Método simplificado versus convencional de confecção de próteses totais: práticas adotadas pelos Cirurgiões-Dentistas
Simplified versus conventional method for the fabrication of complete dentures: procedures adopted by dentists
Caetano, Thais Angelina; Ribeiro, Adriana Barbosa; Della Vecchia, Maria Paula; Cunha, Tatiana Ramirez; Souza, Raphael Freitas de
Resumo
Introdução: A fim de reduzir custos e tempo clínico envolvidos com o tratamento, Dentistas têm utilizado métodos simplificados, omitindo ou abreviando partes da técnica de confecção das próteses totais. Objetivo: Levantar as práticas utilizadas pelos Cirurgiões-Dentistas para a confecção de próteses totais. Material e método: Os dados foram levantados por meio de um formulário eletrônico contendo perguntas relativas ao perfil e aos procedimentos clínicos utilizados, a fim de quantificar o uso de métodos simplificados e convencionais, bem como para determinar a relação com o perfil desses profissionais. Os resultados foram analisados por meio de análise de Aglomerados. Resultado: As respostas foram dadas, em sua maioria, por homens, tendo a prática clínica como sua principal fonte de renda e clínica privada ou conveniada como ambiente principal de trabalho (n=119). Grande parte dos entrevistados relatou realizar duas moldagens por arcada, utilização de articulador semiajustável com arco facial, determinação de plano oclusal por meio de guias anatômicos, utilização de meios métricos para análise da dimensão vertical de oclusão e determinação direta da relação cêntrica. O próprio Cirurgião-Dentista relatou ser o responsável na fase de seleção de dentes. A estatística identificou dois Aglomerados, com base nas características demográficas e na prática clínica, sendo um grupo formado por generalistas adeptos de perfis mais simplificados e outro formado por profissionais mais especializados em prótese que realizam técnicas convencionais. Conclusão: A adoção de técnicas simplificadas é associada àqueles Dentistas com perfil mais generalista, enquanto protesistas tendem a trabalhar mais de acordo com a Academia.
Palavras-chave
Abstract
Introduction: In order to reduce costs and clinical time involved with complete denture treatment, dentists have employed simplified methods based on the reduction or preclusion of certain traditional technical procedures. Purpose: To survey the procedures used by dentists to fabricate complete dentures. Material and method: Data was obtained by an electronic form containing questions about dentists’ profile and clinical procedures, in order to quantify traditional and simplified approaches at several moments and to determine them to different professional profiles. Results were evaluated by means of cluster analysis. Result: The majority of respondents were male dentists with clinical practice as their main income source, mainly in private service (n=119). Most participants use to take a pair of impressions from each arch, employ semiadjustable articulators with facebow transfers, shape the occlusal plane with the aid of anatomic references, determine occlusal vertical dimension by metric methods and use mandibular manipulation for centric relation. The dentists performed tooth selection in most cases. Statistical analysis identified two clusters based on demographic characteristics and clinical procedures. General practitioners adopting simplified methods formed the first cluster, whereas prosthodontists used to conventional methods formed the second. Conclusion: General dentists tend to adopt simplified approaches, and prosthodontists tend to work according to traditional academic methods.
Keywords
References
1. Felton DA. Edentulism and comorbid factors. J Prosthodont. 2009 Feb;18(2):88-96. http://dx.doi.org/10.1111/j.1532-849X.2009.00437.x
2. Petersen PE, Bourgeois D, Ogawa H, Estupinan-Day S, Ndiaye C. The global burden of oral diseases and risks to oral health. Bull World Health Organ. 2005 Sep;83(9):661-9.
3. Brasil. Ministério da Saúde. Projeto SB Brasil 2010: resultados principais. Brasília: Ministério da Saúde; 2011.
4. Rahn AO, Heartwell Jr CM. Textbook of complete dentures. 5th ed. Philadelphia: Lea and Febiger; 1993.
5. Zarb GA, Bolender CL, Eckert S, Jacob R, Fenton A, Jacob R. Prosthodontic treatment for edentulous patients: complete dentures and implant-supported prostheses. 12th ed. St. Louis: Elsevier; 2003.
6. Souza RF, Leles CR, Compagnoni MA. A survey of complete denture teaching in Brazilian dental schools. Pos-Grad Rev Fac Odontol São José dos Campos. 2002 Jan-Apr;5(1):5-11.
7. Rashedi B, Petropoulos VC. Preclinical complete dentures curriculum survey. J Prosthodont. 2003 Mar;12(1):37-46.
8. Duncan JP, Taylor TD. Teaching an abbreviated impression technique for complete dentures in an undergraduate dental curriculum. J Prosthet Dent. 2001 Feb;85(2):121-5. http://dx.doi.org/10.1067/mpr.2001.113699
9. Nascimento DFF, Patto RBL, Marchini L, Cunha VPP. Double-blind study for evaluation of complete dentures made by two techniques with and without facebow. Braz J Oral Sci. 2004 Apr/Jun;3(9):439-45.
10. Sutton AF, Glenny AM, McCord JF. Interventions for replacing missing teeth: denture chewing surface designs in edentulous people. Cochrane Database Syst Rev. 2005 Jan 25;(1):CD004941.
11. Ellis JS, Pelekis ND, Thomason JM. Conventional rehabilitation of edentulous patients: the impact on oral health-related quality of life and patient satisfaction. J Prosthodont. 2007 Jan-Feb;16(1):37-42. http://dx.doi.org/10.1111/j.1532-849X.2006.00152.x
12. Della Vecchia MP, Regis RR, Cunha TR, de Andrade IM, da Matta JC, de Souza RF. A randomized trial on simplified and conventional methods for complete denture fabrication: cost analysis. J Prosthodont. 2013 Jul 26. [Epub ahead of print]. http://dx.doi.org/10.1111/ jopr.12090
13. Cunha TR, Della Vecchia MP, Regis RR, Ribeiro AB, Muglia VA, Mestriner W Jr, et al. A randomised trial on simplified and conventional methods for complete denture fabrication: masticatory performance and ability. J Dent. 2013 Feb;41(2):133-42. http://dx.doi.org/10.1016/j. jdent.2012.09.008
14. Heydecke G, Vogeler M, Wolkewitz M, Turp JC, Strub JR. Simplified versus comprehensive fabrication of complete dentures: patient ratings of denture satisfaction from a randomized crossover trial. Quintessence Int. 2008 Feb;39(2):107-16.
15. Kawai Y, Murakami H, Shariati B, Klemetti E, Blomfield JV, Billette L, et al. Do traditional techniques produce better conventional complete dentures than simplified techniques? J Dent. 2005 Sep;33(8):659-68. http://dx.doi.org/10.1016/j.jdent.2005.01.005
16. Kawai Y, Murakami H, Takanashi Y, Lund JP, Feine JS. Efficient resource use in simplified complete denture fabrication. J Prosthodont. 2010 Oct;19(7):512-6. http://dx.doi.org/10.1111/j.1532-849X.2010.00628.x
17. Omar R, Al-Tarakemah Y, Akbar J, Al-Awadhi S, Behbehani Y, Lamontagne P. Influence of procedural variations during the laboratory phase of complete denture fabrication on patient satisfaction and denture quality. J Dent. 2013 Aug 1. doi:pii: S0300-5712(13)00186-3. [Epub ahead of print].
18. Regis RR, Cunha TR, Della Vecchia MP, Ribeiro AB, Silva-Lovato CH, de Souza RF. A randomised trial of a simplified method for complete denture fabrication: patient perception and quality. J Oral Rehabil. 2013 Jul;40(7):535-45. http://dx.doi.org/10.1111/joor.12063
19. Clark DM, Oyen OJ, Feil P. The use of specific dental school-taught restorative techniques by practicing clinicians. J Dent Educ. 2001 Aug;65(8):760-5.
20. Hyde TP, McCord JF. Survey of prosthodontic impression procedures for complete dentures in general dental practice in the United Kingdom. J Prosthet Dent. 1999 Mar;81(3):295-9. http://dx.doi.org/10.1016/S0022-3913(99)70272-6
21. Nunes MF, Silva ET, Santos LB, Queiroz MG, Leles CR. Profiling alumni of a Brazilian public dental school. Hum Resour Health. 2010 Aug;18;8:20.
22. Pereira MF, Botelho TL. Perfil do cirurgião-dentista no estado de Goiás. Rev Fac Odontol UFG. 1997;1(1):37-40.
23. Silva SRC, Rosa AGF. Características dos cirurgiões dentistas com vínculo empregatício em empresas públicas e/ou privadas no município de Araraquara-SP. Rev Odontol UNESP. 1996 jan-dez;25(n.esp):9-18.
24. Mott ML, Alves OSF, Muniz MA, Martino LVS, Santos APF, Maestrini K. ‘Moças e senhoras dentistas’: formação, titulação e mercado de trabalho nas primeiras décadas da República. Hist Ciênc Saúde-Manguinhos. 2008 jun.;15(suppl.):97-116. http://dx.doi.org/10.1590/ S0104-59702008000500005
25. Chaves MC, Miranda, AS. Discursos de cirurgiões-dentistas do Programa Saúde da Família: crise e mudança de habitus na Saúde Pública. Interface (Botucatu). 2008 jan-mar;12(24):153-67. http://dx.doi.org/10.1590/S1414-32832008000100012
26. Shugars DA, DiMatteo MR, Hays RD, Cretin S, Johnson JD. Professional satisfaction among California general dentists. J Dent Educ. 1990 Nov;54(11):661-9.
27. Nuñez MCO, Silva DC, Barcelos BA, Leles CR. Patient satisfaction and oral health-related quality of life after treatment with traditional and simplified protocols for complete denture construction. Gerodontology 2013 Oct 21. [Epub ahead of print].
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