Percorrer por autor "Cebola, Pedro Miguel Teixeira Carvas"
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- Botulinum toxin type A for trigeminal and postherpetic neuralgia : an umbrella review of systematic reviewsPublication . Canales, Giancarlo De la Torre; Dureisseix, Marie-Amélie; Santos, Thiago Germano dos; Cebola, Pedro Miguel Teixeira Carvas; Nascimento, Glauce Crivelaro do; Foscaldo, Tatiana; Poluha, Rodrigo Lorenzi; Durham, Justin; Christidis, NikolaosBackground and Objective: Trigeminal neuralgia (TN) and postherpetic neuralgia (PHN) are severe peripheral neuropathic pain conditions associated with substantial functional impairment. Although pharmacological treatments are available, many patients experience insufficient efficacy or poor tolerability. Botulinum toxin type A (BoNT-A) has emerged as a potential treatment, but uncertainties remain regarding its efficacy, safety, and clinical positioning. This umbrella review aimed to synthesise evidence from systematic reviews evaluating BoNT-A in TN and PHN. Methods: A systematic search was conducted in MEDLINE, Embase, Cochrane Library, Web of Science, and CINAHL from inception to November 2025. Systematic reviews with or without meta-analysis evaluating BoNT-A in adults with TN or PHN were included. Methodological quality was assessed using AMSTAR-2, and only moderate- or high-quality reviews were included. Primary outcomes were pain intensity reduction and responder rates (≥ 50% pain reduction). Secondary outcomes included quality of life and adverse events. Results: Ten systematic reviews (2015–2024) met the inclusion criteria. Botulinum toxin type A was consistently associated with reductions in pain intensity and higher responder rates than placebo, particularly in TN. In PHN, evidence was more limited but supported short-term (1–3 months) improvements in pain intensity. Evidence on quality of life was scarce and inconclusive. Botulinum toxin type A was well tolerated, with mostly mild and transient adverse events. Conclusions: Botulinum toxin type A appears to provide short-term pain relief in selected patients with TN and PHN and is generally well tolerated. Current evidence supports its role as an adjunctive third-line option for focal peripheral neuropathic pain, although heterogeneity and limited long-term data warrant cautious interpretation.
- 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.
- Effects of therapeutic and aerobic exercise programs in temporomandibular disorder-associated headachesPublication . Moleirinho-Alves, Paula Manuela Mendes; Almeida, André Mariz Coelho Santos de; Cebola, Pedro Miguel Teixeira Carvas; Oliveira, Raul Alexandre Nunes da Silva; Pezarat-Correia, Pedro Luís Camecelha deObjective: To assess the effects of three 8-week exercise programs on the frequency, intensity, and impact of headaches in patients with headache attributed to temporomandibular disorder (TMD). Methodology: Thirty-six patients diagnosed with headache attributed to TMD participated in the study and were divided into three groups of 12 patients: a therapeutic exercise program (G1, mean age: 26.3±5.6 years), a therapeutic and aerobic exercise program (G2, mean age: 26.0±4.6 years), and an aerobic exercise program (G3, 25.8±2.94 years). Headache frequency and intensity were evaluated using a headache diary, and the adverse headache impact was evaluated using the Headache Impact Test (HIT-6). The intensity was reported using the numerical pain rating scale. These parameters were evaluated twice at baseline (A01/A02), at the end of the 8-week intervention period (A1), and 8–12 weeks after the end of the intervention (A2). Results: At A1, none of the G2 patients reported having headaches, in G1, only two patients reported headaches, and in G3, ten patients reported headache. The headache intensity scores (0.3 [95% CI: -0.401, 1.068]), (0.0 [95% CI: -0.734, 0.734]) and HIT-6 (50.7 [95% CI: 38.008, 63.459]), (49.5 [95% CI: 36.808, 62.259]), significantly decreased in G1 and G2 at A1. At A2 headache intensity scores (0.5 [95% CI: -0.256, 1.256]), (0.0 [95% CI: -0.756, 0.756]) and HIT-6 (55.1 [95% CI: 42.998, 67.268]), (51.7 [95% CI: 39.532, 63.802]) in G1 and G2 haven’t change significantly. The effects obtained immediately after the completion of the intervention programs were maintained until the final follow-up in all groups. Conclusion: The programs conducted by G1 (therapeutic exercises) and G2 (therapeutic and aerobic exercise) had significant results at A1 and A2.
- Hypervigilance and kinesiophobia characterize distinct exploratory data-driven profiles of temporomandibular disordersPublication . Archer, Adriana Battisti; Noel, Jonas Davi da Silva Mello; Salinas, Javier; Nordenflycht, Diego De; Cebola, Pedro Miguel Teixeira Carvas; Machado, Tassia Tillemont; Tesch, Ricardo de Souza; Calcia, Thayanne Brasil Barbosa; Souza, Beatriz Dulcineia Mendes de; Melo, Gilberto; Barhanko, Markus; Grigoriadis, Anastasios; Flores, Dyanne Medina; Canales, Giancarlo De la TorreHypervigilance and kinesiophobia have been associated with temporomandibular disorders (TMD), but their relationship with specific diagnostic profiles remains unclear. This study investigated the association between TMD diagnoses, hypervigilance, and kinesiophobia, and whether these variables could differentiate distinct clinical profiles across painful and non-painful conditions. In this multicenter cross-sectional observational study, 862 adults aged 18 to 50 years from Brazil, Chile, and Portugal were classified as controls, non-painful TMD, or painful TMD. Diagnoses were established using the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD). Hypervigilance and kinesiophobia were assessed using the Pain Vigilance and Awareness Questionnaire (PVAQ) and the Tampa Scale for Kinesiophobia for TMD (TSK/TMD). Statistical analyses included factor analysis of mixed data, hierarchical clustering on principal components, and partial least squares discriminant analysis, followed by multivariate and regression analyses to assess potential associations between psychosocial variables and TMD diagnoses. Among 862 participants (312 controls, 550 TMD), kinesiophobia and hypervigilance increased across groups, with the highest levels in painful TMD (p < 0.001). Unsupervised clustering identified three distinct profiles aligned with clinical presentation: controls with low psychological burden, non-painful TMD with intermediate levels, and painful TMD with elevated kinesiophobia and hypervigilance. Multivariate analyses showed associations of psychosocial variables with TMD diagnoses, with kinesiophobia consistently driving group differences, while age, gender, and pain vigilance had a moderate influence. Among TMD subgroups, joint pain was associated with higher pain vigilance and muscular TMD with higher kinesiophobia, suggesting greater clinical complexity. Higher levels of hypervigilance and kinesiophobia were associated with painful and clinical more complex TMD profiles.
- A influência de dispositivos intra-orais nos níveis de cortisol salivar em atletas de golfePublication . Cebola, Pedro Miguel Teixeira Carvas; Santana, Catarina Godinho; Santos, José Martins dosIntrodução: Um dispositivo intra-oral é caracteristicamente um aparelho removível que na sua grande maioria é confecionado em acrílico duro e é colocado sobre as superfícies oclusais e incisais das peças dentárias. Foi sugerido, através de alguma investigação ocorrida no fim dos anos 70 e no início da década de 80 do Século XX, que os dispositivos intra-orais podem proporcionar a otimização da performance atlética. Objetivos: Este estudo teve como objetivos analisar as alterações nos níveis de cortisol salivar e no estado de ansiedade com a utilização de dispositivos intra-orais totalmente adaptados, em atletas de Golfe. Materiais e Métodos: Foram convidados a participar neste estudo atletas de Golfe que treinam no Centro Nacional de Formação de Golfe do Jamor. Foi solicitada a assinatura do consentimento informado, a realização de um questionário de caracterização geral e realizada uma avaliação clínica. Aplicou-se o Diagnostic Criteria para a confirmação dos critérios de exclusão. Os atletas realizaram um Torneio de 9 buracos com duas fases: uma sem dispositivo intra-oral e outra com dispositivo intra-oral. Para analisar os níveis de stress analisaram-se os níveis de cortisol salivar e solicitou-se o preenchimento de um questionário sobre o estado de ansiedade. Resultados: Foram incluídos 8 atletas masculinos, com idade média de 27,3 anos. Observou-se que os níveis de cortisol salivar diminuíram significativamente (p<0,05) com a utilização dos dispositivos intra-orais. Já o estado de ansiedade (avaliado por questionário) não apresentou alterações significativas. Conclusão: Os dispositivos intra-orais diminuíram de forma significativa os níveis de cortisol salivar, contudo, sem repercussões nos níveis de ansiedade subjetiva percebidos pelos atletas deste estudo.
- Is there a link between diet and painful temporomandibular disorders? A cross-sectional studyPublication . Marques, Camila Cury; Cebola, Pedro Miguel Teixeira Carvas; Burusco, Idoya Orradre; González, Maria García; Pedro, Miguel de; Christidis, Nikolaos; Ernberg, Malin; Canales, Giancarlo De la TorreBackground: Nutrition and diet have emerged as potentially modifiable factors in the management of chronic pain, however, there is still limited evidence regarding the direct relationship between diet, nutrition, and Temporomandibular disorders (TMD). The aim of this cross-sectional study was to explore the relationship between dietary patterns and painful TMD, with a particular focus on dietary inflammatory potential, adherence to the Mediterranean diet, and psychosocial predictors. Methods: Ninety-two participants (45 TMD patients and 47 controls) aged 20–50 were recruited in Portugal and Spain. TMD diagnosis was based on the Diagnostic Criteria for TMD (DC/TMD). Psychosocial status was assessed using PHQ-9 (depression), PHQ-15 (somatic symptoms), and the Oral Behavior Checklist (OBC). Dietary data were collected through a 24-hour recall and assessed using the Healthy Eating Index (HEI), Dietary Inflammatory Index (DII), and Mediterranean Diet Adherence Screener (MEDAS). Pressure pain thresholds (PPT) were recorded at the TMJ and masticatory muscles. Data was analyzed using independent t-tests, Mann-Whitney U, and OPLS-DA multivariate modeling. Results: TMD patients showed significantly higher scores for somatic symptoms, depressive symptoms, and maladaptive oral behaviors. While no significant differences were found for DII or MEDAS scores between groups, TMD patients had significantly lower HEI scores and PPTs values in the masseter, temporalis, and TMJ regions. OPLS-DA identified oral behaviors, somatic symptoms, and lower HEI as the strongest predictors distinguishing TMD patients from controls. Conclusions: Painful TMD is associated with higher psychosocial distress and poorer dietary quality. These findings underscore the need to include dietary assessment in the clinical evaluation and management of TMD.
- Prevalence and interplay of hypervigilance and kinesiophobia in TMD patients : implications in clinical outcomesPublication . Cebola, Pedro Miguel Teixeira Carvas; Lourenço, André Schneider; Hoppe, Alexandre Mangabeira; Colombo, Livia Mourão Pereira Costa; Proença, Leilane Samary de; Moleirinho-Alves, Paula Manuela Mendes; Christidis, Nikolaos; Poluha, Rodrigo Lorenzi; Canales, Giancarlo De la TorreBackground: Behavioural cognitive factors, like kinesiophobia and coping skills like hypervigilance, may contribute to a worse prognosis of TMD symptoms. However, there is a lack of evidence about the prevalence and relationship of hypervigilance and kinesiophobia with TMD. Objective: This study aimed to assess the prevalence and associations of hypervigilance and kinesiophobia in TMD. Methods: The sample consisted of 233 participants, divided into the TMD group (133) and a control group (100). The following instruments were used: diagnostic criteria for temporomandibular disorders (DC/TMD), Pain Vigilance and Awareness Questionnaire (PVAQ), and Tampa Scale for kinesiophobia/temporomandibular joint dysfunction (TSK/TMD). Pain pressure threshold (PPT) was measured on the masticatory muscles and the temporomandibular joint. Mandibular movements were assessed with a millimetre ruler. Mann–Whitney U test was used for group comparisons and Spearman's correlation test for association analyses. Results: The TMD-group showed higher hypervigilance and kinesiophobia values,and lower PPT and mandibular movement (opening and protrusion) values compared with controls (p < 0.05). Also, a positive moderate correlation between hypervigilance and kinesiophobia (p = 0.000001), a significant negative correlation between hypervigilance and PPT (p = 0.00001) and a significant negative correlation between hypervigilance, kinesiophobia and mandibular movements (p < 0.05) in the TMD-group were found. A positive weak correlation was found just between hypervigilance and kinesiophobia in the control group (p = 0.01). Conclusion: TMD patients present high levels of kinesiophobia and hypervigilance, which in turn are correlated and affect TMD symptoms.