Registo clínico eletrónico para a periodontologia de precisão

Abstract

Introduction: Periodontitis is among the most common diseases and represents an important public health problem, due to its prevalence and high socioeconomic impact that it constitutes in today's societies. This new classification is based on several clinical parameters, but also considers the
annotation of several risk factors, namely: smoking, uncontrolled diabetes, pregnancy, stress, genetic factors, etc. The verification of these causes and consequences derived from the disease allow doctors to suggest changes to the patient's lifestyle, thus achieving greater control of its progression. However, the clinical record currently used in dental clinics does not consider the collection
of all the information necessary for the application of the new classification in all its fullness, although this type of data constitutes the basis for a true Precision Dentistry (MDP). ), providing dentists with information that will enable them to improve treatment planning and patient response to that treatment. Objectives: The main objective of this work is to adapt the electronic clinical record of the
University Dental Clinic (CDU) of the UCP to the new classification of periodontal diseases. The specific objectives are: • Identification and organization of clinical data necessary for the implementation of the new classification of periodontal diseases; • Identification of risk factors necessary for the implementation of the new classification of periodontal diseases; • Proposal of an integrated clinical file and subsequent application to the CDU-UCP Periodontology consultation.
Materials and methods: To achieve the proposed objectives, a research or review of the scientific literature in this area was carried out, and specialists in the field of Periodontology were consulted, in order to better identify the clinical data and risk factors underlying this disease. Results: The application of the proposed methodologies made it possible to identify the main data essential to the application of Precision Periodontology and the consequent development through a model of a periodontal clinical record in which it is possible to collect the set of information about the patient's clinical history until the moment of the examination. This includes the histories: medical and dental history, the chief complaint or reason for the current consultation, and the course of the current illness. The clinical history is divided into 3 sections: personal data; General anamnesis and anamnesis linked to periodontal risk factors. A pre-validation of the information to be included in the clinical file was carried out through discussion with specialists in Periodontology. Conclusions: In the long term, the benefits of Precision Medicine are numerous. These include disease delineation and stratification, detection and monitoring of disease symptoms, identifying presymptomatic individuals, modeling the dynamics of disease evolution, surveillance and management of causes. But not everything is an advantage because these types of approaches require a lot of time since it becomes necessary to collect and generate a lot of data so that it is possible to implement precision periodontology, and there is still a lack of organized collection and storage of the same. It is works like ours that allow this to happen. It is necessary to change the mentalities of dentists so that they apply as completely as possible the largest possible amount of data, with the highest possible quality. And from a more macro political perspective, the problem of economic investment, in programs for this purpose, and implementation of all the logistics, so that this health problem can be normalized and implemented at a global level.

Date of Award	28 Jul 2022
Original language	Portuguese
Awarding Institution	Universidade Católica Portuguesa
Supervisor	Nuno Rosa (Supervisor) & Rita Bornes (Co-Supervisor)