The dental clinical practice : ergonomic analysis of the sitting posture

Orientador: Antonio Carlos PereiraTese (doutorado) - Universidade Estadual de Campinas, Faculdade de Odontologia de PiracicabaResumo: O objetivo geral deste estudo foi realizar um levantamento sobre o "estado da arte", avaliar a influência do assento tipo sela na prática clínica do acadêmico em odontologia e a satisfação com o tipo de assento utilizado. No artigo 1, o objetivo da revisão sistemática e meta-análise foi verificar se o assento tipo sela proporciona menor risco ergonômico quando comparado aos convencionais, enquanto no artigo 2, o objetivo do ensaio clínico controlado e aleatorizado foi avaliar, em acadêmicos de Odontologia, o impacto dos assentos do tipo sela e convencional, em relação às variáveis centro de gravidade plano frontal e lateral, incapacidade funcional associada à condição de dor cervical e lombar e a satisfação do assento. No artigo 1, a busca foi realizada em oito bases de dados eletrônicas e resultou em 3.147 registros, dos quais dois foram considerados elegíveis. Os achados desta revisão indicam que o assento tipo sela proporciona menor risco ergonômico quando comparado ao assento convencional. No artigo 2, 84 acadêmicos de Odontologia foram alocados em Grupo Controle (GC) e Intervenção (GI). O GC (n = 40) utilizou o assento convencional nos atendimentos clínicos e o GI (n = 44) utilizou o assento tipo sela. Após dez meses de seguimento, observou-se redução estatisticamente significativa nos problemas cotidianos relacionados com dores no pescoço, melhora na projeção do centro de gravidade plano lateral para o GI (p < 0,05) e piora significativa nas médias da projeção do centro de gravidade plano lateral para o GC (p?0,05). O assento do tipo sela foi melhor avaliado em relação a satisfação do assento em todos os aspectos (p < 0,001). O assento do tipo sela apresentou maior satisfação, impactou positivamente no alinhamento corporal lateral e nos problemas cotidianos relacionados à região cervical. Já o assento convencional apresentou impacto negativo no alinhamento corporal lateral. Como conclusão, foi observado que o impacto do assento tipo sela, quando comparado ao assento convencional, foi significativamente positivo em relação ao risco ergonômico, à projeção do centro de gravidade lateral, aos problemas cotidianos relacionados à região cervical e à satisfação. Essa Tese é original e contribuiu para o avanço do conhecimento científico a partir de três pontos principais. Primeiro, trata-se da primeira revisão sistemática da literatura que investigou a influência do tipo de assento sobre o risco ergonômico entre dentistas e/ou acadêmicos de Odontologia. Segundo, refere-se ao primeiro ensaio clínico controlado e aleatorizado que avalia o impacto de diferentes tipos de assentos em acadêmicos de Odontologia ao longo de dez meses nas disciplinas clínicas com paciente. Terceiro, fornece embasamento para novos estudos relacionados a essa temática, podendo este trabalho ser alvo referencial para pesquisas de diversas áreas de estudo, e auxiliar na amenização da carência literária existente em torno do assento tipo sela na prática clínica odontológicaAbstract: The main objective of this study was to perform a survey on the "state of the art", as well as to assess the influence of the saddle seat on the clinical practice of dental students and the satisfaction with the type of seat used. In article 1, the systematic review and meta-analysis aimed to verify whether the saddle seat provides lower ergonomic risk than conventional seats. In article 2, the randomized and controlled clinical trial aimed to assess, in dental students, the impact of saddle and conventional seats regarding the variables of center of gravity of frontal and lateral planes, functional impairment associated with the condition of cervical and low back pain, and seating satisfaction. In article 1, the search was performed in eight electronic databases and resulted in 3,147 records, from which two were considered eligible. The findings of this review indicate that the saddle seat provides lower ergonomic risk than the conventional seat. In article 2, 84 dental students were allocated in Group Control (GC) and Intervention (GI). The GC (n = 40) used the conventional seat for clinical care and the GI (n = 44) used the saddle seat. After ten months of follow-up, a statistically significant reduction was observed for the daily problems related to neck pain, as well as an improvement in the projection of the center of gravity of the lateral plane for GI (p < 0.05) and a significant worsening in the means of projection of the center of gravity of the lateral plane for GC (p ? 0.05). The saddle seat was better evaluated regarding seating satisfaction in all aspects (p < 0.001). The saddle seat presented higher satisfaction and had a positive impact on lateral body alignment and on the daily problems regarding the cervical region, while the conventional seat presented a negative impact on lateral body alignment. In conclusion, the impact of the saddle seat, when compared to the conventional one, was significantly positive regarding ergonomic risk, projection of the lateral center of gravity, daily problems related to the cervical region, and satisfaction. This thesis is original and contributed to the development of scientific knowledge from three main points. Primarily, it is the first systematic review in the literature to investigate the influence of the type of seat on the ergonomic risk among dentists and/or dental students. Second, it is the first randomized and controlled clinical trial to assess the influence of different types of seats on dental students over one academic year in the clinical practices with patients. Third, it provides a background for further studies related to this topic, so this work may be a reference target for research in numerous fields of study, and it helps to decrease the lack of literature on the topic of the saddle seat in the dental clinical practiceDoutoradoSaude ColetivaDoutora em Odontologia1595065157080/2015-5CAPESCNP

Knowledge of undergraduate students of the course in dentistry about the transmission of covid-19 in dental offices / Conhecimento dos estudantes de graduação do curso de odontologia sobre a transmissão da covid-19 em consultórios odontológicos

The aim of this study was to evaluate the knowledge of dental students about the transmission of coronavirus in dental offices, and the biosafety measures that must be adopted to prevent its dissemination. An online questionnaire with 18 questions was applied to  the students to collect the information. The sample was composed of 126 students of the dentistry course of public and private universities who had previous contact with clinical practice. The results revealed that 68.3% of the undergraduates were aware that dentists were among the health professionals who were at most risk for contamination, and 93.7% of them said that the procedures that generated aerosol in the dental office were those that led to the highest chances of transmission of  COVID-19. The responses also showed the awareness of students relative to the need to use all the items of personal protective equipment (PPE), in which 90% of the participants considered masks, caps, gloves, facial protectors, aprons, and protective goggles to be essential for preventing propagation of the virus. When asked about hand hygiene, 92.1% of the students considered soap and water the best option. Based on assessment of patients’ history (recent travels, chronic diseases and present health status), 87% reported that it was also important to obtain these items of  before attending a patient. It was concluded that the undergraduates had knowledge about the transmission and biosafety methods in the dental office, related to COVID-19, which would contribute to the safety of clinical attendance in the universities

Comunicação em saúde entre graduandos de odontologia e seus pacientes / Health communication between undergraduate dental students and their patients

O presente estudo teve por objetivo avaliar técnicas de comunicação utilizadas pelos graduandos de odontologia, incentivando-os a refletirem sobre seu atendimento, bem como analisar a maneira que os pacientes creem ser atendidos. Foram coletados dados de 164 estudantes do terceiro, quarto e quinto ano por meio do instrumento Student Communication Assessment Instrument (SCAI) e de 164 pacientes atendidos na clínica de odontologia do Centro Universitário da Fundação Hermínio Ometto (FHO), por meio do instrumento Patient Communication Assessment Instrument (PCAI). Ambos os instrumentos apresentam 28 questões relacionadas a 3 categorias (1-sendo atencioso e respeitoso, 2- compartilhando informações, 3- cuidando do seu bem-estar). O PCAI apresenta mais uma categoria com 3 questões relacionadas a experiência com o tratamento odontológico. Todas as questões contendo uma escala de comunicação (ruim/médio/bom/muito bom/excelente). Os resultados mostraram concordâncias superiores a 98% na categoria 1,93% na categoria 2 e na categoria 3, e 96% de concordância na escala bom/muito bom/excelente. Em relação a categoria 4, exclusiva aos pacientes, mais de 92% apontaram como muito bom e excelente em relação a sua experiência com o tratamento odontológico oferecido. Conclui-se que, estudantes e pacientes avaliaram as técnicas de comunicação, sobre atendimento clínico, de forma análoga na escala bom/muito bom/excelente, o que refletiu na satisfação do paciente com o tratamento odontológico

Comunicação em saúde entre graduandos de odontologia e seus pacientes / Health communication between undergraduate dental students and their patients

O presente estudo teve por objetivo avaliar técnicas de comunicação utilizadas pelos graduandos de odontologia, incentivando-os a refletirem sobre seu atendimento, bem como analisar a maneira que os pacientes creem ser atendidos. Foram coletados dados de 164 estudantes do terceiro, quarto e quinto ano por meio do instrumento Student Communication Assessment Instrument (SCAI) e de 164 pacientes atendidos na clínica de odontologia do Centro Universitário da Fundação Hermínio Ometto (FHO), por meio do instrumento Patient Communication Assessment Instrument (PCAI). Ambos os instrumentos apresentam 28 questões relacionadas a 3 categorias (1-sendo atencioso e respeitoso, 2- compartilhando informações, 3- cuidando do seu bem-estar). O PCAI apresenta mais uma categoria com 3 questões relacionadas a experiência com o tratamento odontológico. Todas as questões contendo uma escala de comunicação (ruim/médio/bom/muito bom/excelente). Os resultados mostraram concordâncias superiores a 98% na categoria 1,93% na categoria 2 e na categoria 3, e 96% de concordância na escala bom/muito bom/excelente. Em relação a categoria 4, exclusiva aos pacientes, mais de 92% apontaram como muito bom e excelente em relação a sua experiência com o tratamento odontológico oferecido. Conclui-se que, estudantes e pacientes avaliaram as técnicas de comunicação, sobre atendimento clínico, de forma análoga na escala bom/muito bom/excelente, o que refletiu na satisfação do paciente com o tratamento odontológico

[impact Of The Activation Of Intention To Perform Physical Activity In Type Ii Diabetics: A Randomized Clinical Trial].

Type II diabetes mellitus is a highly prevalent disease among the adult Brazilian population, and one that can be controlled by interventions such as physical activity, among others. The aim of this randomized controlled study was to evaluate the impact of a traditional motivational strategy, associated with the activation of intention theory, on adherence to physical activity in patients with type II, diabetes mellitus who are part of the Unified Health System (SUS). Participants were divided into a control group (CG) and an intervention group (IG). In both groups, the traditional motivational strategy was applied, but the activation of intention strategy was only applied to the IG Group. After a two-month follow-up, statistically significant differences were verified between the groups, related to the practice of walking (p = 0.0050), number of days per week (p = 0.0076), minutes per day (p = 0.0050) and minutes walking per week (p = 0.0015). At the end of the intervention, statistically significant differences in abdominal circumference (p = 0.0048) between the groups were observed. The conclusion drawn is that the activation of intention strategy had greater impact on adherence to physical activity and reduction in abdominal circumference in type II diabetics, than traditional motivational strategy.20875-8

O impacto dos diferentes tipos de mochos na ergonomia do cirurgião dentista : uma revisão sistemática

A Odontologia teve um grande avançou tecnológico com a inserção de novos instrumentos e técnicas que simplificam o trabalho do cirurgião-dentista, entretanto o olhar com relação a postura no trabalho diário, não acompanhou esse avanço, ocasionando, na maioria das vezes, problemas de saúde que interferem em sua prática clínica. O objetivo deste estudo foi verificar o impacto de diferentes tipos de assentos na redução dos sintomas musculoesqueléticos e alinhamento postural do Cirurgião-Dentista. Trata-se de um estudo de revisão sistemática, onde adotou-se um conjunto ordenado de critérios que determinam a cientificidade de uma revisão sistemática de literatura, iniciando pela construção de um protocolo, cuja função foi garantir o rigor do processo de pesquisa Artigo 1: Realizou-se busca sistemática nas bases de dados SCOPUS e MEDLINE. Utilizou-se palavras-chaves relacionadas com a pergunta de pesquisa Qual o impacto dos diferentes tipos de mochos na ergonomia do Cirurgião-Dentista? As pesquisas iniciais foram realizadas por dois pesquisadores, que fizeram a localização, seleção dos artigos, leitura completa dos títulos selecionados e posterior avaliação para serem incluídos na amostra. Os estudos que atenderam aos critérios estabelecidos foram considerados na análise final. Possíveis discordâncias durante todo o processo foram solucionadas por um terceiro pesquisador. Foram encontrados 876 artigos. Na base SCOPUS encontrou-se 143 artigos, dos quais 9 foram selecionados; na MEDLINE encontrou-se 733, dos quais 14 foram selecionados. A etapa seguinte consistiu da leitura na íntegra dos artigos identificados e selecionados, focando no tipo de estudo, intervenção realizada e avaliação da qualidade metodológica. Após a leitura completa, 19 foram excluídos por não avaliar os fatores de risco relacionados com a postura de trabalho na prática odontológica por meios de métodos quantitativos e análise estatística dos dados coletados, e quatro estudos foram selecionados por apontarem uma melhor postura de trabalho e redução da atividade muscular imediatamente após a intervenção. Conclui-se que é importante intervir sobre o tipo de assento e a postura de trabalho para reduzir os sintomas musculoesqueléticos do cirurgião-dentista, permitindo-o adotar uma postura sentada ergonômica na prática clínica.The odontology had a great technological advance with the insertion of new instruments and techniques that simplify the work of the dental surgeon, however the concern about the daily work posture, did not follow this advance, causing health problems that interfere in its clinical practice. The objective of this study was to verify the impact of the different kinds of seat in the reduction of the musculoskeletal symptoms and postural alignment of the dental surgeon. Its about a study of systematic review, where it was adopted an ordered set of criteria that determine the scientificity of a literature systematic review, starting from the construction of a protocol, which was made to guarantee the rigor of the research process Article 1: It was made a systematic search in the data bases SCOPUS and MEDLINE. It was used key-words related to the research question: What is the impact of the different kinds of seats in the dental surgeon ergonomy? The initial researches were made by two researchers that made the localization, article selection, complete reading of the selected titles and after an evaluation to include them in the sample. The studies that attended to the established criteria were considered in the final analyses. Possible disagreements during the whole process were resolved by a third researcher. Were found 876 articles. In the SCOPUS data base were found 143 articles, 9 were selected; in the MEDLINE data base were found 733, 14 were selected. The next stage was consisted in a complete reading of the identified and selected articles, focusing in the kind of study, intervention made and the evaluation of the methodological quality. After the complete reading, 19 were excluded by not evaluate the risk factors related to the posture in the odontological work practice through quantitative methods and statistic analyses of the collected data, and 4 studies were select because they appointed a better work posture and reduction of muscular activity immediately after the intervention. It is concluded that is important to interfere over the kind of seat and the work posture to reduce the musculoskeletal symptoms of the dental surgeon, allowing him to adopt a ergonomic sitting posture in the clinical practice

Evaluation Of Knowledge Of Oral Health Of Community Health Agents Connected With The Family Health Strategy.

The aim of this study was to evaluate the knowledge of Community Health Agents (CHA) about the oral health/disease process, and compare the results between those who work in Family Health Teams (FHT), with and without Oral Health Teams (OHT). The participants in this study were 162 subjects, representing 66% of the total number of CHA in the municipality, and 81 of them are connected with Family Health Units (FHU) with OHT, and 81 CHS with FHUs without OHT. Data were collected from October to December 2013, by application of a questionnaire, containing personal and professional data, and 12 validated questions about knowledge of the oral health/disease process. The Mann-Whitney test was applied to verify differences between the groups. Statistically significant differences were verified between the groups of CHA when the total scores of questions about the oral health/disease process were analyzed (p < 0.0021). It was concluded that knowledge about the oral health/disease process, of the CHAs connected with a FHU with an OHT was better when compared with that of CHAs connected with a FHU without an OHT.201185-119

Assessment of the ergonomic risk from saddle and conventional seats in dentistry: A systematic review and meta-analysis.

OBJECTIVE:This study aimed to verify whether the saddle seat provides lower ergonomic risk than conventional seats in dentistry. METHODS:This review followed the PRISMA statement and a protocol was created and registered in PROSPERO (CRD42017074918). Six electronic databases were searched as primary study sources. The "grey literature" was included to prevent selection and publication biases. The risk of bias among the studies included was assessed with the Joanna Briggs Institute Critical Appraisal Tool for Systematic Reviews. Meta-analysis was performed to estimate the effect of seat type on the ergonomic risk score in dentistry. The heterogeneity among studies was assessed using I2 statistics. RESULTS:The search resulted in 3147 records, from which two were considered eligible for this review. Both studies were conducted with a total of 150 second-year dental students who were starting their laboratory activities using phantom heads. Saddle seats were associated with a significantly lower ergonomic risk than conventional seats [right side (mean difference = -3.18; 95% CI = -4.96, -1.40; p < 0.001) and left side (mean difference = -3.12; 95% CI = -4.56, -1.68; p < 0.001)], indicating posture improvement. CONCLUSION:The two eligible studies for this review provide moderate evidence that saddle seats provided lower ergonomic risk than conventional seats in the examined population of dental students