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Scientific Evidence on Teledentistry in Dentistry Diagnosis

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Scientific Evidence on Teledentistry in Dentistry Diagnosis 127 SCIENTIFIC EVIDENCE ON TELEDENTISTRY IN DENTISTRY DIAGNOSIS EVIDENCIAS CIENTÍFICAS EN TELEODONTOLOGÍA EN EL DIAGNÓSTICO ODONTOLÓGICO EVIDÊNCIAS CIENTÍFICAS DA TELEODONTOLOGIA NO DIAGNÓSTICO ODONTOLÓGICO Lara Guabiraba da Silva¹, Rafael Santiago Barroso2, Francisca Tereza Coelho Matos3, Marconi Raphael de Siqueira Rêgo4, Luana Kelle Batista Moura5 1- Centro Universitário UNINOVAFAPI. Acadêmico de Odontologia. E-mail: [email protected] 2 - Centro Universitário UNINOVAFAPI. Acadêmico de Odontologia. E-mail: [email protected] 3 - Centro Universitário UNINOVAFAPI. PhD in Endodontics. E-mail: [email protected] 4 - Centro Universitário UNINOVAFAPI. Master of Science in Health. E-mail: [email protected] 5 - Centro Universitário UNINOVAFAPI. PhD in Endodontics. E-mail: [email protected] Francisca Tereza Coelho Matos (Corresponding author) Centro Universitário UNINOVAFAPI. E-mail: [email protected] 128 Abstract Objective: The objective of the study was to analyze the scientific evidence of teleodontology in diagnosis in dentistry. Material and Methods: Integrative review based on the PICO strategy, which selected articles published in full in the English language, between 2012 and 2017, using the descriptors "telehealth", "dentistry" and "diagnostic" in the Web database of Science™. Results: A total of 464 publications were found, of which 387 were evaluated according to the inclusion and exclusion criteria. After reading the titles and summaries, only 3 articles were fit to the selection criteria. Conclusion: The scientific evidence on diagnosis in teleodontology is referenced with the use of electronic systems and telehealth applications. These new technologies add to the process of academic and professional training, with the aim of improving access to health services. Keywords: Telehealth. Dentistry. Diagnosis. Resumen Objetivo: El objetivo del estudio fue analizar cuáles son las evidencias científicas de la teleodontología en el diagnóstico en odontología. Material y métodos:En el presente trabajo se analizaron los resultados obtenidos en el análisis de los resultados obtenidos en el análisis de los resultados obtenidos en el estudio. de ScienceTM. Resultados: Se han encontrado 464 publicaciones, de las cuales 387 fueron evaluadas según los criterios de inclusión y exclusión. Después de la lectura de los títulos y resúmenes se encuadraron solamente 3 artículos a los criterios de selección. Conclusión: Las evidencias científicas sobre el diagnóstico en teleodontología son referenciadas con uso de sistemas electrónicos y aplicaciones de telesalud. Estas nuevas tecnologías agregan en el proceso de formación académica y profesional, con el objetivo de mejorar el acceso a los servicios de salud. Descriptores: Telelaude. Odontología. Diagnóstico. Resumo Objetivo: O objetivo do estudo foi analisar quais são as evidências científicas da teleodontologia no diagnóstico em odontologia. Material e Metodos: Revisão integrativa baseada na estratégia PICO, onde foram selecionados artigos publicados na íntegra, em língua inglesa, entre os anos de 2012 a 2017, utilizando os descritores “telehealth”, “dentistry” e “diagnostic” na base de dados Web of ScienceTM. Resultados: Foram encontradas 464 publicações, das quais 387 foram avaliadas segundo os critérios de inclusão e exclusão. Após a leitura dos títulos e resumos se enquadraram somente 3 artigos aos critérios de seleção. Conclusão: As evidências científicas sobre o diagnóstico em teleodontologia são referenciadas com uso de sistemas eletrônicos e aplicativos de telesaúde. Estas novas tecnologias agregam no processo de formação acadêmica e profissional, com intuito de melhoria do acesso aos serviços de saúde. Descritores: Telessaúde. Odontologia. Diagnóstico. Introduction Historically, teaching dentistry has been based on the transmission of knowledge focused on the development of technical skills, oral diseases and everyday situations related to clinical practices. Thus, it is extremely important to 129 know and evaluate the new processes of quality education and health education in dentistry, combined with economic, social and cultural development.(1) In Brazil, the requirements of the new National Curricular Guidelines (CND) have caused significant changes in dental education with the insertion of collective oral health policies, in which changes in the practice of the profession and in new jobs for professionals, especially in Health Care Networks.(1-2) Oral health care is characterized by activities of an educational and therapeutic nature, and the latter requires technological devices to guarantee the best possible diagnosis. However, many sites assisted by the Oral Health Strategy (ESB) do not have low-cost publicly available technological resources such as imaging tests, which are considered to be tools that help a great deal in the diagnosis and prognosis of diseases.(2-3) Currently, dentistry uses differentiated equipment, allowing access to important images for the planning of clinical cases, offering technical resources to obtain images of patients, which will favor the dental surgeon, allowing it to make a better diagnosis and for the visualization and understanding of the treatment by the patients.(3) However, as these equipments are not available in certain localities, the need for new technological advances to contemplate the various social aspects and to positively add to the provision of qualified assistance is evident. These advances have as central elements a set of technologies based on microelectronics, telecommunications and information technology, called Information and Communication Technologies (ICT).(4) Telehealth is defined as the use of modern (ICT) for health-related distance activities at its various levels (primary, secondary and tertiary), enabling interaction between health professionals or between them and their patients, as well as remote access to diagnostic or even therapeutic support resources through robotics.(4) Teleodontology can be conceptualized as a tool for provision of dental care, be it diagnostic, treatment or second opinion, carried out through electronic transmission between different sites, proposing its use for case screening and offering support to clinical professionals so that the treatment can be done in their places of origin without the need to refer patients to specialized services.(5) The literature emphasizes that it can be characterized as a practical and economically viable method of promoting health for underserved populations including socially disadvantaged individuals living in remote locations or rural areas who do not have access to routine dental care.(6) However, it is understood that the teaching process in the institutions is still less than expected, reflecting this paradigm in professional practice, even with the new technologies of health education that are easily accessible. With this, the objective of the present study is to analyze the scientific evidences about the diagnosis in teleodontology. Based on the objective, the following guiding question emerges: "What are the scientific evidences about teleodontology as a diagnostic tool in dentistry?". Material and Methods In search of the proposed objective, we selected the integrative review method, which allows us to include in the study theoretical and empirical literature, as well as studies with different methodological approaches.(7) 130 Evidence-Based Practices (EBPs) are methodologies and processes for identifying evidence that a certain treatment or diagnostic environment is effective, strategies for assessing the quality of studies, and mechanisms for implementation in care. care, through the identification and promotion of practices that work and elimination of inefficient or harmful ones, and minimization of the gap between the generation of evidence and its application in patient care.(8) The PBE proposes that the clinical problems that arise in the practice of care, teaching or research, be decomposed and organized using the PICO strategy, which represents an acronym for Patient, Intervention, Comparison and outcome. Within the PBE these four components are the fundamental elements of the research question and the construction of the question for the bibliographic search of evidence. The PICO strategy can be used to construct research questions of different natures, from the clinic, human and material resources management, the search for instruments to evaluate symptoms, among others, the appropriate research questions (well constructed) in which they enable the correct definition of information (evidence) that is necessary to solve the clinical question of research, maximizing the retrieval of evidence in the databases, focusing on the scope of the research and avoiding unnecessary searches.(8) Taking into account the PICO strategy, in this work, the diagnosis of patients will be defined as "P", the "I" will be the telehealth activities, the "C" will be classified as a form of intervention and the "O" as a treatment strategy. This integrative review of the literature was carried out during August 2017 by three reviewers, structured in eight stages: 1) identification of the theme and formulation of the guiding question; 2) establishment of criteria for inclusion and exclusion of studies; 3) definition of research databases; 4) definition of bibliographic search resources; 5) definition of information to be extracted from the selected studies; 6) evaluation of included
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