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Effectiveness of combined virtual and clinical simulation compared with other active teaching strategies on health students' learning: a systematic review protocol.

The objective of this review is to synthesize the available evidence on the effectiveness of combined virtual and clinical simulation compared with other active teaching strategies on health students' learning. Current evidence indicates that both virtual simulation and clinical simulation are effective in assisting students to acquire clinical skills. However, there is a knowledge gap regarding the effectiveness of the combined use of both teaching strategies, which could enhance health students' learning. This review will consider experimental, quasi-experimental, and observational studies that address the combined use of virtual simulation with clinical simulation compared with other active teaching strategies in learning, clinical reasoning, clinical decision-making, and/or clinical competencies of health students. Combining different hybrid simulators to form a new one will not be considered for inclusion in the review. The databases to be searched will include Cochrane Library, MEDLINE (PubMed), CINAHL (EBSCOhost), Scopus, LILACS (VHL), Web of Science Core Collection, Embase, ERIC, and gray literature sources. Two independent reviewers will perform the study selection, critical appraisal, and data extraction using JBI tools. A narrative synthesis will be performed and, if possible, meta-analysis and risk assessment of publication bias. The Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) approach will be used to assess the certainty of the findings. PROSPERO CRD42023422410.

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Interdisciplinary endodontic treatment of a Molar-Incisor Malformation-affected molar using a 3D printing model based on cone-beam computed tomography: A case report and literature review

Abstract Background Molar-Incisor Malformation (MIM) represents a complex dental anomaly entwined with patients’ medical histories, characterized by intricate root canal structures. This study unveils an innovative interdisciplinary digital strategy for managing MIM, accompanied by an extensive literature review. Case presentation The case involves a 7-year-old Caucasian female patient who was referred by the orthodontist for a significant apical lesion detected in the permanent left mandibular first molar (tooth #36). Thorough clinical, radiographic and CBCT examinations the clinical diagnosis definitively identified a MIM in tooth #36 with symptomatic apical periodontitis. Employing Cone Beam Computed Tomography (CBCT) and a meticulously crafted virtual three-dimensional (3D) printed scaled tooth guide model, an endodontic procedure was performed on tooth #36 in a patient with MIM. A one-year follow-up showcased a reduction in the size of the apical lesion, demonstrating a healing process. Conclusions This case underscores the potential of interdisciplinary and technology-driven strategies in effectively managing MIM. Nonetheless, there´s a crucial need of research focusing on higher QoE to identify the most effective approaches for treating MIM-affected teeth.

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Role of salivary proteins on radiation-related caries onset in head and neck cancer patients treated with radiotherapy - a longitudinal study.

Abstract Objective Longitudinal assessment of the role of specific proteins on radiotherapy caries (RC) onset in head and neck cancer patients (HNC)up to one-year post intensity-modulated radiation therapy (IMRT). Methods Dental status/salivary protein data were obtained from 40 HNC patients pre-IMRT (T0), six months (T1) and 12 months (T2) post-IMRT (ethical approval/consent). DMFT and salivary parameters were quantified including flow rate, mucin 5B and 7, Immunoglobulin A (IgA), and cystatin S and α-amylase. Results 45% patients had at least one carious lesion at T2, having a significant reduction in the number of remaining teeth (65% <21), salivary flow rate (<50%,) and, protein secretion (<0.05) post-IMRT. At T1 IgA concentration/secretion rate were associated with caries lesions (p<0.05). Finally, IgA and total protein concentration obtained at T1 could provide a predictive pattern (AUC 82.3%) for the patients more predisposed to developing RC at T2. Conclusion This study demonstrated the significant association of RC with salivary proteins in HNC patients treated with IMRT, revealing the potential role of salivary proteins in the early diagnosis of RC. Clinical relevance: This research contributes to reveal salivary proteins association with RC, and its role in early diagnosis. Therefore, this could be the first step towards for personalized medicine approaches to improve this group quality of life (QoL).

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Cross-cultural adaptation of PIDAQ questionnaire to evaluate the psychosocial impact of dental esthetics in Chilean adolescents with malocclusion

Abstract Background: Psychosocial Impact of Dental Aesthetics Questionnaire (PIDAQ) is a useful index to assess aspects of malocclusion that impact individuals' oral health-related quality of life. This study aimed to perform cross-cultural adaptation of the PIDAQ questionnaire to the language of the Chilean adolescent population. Methods: We used the framework of the Guidelines for the Transcultural Adaptation Process of self-reports and the Manuals for a language inclusive for the transcultural adaptation of the PIDAQ. The instrument was tested on 34 Chilean adolescents with malocclusion between 11 and 17 years of age. We evaluated equivalence considering criterion, content, and construct validity according to COSMIN methodology and performed Cronbach's alpha statistical test. A total of 23 items in the questionnaire were tested according to how clear and understandable the questions were to the reader and according to a Likert scale graduated in: not at all clear, unclear, clear, or very clear. For temporal stability, we calculated intraclass correlation coefficients (ICC). Results: We obtained a more than acceptable reliability with a Cronbach's Alpha of 0.951 for the total questionnaire. The questions grouped according to the dimensions of dental self-confidence, social impact, psychological impact, and esthetic concern obtained a Cronbach's Alpha of 0.955, 0.947, 0.946 and 0.939, respectively. The questionnaire showed high temporal stability at the test-retest with a total ICC of 0.907 (0.885-0.913). Conclusion: The cross-cultural adaptation of the PIDAQ questionnaire achieved equivalence with the original instrument and obtained reliable criterion, content, and construct validity in Chilean adolescents.

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HIV and AIDS in the state of Paraná, Brazil, 2007-2022: trends and spatiotemporal distribution.

The aim of this study was to analyze the spatiotemporal evolution of the incidence rates of human immunodeficiency virus (HIV) and acquired immune deficiency syndrome (AIDS) in the state of Paraná, Brazil. An ecological study with an analytical component of time series analysis was conducted in the state of Paraná from 2007 to 2022. The data source was the Notifiable Diseases Information System. To study the trend, the Prais-Winsten generalized linear regression model was used by decomposing the time series, and for spatial analysis, the Moran's index was applied. The total sample consisted of 50,676 HIV/AIDS records. The incidence rate showed an increasing trend, with an average growth of 2.14% [95% confidence interval - 95%CI 1.16-3.13] per month. From 2007 to 2014 and from 2015 to 2022, the average number of cases in the state was 105.64 and 159.20 per 100,000 inhabitants, respectively, with significant variation among municipalities. Spatial clusters of high risk persisted in the metropolitan region, the capital, and coastal areas, and a new cluster was observed in the northern region of the state. The incidence rates of HIV/AIDS showed an upward trend over time. The number of cases varied considerably in some municipalities, especially in the coastal region. Spatial analysis revealed geospatial patterns of high risk in the main metropolitan areas of Paraná: Curitiba (including the coastal area), Londrina, and Maringá, which share characteristics such as a high degree of urbanization and ongoing economic development.

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