TEDE Coleção:

Avaliação de restaurações CAD-CAM com técnica simplificada: estudo clínico longitudinal prospectivo

Wed, 06 Jul 2022 00:00:00 GMT

Título: Avaliação de restaurações CAD-CAM com técnica simplificada: estudo clínico longitudinal prospectivo Autor: Michelon, Marcela Mendes Medeiros Primeiro orientador: Telles, Daniel de Moraes Abstract: The purpose of this study was to evaluate the clinical performance through the success and survival rates of feldspathic ceramics (CEREC blocs) CAD-CAM (computer-aided design - computer aided manufacturing) restorations, made with a simplified technique. A sample with anterior and posterior CAD-CAM feldspathic ceramics crowns was evaluated. The restorations were carried out using CEREC omnicam system to produce indirect restorations without sintering or glaze. A new evaluation criteria (the UERJ criteria) was used for the clinical evaluation of the indirect restorations. Scores were also measured to assess patient satisfaction. A total of 56 crowns were inserted in 40 patients and evaluated for 2 years. Nine reparable complications were observed. No failures or irreparable complications were observed in the crowns. No significant association was found between age, gender, periodontal status, parafunctional habits and tooth type with the success and survival rate. The 2-year survival and success rates were 10.7% and 89.3% respectively. The overall mean of patient satisfaction was 9.7. CAD-CAM feldspathic crowns made with a simplified technique showed a high success rate after 2 years in function and proved to be a simple restorative treatment option, with high performance and patient satisfaction. The high success rate of CAD-CAM technology in feldspathic ceramics observed with this technique suggests resolubility, speed and reduced cost, in the rehabilitative treatment of a high-demand service. Instituição: Universidade do Estado do Rio de Janeiro Tipo do documento: Tese

Verniz fluoretado em pré-escolares: recomendações de uso e suas bases científicas

Tue, 27 Feb 2024 00:00:00 GMT

Título: Verniz fluoretado em pré-escolares: recomendações de uso e suas bases científicas Autor: Couto, Flávia Macedo Primeiro orientador: Santos, Ana Paula Pires dos Abstract: The aim of this study was to critically evaluate the evidence and recommendations on the use of fluoride varnish (FV) for the prevention and control of caries in preschoolers (children up to 71 months old). Three separate studies were conducted. In the first study, two investigators independently searched for recommendations and clinical practice guidelines (CPG) on the use of FV in preschoolers in October of 2021. This search was conducted on the first five pages of Google Search™ and in three CPG databases Also independently, the evaluators selected and included official documents from government bodies or pediatric dentistry associations on the use of VF and extracted and recorded the data. A third evaluator resolved any discrepancies. Each CPG identified underwent evaluation using the AGREE II instrument. Twenty-nine documents were included, 23 recommendations and 6 CPG. The recommendations exhibited variability based on age, caries risk, and application frequency. Only one out of the six CPGs scored over 70% in the AGREE II overall assessment. In the second study, a review of systematic reviews (SR) was conducted, including SR, with or without meta-analyses, of randomized and quasi-randomized controlled trials assessing the use of FV for caries prevention in preschoolers compared to placebo, standard care, or no intervention. The search, conducted in March 2023, involved eight electronic databases. Two reviewers independently selected SR and extracted their data. The methodological quality (MQ), risk of bias (RB), and certainty of evidence (CE) were accessed using AMSTAR-2, ROBIS, and GRADE, respectively. Of the 13 SRs included, six presented insufficient evidence; five SRs concluded that VF is effective; and two SRs suggested irrelevant clinical benefit. MQ was assessed as high in one SR, low in two and critically low in 11 SR. The RB was considered low in three SR and high in ten. The synthesis and results domain of SR was the most frequently assessed as high risk. The CE ranged from moderate to very low, with RB being the criterion that most contributed to reducing it. Study three investigated the presence of spin in the abstracts of the SRs included in study two. Two independent investigators assessed the presence of spin in the 21 items of the Yavchitz et al. (2016) spin classification, divided into the categories of misleading reporting, misleading interpretation and inappropriate extrapolation. The spin severity ranking was used, categorizing high, medium and low according to their position in the ranking. Ten of the 13 SRs had at least one item with spin and four of these had at least one item of high severity. The most frequent category was misleading reporting. Spin was present in the majority of the SRs included. Currently, the application of fluoride varnish is widely recommended and the CPGs that recommend its use are of low quality. The evidence on the anti-caries benefit of FV diverges in its conclusions, has critically low quality, a high risk of bias and presents spin in its abstracts. Instituição: Universidade do Estado do Rio de Janeiro Tipo do documento: Tese

O Impacto das consequências clínicas de envolvimento pulpar devido a cárie dentária na qualidade de vida de crianças e adolescentes

Thu, 29 Feb 2024 00:00:00 GMT

Título: O Impacto das consequências clínicas de envolvimento pulpar devido a cárie dentária na qualidade de vida de crianças e adolescentes Autor: Reis, Patrícia Papoula Gorni Primeiro orientador: Soviero, Vera Ligia Mendes Abstract: This thesis investigated the impact of the presence of clinical consequences of pulpal involvement due to dental caries on the quality of life of children and adolescents, consisting of two studies: a systematic review with meta-analysis and a cross-sectional study. In the systematic review with meta-analysis, unrestricted systematic searches were conducted in the main databases. Observational studies that assessed children and adolescents (P) with clinical consequences of pulpal involvement due to dental caries (E) compared to individuals without this condition (C) regarding the impact on oral health-related quality of life (OHRQoL)(O) were included. The methodological quality assessment of the studies was carried out using the Joanna Briggs Institute (JBI) Critical Appraisal Tool for cross-sectional studies. Random effects meta-analyses were performed to synthesize data on the impact on OHRQoL. The certainty of the evidence was assessed by GRADEpro. Twenty-nine cross-sectional studies were included in the systematic review. Five studies met all JBI criteria. The remaining 24 studies failed in one or more criteria. The meta-analysis of studies with outcomes in continuous variables found SMD = -2.24; 95% CI: -3.34, -1.14; I2 = 99. The meta-analysis with studies reporting outcomes in dichotomous data found OR: 0.52; 95% CI: 0.30, 0.90; I2 = 78%. The certainty of the evidence was very low. The evidence suggests that the presence of pulpal involvement negatively impacted the OHRQoL of the studied population. The results should be interpreted with caution due to the very low certainty of the evidence. In the cross-sectional study, the sample included 1,054 students aged 5, 8, and 12 from public schools in Petrópolis. Parents answered a questionnaire on socioeconomic information, report of tooth pain and the impact on their children's OHRQoL, through the C-OIDP (Child Oral Impact on Daily Performances). In the clinical examination, the presence of dental caries was assessed using the dmft/DMFT indexes, and clinical consequences of pulpal involvement were assessed using the pufa/PUFA index. The children were categorized into three groups of caries severity: group without caries, group with caries without pulp involvement, and group with caries and pulp involvement. Statistical analysis was performed using Chi-square tests, Mann-Whitney, Kruskal-Wallis. Robust Poisson Regression, with the impact on OHRQoL considered a categorical dependent variable, and Negative Binomial Regression, with the impact on OHRQoL considered a numerical dependent variable. Five-year-old children with pulp involvement had a 2.08 times higher prevalence (95% CI: 1.12-3.86) of impact, and their C-OIDP scores were 2.41 (95% CI: 1.04-5.59) higher, while eight-year-old children with pulp involvement had C-OIDP scores 2.06 higher (95% CI: 1.23-3.43) than those without caries. In the 12-year-old group, the presence of pulp involvement was not significantly associated with a negative impact on OHRQoL (p = 0.09). This study concluded that the presence of consequences of pulp involvement was associated with a negative impact on OHRQoL of children with 5 and 8 years old. The report of tooth pain was the variable most significantly associated with a higher negative impact on OHRQoL in children and adolescents. Instituição: Universidade do Estado do Rio de Janeiro Tipo do documento: Tese

Aferição da força muscular do sorriso gengival: uma nova abordagem

Mon, 26 Feb 2024 00:00:00 GMT

Título: Aferição da força muscular do sorriso gengival: uma nova abordagem Autor: Antunes, Karinne Bueno Primeiro orientador: Fischer, Ricardo Guimarães Abstract: Excessive gingival exposure is considered the second change with the greatest oral aesthetic impact, reflecting on self-esteem. Gummy smile, considering a gingival exposure from 3 mm, can have dental, skeletal and muscular etiologies, with lip hyperactivity being the most prevalent. Currently, the assessment of lip muscle strength (F) is carried out empirically, making the precision of some therapeutic methods difficult. The objective of this study was to create a method for evaluating muscular F related to the act of smiling, through the development of equipment that would make it possible to verify the strength exerted by the different muscles that move the upper lip during a smile, and to establish a correlation between the lip translation and individual/total F exercised. The sample consisted of 89 individuals, mean age 28 ± 8.4 (SD), 80.9% female and 19.1% male, divided into 4 groups (G): G1 - Upper lip hyperactivity (9%); G2 - Other causes (dental, skeletal or joints) (19.1%); G3 - Control (33.7%); G4 - Hyperactivity combined with one or more etiologies (38.2%). Equipment was developed to measure the F of each lip muscle during a smile, compared within the different G, through filming the movements of the equipment's springs analyzed by the Tracker® software. Statistical analysis was performed using SPSS 21.0 software and was subjected to the ANOVA test and then Tukey's post hoc test and the chi-square test. The results demonstrated that lip hyperactivity was the most prevalent isolated or combined etiology (68.2%) in the sample and that this group presented 30% greater strength than the other groups. G4 (0.15 N ±0.03) presented significantly higher F in the 6 muscles evaluated, compared to G2 (0.11 N ±0.03) and G3 (0.01 N ± 0.02) (p< 0.001). The zygomaticus major muscle on the right and left sides of G1 was significantly stronger than G2 and G3. A statistical difference was observed between the F of the zygomaticus major muscle (0.025 N ± 0.007) and the other muscles (0.0021 N ± 0.006 and 0.019 N ± 0.006, zygomaticus minor and lip elevator respectively), being the strongest in the entire the sample (p<0.001). The lip translation in mm was evaluated in its average F and the different displacements from 6 mm, observing a statistically significant difference (p<0.001) between 6mm and 7mm, 7mm and 8mm, 9mm and 10mm, and 9mm and 11mm. The largest DL forces were observed from 8 mm onwards (0.12± 0.02). Between 8/9 mm, 10/11 mm, and 11/12 mm, no significant difference was observed. It was concluded that lip hyperactivity alone or combined with other etiologies was the most prevalent cause of gummy smile. Individuals with lip hyperactivity showed greater muscle F compared to other etiologies or individuals without a gummy smile and, from 8 mm of lip displacement, an increased and significant muscle F is observed. Instituição: Universidade do Estado do Rio de Janeiro Tipo do documento: Tese