published_or_final_version / Medical Sciences / Master / Master of Medical Sciences

published_or_final_version / abstract / Dentistry / Doctoral / Doctor of Philosophy

Made available in DSpace on 2014-06-11T19:26:43Z (GMT). No. of bitstreams: 0 Previous issue date: 2012-09-28Bitstream added on 2014-06-13T18:55:04Z : No. of bitstreams: 1 sigolo_boo_me_mar.pdf: 587255 bytes, checksum: e858f63575fe2a2c021bd913ed6b5265 (MD5) / Face ao desenvolvimento dinâmico de conhecimento na área odontológica, é importante que os cirurgiões-dentistas (CDs) atualizem seus conhecimentos e saibam buscar as informações necessárias para o desenvolvimento e aprimoramento de sua prática clínica. A informação é um importante subsídio para esses profissionais no desenvolvimento de diagnósticos e na tomada de decisão sobre processos terapêuticos a serem utilizados. Objetivo geral desta pesquisa foi caracterizar o comportamento informacional de Cirurgiões Dentistas da especialidade de ortodontia e os objetivos específicos: 1) Conhecer os fatores que motivam ou impedem a busca informacional; 2) Detectar as principais necessidades de informação associadas à prática profissional dos CDs; 3) Identificar as fontes de informação mais empregadas para o desenvolvimento de seu trabalho. Utilizamos como referencial teórico dois modelos de comportamento informacional, o modelo de Wilson e Walsh (1996) e o de Leckie, Pettigrew e Sylvain (1996). Participaram da pesquisa dez cirurgiões-dentistas que atuam na especialidade de ortodontia e em clínicas/consultórios particulares na cidade de São Paulo e foram escolhidos utilizando-se a técnica de bola de neve. A coleta de dados foi realizada por meio de entrevista semi-estruturada e os resultados foram analisados utilizando-se a técnica de análise de conteúdo. Os resultados mostraram que a maioria das necessidades de informação dos CDs está relacionada com os cuidados dos pacientes, e isto os motiva a buscarem informações para atualizar, complementar e confirmar seus conhecimentos. Constatamos que os CDs têm uma forte preocupação em buscar atualizações sobre novas técnicas, materiais e procedimentos na área, empregando para isso fontes de informação, tais como: cursos... / Over the dynamic development of knowledge within dentistry field, it is important that dentist surgeons (DS) update their knowledge and know how to look for the necessary information to the development and improvement of clinical practices. Information is an essential support to these professionals concerning the development of diagnosis and decision-making on therapeutic processes. The objective of this research was to characterize the informational behavior of Dental Surgeons specialty of orthodontics and specific objectives: 1) To know the factors that motivate or hinder the search informational, 2) Detect the main information needs associated with the practice of professional DSs, 3) Identify the sources of information used for the development of their work. It was used as a theoretical two models of information behavior, the model of Wilson and Walsh (1996) and of Leckie, Pettigrew and Sylvain (1996). The participants of this study were ten dentists working in the specialty of orthodontics and clinics / private practices in the city of São Paulo (Brazil) that were chosen using the snowball technique. Data collection was conducted through semi-structured interviews and the results were analyzed using the technique of content analysis. The results have shown that most needs of information by DS are related to patient cares, which motivate them to look for information to update, complement and confirm their knowledge. It has been verified that the surgeons are strongly concerned with looking for updates on new techniques, supplies and proceedings within the orthodontics field, so that they make use of sources of information, such as: courses (specialization, professional improvement and development), congresses, journals, articles and books. When the DS need information to make decisions, solve clinical problems or confirm... (Complete abstract click electronic access below)

Orientador: Helen de Castro Silva Casarin / Banca: Regina Célia Baptista Belluzzo / Banca: Maria Cristiane Barbosa Galvão / Resumo: Face ao desenvolvimento dinâmico de conhecimento na área odontológica, é importante que os cirurgiões-dentistas (CDs) atualizem seus conhecimentos e saibam buscar as informações necessárias para o desenvolvimento e aprimoramento de sua prática clínica. A informação é um importante subsídio para esses profissionais no desenvolvimento de diagnósticos e na tomada de decisão sobre processos terapêuticos a serem utilizados. Objetivo geral desta pesquisa foi caracterizar o comportamento informacional de Cirurgiões Dentistas da especialidade de ortodontia e os objetivos específicos: 1) Conhecer os fatores que motivam ou impedem a busca informacional; 2) Detectar as principais necessidades de informação associadas à prática profissional dos CDs; 3) Identificar as fontes de informação mais empregadas para o desenvolvimento de seu trabalho. Utilizamos como referencial teórico dois modelos de comportamento informacional, o modelo de Wilson e Walsh (1996) e o de Leckie, Pettigrew e Sylvain (1996). Participaram da pesquisa dez cirurgiões-dentistas que atuam na especialidade de ortodontia e em clínicas/consultórios particulares na cidade de São Paulo e foram escolhidos utilizando-se a técnica de bola de neve. A coleta de dados foi realizada por meio de entrevista semi-estruturada e os resultados foram analisados utilizando-se a técnica de análise de conteúdo. Os resultados mostraram que a maioria das necessidades de informação dos CDs está relacionada com os cuidados dos pacientes, e isto os motiva a buscarem informações para atualizar, complementar e confirmar seus conhecimentos. Constatamos que os CDs têm uma forte preocupação em buscar atualizações sobre novas técnicas, materiais e procedimentos na área, empregando para isso fontes de informação, tais como: cursos... (Resumo completo, clicar acesso eletrônico abaixo) / Abstract: Over the dynamic development of knowledge within dentistry field, it is important that dentist surgeons (DS) update their knowledge and know how to look for the necessary information to the development and improvement of clinical practices. Information is an essential support to these professionals concerning the development of diagnosis and decision-making on therapeutic processes. The objective of this research was to characterize the informational behavior of Dental Surgeons specialty of orthodontics and specific objectives: 1) To know the factors that motivate or hinder the search informational, 2) Detect the main information needs associated with the practice of professional DSs, 3) Identify the sources of information used for the development of their work. It was used as a theoretical two models of information behavior, the model of Wilson and Walsh (1996) and of Leckie, Pettigrew and Sylvain (1996). The participants of this study were ten dentists working in the specialty of orthodontics and clinics / private practices in the city of São Paulo (Brazil) that were chosen using the snowball technique. Data collection was conducted through semi-structured interviews and the results were analyzed using the technique of content analysis. The results have shown that most needs of information by DS are related to patient cares, which motivate them to look for information to update, complement and confirm their knowledge. It has been verified that the surgeons are strongly concerned with looking for updates on new techniques, supplies and proceedings within the orthodontics field, so that they make use of sources of information, such as: courses (specialization, professional improvement and development), congresses, journals, articles and books. When the DS need information to make decisions, solve clinical problems or confirm... (Complete abstract click electronic access below) / Mestre

Objective: This research explored how time-to-event dental articles were indexed and reported, and sought solutions to help improve the reporting and identification of these articles, so that they could be more easily found and used to inform practice and research. Methods: Articles reporting time-to-event dental outcomes in humans were identified from the 50 dental journals with the highest impact factor for 2008. These were handsearched, identifying 'case' articles (n=95), active controls (likely false positives, n=91), and passive controls (other true negatives, n=6796). The medical subject headings (MESH) that had been assigned to the articles in MEDLINE, and words used in titles and abstracts describing time-to-events were compared between the 'cases' and controls. Time-to-event words and figures within articles were also sought, and reporting quality was assessed. Search strategies to identify time-toevent articles were developed, using indexing terms and free-text words. An independent cohort of articles was used to validate the search strategies, consisting of 148 time-to-event articles handsearched from 6514 articles in the 50 dental journals with the highest impact factor for 2012. The findings of the research were used to draft guidance to improve reporting, which was circulated amongst 78 stakeholder experts for comment, and modified. Results: MeSH indexing of time-to-event analyses was inconsistent and inaccurate, author descriptions in abstracts and titles varied, and the quality of time-to-event reporting and graphics in the body of those articles was poor. The burden faced by someone wishing to find and use these articles was considered high. Sensitive, precise and optimized electronic search strategies were developed and validated with sensitivities up to 92% and precisions up to 93%. The draft guidance attracted comment from 46 experts across 15 countries, with approximately 90% of the 130 comments accepted into the revised version. The importance of good quality reporting was endorsed, and there was high interest in commending the guidance to authors, reviewers, and training dental specialists. Conclusions: This research programme explored how time-to-event dental articles were reported, and used those findings to suggest solutions that would help to improve the identification and use of these data, reducing research waste.

Indiana University-Purdue University Indianapolis (IUPUI) / Orthodontics research investigates the methods in which tooth displacement may be directed in the tooth-periodontal ligament-bone-complex. In the biological environment, the periodontal ligament is the soft tissue responsible for the absorption of forces on teeth and has a direct connection to tooth mobility. Current research is limited in that it must be conducted in an in-vivo capacity. A major advancement in orthodontics research would be a testing method that allows for the development and analysis of orthodontic devices without a patient present. This study outlines the development and testing methods for the validation of an artificial periodontal ligament to be used in conjunction with an artificial-tooth-periodontal ligament-bone-complex. The study focused on finding the criteria in which consistent results were produced, the mixture that best simulated the human periodontal ligament’s mechanical behavior, and the robustness of the artificial-periodontal ligament-bone-complex. This study utilized a geometrically accurate denture mold filled with varying compositions of an artificial periodontal ligament for testing. Experiments focused on findings of viscoelasticity, curing times, and instantaneous responses of the teeth under direct orthodontic loading, as well as the changes in response from different teeth within the denture mold. Tests confirmed that a mixture composed of 50\% Gasket Sealant No. 2 and 50\% RTV 587 Silicone produced a substance that could adequately serve as an artificial periodontal ligament.

CoordenaÃÃo de AperfeiÃoamento de Pessoal de NÃvel Superior / O incremento na incidÃncia da fluorose dentÃria ocorrido nos Ãltimos tempos, à motivo de preocupaÃÃo dos epidemiologistas em nÃvel nacional e internacional. A diferenciaÃÃo entre as alteraÃÃes do esmalte fluorÃtico e nÃo fluorÃtico leva a importantes decisÃes em epidemiologia e saÃde pÃblica bucal. O objetivo deste estudo à investigar a capacidade dos cirurgiÃes-dentistas do serviÃo pÃblico de saÃde no municÃpio de Fortaleza, em diagnosticar a fluorose dentÃria, frente Ãs diversas afecÃÃes do esmalte dentÃrio, seus graus de severidade e a conduta terapÃutica apropriada a cada caso. Utilizou-se para isso um questionÃrio com questÃes semi-estruturadas, o qual foi aplicado a 200 cirurgiÃes-dentistas, de um universo de 527 profissionais do serviÃo pÃblico de saÃde de Fortaleza. O questionÃrio foi aplicado no local de trabalho dos participantes, cujas respostas se basearam na apresentaÃÃo de 20 fotografias digitalizadas de dentes com alteraÃÃes prÃprias do esmalte. A presenÃa ou ausÃncia de fluorose dentÃria e seus graus de severidade foram determinados pelo Ãndice de Dean. NÃo foram detectadas diferenÃas significativas no nÃvel de acerto do grau de fluorose, quando os respondentes foram classificados segundo a instituiÃÃo de graduaÃÃo (p>0,05). No entanto, aqueles profissionais menos experientes apresentaram melhor desempenho (p<0,05), tanto no diagnÃstico de fluorose, quanto na conduta mas nÃo no grau de severidade da doenÃa. Os profissionais gerenciados pela Secretaria Municipal de SaÃde obtiveram desempenho superior aos gerenciados pelo Estado, em todas as percepÃÃes do teste. Quanto ao agrupamento da amostra por especialidades, nenhuma diferenÃa significativa (p>0,05) foi encontrada entre os Grupos. A mÃdia de acertos no diagnÃstico diferencial da fluorose dentÃria foi de 7,70  0,15. Valores inferiores a 30% de acertos foram obtidos no diagnÃstico do grau de severidade da fluorose, destacando-se as formas mais graves como de maior percentual de acerto. A maioria (90%) dos respondentes admitiram ter sentido dificuldades no diagnÃstico da fluorose, apesar de 75% ter recebido informaÃÃo acerca do assunto no curso de graduaÃÃo, porÃm consideraram escassa e deficiente (79,5%). A mÃdia de acertos da conduta clÃnica foi considerada muito baixa (2,71  0,76). Cerca de 70% dos inquiridos solicitaram curso de capacitaÃÃo acerca do diagnÃstico diferencial da fluorose dentÃria. A partir desses resultados, conclui-se que os cirurgiÃes-dentistas que atuam no serviÃo pÃblico de saÃde de Fortaleza apresentaram um baixo nÃvel de conhecimento e falta de preparo adequado para o diagnÃstico da fluorose dentÃria, a percepÃÃo dos seus graus de severidade e definiÃÃo da conduta clÃnica apropriada. Sugere-se que estudos mais abrangentes sejam conduzidos a fim de identificar as carÃncias do setor pÃblico de saÃde, em todos os nÃveis de atenÃÃo / Increasing levels of dental fluorosis are a major concern to public health authorities. The ability to discriminate fluorosis from other enamel modifications is an important factor to support decision makers in epidemiology and oral health. The main objective of this research is to investigate the ability of the odontologists working for the public health services in Fortaleza, to discriminate fluorosis from other enamel alterations, the severity of the disease and the correct clinical approach. Two hundred dentists out of 527 professionals of the public health services answered a semi-structured survey, based on the evaluation of 20 digitalized pictures showing enamel modifications. The presence or absence of fluorosis, as well as the severity of the disease were determined according to the Deanâs index. We were unable to detect an effect of the school of graduation (p>0.05) on the ability to diagnose fluorosis. However, the youngest, less experienced dentists performed better (p<0.05) for both fluorosis diagnosis and to determine to adequate clinical approach for each case. Also, odontologists working in the city health services were more likely to get higher scores compared to the ones working for the state services, with an average of correct answers for differential diagnosis of 7.70  0.15. Although a few subjects achieved less than 30% of correct answers, pictures displaying more severe cases of fluorosis were more likely to result in correctly answered questions. The vast majority (90%) of the subjects reported to have a poor ability do diagnose fluorosis, although 75% had received information about that disease during undergraduation. The odontologists also displayed a very poor performance (2,71  0,76) in defining the best clinical approach, and about 70% of them asked for specific training for correctly diagnose dental fluorosis. Based on the above results, we conclude that most dental surgeons working for the public health services in Fortaleza displayed a poor knowledge about dental fluorosis and lack an adequate training to diagnose and treat that disease. Similar researchs in other regions of Ceara should be performed in order to better identify the deficiencies of the public health services, at different levels

Indiana University-Purdue University Indianapolis (IUPUI) / Purpose: Patient-provider communication has been studied extensively in the last two decades, and many researchers have confirmed the importance of communication between patient and provider in medical contexts. In spite of increased research in patient-provider communication in dentistry, dental care providers still report that patients often do not accurately follow oral health recommendations. Thus, there is the need for additional study on how patients make sense of the oral health information they receive and how they translate that information into action. This study aimed to obtain insight into how dental care patients perceive and make sense of the information they receive from their dentist and how they translate that information into action. Methods: 16 patients and 8 dentists from Indiana School of Dentistry’s (IUSD) Graduate Prosthodontic Clinic in Indianapolis, Indiana were included. Two in-depth interviews, one immediately following the dental visit and one 7-10 days later, were conducted with the patients, and one short interview was conducted with each patient’s dental care provider. Interviews were audio taped and transcribed. Results: The results show both patients and providers perceived the interaction during consultation positively. The majority of patients were able to accurately recall information they received from their dentists and made sense of new information through the lens of their previous experiences. Four additional factors that explain patients’ adherence with health advice were also found in addition to the previous studies. Conclusions: Successful dentist-patient interaction could be thought of as a match between what dentists think patients need to know, what patients think they want/need to know, and what patients actually know. Thus, some barriers that can keep dentists and patients from reaching information equilibrium are discussed. The study concludes by offering practical and theoretical implications.