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Introducción
La estructura de la estrategia de búsqueda para buscar los artículos con los que
construirá su marco teórico se basa en los principales conceptos o variables
identificadas en la pregunta que guía su proyecto.
1.FORMULE LA PREGUNTA DE SU REVISIÓN
Recuerde que la pregunta de la revisión debe especificar los tipos de población (los
participantes), los tipos de Intervenciones (o Comparaciones), y los tipos de desenlaces
(Outcomes) que son de interés. La sigla PICO (iniciales en inglés) ayuda a recordar estos
conceptos.
Elementos PICO
Paciente o problema. Retracción gingival Miller tipo I
Intervención. Colgajo desplazado coronal
Comparación: Injerto de tejido conectivo
Outcome (desenlace/resultados) Cubrimiento de la retracción
PREGUNTA:
Ejemplo: ¿Cuál procedimiento es más efectivo para el cubrimiento de recesiones
gingivales: el Injerto de tejido conectivo o colgajo desplazado coronal?
Búsquedas
Con base en las palabras MeSH el grupo deberá estructurar una ESTRATEGIA
DE BÚSQUEDA siguiendo el ejemplo a continuación, (esto se realiza a través
de búsqueda avanzada)
#1 AND #2:
((mucogingival surgery) OR
(mucogingival therapy) OR (root
coverage procedures) OR (gingival
#4 graft) OR (connective tissue graft) OR 1.089
(coronally advanced flap) OR
(coronally repositioned flap) OR
(subepithelial connective tissue) AND
(root coverage) OR (recession
coverage) OR (gingival recession
coverage)
#4 AND #3:
(mucogingival surgery) OR
(mucogingival therapy) OR (root
coverage procedures) OR (gingival
#5 graft) OR (connective tissue graft) OR
Estrategi (coronally advanced flap) OR (coronally 202 80
a final repositioned flap) OR (subepithelial
connective tissue) AND (root coverage)
OR (recession coverage) OR (gingival
recession coverage) AND (randomized
clinical trial)
Para seleccionar los artículos a partir de la búsqueda observe en el ejemplo los
títulos de los abstracts que fueron seleccionados o rechazados, y la relación directa
de los títulos con la pregunta de investigación
Para salvar o tener los abstracts seleccionados hay varias formas;
marque con ✔ (signo de visto bueno) en el RECHAZADOS
SELECCIONADOS
recuadro derecho de cada uno y vaya a la pestaña
superior izquierda que dice Send To y despliéguela y:
● marque clipboard e inmediatamente los abstracts se guardaran de manera
ordenada con esta herramienta de PUBMED.
● Marque E – Mail para enviárselos a su correo.
BACKGROUND:
Numerous surgical approaches for the treatment of single gingival recession (GR) defects
are documented in the literature. The aim of this 5-year, split mouth-design, randomized
clinical trial was to evaluate the effectiveness of coronally advanced flap (CAF) alone
versus CAF with connective tissue graft (CAF+CTG) in the treatment of single Miller Class
I and II GR defects.
METHODS:
Thirty-seven patients with 114 bilateral, single Miller Class I and II GR defects were treated
with CAF on one side of the mouth and CAF+CTG on the other side. Clinical
measurements (GR length [REC], keratinized tissue width [KT], complete root coverage
[CRC], and percentage of root coverage [PRC]) were evaluated before surgery and after
6, 12, 24, and 60 months.
RESULTS:
There was a significant reduction of REC and increase of KT after surgery in both groups.
CAF+CTG showed significantly better results for all evaluated clinical parameters in all
observed follow-up periods. Miller Class I defects showed better results in terms of REC,
CRC, and PRC, whereas Miller Class II showed better results in KT, both in favor of
CAF+CTG. Miller Class I defects showed better results than Miller Class II GR defects
regardless of the surgical procedure used.
CONCLUSIONS:
Both surgical procedures were effective in the treatment of single Miller Class I and II GR
defects. The CAF+CTG procedure provided better long-term outcomes (60 months
postoperatively) than CAF alone. Long-term stability of the gingival margin is less
predictable for Miller Class II GR defects compared to those of Class I.
Salhi L, Lecloux G, Seidel L, Rompen E, Lambert F. Coronally advanced flap versus
the pouch technique combined with a connective tissue graft to treat Miller's class
I gingival recession: a randomized controlled trial. J Clin Periodontol. 2014
Apr;41(4):387- 95.
AIM:The objective of this study was to compare two different periodontal plastic surgery
procedures to treat Miller's class I recession: a coronally advanced flap(control group)
versus the pouch technique (test group), both of which were associated with connective
tissue graft.
METHODS:
Forty consecutive patients were included, with 20 patients being allocated for each group.
The level of recession coverage, the keratinized tissue (KT)quantity, gingival aesthetics
(PES) and post-operative outcomes were assessed for a follow-up period of 6 months.
RESULTS:
After 6 months, both techniques allowed for the excellent mean root coverage of 96.3
plus/minus 12.1% in the control group and of 91.3 plus/minus 17.6% in the test
group.Complete root coverage was achieved in 89.5% (17/19) and 79% (15/19) of the
recession cases in the control and the test groups respectively. A significant increase in
KT height (p = 0.0011) was observed in the test group. A significant improvement in the
pink aesthetic score was found in the two groups, but gingival texture displayed
significantly better results in the test group (p < 0.0001). No significant difference between
the two groups was found in terms of the morbidity outcomes. Pain killer consumption was
similar in the two groups and significantly decreased over time.
CONCLUSIONS:
Both surgical techniques are relevant in treating Miller's class I recession. The pouch
technique seems to increase the height of KT better and provides good gingival-related
aesthetic outcomes.
Artículos similares
Referencias bibliográficas
● Bittencourt S , Del Peloso Ribeiro E, Sallum EA, Nociti FH Jr, Casati MZ.
Surgical microscope may enhance root coverage with subepithelial
connective tissue graft: a randomized-controlled clinical trial. J Periodontol.
2012 Jun;83(6):721-30. doi: 10.1902/jop.2011.110202. Epub 2011 Aug 26
● Cordioli G, Mortarino C, Chierico A, Grusovin MG, Majzoub Z. Comparison
of 2 techniques of subepithelial connective tissue graft in the treatment of
gingival recessions. J Periodontol. 2001 Nov;72(11):1470-6.
GUIA DE TRABAJO
A) Instrumento preventivo
● Técnicas de auto cuidado oral
● Medida preventiva en higiene oral
B) Cuidado y autocuidado en salud oral
C) Enfermedad mental
Liste los abstracts de los artículos preseleccionados y las referencias de los artículos
relacionados:
Abstract
Los pacientes con trastornos mentales están sometidos a un mayor número de factores
de riesgo de enfermedades bucodentales. Ello debido a los efectos secundarios de las
medicaciones que consumen, la falta de autocuidado, la dificultad para acceder a
atención, la actitud hacia los profesionales sanitarios y también la falta de cooperación
en los tratamientos dentales. Los trastornos mentales más comunes en nuestra población
incluye a la depresión, la ansiedad, la esquizofrenia, el trastorno bipolar y la demencia.
En trastornos como la ansiedad y la depresión, el mayor problema está en la pérdida del
interés hacia la salud, lo que deriva en una mala higiene. Las patologías bucodentales
más frecuentes en estos pacientes son las caries y las enfermedades periodontales. El
objetivo de esta breve revisión narrativa, es proporcionar información actualizada sobre
el manejo de las enfermedades bucodentales de pacientes con trastornos mentales.
Métodos
Resultados
Es importante que los profesionales odontólogos puedan identificar a estos pacientes, ya que
son un grupo con características particulares y factores de riesgo comunes para desarrollar
patologías bucodentales. Así también, la consulta odontológica es fundamental para poder
brindar una atención integral a este grupo de pacientes [14].
Conclusión
Viendo que la salud bucal es un componente muy importante del bienestar de los
pacientes con trastornos mentales, debemos enfocarnos en brindarles una atención
integral y multidisciplinaria con médicos, psiquiatras, odontólogos, psicólogos y
nutricionistas. Es de especial importancia conocer los problemas comunes de esta
población, ya que son grupos vulnerables por varias razones.
María Cristina Giraldo-Zuluaga, Cecilia María Martínez-Delgado, Natalia Cardona-
Gómez ,José Luis Gutiérrez-Pineda , Karen Andrea Giraldo-Moncada , Paula
Marcela Jiménez-Ruíz et.al, ORAL health management in people with
disabilities.Rev. CES Odont 2017; 30(2): 23-36.
Abstract
In the world there are more than one billion people with disabilities and although these
terms are not synonymous with severe oral changes, it has been detected that people
with disabilities have more risk to suffer oral pathologies due to poor dental service related
to the reluctance dentist have to take care of these patients. Communication with patients
with conditions such as autism, Down syndrome, cerebral palsy, hearing impairment;
presents an additional component of difficulty, so it is necessary to rely on a system of
communicative strategies, care protocols and means of support that may vary among
different disabilities. These enable people with communication difficulties to interact with
their environment. Training for dentists on this field is not easy, since there are not
sufficient programs covering completely professional training in dentistry in this area. The
purpose of this article was to review some types of disabilities, their most common oral
manifestations, dental management and appropriate alternative communication strategies
to provide good dental services.
Conclusiones
Las enfermedades bucales más comunes en pacientes en situación de discapacidad
como el autismo, la parálisis cerebral y el síndrome Down son las mismas enfermedades
bucales que en la población general, pero con una presentación más severa, por la
dificultad para la realización de una higiene bucal estricta y por el deficiente conocimiento
en el manejo de técnicas apropiadas para la remoción de placa.
No solo es importante realizar una estrategia preventiva individualizada controlando
y removiendo la placa bacteriana mediante la enseñanza de higiene oral adaptada y el
uso de hilo dental en el hogar o centros de educación especial; es de vital importancia
reforzar el esmalte dental mediante el uso de flúor, sellantes de fosas y fisuras y disminuir
el potencial cariogénico de la dieta mediante asesoramiento dietético a familiares.
Zifeng Liu , Dongsheng Yu, Wei Luo, Jing Yang, Jiaxuan Lu, Shuo Gao et.al,
IMPACT of Oral Health Behaviors on Dental Caries in Children with Intellectual
Disabilities in Guangzhou, Rev IJERPH, China. 2014. 11, 11015-11027.
Abstract:
Dental care is consistently reported as one of the primary medical needs of children with
disabilities (IDC). The aim of the present study was to explore the influence of oral health
behaviors on the caries experience in children with intellectual disabilities in Guangzhou,
China. A cross-sectional study was carried out in 477 intellectually disabled
children, 12 to 17 years old, who were randomly selected from special educational schools
in Guangzhou. A self-administered parental questionnaire was used to collect data on
sociodemographic characteristics and oral health behavior variables, and 450 valid
questionnaires were returned. Multiple regression analysis was used to examine the
factors associated with dental caries. The average age of those in the sample was 14.6
years (SD = 1.3), 68.4% of whom were male, and the caries prevalence rate was 53.5%
(DMFT = 1.5 ±2.0). The factors significantly affecting the development of dental caries in
IDC included gender, the presence or absence of cerebral palsy, and the frequency of
dental visits and toothbrushing.
Methods
2.1. Study Design, Population and Sample
This study conservatively estimated caries prevalence in IDC to be 50.0%. Standard error
was set at 5.0%, and the response rate was assumed to be 90.0%. At least 427 children
were needed for study validity. Our study was reviewed and approved by the Ethical
Review Committee of the Institute of Stomatological Research, Sun Yat-Sen University,
before the study began. The approval number is ERC-2012-028.
The present cross-sectional study was conducted among individuals from special
educational schools in Guangzhou in March and April of 2013. Stratified by the numbers
of schools and of the IDC enrolled, a representative sample of 6 special educational
schools with 551 children was randomly selected. Schoolchildren were selected if they
met the inclusion and didn’t have any exclusion criteria.
They were included if they were aged between 12 and 17 years old and had a clinical
diagnosis of intellectual disability based on the criteria and classification established by
Standardization Administration of the People’s Republic of China [14], as registered in
their medical records.We excluded children from the study for the reason that their parents
refused to allow them to undergo the dental examination. The parents of each child were
contacted and informed in writing about the study design and dental examination
proposed for their children. If they agreed to have their children participate in the survey,
a document of informed consent was voluntarily signed by the parents. In total, 477 IDC
were recruited in the final sample.
2.2. Data Collection and Study Variables
The children’s DMFT scores were based on clinical examinations performed by two well-
trained and calibrated dental practitioners (kappa = 0.87) [15]. The DMFT score has been
well established as the key measure of caries experience in dental epidemiology,
reflecting the degree of caries experience, and is calculated by adding results for
Decayed, Missing due to caries, and Filled Teeth in the permanent dentition. Visual
examination by means of an artificial white light source and plane mouth mirror was
combined with probing diagnosis in caries examination, with codes and criteria as
established by the who [16]. The information on grade of intellectual disability and the
presence or absence of cerebral palsy was supplied by the special education school.
Every child with a disability had been examined and assessed by the designated and
qualified hospital. The results of the assessment were registered in the school’s medical
records.
Results
3.1. Description of the Study Sample
The average age of the children was 14.6 years (SD = 1.3), and 68.4% were male. The
sample consisted of 450 children (241 DMFT > 0, 209 DMFT = 0), and the caries
prevalence rate was 53.5% (DMFT = 1.5 ±2.0). Table 1 displays the distribution of socio-
demographic characteristics, oral health behavior variables, and DMFT scores (mean ±
SD). A statistically significant difference in DMFT scores was detected between
subgroups stratified by gender, the presence/absence of cerebral palsy, dental visit in the
preceding 12 months, and frequency of toothbrushing, respectively (p < 0.05).
Results of the multivariate logistic regression analysis are shown in Table 4, which
presented an adequate fit (goodness of fit, Hosmer and Lemeshow: χ2 (7) = 6.28, p =
0.508). The prevalence of caries was significantly related to some socio-demographic
characteristics and oral health behaviors. The odds for girls having caries (DMFT > 0)
were 1.9 times more than for boys. The odds for children with cerebral palsy having caries
were 1.6 times more than for those without cerebral palsy. Having dental visits in the
preceding 12 months (adjusted OR = 0.4, p < 0.05, 95% CI = 0.2–0.6) and toothbrushing
at least twice a day (adjusted OR = 0.5, p < 0.05, 95% CI = 0.3–0.8) were caries-protective
factors.
Conclusions
The results of this study show poorer dental health status in IDC, who have higher caries
prevalence rates and DMFT scores, and enhance our understanding of the role that oral
health behaviors play in the dental health status of IDC in Guangzhou, China. IDC with
CP have a higher risk of caries experience than IDC without CP, while toothbrushing more
than twice a day and routine dental visits are caries protective factors. These results
indicate that improving the IDC’s access to dental care and comprehensive oral health
educational programs for parents are urgently needed, which may lead to a reduction in
dental caries levels in IDC.
Caroline Buff Gouveia Passonea, Paula Lage Pasqualuccia, Ruth Rocha Francoa,
Simone Sakura Itoa, Larissa Baldini Farjalla Mattara, Celia Priszkulnik Koiffmannb
et.al, PRADER‐ Willi syndrome: what is the general pediatrician supposed to do? ‐
a review. Rev Paul Pediatr. 2018 Jul-Sep;36(3):345-352.
Abstract:
Objective: To carry out a review about Prader‐ Willi Syndrome based on the most recent
data about the subject and to give recommendation for the general pediatricians for early
diagnoses and follow‐ up. Data sources: Scientific articles in the PubMed and SciELO
databases. The research was not limited to a specific time period and included all articles
in such databases. Data synthesis: The Prader‐ Willi Syndrome (PWS) is a rare genetic
disorder resulting from the loss of imprinted gene expression within the paternal
chromosome 15q11‐ q13. PWS is characterized by endocrine abnormalities, such as
growth hormone (GH) deficiency, obesity, central adrenal insufficiency, hypothyroidism,
hypogonadism and complex behavioral and intellectual difficulties. PWS individuals also
may present other comorbidities, such as sleep disorders, scoliosis, constipation, dental
issues and coagulation disorders. The follow‐ up protocol of the Children’s Institute at
Universidade de São Paulo is based on four main pillars: diet, exercise, recombinant
human growth hormone (rhGH) therapy and behavioral and cognitive issues. The diet
must include a caloric restriction of 900 kcal/ day, according to the Prader‐ Willi Eating
Pyramid and exercise plan is focused on daily aerobic exercises and postural therapy.
The rhGH therapy is highly recommended by the international scientific literature and must
be started as soon as the diagnostic is made. The management of behavioral issues is
based on strategies to establish routine and rules.
CONCLUSIÓN
The Prader‐ Willi Syndrome is rare genetic disease, even though it is the main genetic
cause of obesity in children. Early diagnosis can prevent complications and improve
quality of care throughout life. The treatment focuses on four main pillars: diet, exercise,
rhGH therapy and behavioral strategies. If the general pediatrician becomes more familiar
with PWS, the diagnosis will have a higher probability to take place and, so, treatment will
start earlier. This may improve the quality of life and care for these individuals.
Danielle de Moraes Pini,Paula Cristina Gil Ritter Fröhlich, Lilian Rigo et.al, ORAL
health evaluation in special needs individuals. Einstein (Sao Paulo). 2016 Oct-Dec;
14(4): 501–507.
Abstract
Objective
To identify the prevalence of the main oral problems present in special needs children and
to relate the underlying conditions with the clinical and demographic variables.
Methods
The study was based on the physical examination of 47 students from the Associação de
Pais e Amigos dos Excepcionais diagnosed as Down syndrome, cerebral palsy and
intellectual deficit. For data collection, we used a self-administered questionnaire that
included indices of dental caries and oral hygiene, Angle classification, malposition of
dental groups and oral hygiene habits.
Results
The predominant age group was 12-25 years (46.8%) and most patients were male
(55.3%). Regarding daily brushing, 63.8% reported brushing their teeth three times a day,
and 85.1% did it by themselves. A total of 48.9% were rated as Angle class I, and 25.5%
had no type of malocclusion. A high dental carries index (decayed, missing, filled >10)
was observed in 44.7%, and 53.2% had inadequate oral hygiene (zero to 1.16). There
was a statistically significant difference between cerebral palsy and the act of the
participants brushing their teeth by themselves.
Conclusión
There was a high decayed-missing-filled teeth index and malocclusion class I, as well as
inadequate oral hygiene. The type of underlying condition of the participants influenced
the act of brushing teeth by themselves.
é
Artículos similares
Referencias bibliográficas
● Liliana Ganciné Copês, Márcia Canèado Figueiredo. Katia Silva et.al,
ACCIONES para la salud general y bucal con pacientes psiquiátricos en
talleres terapéuticos. Odontoestomatología Montevideo May 2011. vol.13
(no.17), 9.
● Medina, M. C. (2009). Los ausentes están siempre presentes: Una
aproximación interpretativa de la experiencia maternofilial transnacional
entre España y Colombia (Tesis doctoral). Universidad Complutense de
Madrid, Facultad de Ciencias Políticas y Sociología, Madrid, España.
● Micheline Sandini TRENTIN, Antônio Augusto, Iponema COSTA, Maurício
BARANCELLI, Marilia Fagury Videira Marceliano-ALVES et.al. PREVALENCE
of dental caries in patients with intellectual disabilities from the Association
of Exceptional Children’s Parents and Friends of Southern Brazil. Rev.
Gaúch. Odontol. Campinas Oct./Dec. 2017, vol.65 (no.4).7.
● José A. Posada et.al, LA SALUD mental en Colombia, Biomédica Instituto
Nacional de Salud, Diciembre, 2013, Volumen 33, (No. 4), Bogotá, D.C.,
Colombia, 3 páginas.
http://www.scielo.org.co/pdf/bio/v33n4/v33n4a01.pdf
● Antônio Augusto Iponema Costa, Álvaro Della Bona, Micheline Sandini
Trentin et.al, INFLUENCE of different Intellectual Disability Levels on Caries
and Periodontal Disease. Brazilian Dental Journal (2016) 27(1): 52-55.
● Fátima Antonio, Elide Mill, Mariel Páez, Gabriela Sayago, Daniurka Valero
et.al, MANEJO de pacientes con diversidad funcional en el ámbito
odontológico. Rev Venez Invest Odont IADR 2013; 1 (2): 121-135.
● Carlos Gómez-Restrepo, Cecilia de Santacruz b, María Nelcy Rodriguezc,
Viviana Rodriguezc, Nathalie Tamayo Martínezc, Diana Matallanab et.al,
ENCUESTA Nacional de Salud Mental Colombia 2015. Protocolo del estudio,
rev colomb psiquiat. 2016;45(S1):2–8
● ACTUALIZACIÓN Suplemento del MANUAL DIAGNÓSTICO Y ESTADÍSTICO
DE TRASTORNOS MENTALES, Rev APA DSM 5, septiembre 2016, 5, 1-33.
● Grupo de Gestión Integrada para la Salud Mental et.al, ABECÉ sobre la salud
mental, sus trastornos y estigma, Rev. MinSalud, octubre 2014, 1-5.
A partir de los artículos preseleccionados seleccione con sus asesores los artículos
definitivos para estructurar su marco teórico definitivo.