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- Relationship between blood and standard biochemistry levels with periodontitis in Parkinson’s disease patients: data from the NHANES 2011–2012Publication . Botelho, João; Lyra, Patrícia; Proença, Luis; Godinho, Catarina; Mendes, José João; Machado, VanessaPeople with Parkinson’s Disease (PD) are associated with the presence of periodontitis. We aimed to compare blood and standard biochemical surrogates of PD patients diagnosed with periodontitis with PD individuals without periodontitis. This retrospective cohort study used a sample from the National Health and Nutrition Examination Survey (NHANES) 2011–2012 that underwent periodontal diagnosis (n = 3669). PD participants were identified through specific PD reported medications. Periodontitis was defined according to the 2012 case definition, using periodontal examination data provided. Then, we compared blood levels and standard chemical laboratory profiles of PD patients according to the presence of periodontitis. Multivariable regression was used to explore this dataset and identify relevant variables towards the presence of periodontitis. According to the medication report, 37 participants were eligible, 29 were secure and 8 were unsecure PD medications regimens. Overall, PD cases with periodontitis presented increased levels of White Blood Cells (WBC) (p = 0.002), Basophils (p = 0.045) and Segmented neutrophils (p = 0.009), and also, lower levels of Total Bilirubin (p = 0.018). In the PD secure medication group, a significant difference was found for WBC (p = 0.002) and Segmented neutrophils (p = 0.002) for the periodontitis group. Further, WBC might be a discriminating factor towards periodontitis in the global sample. In the secure PD medication, we found gender, segmented neutrophils and Vitamin D2 to be potential discriminative variables towards periodontitis. Thus, periodontitis showed association with leukocyte levels alterations in PD patients, and therefore with potential systemic changes and predictive value. Furthermore, Vitamin D2 and gender showed to be associated with periodontitis in with secure medication for PD. Future studies should assess in more detail the potential systemic repercussion of the presence of periodontitis in PD patients.
- Tooth reattachment and palatal veneer on a multidisciplinary approach of crown fractures in upper central incisorsPublication . Machado, Vanessa; Alves, Ricardo; Lopes, Luísa; Botelho, João; Mendes, José JoãoDental trauma is more common in young patients and its sequelae may have great impact on the esthetics, functions, and phonetics. This paper reports a case of trauma in both central incisors in a young 17-year-old patient who was treated using adhesive tooth fragment reattachment on tooth 2.1 and a palatal indirect composite veneer on tooth 1.1. Regarding the available literature and fracture extension, the treatment approach proposed for this case provided good functional and esthetic outcomes. Clinical and radiographic results after 1 year were successful. This case demonstrates the importance of establishing a multidisciplinary approach for successful dental trauma management.
- Parkinson’s disease, periodontitis and patient-related outcomes: a cross-sectional studyPublication . Lyra, Patrícia; Machado, Vanessa; Proença, Luis; Domingos, Josefa; Godinho, Catarina; Mendes, José João; Botelho, JoãoBackground and objectives: People with Parkinson’s disease (PD) may be at risk of having bad periodontal status. A consistent periodontal examination is critical to investigate how it impacts on PD quality of life. We aimed to assess the periodontal status of people with PD, and its association with quality of life and self-perceived xerostomia. Materials and Methods: To this end, from February to March 2020, we consecutively enrolled 28 PD individuals, and motor and non-motor symptoms of PD were assessed using the Movement Disorder Society Unified Parkinson’s Disease Rating Scale (MDS-UPDRS). We performed full-mouth periodontal examination and gathered information on self-perceived quality of life in PD, oral health impact profile (OHIP-14) and xerostomia. Results: The prevalence of periodontitis was 75.0% and most cases were identified as severe (46.4%). Upper extremity rigidity, hand posture and kinetic tremors were significantly correlated with worse periodontal status. PDQ-8 showed to be correlated with self-perceived oral health-related quality of life and xerostomia levels. Conclusions: This group of people with PD had a high prevalence of periodontitis. Deteriorated levels of the upper extremities in advanced stages of PD were associated with worse periodontal status and hygiene habits. Quality of life in PD appears to be associated with self-perceived OHRQoL and xerostomia.
- Gut status in Parkinson’s disease: the GutSPark protocolPublication . Grunho, Miguel; Godinho, Catarina; Matos, António Alves de; Barroso, Helena; Carregosa, Ricardo; Marx, Frederico; Tomé, Morgane; Domingos, Josefa; Sousa-catita, Diogo; Botelho, João; Machado, Vanessa; Mendes, José João; Outeiro, Tiago; Fonseca, JorgeThe neuropathological hallmark of Parkinson’s disease (PD) is the accumulation of alpha–synuclein (AS) aggregates. The identification of AS aggregates in gut biopsy specimens from people with PD may provide an opportunity to identify PD at a very early stage, prior to symptom onset. Changes in gut microbiota and inflammatory conditions (such as periodontitis) may be linked with PD onset/evolution. This project aims to explore the concept of microbiota–gut–brain axis in PD, studying gut biopsy specimens for AS aggregates, oral and intestinal microbiota, associated digestive disorders and oral health, of both patients with PD and controls.