RESUMO
PURPOSE: To evaluate the oral health-related quality of life (OHRQoL) of individuals diagnosed with Fanconi anemia (FA). METHODS: A cross-sectional study was conducted with FA patients from two Brazilian referral centers. Participants underwent a complete dental, periodontal, and oral mucosa examination, as well as assessment of resting salivary flow. The short version of the Oral Health Impact Profile (OHIP-14) questionnaire was administered. Descriptive and bivariate analyses were performed, followed by multivariate analysis to examine the impact of independent variables on OHRQoL. RESULTS: The study included 20 (57.1%) males and 15 (42.9%) females, with a mean age of 18.9 years. Oral leukoplakia (OL) was found in 18 individuals. The overall OHIP-14 score was 9.9 ± 10.5. Individuals aged ≥ 16 years had higher OHIP-14 scores, indicating worse OHRQoL for physical pain (p = 0.007), psychological discomfort (p = 0.001), physical disability (p = 0.03), psychological disability (p = 0.001), handicap (p = 0.004), and overall score (p = 0.007). Females reported more negative OHRQoL than males for physical pain (p = 0.02), psychological discomfort (p = 0.03), psychological disability (p = 0.009), and overall score (p = 0.02). Individuals with OL had an overall OHIP-14 score 1.83 times higher than those without OL (95% CI: 1.02-3.28; p = 0.04). Lower salivary flow correlated with higher overall OHIP-14 scores (95% CI: 0.14-0.84; p = 0.01). CONCLUSION: This study represents the first attempt to evaluate OHRQoL in individuals with FA. The presence of OL and reduced salivary flow were identified as predictors of a negative impact on OHRQoL. It is imperative to integrate patients' quality of life in the clinical treatment protocols for the FA population.
Assuntos
Anemia de Fanconi , Saúde Bucal , Qualidade de Vida , Humanos , Masculino , Feminino , Estudos Transversais , Adolescente , Adulto Jovem , Anemia de Fanconi/psicologia , Inquéritos e Questionários , Brasil , Adulto , Leucoplasia Oral/psicologia , Criança , Análise MultivariadaRESUMO
The aim of this study was to evaluate the impact of oral conditions and health-related quality of life (HRQoL) on oral health-related quality of life (OHRQoL) in children and adolescents with blood coagulation disorders and hemoglobinopathies (BCDH). The study was cross-sectional and included 61 individuals aged 2 to 18 years with BCDH. Exams for dental caries (dmft/DMFT index), oral hygiene (simplified oral hygiene index - OHI-S), and gingival health (modified gingival index - MGI) were performed. The pediatric quality of life inventory™ (PedsQL™) generic core scale and oral health scale were used to measure HRQoL and OHRQoL. Spearman's correlation coefficient (ρ) and the Mann-Whitney test (α = 0.05) were conducted to assess the relationship between covariates and the PedsQL™ oral health scale. The mean PedsQL™ oral health scale score was 76.66 (SD = 21.36). Worse OHRQoL was correlated with poor oral hygiene (ρ = -0.383; p: 0.004), poor gingival health (ρ = -0.327; p = 0.014), and better HRQoL (ρ = 0.488; p < 0.001). Greater untreated dental caries experience was associated with worse OHRQoL (p = 0.009). Worse oral health status in children and adolescents with BCDH negatively impacts OHRQoL, and OHRQoL and quality of life analyzed from a generic perspective are positively correlated constructs in this population.
Assuntos
Transtornos da Coagulação Sanguínea , Cárie Dentária , Hemoglobinopatias , Saúde Bucal , Qualidade de Vida , Humanos , Criança , Adolescente , Feminino , Masculino , Estudos Transversais , Saúde Bucal/estatística & dados numéricos , Pré-Escolar , Cárie Dentária/psicologia , Hemoglobinopatias/psicologia , Hemoglobinopatias/fisiopatologia , Hemoglobinopatias/complicações , Transtornos da Coagulação Sanguínea/psicologia , Estatísticas não Paramétricas , Índice de Higiene Oral , Índice Periodontal , Índice CPO , Inquéritos e Questionários , Fatores Socioeconômicos , Higiene BucalRESUMO
BACKGROUND: The use of communication technologies has allowed a substantial improvement in telediagnosis. OBJECTIVES: To evaluate the feasibility and diagnostic agreement of synchronous teleconsultation compared to physical standard examination for temporomandibular disorders (TMD) and orofacial pain. METHODS: Sixty-one patients (50 women, 11 men) with a mean age of 46.07 years referred to the Orofacial Pain Ambulatory Service (SAMDOF -UFPR) were evaluated remotely. They were then examined in person by another evaluator, blinded for the first evaluation. Data on the experience and level of satisfaction with the teleconsultation were also collected. RESULTS: For each type and subtype of TMD, diagnostic agreement values, sensitivity, specificity, positive predictive values and negative predictive values were calculated with a 95% confidence interval. 'Almost perfect' agreement was found for Myalgia (k = 0.915), Arthralgia (k = 0.863), disc displacement without reduction without limited opening (k = 0.955) and no TMD (k = 1.00). 'Substantial' agreement for the subtypes headache attributed to TMD (k = 0.761), disc displacement without reduction with limited opening (k = 0.659) and subluxation (k = 7.82). The diagnoses of local myalgia (k = 0.573), myofascial pain with referral (k = 0.524) and disc displacement with reduction (k = 0.563) obtained 'moderate' agreement. Degenerative joint disease (k = 0.170) and disc displacement with reduction with intermittent locking (k = 0.000) obtained 'weak' and 'no agreement', respectively. More than 90% of the participants were satisfied and reported no discomfort during the assessment, agreeing to participate in another teleconsultation. CONCLUSION: Synchronous teleconsultation proved to be feasible and presented adequate diagnostic agreement for the main painful TMDs, especially for the diagnosis of myalgia and arthralgia. This format was also well accepted among patients.
Assuntos
Dor Facial , Estudos de Viabilidade , Transtornos da Articulação Temporomandibular , Humanos , Transtornos da Articulação Temporomandibular/diagnóstico , Feminino , Masculino , Pessoa de Meia-Idade , Dor Facial/diagnóstico , Adulto , Consulta Remota , Sensibilidade e Especificidade , Exame Físico/métodos , Idoso , Reprodutibilidade dos TestesRESUMO
INTRODUCTION: Fanconi anemia (FA) is a recessive hereditary disease characterized by bone marrow failure, and the treatment is hematopoietic stem cell transplantation (HSCT). Patients diagnosed with FA are more predisposed to develop oral squamous cell carcinoma (SCC), and this risk increases in transplant patients. The clinical characteristics of the oral manifestations of SCC in this group of patients do not differ from the lesions present in patients without the disease; however, they can be diagnosed in young patients and less common locations, such as, for example, in the buccal mucosa. OBJECTIVE: To report a case series of patients diagnosed with FA with oral SCC. METHOD: Included in this case series are six patients diagnosed with SCC in the buccal mucosa with similar clinical characteristics. FINAL CONSIDERATIONS: There are still difficulties in establishing the natural history of oral lesions in patients with FA. Thus, disclosing a series of cases with similar changes may be relevant to improving and refining the multidisciplinary team's clinical view of suspected SCC or oral potentially malignant disorders (OPMD), providing surveillance and timely management.
Assuntos
Carcinoma de Células Escamosas , Anemia de Fanconi , Transplante de Células-Tronco Hematopoéticas , Neoplasias Bucais , Humanos , Anemia de Fanconi/complicações , Anemia de Fanconi/diagnóstico , Anemia de Fanconi/terapia , Neoplasias Bucais/diagnóstico , Mucosa BucalRESUMO
Abstract The aim of this study was to evaluate the impact of oral conditions and health-related quality of life (HRQoL) on oral health-related quality of life (OHRQoL) in children and adolescents with blood coagulation disorders and hemoglobinopathies (BCDH). The study was cross-sectional and included 61 individuals aged 2 to 18 years with BCDH. Exams for dental caries (dmft/DMFT index), oral hygiene (simplified oral hygiene index - OHI-S), and gingival health (modified gingival index - MGI) were performed. The pediatric quality of life inventory™ (PedsQL™) generic core scale and oral health scale were used to measure HRQoL and OHRQoL. Spearman's correlation coefficient (ρ) and the Mann-Whitney test (α = 0.05) were conducted to assess the relationship between covariates and the PedsQL™ oral health scale. The mean PedsQL™ oral health scale score was 76.66 (SD = 21.36). Worse OHRQoL was correlated with poor oral hygiene (ρ = -0.383; p: 0.004), poor gingival health (ρ = -0.327; p = 0.014), and better HRQoL (ρ = 0.488; p < 0.001). Greater untreated dental caries experience was associated with worse OHRQoL (p = 0.009). Worse oral health status in children and adolescents with BCDH negatively impacts OHRQoL, and OHRQoL and quality of life analyzed from a generic perspective are positively correlated constructs in this population.
RESUMO
Por apresentarem maior risco de sangramento durante a realização de procedimentos odontológicos, pacientes diagnosticados com coagulopatias ou trombopatias hereditárias apresentam, frequentemente, dificuldade de acesso à assistência odontológica na Atenção Primária em Saúde. Alguns centros especializados no tratamento dessas doenças contam com o cirurgião-dentista como parte da equipe multiprofissional, permitindo que a maioria dos pacientes realizem o acompanhamento odontológico em tais serviços. Este estudo tem como objetivo relatar a experiência dos discentes de graduação e pós-graduação em Odontologia da Universidade Federal do Paraná na reabertura do ambulatório odontológico de assistência à pacientes com coagulopatias e trombopatias hereditárias do estado. Com a aposentadoria da profissional responsável pelos atendimentos odontológicos deste serviço, os pacientes ficaram desassistidos. Para suprir a demanda reprimida, o ambulatório foi reaberto como atividade extramuros da graduação e pós-graduação em Odontologia. Este fato possibilitou, além da retomada ao cuidado odontológicode pacientes com predisposição a hemorragias, o aprimoramento dos alunos no atendimento de pacientes com comprometimento sistêmico. A reabertura de um ambulatório de alta complexidade em saúde como campo de prática acadêmico é atípico, uma vez que comumente o processo se dá de forma inversa: o discente ingressando em um serviço bem estabelecido. Na presente experiência, os discentes tiveram atuação fundamental no restabelecimento da assistência à saúde pelo ambulatório de Odontologia do hemocentro (AU).
Debido a su mayor riesgo de hemorragia durante los procedimientos dentales, los pacientes diagnosticados con coagulopatías o trombopatías hereditarias a menudo tienen dificultades para acceder a la atención dental en la Atención Primaria de Salud. Algunos centros especializados en el tratamiento de estas enfermedades cuentan con el odontólogo como parte del equipo multidisciplinario, haciendo que la mayoría de los pacientes se sometan a un seguimiento odontológico en dichos servicios. Este estudio tiene como objetivo reportar la experiencia de estudiantes de pre y posgrado en Odontología de la Universidade Federal do Paraná en la reapertura de laconsulta externa de odontología para pacientes con coagulopatías y trombopatías hereditarias en el estado. Con la jubilación del profesional responsable de la atención odontológica de este servicio, los pacientes quedaron desatendidos. Para atender la demanda reprimida, se reabrió el ambulatorio como actividad extramuros para los cursos de grado y posgrado en Odontología. Este hecho posibilitó, además de la reanudación de la atención odontológica de los pacientes con predisposición a la hemorragia, la mejora de los estudiantes en la atención de los pacientes con deterioro sistémico. La reapertura de una clínica de salud de alta complejidad como campo de práctica académica es atípica, ya que el proceso comúnmente se da a la inversa: el estudiante ingresa a un servicio bien establecido. En la experiencia actual, los estudiantes tuvieron un papel fundamental en el restablecimiento de la atención de la salud por parte de la consulta externa de Odontología del Hemocentro (AU).
Due to their increased risk of bleeding during dental procedures, patients diagnosed with hereditary coagulopathies or thrombopathies often have difficulty in accessing dental care in primary health care. Some centres specialised in the treatment of these diseases have a dentist as part of the multidisciplinary team, making most patients undergo dental follow-up in such services. This study aims to report the experience of undergraduate and graduate students in dentistry at the Federal University of Paraná in the re-opening of the dental outpatient clinic for patients with hereditary coagulopathies and thrombopathies in the State of Paraná. With the retirement of the dentist accounting for local dental care, the patients were left unattended. To meet the repressed demand, the dental outpatient clinic was re-opened as an extramural activity for undergraduate and postgraduate courses in dentistry. This fact made it possible to improve the students' care for patients with systemic impairment, in addition to resuming dental care for patients with predisposition to haemorrhage. The re-opening of a highly complex clinic as a field of academic practice is atypical, as the process commonly takes place in reverse order, that is, with the student entering well-established service. In the present experience, the students played a fundamental role in the re-establishment of dental care at the blood centre (AU).
Assuntos
Estudantes de Odontologia , Transtornos da Coagulação Sanguínea , Assistência Odontológica , Serviço de Hemoterapia , Equipe de Assistência ao Paciente , Atenção Primária à SaúdeRESUMO
Fanconi anemia is a rare autosomal recessive disease. In this disease, cytokine pathways can induce the bone marrow failure that is observed in individuals with Fanconi anemia. Interleukin IL-17 exhibits a protective effect in organisms because it induces neutrophil recruitment and shows a pathological role in several models of autoimmune diseases, periodontal disease, cancer, allograft rejection, and graft versus host disease. Polymorphisms in the IL17A and IL17RA genes were evaluated from DNA in saliva, comparing individuals with or without Fanconi anemia, using models of genotypic transmission (additive, dominant, and recessive). Polymorphisms in the IL17A and IL17RA genes (rs2241044 [C allele], rs879577 [C allele], rs9606615 [T allele], and rs2241043 [C allele]) were risk factors for developing Fanconi anemia. We also performed an analysis of gene markers with clinical variables in the Fanconi group. Polymorphisms in the IL17A gene (rs3819025 [A allele] and rs2275913 [G allele], respectively) were associated with an age of less than 20 years (p = 0.026; RP 0.65) and the female sex (p = 0.043; RP 0.88). The IL17RA gene was also associated with age and the presence of leukoplakia (a potentially malignant oral disorder). An age of less than 20 years was associated with rs917864 (T allele; p = 0.036; RP 0.67). The presence of leukoplakia was associated with rs17606615 (T allele; p = 0.042; RP 0.47). To our knowledge, this is the first study that associates IL17A and IL17RA gene polymorphisms with Fanconi anemia and examines rs2241044 polymorphisms in scientific literature thus far.
Assuntos
Anemia de Fanconi , Adulto , Feminino , Humanos , Adulto Jovem , Anemia de Fanconi/genética , Genótipo , Interleucina-17/genética , Interleucina-17/metabolismo , Polimorfismo de Nucleotídeo Único , Receptores de Interleucina-17/genética , Fatores de Risco , MasculinoRESUMO
Abstract Fanconi anemia is a rare autosomal recessive disease. In this disease, cytokine pathways can induce the bone marrow failure that is observed in individuals with Fanconi anemia. Interleukin IL-17 exhibits a protective effect in organisms because it induces neutrophil recruitment and shows a pathological role in several models of autoimmune diseases, periodontal disease, cancer, allograft rejection, and graft versus host disease. Polymorphisms in the IL17A and IL17RA genes were evaluated from DNA in saliva, comparing individuals with or without Fanconi anemia, using models of genotypic transmission (additive, dominant, and recessive). Polymorphisms in the IL17A and IL17RA genes (rs2241044 [C allele], rs879577 [C allele], rs9606615 [T allele], and rs2241043 [C allele]) were risk factors for developing Fanconi anemia. We also performed an analysis of gene markers with clinical variables in the Fanconi group. Polymorphisms in the IL17A gene (rs3819025 [A allele] and rs2275913 [G allele], respectively) were associated with an age of less than 20 years (p = 0.026; RP 0.65) and the female sex (p = 0.043; RP 0.88). The IL17RA gene was also associated with age and the presence of leukoplakia (a potentially malignant oral disorder). An age of less than 20 years was associated with rs917864 (T allele; p = 0.036; RP 0.67). The presence of leukoplakia was associated with rs17606615 (T allele; p = 0.042; RP 0.47). To our knowledge, this is the first study that associates IL17A and IL17RA gene polymorphisms with Fanconi anemia and examines rs2241044 polymorphisms in scientific literature thus far.
RESUMO
Introduction: The bias of unrealistic optimism is people's tendency to believe that they are less likely to experience negative events than others. Dental professionals are part of a high-risk group for COVID-19. Objectives: The objective of this study is to investigate whether unrealistic optimism bias, concern, and regret can affect the adoption of preventive measures by these professionals. Methods: We conducted a cross-sectional observational study of dentists recruited remotely by using an electronic form sent by email and social media. A five-point scale was used to identify whether unrealistic optimism, concern, and regret affected the adoption of preventive measures. The study included a total of 339 dentists. The group considered to be unrealistically optimistic accounted for 24.8% of the sample. Results: Unrealistic optimism negatively affected the use of protective equipment by dental professionals. Conversely, concern positively affected preventive measures. Conclusions: Although most dentists are realistic about the risk of infection compared with their peers, those with optimistic bias might be more susceptible to the disease, as they tend not to adopt recommended protective measures in the workplace. Future studies should also investigate ways of debiasing.
RESUMO
This study aimed to describe the telediagnosis of oral lesions through a telehealth program offered in the State of Paraná, southern Brazil. This report included all oral medicine-related teleconsultations between January 2015 and December 2019. Primary care dentists from the public health services of the state were trained to use the Telessaúde Brasil Redes platform, a national telehealth program that provides telediagnostic support through teleconsultations with specialists. Clinical information and images of oral lesions were solicited to each teleconsultation request. An oral medicine specialist evaluated the cases and provided diagnostic hypotheses, management, and referral suggestions. Finally, dentists were invited to evaluate the services. A total of 162 cases were submitted by 44 dentists. The patient's main complaint was described in 98.8% of cases, while the duration/evolution and the type of lesions were 64.81% and 40.12%, respectively. No images were attached to 19 (11.70%) patients. The information sent was sufficient for diagnostic reasoning in 125 (77.16%) requests. The specialist considered 78 cases (48.1%) to be resolved in primary care. Among respondents (45.7%), dentists considered that the teleconsultation "totally attended" their needs in 92% of requests. The description of the telehealth platform usage in oral medicine in Paraná showed the need to improve the participation of primary care dentists and the quality of clinical information provided as barriers to be overcome, aiming for the best usage of the platform.
Assuntos
Medicina Bucal , Consulta Remota , Telemedicina , Brasil , Humanos , Atenção Primária à Saúde/métodos , Saúde PúblicaRESUMO
The objective of this study is to present a tool to help understand how variables associated with oral cancer prevention relate to each other in a social network. A search of the Scopus database was performed using terms related to oral cancer and prevention from 2000 to 2020. The keywords were used as nodes and were analyzed using NodeXL, which produced the network graphic analysis. From the 1004 publications available, 4038 different keywords were obtained and then grouped into 75 constructs based on conceptual similarity. The most influential nodes were risk factors, comorbidities, epidemiology, and treatment. However, topics such as technology, telemedicine, self-examination, and diagnostic delay remain far removed from central relations. Network analysis enabled us to observe the bias of biological and basic science in the field and identify a need for studies concerning primary prevention, behavioral interventions, and inequalities in oral cancer.
Assuntos
Diagnóstico Tardio , Neoplasias Bucais , Bibliometria , Humanos , Neoplasias Bucais/diagnóstico , Neoplasias Bucais/prevenção & controle , Pesquisa , Análise de Rede SocialRESUMO
AIM: To identify the main barriers to dental care access for patients with inherited bleeding (IBD) and hemoglobin disorders (HbD). METHODS: Patients with IBD and HbD were invited to participate in this study between August 2019 and March 2020. Data were collected through a questionnaire consisting of socioeconomic and demographic items and questions about access to dental services and history of dental treatment. Univariate and multiple Poisson regression model was used to determine associations between professional refusal of dental care and other co-variables (p < .05). RESULTS: The participants (29.1%) have already had professional refusal of dental care and participants with IBD (53.2%) did not feel confident with their local dentist due to their bleeding tendency. Most (64.6%) felt apprehensive about visiting the local dentist and high prevalence of refusal to provide dental care was associated with age (prevalence ratio [PR] = 1.021; 95% confidence interval [CI] = 1.010-1.032). Individuals with low bleeding risk were less likely to be denied dental care by a professional compared to those with high bleeding risk (PR = 0.536; 95%CI = 0.291-0.990). CONCLUSION: Professional refusal of dental care was high among patients with IBD, particularly older adults and with an increased risk of bleeding.
Assuntos
Assistência Odontológica , Hemoglobinas , Idoso , Humanos , Inquéritos e QuestionáriosRESUMO
OBJECTIVE: The objective of this observational study was to evaluate telediagnosis of oral lesions using smartphone photography. MATERIALS AND METHODS: Individuals with visible oral lesions composed a convenience sample. The lesions were photographed using a smartphone camera and emailed along with clinical information to three evaluators, who formulated up to two diagnostic hypotheses for each case. A total of 235 photographs from 113 clinical cases were obtained. The evaluators answered questions regarding referral decisions, requests for additional tests, diagnostic difficulties, and image quality. The diagnostic hypotheses were compared to the gold standard by means of percent agreement and kappa coefficient. Consensual face-to-face diagnoses of three specialists-when only a clinical diagnosis was necessary-or histopathological results-when a biopsy was necessary-were considered the gold standard. RESULTS: The telediagnosis was similar to the gold standard in 76% of the cases, and kappa coefficients showed almost perfect agreement (k = 0.817-0.903). The evaluators considered that referrals could have been avoided on an average of 35,4% of the cases. CONCLUSION: Diagnosis of oral lesions using images taken with a smartphone showed almost perfect agreement and diagnostic accuracy comparable to face-to-face diagnosis.
Assuntos
Smartphone , Telemedicina , Biópsia , Humanos , Fotografação/métodos , Encaminhamento e Consulta , Telemedicina/métodosRESUMO
INTRODUCTION: Graft-versus-host disease (GVHD) is a systemic complication that can affect patients undergoing allogeneic hematopoietic stem cell transplantation (HSCT) and the mouth is one of the places affected by the disease (oGVHD). Topical corticosteroids are used to control the painful symptoms, causing a local immunosuppression and increasing the risk for opportunistic infections. OBJECTIVE: This study aims to report a case of a 42-year-old woman, diagnosed with Chronic Myeloid Leukemia, who developed oGVHD and herpes simplex virus (HSV) infection after HSCT. CASE REPORT: oGVHD was confirmed by incisional biopsy and viral infection by HSV types 1 and 2 was confirmed by PCR. Topical and systemic corticotherapy and antiviral therapies were instituted. The immunosuppression intensified viral infection and antimicrobial photodynamic therapy (aPDT) was instituted as an adjuvant treatment. aPDT application, along with the patient's immune recovery, antivirals and corticosteroids resulted in clinical improvement of oral lesions. FINAL CONSIDERATIONS: This study highlights aPDT as an effective adjunct therapy in the local treatment of opportunistic infections in onco-hematological patients.
Assuntos
Doença Enxerto-Hospedeiro , Transplante de Células-Tronco Hematopoéticas , Herpes Simples , Adulto , Antivirais/uso terapêutico , Feminino , Doença Enxerto-Hospedeiro/tratamento farmacológico , Transplante de Células-Tronco Hematopoéticas/efeitos adversos , Herpes Simples/tratamento farmacológico , Humanos , SimplexvirusRESUMO
Abstract Objective: To analyze if the oral health conditions in children and adolescents are associated with hemophilia (PROSPERO-42020168192). Material and Methods: The search strategy was performed in PubMed, Scopus, Lilacs/BBO, Web of Science, Cochrane, and Grey literature databases. Two independent researchers assessed the risk of bias in these studies by the Newcastle-Ottawa Scale. For the meta-analysis, the clinical conditions data were extracted as numerical variables according to their indexes, such as dental caries experience (dmft/DMFT), gingival condition (Modified Gingival Index - IGM), and oral hygiene (Plaque Index - PI). The quality of the evidence of the meta-analysis was evaluated by the GRADE tool (GRADEproGDT). Results: From a total of 431 studies, 27 were included, and 10 were included in the meta-analysis. The studies presented a moderate risk of bias, ranging from 2 to 7 points. The dental caries experience in primary (-0.62; CI95%: -1.68-0.43) and permanent dentitions (-0.05; CI95%: -0.69-0.59), gingival condition (-0.12; CI95%: -0.27-0.03), and oral hygiene (0.36; CI95%: -0.06-0.77) did not differ between the groups. Conclusion: Based on studies with very weak evidence, there were no differences in the oral health conditions of children and adolescents with and without hemophilia (AU).
Assuntos
Humanos , Masculino , Feminino , Recém-Nascido , Lactente , Pré-Escolar , Criança , Adolescente , Higiene Bucal , Criança , Saúde Bucal , Adolescente , Hemofilia A/sangue , Índice PeriodontalRESUMO
Abstract: This study aimed to describe the telediagnosis of oral lesions through a telehealth program offered in the State of Paraná, southern Brazil. This report included all oral medicine-related teleconsultations between January 2015 and December 2019. Primary care dentists from the public health services of the state were trained to use the Telessaúde Brasil Redes platform, a national telehealth program that provides telediagnostic support through teleconsultations with specialists. Clinical information and images of oral lesions were solicited to each teleconsultation request. An oral medicine specialist evaluated the cases and provided diagnostic hypotheses, management, and referral suggestions. Finally, dentists were invited to evaluate the services. A total of 162 cases were submitted by 44 dentists. The patient's main complaint was described in 98.8% of cases, while the duration/evolution and the type of lesions were 64.81% and 40.12%, respectively. No images were attached to 19 (11.70%) patients. The information sent was sufficient for diagnostic reasoning in 125 (77.16%) requests. The specialist considered 78 cases (48.1%) to be resolved in primary care. Among respondents (45.7%), dentists considered that the teleconsultation "totally attended" their needs in 92% of requests. The description of the telehealth platform usage in oral medicine in Paraná showed the need to improve the participation of primary care dentists and the quality of clinical information provided as barriers to be overcome, aiming for the best usage of the platform.
RESUMO
Abstract: The objective of this study is to present a tool to help understand how variables associated with oral cancer prevention relate to each other in a social network. A search of the Scopus database was performed using terms related to oral cancer and prevention from 2000 to 2020. The keywords were used as nodes and were analyzed using NodeXL, which produced the network graphic analysis. From the 1004 publications available, 4038 different keywords were obtained and then grouped into 75 constructs based on conceptual similarity. The most influential nodes were risk factors, comorbidities, epidemiology, and treatment. However, topics such as technology, telemedicine, self-examination, and diagnostic delay remain far removed from central relations. Network analysis enabled us to observe the bias of biological and basic science in the field and identify a need for studies concerning primary prevention, behavioral interventions, and inequalities in oral cancer.
RESUMO
ABSTRACT Introduction: Fanconi anemia (FA) is a rare genetic disease characterized by congenital malformations and bone marrow failure. One of the most common oral diseases in individuals with FA is periodontitis and adequate self-perception of periodontal status could contribute to its prevention and early detection. Aim: To compare oral health self-perception, measured by a questionnaire, with the clinical oral condition of patients with FA. Methods and Results: Fifty-six patients with FA, over 11 years of age, answered a questionnaire about dental history and self-reported oral health. Decayed, missing, and filled teeth (DMFT), Visible Plaque Index (VPI) and Gingival Bleeding Index (GBI) were measured. The median age of participants was 21 years (min 11, max 44), 31 (55%) were females and 25 (45%) males. Thirty-five (62.5%) participants rated their oral condition as satisfactory and 7 (12.5%) participants reported tooth mobility, 10 (17.9%) exposed roots and 21 (37.5%) gingival bleeding. Clinical examination detected average DMFT = 5.23, VPI = 31.36% and GBI = 33.77%. The gingival bleeding report was more frequent among individuals with higher GBI (p = 0.014). The DMFT was higher in those who had already undergone dental treatments (p = 0.031). There was an association between participants who presented dental caries and who rated their oral health as poor (p = 0.03). The question "Do your gums bleed easily?" had good accuracy in the evaluation of periodontal disease (p = 0.68). Conclusion: Oral health self-perception of individuals with FA about gingival inflammation was associated with their gingival bleeding index.
Assuntos
Humanos , Masculino , Feminino , Criança , Adolescente , Adulto , Anemia de Fanconi , Doenças Periodontais , AutorrelatoRESUMO
INTRODUCTION: Fanconi anemia (FA) is a rare genetic disease characterized by congenital malformations and bone marrow failure. One of the most common oral diseases in individuals with FA is periodontitis and adequate self-perception of periodontal status could contribute to its prevention and early detection. AIM: To compare oral health self-perception, measured by a questionnaire, with the clinical oral condition of patients with FA. METHODS AND RESULTS: Fifty-six patients with FA, over 11 years of age, answered a questionnaire about dental history and self-reported oral health. Decayed, missing, and filled teeth (DMFT), Visible Plaque Index (VPI) and Gingival Bleeding Index (GBI) were measured. The median age of participants was 21 years (min 11, max 44), 31 (55%) were females and 25 (45%) males. Thirty-five (62.5%) participants rated their oral condition as satisfactory and 7 (12.5%) participants reported tooth mobility, 10 (17.9%) exposed roots and 21 (37.5%) gingival bleeding. Clinical examination detected average DMFTâ¯=â¯5.23, VPIâ¯=â¯31.36% and GBIâ¯=â¯33.77%. The gingival bleeding report was more frequent among individuals with higher GBI (pâ¯=⯠0.014). The DMFT was higher in those who had already undergone dental treatments (pâ¯=⯠0.031). There was an association between participants who presented dental caries and who rated their oral health as poor (pâ¯=⯠0.03). The question "Do your gums bleed easily?" had good accuracy in the evaluation of periodontal disease (pâ¯=⯠0.68). CONCLUSION: Oral health self-perception of individuals with FA about gingival inflammation was associated with their gingival bleeding index.
RESUMO
Systemic medications categorized as diphenylhydantoin, calcineurin inhibitor and calcium channel blocker may have effects on the oral cavity by modifying the inflammatory and immune response and causing undesired tissue proliferative reactions. Calcineurin inhibitors are medications commonly used for long periods in patients undergoing allogeneic hematopoietic stem cell transplant (HSCT) and solid organ transplantation. Medication-related fibrovascular hyperplasia (MRFH) is an extra gingival hyperplastic nodular growth associated with medications use. This study reports five cases of pediatric patients (6 to 12-years-old) diagnosed with Fanconi anemia (FA) after HSCT who presented similar oral mucosal lesions associated with the use of cyclosporine, phenobarbital and amlodipine. After excision of the lesions, histopathological analysis described them as pyogenic granuloma (PG). As the aetiology of the lesions manifested by the patients was associated with the use of medications, the final diagnosis was MRFH. Despite the clinical and histopathological similarity between PG and MRFH, it is fundamental to know the aetiological agent for achieving definitive diagnosis and correct management. Considering the etiologic agent (medication) and histopathological findings, it is suggested that the most appropriate term for this manifestation should be "medication-related fibrovascular hyperplasia". The correct nomenclature related to extra gingival hyperplastic lesions identified in patients on medications with potential to induce hyperplastic reactions should be adopted to facilitate scientific communication and improve the treatment.