RESUMO

INTRODUCTION: Health information and communication technologies, such as Teledentistry, can help expand access to dental health public services making it more effective. OBJECTIVE: To analyze the factors that affect the implementation of a Teledentistry system in dental health public services. METHODS: The study follows the Implementation Research methodological framework. A mixed-method approach was applied using a triangulation design-sequential model to collect, analyze, and interpret qualitative and quantitative data about the implementation of a Teledentistry system. A compulsory teleconsultation from the general dentist was planned to access periodontics specialized care. The study was developed in a South Brazilian capital city and the platform of the Santa Catarina Telehealth Center was used. Qualitative and quantitative data were collected sequentially to achieve a better understanding of implementation research issues. RESULTS: In seven months, 68 teleconsulting was performed by 22% of the general dentists, prior to the referrals on periodontics. Only one reported not needing to refer the patient to the periodontist as a result of the teleconsulting guidance. Teledentistry system implementation and usage were influenced by the managers' political and administrative awareness to deploy and maintain the intervention. Lack of sufficient resource investment, lack of system integration, and internet failures were relevant limiting factors. The teleconsultant guidelines contributed to general dentistry's better decision-making regarding treatment, urgency of case management, and prioritization of referrals to the periodontists CONCLUSION: Identifying the factors that influence the implementation and finding solutions to overcome them, can prevent future failures and improve usage of the system.

Assuntos

Consulta Remota , Telemedicina , Brasil , Odontólogos , Humanos

RESUMO

The most important microscopic characteristic of Cyclosporine A-induced gingival overgrowth is fibroepithelial hyperplasia. OBJECTIVE: The objective was to investigate the influence of previous exposure to Cyclosporine A over gingival epithelium in experimental periodontitis in rats. METHODS: Twenty Wistar rats with 12 weeks-old were divided into four groups with 5 animals each: Control Group (CG); Cyclosporine Group (CsAG); Ligature group (LG) and Cyclosporine and Ligature Group (CsALG). Daily doses of CsA (10 mg/kg) were applied to CsAG and CsALG during 60 days since the beginning of the experiment and, a ligature was placed in LG and CsALG 30 days after the beginning of the experiment. After 60 days, animals were euthanized and gingival tissue was processed to histomorphometric analysis of epithelial thickness (mm2), immunohistochemical expression of PCNA (%) and inflammatory response. Data were analyzed by Kruskal-Wallis and Mann Whitney at 0.05 significance level. RESULTS: Considering epithelial thickness, CG was thinner than all groups, CsALG was the largest and CsAG and LG were similar between each other. Regarding the PCNA expression CG (16.46 ± 9.26) was similar to CsAG (34.47 ± 19.75) and, LG (59.02 ± 10.33) was similar to CsALG (40.59 ± 18.25). Significant difference (p < 0.05) occurred only in inflammation presence comparing CG/LG and CsAG/CsALG. A weak positive correlation between the number of PCNA+ and inflammatory cells (p = 0.001; r = 0.611) was observed. CONCLUSION: Based on these results it was concluded that the enlargement of gingival epithelium observed in experimental periodontitis can be increased by previous exposition to CsA and inflammatory conditions enhanced proliferative activity of the keratinocytes.