, 210 and 100 heterogeneous studies on visual and radiographic caries detection were included in our meta-analyses. For radiographic detection, sensitivity and specificity estimates derived from conventional and tailored meta-analysis were similar. For visual detection of advanced occlusal carious lesions, the conventional meta-analysis yielded a sensitivity and specificity (95% CI) of 64.6% (57–71) and 90.9% (88–93), whereas the tailored estimates for Egypt were 75.1% (70–81) and 84.9% (82–89), respectively, and 43.7% (37–51) and 96.5% (95–97) for Germany, respectively.\ud \ud \ud Conclusion\ud Conventional test accuracy meta-analyses may yield aggregate estimates which are inapplicable to specific settings. Routine data may be used to produce a meta-analysis estimate which is tailored to the setting and thereby improving its applicability.BHW is in receipt of an Medical Research Council Clinician Scientist’s award\ud (MR/N007999/1). The funding body had no role in the design of the study and\ud collection, analysis, and interpretation of data and in writing the manuscript

Risk factors associated with cusp fractures in posterior permanent teeth—a cross-sectional study

Objectives: This cross-sectional study aimed to evaluate the frequency and risk factors associated with cusp fractures in posterior permanent teeth. Methods: Patients presented cusp fractures on posterior permanent teeth, clinically assessed in up to 7 days after the event, and requesting dental treatment at two public services were included in this cross-sectional study. Fractured teeth already treated, with antagonist absence, or with prosthesis (total or removable) were excluded. Demographic and clinical data were collected to draw the patient profiles and establish how teeth were affected individually. Statistical analysis was performed by the Fisher exact test, and uni- and multivariate logistic regression (α = 0.05). Results: One hundred and seventy-seven (177) patients from 16 to 66 years old (±41.56), from 1998 to 2016, were included in this study. Non-functional and lingual cusps presented a higher fracture than functional and buccal cusps, respectively. Fractures were more common in teeth with isthmus wider than 1/3 of the intercuspid distance and/or more than three restored surfaces. Teeth with endodontic treatment presented a higher subgingival fracture. On lingual cusps, fracture type and location were significantly associated, being that total fractures were 3.2 times more likely to occur than partial fractures, and subgingival were 3.62 times more likely to occur than supragingival fractures. Conclusion: Indications of classic protection on functional cusps (LUBL) was refuted since, generally, nonfunctional cusps fractured more than the functional cusps. However, upper pre-molars showed more fractures in functional cusps and lower molars presented more fractures on the nonfunctional cusps. In general, lingual cusps were the most fractured and were associated with a higher prevalence of severe fractures (total fractures at the subgingival level). Fractures were more common in teeth where the restoration had an isthmus wider than 1/3 of the intercuspid distance and/or involved more than three restored surfaces. Most of the patients did not show previous symptoms and signs. Overall, teeth with endodontic treatment presented a higher subgingival fracture