Percorrer por autor "Hassan, Haidar"
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- 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 effects on biochemical biomarkers related to inflammation-associated head and neck chronic conditions : a systematic review of preclinical researchPublication . Pereira, Inês Novo; Canales, Giancarlo De La Torre; Durão, Sara; Shado, Rawand; Braga, Ana Cristina; Almeida, André Mariz de; Hassan, Haidar; Manso, Ana Cristina; Faria-Almeida, RicardoCurrent research reported that the number of clinical studies found for botulinum toxin (BoNT) key effects on biochemical biomarkers in head and neck chronic conditions linked to inflammation was very low. There are no systematic reviews of animal studies on this topic, and hence our review aimed to evaluate the quality of the preclinical evidence. We searched PubMed, Scopus, and Web of Science databases, and registries up to 29 January 2024. There were 22 eligible records, and data were available for 11 randomised controlled trials. There were concerns about the risk of bias and great variations of data obtained regarding chronic conditions, which included mostly trigeminal neuralgia. The leading biomarkers were proinflammatory cytokines (IL-1β, TNF-α) and synaptosomal-associated protein-25 (SNAP25), followed by neuron activation marker c-Fos and calcitonin gene-related peptide (CGRP). Overall, data found that BoNT significantly altered the under/over-expression of biomarkers evoked by the investigated disease models and had no effect when the levels of these biomarkers were not changed by the induced chronic conditions in animals. However, there were some mixed results and exceptions, and the certainty evidence found was very low to low. Although the sample sizes detected significant effect size (p < 0.05), most studies are based on male inferior animals, which may limit the recommendations for clinical trials. This study is registered on PROSPERO (CRD42023432411).
- Enhancing preclinical proficiency in aesthetic medicine and cosmetic dermatology : an evidence-based review of interactive visual simulation techniquesPublication . Khalil, Hassan; Pereira, Inês Novo; Shatta, Bashar; Magrin, Anna Maria Fenech; Hassan, HaidarBackground: Unlike many clinical disciplines where simulation is already embedded in curricula, aesthetic medicine and cosmetic dermatology present distinctive training challenges. Interactive visual simulation techniques offer immersive, risk-free environments for developing technique-dependent competencies, but their evidence base within this specific field remains comparatively limited. Aims: To identify the key features and potential value of interactive visual simulation techniques for aesthetic medicine and cosmetic dermatology, and to provide evidence-based insights for integrating these technologies into academic training programs. Methods: An evidence-based review using the Best Bets methodology was conducted. Two independent reviewers searched PubMed and Google Scholar (October 2024–February 2025) for literature published between 2015 and 2025. Evidence was graded using the Oxford Centre for Evidence-Based Medicine (OCEBM) 2011 Levels of Evidence, and quality was assessed using Critical Appraisal Skills Programs (CASP) checklists. Results: Thirteen studies met the inclusion criteria, encompassing 897 reported participants across nine simulation modalities: virtual reality (n = 2), augmented/mixed reality (n = 1), 3D-printed models (n = 2), 3D digital simulation (n = 1), hands-on simulation (n = 2), simulation-based education (n = 2), haptic feedback (n = 1), smartphone applications (n = 1), and AI applications (n = 1). Three of the 13 studies were cross-disciplinary (general dermatological suturing, smartphone adoption patterns, and AI-assisted patient education) and were retained as contextual evidence rather than as direct tests of aesthetic-specific training efficacy. Evidence was predominantly low-level: Level II (n = 2), Level III (n = 3), Level IV (n = 2), and Level V (n = 6). Risk of bias was high across the majority. Reported outcomes clustered at Kirkpatrick Levels 1–2a (learner satisfaction and confidence), with only one study demonstrating objective skill improvement (Level 2b). Despite these limitations, simulation-based techniques consistently demonstrated potential to improve self-reported procedural knowledge and trainee confidence. Conclusion: Simulation-based training shows promise for aesthetic medicine and cosmetic dermatology. Although favorable outcomes were reported, these were predominantly confidence-based (Kirkpatrick Level 2a) rather than objective skill measures. These results cautiously support integration of simulation technologies into training programs but underscore the urgent need for rigorous, randomized controlled trials with objective competence outcomes to establish long-term efficacy and generalizability.
- Non-surgical cosmetic treatment modalities for interdental papilla reconstruction “black triangles” : an evidence-based reviewPublication . Elhaj, Ayah; Shatta, Bashar; Nguyen, Sheila; Pereira, Inês Novo; Hassan, HaidarBackground: The interdental papilla plays a vital role in dental and facial aesthetics, as the loss of papilla manifests as unesthetic “black triangles”. In recent years, non-surgical approaches such as hyaluronic acid injections, autologous platelet concentrates, laser therapy, and microneedling with vitamin C have emerged as alternatives to technically demanding and unpredictable surgical reconstruction. Aim: To evaluate the effectiveness, patient satisfaction, and safety of cosmetic non-surgical treatment modalities for the correction of black triangles. Materials and Methods: A comprehensive literature search was conducted using the PubMed, Cochrane Library, Scopus, and Embase databases, from January 2013 to January 2024. All case series, cohort studies, and randomized controlled trials with relevant outcomes were included. The BestBETs methodology was used, and the risk of bias was assessed using the “Quality Assessment Tool for Quantitative Studies.” Results: A total of 19 human studies met the inclusion criteria. Of these, six studies were classified as level II evidence, while the remaining 13 were categorized as level III or level IV evidence. Based on level II evidence, hyaluronic acid injections were effective and safe for correcting the black triangles and improving the smile. Evidence on non-surgical modalities such as autologous platelet concentrates, photobiomodulation therapy, and microneedling with vitamin C remains limited. Based on level II to level IV evidence, these conservative treatments are recommended as clinically effective for filling black triangle spaces, demonstrating high patient satisfaction and minimal adverse events. Conclusion: Non-surgical cosmetic treatments offer a promising alternative for reconstructing interdental papilla deficiencies, with benefits including reduced complications and favorable aesthetic outcomes. However, the current evidence remains limited, and findings should be interpreted with caution. Further well-designed, standardized clinical trials are required to establish the effectiveness, long-term stability, and patient-centred outcomes of these interventions.
- Occlusal vs non-occlusal modality of the loading protocol for oral implants in partially edentulous patients : a systematic review and meta-analysisPublication . Kourkoutis, Panagiotis; Shado, Rawand; Pereira, Ines Novo; Madruga, David; Hassan, HaidarBackground: Occlusal loading refers to a modality in which an implant-supported prosthesis is subjected to functional loading, maintaining contact with the opposing dentition from the onset of prosthetic placement. In contrast, non-occlusal loading represents a non-functional approach, wherein a provisional implant prosthesis is initially placed in infra-occlusion or fully relieved of contact with the opposing dentition, which is subsequently (at a later stage) followed by functional (occlusal) loading with the definitive prosthesis. Aim: To compare clinical outcomes in partially edentulous cases following an occlusal modality of loading versus non-occlusal modality of loading. Method: A search on Pubmed, Scopus and Embase databases was conducted to identify randomised controlled trials (RCTs) comparing occlusal versus non-occlusal modalities of implant loading in partially edentulous patients receiving implants with single crowns or fixed bridges, between January 1 (2004) to June 12 (2024), examining implant survival, complications and marginal bone loss (MBL) of implants. The inclusion criteria involved RCTs of evidence level II (Oxford Centre for Evidence-Based Medicine Levels of Evidence). For assessing bias in the included studies, the Cochrane Risk of Bias tool was used. Results: This review identified seven RCTs investigating 273 implants over 1–3 years follow-up periods. seven studies reported 1-year MBL data and three reported 3-year data. Publication bias was noted at the 1-year follow-up (p < 0.01) but not at 3 years (p > 0.05). Differences in MBL were not statistically significant at both 1 year (Hedges’ d = 0.01, p = 0.920, 95% CI: [−0.21, 0.24]) and 3 years (Hedges’ d = 0.01, p = 0.952, 95% CI: [−0.28, 0.30]). Differences in complication occurrences were not statistically significant (RR = 0.882, p = 0.759, 95% CI: [0.397, 1.964]). The nature of data on implant survival rates prevented a meaningful meta-analysis. Conclusion: For short-term periods of 1–3 years, no significant evidence supports clinical superiority in terms of complication rates and MBL between non-occlusal and occlusal modalities of implant loading. Future studies should explore functional and aesthetic aspects, as well as patient reported outcomes to determine any short-term differences or consider long-term follow-up with large sample sizes to detect significant clinical differences.
- Patient reported pain following tooth extraction with different autologous platelet concentrates : systematic reviewPublication . Hassan, Haidar; Shado, Rawand; Pereira, Ines Novo; Madruga, DavidBackground: Autologous platelet concentrates (APCs) have played a significant role in regenerative dentistry, with clinical evidence suggesting its benefits over controls. Particularly, APCs could reduce postoperative pain following tooth extractions. Aim: To compare patient reported pain after tooth extractions using different autologous platelet concentrates (APCs) such as platelet-rich plasma (PRP) and platelet-rich fibrin (PRF). Method: A search on Pubmed, Scopus, Embase and Google Scholar databases was conducted to identify human studies using APC(s) in extraction sockets between January 2014 and June 2024. This review followed the PRISMA guidelines. The inclusion criteria involved comparative human studies ranging from evidence levels II to III (Oxford Centre for Evidence-Based Medicine Levels of Evidence). For assessing bias in the included studies, the Cochrane Risk of Bias tools were used. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach was used to determine the quality of evidence available. Results: This review identified 8 studies; with 338 extraction sites in total and 1–15 days pain follow up. Four studies showed no statistically significant difference in postoperative pain reduction between PRP and PRF. One study observed no statistically significant difference between leukocyte-rich PRF (L-PRF) and titanium-prepared PRF (T-PRF). One study indicated that advanced platelet-rich fibrin (A-PRF) is superior to PRF in reducing postoperative pain on day 2 postoperatively. In addition, two studies reported that A-PRF is more effective than L-PRF on day 2. Moderate-to-high risk of bias was identified within 75% of the selected papers. GRADE score for evidence quality assessment was ‘Low’. Conclusion: A-PRF was favoured to reduce postoperative pain on day 2 among the investigated APCs, although the GRADE criteria rate the evidence as “Low”. Future trials should directly compare A-PRF with PRF and L-PRF using high-quality randomized controlled designs.
- The role of educational interactive virtual simulation app in aesthetic medicine and cosmetic dermatology preclinical skillsPublication . Hassan, Haidar; Khalil, Hassan; Shatta, Bashar; Magrin, Anna Maria Fenech; Pereira, Ines Novo; Matin, AtifBackground: The rapid progress in the field of aesthetic medicine and cosmetic dermatology drives the demand for skilled healthcare practitioners able to provide safe, complex treatments accurately and confidently. Traditional training approaches, which emphasize didactic teaching and little hands-on experience, typically fail to prepare postgraduate students for these challenges. We hypothesized that interactive visual simulation may improve preclinical competency in aesthetic medicine and cosmetic dermatology. Aims: The aim of this study is to explore the impact of interactive visual simulations 3D app on the development of preclinical skills in aesthetic medicine and cosmetic dermatology. Methods: The study was designed as a mixed-methods approach, which combined quantitative analysis of simulation performance data with quantitative feedback from participants. The study is based on a purposive sample of 25 healthcare professionals enrolled in aesthetic medicine postgraduate training programs at the Queen Mary University of London (QMUL). Data were collected through post-training assessment questionnaires and performance metrics during simulations. Results: The findings clearly emphasized an improvement in the proficiency and confidence of participants who trained using interactive visual simulations. Trainees reported a greater sense of realism and immersion in their training, which helped them better understand the spatial relationships and anatomical structures involved in aesthetic procedures. Additionally, participants expressed increased confidence in their ability to perform these procedures on real patients. Conclusion: The study found that interactive visual simulation may help to improve aesthetic medicine and cosmetic dermatology preclinical competency. This technology has the potential to offer a better training experience than traditional approaches, resulting in more confident and skilled healthcare practitioners who can conduct difficult and safe aesthetic interventions.