Percorrer por autor "Leira, Yago"
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- Association between periodontitis and high blood pressure: results from the study of periodontal health in Almada-Seixal (SoPHiAS)Publication . Machado, Vanessa; Aguilera, Eva Muñoz; Botelho, João; Hussain, Syed Basit; Leira, Yago; Proença, Luís; D’Aiuto, Francesco; Mendes, José JoãoPeriodontitis is a common chronic inflammatory disease which could have an important impact on blood pressure (BP). This study aimed to explore (a) the association between periodontal health and BP in a large representative cohort, (b) the predictive value of diagnosis of periodontitis in undiagnosed raised BP and (c) whether age is a mediator of this relationship. In total, 1057 randomly recruited individuals (mean age, 60.9 ± 16.3 years, 57.7% women) underwent periodontal clinical assessment and one-single BP measurement using an automated sphygmomanometer device. Logistic and linear regression models were used to estimate the odds of hypertension based on periodontitis case definitions. Mediation analysis was performed to understand the effect of age on the association of periodontitis with hypertension. Adjusted logistic model for gender, smoking habits and body mass index confirmed the association between high BP and periodontitis (OR = 2.31, 95%CI: 1.75–3.04, p < 0.001). Among 168 participants with undiagnosed high BP (15.9% of the study sample), 62.5% had periodontitis (n = 105). In this study, the association between periodontitis with both systolic blood pressure (SBP) (77.6%, p < 0.001) and diastolic blood pressure (DBP) (66.0%, p < 0.001) was mediated by age. Periodontitis is closely linked to BP in a representative Portuguese population.
- Association between periodontitis and peripheral markers of innate immunity activation and inflammationPublication . Dopico, José; Botelho, João; Ouro, Alberto; Domínguez, Clara; Machado, Vanessa; Aramburu-Nuñez, Marta; Custodia, Antía; Blanco, Teresa; Vázquez-Reza, María; Romaus-Sanjurjo, Daniel; Blanco, Juan; Leira, Rogelio; Sobrino, Tomás; Leira, YagoBackground: Immune response leading to increased systemic inflammation is one of the mechanisms linking periodontitis to chronic inflammatory diseases. The aim of this study was to compare the expression of toll-like receptors 2 and 4 in monocytes and neutrophils (TLR2M, TLR2N, TLR4M, and TLR4N) and its endogenous ligands (cellular fibronectin [cFN] and heat shock protein 60 [HSP60]) in patients with and without periodontitis. Additionally, the relationship between cFN and HSP60 expression with innate immunity activation and systemic inflammatory response (interleukin 6 [IL-6]) was also evaluated. Methods: A case-controlled study was designed in which 30 patients with periodontitis (cases) and 30 age- and sex-matched participants without periodontitis (controls) were included. Fasting blood samples were collected to determine: (1) expression of TLR2N, TLR2M, TLR4N, and TLR4M by flow cytometry; and (2) serum concentrations of cFN, HSP60, and IL-6 by ELISA technique. Results: Expression of TLR2M (411.5 [314.2, 460.0] vs. 236.5 [204.0, 333.0] AFU), TLR2N (387.0 [332.0, 545.5] vs 230.0 [166.2, 277.7] AFU), TLR4M (2478.5 [1762.2, 2828.0] vs 1705.0 [1274.5, 1951.2] AFU), and TLR4N (2791.0 [2306.7, 3226.2] vs. 1866.0 [1547.5, 2687.2] AFU) as well as serum levels of cFN (301.1 [222.2, 410.9] vs. 156.4 [115.3, 194.0] ng/ml) and IL-6 (10.4 [6.5, 11.5] vs. 3.5 [2.6, 4.9] pg/ml) were significantly higher in periodontitis patients than those without periodontitis. A positive association was found between periodontitis and cFN (odds ratio [OR] = 1.028, p < 0.001), TLR2N (OR = 1.026, p < 0.001), TLR4M (OR = 1.001, p = 0.002), and IL-6 (OR = 1.774, p < 0.001). Conclusions: Periodontitis patients exhibited high expression of TLRs, cFN, and IL-6.
- Association of periodontitis with cognitive decline and its progression : contribution of blood-based biomarkers of Alzheimer's disease to this relationshipPublication . Carballo, Álvaro; López-Dequidt, Iria; Custodia, Antía; Botelho, João; Aramburu-Núñez, Marta; Machado, Vanessa; Pías-Peleteiro, Juan Manuel; Ouro, Alberto; Romaus-Sanjurjo, Daniel; Vázquez-Vázquez, Laura; Jiménez-Martín, Isabel; Aguiar, Pablo; Rodríguez-Yáñez, Manuel; Aldrey, José Manuel; Blanco, Juan; Castillo, José; Sobrino, Tomás; Leira, YagoAim: To assess whether periodontitis is associated with cognitive decline and its progression as well as with certain blood-based markers of Alzheimer's disease. Materials and Methods: Data from a 2-year follow-up prospective cohort study (n = 101) was analysed. Participants with a previous history of hypertension and aged ≥60 years were included in the analysis. All of them received a full-mouth periodontal examination and cognitive function assessments (Addenbrooke's Cognitive Examination (ACE) and Mini-Mental State Examination [MMSE]). Plasma levels of amyloid beta (Aβ)1-40, Aβ1-42, phosphorylated and total Tau (p-Tau and t-Tau) were determined at baseline, 12 and 24 months. Results: Periodontitis was associated with poor cognitive performance (MMSE: β = −1.5 [0.6]) and progression of cognitive impairment (hazard ratio [HR] = 1.8; 95% confidence interval: 1.0–3.1). Subjects with periodontitis showed greater baseline levels of p-Tau (1.6 [0.7] vs. 1.2 [0.2] pg/mL, p < .001) and Aβ1-40 (242.1 [77.3] vs. 208.2 [73.8] pg/mL, p = .036) compared with those without periodontitis. Concentrations of the latter protein also increased over time only in the periodontitis group (p = .005). Conclusions: Periodontitis is associated with cognitive decline and its progression in elderly patients with a previous history of hypertension. Overexpression of p-Tau and Aβ1-40 may play a role in this association.
- Combining self-reported information with radiographic bone loss to screen periodontitis : a performance studyPublication . Mendes, José João; Neves, Margarida; Supiot, Clara; Pinto, Leonor; Tenda, Diogo; Silva, Nuno; Proença, Luís; Leira, Yago; Machado, Vanessa; Botelho, JoãoBackground/Objectives: The objective of this study is to evaluate the diagnostic performance of a combined screening approach using self-reported periodontal information and radiographic periodontal bone loss (R-PBL) in identifying individuals with periodontitis. Methods: An exploratory cross-sectional study was conducted including adult participants with available panoramic radiographs and responses to a validated self-reported periodontal screening questionnaire. R-PBL was assessed on interproximal sites and classified according to established thresholds. Self-reported information followed a validated strategy based on the Center for Diseases Control tool. The performance of individual and combined indicators was analyzed against the 2018 case definition for periodontitis, calculating sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and area under the receiver operating characteristic curve (AUC). Results: A total of 150 participants were included, equally divided between periodontitis cases and controls, with a mean age of 46.5 years. The R-PBL model demonstrated the best predictive performance for both periodontitis (AUC: 0.833) and severe periodontitis (AUC: 0.796), with the highest precision and net benefit across thresholds. The Either model showed similar performance, particularly in sensitivity, while SR and Both models underperformed. Decision curve analysis confirmed the superior clinical utility of ‘R-PBL’ and ‘Either’ models in guiding decision-making. Conclusions: Combining self-reported information with radiographic bone loss showed adequate screening performance for periodontitis. This dual approach may provide a feasible strategy for identifying high-risk individuals in settings where full clinical examination is not possible.
- Influence of low insertion torque values on survival rate of immediately loaded dental implants : a systematic review and meta-analysisPublication . Darriba, Iria; Seidel, Anna; Moreno, Federico; Botelho, João; Machado, Vanessa; Mendes, José João; Leira, Yago; Blanco, JuanAim: The aim was to systematically evaluate the effect of low insertion torque values on the survival rate of immediately loaded dental implants. Materials and Methods: The protocol was registered with PROSPERO (ID CRD42020189499). An electronic search was performed in PubMed, Embase, Web of Science, and Cochrane Central Register of Controlled Trials until June 2022 in English and Spanish. Studies analysing the failure or survival rate of immediately loaded dental implants according to different insertion torque values were included. Results: Five-hundred seventy-three articles were assessed for eligibility, of which seven articles, four randomized clinical trials (RCTs), one controlled clinical trial, and two prospective case series studies were included in the qualitative analysis. The RCTs were classified as having low risk of bias and the non-RCTs as having moderate and serious risk of bias. The mean survival rate for implants with low insertion toque (≤35 Ncm) was 96% (p > .001, 95% confidence interval [CI]: 0.91–0.98) and that for implants with medium or high insertion torque (>35 Ncm) was 92% (p > .001, 95% CI: 0.86–0.96) (incidence rate ratio [IRR] = 1.05, 95% CI: 0.79–1.39, p = .175, I2 = 0.0%). Splinted implants with insertion torque >20 Ncm and single implants with insertion torque >35 Ncm had a higher survival rate than implants with lower insertion torque values (IRR = 1.05, 95% CI: 0.78–1.43, p = .956, I2 = 0.0%, and RR = 0.92, 95% CI: 0.48–1.75, p = .799, I2 = 0.0%, respectively). Different insertion torque values achieved equivalent outcomes. The mean follow-up was 24 months. Conclusions: Low insertion torque values have no significant effect on survival rates of immediate loading implants at a mean follow-up of 24 months.
- Integrating sustainability in dentistry : a pathway towards achieving the UN 2030 agendaPublication . Guerra, Matilde; Morgado, Mariana; Leira, Yago; Leitão, Tiago; Botelho, João; Mendes, José JoãoThe growing impact of the climate crisis has raised significant concerns due to its profound effects on public health and ecological stability. This article explores how the implementation of sustainable practices in dentistry can contribute to a more efficient, safe and environmentally responsible approach, in line with the Sustainable Development Goals outlined in the United Nations’ 2030 Agenda. A key focus is on waste reduction, which is achieved through the promotion of oral health and disease prevention, thereby minimising the waste and carbon emissions associated with dental care. In addition, the responsible use of resources such as water and energy and the use of environmentally sustainable dental materials play a critical role in reducing the environmental footprint of dentistry. Key measures such as the recycling of single-use plastics are essential to curb pollution and reduce the uptake of microplastics by marine ecosystems and humans. Education and awareness of sustainability is also essential. This can be promoted by integrating sustainable principles into the curriculum of dental courses and within scientific committees. Promoting these practices among emerging health professionals and researchers will drive the development of innovative alternatives that further reduce the environmental impact of the field.
- Network protein interaction in the link between stroke and periodontitis interplay : a pilot bioinformatic analysisPublication . Leira, Yago; Mascarenhas, Paulo; Blanco, Juan; Sobrino, Tomás; Mendes, José João; Machado, Vanessa; Botelho, JoãoThe clinical interaction between stroke and periodontitis has been consistently studied and confirmed. Hence, exploring potentially new protein interactions in this association using bioinformatic strategies presents potential interest. In this exploratory study, we conducted a protein–protein network interaction (PPI) search with documented encoded proteins for both stroke and periodontitis. Genes of interest were collected via GWAS database. The STRING database was used to predict the PPI networks, first in a sensitivity purpose (confidence cut-off of 0.7), and then with a highest confidence cut-off (0.9). Genes over-representation was inspected in the final network. As a result, we foresee a prospective protein network of interaction between stroke and periodontitis. Inflammation, pro-coagulant/pro-thrombotic state and, ultimately, atheroma plaque rupture is the main biological mechanism derived from the network. These pilot results may pave the way to future molecular and therapeutic studies to further comprehend the mechanisms between these two conditions.
- Periodontal inflamed surface area mediates the link between homocysteine and blood pressurePublication . Botelho, João; Machado, Vanessa; Leira, Yago; Proença, Luís; Mendes, José JoãoHere, we assess the association between homocysteine (Hcy) serum levels and periodontal status in a large representative sample of the National Health and Nutrition Examination Survey (NHANES). Using the 2001–2002 and 2003–2004 NHANES databases, participants with a periodontal examination, medical self-reported data, blood pressure (BP) and blood samples to determine complete blood count, C-reactive protein (CRP) and Hcy levels. We then calculated the periodontal inflamed surface area (PISA) and the periodontal epithelial surface area (PESA). Multivariable regression analysis explored the association between Hcy, periodontal measures and BP. Mediation analysis was performed to understand the effect of PISA and PESA in the link between Hcy and BP. 4021 participants fulfilled the inclusion criteria. Hcy levels showed significant correlations with systolic BP, diastolic BP, PISA, PESA and age. PESA showed to be significantly associated with Hcy both for the crude and adjusted models (p < 0.01), but not PISA (p > 0.05). In the association of Hcy with systolic BP, PISA significantly mediated 17.4% and PESA 0.9%. In the association of Hcy with diastolic BP, PISA significantly mediated 16.3% and PESA 47.2%. In conclusion, Hcy and periodontitis are associated. Further, both PISA and PESA significantly mediated the association of Hcy with systolic BP and diastolic BP. Future studies shall deepen the mechanisms by which Hcy levels increase in a clinical situation of periodontitis.
- Periodontal inflammation is associated with increased circulating levels of endothelial progenitor cells : a retrospective cohort study in a high vascular risk populationPublication . Vázquez-Reza, María; Custodia, Antía; López-Dequidt, Iria; Aramburu-Núñez, Marta; Romaus-Sanjurjo, Daniel; Ouro, Alberto; Botelho, João; Machado, Vanessa; Iglesias-Rey, Ramón; Pías-Peleteiro, Juan Manuel; Leira, Rogelio; Blanco, Juan; Castillo, José; Sobrino, Tomás; Leira, YagoBackground: One of the main biological mechanisms behind the link between periodontitis and atherosclerotic vascular diseases is vascular endothelial dysfunction. Particularly, circulating endothelial progenitor cells (EPCs) have been considered a biomarker of altered vascular endothelial function. Objectives: The aim of this study was to investigate relationship between periodontal inflammation and increased number of circulating EPCs. Design: This is retrospective cohort study. Methods: In this study, 85 elderly patients with a previous history of hypertension were followed up to 12 months. A baseline full-mouth periodontal assessment was carried out, and the amount of periodontal tissue inflamed per subject was calculated as a proxy of periodontal inflammation [periodontal inflamed surface area (PISA)]. The number of circulating EPCs (CD34+/CD133+/KDR+) was determined by flow cytometry from peripheral blood samples collected at baseline and 12 months. Results: Mean concentrations of CD34+/CD133+/KDR+ progenitor cells were higher in periodontitis patients than in those without periodontitis at baseline [55.4, 95% confidence interval (CI) = 20.8 to 90.0 versus 27.2, 95% CI = 13.6 to 40.8, p = 0.008] and 12 months (114.6, 95% CI = 53.5 to 175.7 versus 19.1, 95% CI = 10.8 to 27.4, p = 0.003). A significant increase over the follow-up was noticed in the group of subjects with periodontitis (p = 0.049) but not in the nonperiodontitis group (p = 0.819). PISA was independently associated with CD34+/CD133+/KDR+ EPCs at baseline (B coefficient = 0.031, 95% CI = 0.005 to 0.058; p = 0.021). The relationship between PISA and CD34+/CD133+/KDR+ EPCs at 12 months was confounded by increased baseline body mass index (B coefficient = 0.064, 95% CI = −0.005 to 0.132; p = 0.066). Conclusion: Periodontal inflammation is associated with high number of CD34+/CD133+/KDR+ EPCs, thus supporting a potential link between periodontitis and endothelial dysfunction.
- The role of inflammatory diet and vitamin D on the link between periodontitis and cognitive function : a mediation analysis in older adultsPublication . Botelho, João; Leira, Yago; Viana, João; Machado, Vanessa; Lyra, Patrícia; Aldrey, José Manuel; Pías-Peleteiro, Juan Manuel; Blanco, Juan; Sobrino, Tomás; Mendes, José JoãoPatients suffering from periodontitis are at a higher risk of developing cognitive dysfunction. However, the mediation effect of an inflammatory diet and serum vitamin D levels in this link is unclear. In total, 2062 participants aged 60 years or older with complete periodontal diagnosis and cognitive tests from the National Health and Nutrition Examination Survey (NHANES) 2011–2012 and 2013–2014 were enrolled. The Consortium to Establish a Registry for Alzheimer’s disease (CERAD) word learning subtest (WLT) and CERAD delayed recall test (DRT), the animal fluency test (AFT) and the digit symbol substitution test (DSST) was used. Dietary inflammatory index (DII) was computed via nutrition datasets. Mediation analysis tested the effects of DII and vitamin D levels in the association of mean probing depth (PD) and attachment loss (AL) in all four cognitive tests. Periodontitis patients obtained worse cognitive test scores than periodontally healthy individuals. DII was negatively associated with CERAD-WLT, CERAD-DRT, AFT and DSST, and was estimated to mediate between 9.2% and 36.4% of the total association between periodontitis with cognitive dysfunction (p < 0.05). Vitamin D showed a weak association between CERAD-DRT, AFT and DSST and was estimated to between 8.1% and 73.2% of the association between periodontitis and cognitive dysfunction (p < 0.05). The association between periodontitis and impaired cognitive function seems to be mediated both by a proinflammatory dietary load and vitamin D deficiency. Future studies should further explore these mediators in the periodontitis-cognitive decline link.