Prevalência da disfunção temporomandibular em estudantes de odontologia por meio de diferentes índices

The epidemiology of temporomandibular disorders varies widely in the literature. The aim of this study was to determine the prevalence of TMD in dental students of the Federal University of Rio Grande do Norte assessed by different indexes. The sample consisted of 101 individuals selected by a randomized process, whose general outline was systematic sampling. For evaluation of the signs and symptoms of TMD, an anamnestic index, Fonseca s protocol, and two clinical indexes, the RDC/TMD (Research Diagnostic Criteria for Temporomandibular Disorders), or standard index, and the Helkimo s Clinical Dysfunction Index were applied. Data were analyzed using the chi-square test and kappa, besides verifying the sensitivity and specificity (5% significance). The diagnosis of TMD by different indexes showed a variation in the prevalence between 72.3% (Helkimo s Clinical index), 64.4% (Fonseca s anamnestic index) and 35.6% (RDC/TMD). There was no statistical difference between the sexes for the RDC/TMD, although this difference was found for Fonseca s and Helkimo s indexes (p<0.05). The most frequent type of TMD were joint disorders (Groups II and III), and the subtypes disc displacement with reduction (17.8%) and arthralgia (15.8%). Most individuals showed a mild TMD (45.5%) for both indexes, Fonseca and Helkimo. When comparing the types of diagnoses, RDC/TMD with Fonseca and Helkimo, low agreement was found (k=0.17 and k= 0.35, respectively). A moderate correlation between the severity of TMD was obtained (kw= 0.53) for Fonseca s protocol and Helkimo s index. High sensitivity and low specificity were seen for both diagnoses compared to standard, resulting in excessive false positives. Within the limitations of the study, it was concluded that the prevalence of TMD can vary widely, depending on the index used for its diagnosis

Caminhos para a avaliação da formação em odontologia: desenvolvimento, validação e aplicação de critérios

The need for universal access to health and the failure of the pedagogical model centered on the transmission of knowledge has led to changes in the training of health professionals. The objective of this study was to provide a new alternative for evaluating dental students through the development, validation and application of evaluation criteria based on the National Curriculum Guidelines (DCN in Brazil). Therefore, the study was conducted in three phases: development and validation of evaluation criteria of Dentistry courses based on the DCN; a pilot study to verify the applicability of the validated criteria and evaluation of the dentistry courses in the Northeast. In the first stage, a logical model was formulated, allowing for the construction of a criteria matrix, validated by a modified Delphi consensus technique. The validated matrix has the following dimensions: Profile of graduates, health care guidance, teaching and service integration, and pedagogical approach. The pilot study was conducted in five dental courses through a documentary study of the pedagogical project course (PPC), and application of validated questionnaires and interviews with course coordinators. The results of the pilot study indicate the possibility of being verified by means of validated criteria and using different methodological proposals, advances and curricular limitations facing the proposed reorientation of training recommended by DCN. The evaluation of Northeast Dentistry courses was carried out by applying a questionnaire validating a matrix of 30 course coordinators, including public and private institutions. The data were submitted to descriptive analysis, and also tested the difference between means and the correlation between the assessment of the coordinators in the dimensions and sub-dimensions with each other, among the general evaluation of courses and between the following variables: administrative category, time since last curriculum updating, participation in reorienting the training of health professionals programs, ENADE and CPC (Preliminary Concepts of the Course) scores in the year 2013. Positive correlation (p <0.01) was found between the means obtained by the perception of the coordinators in most dimensions, and also between them and the overall performance of the course. There were no significant differences between the coordinators’ perception about course performance and the administrative category (public / private). This difference is slightly higher when the average performance is compared with respect to time due to the last curriculum update, getting better performance in courses with the latest updated curriculum, even with there not 11 being this significant difference between dimensions. Better averages of performance were obtained in courses that do not participate in reorientation programs of professional training, with a significant difference (p<0.05) for the overall score and for all dimensions except the dimensions of teaching-service Integration (p = 0.064). There was no significant correlation between the assessment of coordinators in all dimensions, in the overall assessment or ENADE and CPC scores in 2013. The final instrument proposed in this study is a different alternative assessment for health training of both dentists and other professionals, considering that the DCN providing for the training and graduation of professionals is focused on the health needs of the population, integrated with the SUS (the National Brazilian Health System) and based on student-centered learning.