Percorrer por autor "Canales, Giancarlo De la Torre"
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- Beauty choices : uncovering the profile of who opts for aesthetic proceduresPublication . Agrizzi, Rafaela Rocha; Peroni, Matheus Bellanda; Gonçalves-Soares, Leticia Machado; Carbone, Ana Claudia; Câmara-Souza, Mariana Barbosa; Sanchez-Ayala, Alfonso; Manso, Ana Cristina; Canales, Giancarlo De la TorreBackground: The demand for aesthetic procedures has increased, driven by advances in aesthetic therapies. Therefore, understanding the factors that influence individuals to undergo aesthetic procedures is important. This study aimed to assess the profile of patients that received or did not receive aesthetic procedures. Methods: This cross-sectional study enrolled 834 female participants aged between 18 and 65 years which were divided in two groups: yes to aesthetic procedures (YAP) and no to aesthetic procedures (NAP). Participants were instructed to fill out a form that included sociodemographic questions, a question regarding performing or not aesthetic procedures and the Portuguese validated versions of five FACE-Q scales. Data were collected electronically from October 2023 to February 2025. For group comparison for continuous variables, the Yuen test was used and Fisher's exact test for categorical variables. Multivariate logistic regression was also performed to assess the influence of variables in performing aesthetic procedures. Results: The sociodemographic data showed group differences in age, education and marital status and income (p < 0.001). Botulinum toxin type A was the most common minimally invasive procedures reported by the participants. Also, volunteers of the YAP group showed greater self-perception and concern about ageing (FACE-Q1 ageing appraisal) (p=0.001). Multivariate logistic regression analysis showed that marital and education status, income and FACE-Q1 influence the decision of performing aesthetic procedures. Conclusion: Women of higher educational level, divorce, with higher income and that present higher concerns about ageing are linked to a greater likelihood of undergoing facial aesthetic procedures.
- Botulinum toxin effects on biochemical biomarkers related to inflammation-associated head and neck chronic conditions : a systematic review of clinical researchPublication . Pereira, Inês Novo; Durão, Sara; Hassan, Haidar; Braga, Ana Cristina; Almeida, André Mariz de; Manso, Ana Cristina; Faria- Almeida, Ricardo; Canales, Giancarlo De la TorreBotulinum toxin type A (BoNT) has emerged as a potential alternative to conventional therapies to many debilitating chronic diseases characterised by inflammatory states. However, the biological rationale remains ambiguous. Our review aimed to systematically assessed which biochemical biomarkers have been reported in clinical research to evaluate BoNT analgesic and mood-lifting effects in head and neck chronic conditions related to inflammation. We searched databases and registries between inception and September 29, 2023. Of the nine included studies, there were concerns about risk of bias for six studies. The leading biomarker with five studies was the calcitonin gene-related peptide (CGRP), followed by serotonin with two studies. Oxidative stress biomarkers were only reported in one study. Several important players in inflammatory processes and different immune cell classes have been evaluated in four studies. There was only one trial measuring changes in beta Tubulin and SNAP-25, and another study evaluating cutaneous neuropeptide substance-P. After BoNT, a significant effect was reported in six studies, including decrease in plasma levels of CGRP in chronic migraine and trigeminal neuralgia; serotonin decrease when collected from human tears in refractory intractable dry eye disease and increase in peripheral blood platelets in painful cervical dystonia associated to depression and anxiety; decrease in plasma concentration of markers of oxidative damage to proteins and increase in biomarkers for antioxidant power; decrease in expression of gene sets involved in inflammatory pathways and immune cells classes in the periosteum and metalloproteinase-9 molecule in the tears. BoNT seems to affect some biomarkers present in chronic inflammatory conditions. However, the certainty evidence found was very low to moderate. This study is registered on PROSPERO (CRD42023432131).
- Botulinum toxin type A for the prevention of migraines : an umbrella review of systematic reviewsPublication . Chamani, Goli; Jasim, Hajer; Minston, Ava; Dias, Marlon Ferreira; Poluha, Rodrigo Lorenzi; Gonçalves, Daniela A. Godoi; Christidis, Maria; Al-Moraissi, Essam Ahmed; Christidis, Nikolaos; Canales, Giancarlo De la Torre; Ernberg, MalinBotulinum toxin type A (BoNT-A) is an established preventive therapy for chronic migraines; however, uncertainty remains regarding its comparative efficacy and safety. Thus, we aimed to summarize current evidence from high-quality systematic reviews of the therapeutic effects of BoNT-A in migraine management. An umbrella review was conducted following PRISMA guidelines and registered in PROSPERO. High-quality systematic reviews with meta-analysis evaluating BoNT-A efficacy were identified through five databases up to August 2024. Primary outcomes included monthly headache frequency and severity. Methodological quality and risk of bias were assessed using the umbrella review checklist. Fourteen articles were included. Overall, quantitative evidence indicated favorable effects of BoNT-A compared with placebo for chronic migraines, across headache frequency, headache severity, and acute medication use, but less efficacy than topiramate and the CGRP monoclonal antibodies (CGRPmAbs) galcanezumab and fremanezumab. Though the adverse events were frequent, BoNT-A was generally well-tolerated. Comparative data suggested superior tolerability versus topiramate and a safety profile like CGRPmAbs. Although botulinum toxin type A is widely used as a preventive treatment for chronic migraines, the available evidence supports its efficacy at a moderate level. Further head-to-head and long-term analyses are needed to clarify its comparative role alongside newer biologic treatments.
- Botulinum toxin-A effects on pain, somatosensory and psychosocial features of patients with refractory masticatory myofascial pain : a randomized double-blind clinical trialPublication . Canales, Giancarlo De la Torre; Poluha, Rodrigo Lorenzi; Bonjardim, Leonardo Rigoldi; Ernberg, Malin; Conti, Paulo César RodriguesThe antinociceptive effect of BoNT-A have been well documented in animal studies; however, results of few but well-designed randomized placebo-controlled clinical trials about BoNT-A efficacy in masticatory myofascial pain (MFP) are inconsistent. Therefore, the present randomized, double-blind, placebo-controlled clinical trial evaluated the efficacy of BoNT-A in patients with refractory MFP. Twenty-eight patients with pain reduction of less than 30% despite conservative treatment and with an average pain intensity of > 50 mm on the visual analogue scale (VAS) participated. Patients were randomly assigned to receive a total of 80 U of BoNT-A or saline solution (SS) injected into the masseter and anterior temporalis muscles. Pain intensity (VAS), quantitative sensory testing (QST), conditioned pain modulation (CPM), and psychosocial status were examined. Follow-up was performed at 1 and 6 months. For repeated-measure comparisons between evaluation times, Friedman test with Bonferroni correction was used for pain and somatosensory variables and the Wilcoxon test for the psychosocial variables. The Mann–Whitney test was used for all comparisons between groups. The BoNT-A group had a significant decrease in pain intensity at follow-ups compared with the SS group (p < 0.001). QST assessment revealed higher pressure pain threshold values in the masseter muscle for BoNT-A group compared to SS (p < 0.03) at all follow-ups. No differences were found for mechanical pain threshold and wind-up ratio values (p > 0.05) in the entire study. The BoNT-A group presented the most efficient CPM effect (p < 0.03) only at the 1 month follow-up in the masseter muscle. There was a significant time effect for BoNT-A in all psychosocial variables (p < 0.05) and a drug effect in the Central Sensitization Inventory (p < 0.01), Pittsburgh Sleep Quality Index (p < 0.004), and Healthy Survey 36 (p < 0.05) at 6 months follow-up. The study demonstrates that a single injection-session of BoNT-A has positive effects on the hall pain spectrum of patients with refractory masticatory myofascial pain.
- Botulinum toxin-A for the treatment of myogenous temporomandibular disorders : an umbrella review of systematic reviewsPublication . Canales, Giancarlo De la Torre; Câmara-Souza, Mariana Barbosa; Ernberg, Malin; Al-Moraissi, Essam Ahmed; Grigoriadis, Anastasios; Poluha, Rodrigo Lorenzi; Christidis, Maria; Jasim, Hajer; Lövgren, Anna; Christidis, NikolaosObjective: Temporomandibular disorders (TMDs) encompass several conditions that cause pain and impair function of the masticatory muscles (M-TMDs) and temporomandibular joints. There is a large interest among clinicians and researchers in the use of botulinum toxin-A (BoNT-A) as a treatment for M-TMD. However, due to the lack of consistent evidence regarding the efficacy as well as adverse events of BoNT-A, clinical decision making is challenging. Therefore, this umbrella review aimed to systematically assess systematic reviews (SRs) evaluating BoNT-A treatment effects on pain intensity, mandibular movements, and adverse events in patients with M-TMDs. Method: An electronic search was undertaken in the databases MEDLINE, EMBASE, CINAHL, Cochrane Central Registry of Controlled Trials (CENTRAL), Web of Science, Epistemonikos, ClinicalTrials.gov, and ICTRP to identify SRs investigating BoNT-A effects on M-TMDs, published from the inception of each database until 6 December 2023. The quality of evidence was rated according to the critical appraisal checklist developed by the umbrella review methodology working group. Only high-quality SRs were included. Results: In total, 18 SRs were included. BoNT-A was shown to be more effective than placebo to reduce pain intensity, but not compared to standard treatments. Additionally, BoNT-A was not superior to placebo or standard treatments regarding improvement of mandibular movements. BoNT-A was considered to have a higher risk for adverse events on muscle and bony tissue compared with other treatments. Conclusion: The synthesis in this umbrella review provides the highest level of evidence present. Taken together, there are indications of effectiveness of BoNT-A for treatment of M-TMDs, supported by moderate evidence. However, considering the risk of causing serious adverse events, treatment with BoNT-A is recommended to be the last treatment alternative.
- Can poor nutrition and diet influence temporomandibular disorder? A systematic reviewPublication . Lima, Flávio Fidêncio de; Razavian, Artin; Hosokawa, Mai; Foscaldo, Tatiana Ferreira; Koldzo, Melisa; Poluha, Rodrigo Lorenzi; Christidis, Maria; Christidis, Nikolaos; Canales, Giancarlo De la TorreBackground: The relationship between diet, nutrition, and painful temporomandibular disorders (TMD) is not well established, despite increasing interest in lifestyle factors in chronic pain. This systematic review aimed to synthesize available evidence on how dietary patterns and nutritional status may be associated with painful TMD. Methods: An electronic search was conducted in the databases MEDLINE, CINAHL, EMBASE, the Cochrane Central Registry of Controlled Trials (CENTRAL) and Web of Science for clinical and observational trials from the beginning of each database to November 2025. Risk of bias was performed using the Study Quality Assessment Tools from the National Heart, Lung, and Blood Institute (NHLBI). Results: Out of 7,760 records and after the risk of bias assessment, only seven studies judged as having a low risk of bias were included. Overall, the included studies indicate that the association between dietary factors and TMD remains unclear. Prospective cohort studies did not demonstrate that prenatal or adolescent diet quality independently predicted TMD. Cross-sectional studies suggested that specific dietary patterns may be related to TMD-related symptoms. Women with myogenous TMD showed lower intake of several nutrients compared with controls. Experimental evidence indicated that monosodium glutamate ingestion increased pain intensity in myofascial TMD, while the only randomized trial found no significant pain differences between vitamin D supplementation and diclofenac. Conclusions: Current evidence suggests that some dietary components and nutritional factors may be associated with TMD-related symptoms or pain responses; however, the findings are limited, heterogeneous, and insufficient to support firm causal or therapeutic conclusions.
- Cognitive and orofacial intersections : prevalence of temporomandibular disorders and bruxism in individuals with symptoms of attention deficit hyperactivity disorderPublication . Caron, Arthur Alexis Valentin; Poluha, Rodrigo Lorenzi; Dias, Marlon Ferreira; Flores, Dyanne Medina; Sanchéz-Ayala, Alfonso; Durham, Justin; Canales, Giancarlo De la TorreObjective: Despite emerging evidence pointing to a comorbidity between temporomandibular disorders (TMD), bruxism, and neuropsychiatric conditions such as Attention-Deficit/Hyperactivity Disorder (ADHD), limited studies have explored this relationship in adult populations. This study aimed to investigate the prevalence of painful TMD and self-reported bruxism in adults with highly consistent ADHD symptoms. Methodology: In total, 90 adult participants were divided into two groups based on the Adult ADHD Self-Report Scale Screener, G1: individuals with highly consistent ADHD symptomatology (n=60), and G2: controls (n=30). All participants completed validated instruments assessing TMD (TMD Pain Screener), self-reported bruxism (OBC), anxiety (GAD-7), somatization (PHQ-15), perceived stress (PSS), sleep quality (PSQI), pain hypervigilance (PVAQ), and jaw function (JFLS-8). The chi-square test, adjusted using Bonferroni criteria for multiple comparisons, and the Mann-Whitney U-test were used. Results: A higher prevalence of women (p=0.006), South Americans (p=0.008), and individuals with low/lower middle income (p=0.0001) was found in G1. G1 showed a significantly higher prevalence of painful TMD (p=0.001) and awake bruxism (p=0.013) compared to G2. Participants in G1 also exhibited significantly higher levels of anxiety, somatization, stress, poor sleep quality, pain hypervigilance, and jaw limitation (p<0.05). No significant differences in sleep bruxism were found between groups (p>0.05). Conclusion: These findings suggest a potential behavioral and emotional vulnerability to orofacial disorders in adults with highly consistent ADHD symptoms.
- Comparing botulinum toxin and biofeedback therapies for awake bruxism : a randomized clinical trialPublication . Foscaldo, Tatiana Ferreira; Belo Junior, Paulo Henrique dos Santos; Ribeiro, Giselle Rodrigues; Proença, Leilane Samary de; Canales, Giancarlo De la Torre; Senna, Plinio MendesBackground: Behavioral therapy using electromyography-based biofeedback (BIO) and botulinum toxin type A (BTA) injections are potential treatments for managing awake bruxism (AB) in patients with temporomandibular disorders (TMD). The aim of this study was to compare the effectiveness of BIO and BTA in reducing AB behaviors, pain intensity, and psychosocial distress in individuals with TMD. Methods: This single-center, single-blind, parallel-group randomized clinical trial enrolled 40 adults with TMD diagnosed with AB. AB was assessed using the Oral Behavior Checklist (OBC) and smartphone-based Ecological Momentary Assessment (EMA). Participants presenting an AB frequency of ≥ 60% were randomly allocated to receive BIO or BTA intervention. Pain intensity was measured by the Characteristic Pain Intensity (CPI) score, and psychosocial status was evaluated using the Patient Health Questionnaires (PHQ-9, PHQ-15) and the Generalized Anxiety Disorder questionnaire (GAD-7). Assessments were conducted at baseline, and at 1-, 3-, and 6-month follow-ups. Statistical analyses included Mann–Whitney U for AB behaviors, Wilcoxon Signed Rank test for within-group comparisons, and the Kruskal–Wallis test followed by the Dwass-Steel-Critchlow-Fligner post hoc test for between-group comparisons. Results: Intra-group comparisons showed a significant reduction in BIO group for sustained teeth contact (BIO: p = 0.004) and EMA-assessed AB global behavior (BIO: p = 0.008). No significant improvements were found in BTA group for the same variables in all follow-ups (p > 0.05). However, no significant differences were found between groups in all follow-ups for OBC and EMA scores (p > 0.05). Similarly, there were no significant differences between groups for CPI (p = 0.39) or psychosocial outcomes (p > 0.05). Conclusion: Even though neither intervention improved pain nor psychosocial outcomes, BIO significantly reduced AB behaviors, indicating that BIO may be preferable for controlling AB behaviors in TMD patients.
- Comparing ready-to-use and powder abobotulinumtoxinA for glabellar lines : a randomized, controlled, triple-blinded clinical trialPublication . Silva Junior, Silvio Ventura da; Neves, Maria Luiza Boechat Borges; Sanchez-Ayala, Alfonso; Cebola, Pedro Miguel Teixeira Carvas; Carbone, Ana Claudia; Câmara-Souza, Mariana Barbosa; Poluha, Rodrigo Lorenzi; Canales, Giancarlo De la TorreBackground: Botulinum toxin A (BoNT-A) is the most used procedure to treat glabellar lines; however, limited data exist about the effectiveness of ready-to-use BoNT-A (RTUaboBoNT-A) for this indication. Aims: This study compared the efficacy, durability, and safety of RTUaboBoNT-A for moderate and severe glabellar wrinkles. Methods: This randomized triple-blinded trial included 38 male volunteers aged between 25 and 50 years. Participants were randomly divided into two groups: abobotulinumtoxinA (aboBoNT-A, n = 18) and RTUaboBoNT-A (n = 20). Groups received 10 U for procerus muscle and 20 U for the corrugator muscle. Assessed variables included, electromyography activity (EMG), Merz 5-point glabellar lines scale, FACE-Q appraisal for lines between the eyebrows and Visual Analogue Scale for pain intensity. Assessments were performed before and 1, 2, 3, and 4 months after injections. For differences in EMG and satisfaction scores, the two-way repeated-measures ANOVA and Bonferroni's post hoc analyses were conducted. Wrinkle severity scores were analyzed with the chi-squared test. Results: Inter-group comparisons revealed no significant differences in EMG scores in all assessed periods for the corrugator supercili (p = 0.11) and the procerus muscles (p = 0.93); for severity of glabellar lines, no significant differences were also found in all follow-ups for rest (p = 0.737) and contracted position (p = 0.390), as well as for satisfaction with the treatments. However, the RTUaboBoNT-A group presented higher levels of pain intensity during the injection procedure (p = 0.01). Conclusion: The RTUaboBoNT-A and aboBoNT-A are comparable in efficacy, durability, and safety.
- Comparison of the effects of oral hygiene instruction methods on oral hygiene and self-perception in older adults : a randomized controlled trialPublication . Santos, Inês Caetano; Colaço, Catarina; Canales, Giancarlo De la Torre; Proença, Luís; Polido, Mário; Mendes, José João; Canhão, Helena; Manso, Ana CristinaBackground: Age-related conditions, such as being misinformed, having limited oral health literacy, and the loss of manual dexterity, autonomy, or visual acuity, may act as barriers to oral health. The aim of this study was to evaluate the effectiveness of two different oral hygiene instruction methods on oral hygiene and the self-perception of oral health in older adults. Methods: This randomized controlled trial included participants aged 65 and older who completed a questionnaire on socio-economic factors, self-perceived oral health, and oral hygiene behaviours. Oral hygiene status was assessed using the Oral Hygiene Index—Simplified (OHI-S). Participants were randomly allocated into two different groups, according to the method of oral hygiene instruction: a “General Approach” (GA) (n = 28) and a “Personalized Technique” (PT) (n = 26). After two months, a follow-up session was conducted. Data were analysed using descriptive and inferential methodologies. Results: The GA and PT methods were effective in promoting oral hygiene behaviours, with a significant increase in the use of interdental devices, but no significant differences were found between the two methods. Self-perceived oral health did not change significantly, neither after the instruction nor between methods. Significant improvements were achieved with both methods for the OHI-S, with significant differences between the two methods for the Calculus Index, where the PT achieved better results. Conclusions: Oral hygiene education leads to improvements in the adoption of oral hygiene behaviours and clinical indicators. Furthermore, a personalized approach promoted better results in clinical indicators.
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