Purpose: The purpose of this study was to evaluate esthetic posterior stainless steel crowns (EP-SSC) and compare their relative shear strengths.Methods: Sixty EP-SSC were compared. 15 crowns from NuSmile® Primary Crowns, Kinder Krowns, and Dental Innovators 1UP and EC Crowns were studied. The crowns were cemented to a typodont tooth then thermally cycled in water baths to simulate oral conditions. Shear strengths were evaluated by subjecting these crowns to simulated forces of occlusion.Results: The force required to cause shearing of the esthetic facings was statistically significant. With the 1UP crown being significantly weaker than the other crowns tested. Conclusion: The 1 UP crowns failed at lower levels of force than the other types of EP-SSC. The shear strengths for the three other crown types were not statistically different from each other. The esthetic facings do not likely fail from the single point load of a child's bite.

Purpose: The purpose of this study is to examine the baseline oral health status of infants and the level of their caregiver's oral health knowledge for families who received preventive oral health services in a medical setting. Methods: Using a prospective cohort study, children 0-3 years of age received an oral health screening, risk assessment, caregiver education, and a fluoride varnish treatment in an ambulatory pediatric medical clinic. A 16-item oral health knowledge and socio-demographic questionnaire was delivered to the caregiver of child. This questionnaire included knowledge, behavior and opinion items on risk factors for dental diseases, care of child's teeth, and socio-demographic characteristics of the family. Six-months after the medical visit, dental claims were examined to see if children had made a dental visit. Results: One hundred and ninety-five children received preventive oral health services in this clinic. Of these, 103 caregivers agreed to complete the oral health knowledge and socio-demographic questionnaire. Twenty-percent of children screening had visible signs of tooth decay, according to risk-assessment 72% were categorized as high-risk for tooth decay, and 83% received a fluoride varnish treatment. At 6-months, 9% of children were found to have had a dental visit. According to the caregiver questionnaire the likelihood of having a dental visit was correlated with the caregiver's knowledge of when a child should have their first dental visit and having been told by a medical professional when their child should be going to the dentist. Conclusion: Children are more likely to have a dental visit when caregivers are aware of the age 1 dental visit, or when advised to seek care by a medical professional. With increased education of medical providers, starting in medical residency training, more children can be seen for preventive oral health care resulting in an earlier establishment of a dental home.

Purpose: The purpose of this study was to compare the adverse events that occur with general anesthesia for dental rehabilitation between a hospital setting and dental clinic setting. Methods: A retrospective chart review was performed examining patients who had received dental rehabilitation with general anesthesia at the Virginia Commonwealth University Department of Pediatric Dentistry. Subjects were either treated in the Pediatric Dental Clinic or the Hospital Ambulatory Surgery Center (ASC) from July 2005 to December 2006. Anesthesia records of induction, intubation, maintenance, emergence and recovery were compared between the two settings.Results: There were a total of 422 charts reviewed with n=193 cases in the dental clinic and n=229 cases in the ASC. Patients in the dental clinic setting were slightly older (t = 2.63, df = 420, p-value = 0.0089), and healthier (chi-square = 45.9, df = 2, p-value Conclusion: Overall, the prevalence of adverse events occurring with dental rehabilitation under general anesthesia in the dental clinic setting was lower compared to adverse events in the hospital-based ambulatory surgical setting.

Purpose: The purpose of this study was to asses the oral health quality of life of children with special health care needs. This study examined the effects of oral health conditions on general well-being and family life of these children. A secondary aim of the study was to investigate correlations between specific health care conditions, gender, and age of these children and their global ratings of oral health and well-being.Methods: This study was a cross-sectional design with subjects who are members of the Virginia Care Connection for Children program, based at Virginia Commonwealth University. The oral health quality of life was measured using a shortened version of the Parental – Caregiver Perceptions Questionnaire (P-CPQ). The questionnaire includes measures of global ratings of oral health and well-being as well as effects of oral health on domains of oral symptoms, functional limitations, emotional well-being, and family well-being/parental distress. The parents/caregivers were asked to report on these domains as they related to their child's oral health within the past 3 months. Additional survey items included questions regarding demographic factors of the child (age, sex, special health care conditions) and parent (i.e. mother, father, or other). Results: The survey was sent out to 429 individuals and 137 usable surveys were returned for a response rate of 32%. Special health care conditions of the children were categorized and reported as follows: 1) Neurodevelopmental/Genetic/Neuro-muscular disorders, N=69 (59.13%); 2) Respiratory disorders, N=12 (10.43%); 3) Cardiac disorders, N=5 (4.35%); 4) Craniofacial disorders, N=12 (10.43%); 5) Metabolic disorders, N=15 (13.04%); 6) Psychological disorders, N=3 (2.61%). In general, caregivers reported the children to have a fair to good oral health quality of life in each domain. It was determined that two of the domains, functional limitations and emotional well-being, were not correlated with the child's oral health or well-being. However, the oral symptoms and family well-being/parental distress domains did have a positive correlation (p = 0.0340 and p = 0.0420, respectively). Conclusions: In a population of children with special health care needs it appears that oral symptoms and family well-being outweighed functional limitations and emotional well-being.

O exercício da Odontologia, apesar de ser uma atividade antiga, tem ganhado uma maior visibilidade na literatura científica contemporânea sob a ótica da humanização em saúde, que se refere tanto à sua prática profissional quanto ao processo de ensino-aprendizagem. Objetivou-se compreender as vivências de graduandos de Odontologia frente à formação para o atendimento odontopediátrico, bem como a humanização dos serviços prestados e das relações estabelecidas nesse contexto. Para tanto, foi realizado um estudo descritivo de abordagem qualitativa, tendo como instrumento uma entrevista semiestruturada, composta de quatro questões norteadoras. Os dados obtidos foram analisados seguindo os princípios da Análise de Conteúdo Temática e discutidos a partir de autores da saúde coletiva. Os resultados foram organizados em dois Eixos de Análise, a saber: Eixo I: Dificuldades na Clínica-escola: do saber técnico às vivências na clínica, que foi desdobrado em três subeixos: Especificidades do Atendimento à Criança na Clínica-escola; A Complexidade nas Relações com os Acompanhantes; Desafios na Articulação entre Formação Teórica e a Prática do Atendimento à Criança; e Eixo II: Humanização nas Práticas da Clínica-escola: percepções, vivências e desafios, com os subeixos A Humanização na Prática Odontopediátrica e Dificuldades e Desafios para a Humanização dos Atendimentos na Clínica-escola. O primeiro Eixo de análise abordou as dificuldades vivenciadas pelos estudantes na Clínica-escola de Odontopediatria. Os alunos relataram suas experiências e sentimentos em relação a diversos aspectos presentes na dinâmica da Clínica, no que se refere às relações interpessoais e aos atendimentos realizados. O segundo Eixo apresentou a apropriação que os alunos fazem sobre o processo de humanização nas vivências e no cuidado em saúde na Clínica Odontopediátrica. Os relatos versaram sobre como os estudantes significam a humanização, como percebem sua prática no contexto estudado e os desafios para sua efetivação. A análise do corpus apontou que o processo de ensino-aprendizagem, no contexto estudado, enfatiza os procedimentos técnicos imersos nas contradições suscitadas nas tentativas de aplicação de práticas humanizadas. Ressalta-se que as práticas ocorrem em um ambiente por vezes ansiogênico, competitivo e pautado em posturas assimétricas e relações interpessoais marcadas pelo distanciamento. Em síntese, o estudo aponta para a necessidade de que a questão da humanização saia do discurso e se atualize no fazer em saúde, sendo que um projeto integrado de ensino-aprendizagem entre as disciplinas de Psicologia e de Odontopediatria pode favorecer o desenvolvimento de práticas mais alinhadas ao cuidado integral e humanizado / The practice of Dentistry, despite being an old activity, has been widely disseminated in the literature from the point of view of humanization in health, which refers to both the practice and the teaching-learning process. The objective of this research was to understand the experiences of undergraduates of Dentistry in front of the training for pediatric dentistry care, as well as the humanization of the services provided and the relations established in this context. or that, a descriptive study of a qualitative approach was carried out, using as a instrument a semi-structured interview, composed of four guiding questions. The data obtained were analyzed according to the principles of the Thematic Content Analysis and discussed from authors of collective health. The results were organized in two Axes of Analysis, namely: Axis I: Difficulties in the School Clinic: from the technical knowledge to the experiences in the clinic, which was deployed in three sub-axes: Child Care Specificities in the School Clinic; The Complexity in the Relations with the Companions; Challenges in the Articulation between Theoretical Formation and the Practice of the Attendance to the Child; and Axis II: Humanization in School Clinic Practices: perceptions, experiences and challenges, with the sub-axes \"Humanization in Pediatric Dentistry Practice and Difficulties and Challenges for the Humanization of Clinic-School Care\". The first Axis of analysis discussed the difficulties experienced by the students in the pediatric dentistry school clinic. The students reported their experiences and feelings in relation to several aspects present in the dynamics of the Clinic, regarding the interpersonal relationships and the care given. The second Axis presented the appropriation that the students make about the process of humanization in the experiences and health care in the Pediatric Clinic. The reports dealt with how students mean humanization, how they perceive their practice in the context studied, and the challenges to their realization. The analysis of the corpus pointed out that the teaching-learning process, in the context studied, emphasizes the technical procedures immersed in the contradictions raised in the attempts to apply humanized practices. It is emphasized that the practices occur in an environment sometimes anxiogenic, competitive and based on asymmetric positions and interpersonal relations marked by distance. In summary, the study points to the need for the issue of humanization to leave the discourse and be updated in the \"doing\" in health, and an integrated teaching-learning project between the disciplines of Psychology and Pediatric Dentistry can favor the development of practices that are more in line with integral and humanized care

Essa foi uma pesquisa qualitativa que aplicou, avaliou os resultados e comprovou a utilidade da aplicação do Procedimento de Desenhos-Estórias na apreensão dos conteúdos emocionais de crianças e adolescentes com receio do tratamento odontopediátrico. O objetivo do estudo foi pesquisar os pontos nodais das angústias, conflitos, fantasias e mecanismos de defesa que emergem nessa situação de crise. A metodologia consistiu na utilização de entrevistas clínicas com as mães e crianças, na observação clínica da criança e na aplicação do procedimento. Foram estudadas 15 crianças entre 8 e 14 anos, utilizando-se de 3 a 12 sessões. O referencial de abordagem e interpretação foi o psicanalítico. Como modificação em relação à proposta original do instrumento, foram utilizadas intervenções auxiliares de associações livres e propiciadoras de aprofundamento no material emergente e compreensão dos conteúdos emocionais. Observou-se que: a. A necessidade de atendimento odontopediátrico exacerba com intensidade fantasias, conflitos e mecanismos de defesa primitivos. b. O instrumento facilita o contato e aprofundamento com focos nodais de conflitos e angústias inconscientes. c. O processo auxilia no conhecimento dos conflitos, mobilizando uma tendência para a integração dos mesmos. Verificou-se que as intervenções com o Procedimento de Desenhos- Estórias foram plenamente adequadas à apreensão dos conteúdos emocionais profundos de crianças e adolescentes nessa condição de crise. Concluiu-se que, a situação de crise que antecede o atendimento odontopediátrico dos pacientes estudados, foi ampla de mobilização de angústias primitivas e intensas fantasias que necessitam ser comunicadas e elaboradas em um processo psicoterapêutico. / This is a qualitative research, viewing to apply, evaluate results and demonstrate the need of employing the Drawing-and-Story Procedure. while understanding and elaborating emotional contents of children and adolescents who fear pediatric-dentistry treatment. This study also aims to examine the nodal points of anguish, conflicts, fantasies and the mechanisms of defense that emerge from the crisis situation. The methodology consisted in the use of clinical interviews with mothers and children, in the clinical observation on the child and in undertaking of procedure. A research, devided in 3-12 sections, was made with fifteen children, aged 8-14 in private clinic. Psychoanalysis was used as a system of approach and interpretation. As a modification, related to the original consideration, a free-associated auxiliary therapeutic verbalization has been used, as well as a deepening in the emerging material and understanding of the emotional contents.The results were as follows: a. The need of pediatric dentistry attendance will intensively exacerbate fantasies, conflicts and selfdefense primitive mechanisms. b. The instrument facilitates the contact and deepening of nodal points in conflicts and unconcious anguish. c. The process assists in knowing all conflicts by mobilizing a trend for integrating them. The results has led to conclude that the Drawing-and-Story Procedure used in this clinical situation, has shown as being highly suitable to the whole aprehension of emotional contents in children and adolescents in this crisis situation.This study has taken the initial hypothesis which a crisis situation that precedes the pediatric dentristy attendance in case study patients has a wide range of distresses and intense fantasies that should be notified and elaborated within a psychotherapeutical process.

Os jogos eletrônicos constituem uma ponte natural entre os usuários e a informação, e possibilitam um equilíbrio entre o desafio e o envolvimento do jogador durante a interação. Os serious games, por sua vez, representam uma categoria distinta de jogos eletrônicos que explora a expertise da indústria de jogos com objetivo de imprimir atratividade às simulações, sem deixar de lado a consolidação de conceitos e/ou desenvolvimento de habilidades psicomotoras. Na atualidade, a busca por aplicações instrucionais tem-se expandido em diversos setores, sobretudo na área de saúde. Além disso, o treinamento prévio dos profissionais de saúde é de grande importância à segurança dos pacientes. Os serious games, em razão de oferecerem a possibilidade de experimentação segura, permitem ao estudante de Graduação ou profissional da área, inserido no papel de jogador, testar ações e tomar decisões em situações que exporiam o paciente ao risco em um caso clínico real, sem implicações. Nesse sentido, o objetivo deste estudo foi o desenvolvimento de um serious game educativo, para dispositivos móveis, com caráter de simulação e treinamento, voltado ao estudante de Odontologia (e a outros profissionais da área), com atenção às técnicas e particularidades do atendimento clínico odontopediátrico. A onipresença dos dispositivos móveis e a sua interface de usuário intuitiva também motivaram o desenvolvimento do aplicativo Dental Training e o seu direcionamento à simulação do atendimento e no treinamento clínico, uma vez tablets e smartphones adaptam-se facilmente a qualquer ambiente de aprendizado. Em decorrência deste estudo, pode-se constatar que as atividades de treinamento e simulação suportadas por novas tecnologias podem ser mais do que meros coadjuvantes no processo de formação, beneficiando, assim, tanto pacientes como profissionais. Os serious games podem ser aplicados, de fato, para aprimorar o desenvolvimento cognitivo, especialmente a capacidade de descobrir, explorar, aprimorar o raciocínio lógico, solucionar problemas, e de desenvolver habilidades como concentração, curiosidade, estimulando a autoconfiança no processo. Desta forma, com a inserção deste serious game em um modelo tradicional de ensino de Graduação, será possível flexibilizar o quociente da relação presencial-digital paulatinamente, por meio de maior ênfase na aprendizagem das tecnologias digitais, e robustecer a atuação dos estudantes nas atividades práticas do curso. / Electronic games represent a natural bridge between users and information, in a proper balance between challenge and player involvement during interaction. Serious games, in turn, represent a distinct category of electronic games that exploit the gaming industry\'s expertise in order to bring attractiveness to simulations, without neglecting the development of psychomotor skills. Nowadays, the research for instructional applications has expanded in several sectors, especially in the health area. In addition, previous training of health professionals is of great importance to patient safety. Serious games, by virtue of offering the possibility of safe experimentation, allow either undergraduate student or professionals, inserted in the role of player, to test actions and take the proper decisions in situations that would expose the patient to risk in real life, without any implications. Therefore, this study was aimed to create and develop an educational serious game, for mobile devices, with a simulation and training character, aimed at the student of Dentistry (and other professionals as well), with attention to the techniques and particularities of pediatric dentistry care. The omnipresence of mobile devices and the fluid user interface have also motivated the development of the application Dental Training by focusing in simulation and clinical training as tablets and smartphones adapt easily to any learning environment. As a result of this study, it should be noted that the training and simulation activities supported by new technologies could be more than mere adjuncts in the training process, thus benefiting both patients and professionals. Serious games can be used to enhance cognitive development, especially the ability to discover, explore, improve logical reasoning, solve problems, and develop skills such as concentration, curiosity and self-confidence. In this fashion, with the inclusion of this serious game in a traditional model of undergraduate education, it will be possible to increase the \"face-to-face relationship\" quotient gradually, by means of a greater emphasis on learning digital technologies, and to strengthen students\' performance in practical course activities.

Jogos são uma ponte natural entre educação e diversão. Seu uso já provou ser eficaz em várias áreas do saber, pois fornece, junto da interatividade, novas formas de aplicação do conhecimento, através de desafios propostos ao usuário. Tal meio, amplamente utilizado na indústria do entretenimento, pode assumir papel social quando aplicado a áreas diversas, como a da saúde. Esta categoria de jogos, com propósitos específicos como treinamento, reabilitação e prevenção, denomina-se serious games. No entanto, os materiais disponíveis para a propagação de conceitos referentes à prevenção em saúde, destinados ao público infantil, ainda são escassos e com pouco nível de atratibilidade. Compostos geralmente por materiais impressos, são meios de difícil acesso a todas as camadas da população. No âmbito da Odontologia, tal área se mostra pouco explorada, oferecendo às crianças apenas orientações quanto à prevenção de doenças, importância da boa higiene bucal e das visitas regulares ao profissional dentista. Esta dissertação apresenta, portanto, a criação, desenvolvimento e aplicação de um serious games, chamado Caí, Perdi um Dente... E daí?, focado no assunto avulsão dentária de um dente permanente, situação comumente vivenciada por responsáveis, educadores e crianças em fase escolar, que necessita de procedimentos rápidos para que o dente perdido possa ser reimplantado, evitando a necessidade de próteses dentárias. A pesquisa se desenvolveu na aplicação e análise dos resultados referentes à comparação de tal material com outros, comumente utilizados (cartilha e desenho animado), mostrando a eficácia da interatividade, quando combinada à educação para a saúde. Este trabalho também ofereceu as prerrogativas para especificar os requisitos de projeto do design do jogo, observando as necessidades evidenciadas para identificar as funções que este deverá desempenhar. Visamos, com este estudo, estimular a pesquisa na área de educação e interatividade dirigidas à saúde, oferecendo novas ferramentas para o auxílio de profissionais e melhoria da qualidade de vida de toda a população. / Games are a natural bridge between education and entertainment. Its use has already proven efficient in many areas of knowledge, since it provides (along with interactivity) new forms to knowledge application, through issuing challenges to the user. These means, widely applied in entertainment industry, can play a social role when applied to other areas, such as healthcare. This category of games, with specific purposes such as training, rehabilitation and prevention, is generally classified into the category of serious games. However, the available materials for teaching concepts related to health prevention among children are still scarce and with currently low attractiveness. Composed usually of print material, they are means of difficult access to whole of the population. Since dentistry is a not well explored area by games, children are provided only with some guidance towards the prevention of diseases, the importance of good oral hygiene and regular appointments with the dentist. This dissertation thus presents the concept, the development and the application of a serious game called I Fell Down and Lost my Tooth, So?, focused on a permanent tooth avulsion, usually experienced by persons in charge, educators and children in learning stage, who need rapid procedures to promote tooth reimplantation, avoiding the need for dental prostheses. This work was developed with the application and analysis of results by comparision with other educational materials usually applied (as guidebook and animated cartoon), proving its higher efficiency in interactivity, combined with education towards healthcare. Also, prerogatives were offered to detail the game design requirements, to observing the needs to identify the functions it must perform. It was also aimed to stimulate further research concerning education and interactivity towards healthcare, providing new tools to aid professionals, as well as improvements in the overall life quality of all people.

A comparison of the antimicrobial efficacy of silver diamine fluoride and silver nitrate on various cariogenic bacteria: an ex vivo study By: Reham AlNajjar, D.D.S. A thesis submitted in partial fulfillment of the requirements for the degree of Master of Science in Dentistry at Virginia Commonwealth University. Virginia Commonwealth University, 2019 Thesis Advisor: William Dahlke, D.M.D., Associate Professor and Chair of Pediatric Dentistry, School of Dentistry Purpose: The use of silver-based antimicrobials is an emerging method for the treatment of dental caries. In this study, the authors compare the efficacy of the two most prominent silver- based therapeutics, silver diamine fluoride (SDF) and silver nitrate (AgNO3), on cariogenic and non-cariogenic multispecies biofilms. Currently there is a lack of studies comparing the efficacy of SDF to AgNO3. Methods: Plaque samples from anterior and posterior tooth sites from children presenting both with early childhood caries and caries-free children were collected, pooled, and utilized to create four ex vivo biofilm systems in artificial saliva. SDF and AgNO3 were administered to these biofilms and bacterial survival was quantified and compared to untreated controls. Results: Each of the four pooled sample types was applied to plates coated in artificial saliva + 1% sucrose. Both SDF and AgNO3 were very effective against plaque derived biofilms when compared to untreated biofilms (P0.05) in the potency of each compound. Conclusions: SDF and AgNO3 significantly inhibit ex vivo cariogenic and non-cariogenic biofilms at similar levels.

QUALITY EVALUATION OF DENTAL SERVICE FOR CHILDREN FROM THE PARENTS' POINT OF VIEW Aistė Kavaliauskienė Supervisor Antanas Šidlauskas, Assoc. Prof., D.D.S., PhD., Department of Social Medicine, faculty of Public Health, Kaunas University of Medicine. – Kaunas, 2005. �� P.74 Aim of the study – to evaluate the quality of dental services for children from the parents’ point of view. Methods. The anonymous questionnaire survey was performed among 280 parents of children visiting their pediatric dentists or orthodontists in four Kaunas public health care institutions. The research methodology used the questionnaire based upon SERVQUAL instrument. Two sets of questions, one relating to the respondents’ expectations, the other relating to the respondents’ perceptions of a particular aspect of service quality, comprised the questionnaire. The perceived gaps between expectations and perceptions were analysed regarding five service quality dimensions (tangibles, responsiveness, reliability, assurance, empathy). Likert-type scales were used for the evaluation of the examined characteristics. The statistical package SPSS version 11.0 for Windows was used to conduct data analysis. Results. There was a statistically significant difference between the parents’ expectations (mean score 4,31±0,36) compared with their perceptions (mean score 3,86±0,46) of the dental service provided. The largest quality gap was observed in characteristic regarding reliability while the smallest gap concerned... [to full text]