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Carneiro ALE, Reis INR, Bitencourt FV, Salgado DMRA, Costa C, Spin-Neto R. Accuracy of linear measurements for implant planning based on low-dose cone beam CT protocols: a systematic review and meta-analysis. Dentomaxillofac Radiol 2024; 53:207-221. [PMID: 38429951 PMCID: PMC11056743 DOI: 10.1093/dmfr/twae007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Revised: 02/09/2024] [Accepted: 02/21/2024] [Indexed: 03/03/2024] Open
Abstract
OBJECTIVES The aim of this systematic review was to verify the accuracy of linear measurements performed on low-dose CBCT protocols for implant planning, in comparison with those performed on standard and high-resolution CBCT protocols. METHODS The literature search included four databases (Pubmed, Web of Science, Embase, and Scopus). Two reviewers independently screened titles/abstracts and full texts according to eligibility criteria, extracted the data, and examined the methodological quality. Risk of bias assessment was performed using the Quality Assessment Tool For In Vitro Studies. Random-effects meta-analysis was used for pooling measurement error data. RESULTS The initial search yielded 4684 titles. In total, 13 studies were included in the systematic review, representing a total of 81 samples, while 9 studies were included in the meta-analysis. The risk of bias ranged from medium to low. The main results across the studies indicate a strong consistency in linear measurements performed on low-dose images in relation to the reference methods. The overall pooled planning measurement error from low-dose CBCT protocols was -0.24 mm (95% CI, -0.52 to 0.04) with a high level of heterogeneity, showing a tendency for underestimation of real values. Various studies found no significant differences in measurements across different protocols (eg, voxel sizes, mA settings, or dose levels), regions (incisor, premolar, molar) and types (height vs. width). Some studies, however, noted exceptions in measurements performed on the posterior mandible. CONCLUSION Low-dose CBCT protocols offer adequate precision and accuracy of linear measurements for implant planning. Nevertheless, diagnostic image quality needs must be taken into consideration when choosing a low-dose CBCT protocol.
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Affiliation(s)
- Ana Luiza E Carneiro
- Department of Stomatology, School of Dentistry, University of São Paulo (USP), São Paulo, 05508-000, Brazil
| | - Isabella N R Reis
- Department of Stomatology, School of Dentistry, University of São Paulo (USP), São Paulo, 05508-000, Brazil
| | - Fernando Valentim Bitencourt
- Section for Oral Ecology and Inflammation, Department of Dentistry and Oral Health, Aarhus University, Aarhus, 8000, Denmark
- Steno Diabetes Center Aarhus, Aarhus, 8200, Denmark
| | - Daniela M R A Salgado
- Department of Stomatology, School of Dentistry, University of São Paulo (USP), São Paulo, 05508-000, Brazil
| | - Claudio Costa
- Department of Stomatology, School of Dentistry, University of São Paulo (USP), São Paulo, 05508-000, Brazil
| | - Rubens Spin-Neto
- Department of Dentistry and Oral Health—Section for Oral Radiology and Endodontics, Aarhus University, Aarhus, 8000, Denmark
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Macedo AC, Bitencourt FV, Faria AOVD, Bizzi IH, Durço DDFPÂ, Azevedo CB, Morris M, Ferreira KDS, De Souza LC, Velly AM. Prevalence of orofacial pain in individuals with mild cognitive impairment or dementia: A systematic review and meta-analysis. Gerodontology 2024. [PMID: 38247027 DOI: 10.1111/ger.12740] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/03/2024] [Indexed: 01/23/2024]
Abstract
BACKGROUND This systematic review investigated the prevalence of orofacial pain in patients with mild cognitive impairment (MCI) or dementia. MATERIALS AND METHODS The search was conducted in five databases (Medline (Ovid), Embase (Ovid), CINAHL, Scopus and LILACS), in three grey literature sources and in included articles' reference lists. Three independent reviewers performed study selection, quality appraisal and data extraction. The risk of bias was assessed with the National Institutes of Health tool. Prevalence was calculated using the random-effects model. Subgroup analysis and meta-regression were used to explore the heterogeneity of results. RESULTS The database and grey literature search led to 12 246 results, from which nine studies were included; a further four were selected through citation searching. The total sample comprised 6115 patients with dementia and 84 with MCI. All studies had high risk of bias. The overall estimated pooled prevalence of orofacial pain among dementia participants was 19.0% (95% CI, 11.0%-27.0%; I2 , 97.1%, P < .001). Only one study included MCI participants, among which the prevalence of orofacial pain was 20.5%. Subgroup analysis demonstrated that the different sources of diagnosis might explain the heterogeneity. A higher prevalence of orofacial pain was observed in dementia participants aged over 80 years or living in nursing homes. Meta-regression analysis showed a nonlinear relationship between age and the prevalence of orofacial pain. CONCLUSIONS The pooled data from the primary studies revealed that 2 out of 10 patients with dementia have orofacial pain. Further research is needed to clarify the magnitude in individuals with MCI.
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Affiliation(s)
- Arthur C Macedo
- Department of Neurology and Neurosurgery, McGill University, Montréal, Québec, Canada
| | - Fernando Valentim Bitencourt
- Department of Dentistry and Oral Health, Section for Periodontology, Aarhus University, Aarhus, Denmark
- Steno Diabetes Center Aarhus, Aarhus University Hospital, Aarhus, Denmark
| | | | - Isabella Harb Bizzi
- Faculdade de Odontologia, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | | | - Claudia Britto Azevedo
- Faculdade de Odontologia, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Martin Morris
- Schulich Library of Science and Engineering, McGill University, Montréal, Québec, Canada
| | | | | | - Ana Miriam Velly
- Faculty of Dental Medicine and Oral Health Sciences, McGill University, Montréal, Québec, Canada
- Dentistry Department, Lady Davis Institute, Jewish General Hospital, Montreal, Québec, Canada
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Nascimento GG, Balan P, Alves-Costa S, Bitencourt FV, Kalhan AC, Leite FRM. Oral and systemic health in Singapore: Revisiting the past to define the future. Community Dent Oral Epidemiol 2023. [PMID: 37779341 DOI: 10.1111/cdoe.12913] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Revised: 08/04/2023] [Accepted: 09/22/2023] [Indexed: 10/03/2023]
Abstract
OBJECTIVES This study aimed to identify studies exploring oral and systemic conditions using Singapore data. METHODS Studies were searched using the databases PubMed, Embase and Web of Science, with no publication date or language restrictions. Studies analysing Singaporean data were included in this review. RESULTS Six domains were identified: pregnancy and gingivitis; tooth eruption, dental caries and early-life factors; Crohn's disease and oral microbiome; diabetes and periodontal diseases; number of teeth, chewing ability and cognitive status; and oral health and pneumonia. Using data from Singapore, oral-systemic studies have prompted reflections on the aetiopathogenesis of oral disorders, such as common causes connecting oral and systemic chronic conditions. Moreover, it is speculated whether oral conditions could be used as a marker to predict future systemic diseases or whether early-life factors could affect the development of oral and systemic immune responses. CONCLUSIONS While Singapore provides opportunities to explore challenges connected to healthy ageing, it also explores health development in many stages of life. Singapore has been prioritizing investigations on a healthier life, and new initiatives are paving the way for oral health research across the lifespan.
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Affiliation(s)
- Gustavo G Nascimento
- National Dental Centre Singapore, National Dental Research Institute Singapore, Singapore, Singapore
- Oral Health Academic Clinical Programme, Duke-NUS Medical School, Singapore, Singapore
| | - Preethi Balan
- National Dental Centre Singapore, National Dental Research Institute Singapore, Singapore, Singapore
- Oral Health Academic Clinical Programme, Duke-NUS Medical School, Singapore, Singapore
| | - Silas Alves-Costa
- National Dental Centre Singapore, National Dental Research Institute Singapore, Singapore, Singapore
- Graduate Dentistry Program, Federal University of Maranhão, São Luís, Brazil
| | - Fernando Valentim Bitencourt
- Department of Dentistry and Oral Health, Aarhus University, Aarhus, Denmark
- Steno Diabetes Center Aarhus, Aarhus, Denmark
| | - Ashish C Kalhan
- National Dental Centre Singapore, National Dental Research Institute Singapore, Singapore, Singapore
- Oral Health Academic Clinical Programme, Duke-NUS Medical School, Singapore, Singapore
| | - Fabio R M Leite
- National Dental Centre Singapore, National Dental Research Institute Singapore, Singapore, Singapore
- Oral Health Academic Clinical Programme, Duke-NUS Medical School, Singapore, Singapore
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Bitencourt FV, Lia EN, Pauletto P, Martins CC, Stefani CM, Massignan C, Canto GDL. Prevalence of SARS-CoV-2 infection among oral health care workers worldwide: A meta-analysis. Community Dent Oral Epidemiol 2023; 51:718-728. [PMID: 36576013 PMCID: PMC9880752 DOI: 10.1111/cdoe.12827] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2022] [Revised: 11/24/2022] [Accepted: 11/28/2022] [Indexed: 12/29/2022]
Abstract
OBJECTIVES This systematic review aimed to answer the following question 'What are the worldwide prevalence of SARS-CoV-2 infection and associated factors among oral health-care workers (OHCWs) before vaccination?' METHODS Seven databases and registers as well as three grey databases were searched for observational studies in the field. Paired reviewers independently screened studies, extracted data and assessed the methodological quality. Overall seroprevalence for SARS-CoV-2 infection was analysed using a random-effect model subgrouped by professional category. Meta-regression was used to explore whether the Human Development Index (HDI) influenced the heterogeneity of results. The associated factors were narratively evaluated, and the certainty of the evidence was assessed using the GRADE approach. RESULTS Seventeen studies were included (five cohorts and twelve cross-sectional studies), summing 73 935 participants (54 585 dentists and 19 350 dental assistants/technicians) from 14 countries. The overall estimated pooled prevalence of SARS-CoV-2 infection among OHCWs was 9.3% (95% CI, 5.0%-14.7%; I2 = 100%, p < .01), being 9.5% for dentists (95% CI, 5.1%-15.0%; I2 = 100%, p < .01) and 11.6% for dental assistants/technicians (95% CI, 1.6%-27.4%; I2 = 99.0%, p < .01). In the meta-regression, countries with lower HDI showed higher prevalence of SARS-CoV-2 infection (p = .002). Age, comorbidities, gender, ethnicity, occupation, smoking, living in areas of greater deprivation, job role and location/municipalities, income and protective measures in dental settings were associated with positive serological SARS-CoV-2 test, with very low certainty of evidence. CONCLUSIONS The SARS-CoV-2 virus infected 9.3% of the OHCWs evaluated worldwide before vaccination. OHCWs should be included in policy considerations, continued research, monitoring and surveillance (PROSPERO CRD42021246520).
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Affiliation(s)
- Fernando Valentim Bitencourt
- Department of Dentistry and Oral Health, Section for PeriodontologyAarhus UniversityAarhusDenmark
- Steno Diabetes Center AarhusAarhusDenmark
| | - Erica Negrini Lia
- Department of Dentistry, School of Health SciencesUniversity of BrasíliaBrasíliaBrazil
| | - Patrícia Pauletto
- Brazilian Centre for Evidence‐Based Research (COBE), Department of DentistryFederal University of Santa CatarinaFlorianópolisBrazil
- Dentistry of SchoolUniversidad De Las Américas (UDLA)QuitoEcuador
| | - Carolina Castro Martins
- Department of Pediatric Dentistry, School of DentistryFederal University of Minas GeraisBelo HorizonteBrazil
| | - Cristine Miron Stefani
- Brazilian Centre for Evidence‐Based Research (COBE) and Department of DentistryUniversity of BrasíliaBrasíliaBrazil
| | - Carla Massignan
- Brazilian Centre for Evidence‐Based Research (COBE) and Department of DentistryUniversity of BrasíliaBrasíliaBrazil
| | - Graziela De Luca Canto
- Brazilian Centre for Evidence‐Based Research (COBE), Department of DentistryFederal University of Santa CatarinaFlorianópolisBrazil
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Bitencourt FV, Nascimento GG, Costa SA, Andersen A, Sandbæk A, Leite FRM. Co-occurrence of Periodontitis and Diabetes-Related Complications. J Dent Res 2023; 102:1088-1097. [PMID: 37448314 DOI: 10.1177/00220345231179897] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/15/2023] Open
Abstract
Periodontitis is a common finding among people with diabetes mellitus (DM) and has been cited as a DM complication. Whether and how periodontitis relates to other diabetes-related complications has yet to be explored. This study aims to examine the clustering of periodontitis with other diabetes-related complications and explore pathways linking diabetes-related complications with common risk factors. Using data from participants with DM across 3 cycles of the National Health and Nutrition Examination Survey (NHANES) (n = 2,429), we modeled direct and indirect pathways from risk factors to diabetes-related complications, a latent construct comprising periodontitis, cardiovascular diseases, proteinuria, and hypertension. Covariates included age, sex, socioeconomic status (SES), smoking, physical activity, healthy diet, alcohol consumption, hemoglobin A1c (HbA1c), dyslipidemia, and body mass index (BMI). Sensitivity analyses were performed considering participants with overweight/obesity and restricting the sample to individuals without DM. Periodontitis clustered with other diabetes complications, forming a latent construct dubbed diabetes-related complications. In NHANES III, higher HbA1c levels and BMI, older age, healthy diet, and regular physical activity were directly associated with the latent variable diabetes-related complications. In addition, a healthy diet and BMI had a total effect on diabetes-related complications. Although sex, smoking, dyslipidemia, and SES demonstrated no direct effect on diabetes-related complications in NHANES III, a direct effect was observed using NHANES 2011-2014 cycles. Sensitivity analysis considering participants with overweight/obesity and without DM showed consistent results. Periodontal tissue breakdown seems to co-occur with multiple diabetes-related complications and may therefore serve as a valuable screening tool for other well-known diabetes-related complications.
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Affiliation(s)
- F V Bitencourt
- Department of Dentistry and Oral Health, Section for Periodontology, Aarhus University, Aarhus, Denmark
- Steno Diabetes Center Aarhus, Aarhus University Hospital, Aarhus, Denmark
| | - G G Nascimento
- National Dental Research Institute Singapore, National Dental Centre Singapore, Singapore
- Oral Health Academic Clinical Programme, Duke-NUS Medical School, Singapore
| | - S A Costa
- Graduate Dentistry Program, Federal University of Maranhão, São Luís, Maranhão, Brazil
| | - A Andersen
- Steno Diabetes Center Aarhus, Aarhus University Hospital, Aarhus, Denmark
| | - A Sandbæk
- Steno Diabetes Center Aarhus, Aarhus University Hospital, Aarhus, Denmark
- Department of Public Health, Aarhus University, Aarhus, Denmark
| | - F R M Leite
- National Dental Research Institute Singapore, National Dental Centre Singapore, Singapore
- Oral Health Academic Clinical Programme, Duke-NUS Medical School, Singapore
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Warmling CM, Spin-Neto R, Palma LZ, Silva-Junior MF, Castro RG, Finkler M, Baldani MH, Bitencourt FV. Impact of the COVID-19 Pandemic on the Oral Health Workforce: A Multicenter Study from the Southern Region of Brazil. Int J Environ Res Public Health 2023; 20:1301. [PMID: 36674057 PMCID: PMC9859153 DOI: 10.3390/ijerph20021301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Revised: 12/29/2022] [Accepted: 01/04/2023] [Indexed: 06/17/2023]
Abstract
The aim of this study was two-fold: (1) to describe the surveillance and biosafety measures adopted by dentists, dental hygienists, and dental assistants who worked in the Southern Region of Brazil and (2) to evaluate access to information in the context of the COVID-19 pandemic. This was a multicenter and cross-sectional design, using a self-applied and validated online questionnaire. The availability of health-care-related supplies and the adoption of biosafety measures recommended by the Technical Note of the National Health Surveillance Agency No. 04/2020 were analyzed. A total of 2560 Brazilian workers participated (75.8% dentists, 15.7% dental assistants and 8.5% dental hygienists), 52.7% from the public and 37.7% from the private sector. Approximately 70% of the individuals reported being away from work during the pandemic. The surveillance measures adopted with higher mean scores were the investigation of respiratory infection symptoms when scheduling appointments and the adoption of distancing in the waiting room. Of the biosafety measures to avoid aerosols, the procedures with lower compliance were those related to the use of intraoral radiographs and rubber dams. Moreover, the correct use of personal protective equipment at work seems to be related to self-perceived stress and anxiety. Worryingly, high access to information through non-governmental documents was observed. Permanent health education policies should reinforce safe practices and encourage workers to implement biosafety and surveillance measures in health services.
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Affiliation(s)
- Cristine Maria Warmling
- Graduate Program Teaching in Health, Federal University of Rio Grande do Sul, Porto Alegre 90010-150, RS, Brazil
| | - Rubens Spin-Neto
- Department of Dentistry and Oral Health, Section for Oral Radiology, Aarhus University, 8000 Aarhus, Denmark
| | - Luciana Zambillo Palma
- Graduate Program Teaching in Health, Federal University of Rio Grande do Sul, Porto Alegre 90010-150, RS, Brazil
| | | | - Renata Goulart Castro
- Department of Dentistry, Federal University of Santa Catarina, Florianópolis 88040-900, SC, Brazil
| | - Mirelle Finkler
- Department of Dentistry, Federal University of Santa Catarina, Florianópolis 88040-900, SC, Brazil
| | - Márcia Helena Baldani
- Department of Dentistry, State University of Ponta Grossa, Ponta Grossa 84010-330, PR, Brazil
| | - Fernando Valentim Bitencourt
- Department of Dentistry and Oral Health, Section for Periodontology, Aarhus University, 8000 Aarhus, Denmark
- Steno Diabetes Center Aarhus, 8200 Aarhus, Denmark
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Bitencourt FV, Nascimento GG, Costa SA, Orrico SRP, Ribeiro CCC, Leite FRM. The Role of Dyslipidemia in Periodontitis. Nutrients 2023; 15:nu15020300. [PMID: 36678171 PMCID: PMC9864120 DOI: 10.3390/nu15020300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Revised: 12/27/2022] [Accepted: 12/31/2022] [Indexed: 01/10/2023] Open
Abstract
Studies have suggested an important role of dyslipidemia, a condition with alterations in blood lipid levels, in promoting an additional effect on periodontal breakdown. Thus, this study aimed to explore the theoretical pathways associated with dyslipidemia and periodontitis. We used data from 11,917 US adults with complete periodontal examinations participating in the Third National Health and Nutrition Examination Survey (NHANES III). Our hypothesis was tested using structural equation modelling (SEM). Dyslipidemia was defined according to the National Cholesterol Education Program (NCEP-ATP III) and periodontitis as a latent variable reflecting the shared variance of the number of surfaces with periodontal pocket depth [PPD] = 4 mm, PPD = 5 mm, PPD ≥ 6 mm, clinical attachment level [CAL] = 4 mm, CAL = 5mm, CAL ≥ 6 mm, and furcation involvement. The model also considered distal determinants (age, sex, and socioeconomic status) and proximal determinants (HbA1c, smoking and alcohol consumption, and obesity). The model showed sufficient global fit (Root Mean Squared Error of Approximation = 0.04, 90%CI = 0.04−0.05, Tucker−Lewis Index = 0.93, Comparative Fit Index = 0.95). Age, sex, socioeconomic status, obesity, and smoking were directly associated with periodontitis (p < 0.01). Dyslipidemia revealed a significant direct effect on periodontitis (standardized coefficient [SC] = 0.086, SE 0.027; p < 0.01), also mediated via an indirect pathway through HbA1c (SC = 0.021; SE 0.010; p = 0.02) and obesity (SC = 0.036; SE 0.012; p < 0.01) and resulted in a total effect on periodontitis. Dyslipidemia was associated with periodontitis through a direct pathway and indirectly through HbA1c and obesity in the US population. These results support the need for a multi-professional approach to tackling oral and noncommunicable diseases (NCDs), directed at their common risk factors.
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Affiliation(s)
- Fernando Valentim Bitencourt
- Department of Dentistry and Oral Health, Section for Periodontology, Aarhus University, 8000 Aarhus, Denmark
- Steno Diabetes Center Aarhus, 8200 Aarhus, Denmark
- Correspondence:
| | - Gustavo G. Nascimento
- Department of Dentistry and Oral Health, Section for Periodontology, Aarhus University, 8000 Aarhus, Denmark
- National Dental Centre Singapore, National Dental Research Institute Singapore, Singapore 168938, Singapore
- Oral Health Academic Clinical Programme, Duke-NUS Medical School, Singapore 169857, Singapore
| | - Susilena Arouche Costa
- Department of Dentistry and Oral Health, Section for Periodontology, Aarhus University, 8000 Aarhus, Denmark
- Graduate Dentistry Program, Federal University of Maranhão, São Luís 65080805, Brazil
| | - Silvana Regina Perez Orrico
- Department of Diagnosis and Surgery, School of Dentistry at Araraquara, São Paulo State University (UNESP), Araraquara 14801385, Brazil
- Advanced Research Center in Medicine, Union of the Colleges of the Great Lakes (UNILAGO), São José do Rio Preto 15030070, Brazil
| | | | - Fábio Renato Manzolli Leite
- Department of Dentistry and Oral Health, Section for Periodontology, Aarhus University, 8000 Aarhus, Denmark
- National Dental Centre Singapore, National Dental Research Institute Singapore, Singapore 168938, Singapore
- Oral Health Academic Clinical Programme, Duke-NUS Medical School, Singapore 169857, Singapore
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Valentim Bitencourt F, Falcão Gaspar C, Scheffler C, Almeida Rodrigues J, Fernanda Ceriotti Toassi R. Therapeutic itineraries of children with the early loss of primary teeth: A qualitative phenomenological study. Int Health Trends & Persp 2022. [DOI: 10.32920/ihtp.v2i3.1661] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
Background: Children with untreated dental caries tend to have a higher prevalence of early tooth loss, causing physical, psychosocial, and financial impacts on children and their families. The present study aims to understand the therapeutic itineraries of children with the early loss of primary teeth due to caries by analyzing the access to and integrality of care. Methods: This was a qualitative phenomenological study. Participants were caregivers, aged 18 years or older, of children up to 12 years of age who attended the University Dental Clinic of a Public University in Southern Brazil. Analysis of medical records and interviews were performed. The saturation criterion defined the sample size (n=44). Results: Public and private health services were accessed by families in the search for treatments for children's oral health conditions until they reached the University Dental Clinic. Children experiencing suffering and pain, who had had multiple extractions, and families affected financially and emotionally by the oral health condition of their children highlighted these itineraries. The resilience of these families in overcoming the challenges experienced and their continuous efforts to find solutions for the oral health care of their children were emphasized. Their relations with students and teachers at the University Dental Clinic were also discussed. Conclusion: The study showed a range of paths taken by children and their families and suggested weaknesses in ensuring the integrality of care for children in the Brazilian National Health System. Qualitative analysis of the therapeutic itineraries of children’s families presented in this study is proposed as a complementary tool for health care. This study has the potential to contribute to the evaluation of health services in the country, strengthening children's oral health.
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Bitencourt FV, Olsson TO, Lamers JMDS, Leite FRM, Nascimento GG, Toassi RFC. Impact of public health and higher education policies on the profile of final-year Brazilian dental students: Challenges and future developments. Eur J Dent Educ 2022. [PMID: 35869678 DOI: 10.1111/eje.12840] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Revised: 05/30/2022] [Accepted: 06/12/2022] [Indexed: 06/15/2023]
Abstract
INTRODUCTION Brazil has experienced transformations in higher education and health services, including launching more inclusive public policies focused on these two areas. OBJECTIVE To evaluate the profile of final-year dental students from a Brazilian public university from 2010 to 2019, accompanied by changes in public health and higher education policies. METHODS A prospective observacional study was carried out with final-year dental students. A self-applicable semi-structured questionnaire was applied. RESULT Six-hundred and seventy-seven students participated, of which 71.5% were women, 72.9% aged between 21 and 25 years, 96.2% single, and 96.4% were without children. Over ten years, it was possible to identify trends in the profile explained by implementing public policies toward more inclusive access to Brazilian higher education by socioeconomically disadvantaged individuals. Students who completed the course between 2018 and 2019 did not have the state capital city (the wealthiest area) as their origin city and had lower parental education and income levels than dental students graduating between 2010 and 2011. Moreover, working as a primary care dentist in the Brazilian National Health System was considered a professional possibility by 61.4% of the students, and has gained prominence significantly over time, ranging from 21.1% in 2010 to 72.9% in 2019 (p < .05). CONCLUSION Over the study period, concomitantly to advances in public health and higher education policies in Brazil, more diverse access to public dental education was observed, allowing students from low socioeconomic positions to take the education. Changes have also impacted the students' perspectives regarding the need for postgraduate training and a career in public health dentistry. However, these trends need to be consolidated, and public policies continued and strengthened.
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Affiliation(s)
| | - Thaís Ostroski Olsson
- Department of Preventive and Social Dentistry, School of Dentistry, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
| | - Juliana Maciel de Souza Lamers
- Pedagogue, Technician in Educational Affairs at the Faculty of Dentistry of the Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
| | | | | | - Ramona Fernanda Ceriotti Toassi
- Department of Preventive and Social Dentistry, School of Dentistry, Postgraduate Program in Teaching in Health Science, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
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Valentim Bitencourt F, Cardoso De David S, Schutz JDS, Otto Kirst Neto A, Visioli F, Fiorini T. Effect of photobiomodulation therapy on patient morbidity and wound healing at donor site after free gingival graft harvesting: a triple-blind randomized-controlled clinical trial. Clin Oral Implants Res 2022; 33:622-633. [PMID: 35305280 DOI: 10.1111/clr.13923] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Revised: 02/02/2022] [Accepted: 02/22/2022] [Indexed: 11/29/2022]
Abstract
OBJECTIVES This study aimed to evaluate the effect of photobiomodulation therapy (PBMT) on patient morbidity and donor site healing after free gingival graft (FGG) harvesting. METHODS Forty-four patients requiring FGG were selected for this trial. Individuals were randomly assigned to test group (PBMT, n=22) or control group (placebo, n=22) applied immediately after surgery, 24 and 48 hours after. Demographic, surgical-related and psychosocial variables possibly associated with treatment response were collected. The primary outcome was postoperative pain at the donor site evaluated using Visual Analogue Scale (VAS) immediately after surgery and 6, 24, 48 and 72 hours after. Secondary outcomes include medication consumption, patient-reported outcome measures (PROMs) and percentage of wound closure. RESULTS Intragroup analysis showed no differences in VASLog means for placebo group throughout the study (p>0.05), whereas a significant difference in PBMT group at 6h, 24h, 48h and 72h (p<0.05) were observed. Postoperative rescue analgesic requirement was significantly higher in the placebo group (p=0.004). The number needed to treat(NNT) was 2.43. PBMT group reported significant better function related to sleeping, going to work/school and daily routine activities, less restriction to mouth opening, chewing and food consumption, less swelling and bleeding (p<0.05), mainly in the first 48hs. PBMT group presented a significantly higher palatal wound closure at 7 days compared to placebo group (33.41 vs 21.20 respectively, p=0.024) after adjustment for confounding. No adverse effects were reported. CONCLUSIONS PBMT accelerated the pain resolution time and palatal closure, decreased rescue medication consumption and significantly improved patient satisfaction in the postoperative period.
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Affiliation(s)
| | - Silvia Cardoso De David
- Department of Conservative Dentistry - Periodontology, Federal University of Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
| | - Jasper da Silva Schutz
- Department of Conservative Dentistry - Periodontology, Federal University of Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
| | - Alfredo Otto Kirst Neto
- Department of Conservative Dentistry - Periodontology, Federal University of Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
| | - Fernanda Visioli
- Department of Conservative Dentistry - Oral Pathology, Federal University of Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
| | - Tiago Fiorini
- Department of Conservative Dentistry - Periodontology, Federal University of Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
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Roxo-Gonçalves M, Bitencourt FV, Azevedo CB, Fiorini T, Carrard VC. Online search interest in the use of antibiotics for dental pain: an infodemiology study. Braz Dent Sci 2022. [DOI: 10.4322/bds.2022.e2894] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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Bitencourt FV, Rodrigues JA, Toassi RFC. Narratives about a stigma: attributing meaning to the early loss of deciduous teeth on children's caregivers. Braz Oral Res 2021; 35:e044. [PMID: 33909866 DOI: 10.1590/1807-3107bor-2021.vol35.0044] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2020] [Accepted: 12/16/2020] [Indexed: 11/22/2022] Open
Abstract
Qualitative approach about the implications that occur succeeding the premature loss teeth is still insufficient. This study aimed to understand the experience of early loss of deciduous teeth in children's lives, from the perspective of their caregivers. Qualitative case study included 52 caregivers of children from an outpatient service of a public university in the south of Brazil. Early loss of deciduous teeth to trauma or caries was identified through analysis of health records, and afterwards, semi-structured interviews were performed. Textual material was interpreted through the content analysis proposed by Bardin, supported by the ATLAS.ti software. The theoretical perspective of stigma was guided according to the principles of the phenomenology of Maurice Merleau-Ponty, centred on the experience of early loss of deciduous teeth as a historic-cultural expression of a social group. According to caregivers, premature loss of deciduous teeth due to trauma or decay brings functional limitations with chewing and speaking, and impairments related to social interaction with other children. The repercussions of missing teeth were not limited to the child's image, but also brought changes in families' daily lives. However, when early tooth loss was due to extraction because of pain and suffering, caregivers perceived the loss as 'commonplace' in children's lives. The understanding of how children see themselves without teeth in their social world for their caregivers, which also includes their family and friends, determines how much experiencing tooth loss affects their lives. Besides, caregivers' perceptions related to early loss of deciduous teeth should be included in strategies of oral health promotion programs.
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Affiliation(s)
- Fernando Valentim Bitencourt
- Universidade Federal do Rio Grande do Sul - UFRGS, School of Dentistry, Post-Graduate Program in Dentistry, Porto Alegre, RS, Brazil
| | - Jonas Almeida Rodrigues
- Universidade Federal do Rio Grande do Sul - UFRGS, School of Dentistry, Department of Surgery and Orthopedics, Porto Alegre, RS, Brazil
| | - Ramona Fernanda Ceriotti Toassi
- Universidade Federal do Rio Grande do Sul - UFRGS, School of Dentistry, Department of Preventive and Social Dentistry, Porto Alegre, RS, Brazil
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13
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Bitencourt FV, Bender CV, Fiorini T, Gomes SC, Visioli F, Angst PDM. Periodontal condition and treatment in a patient with rare systemic condition: A case report for acid sphingomyelinase deficiency. Spec Care Dentist 2020; 41:103-110. [PMID: 33179797 DOI: 10.1111/scd.12540] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Revised: 10/15/2020] [Accepted: 10/16/2020] [Indexed: 11/30/2022]
Abstract
BACKGROUND Acid sphingomyelinase deficiency (ASMD) is a rare group of autosomal recessive disorders. This report provides the first detailed description of the periodontal condition and treatment response in a patient with chronic visceral ASMD. CASE DESCRIPTION A 49-year-old white woman with ASMD showed elevated visible plaque index (VPI), gingival bleeding index (GBI), and bleeding on probing (BOP) at 100% of sites. Periodontal pocket depths (PPD) were mostly shallow to moderate (at 96% of sites), whereas the loss of clinical attachment (CAL) was moderate to severe (54% and 46% of sites, respectively, at 4-6 mm and ≥7 mm categories). Periapical radiographs revealed the presence of furcation involvement and intra-bony defects. The periodontal diagnosis was periodontitis stage IV, generalized, grade C. Ninety days after the end of the supra and subgingival control (e.g., cause-related therapy), marked reduction was observed for all periodontal indicators: VPI (-83%), GBI (-79%), BOP (-85%), elimination of sites PPD ≥7 mm, 27% increase in sites PPD 1-3 mm (from 64% to 91%), and gain of clinical attachment (gain of 11% CAL 1-3 mm and 25% CAL 4-6 mm; and a reduction of 36% CAL ≥7 mm). PRACTICAL IMPLICATIONS Despite the severity of the initial periodontal condition, the patient with chronic visceral ASMD responded well to the non-surgical periodontal treatment.
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Affiliation(s)
- Fernando Valentim Bitencourt
- Department of Conservative Dentistry - Periodontology, Federal University of Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
| | - Cláubia Viegas Bender
- Department of Conservative Dentistry - Oral Pathology, Federal University of Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
| | - Tiago Fiorini
- Department of Conservative Dentistry - Periodontology, Federal University of Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
| | - Sabrina Carvalho Gomes
- Department of Conservative Dentistry - Periodontology, Federal University of Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
| | - Fernanda Visioli
- Department of Conservative Dentistry - Oral Pathology, Federal University of Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
| | - Patricia Daniela Melchiors Angst
- Department of Conservative Dentistry - Periodontology, Federal University of Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
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Bitencourt FV, Corrêa HW, Toassi RFC. Tooth loss experiences in adult and elderly users of Primary Health Care. Cien Saude Colet 2019; 24:169-180. [PMID: 30698251 DOI: 10.1590/1413-81232018241.09252017] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2016] [Accepted: 06/04/2017] [Indexed: 11/22/2022] Open
Abstract
From the theoretical perspective of phenomenology, this article seeks to understand the experiences of tooth loss in adult and elderly users of Primary Health Care in Porto Alegre, Rio Grande do Sul. Tooth loss was identified by the analysis of dental records of users that attended the oral health service at the Health Unit under study. Following this identification, individual household interviews were carried out. The sample was intentional. Data were interpreted by content analysis using the software ATLAS.ti (Visual Qualitative Data Analysis). The study had ethical approval. Losing teeth was an experience that expresses subjectivities, showing plural narratives and highlighting the social function of the mouth. Besides the number of missing teeth, the understanding of how people perceived themselves without their teeth determined how much tooth loss affected their lives. Wearing prostheses adds significance to individuals' perceptions of their body, restoring the balance between their body and the world. Qualitative approach studies in health services should be considered in order to plan interventions which prioritize people's individual needs in their own territories, thus reducing stigmas and social inequalities.
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Affiliation(s)
- Fernando Valentim Bitencourt
- Departamento de Odontologia Preventiva e Social, Faculdade de Odontologia, Universidade Federal do Rio Grande do Sul. R. Ramiro Barcelos 2492, Santana. 90035-003 Porto Alegre RS Brasil.
| | - Helena Weschenfelder Corrêa
- Departamento de Odontologia Preventiva e Social, Faculdade de Odontologia, Universidade Federal do Rio Grande do Sul. R. Ramiro Barcelos 2492, Santana. 90035-003 Porto Alegre RS Brasil.
| | - Ramona Fernanda Ceriotti Toassi
- Departamento de Odontologia Preventiva e Social, Faculdade de Odontologia, Universidade Federal do Rio Grande do Sul. R. Ramiro Barcelos 2492, Santana. 90035-003 Porto Alegre RS Brasil.
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Schaarschmidt GM, Bitencourt FV, Baumgarten A, Souza JMD, Toassi RFC. PESQUISA QUALITATIVA NA SAÚDE BUCAL COLETIVA: UMA ANÁLISE BIBLIOMÉTRICA. R Fac Odontol Porto Alegre 2018. [DOI: 10.22456/2177-0018.61787] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Introdução: Pesquisas qualitativas são utilizadas quando o objeto de pesquisa exige respostas que não se traduzem em números, sendo estruturada na experiência, na vivência, no senso comum e na ação. Busca a compreensão subjetiva das pessoas a respeito de sua vida diária. Objetivo: Analisar a produção científica em relação à pesquisa qualitativa na saúde bucal coletiva. Metodologia: Uma análise bibliométrica foi conduzida na base de dados da Biblioteca Virtual em Saúde com descritores controlados. Resultados: Foram avaliados 55 artigos publicados entre 1998-2013, observando-se um crescimento dessas publicações de 1998-2009 e desde então uma redução até 2013. O primeiro autor, em mais da metade dos artigos, era do Brasil, seguido pelo Reino Unido, Canadá e EUA. Esses autores estavam vinculados principalmente a instituições públicas. Os artigos, em sua maioria, foram publicados em periódicos de saúde pública e odontologia, incluindo dentistas, profissionais da saúde, pacientes/usuários de serviços de saúde e estudantes de odontologia, utilizando a técnica da entrevista. Destacam-se as pesquisas qualitativas com temáticas voltadas à Política de Saúde Bucal, Estratégia de Saúde da Família e Educação em Odontologia. A análise temática e a análise de conteúdo foram os métodos de interpretação mais utilizados nos estudos. Conclusão: Desafios importantes devem ser superados para a consolidação da pesquisa qualitativa na saúde bucal coletiva, o que inclui um maior número de artigos publicados, a apresentação dos aspectos éticos, financiamento para a realização das pesquisas qualitativa, vinculação com trabalhos acadêmicos e definição teórico-conceitual com o necessário fundamento epistemológico.
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