Factors associated with the quality of life of subjects with facial disfigurement due to surgical treatment of head and neck cancer

Facial disfigurement has been considered one of the most challenging consequences of the surgical treatment for head and neck cancer patients, mainly due to the importance of the facial region for the personal identity, body self-image and interpersonal interactions, which might affect negatively the quality of life. The aim of this study was to assess factors associated with the quality of life of subjects with facial disfigurement due to surgical treatment. Clinical data were retrieved from 103 patient?s medical records and quality of life data were collected using the Functional Assessment of Cancer Therapy (FACT-H&N) questionnaire. Moreover, the degree of facial disfigurement was classified by means of a specific ordinal scale. Data from the FACT-H&N questionnaire showed that the domain directly related to head and neck symptoms was considered the most impacted, while emotional domain was the least affected. Lower quality of life was associated with sequels in the neck and/or lower third of the face (?=-0.39; p=0.001), a higher level of disfigurement (?=-0.29; p=0.016) and female gender (?=-0.20; p=0.038). Disfigurement due to surgical treatment was significantly associated with the functional dimension of the patients, especially in extensive sequels in the cervical and lower regions of the face

Nitric Oxide Concentration and Other Salivary Changes after Insertion of New Complete Dentures in Edentulous Subjects

Objective. To assess changes in levels of salivary nitric oxide (NO) after insertion of new complete dentures and its association with clinical and salivary parameters. Methods. Nineteen fully edentulous subjects were included, mean age 64.4. Unstimulated whole saliva was collected before and after insertion of the dentures, at follow-up visits, and after 12 months. The concentration of the final stable NO product (nitrite) was measured by a colorimetric assay based on the Griess reaction. Clinical parameters were assessed during all clinical visits. Results. Functional adaptation to the dentures progressively improved, with no complaints at the long-term follow-up. NO concentration was not influenced by the level of functional adaptation, presence of injuries to the mucosa, salivary flow, and saliva viscosity. Pairwise comparison showed a reduction in NO concentration at the first follow-up compared to baseline values but differences were not statistically significant. Significant differences were observed in NO concentrations at the long-term follow-up when compared to the first (p=0.024) and second (p=0.027) visits. Conclusion. NO concentration reduced after denture insertion and returned to baseline levels in the long-term follow-up. This appears to be an autonomic response of the body and provides valuable complementary information for the management of the edentulous patient

Imagem do cirurgião-dentista em sites de busca da web

http://dx.doi.org/10.5216/ree.v14i2.13936 O objetivo deste estudo foi analisar as imagens dos sites de busca da Web relacionadas ao cirurgião-dentista. Quatro pesquisadores realizaram o levantamento diariamente em sete grandes sites durante um mês. Foram usadas como palavras-chave para a busca: cirurgião-dentista, dentista e odontólogo.  Para a análise das imagens foi utilizado o método de análise da imagem proposto por Joly e análise descritiva. O resultado obtido após a análise conjunta pelos pesquisadores foi de onze categorias: Rotina (159=26,72%), Humor (104=17,47%), Visão restrita (58=9,74%), Sadismo/Brutalidade (57=9,57%), Insalubridade (47=7,89%), Medo (47=7,89%), Dor/Sofrimento (47=7,89%), Entretenimento (37=6,21%), Erotismo/Sexualidade (28=4,70%), Mutilação (8=1,34%) e Narcisismo (3=0,50%). Das 595 imagens encontradas, mais da metade (66,55%) representavam negativamente o cirurgião-dentista. Conclui-se que a profissão de cirurgião-dentista veiculada em grandes sites de busca aparece, dentre as imagens não convencionais do exercício da profissão, com predominância negativa

Dor nos membros inferiores

Lower limb pains are very commom. Many muscle-skeletal, neuropathic, vascular and visceral abnormalities may be responsible for pain in the lower limbs. The analysis of the clinical history, the medical evaluation and, when necessary, thecomplementary exams allows the precise diagnosis in majority of the cases. The treatment is based in the elimination of the causal condictions and, when necessary, in the use of analgesics, psychotropics, physical medicine, psychotherapy and functionalneurosurgical procedures.Dor é fenômeno comum nos membros inferiores. Várias são as razões de sua ocorrência. Afecções músculo-esqueléticas,dermatológicas, vasculares, neuropáticas ou viscerais abdominais. Destacam-se as músculo-esqueléticas, especialmente as síndromes dolorosas miofasciais. Os dados de história e de exame clínico e, quando necessário, os exames subsidiários possibilitam diagnóstico preciso na maioria dos casos. O tratamento da condição primária e o uso de medidas analgésicas especialmente de medicamentos antiinflamatórios ou opióides, psicotrópicos, medicina física, psicoterapia e, quando necessário, intervenções neurocirúrgicas funcionais aliviam a dor na maioria dos casos

A survey of retracted articles in dentistry

Abstract Background Publication retraction is a mechanism to preserve the scientific literature against publications that contain seriously flawed or erroneous data, redundant publication, plagiarism, unethical research, and other features that compromise the integrity of science. An increase in the occurrence of retractions in recent years has been reported. Nevertheless, there is scarce information on this topic concerning publications in dentistry and related specialties. Thus, this study aimed to investigate retracted papers published in dental journals. Methods Data collection included an exploratory search in PubMed and a specific search in SCImago Journal Rank indexed journals, complemented by the cases reported on the Retraction Watch website and in PubMed. All 167 dental journals included in SCImago were searched for identification of retracted articles up to March 2016. The selected retracted articles and their corresponding retraction notices were recorded and assessed for classification according to the reason for retraction and other additional information. Results Forty of the 167 journals scrutinised at SCImago (23.9%) had at least one retracted article, and four additional journals were identified from the Retraction Watch website. A total of 72 retracted found were retracted for the reasons: redundant publication (20.8%), plagiarism (18.1%), misconduct (13.8%), overlap (13.6%) and honest error (9.7%). Higher number of retractions were reported in those journals with cites/doc <2.0—n = 49 (74.2%). The types of studies were mainly laboratory studies (34.7%), case reports (22.2%) and review articles (13.9%). Conclusions The approach to ethical problems in papers published in dental scientific journals is still incipient; retractions were mostly due to the authors’ malpractice and were more frequently related to journals with less impact

Individual factors associated with masticatory performance of complete denture wearers: A cross-sectional study.

AIM The aim of this study was to assess whether differences in inter-individual clinical and prosthodontic variables affect masticatory performance (MP) of edentulous subjects who received new complete dentures. MATERIALS AND METHODS There were 204 edentulous participants who received new maxillary and mandibular complete dentures between October 2014 and March 2018 at a university clinic. MP was measured by a mixing ability test with a two-coloured chewing gum for 20 and 50 chewing cycles. The outcome variable was the degree of colour mixing of the chewed gum, expressed by the variation of hue (VOH) and measured by electronic colourimetric analysis. Explanatory variables included gender and age, quality of the dentures, classification of edentulous ridges and prognostic features, time since the insertion of the new dentures and patient-reported outcomes related to complete denture treatment. Bivariate correlation tests, multiple linear regression and a linear mixed model were used for data analysis. RESULTS Mean VOH values were 0.57 (±0.13) and 0.43 (±0.16) for 20 and 50 chewing cycles, respectively. Mixing ability was higher in females than in males for 20 (P = 0.036) and 50 (P = 0.006) chewing cycles. No effects on the patient-reported outcome measures were observed. The time since denture delivery, gender, age and Prosthodontic Diagnostic Index (PDI) score were independently associated with masticatory performance at 20 and/or 50 chewing cycles. Overall masticatory performance tested by the linear mixed-effect model confirmed that VOH value was negatively influenced by male gender, older age and shorter time since denture delivery. CONCLUSION Masticatory performance seems to be improved with the continuous use of newly inserted dentures and negatively influenced by advanced age

Immediately loaded single-implant mandibular overdentures compared to conventional complete dentures: A cost-effectiveness analysis

BACKGROUND In recent years, the single-implant mandibular overdenture (SIMO) has been proposed as an alternative to more complex overdenture designs as a simplified implant intervention for edentulous patients. OBJECTIVE The aim of this study was to run a cost-effectiveness analysis alongside a randomized clinical trial comparing the SIMO and the conventional complete denture (CCD) treatment. Imediately loaded external hexagon implant and ball attachment were used for the overdenture goup. Direct costs related to therapies were identified and valuated throughout a 1-year period after delivery, in Brazilian currency (R$) and converted into international dollars (I$) using purchase power parity exchange rates. Treatment effectiveness was measured using the OHIP-Edent and satisfaction scores for calculation of incremental cost-effectiveness ratios (ICER). RESULTS Outcomes were assessed at the 1-year follow-up for 65 patients (CCD=34; SIMO=31). Overall OHIP-Edent and satisfaction scores improved significantly in the SIMO group, while remained unchanged in the CCD group. The mean overall costs were R$1,179.04 (I$590.99) for the CCD group and R$2,127.91 (I$1,068.20) for the SIMO group - 80.7% incremental cost for SIMO. The ICER calculation for SIMO treatment showed a mean cost of I$48.20 for 1-point reduction in OHIP-Edent scores, and I$12.56 for 1-point increase in satisfaction score. CONCLUSIONS Findings support the effectiveness of this simplified and low-cost implant intervention for edentulous patients. SIMO also seems a cost-effective alternative to the CCD and the relatively low incremental cost may potentially increase the utilization of dental implants among older subjects, especially those with limited financial resources. CLINICAL SIGNIFICANCE The immediately loaded single-implant mandibular overdenture was superior to the conventional complete denture in terms of patient-reported outcome measures at a low incremental cost