Percorrer por autor "Delgado, Ana Sintra"
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- Association between dietary inflammatory index and periodontitis: a cross-sectional and mediation analysisPublication . Machado, Vanessa; Botelho, João; Viana, João; Pereira, Paula; Lopes, Luísa Bandeira; Proença, Luís; Delgado, Ana Sintra; Mendes, José JoãoInflammation-modulating elements are recognized periodontitis (PD) risk factors, nevertheless, the association between dietary inflammatory index (DII) and PD has never been appraised. We aimed to assess the association between DII and PD and the mediation effect of DII in the association of PD with systemic inflammation. Using the National Health and Nutrition Examination Survey 2009–2010, 2011–2012 and 2013–2014, participants who received periodontal exam and provided dietary recall data were included. The inflammatory potential of diet was calculated via DII. PD was defined according to the 2012 case definition. White blood cells (WBC), segmented neutrophils and C-reactive protein (CRP) were used as proxies for systemic inflammation. The periodontal measures were regressed across DII values using adjusted multivariate linear regression and adjusted mediation analysis. Overall, 10,178 participants were included. DII was significantly correlated with mean periodontal probing depth (PPD), mean clinical attachment loss (CAL), thresholds of PPD and CAL, WBC, segmented neutrophils and DII (p < 0.01). A linear regression logistic adjusted for multiple confounding variables confirmed the association between DII and mean PPD (B = 0.02, Standard Error [SE]: 0.02, p < 0.001) and CAL (B = −0.02, SE: 0.01, p < 0.001). The association of mean PPD and mean CAL with both WBC and segmented neutrophils were mediated by DII (from 2.1 to 3.5%, p < 0.001). In the 2009–2010 subset, the association of mean CAL with serum CRP was mediated by DII (52.0%, p < 0.01). Inflammatory diet and PD may be associated. Also, the inflammatory diet significantly mediated the association of leukocyte counts and systemic inflammation with PD.
- Blood pressure and tooth loss : a large cross-sectional study with age mediation analysisPublication . Mendes, José João; Viana, João; Cruz, Filipe; Pereira, Dinis; Ferreira, Sílvia; Pereira, Paula; Proença, Luís; Machado, Vanessa; Botelho, João; Rua, João; Delgado, Ana SintraWe aimed to investigate the association between blood pressure (BP) and tooth loss and the mediation effect of age. A cross-sectional study from a reference dental hospital was conducted from September 2017 to July 2020. Single measures of BP were taken via an automated sphygmomanometer device. Tooth loss was assessed through oral examination and confirmed radiographically. Severe tooth loss was defined as 10 or more teeth lost. Additional study covariates were collected via sociodemographic and medical questionnaires. A total of 10,576 patients were included. Hypertension was more prevalent in severe tooth loss patients than nonsevere tooth lost (56.1% vs. 39.3%, p < 0.001). The frequency of likely undiagnosed hypertension was 43.4%. The adjusted logistic model for sex, smoking habits and body mass index confirmed the association between continuous measures of high BP and continuous measures of tooth loss (odds ratio (OR) = 1.05, 95% CI: 1.03–1.06, p < 0.001). Age mediated 80.0% and 87.5% of the association between periodontitis with both systolic BP (p < 0.001) and diastolic BP (p < 0.001), respectively. Therefore, hypertension and tooth loss are associated, with a consistent mediation effect of age. Frequency of undiagnosed hypertension was elevated. Age, gender, active smoking, and BMI were independently associated with raised BP.
- Chronological age range estimation of cervical vertebral maturation using Baccetti method : a systematic review and meta-analysisPublication . Magalhães, Maria Inês; Machado, Vanessa; Mascarenhas, Paulo; Botelho, João; Mendes, José João; Delgado, Ana SintraBackground: The timing of growth is a key factor for correct orthodontic treatment planning. Cervical vertebrae maturation (CVM) is no exception, although the reported chronological ages vary in the literature. Objective: We aimed to estimate the average chronological age for each Baccetti’s CVM staging. Search methods: Search on MEDLINE-PubMed, Scopus, LILACS, Google Scholar, Cochrane Central Register of Controlled Trials (CENTRAL) was conducted until July 2021. The review was performed according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Selection criteria: Observational or interventional studies reporting chronological age classified through Baccetti’s CVM method were included. Data collection and analysis: Methodological quality was assessed, and pooled estimates were carried out through random-effects meta-analysis of single means. The impact of sex and continent were also investigated through subgroup analyses. Results: Forty-one studies were included (9867 participants, 4151 men, and 5716 women). The average chronological age was 9.7 years old (95% confidence interval [CI]: 9.4 to 10.1) in CS1, 10.8 years old (95% CI: 10.5 to 11.1) in CS2, 12.0 years old (95% CI: 11.7 to 12.2) in CS3, 13.4 years old (95% CI: 13.2 to 13.6) in CS4, 14.7 years old (95% CI: 14.4 to 15.1) in CS5, and 15.8 years old (95% CI: 15.3 to 16.3) in CS6. A significant difference was found between the sexes in all CVM stages. We also found significant differences across continents. Conclusions: For each CVM staging a chronological age range was successfully estimated. Girls presented an earlier skeletal maturation compared to boys. The skeletal maturation differs also according to continents, except for CMV stage 1, pointing to the need for personalized ranges according to each region.
- Comparison of pain perception between clear aligners and fixed appliances: a systematic review and meta-analysisPublication . Pereira, Dinis; Machado, Vanessa; Botelho, João; Proença, Luís; Mendes, José João; Delgado, Ana SintraWe aimed to compare the pain discomfort levels between clear aligners and fixed appliances at multiple time points. Four electronic databases (Pubmed, Medline, CENTRAL and Scholar) were searched up to May 2020. There were no year or language restrictions. Randomized clinical trials and case–control studies comparing pain perception through pain visual analog scale (VAS) in patients treated with clear aligners and with fixed appliances were included. Risk of bias within and across studies was assessed using Cochrane tool and Newcastle–Ottawa Scale (NOS) approach. Random-effects meta-analysis were conducted. VAS score and analgesic consumption were collected. Random-effects meta-analyses were used to synthesize available data. Following the review protocol, five articles met the inclusion criteria and were included, with a total of 273 participants (177 females, 96 males). Overall, clear aligners were associated with significantly less pain than fixed appliances during the first seven days of orthodontic treatment. Patients treated with clear aligners experience less pain discomfort than those treated with fixed appliances and consume less analgesics, with SORT A recommendation.
- Cross-cultural adaptation and validation of the oral health values scale for the Portuguese populationPublication . Machado, Vanessa; Mendonça, André; Proença, Luís; Mendes, José João; Botelho, João; McNeill, Daniel W.; Delgado, Ana SintraBackground: To adapt and validate cross-culturally the Oral Health Values (OHVS) questionnaire to Portuguese language. Methods: The OHVS questionnaire was culturally translated and adapted according to international guidelines. We enrolled 280 patients in a population-based epidemiological survey conducted at the Egas Moniz Dental Clinic (Almada, Portugal). The participants answered the Portuguese version of the OHVS (OHVS-PT), which is a 12-item scale with four-factor structure (Professional Dental Care, Appearance and Health, Flossing and Retaining Natural Teeth factor). Psychometric properties were tested using content validity, construct validity, internal consistency, and test–retest reliability. Results: The OHVS-PT presented adequate reliability (ICC = 0.93, 95% confidence interval (CI): 0.86; 0.97, p < 0.001) with values for the Cronbach’s alpha coefficient of the sub-constructs ranging from 0.92 to 0.98. In the Confirmatory Factor Analysis, the final models presented good fit, with the Comparative Fit Indices ranging from 0.882 to 0.891 and the root-mean-squared error of Approximation between 0.065 and 0.069. Conclusions: The OHVS-PT was shown to be a valid and reliable tool to assess oral health values in a Portuguese population. Further studies should evaluate the psychometric properties of the oral personal representation on dental specialties and its impact on dental appointments and procedures.
- Cross-cultural adaptation and validation of the Portuguese version of the psychosocial impact of dental aesthetics questionnairePublication . Fidalgo, João; Botelho, João; Proença, Luís; Mendes, José João; Machado, Vanessa; Delgado, Ana SintraThe aim of this study was to cross-culturally adapt and validate the psychosocial impact of dental esthetics questionnaire (PIDAQ) to the Portuguese language. The PIDAQ was culturally translated and adapted according to international guidelines. In this cross-sectional study, we enrolled 501 subjects in a population-based epidemiological survey conducted at the Egas Moniz Dental Clinic (Almada, Portugal) in June 2022. The participants answered the Portuguese version of the PIDAQ (PIDAQ-PT), which was a 23-item scale with four conceptual domains (self-confidence, social impact, psychological impact and esthetic concern factor). Psychometric properties were estimated using content validity, construct validity, internal consistency and test–retest reliability. The PIDAQ-PT presented an intraclass correlation coefficient (ICC) of 0.84, and a 95% confidence interval (0.73–0.90, p < 0.001), with values for the Cronbach’s alpha coefficient of the subconstructs ranging from 0.93 to 0.98. In the confirmatory factor analysis (CFA), the final models presented a good fit, with the comparative fit indices (CFIs) ranging from 0.905 to 0.921 and the root mean squared error of approximation (RMSEA) ranging between 0.088 and 0.090. The PIDAQ-PT was shown to be a valid and reliable tool to assess oral health values in a Portuguese population. Further studies should evaluate the psychometric properties of the oral personal representation on dental specialties and its impact on dental appointments and procedures.
- From the orthodontic smile to the new smile: a new categorizationPublication . Dias, Maria do Rosário; Alves, Valter Pedroso; Kizi, Gunel Mammadova; Delgado, Ana SintraThe facial symmetry from an esthetic standpoint is crucial. However, there are not much research that examine the malocclusion issue or the significance of the mouth and smile in the mental representation of the face. In this study, 151 kids and teenagers, both genders, aged 8 to 24, were asked to sketch two self-portraits of their mouths or smiles—before (and during) the usage of the orthodontic appliance. Participants seek therapy mostly for functional problems rather than cosmetic ones. The findings of this study provide insight into the significance of the mouth and smile for an individual’s sense of self and psychological well, where the maximization of the mental representation of the orthodontic smile emerges as a new categorization of the perfect smile.
- Geographical distribution of periodontitis risk and prevalence in Portugal using multivariable data mining and modelingPublication . Antunes, Ana; Botelho, João; Mendes, José João; Delgado, Ana Sintra; Machado, Vanessa; Proença, LuísWe aimed to estimate the geographical distribution of periodontitis prevalence and risk based on sociodemographic and economic data. This study used sociodemographic, economic, and health services data obtained from a regional survey and governmental open data sources. Information was gathered for all 308 Portuguese municipalities and compiled in a large set of 52 variables. We employed principal component analysis (PCA), factor analysis (FA) and clustering techniques to model the Portuguese nationwide geographical distribution of the disease. Estimation of periodontitis risk for each municipality was achieved by calculation of a normalized score, obtained as an adjusted linear combination of six independent factors that were extracted through PCA/FA. The municipalities were also classified according to a quartile-based risk grade in each cluster. Additionally, linear regression was used to estimate the periodontitis prevalence within the peri-urban municipality clusters, accounting for 30.5% of the Portuguese population. A total of nine municipality clusters were obtained with the following characteristics: mainly rural/low populated, including small villages (one), partly rural, including small cities (two), mainly urban/peri-urban, including medium-sized to large cities (4), and urban/large cities (2). Within the clusters, a higher periodontitis risk was identified for municipalities with lower income, older populations. The estimated periodontitis prevalence for the 18 municipalities included in the four peri-urban clusters ranged from 41.2% to 69.0%. Periodontitis prevalence estimates range from 41.2% to 69.0% for the municipalities characterized as peri-urban and mainly urban, most of them located in the Lisbon Metropolitan Area, the tenth largest in Europe.
- Geriatric dentistry curriculum in six continentsPublication . Xavier, Irina; Ettinger, Ronald L.; Proença, Luís; Botelho, João; Machado, Vanessa; Rua, João; Delgado, Ana Sintra; Mendes, José JoãoThe purpose of this study was to examine the presence of geriatric dentistry (GD) in the curricula of worldwide dental schools, and to identify and compare their curriculum content. Eighty-three dental schools (16.4% response rate), from 24 countries, in six continents, completed a 25-item online questionnaire, to assess their GD curriculum, and were included in the study. GD was a mandatory course in 56 dental schools (67.5%), an independent subject in 14 schools (16.9%), and was taught as a series of lectures in 31 schools (37.4%). Clinically, 56 dental schools (67.5%) had some form of mandatory education in GD. The type of school, location and method of presentation were not associated with greater interest in expanding their curriculum in GD (p = 0.256, p = 0.276, and p = 0.919, respectively, using the Chi-square test). We found GD is a curriculum requirement in most of the surveyed dental schools and is becoming more common among dental school curricula. This survey is the first study to present data from dental schools from all continents, using a web-based survey which is a resourceful, less-expensive tool to gather data.
- Impact of malocclusion, tooth loss and oral hygiene habits on quality of life in orthodontic patients : a cross-sectional studyPublication . pereira, Dinis; Machado, Vanessa; Botelho, João; Proença, Luís; Rua, João; Lemos, Carolina; Mendes, José João; Delgado, Ana SintraWe aimed to assess the impact of malocclusion on oral health-related quality of life (OHRQoL) in a sample composed of adolescents, younger adults and adults seeking orthodontic treatment. Participants were consecutively enrolled from January 2019 to March 2020. The oral health impact profile (OHIP-14) was used to measure the OHRQoL. The index of complexity, outcome and need (ICON) was used to assess malocclusion. Sociodemographic, medical, and clinical questionnaires were recorded. Statistical analyses were performed according as a function of sex and age range (15–30 or >30 years old). Linear and logistic regression models were applied to assess the association between OHIP-14 total score, malocclusion, and other relevant confounding variables. In a final sample of 93 participants (60 females and 33 males, aged 15 to 60 years), men reported significantly better OHRQoL (p = 0.005). Participants aged 30 years or older reported significantly worse OHRQoL (p = 0.042). OHIP-14 was significantly correlated with age (ρ = 0.259, p < 0.05) and the number of missing teeth (ρ = 0.369, p < 0.001). Multivariable regression showed OHIP-14 being associated with the number of missing teeth (B = 1.48, SE = 0.57, p < 0.05) and the presence of missing teeth (B = 1.38, SE = 0.65, p < 0.05). Malocclusion showed no association with OHRQoL. Age and the number of missing teeth may be key factors on self-perceived OHRQoL in adult patients seeking orthodontic treatment.
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