Percorrer por autor "Cavacas, Maria Alzira"
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- Cirurgia periodontal de retalho de Widman modificada no sextante anterior : caso clínicoPublication . Cavacas, Maria Alzira; Gancho, Rita Passos; Pereira, Andreia; Mendes, José JoãoIntrodução: O tratamento da doença periodontal é considerado complexo, incluindo numa primeira fase uma terapia não cirúrgica, e seguidamente, uma eventual terapia cirúrgica. O retalho de Widman modificado apresenta-se como uma técnica que permite uma diminuição da profundidade de sondagem das bolsas com máxima preservação do tecido periodontal, estando indicado quando a estética é um fator importante. Descrição do caso clínico: Paciente de 53 anos, sexo feminino, diagnóstico de doença periodontal estágio IV grau B. Foi iniciado o tratamento periodontal não cirúrgico, através do alisamento radicular. Na consulta de reavaliação constatou-se que a profundidade de sondagem das bolsas não atingiu a normalidade. Prosseguiu-se o tratamento, através da técnica cirúrgica periodontal de retalho de Widman modificada no sextante anterior. Conclusões: A técnica cirúrgica de retalho de Widman modificada mostrou-se uma opção de tratamento, alcançando estabilidade e saúde periodontal.
- Effects of industrial noise on circumpulpar dentin - a field emission scanning electron microscopy and energy dispersive spectroscopy analysisPublication . Cavacas, Maria Alzira; Tavares, Vitor; Oliveira, Maria João; Oliveira, Pedro; Sezinando, Ana; Martins dos Santos, José"Chronic exposure to Industrial Noise (IN), rich in Low Frequency Noise (LFN), causes systemic fibrotic transformation and sustained stress. Dental wear, significantly increased with exposure to LFN, affects the teeth particularly through the circumpulpar dentin. Our goal is to understand the consequences of IN exposure on the circumpulpar dentin of Wistar rats. 10 Wistar rats were exposed to IN for 4 months, according to an occupationally simulated time schedule and 10 animals were used as age-matched controls. The first and the second upper and lower molars of each animal were processed for observation by Field Emission Scanning Electron Microscopy (FESEM) and Energy Dispersive Spectroscopy (EDS) analysis was performed. In exposed animals FESEM showed a 2.0 to 6.0 μm-dense mineral band between dentin and the pulp with no regular continuity with the tubules. This structure had a few tubules where the odontoblasts processes could be observed embedded within the band and collagen fibers were trapped inside. EDS analysis revealed that it was hydroxyapatite similar to dentin, with a higher carbon content. FESEM results show that the band may be tertiary reparative dentin formed by odontoblast-like cells, but the increased amount of carbon (EDS) could mean that it is sclerotic dentin. IN should be acknowledge as a strong stimulus, able to cause an injury to odontoblasts and to the formation of reparative tertiary dentin, in a process that may accelerate the aging of the teeth, either by direct impact of acoustic pressure pulsations or by increased stress and dental wear."
- Evaluation of periodontally diseased molars based on the Miller McEntire Periodontal Prognostic IndexPublication . Machado, Vanessa; Botelho, João; Proença, Luís; Alves, Ricardo; Cavacas, Maria Alzira; Amaro, Luís; Mendes, José João
- Fine-tuning multilevel modeling of risk factors associated with nonsurgical periodontal treatment outcomePublication . Machado, Vanessa; Botelho, João; Mascarenhas, Paulo; Cavacas, Maria Alzira; Alves, Ricardo; Mendes, José JoãoThis retrospective study evaluated the influence of known risk factors on nonsurgical periodontal treatment (NSPT) response using a pocket depth fine-tuning multilevel linear model (MLM). Overall, 37 patients (24 males and 13 females) with moderate-to-severe chronic periodontitis underwent NSPT. Follow-up visits at 3, 6, and 12 months included measurements of several clinical periodontal parameters. Data were sourced from a previously reported database. In a total of 1416 initially affected sites (baseline PD ≥ 4 mm) on 536 teeth, probing depth (PD) and clinical attachment loss (CAL) reductions after NSPT were evaluated against known risk factors at 3 hierarchical levels (patient, tooth, and site). For each post-treatment follow-up, the variance component models fitted to evaluate the 3-level variance of PD and CAL decrease revealed that all levels contributed significantly to the overall variance (p < 0.001). Patients who underwent NSPT and were continually monitored had curative results. All 3 hierarchical levels included risk factors influencing the degree of PD and CAL reduction. Specifically, the type of tooth, surfaces involved, and tooth mobility site-level risk factors had the strongest impact on these reductions and were highly relevant for the success of NSPT.
- Human ex vivo dentin-pulp complex preservation in a full crown modelPublication . Botelho, João; Cavacas, Maria Alzira; Borrecho, Gonçalo; Polido, Mário; Oliveira, Pedro; Martins dos Santos, JoséObjectives: Currently, there is lack of human in vitro full tooth models that hold the odontoblast layer with pulp tissue in their native environment. The appearance of new in vitro and in vivo models has provided new understanding of the potential of tissue engineering in dental pulp regeneration. However, the development of new in vitro full tooth models will allow us to get closer to in vivo conditions. Thus, the aim of this study is to preserve a living dentin-pulp complex, in a novel in vitro full crown model, after tooth extraction.
- Incidence of oral mucositis in patients undergoing head and neck cancer treatment: systematic review and meta-AnalysisPublication . Pacheco, Raquel; Cavacas, Maria Alzira; Mascarenhas, Paulo; Oliveira, Pedro; Zagalo, CarlosThis systematic review and meta-analysis aimed to assess the literature about the incidence of oral mucositis and its degrees (mild, moderate, and severe), in patients undergoing head and neck cancer treatment (radiotherapy, chemotherapy, and surgery). Addressing this issue is important since oral mucositis has a negative impact on oral health and significantly deteriorates the quality of life. Therefore, a multidisciplinary team, including dentists, should be involved in the treatment. The overall oral mucositis incidence was 89.4%. The global incidence for mild, moderate, and severe degrees were 16.8%, 34.5%, and 26.4%, respectively. The high incidence rates reported in this review point out the need for greater care in terms of the oral health of these patients.
- Industrial noise : a new stimulus for dental pulp aging? Qualitative and quantitative analysis in Wistar rat teeth : a pilot studyPublication . Cavacas, Maria Alzira; Doroteia, Carolina; Leonardo, Ana Margarida; Proença, Luís; Tavares, VítorMorphological changes induced by industrial noise have been experimentally observed in several organs. This study aims to characterize the effect of industrial noise on the pulp cell density of Wistar rats from a histological point of view, through qualitative and quantitative analysis. The histologic sections were observed over the optical microscope and photographed using 10x and 40x magnifications and analyzed using an image processing software. They refer to a group of animals exposed to industrial noise for 3 months and for 7 months (EG) and another group of animals kept in silence for control (CG) during the same periods. There was a significant decrease in pulp cell density in teeth of the animals exposed for 3 months when compared to control teeth group (p = 0.01). However, in the group exposed for 7 months, no statistically significant differences were found (p = 0.66). Even so, we found an evident relationship between exposure to industrial noise and teeth morphological changes. The observed changes are similar to the modifications found on aged teeth. Therefore, this study places industrial noise as an aggressive stimulus that can cause a reaction of the pulp-dentin complex with morphological changes compatible with premature aging of the tooth.
- Partial recording protocols performance on the assessment of Periodontitis severity and extent: bias magnitudes, sensibility, and specificityPublication . Machado, Vanessa; Botelho, João; Mascarenhas, Paulo; Cavacas, Maria Alzira; Alves, Ricardo; Mendes, José JoãoObjectives: This study aimed to assess bias magnitudes, sensibility, and specificity of particular partial-mouth recording protocols (PRPs) to estimate periodontal clinical measurements and periodontal status. Methods: Estimates of mean clinical attachment loss (MCAL) and mean probing depth (MPD) were calculated for 15 different PRPs and were compared to full-mouth recording protocol (FRP) data from 402 Portuguese. Biases, relative biases and intra-class correlations for all PRPs were evaluated. Bland–Altman plots and Receiver Operating Characteristic / Area Under the Curve (ROC/AUC) analysis were used to assess the sensitivity and specificity for each PRP periodontal diagnosis. Results: Regarding MPD, Half RD6 UR/LL and RD6 UL/LR had the lowest bias observed with 0.00 mm (-0.22% and 0.22%, respectively) and all full-mouth PRPs significantly produce an underestimation. Concerning MCAL, the Half MB-B-DL UR/LR had the lowest bias observed with 0.01 mm (0.16%). Excluding CPITN, Full-Mouth PRPs outperforms in average Half Mouth PRPs correlations. The Half RD6 UR/LL had the highest AUC (0.96) with 95.5 and 97.1% of sensitivity and specificity, respectively. Conclusions: Three half-mouth PRPs (Half MB-B-DL UR/LR, Half RD6 UR/LL and Half RD6 UL/ LR) protocols can be used to estimate periodontal clinical measurements with limited bias, and high sensitivity, specificity, and concordance. All full-mouth PRPs failed to estimate pocket depth means, and for clinical attachment loss, they present less ability then half-mouth partial protocols, despite presenting high sensitivity levels.
- Perceived xerostomia, stress and periodontal status impact on elderly oral health-related quality of life: findings from a cross-sectional surveyPublication . Botelho, João; Machado, Vanessa; Proença, Luís; Oliveira, Maria João; Cavacas, Maria Alzira; Amaro, Luís; Águas, Artur; Mendes, José JoãoBackground: To investigate if self-perceived xerostomia and stress are significant variables on the Oral-Health Related Quality of Life (OHRQoL) of elderly patients, considering the periodontal status, oral hygiene habits and sociodemographic characteristics simultaneously. Methods: The study cohort included 592 participants (320 females/272 Males), aged 65 years or older, representing the elder inhabitants of the Study of Periodontal Health in Almada-Seixal (SoPHiAS). Patients answered a socio-demographic and oral hygiene habits questionnaire. The Oral Health Impact Profile-14 (OHIP-14), Summated Xerostomia Inventory-5 (SXI-5) and Perceived Stress Scale-10 (PSS-10) were used. Full-mouth circumferential periodontal inspection was carried out. Multivariable regression analyses were used considering the level of periodontitis, clinical characteristics, the number of teeth, SXI, PSS-10, age, gender and oral hygiene habits. Results: Self-perceived xerostomia and stress showed a positive significant correlation with OHRQoL and each of its domains. Multiple linear regression analysis demonstrated the significant impact of SXI-5 (B = 1.20, p < 0.001) and PSS-10 (B = 0.35, p < 0.001) on the OHRQoL. SXI-5 (Odds Ratio (OR) = 1.28, p < 0.001) and PSS-10 (OR = 1.03, p = 0.022) were associated with a more frequently affected OHRQoL. The number of missing teeth, being male, mean probing depth and mean clinical attachment loss were also significant towards a frequently affected OHRQoL. Conversely, age was negatively associated with a lower OHRQoL. Conclusion: Self-perceived xerostomia and stress are significant variables towards OHRQoL in elderly patients. Future studies should consider these self-perceived xerostomia and stress when investigating the impact of periodontitis and missing teeth on quality of life of older adults.
- Prevalence and extent of chronic periodontitis and its risk factors in a Portuguese subpopulation: a retrospective cross-sectional study and analysis of clinical attachment lossPublication . Machado, Vanessa; Botelho, João; Amaral, António; Proença, Luís; Alves, Ricardo; Rua, João; Cavacas, Maria Alzira; Delgado, Ana Sintra; Mendes, José JoãoOBJECTIVES: To assess the prevalence and extent of chronic periodontitis, and its risk factors in a Portuguese subpopulation referred to periodontal examination. METHODS: This retrospective cross-sectional study used a subset of data from patients who sought dental treatment in a university dental clinic in the Lisbon metropolitan area. The sample consisted of 405 individuals (225 females/180 males), aged 20-90 years. All patients underwent a full-mouth periodontal examination and chronic periodontitis was defined as Clinical Attachment Loss (CAL) ≥ 3 mm affecting two or more teeth. Aggressive periodontitis cases were excluded from the analysis. RESULTS: Prevalence of chronic periodontitis was 83.5% (95% CI [80.4-86.6%]). For these subjects, CAL ≥ 3 mm affected 86.0% (95% CI [84.7-87.2]) of sites and 83.7% (95% CI [81.7-85.6]) of teeth, respectively. Mean CAL ranged from 3.6 to 4.3 mm, according to age. In the multivariate logistic regression model, smoking (OR = 3.55, 95% CI [1.80-7.02]) and older age (OR = 8.70, 95% CI [3.66-20.69] and OR = 4.85, 95% CI [2.57-9.16]), for 65+ and 45-64 years old, respectively, were identified as risk indicators for CAL ≥ 3 mm. CONCLUSIONS: This particular Portuguese adult subpopulation had a high prevalence of chronic periodontitis, with severe and generalized clinical attachment loss, and its presence was significantly associated with age and smoking. This data should serve to prepare future detailed epidemiological studies and appropriate public health programs.