RESUMO
Os traumatismos dentaÌrios representam um problema de sauÌde pública devido aÌ alta prevaleÌncia e impacto psicossocial, sendo muito frequentes em crianças podendo resultar em necrose pulpar e culminar na rizogeÌnese incompleta de dentes permanentes. Nestes casos de traumatismos em dentes permanentes com rizogeÌnese incompleta e necrose pulpar, o tratamento mais indicado pela literatura eÌ a apicificaçaÌo, sendo um tratamento complexo e longo. Considerando a importaÌncia deste tema, o objetivo deste trabalho eÌ relatar o caso de um paciente com traumatismo dental e necrose pulpar, que acarretou a interrupçaÌo do desenvolvimento completo e adequado do aÌpice dentaÌrio, sendo necessaÌria a intervençaÌo por meio da técnica de apicificaçaÌo e o acompanhamento a longo prazo. O caso trata-se de uma menina em que um traumatismo dentaÌrio acarretou fratura de um incisivo central superior com formaçaÌo radicular incompleta, comprometendo tanto a esteÌtica quanto a vitalidade do dente. Foi realizado o tratamento endodoÌntico com apicificaçaÌo e posteriormente ao plug apical de MTA. O dente foi restaurado definitivamente com resina composta e realizado acompanhamento do paciente. Nas consultas de acompanhamento houve ausência de sintomatologia dolorosa e satisfação da paciente com a aparência atual. Sendo assim, a apicificação apresenta-se como uma ótima alternativa para dentes com rizogênese incompleta e necrose pulpar, embora longo houve uma melhora estética e satisfação do paciente.
Dental trauma represents a public health problem due to its high prevalence and psychosocial impact, being very frequent in children and can result in pulp necrosis and culminate in incomplete root formation of permanent teeth. In these cases of trauma to permanent teeth with incomplete root formation and pulp necrosis, the most indicated treatment in the literature is apexification, which is a complex and long treatment. Considering the importance of this topic, the objective of this work is to report the case of a patient with dental trauma and pulp necrosis, which caused the interruption of the complete and adequate development of the dental apex, requiring intervention through the apexification technique and follow-up. long-term. The case is about a girl in which a dental trauma resulted in a fracture of a maxillary central incisor with incomplete root formation, compromising both the esthetics and the vitality of the tooth. Endodontic treatment was performed with apexification and then apical MTA plug. The tooth was definitively restored with composite resin and the patient was followed up. In the follow- up consultations, there was no painful symptomatology and the patient was satisfied with her current appearance. Thus, the apexification presents itself as a great alternative for teeth with incomplete root formation and pulp necrosis, although in the long run there was an aesthetic improvement and patient satisfaction.
Los traumatismos dentales representan un problema de salud pública debido a su alta prevalencia e impacto psicosocial, siendo muy frecuentes en niños y pudiendo dar lugar a necrosis pulpar y culminar en la formación incompleta de la raíz de los dientes permanentes. En estos casos de traumatismos en dientes permanentes con formación radicular incompleta y necrosis pulpar, el tratamiento más indicado en la literatura es la apexificación, que es un tratamiento complejo y largo. Considerando la importancia de este tema, el objetivo de este trabajo es relatar el caso de una paciente con traumatismo dentario y necrosis pulpar, que causó la interrupción del desarrollo completo y adecuado del ápice dentario, requiriendo intervención a través de la técnica de apexificación y seguimiento. a largo plazo. Se trata de una niña en la que un traumatismo dental provocó la fractura de un incisivo central maxilar con formación radicular incompleta, comprometiendo tanto la estética como la vitalidad del diente. Se realizó tratamiento endodóntico con apexificación y posterior taponamiento apical con MTA. El diente fue restaurado definitivamente con resina compuesta y el paciente fue sometido a seguimiento. En las consultas de seguimiento, no había sintomatología dolorosa y la paciente estaba satisfecha con su aspecto actual. Así, la apexificación se presenta como una gran alternativa para dientes con formación radicular incompleta y necrosis pulpar, aunque a la larga se produjo una mejoría estética y satisfacción de la paciente.
Assuntos
Humanos , Feminino , Criança , Dentição Permanente , Endodontia/instrumentação , Ferimentos e Lesões/diagnóstico , Satisfação do Paciente , Resinas Compostas , Necrose da Polpa Dentária/diagnóstico , Odontólogos , Estética , Apexificação/instrumentação , Endodontia Regenerativa , Relatos de Casos como AssuntoRESUMO
O objetivo do estudo foi buscar informações documentais para caracterizar casos de urgências e emergências odontológicas na Unidade de Pronto Atendimento (UPA), em Santa Maria/RS. Para isso, realizou-se uma análise retrospectiva de dados nos prontuários dos pacientes de ambos os sexos e maiores de 18 anos, no período de seis meses. A amostra foi coletada de acordo com o perfil do paciente e levou-se em consideração: queixa principal, procedimentos realizados,tempo de permanência na UPA, sexoe idade.Aamostra foi composta pordados de 625 prontuários. A média de idade dos usuários foi de39,6±14,5 anos. A principal queixa encontrada foi ador (190, 24,4%), seguida de edema (49,6,3%), enquanto prescrições de medicamentos (250, 27,1%) e acesso àpolpa (235, 25,5%) foram os procedimentos mais realizados. O retorno de consultas no período analisado se deu em 189 (30,2%) dos casos, para realização de procedimentos como prescrição de medicamentos (130,27%), acesso àpolpa (122,26%) e troca de medicação intracanal (96,20%). Concluiu-se que, à medida em que a idade dos pacientes aumenta, os tratamentos endodônticos diminuem e as exodontias crescem. Além disso, foi possível identificar o perfil da população atendida: pacientes de ambos os sexos, comidade mediana de 37 anos, cujo tempo de permanência na UPA foi inferior a1hora, tendo como queixa principal a dor, enquanto o procedimento mais realizado foi a prescrição de medicamentos (AU).
The aim of the present study was to analyze documental information to characterize cases of urgent and emergency dental care at an Urgent Care Unit in the city of Santa Maria, state of Rio Grande do Sul, Brazil. A retrospective analysis was performed of data from the records of male and female patients 18 years of age or older in a six-month period. The variables of interest were patient's sex, age and main complaint as well as the procedures performed and duration in the Urgent Care Unit. The sample was composed of 625 patient records. Mean age was 39.6±14.5 years.The main complaint was pain (n = 190;24.4%), followed by edema (n = 49;6.3%). The most frequent procedures were the prescription of medication (n = 250;27.1%) and pulp access (n = 235;25.5%). Follow-up appointments occurred in 189 cases (30.2%) for procedures such as the prescription of medication (n = 130;27%), pulp access (n = 122;26%) and exchange of the intracanal medication (n = 96;20%). Endodontic treatment diminished and extractions increased with the increase in patient age. In summary, the following urgent dental care profile was found: male and female patients with a median age of 37 years who spent less than one hour at the Urgent Care Unit whose main complaint was pain and the most frequent procedure was the prescription of medication (AU).
Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Assistência Odontológica , Serviços de Saúde Bucal , Serviços Médicos de Emergência , Registros Eletrônicos de Saúde/instrumentação , Assistência Ambulatorial , Prescrições de Medicamentos , Brasil , Distribuição de Qui-Quadrado , Estudos RetrospectivosRESUMO
The objective of this article is to identify the scientific productions on the access and use of dental services by pregnant women. A search was carried out on the BVS and MEDLINE/PubMed online databases to produce this integrative literature review. In the BVS database, the Portuguese descriptors were: "acesso aos serviços de saúde", "saúde bucal" and "gestantes", and in PubMed: "Health services accessibility", "oral health" and "pregnant women", all associated with each other by the Boolean operator "AND". We identified five studies that met the inclusion and exclusion criteria and were systematized into two empirical and co-related categories: the significant number of pregnant women who do not perform prenatal dental care and the importance of educational measures that signal the need to receive dental care during prenatal visits. Further studies on the subject are required to support public health policies that consider this theme. Existing research shows low adherence to prenatal dental care and that the main factors hindering the access to and use of dental services were related to socioeconomic, cultural and educational aspects.
O objetivo deste artigo é identificar as produções científicas sobre o acesso e utilização de serviços odontológicos por gestantes. Foi realizada uma revisão integrativa de literatura com busca nas bases de dados BVS e MEDLINE/PubMed. Na base BVS os descritores foram: "acesso aos serviços de saúde", "saúde bucal" e "gestantes", e na PubMed: "Health services accessibility", "oral health" e "pregnant women", associados entre si pelo operador booleano AND. Foram encontrados cinco estudos que preencheram os critérios de inclusão e exclusão, sendo sistematizados em duas categorias empiricas e co-relacionadas: número expressivo de gestantes que não realizam o pré-natal odontológico e importância de medidas educativas que sinalizem a necessidade de receberem acompanhamento odontológico durante as consultas de pré-natal. Existe a necessidade de mais estudos, para embasar políticas de saúde pública que contemplem esta temática. As pesquisas existentes demonstram baixa adesão ao pré-natal odontológico e que os principais fatores observados como complicadores do acesso e utilização dos serviços odontológicos foram os relacionados aos aspectos socioeconômicos, culturais e educacionais.
Assuntos
Serviços de Saúde Bucal/estatística & dados numéricos , Utilização de Instalações e Serviços/estatística & dados numéricos , Acessibilidade aos Serviços de Saúde/estatística & dados numéricos , Cuidado Pré-Natal/estatística & dados numéricos , Feminino , Humanos , GravidezRESUMO
Resumo O objetivo deste artigo é identificar as produções científicas sobre o acesso e utilização de serviços odontológicos por gestantes. Foi realizada uma revisão integrativa de literatura com busca nas bases de dados BVS e MEDLINE/PubMed. Na base BVS os descritores foram: "acesso aos serviços de saúde", "saúde bucal" e "gestantes", e na PubMed: "Health services accessibility", "oral health" e "pregnant women", associados entre si pelo operador booleano AND. Foram encontrados cinco estudos que preencheram os critérios de inclusão e exclusão, sendo sistematizados em duas categorias empiricas e co-relacionadas: número expressivo de gestantes que não realizam o pré-natal odontológico e importância de medidas educativas que sinalizem a necessidade de receberem acompanhamento odontológico durante as consultas de pré-natal. Existe a necessidade de mais estudos, para embasar políticas de saúde pública que contemplem esta temática. As pesquisas existentes demonstram baixa adesão ao pré-natal odontológico e que os principais fatores observados como complicadores do acesso e utilização dos serviços odontológicos foram os relacionados aos aspectos socioeconômicos, culturais e educacionais.
Abstract The objective of this article is to identify the scientific productions on the access and use of dental services by pregnant women. A search was carried out on the BVS and MEDLINE/PubMed online databases to produce this integrative literature review. In the BVS database, the Portuguese descriptors were: "acesso aos serviços de saúde", "saúde bucal" and "gestantes", and in PubMed: "Health services accessibility", "oral health" and "pregnant women", all associated with each other by the Boolean operator "AND". We identified five studies that met the inclusion and exclusion criteria and were systematized into two empirical and co-related categories: the significant number of pregnant women who do not perform prenatal dental care and the importance of educational measures that signal the need to receive dental care during prenatal visits. Further studies on the subject are required to support public health policies that consider this theme. Existing research shows low adherence to prenatal dental care and that the main factors hindering the access to and use of dental services were related to socioeconomic, cultural and educational aspects.
Assuntos
Humanos , Feminino , Gravidez , Cuidado Pré-Natal/estatística & dados numéricos , Serviços de Saúde Bucal/estatística & dados numéricos , Utilização de Instalações e Serviços/estatística & dados numéricos , Acessibilidade aos Serviços de Saúde/estatística & dados numéricosRESUMO
Wide availability of access to dental services can be considered a predictor of better oral health outcomes in a population. This article aims to compare data from the Brazilian National Household Sample Surveys (PNAD) on dental services utilization among children aged 4 to 12 years. This cross-sectional study was carried out using data from the 1998, 2003, and 2008 National Household Sample Surveys, involving a total of 61.438, 64.659 and 59.561 children, respectively. Ninety-nine percent confidence intervals were considered for the prevalence of each outcome of interest. In 1998, 60.8% (99%CI: 59.4;62.1) of children had been to a dentist; this prevalence was 65.5% (99%CI: 64.4;66.7) in 2003 and 73.8% (99%CI: 72.1;74.2) in 2008. In 1998, 41.2% (99%CI: 39.1;43.3) of children in the lowest household income quartile had been to a dentist; this value was 61.4% (99%CI: 59.5;63.2) in 2008. Among children from families whose head of household had 4 years of formal education or fewer, 49.5% and 63% had been to a dentist in 1998 and 2008, respectively. The lifetime prevalence of dentist attendance among Brazilian children increased between 1998 and 2008, especially among those from low-income families and those whose head of household had a low educational level.
Assuntos
Assistência Odontológica/estatística & dados numéricos , Acessibilidade aos Serviços de Saúde , Saúde Bucal , Brasil , Criança , Pré-Escolar , Estudos Transversais , Escolaridade , Feminino , Inquéritos Epidemiológicos , Humanos , Masculino , Pobreza , Prevalência , Fatores SocioeconômicosRESUMO
Abstract Wide availability of access to dental services can be considered a predictor of better oral health outcomes in a population. This article aims to compare data from the Brazilian National Household Sample Surveys (PNAD) on dental services utilization among children aged 4 to 12 years. This cross-sectional study was carried out using data from the 1998, 2003, and 2008 National Household Sample Surveys, involving a total of 61.438, 64.659 and 59.561 children, respectively. Ninety-nine percent confidence intervals were considered for the prevalence of each outcome of interest. In 1998, 60.8% (99%CI: 59.4;62.1) of children had been to a dentist; this prevalence was 65.5% (99%CI: 64.4;66.7) in 2003 and 73.8% (99%CI: 72.1;74.2) in 2008. In 1998, 41.2% (99%CI: 39.1;43.3) of children in the lowest household income quartile had been to a dentist; this value was 61.4% (99%CI: 59.5;63.2) in 2008. Among children from families whose head of household had 4 years of formal education or fewer, 49.5% and 63% had been to a dentist in 1998 and 2008, respectively. The lifetime prevalence of dentist attendance among Brazilian children increased between 1998 and 2008, especially among those from low-income families and those whose head of household had a low educational level.
Resumo A ampla disponibilidade de acesso aos serviços odontológicos pode ser considerada um fator preditor de melhores resultados na saúde bucal da população. O objetivo deste artigo é comparar os dados obtidos das Pesquisas Nacionais por Amostras de Domicílios (PNADs), em relação a utilização de serviços odontológicos, entre crianças de 4 a 12 anos. Estudo transversal, com dados obtidos a partir das PNADs realizadas em 1998, 2003 e 2008, envolvendo um total de 61.438, 64.659 e 59.561crianças, respectivamente. Considerou-se intervalos de confiança de 99% para os desfechos. No ano de 1998, 60,8% (IC99%: 59,4;62,1) das crianças haviam ido ao dentista, em 2003, 65,5% (IC99%: 64,4;66,7), e em 2008, 73,8% (IC99%: 72,1;74,2). Com relação à renda domiciliar, em 1998, 41,2% (IC99%: 39,1;43,3) das crianças inseridas nas famílias na menor faixa de renda foram ao cirurgião-dentista, em 2003 49,9% (IC99%: 48;51,9) o fizeram e, em 2008, 61,4% (IC99%: 59,5;63,2). Entre as que pertenciam a famílias onde o chefe possuía até 4 anos de estudo, 49,5% e 63%, em 1998 e 2008, foram às consultas odontológicas. A prevalência de crianças brasileiras que já haviam ido ao dentista aumentou entre 1998 e 2008, especialmente entre aquelas pertencentes a famílias com renda domiciliar menor e com chefes possuindo menor escolaridade.
Assuntos
Humanos , Masculino , Feminino , Pré-Escolar , Criança , Saúde Bucal , Assistência Odontológica/estatística & dados numéricos , Acessibilidade aos Serviços de Saúde , Pobreza , Fatores Socioeconômicos , Brasil , Prevalência , Estudos Transversais , Inquéritos Epidemiológicos , EscolaridadeRESUMO
PURPOSE: To evaluate the longevity and factors associated with failure of primary teeth restorations placed in high caries-risk children. METHODS: The sample was comprised of children treated in a University Dental Service. Patients' records were screened retrospectively to determine whether they had received restorative treatment in primary teeth presenting cavitated caries lesions. Kaplan-Meier estimator and Multivariate Cox regression analysis with shared frailty were used to assess restorations' survival and factors associated with failure, respectively. RESULTS: 123 high caries-risk children (10.3±4 DMF-T) with 316 restorations were analyzed. The 3-year survival reached 53.4% (AFR=18.8%). Restorations placed without rubber dam (P= 0.04), over selective caries removal (P= 0.03), with calcium hydroxide liner (P< 0.01) and glass-ionomer cement (P= 0.04) presented lower survival rates. Caries-controlled patients presented significantly (P= 0.03) higher rates of restoration survival (77.7%) than caries-active patients (49.9%). The adjusted model showed that restorations placed in teeth after selective caries removal showed 3.41 times higher risk of failure compared with restorations over complete caries removal (95%CI:1.37-8.46). CLINICAL SIGNIFICANCE: Adhesive restorations placed in high-caries experience patients have limited survival rates. Some treatment-related factors may influence the performance of these restorations. A strict preventive regimen to control dental caries activity must be followed in order to increase the restoration survival.
Assuntos
Resinas Compostas , Cárie Dentária , Restauração Dentária Permanente , Criança , Falha de Restauração Dentária , Cimentos de Ionômeros de Vidro , Humanos , Estudos Retrospectivos , Dente DecíduoRESUMO
Objective: To investigate the perceptions of dental students on the learning process regarding the dentist-pediatric patient relationship. Material and Methods: A qualitative study with an exploratory approach was conducted involving semistructured interviews with sixteen dental undergraduate students randomly selected from the thirty-two students in the last semester of the dentistry course. The transcribed interviews were submitted to content analysis. Results: The sample was composed of nine female (56.3%) and seven male (43.7%) students (median age: 23 years). The factors perceived as most influential with regard to learning the dentistpediatric patient relationship were observations of professors, other dentists or colleagues and the regular practice of dental procedures. While half of the participants considered lectures on the subject satisfactory, the other half reported a need for more instruction on how to deal with specific clinical situations. Most of the participants would like to have learned more about the dentist-pediatric patient relationship. Conclusion: The majority of students recognized that the teaching and learning process regarding the dentist-pediatric patient relationship is not easy. They reported having little counseling on the how to develop this relationship. The students suggested that the dentist-patient relationship should be addressed more during the course through the inclusion of lectures or classes on this issue as well as the demonstration of specific clinical situations.
Assuntos
Humanos , Masculino , Feminino , Adulto , Assistência Odontológica para Crianças , Pesquisa Qualitativa , Relações Dentista-Paciente , Odontólogos , Educação em Odontologia , Estudantes de Odontologia , BrasilRESUMO
Objective: To describe the use of dental services among children aged zero to three years in Brazil according to socio-demographic characteristics. Material and Methods: A cross-sectional study was carried out using data from the 1998, 2003 and 2008 Brazilian National Household Surveys involving a total of 25,769, 25,644 and 22,237 children, respectively. Prevalence rates and 99% confidence intervals (CI) were calculated. Results: : In 1998, 10.4% (99%CI: 9.7-11.1) of the children had been to the dentist. This figure was 13.4% (99%CI: 12.6-14.3) in 2003 and 16.2% (99%CI: 15.2-17.1) in 2008. In 2008, the prevalence rates of dental appointments in lifetime were respectively 10.2% (99%CI: 9.2-11.4) and 30.6% (99%CI: 27.7-33.6) for children in the lowest and highest income quartiles, 10.2% (99%CI: 8.9-11.7) and 22.4% (99%CI: 20.9- 23.9) for children from families whose head of household had up to four and nine or more years of schooling, 9.6% (99%CI: 2.2-11.1) and 27.5% (99%CI: 24.5-30.8) for those living in the northeast and central west regions of the country. Conclusion: Statistically significant increases in the prevalence rates of the use of dental services among Brazilian children aged zero to three years occurred between 1998 and 2008. The rates were lower among children belonging to socially and ethnically disadvantaged groups.
Assuntos
Humanos , Masculino , Feminino , Recém-Nascido , Lactente , Pré-Escolar , Brasil , Criança , Assistência Odontológica para Crianças , Serviços de Saúde Bucal , Acessibilidade aos Serviços de Saúde , Fatores Socioeconômicos , Estudos Transversais/métodos , Indicadores DemográficosRESUMO
Objective: To determine anxiety in children undergoing dental treatment and to evaluate associated factors. Material and Methods: The sample consisted of 48 children during dental appointment in dental clinics of the Franciscano University Center, 48 caregivers, and 46 dentistry students. The modified Venham Picture Test was used to determine anxiety of children during dental appointment, before and after treatment. For determining anxiety related to dental care among caregivers, the modified Corah's dental anxiety scale was used. The Lipp`s stress symptoms inventory for adults was applied to determine the stress level of dentistry students. In addition, the individual characteristics of participants were recorded to determine their association with the presence of anxiety. Results: Anxiety was observed in 60.4% of children, and it was related to invasive dental procedures (p = 0.021), history of dental pain (p = 0.002), presence of bruxism (p = 0.028), anxious caregivers (p = 0.023), and stress of the dental student that conducted the appointment (p = 0.005). Conclusion: Overall, the majority of pediatric patients showed anxiety, which was directly related to misbehavior during dental care. Moreover, anxiety was related to individual characteristics of children and was influenced by the anxiety level of caregivers, as well as the emotional state of dentistry students during the dental appointment.