Percorrer por autor "Lopes, Luísa Bandeira"
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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.
- Autism spectrum disorders and malocclusions : systematic review and meta-analysesPublication . Barros, Aline; Mascarenhas, Paulo; Botelho, João; Machado, Vanessa; Balixa, Gabriela; Lopes, Luísa BandeiraStudies heretofore have shown inconsistent results on the link of ASD to malocclusion. Herein, we aimed to compare the prevalence of malocclusion among children and adolescents with ASD compared with non-ASD healthy counterparts through a systematic review. The electronic search focused on five databases, PubMed, Web of Science, EMBASE, LILACS, and OpenGrey until January 2022, and followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines (PROSPERO No. CRD42022298023). Observational and intervention studies that compared occlusion characteristics of ASD individuals under 18 years old with healthy controls were included. Pairwise random effects meta-analyses of odds ratio (OR) were performed. Methodological quality was assessed by using the Joanna Briggs Institute Critical Appraisal Checklist for cross-sectional studies. A total of thirteen studies were included for qualitative analysis, and seven for quantitative analysis. The results presented a great heterogeneity and moderate risk of bias; thus, it was not possible to state that there is a risk of malocclusion in individuals with ASD. Future studies should be carried out with strict criteria in the choice of samples, control group, and diagnosis of malocclusion in order to meet the necessary requirements for greater methodological quality.
- Chemotherapy and radiotherapy long-term adverse effects on oral health of childhood cancer survivors : a systematic review and meta-analysisPublication . Lopes, Joana Pombo; Rodrigues, Inês; Machado, Vanessa; Botelho, João; Lopes, Luísa BandeiraThe survival rate for pediatric cancer has increased over the past few decades, short- and long-term complications have been detected and studied, and oral complications have emerged as an important topic of research. Here, we aimed to highlight the importance of oral manifestations that may only become apparent years or even decades after cancer treatment. This systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis. We searched articles using PubMed via the MEDLINE, Web of Science, and LILACS databases until October 2023. Overall, 35 observational studies were included, and the results estimated a pooled prevalence of the following dental anomalies: discoloration, 53%; crown-root malformations and agenesis, 36%; enamel hypoplasia, 32%; root development alterations, 29%; unerupted teeth, 24%; microdontia, 16%; hypodontia, 13%; and macrodontia, 7%. Most childhood cancer survivors have at least one dental sequela. Childhood cancer survivors presented a higher risk of having dental alterations than control counterparts. Additional analyses reveal possible sex-based differences that should be explored in future studies. These results collectively highlight the importance of oral healthcare and the prevention of disease in childhood cancer survivors.
- The child oral health impact profile : short form 19 cross-cultural adaptation and validity for the Portuguese pediatric populationPublication . Laborne, Fanny; Machado, Vanessa; Botelho, João; Lopes, Luísa BandeiraBackground/Objectives: To better understand the impact of different oral conditions on children, several instruments are available to measure oral health-related quality of life (OHRQoL). To adapt and validate cross-culturally the Child Oral Health Impact Profile—Short Form 19 (COHIP-SF19) questionnaire to the Portuguese language. Methods: The COHIP SF-19 was translated and back-translated, and tested for its reliability and for psychometric properties in children who were aged between 8 and 17 years old. The COHIP-19-PT was tested for its internal consistency, construct validity, content validity, and test–retest reliability. Results: The COHIP-19-PT revealed good internal consistency (Cronbach’s alpha = 0.88) and test–retest reliability (interclass correlation = 0.78). The CFA analysis confirmed the structure of COHIP-19-PT. The first-order model showed an adequate fit: GFI = 0.878; CFI = 0.812; RMSEA = 0.083 (90% CI: 0.077–0.090). No invariance was found for the gender-based groups. The correlation between the sub-scales was also assessed, confirming significant correlations between all subdomains. Conclusions: The COHIP-19-PT is a valid and reliable scale for measuring children’s oral health-related quality of life.
- Children’s attitudes and behaviors about oral health and dental practicesPublication . Fernandes, Sara Costa; Louceiro, Ana; Lopes, Luísa Bandeira; Esteves, Francisco; Arriaga, PatríciaThe present study sought to contribute to a better understanding of children’s attitudes and behaviors regarding oral health and dental practices. The sample was composed of 101 children (8–10 years), collected from several schools in the Lisbon metropolitan area. Our main goals were to collect a survey of information about the beliefs, attitudes, habits and knowledge of children about oral and dental issues in order to not only have an overview of them but also to serve as a basis and a starting point for the development of intervention programs to increase positive attitudes and behaviors related to oral health and promote greater knowledge about these subjects. In general, children reported positive behaviors regarding dental habits and oral hygiene practices. Children’s opinions and beliefs about dentists were also globally positive; however, the results suggested that younger children reported more positive attitudes, emotions and previous experiences. Regarding children’s knowledge about these dental issues, the results were quite negative and worrying, ruled by ignorance and incorrect beliefs and behaviors. In sum, all the results and conclusions of this study may contribute to the development of educational programs within the scope of the promotion of oral health and hygiene practices—“An Adventure about Oral Health.”
- Evaluating the quality of systematic reviews on pediatric sedation in dentistry : an umbrella reviewPublication . Marques, Carolina; Dinis, Mafalda; Machado, Vanessa; Botelho, João; Lopes, Luísa BandeiraSedation is a depression of a patient’s state of consciousness, induced by medications, that can reach different levels of intensity during a medical procedure. Conscious sedation produces a minimally depressed level of consciousness without impairment of the ability to maintain an open airway, of protective reflexes or of responses to verbal and physical stimulation. This umbrella review is aimed at critically assessing the available systematic reviews (SRs) and meta-analyses (MA) on sedation in children/adolescents. An electronic database search was conducted that included Pubmed-Medline, Web of Science, Cochrane, Scopus, Scielo, Embase, LILACS and TRIP and the scope of which extended until January 2023. The risk of bias (RoB) of SRs was analyzed using the Measurement Tool to Assess SRs criteria 2 (AMSTAR2). Of 998 entries, 37 SRs were included. In terms of methodological quality, eight studies were assessed as having critically low quality, four studies had low quality, nine studies had moderate quality, and sixteen were considered to be of high quality. Based on the current guidelines, the most employed drugs in pediatric dentistry for sedation are nitrous oxide and midazolam; however, the available evidence supporting their use is insufficient and of low/critically low quality. The combined technique is recommended (nitrous oxide (30–50%) + midazolam). The optimal dose of oral midazolam is 0.75 mg/kg. The level of methodological quality of SRs is expected to increase according to the results and future directions of this umbrella review.
- Evidence of age estimation procedures in forensic dentistry : results from an umbrella reviewPublication . Neves, João Albernaz; Lopes, Luísa Bandeira; Machado, Vanessa; Botelho, João; Delgado, Ana Sintra; Mendes, José JoãoBackground and objective: Age estimation is an important tool when dealing with human remains or undocumented minors. Although the skull, the skeleton or the hand-wrist are used in age estimation as maturity indicators, they often present a lack of good conditions for a correct identification or estimation. Few systematic reviews (SRs) have been recently published; therefore, this umbrella review critically assesses their level of evidence and provides a general, comprehensive view. Materials and methods: Considering the review question “What is the current evidence on age determination approaches in Forensic Dentistry?” an electronic database search was conducted in four databases (PubMed, Cochrane, WoS, LILACS) up to December 2022, focusing on SRs of age estimation through forensic dentistry procedures. The methodological quality was analyzed using the measurement tool to assess SRs criteria (AMSTAR2). Results: Eighteen SRs were included: five of critically low quality, six of low quality, three of moderate quality and four of high quality. The SRs posited that Willems’ method is more accurate and less prone to overestimation; most methods seem to be geographically sensitive; and 3D-imaging and artificial intelligence tools demonstrate high potential. Conclusions: The quality of evidence on age estimation using dental approaches was rated as low to moderate. Well-designed clinical trials and high-standard systematic reviews are essential to corroborate the accuracy of the different procedures for age estimation in forensic dentistry.
- A four-year follow-up case report of hypomineralized primary second molars rehabilitated with stainless steel crownsPublication . Lopes, Luísa Bandeira; Machado, Vanessa; Botelho, JoãoHypomineralized primary second molars (HPSM) are characterized by enamel opacities accompanied by hypersensitivity and atypical caries lesion, on one to four primary second molars. The correct treatment and follow-ups of those teeth have an important impact on a correct eruption of the first permanent molars and future occlusion. Hence, this report aims to describes a case of a severe HPSM in all second molars of a four-year-old girl and subsequent four-year follow-ups. The rehabilitation involved the placement of four stainless steel crowns on all four second primary molars under general anesthesia. Concerning the available literature and the case severity of HPSM, the treatment approach proposed for the case provided good functional outcome.
- International guidelines on conscious sedation in pediatric dentistry : a comparative analysis and evidence mapping studyPublication . Marques, Carolina; Dinis, Mafalda; Botelho, João; Machado, Vanessa; Lopes, Luísa BandeiraConscious sedation is widely used in pediatric dentistry to manage dental anxiety, behavioral difficulties, and systemic diseases that compromise patient compliance with dental care. Despite its clinical importance, international recommendations vary considerably. Objective: To conduct a comparative analysis and evidence mapping of international clinical practice guidelines on conscious sedation in pediatric dentistry. Methods: A comparative guideline analysis and evidence mapping study was performed. Electronic searches were conducted in PubMed (MEDLINE), Scopus, EMBASE, Cochrane Database of Systematic Reviews, Web of Science, LILACS, SciELO, TRIP, and OpenGrey up to December 2023. Guidelines issued by recognized professional or governmental organization addressing conscious sedation in pediatric dentistry were included. Predefined domains were analyzed, including indications, contraindications, pharmacological agents, dosages, routes of administration, monitoring, discharge criteria, and professional training. Data were synthesized descriptively and graphically mapped to illustrate coverage patterns. Results: Twelve international guidelines were included. Complete convergence (100%) was observed in core safety domains, such as patient assessment, monitoring, and professional training. A high agreement was found for discharge criteria (91.67%) and contraindications (83.33%). However, substantial variability emerged in pharmacological protocols, with only 16.67% of guidelines providing comprehensive drug and dosage descriptions. Routes of administration and emergency equipment recommendations were inconsistently reported, appearing in 66.67% and 50% of guidelines, respectively. Conclusions: Although foundational safety principles are consistently addressed, significant heterogeneity persists in pharmacological and procedural recommendations. This variability may contribute to differences in practice and uncertainty among practitioners. Greater international harmonization of guidelines may improve consistency, enhance clinical decision-making, and strengthen patient safety in pediatric dental care. Clinical Relevance: Identifying areas of convergence and variability across international guidelines may support the development of more standardized sedation protocols and promote safer evidence-based clinical practice in pediatric dentistry.
- Knowledge, perception, and clinical experiences on molar incisor hypomineralization amongst dental professionals : a systematic review and meta-analysisPublication . Balixa, Gabriela; Rodrigues, Carlota; Botelho, João; Machado, Vanessa; Lopes, Luísa BandeiraBackground: Molar–incisor hypomineralization (MIH) is a common developmental enamel defect that presents important diagnostic and therapeutic challenges in pediatric dentistry. Differences in dental professionals’ knowledge and clinical confidence may affect patient care. Aim: To evaluate dental professionals’ awareness, diagnostic confidence, clinical management, referral practices, and training related to MIH. Methods: A systematic review and meta-analysis were conducted in accordance with PRISMA guidelines. Random-effects meta-analyses were performed to calculate pooled estimates, with subgroup analyses by geographic region, dental specialty, and risk of bias. Results: Thirty-six observational studies including over 10,000 dental professionals were included. Awareness of MIH diagnostic criteria was moderate (72.1%) and higher among pediatric dentists than general dental practitioners. Diagnostic confidence (67.5%) and comfort in providing treatment (64.1%) were suboptimal, particularly among non-specialists. Most respondents perceived a distinct caries pattern in MIH-affected teeth (84.8%), while referral to pediatric dentists was inconsistent (52.5%). Approximately 80% of participants reported a need for additional MIH-related training. Substantial heterogeneity was observed across analyses. Conclusions: Despite moderate awareness of MIH, important gaps persist in diagnostic confidence, clinical management, and referral practices. Strengthening undergraduate education, continuing professional development, and structured referral pathways is essential to improve early diagnosis, appropriate management, and outcomes for children affected by MIH, highlighting the pivotal role of paediatric dentists in interdisciplinary care.