Browsing by Author "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.
- 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.
- 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.
- 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.
- Is the orthodontic smile considered as aesthetic in adult patients?Publication . Mello, Gabriela; Evangelista, José Grillo; Alves, Valter Pedroso; Delgado, Ana Sintra; Dias, Maria do RosárioIn the last five years, pioneer studies were carried out in the Egas Moniz University Clinic surrounding the mental representation of the smile, centred on adolescent patients wearing orthodontic appliances, emerging with the results obtained as a new form of categorizing the perfect smile: The Orthodontic Smile. The present study is qualitative and exploratory and aims to understand the importance of the self-perception (mental representation) of the smile, now with the help of a new age range - Adult Patients. The sample consists of 100 subjects in the adult phase (25–59 y), namely patients wearing orthodontic appliances who were asked to draw two percepts about the self-perception of their own smile in two distinct moments: the first drawing, corresponding to before the wear of the orthodontic appliance (M1), and the second one, corresponding to drawing their smile after undergoing the orthodontic treatment (M2). The content analysis of the 200 drawings obtained was realized through a grid of content analysis, constituted by categories and subcategories. The patients also filled out a sociodemographic questionnaire, in which they responded to four open-ended questions in relation to the mental representation of the smile. Regarding the content analysis of the narrative, we highlight the fact that a Nice Smile seems to be mostly described as a Natural Smile and Aligned, being a motive for the seeking of dental treatment, primarily aesthetic issues, followed by functional considerations. When comparing the drawings before (M1) and after (M2) the wear of orthodontic appliances, the Category Broad Smile, is set up as the smile chosen as the most aesthetic. It seems that aesthetic motives represent the motivational power for the patient in the adult phase, when they decide to look for Orthodontic treatment.
- Mouth breathing and atypical swallowing in adult orthodontic patients at Egas Moniz Dental Clinic: a pilot studyPublication . Barata, Ana Raquel; Kizi, Gunel; Proença, Luís; Alves, Valter; Delgado, Ana SintraBackground: Mouth breathing and atypical swallowing are myofunctional problems, emerging as a pathological adaptation. This exploratory study was aimed to investigate the possible relation between breathing and swallowing patterns in adults. Methods: A total of 58 patients referred to the Orthodontic Department at Egas Moniz Dental Clinic were enrolled. Results: Atypical swallowing was more prevalent in women (78.0%) than in men (47.1%). A significantly higher proportion of patients exhibiting both mouth breathing and atypical swallowing were identified (46.6%). Swallowing pattern was found to be significantly associated with gender and breathing pattern.
- Ortodontia plástica - conceito e diferentes sistemasPublication . Pereira, Dinis; Fernandes, Margarida; Gaudêncio, Filipa; Retto, Paulo Fernandes; Delgado, Ana SintraA necessidade de tratamento ortodôntico, na maioria dos pacientes, prende-se com a procura de alinhamento dentário ou de estética facial. A pouca popularidade dos aparelhos fixos tradicionais metálicos entre os pacientes deve-se ao reduzido sentido estético e receio de dor. Os aparelhos plásticos transparentes são uma boa alternativa (especialmente em jovens adultos com dentição permanente) para proceder ao tratamento ortodôntico, na medida em que não levantam tantas questões estéticas. Porém, há sistemas de ortodontia plástica que apresentam limitações e apenas tratam casos simples a nível anterior ou recidivas após tratamento ortodôntico. Existem assim vários sistemas que conseguem corrigir diversos tipos de maloclusões mais severas, mas o clínico tem que estar ciente sempre das limitações e decidir qual o sistema viável para proceder ao tratamento com ortodontia plástica.
- 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.