RESUMO

PURPOSE: This study aimed to examine health-related quality of life (HRQoL) in head and neck cancer patients at 1 and 5 years after successful treatment of their tumors, and to explore the usefulness of 2 instruments for assessing the need of dental care services. METHODS: This cross-sectional pilot study included 20 adult patients with head and neck cancer who completed the Functional Assessment of Cancer Therapy-Head and Neck (FACT H&N) Symptom Index and the European Organization for Research and Treatment of Cancer Quality of Life Head and Neck Module (EORTC QLQ-H&N43) after 1 and 5 years of treatment. RESULTS: Mean (standard deviation, SD) scores of the FACT H&N Symptom Index were higher (better HRQoL) at 5 years than at 1 year (24.1 [4.4] vs. 21.1 [6.4]; p = 0.236). Only three of the ten items of FACT H&N (swallow, pain in mouth/throat or neck, and solid foods) evaluated oral health. In the EORTC QLQ-H&N43 questionnaire, scores were lower at 5 years (better HRQoL) in almost all multi- and single-item symptoms. This questionnaire includes four multi-item scales (pain in the mouth, social eating, swallowing, and problems with teeth) measuring dental and orthodontic needs. CONCLUSION: HRQoL in patients with head and neck cancer improved with the length of follow-up. The EORTC QLQ-H&N43 has more items addressing oral health compared to the FACT H&N Symptom Index and may be more adequate to assess the need of dental therapy in clinical practice.

RESUMO

BACKGROUND: A cross-sectional survey was conducted to gather information regarding the opinion of Brazilian specialists in both orthodontics and implantology on multidisciplinary oral rehabilitation in partially edentulous patients with malocclusion. MATERIAL AND METHODS: A total of 305 specialists participated in a telephone survey and answered an ad hoc 10-item questionnaire, including the request of total skull cone-beam tomographies (CBCT) and the use of 3D digital planning software, the best moment of treatment to place dental implants, and the integration of orthodontics in implantology. RESULTS: Most participants did not request CBCT (90.8%) or 3D digital planning software images (92.3%) to diagnose and plan multidisciplinary oral rehabilitation. By contrast, 91.1% of participants would use an already dental implant as anchorage for orthodontics, 73.8% had already used implants for this purpose, 47.9% selected 4 months as the waiting time between implant placement and its use as anchorage, and 58.4% had already placed dental implants having in mind using them as anchorage for orthodontics and anticipating the oral rehabilitation process. Moreover, 93.4% of participants stated to avoid applying orthodontic forces in implants with unfavourable prognosis. A total of 67.9% of participants got the degree of specialist in Orthodontics before that of specialist in Implantology. The main reason for obtaining the other specialty degree was to be able to thoroughly exercise the two specialties. CONCLUSIONS: The use of technological advances, such as CBCT and 3D digital planning software was limited. Most dental specialists would wait the osseointegration recommended time before applying orthodontic forces and thus using them as anchorage for orthodontics. The majority of interviewed dentists sought the other specialty to acquire multidisciplinary knowledge. Key words:Cross-sectional study, orthodontics, implantology, partially edentulous, malocclusion, oral rehabilitation.

RESUMO

Uma tomografia de feixe cônico total do crânio associada a um software tridimensional de planejamento digital permite um diagnóstico mais completo e a simulação de diferentes planos de tratamento para a reabilitação oral multidisciplinar de pacientes adultos edêntulos parciais portadores de má oclusão. Um total de 305 cirurgiões-dentistas especialistas, simultaneamente em Ortodontia e em Implantodontia, foram entrevistados e responderam a um questionário com o objetivo de coletar informações importantes sobre a integração da Ortodontia com a Implantodontia para a instalação de implantes dentários em pacientes adultos edêntulos parciais que também necessitam de tratamento ortodôntico. Este estudo foi dividido em uma trilogia de artigos científicos. Esta, a Parte 1, refere-se a perguntas sobre a solicitação de uma tomografia de feixe cônico total do crânio e o uso de softwares tridimensionais de planejamento digital para diagnosticar e planejar reabilitações orais multidisciplinares em pacientes adultos edêntulos parciais portadores de má oclusão. Como a tecnologia já está disponível, era de se esperar uma maior solicitação de tomografias de feixe cônico total do crânio e um maior uso de softwares tridimensionais de planejamento digital por cirurgiões-dentistas, especialistas simultaneamente em Ortodontia e em Implantodontia, mas os resultados mostram o contrário.(AU)

A total skull cone beam tomography associated to a three-dimensional digital planning software permits a more complete diagnostic and the simulation of different treatment plans for the multidisciplinary oral rehabilitation of partially edentulous adult patients with malocclusion. A total of 305 dental specialists in both orthodontics and implantology were interviewed and answered a questionnaire in order to collect relevant information about the integration of orthodontics to implantology for the placement of dental implants on partially edentulous adult patients that also need orthodontic treatment. This study was divided in a trilogy of scientific articles. This, the Part 1, refers to questions about the request of a total skull cone beam tomography and the use of three-dimensional planning softwares to diagnose and plan a multidisciplinary oral rehabilitation for partially edentulous adult patients with malocclusion. As technology is already available, it was expected a higher number of dental specialists in both orthodontics and implantology requesting a total skull cone beam tomography and a greater use of three-dimensional digital planning softwares. But results show the opposite. (AU)

Assuntos

RESUMO

Para se conduzir uma reabilitação oral multidisciplinar em um paciente adulto edêntulo parcial portador de má oclusão deve haver uma equipe de cirurgiões-dentistas especialistas trabalhando sincronizadamente. Juntos, devem definir qual é o melhor plano de tratamento que integre a Ortodontia com a Implantodontia para a obtenção de uma oclusão estável e harmonização facial. No entanto, se um único cirurgião-dentista pretende conduzir uma reabilitação oral multidisciplinar em um paciente adulto edêntulo parcial portador de má oclusão, ele deve reunir habilidades multidisciplinares para competentemente diagnosticar, planejar e conduzir o caso. Um total de 305 cirurgiões-dentistas especialistas simultaneamente em Ortodontia e em Implantodontia foram entrevistados e responderam a um questionário para coletar importantes informações sobre a integração da Ortodontia com a Implantodontia para a instalação de implantes dentários em pacientes adultos edêntulos parciais, que também necessitam de tratamento ortodôntico. Este estudo foi dividido em uma trilogia de artigos científicos. Esta, a Parte 3, refere-se às perguntas sobre a primeira formação especializada desses cirurgiões-dentistas e os motivos que os levaram a cursar outra especialidade para integrar a Ortodontia com a Implantodontia. Os resultados demonstraram que a maioria dos cirurgiões-dentistas entrevistados buscou adquirir conhecimentos multidisciplinares, mas que a busca por maiores ganhos financeiros também foi um dos principais motivos para a obtenção de outro título de especialista.(AU)

In pursuance of conducting a multidisciplinary oral rehabilitation for a partially edentulous adult patient with malocclusion, there must be a dental specialist team working synchronically. Together they must define the most suitable treatment plan to accomplish stable occlusion and facial harmonization. However, if one single dentist intends to conduct a multidisciplinary oral rehabilitation for a partially edentulous adult patient with malocclusion, he should have the expertise in multiple specialties to competently diagnose, plan and conduct the case. A total of 305 dental specialists in both orthodontics and implantology were interviewed and answered a questionnaire in order to collect relevant information about the integration of orthodontics to implantology to place dental implants on partially edentulous adult patients that also need orthodontic treatment. This study was divided in a trilogy of scientific articles. This, the Part 3, refers to questions about their first post graduate training and the reasons that led them to get another specialist title to integrate orthodontics to implantology. The results showed that the majority of interviewed dentists sought to acquire multidisciplinary knowledge. But the surch for greater financial gains was also one of the main reasons for obtaining another specialist title.(AU)

Assuntos