Desconforto percebido no tratamento com overdenture mandibular sobre implante: estudo prospectivo com participantes de um ensaio clinico
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2019-08-21
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Universidade Federal de Goiás
Resumo
Introduction: Multiple factors may influence the intention and behavior of edentulous
patients when it comes to oral rehabilitation, including their perception of costs and access to
dental care. However, another relevant aspect of adherence to treatments is the way patients
perceive the burdens associated with treatment itself. Perceived burdens by patients, due to
the treatment process, can be defined as the burden during treatment and the impact of
treatments on daily activities and on the patient's well-being. Objective: To evaluate the
patient's perceived burdens during the rehabilitation treatment stages with mandibular
overdenture retained by one or two implants. Material and Methods: A sample of 47 total
edentulous individuals was rehabilitated with conventional maxillary total prosthesis and
mandibular overdenture retained by 1 (n=24) or 2 implants (n=23). Each of the relevant
clinical procedures adopted during all stages of treatment were listed in order to record
patients' perceptions of their burdens four stages of treatment - pre-surgical, surgical, post-
surgical and prosthetic - defined and divided according to clinical specific and sequential
procedures at each stage. The questionnaire was applied in two periods: (1) before the
treatment in the planning consultation of the preoperative treatment and (2) immediately
after each of the treatment stages. Patients were asked to rank how burdensome are each of
these items, measured on a four-point ordinal scale: (1) not at all; (2) somewhat
burdensome; (3) very burdensome; and (4) extremely burdensome. The first application was
considered as the patient’s "expected" burden, and the second application was defined as the
"experienced" burden of the patient. After each dental visit, the clinician also evaluated the
perceived burdens on a four-point ordinal response scale, according to the quality of the
procedure: (1) very favorable; (2) favorable; (3) unfavorable; and (4) very unfavorable. Data
were first analyzed by means of descriptive statistics and bivariate comparison tests. Beside
that, the reliability of the composite item score of the scale of overloads and subscales was
calculated using Cronbach's Alpha to measure the internal consistency of the instruments.Results: The perceived burdens were low both before and after the treatment. Regarding the
measured global scores, from a range of 1-4, we found 0.46± and 0.33± for expected and
perceived burdens, respectively. In all clinical stages the perceived burdens were lower than
expected except for anesthesia and suture removal. Although the duration of surgery was
higher for the group of two implants (92.2±21.4 vs 71.3±13.0; p<0.001), the operator
perceived burden did not differ between groups (p=0.259).There was a significant moderate
correlation between patient’s experience burdens and the burdens perceived by the operator
(r s =0.33; p=0.026). The analysis showed that the patient's overall burden was significantly
affected by the patient's expected burdens (f= 44.9, p<0.001) and by the operator's
perceived burdens (f=4.26, p=0.045) (Adjusted R 2 =0,57). Conclusion: Both perceived and
expected burdens were considered low. Perceived burdens had lower scores than expected
burdens at all clinical stages, except for anesthesia and suture removal. Although the duration
of surgery was higher for the group of two implants the operator perceived burden did not
differ between groups. In addition, the analysis showed that the patient's overall burden was
significantly affected by the expected burdens of the patient and by the operator perceived
burdens.
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Citação
SOUSA, C. G. Desconforto percebido no tratamento com overdenture mandibular sobre implante: estudo prospectivo com participantes de um ensaio clinico. 2019. 53 f. Dissertação (Mestrado em Odontologia) - Universidade Federal de Goiás, Goiânia, 2019.