Programa de Pós-graduação em Odontologia

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    Ansiedade e problema de manejo de comportamento após tratamento odontológico na primeira infância: revisão de escopo
    (Universidade Federal de Goiás, 2024-09-02) Alves, Thais Cristina de Souza; Costa, Luciane Ribeiro Rezende Sucasas da; http://lattes.cnpq.br/9906371509661305; Faria, Patricia Correa De; Antunes, Denise Espindola; Costa, Luciane Ribeiro De Rezende Sucasas Da
    Introduction: Dental fear/anxiety (DFA) and dental behavior management problems (DBMP) in dental care are common during procedures performed in early childhood. This relationship between them has been observed in primary studies, that have specifically evaluated the effect of behavior management techniques and/or specific procedures in reducing DFA and DBMP in children under the age of six. Little is known about the impact of early childhood dental experience on DFA and DBMP in older children. Objective: The objective of this scoping review was to map and synthesize the evidence on the impact of early childhood dental treatment DFA and DBMP throughout childhood. Methods: The search for articles was carried out in the electronic databases APA PsycNet, Cochrane, Embase, LILACS, PubMed, Scopus and Google Scholar. For the search, terms related to preschool children, DFA, DBMP, caries, follow-up were combined. There were no restrictions on the language of publication or date of publication. Clinical trials and longitudinal observational studies carried out with children aged between two and six years at baseline were included. Narrative and systematic reviews, cross-sectional studies, case-controls, case reports and series, clinical trial protocols, abstracts in conference proceedings, editorials and opinion pieces were excluded. The process of selecting studies and extracting information was carried out by two researchers. Information on the treatments carried out, management techniques and follow-up time was extracted from the studies and summarized in a chart and text. Results: Out of a total of 742 studies identified, nine were included, of which five were randomized clinical trials, one was a non-randomized clinical trial and three were prospective longitudinal studies. The change in DFA level after dental care in early childhood was measured in six studies. In three there was an improvement. In the others, the DFA level worsened (n=2) or there was no change (n=1). In the other studies, DBMP was measured in isolation or in conjunction with DFA. Of the three, two showed an improvement in behavior. Follow-up times ranged from seven days to 30 months. Conclusion: From the studies selected, it was noted that there is no consensus on the effect of dental treatment carried out in early childhood on DFA and DBMP at future visits. The number of studies is limited, and the methods and results are heterogeneous.
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    Desenvolvimento e implementação de uma escala de autoeficácia em saúde oral para usuários de overdenture mandibular
    (Universidade Federal de Goiás, 2023-11-06) Moore, Steven Kadeem; Leles, Cláudio Rodrigues; http://lattes.cnpq.br/6740286066154410; Leles, Cláudio Rodrigues; Srinivasan, Murali; Nogueira, Túlio Eduardo
    Introduction: Self-efficacy, a concept coined by Albert Bandura, refers to an individual's belief in their ability to perform behaviors necessary to achieve specific performance goals. In the context of oral health, self-efficacy plays a pivotal role in influencing behaviors related to oral hygiene practices. Objective: This study aimed to develop an oral health self-efficacy scale and evaluate the relationship between oral health self-efficacy and the peri-implant health status of individuals using implant-retained overdentures. Materials and Methods: This was a cross-sectional observational study nested within a clinical trial at the Prosthesis and Implant Research Center (NPPI) at the Federal University of Goiás (UFG), Goiânia, Brazil. The project received approval from the Ethics Committee for Research at the Federal University of Goiás. A 25-item questionnaire was developed based on the Dental Self-Efficacy Scale (DSE), revised by a panel of experts, translated into Brazilian Portuguese, and piloted for clarity. The 25-item OHSE-OVER questionnaire collected data across four dimensions: (1) routine challenges – 4 items; (2) self-rated performance – 5 items; (3) attitudes towards oral health – 6 items; (4) challenges in special occasions – 10 items. The questionnaire score was calculated by first reversing the scale of dimensions 1 and 4 and then summing the scores of all dimensions. The final score repre-sented oral health self-efficacy (higher scores indicating greater oral health self-efficacy). The study included patients with mandibular overdentures retained by implants as part of a larger study involving mini-implants. Randomization was based on a surgical approach and loading protocol. All clinical procedures took place at NPPI/UFG, with no cost to the participants. Twelve-month follow-up assessments included pillar plaque evaluations, peri-implant bleeding, and denture surface plaque. A single clinician conducted clinical assessments for all patients and administered the Oral Health Self-Efficacy Evaluation for Overdenture Users (OHSE-OVER) questionnaire in an interview format during evaluation. Clinical data were compared with OHSE-OVER questionnaire responses. Statistical analyses, including Confirmatory Factor Analysis and regression, were conducted using IBM-SPSS 22.0 and Mplus 8.8 software, with a significance level of p < 0.05. Results: Out of the initially invited 74 patients, 69 participated in the study. Among them, the majority were female (63.8%), aged between 36 and 81 years (mean = 65.0; SD = 8.1), with nearly half being current or ex-smokers (47.8%), and most were taking regular medication (82.6%). Self-efficacy scores varied across different dimensions, with an overall mean score of 2.35. The scale demonstrated good reliability (Cronbach's alpha = 0.799). Con-firmatory factor analysis supported the four-factor model, with the removal of two items due to their low factor loadings. Regression analysis revealed that higher self-efficacy was linked to better denture hygiene outcomes in the overall scale, a positive association between oral health self-efficacy and sex(male), as well as an inverse relationship between oral health self-efficacy and plaque index in dimensions 1 and 2, respectively. No significant associations were observed in dimensions 3 and 4. Conclusion: The research underscores the fundamental role of self-efficacy in determining oral health outcomes in individuals using implant-retained overdentures. It establishes a significant association between oral health self-efficacy and key oral hygiene indicators, such as plaque index and denture hygiene, in patients relying on implant-retained overdentures. Additionally, the validation of the OHSE-OVER's psychometric robustness and internal structure reinforces its efficacy as a valuable instrument specifically developed to assess and address oral health self-efficacy in patients with mandibular overdentures, both in clinical and research contexts.
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    Avaliação por tomografia computadorizada de feixe cônico da posição relativa de mini-implantes instalados com cirurgia não guiada para retenção de overdentures mandibulares
    (Universidade Federal de Goiás, 2024-05-29) Moura Neto, Leuçon de Oliveira; Leles , Claudio Rodrigues; http://lattes.cnpq.br/6740286066154410; Leles , Cláudio Rodrigues; Hartmann, Roberto; Costa, Nádia do Lago
    Introduction: Parallelism between mini-implants plays a fundamental role in the effectiveness of retentive overdenture systems. Objectives: This cross-sectional study is part of a randomized clinical trial and aimed to evaluate the relative position of mini-implants installed to retain a mandibular overdenture. Furthermore, the aim was to investigate the association of surgical protocol, technical and anatomical factors in the relative position of mini-implants through cone beam computed tomography images. Materials and methods: Tomography scans were analyzed in 73 patients who received four single-body mini-implants. Drilling was performed with a 1.6mm needle drill and 2.2mm Pilot Drill, according to the patient's bone density and the orientation of the surgical guide. Post-insertion CBCT images were analyzed using E-Vol-DX software with bone tissue removal filters. Divergence angles between implants and between the implants and the overdenture insertion path were measured using CliniView 10.2.6 software. Results: The divergence angles between the implants ranged from 0° to 22.3° (mean=4.2; SD=3.7) and from 0° to 26.2° (mean=5.3; SD=4 ,1) in the lateral and frontal projections, respectively (p<0.001). Only 1 (0.2%) and 3 (0.7%) of the measurements were greater than 20° in the lateral and frontal views, respectively. The average angulations between the implant and the overdenture insertion path were 9.3° (SD=7.5) and 4.0° (SD=2.9) for the lateral and frontal views, respectively (p<0.001). Regression analyzes showed a significant association between implant divergence and frontal view projection (p<0.001), greater distance between paired implants (p=0.017), surgical protocol (p=0.002), greater insertion torque final (p=0.011) and deeper preparation with the needle drill (p<0.001). The position of the implants was also associated with divergence in relation to the insertion path (p<0.05) Conclusions: The results showed that the mini-implants in this study were placed with low divergence angles and satisfactory parallelism. Factors such as shorter distances between implants, higher bone density and a flapless surgical approach have contributed positively to improving the parallelism of mini-implants.
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    Ambiente escolar promotor de saúde, qualidade educacional e saúde bucal de adolescentes das capitais brasileiras: estudo com base na Pesquisa Nacional de Saúde do Escolar (PeNSE 2015)
    (Universidade Federal de Goiás, 2020-02-20) Nery, Newillames Gonçalves; Jordão, Lidia Moraes Ribeiro; http://lattes.cnpq.br/8872679253627903; Freire, Maria do Carmo Matias; http://lattes.cnpq.br/6056344372250078; Freire, Maria do Carmo Matias; Costa, Luciane Ribeiro de Rezende Sucasas da; Novais, Tatiana Oliveira; Weiss, Veruska Prado Alexandre; Faria, Patrícia Corrêa de
    Evidence about the influence of contextual factors of schools and municipalities on the oral health of adolescents is scarce, with important gaps in relation to the school environment. The aim of this study was to investigate associations between the potential support of schools for oral health promotion, the educational quality of the school and oral health outcomes among adolescents in the Brazilian State Capitals. The study was cross-sectional, with individual and aggregated approaches. Data were obtained from the Brazilian National Adolescent School-Based Health Survey (PeNSE) and the Basic Education Development Index (IDEB), conducted in 2015, in addition to other secondary sources. The individual variables referred to students in the 9th grade of elementary schools: sociodemographic, prevalence of dental pain and oral health-related behaviours (frequencies of dental visits, toothbrushing, and soft drinks and sweets consumption, cigarette and alcoholic beverages experimentation). The contextual variables were related to schools, Brazilian capitals and regions (educational quality of the school – measured by IDEB, Human Development Index - HDI and Gini Index). The analyses were carried out in three steps. In step 1, the Oral Health Promoting School Environment (OHPSE) indicator was obtained using the Categorical Principal Components Analysis (CATPCA), to measure the potential support of school environment for oral health promotion in public and private schools of the capitals. Bivariate associations (Chi-square test) between OHPSE and contextual variables were verified. In step 2, associations between OHPSE (explanatory variable) and dental pain and oral health-related behaviours (outcome variables) were tested in two-level multi-level mixed-effects Poisson regression. And in step 3, with data aggregated by capitals, associations were verified between IDEB and the outcomes: the OHPSE indicator and its dimensions (in public schools), dental pain and oral health-related risk behaviours. In all steps, the level of significance was 5%. The results were: Step 1 - There was a higher frequency of schools with higher OHPSE in the public schools (58.1%), and in regions and capitals with a lower Gini Index (52.8% / 55.7%) and higher HDI (57.4% / 61.0%), respectively. Step 2 - In the adjusted model, private and public schools with higher OHPSE had 6%, 6% and 4% lower prevalence rates of a “low frequency of annual dental visits” [PR = 0.94 (95%CI 0.90; 0.99)], “high weekly soft drinks consumption” [PR = 0.94 (95%CI 0.89; 0.99)] and “high weekly sweets consumption” [PR = 0.96 (95%CI 0.93; 1.00)], respectively. Schools with intermediate OHPSE had 12% and 8% higher prevalence ratios of a “low daily toothbrushing frequency” [PR = 1.12 (95%CI 1.03; 1.23)] and “cigarette experimentation” [PR = 1.08 (95%CI 1.01; 1.16)]. OHPSE was not associated with dental pain and "alcoholic beverages experimentation". Step 3: IDEB correlated with the OHPSE dimension referred to within-school aspects, with “low daily toothbrushing frequency” and with “low frequency of annual dental visits”. In the adjusted regression model, capitals with the higher IDEB were associated with “low daily toothbrushing frequency” [B = 1.560 (95% CI 0.360; 2.760), p = 0.013; β = 0.519]. It was concluded that were associations between the potential support of school environment for oral health promotion and some oral health outcomes of adolescents in the Brazilian capitals. Higher potentials for oral health promotion (in private and public schools) were related to more favorable behaviours regarding dental visits and consumption of food with added sugars, and less favorable for toothbrushing frequency and cigarette experimentation, while better educational quality (in public schools) was related to low toothbrushing frequency among adolescents. Inequalities among schools regarding oral health promotion were also found, indicating the need to reorient public policies for the oral health of schoolchildren.
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    Avaliação clínica e termográfica após exodontias de terceiros molares inferiores e diferentes terapias de fotobiomodulação: um ensaio clínico randomizado duplo-cego
    (Universidade Federal de Goiás, 2024-01-30) Paula, Laiz Moreira de; Roriz, Virgílio Moreira; http://lattes.cnpq.br/4602848040014140; Roriz, Virgílio Moreira; Freitas, Gileade Pereira; Ferraz, Emanuela Prado
    The aim of this study was to compare the parameters of pain, edema, temperature and soft tissue closure, after extractions of lower third molars, in dental sockets that received two different photobiomodulation therapy (PBMT) protocols. This is a double-blind, split-mouth randomized clinical study, in which 31 participants had their teeth 38 and 48 extracted. After extractions, one of the dental socket received PBMT at a wavelength of 808 nanometers (nm) (infrared – group 808) and the other dental socket received irradiation at wavelengths of 808 nm and 660 nm associated simultaneously (infrared + red – group 808+660), both in 3 points in the region of the dental socket, after the surgical procedure and on the 3rd and 7th days. Patients were evaluated for pain perception using the Visual Analogue Scale (VAS) and measurements were taken of facial edema, in centimeters (cm), temperature using Infrared Thermography, in degrees Celsius (ºC) and the distance between the edges of surgical wounds, in millimeters (mm), in the immediate postoperative period and on the 3rd, 7th and 28th days. For both 808+660 and the 808 groups, the mean VAS values for pain were 1.45 for the 3rd day and 0.52 for the 7th day. Regarding the assessment of facial edema, the averages for the pogonion-tragus measurement, on the 3rd day, were 15.38 cm for the 808+660 group and 15.48 cm for the 808 group and the averages for the labial commissure measurement-tragus, on the 3rd day, was 11.97 cm for the 808+660 group and 12 cm for the 808 group. The average temperatures for the 808+660 group were 34.9 ºC for the 3rd day and 35 ºC for the 7th day and for group 808, it was 34.9 ºC for the 3rd and 7th days. Regarding the size of the dental socket, measured on the 28th day, the averages for the 808+660 group were 5.25 mm (length) and 2.38 mm (width) and for the 808 group they were 5.12 mm (length) and 2.45 mm (width). All patients benefited from the effects of both PBMT protocols and no complications or adverse effects were encountered. After statistical analyses, adopting the value of p<0.05, no significant differences were found for the parameters of edema, temperature and socket healing, when comparing the two protocols. For the pain parameter, significant differences were found only for the 7th day, being greater for the 808+660 group (p=0.031). It can be concluded that the addition of the red laser (660nm) and the increase in energy did not intensify the benefits in reducing pain, edema or closing the soft tissues of the alveoli of lower third molars, in the protocols used here
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    Risco e prevalência de câncer oral em pacientes com diferentes tipos de lúpus eritematoso: uma revisão sistemática e metanálise
    (Universidade Federal de Goiás, 2024-02-02) Rodrigues, Larissa Rosa Santana; Silva , Brunno Santos de Freitas; http://lattes.cnpq.br/1575170017237525; Silva, Brunno Santos de Freitas; Silva, Maria Alves Garcia Santos; Silva, Lorena Rosa
    Lupus erythematosus (LE) is an autoimmune disease that can manifest itself systemically and/or cutaneous, with several clinical presentations, some of which are: systemic lupus erythematosus (SLE) and discoid lupus erythematosus (DLE). The SLE and DLE forms are those that commonly present the highest risk of malignancy, including oral cancer, thus justifying the review of this entity in the latest update of the group potentially malignant oral disorders (DOPMs). More than 40% of patients with SLE present oral manifestations, including: oral ulcers, lichenoid lesions, leukoplasia lesions, plaques, petechiae, elevated keratotic plaques, purpura and erythematous areas. The literature presents several controversies regarding the relationship between LE and oral cancer, which is why several epidemiological studies have been carried out. With the aim of evaluating the risk and prevalence of oral cancer in patients with SLE or DLE, a systematic review of the literature with meta-analysis was carried out. This review followed the recommendations of PRISMA (Preferred Reporting Items for Systematic Review and Meta-analyses), initially, searches were carried out in the following databases: PubMed, Scopus, EMBASE, LILACS, Web of Science, Scopus and Livivo and, Google Scholar and ProQuest, without restrictions on language or publication date. The reading of the studies was conducted in two phases, independently, in which three reviewers, first, evaluated the titles and abstracts of 3580 studies and, subsequently, carried out the complete reading of 28 works to include the studies according to the criteria pre-defined eligibility criteria. At the end of phases one and two, eight studies were included for data extraction and qualitative analysis, two of which were cross-sectional studies and six were cohorts. The risk of bias was carried out using the JBI critical assessment tool (Joanna Briggs Institute) for analytical cross-sectional studies and cohort studies. The analytical cross-sectional studies were analyzed separately from the cohorts, and, coincidentally, participants in the cross-sectional studies had DLE, and those in the SLE cohorts. Through quantitative data analysis, the pooled prevalence of oral cancer in patients with DLE was 10% (95% CI; 0.03-0.13; I 2 = 59%; p = 0.12). The pooled risk indicated a significantly increased risk of oral cancer in patients with SLE (RR = 2.69; 95% CI, 1.75-4.16; I 2 = 0%; P = 0.78) compared to general population. The present review shows that patients with SLE/DLE have an increased risk of developing oral cancer, and that the oral manifestations of these entities are multiform. Individuals with SLE/DLE should be closely monitored to monitor the oral manifestations of SLE/DLE, and for early detection and treatment of oral cancer when appropriate.
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    Terapia de fotobiomodulação associada a l-glutamina e ácido hialurônico para prevenção e controle da mucosite oral em pacientes com câncer de boca e orofaringe submetidos a radioterapia e ou quimioradioterapia: ensaio clínico randomizado controlado
    (Universidade Federal de Goiás, 2024-02-09) Santos, Rodrigo Wilmes dos; Mendonça, Elismauro Francisco de; http://lattes.cnpq.br/2305019128015847; Mendonça, Elismauro Francisco de; Assunção Junior, José Narciso Rosa; Morais, Marília Oliveira
    Oral mucositis (OM) is an important adverse effect of radiotherapy (RT) in the mucosal region of the oral cavity and oropharynx, which can range from erythematous areas to large confluent ulcerations. The clinical severity of this inflammatory condition can lead to interruption of oncological treatment and impact the patient's prognosis. In this context, photobiomodulation therapy (TFBM) has been shown to be effective in reducing the severity of OM, controlling pain and promoting the repair of compromised mucous membranes. Other therapies have been investigated to control OM, such as the use of compounds based on l-glutamine (L-G) and hyaluronic acid (HA) (Topical Medication Treatment - TTM), both in the form of a gel and as a mouthwash. The objective, therefore, of this study was to investigate whether the application of TTM associated with TFBM and the Dental Preventive Protocol (PPO) would be more effective than the exclusive use of TFBM associated with PPO in preventing and controlling severe OM. Patients with oral cancer (BC) (lip and oral cavity) and oropharynx (n=48) undergoing adjuvant radiotherapy (≥60 Gy) and/or chemoradiotherapy (QRT) were investigated and randomized into two groups: A ( TFBM + PPO) (n=24) and B (TFBM + PPO + TTM) (n=24). To evaluate the effectiveness of therapies, the degree of clinical severity of OM was evaluated according to the scales of the National Cancer Institute (NCI) and the World Health Organization (WHO); patients' quality of life using the OHIP-14 questionnaires and symptom perception using the PROMS scale; number of RT interruptions and rate of adherence to cancer treatment. OM was a constant event in the groups evaluated, and all participants showed signs and symptoms from the 7th RT session onwards. Evaluation of the 30th session showed that both in group A and group B, severe OM occurred, 83.3% (n=20) and 87.5% (n=21), respectively. When evaluated based on the WHO scale, 50% (n=12) of group A had severe OM, while in group B only 8.3 of the participants had OM grade 3 and no grade 4. Regarding adherence to the PPO, note It is clear that the members of group B had significantly greater adherence than group A throughout the entire RT treatment [7th, 14th, 21st and 30th RT sessions (p<0.05)]. In the quality of life (QOL) results, it was observed that QRT therapies had a negative impact on QOL in relation to oral health in both groups, with group A having a higher score during all moments of treatment. Regarding the scores obtained in the OHIP-14 questionnaire, the results demonstrated that participants in group B had less impacted QoL throughout the course of RT or QRT, being that in the 14th, 21st, and 30th RT session assessments (p<0.001) reached statistical significance. In summary, the results indicate that the therapeutic combination of TTM+TFBM+PPO, although it did not prevent the clinical manifestation of chemoradio-induced BM, allowed greater adherence to oncological treatment and less impact on QoL.
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    Incidência de desfechos protéticos associados à overdenture mandibular retida por quatro mini-implantes: estudo prospectivo aninhado a ensaio clínico randomizado
    (Universidade Federal de Goiás, 2023-10-20) Silva, Jésio Rodrigues; Leles, Cláudio Rodrigues; http://lattes.cnpq.br/6740286066154410; Leles, Cláudio Rodrigues; Roriz, Virgílio Moreira; Hartmann, Roberto
    The use of mini-implants is gaining popularity due to less surgical complexity and advantages for cases of atrophic mandibles, and a new system of mini-implants was recently launched (Straumann Optiloc Mini-Implant System®). Aim: This prospective study is part of a randomized clinical trial and aimed to evaluate the incidence of prosthetic outcomes and associated factors in completely edentulous patients after the insertion of mandibular overdentures retained by four mini-implants. Methods: Completely edentulous individuals using conventional complete dentures were recruited for the installation of four mini-implants for treatment with mandibular overdenture. The study combined two surgery protocols (flapped or flapless) and loading (immediate or delayed). During follow-up, the incidence of prosthetic complications and maintenance events were recorded at scheduled and unscheduled appointments. Independent variables were considered as age, gender, surgery and loading protocol, and ridge form (CAWOOD & ROWEL, 1988). A classification of prosthetic outcome (six-field protocol) (PAYNE et al., 2001) was assessed at the end of the follow-up period. Descriptive statistical analysis was performed, with measurements of incidence rates, as well as Kaplan-Meier survival analysis and Cox regression, considering the significance level of p<0.05. Results: 74 participants were accompanied, with a mean age of 64 years (35-80 years), and total follow-up time varied between 19 and 26 months. There were a total of 182 prosthetic events in 147 consultations, 88 of which (59.87%) were unscheduled. The most frequent event was the need for minor adjustments to the base of the overdenture (incidence of 38), due to sore spots; followed by minor repairs at the base (incidence of 16); total (incidence of 21) or partial (incidence of 11) exchange of matrices; indirect relining (incidence of 21) due to instability; new intraoral capture (incidence of 8); fracture of the overdenture (n = 1) and tooth fracture (n = 1). The outcome of success was attributed to 69 participants (93.2%). The most significant predictor for the incidence of adjustments was the flapless surgery protocol (p=0.011), and the age was the most one for the incidence of total matrix replacement (p=0.031). There was no statistically significant difference in the incidence of other prosthetic complications with regard to gender, loading protocol, or ridge form (p>0.05). Conclusions: There was a high incidence of prosthetic events, but they were considered acceptable and mostly represented by small adjustments or repairs to the overdenture base in the initial period of treatment. The high survival and success rate of the implant and prosthesis shows that this is a favorable treatment option for this follow-up, and it is recommended to establish scheduled appointments for the expected events. Longer follow-ups are recommended to obtain more representative data regarding prosthetic outcomes.