Objetivos: Evaluar el impacto de los problemas bucales en la calidad de vida en niños de 3 a 5 años de la Institución Educativa Inicial del distrito Hualmay de la provincia de Huaura, departamento de Lima en el 2011. Material y Métodos: Este estudio fue de tipo descriptiva, transversal. Evaluó a 153 niños, a quienes se les examinó la cavidad bucal y al responsable del cuidado del niño se aplicó el Early Childhood Oral Health Impact Scale (ECOHIS); previamente se realizó la validación peruana. Un examinador calibrado evaluó tres problemas bucales: caries de infancia temprana, traumatismos dento-alveolares y maloclusiones en dientes anteriores. Se realizó el análisis estadístico; aplicando pruebas de Anova, U Mann Whitney y Kruskal Wallis con un nivel de significancia de 95%. Resultados: La frecuencia de caries de infancia temprana fue de 76,47%; de traumatismos dento-alveolares 9,8% y de maloclusiones anteriores 6,54%. Las preguntas mayormente respondidas del ECOHIS fueron sobre: el dolor (54,9%), dificultad para comer (49,7%) y beber (41,9%). La dimensión limitación funcional del ECOHIS presentó el promedio más alto (4,75±3,44). La severidad alta de caries de infancia temprana obtuvo el promedio más elevado en relación al ECOHIS (24,88±9,43). Conclusiones: La caries de infancia temprana presentó impacto negativo en la calidad de vida relacionada a la salud bucal de los niños evaluados.
Introduction The evidence of effectiveness of integrated care initiatives for home-dwelling frail older persons is still inconclusive. There is a need for more studies, especially in developing countries. Our objective was to assess the effectiveness of a health and social care integration programme versus the best standard of care to date in this population. Methods Quasi-experimental study performed in patients' homes in Buenos Aires, Argentina. The intervention arm had a health and social care counsellor that systematically reviewed the social and biological situation following a structured process, evaluating: functionality, nutrition, mobility, pain, cognition, medication reconciliation and adherence, need for care, quality of care, and environmental safety. The control group received the best standard of care to date, with access to the same health or social care services, but without the counsellor and related processes. The main outcome was the adjusted hazard ratio for hospitalizations after one year using a Cox-proportional hazards model. Results We recruited 121 persons in each group. The crude hazard ratio for hospital admissions, comparing the intervention to the control group was 0.622 (95% CI: 0.427–0.904; p = 0.013). The adjusted hazard ratio (aHR) was 0.503 (95% CI: 0.340–0.746; p = 0.001). The aHR for death was 0.993 (95% CI: 0.492–2.002; p = 0.984). The absolute difference in the quality of life was 16.59 points (95% CI: 12.03–21.14; p < 0.001). Discussion The integration programme had lower hospital admissions and better quality of life than the usual care. There was no significant difference in death rates.
Background: Wolff-Parkinson-White syndrome is a congenital abnormality of the heart. Patients with this syndrome and multiple dental caries with pulp exposure may require comprehensive dental treatment under general anesthesia. Pulpectomy is performed in primary teeth with pulp expose. This treatment in anterior teeth requires palatal access and the majority there is no good visibility, requiring more time to perform. Therefore, this case aimed to demonstrate a pulp chamber opening alternative in pulpectomies in a child with Wolff-Parkinson-White syndrome.Case Presentation: A 3-year-old female patient with Wolff-Parkinson-White syndrome and multiple dental caries with reversible pulpitis in anterior upper teeth. The dental treatment was performed under general anesthesia. Due to abundant hemorrhage in anterior upper teeth, pulpectomies were performed, which pulp chamber openings were modified by labial and the treatment itself was completed. After, these teeth were rehabilitated with direct restorative veneers using light-curing composite resin. The follow-up at 12 months showed an absence of evidence clinic and radiographic. Conclusion: This case demonstrated the pulp chamber opening performed by labial in pulpectomy is an effective and viable alternative to reduce operative time and improve visibility in pulpotomies in a child with Wolff-Parkinson-White syndrome.
Los infantes que padecen múltiples enfermedades sistémicas son más propensos de presentar problemas en la cavidad bucal. Al no ser diagnosticados y tratados oportunamente, y además la falta de conocimiento de parte de profesionales de salud y de los padres sobre la repercusión de estos problemas bucales; pueden complicar aún más el estado de estos pacientes; afectando negativamente la calidad de vida del menor. Objetivo. Describir el manejo odontológico integral de un infante comprometido sistémicamente en centro quirúrgico.Caso clínico. Paciente de 3 años 5 meses de edad, de sexo femenino, con diagnóstico de cardiopatía congénita, desnutrición crónica, leishmaniasis cutánea; y a nivel estomatológico: pulpitis irreversible y necrosis pulpar; por la complejidad del caso fue sometida a tratamiento odontológico integral en el centro quirúrgico del Instituto Nacional de Salud del Niño, Lima, Perú.Conclusión. El manejo odontológico integral, en especial en infantes que padecen enfermedades múltiples y complejas, se debe realizar oportunamente en un ambiente adecuado y con el apoyo de un equipo multidisciplinario de salud.
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