RESUMO
Historically, facial prosthetics have successfully rehabilitated individuals with acquired or congenital anatomical deficiencies of the face. This history includes extensive efforts in research and development to explore best practices in materials, methods, and artisanal techniques. Presently, extraoral maxillofacial rehabilitation is managed by a multiprofessional team that has evolved with a broadened scope of knowledge, skills, and responsibility. This includes the mandatory integration of different professional specialists to cover the bio-psycho-social needs of the patient, systemic health and pathology surveillance, and advanced restorative techniques, which may include 3D technologies. In addition, recent digital workflows allow us to optimize this multidisciplinary integration and reduce the active time of both patients and clinicians, as well as improve the cost-efficiency of the care system, promoting its access to both patients and health systems. This paper discusses factors that affect extraoral maxillofacial rehabilitation's present and future opportunities from teamwork consolidation, techniques utilizing technology, and health systems opportunities.
RESUMO
The study aim was to explore the underlying dimensions of patients' perceptions and experiences of facial disfigurement following surgery for cancer treatment, using a qualitative approach based on individual in-depth interviews. Data analysis and interpretation consisted of separating responses into phrases or statements with a single thematic aspect. Subsequently, a number of dimensions and categories were created using a deductive-inductive content analysis. Three main categories emerged: discovering of the cancer, coping with the disease and disfigurement, and reconstructing a new identity. The initial stage elicited feelings of fear, denial, and guilt as a reaction to the stigma and prejudice. Coping strategies included resignation and acceptance, deepening religiosity, reinforcement of familiar cohesion, and creation of a social network of solidarity and support. The final stage comprised incorporation of the altered facial image, rehabilitation possibilities, reconstruction of personality and self-image, and the feeling of having overcome the disease. It was concluded that individual experiences are complex, challenging, and have striking effects on their lives. There is an urgent need for training and improvement in human resources to manage these patients in a multidisciplinary approach, aimed at their reintegration into society and reducing the prejudice and stigma of the disease and disfiguration.
Assuntos
Face , Neoplasias de Cabeça e Pescoço/cirurgia , Pacientes/psicologia , Adulto , Idoso , Feminino , Neoplasias de Cabeça e Pescoço/psicologia , Humanos , Masculino , Pessoa de Meia-Idade , Pesquisa QualitativaRESUMO
In the present investigation, an experimental dental arch model fabricated in epoxy was assayed in Kratos universal testing machine to study the mechanical behavior of ethylene and vinyl acetate copolymer (EVA) in the form of mouthguard for sports and flat plate. The following variables were considered: thickness (3 and 4-mm plates), temperature (room and mouth temperature) and presence/absence of artificial saliva. Mechanical properties of EVA were tested under compressive strength: apparent absorbed energy (J.mm-1), maximum tension (N.mm-1), maximum dislocation (mm) and maximum strength (N). Data were recorded and modeled mathematically. Regarding the absorbed energy, maximum tension and maximum force, it was verified that the higher the thickness of the mouthguards, the better the results of force dissipation and redirection to the system and to several regions of the dental arch. In the presence of saliva and close to mouth temperature, the material responded positively to these alterations, resenting increased ductibility as well as improved mechanical responses. Regarding maximum dislocation, it was observed a better accommodation of the occlusion under conditions that simulate those observed in the oral environment. In conclusion, EVA proved to be an adequate material for fabrication of mouthguards and interocclusal splints. In addition, EVA showed good results in force dissipation and demonstrated a shock-absorbing capacity and a great protection potential.
Um modelo experimental de arco dentário, obtido em epóxi, acoplado a uma máquina universal de ensaios Kratos, foi utilizado para estudar o comportamento mecânico do copolímero de etileno e acetato de vinila (EVA), na forma de protetor bucal para esporte e placa plana. As seguintes variáveis foram observadas: espessura (lâminas de 3 e 4 mm), temperatura (ambiente e bucal) e presença ou ausência de saliva artificial. As propriedades mecânicas do EVA, foram testadas ao esforço compressivo: energia aparente absorvida (J.mm-1), tensão máxima (N.mm-1), deslocamento máximo (mm) e força máxima (N). Dados foram registrados e modelados matematicamente. Considerando a energia aparente absorvida, tensão máxima e força máxima, verificou-se que com o aumento da espessura dos protetores bucais houve melhores resultados de dissipação de forças compressivas e seu redirecionamento para o sistema e diversas regiões do arco dental. Com a presença de saliva e temperatura próxima a bucal o material respondeu positivamente a essas alterações aumentando sua ductibilidade apresentando assim melhora em sua resposta mecânica. Com respeito ao deslocamento máximo observou-se que houve melhor acomodação da oclusão quando em condições próximas à bucal. Conclue-se que o EVA provou ser um material adequado para a confecção de protetores bucais para esporte e placas interoclusais.O EVA mostrou melhores resultados na dissipação de forças demonstrando sua grande capacidade amortecedora e grande potencial de proteção.