1
|
Ângelo DF, Nunes M, Monje F, Mota B, Salvado F. A role for total alloplastic temporomandibular joint replacement in Gardner syndrome. Int J Oral Maxillofac Surg 2024; 53:219-222. [PMID: 37985266 DOI: 10.1016/j.ijom.2023.10.032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2023] [Revised: 10/12/2023] [Accepted: 10/27/2023] [Indexed: 11/22/2023]
Abstract
Gardner syndrome (GS) is a rare autosomal dominant disorder that can present with craniomaxillofacial abnormalities. The identification of osteomas or craniomaxillofacial abnormalities can therefore serve as a marker of this condition, facilitating early referral and diagnosis. A 17-year-old female with GS was referred for the management of severe limited mouth opening, causing a major problem for routine endoscopy to monitor the gastrointestinal alterations of GS. Clinical and radiological evaluations showed multiple osteomas in the mandibular angle, condylar and coronoid regions bilaterally and maximum mouth opening of 8 mm. The patient underwent surgery for osteoma removal and bilateral customized alloplastic total temporomandibular joint replacement (TMJ-TJR). At the 2-year follow-up, the patient showed improvements in quality of life, with a maximum mouth opening of 34 mm, allowing routine upper endoscopy to be performed. This is the first report of GS, a rare and challenging craniomaxillofacial abnormality, treated with TMJ-TJR. A comprehensive overview of the patient's clinical presentation, diagnostic assessment, treatment planning, and outcomes is provided.
Collapse
Affiliation(s)
- D F Ângelo
- Instituto Português da Face, Lisbon, Portugal; Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal; Clinica Universitária de Estomatologia, Centro Hospitalar Universitário Lisboa Norte (CHUNL), Lisbon, Portugal.
| | - M Nunes
- Clinica Universitária de Estomatologia, Centro Hospitalar Universitário Lisboa Norte (CHUNL), Lisbon, Portugal
| | - F Monje
- Department of Oral and Maxillofacial Surgery, Hospital Universitario de Badajoz, Badajoz, Spain
| | - B Mota
- Clinica Universitária de Estomatologia, Centro Hospitalar Universitário Lisboa Norte (CHUNL), Lisbon, Portugal
| | - F Salvado
- Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal; Clinica Universitária de Estomatologia, Centro Hospitalar Universitário Lisboa Norte (CHUNL), Lisbon, Portugal
| |
Collapse
|
2
|
Picolo M, de Araújo Nobre MA, Salvado F, Barroso H. Association of Herpesvirus and Periodontitis: A Clinical and Laboratorial Case-Control Study. Eur J Dent 2023; 17:1300-1308. [PMID: 37295456 PMCID: PMC10756839 DOI: 10.1055/s-0043-1761423] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/12/2023] Open
Abstract
OBJECTIVES A significant influence of the Herpesviridae family in the progression of periodontal disease has been suggested. The aim of this study was to investigate the potential association of four Herpesviruses (HSV-1, HSV-2, cytomegalovirus [CMV], and Epstein-Barr virus [EBV]) with periodontal disease using a qualitative test for evaluating the presence or absence of viral DNA in crevicular fluid samples of both healthy periodontal patients and periodontal compromised patients. MATERIALS AND METHODS A case-control study was conducted in 100 participants at a university clinic. A qualitative test was used for evaluating the presence/absence of viral DNA in crevicular fluid samples of both healthy periodontal patients and periodontal compromised patients, and considering the periodontitis staging (stage II, stage III, and stage IV) and grading (grade A, grade B, and grade C). STATISTICAL ANALYSIS The distribution of the same exposure variables to the periodontitis staging and grading was compared using Chi-square, Fisher's exact, and Gamma tests depending on the variable characteristics. The significance level was set at 5%. The association of the variables: age, sex, diabetes, smoking, alcohol, and oral hygiene was also considered. RESULTS The prevalence of Herpesviridae family virus DNA was 6% for the periodontal healthy group and 60% for the periodontitis group (roughly 60% on periodontitis stages II, III, and IV, p <0.001; and twofold increase in moderate and rapid progression grades compared with the slow progression grade, p <0.001). HSV1 DNA was prevalent in all periodontitis stages and grades. HSV 2, EBV, and CMV DNA had increasing prevalence rates in more severe stages (stages III and IV, p <0.001); while considering periodontitis grade, HSV2 (p = 0.001), CMV (p = 0.019) and EBV (p <0.001) DNA were prevalent only in grades B and C, with EBV DNA registering a marked prevalence in grade C. CONCLUSION A significant different distribution of Herpesviridae virus DNA per each stage of disease was registered.
Collapse
Affiliation(s)
- Marta Picolo
- Mestrado Integrado de Medicina Dentária, Instituto Universitário Egas Moniz (IUEM), Caparica, Portugal
| | - Miguel A. de Araújo Nobre
- Clínica Universitária de Estomatologia, Faculdade de Medicina, Universidade de Lisboa, Portugal
- Research and Development Department, Maló Clinic, Lisboa, Portugal
| | - Francisco Salvado
- Clínica Universitária de Estomatologia, Faculdade de Medicina, Universidade de Lisboa, Portugal
- Centro de Investigação Interdisciplinar Egas Moniz (CiiEM) – Instituto Universitário Egas Moniz (IUEM), Caparica Portugal
| | - Helena Barroso
- Centro de Investigação Interdisciplinar Egas Moniz (CiiEM) – Instituto Universitário Egas Moniz (IUEM), Caparica Portugal
| |
Collapse
|
3
|
Pereira CP, Belo C, Sardinha J, Santos R, Salvado F, Cameriere R. Quantitative and Qualitative Approaches for Dental Age Assessment in Sub Adult Portuguese Population: European Regression Formula and Demirjian Stages. Acta Stomatol Croat 2022; 56:288-298. [PMID: 36382212 PMCID: PMC9635504 DOI: 10.15644/asc56/3/7] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Accepted: 07/04/2022] [Indexed: 08/07/2023] Open
Abstract
INTRODUCTION Over the last decade, the criminal justice system among the European countries deals with a new group of people, the undocumented people. In the criminal field, most of the suspected claimed to be under the minor legal age according to the type of crime. The government of each European country is committed to protecting the children and vulnerable people. There are serious safety concerns since adults falsely claim to be minors and legal systems oppose to such claims. In this study, we have used different age assessment methods and some of them without accuracy. OBJECTIVE To meet the general considerations we developed a study using the current dental age assessment methods. Hence, for the Portuguese population, this study aims to validate the European regression formula between the ages of 6 and 15 years of age; to estimate the cut-off point for the age of 12 years, and to compare the quantitative approach of European regression formula with Demirjian's qualitative approach for age estimation. MATERIAL AND METHODS 483 orthopantomograms were analysed using the European formula and Demirjian scoring stages. A new method, Model 2, was designed to better suit the Portuguese population. RESULTS The European formula: average age underestimation of 4.88 for the third quadrant and 4.04 months for the fourth quadrant; and a mean absolute error (MAE) of 10.93 and 10.68 months respectively. Demirjian method: average overestimation of 8.70 months, MAE of 12.85 months. In Model 2: MAE of 9.37 months for the third quadrant, and 9.28 months for the fourth quadrant. Both European formula and Demirjian method had an area under ROC curves results above 0.93. Discrepancy of sensitivity between methods for the specific cut-off point: 11.48. The results obtained in this study can be extrapolated to 87.33% of the Portuguese population. CONCLUSIONS The European regression formula can be applied for the Portuguese population, and seems to be more accurate than Demirjian's methodology in this population. Nevertheless, both European regression formula and Demirjian method present similarly suitable results in the classification of 12 years of age, although there is a noticeable discrepancy favouring the European regression formula. The European Formula when applied for criminal age assessment, independently of population, is mandatory to indicate to the judicial institutions, the sensitivity of the results.
Collapse
Affiliation(s)
| | - Carla Belo
- Student of Postgraduate Specialisation Course, Faculty of Dental Medicine, University of Lisbon, Portugal
| | - Joana Sardinha
- Student of Postgraduate Specialisation Course, Faculty of Dental Medicine, University of Lisbon, Portugal
| | - Rui Santos
- Department of Mathematics, School of Technology and Management, Polytechnic of Leiria, Portugal
| | - Francisco Salvado
- Centre of Statistics and Applications, Faculty of Medicine of University of Lisbon, Portugal
| | - Roberto Cameriere
- Age Estimation Project, FOR.MED.LAB, University of Macerata, Macerata, Italy
| |
Collapse
|
4
|
C Romão V, Sousa Bandeira MJ, Silvério-António M, Simão R, Pinto J, Gonçalves AI, Gonçalves MJ, Martins AL, José P, Coutinho G, Morena Bueno Silva L, Brito Lança M, Esteves Marques R, Macieira C, Khmelinskii N, Rodrigues W, Salvado F, Fonseca JE. AB0501 COMPREHENSIVE ASSESSMENT OF PATIENTS WITH SUSPECTED SJÖGREN’S SYNDROME: 5-YEAR RESULTS OF A MULTIDISCIPLINARY SJÖGREN’S SYNDROME CLINIC. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.2436] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BackgroundPrimary Sjögren’s syndrome (pSS) is a systemic rheumatic disease that affects several organ systems, most frequently the ocular, oral and musculoskeletal domains. Multidisciplinary care is thus crucial in the optimal management of SS patients.ObjectivesTo report the clinical impact of a Multidisciplinary SS Clinic (MSSC) over a 5-year period.MethodsWe prospectively included patients assessed in the MSSC from September 2015 to October 2020. All patients had a full clinical evaluation, including disease-related questionnaires, specialized oral/ocular assessment, salivary gland biopsy (SGB) and ultrasound (SGUS), tear and salivary flow and ocular staining scores. We compared the results of patient-reported outcomes, comprehensive clinical assessments and specialized complementary exams in patients with pSS and other diagnoses.Results445 patients (96% women, mean age 57±14 years) with sicca symptoms underwent complete multidisciplinary evaluation. Patients were most frequently referred from Rheumatology (91%), but also from Stomatology (5%), Ophthalmology (2%), Internal Medicine (1%) and other medical specialties (1%). Most patients were diagnosed with pSS (n=221; 50%), followed by non-Sjögren sicca syndrome (nSSS, n=134; 30%), secondary SS (sSS, n=60; 13%) and undifferentiated connective tissue disease (n=30; 7%). Positive sicca tests were present in 217/385 patients (56%): unstimulated whole salivary flow (UWSF) ≤0.1ml/min in 84/317 (27%); Schirmer’s test ≤5mm/5min in 163/354 (46%); van Bijsterveld score ≥4 in 42/349 (12%); Ocular Staining Score (OSS) ≥5 in 36/343 (11%). Subjective complaints assessed by the EULAR Sjögren’s Syndrome Patient Reported Index (ESSPRI), the EULAR Sicca Score (ESS), the Profile of Fatigue and Discomfort - Sicca Symptoms Inventory (PROFAD-SSI), the Xerostomia Inventory (XI), and the Ocular Surface Disease Index (OSDI) did not differ between patients with pSS and other diagnoses. However, objective dryness measures such as UWSF (31vs20%, p=0.028), Schirmer’s test (51vs40%, p=0.040) and OSS (14vs7%, p=0.048) were significantly associated with pSS. A positive SGB (focus score≥1) was seen in 48% of patients with a clinical diagnosis of pSS (p<0.001 vs. other diagnoses), with a mean focus score of 1.1±1.6. Instead, 94% of patients with nSSS had grade 0-1 biopsies. Mean SGUS scores (p=0.006) and the frequency of moderate/severe changes (p<0.001) were higher in pSS patients.ConclusionMultidisciplinary evaluation was crucial in the assessment of patients with similar sicca complaints and in the management of ocular/oral/systemic involvement. Objective measurements and specialized complementary exams greatly contribute to establishing or confirming the diagnosis of pSS.Disclosure of InterestsNone declared
Collapse
|
5
|
Ferreira PW, Nogueira PJ, de Araújo Nobre MA, Guedes CM, Salvado F. Impact of Mechanical Complications on Success of Dental Implant Treatments: A Case-Control Study. Eur J Dent 2021; 16:179-187. [PMID: 34587636 PMCID: PMC8890925 DOI: 10.1055/s-0041-1732802] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
Objective
This study aimed to investigate the impact of mechanical complications on outcome measures for implant dentistry.
Materials and Methods
This case–control study included 282 patients with mechanical complications occurring in fixed prosthetic rehabilitation supported by immediate function implants with external connection (cases) and 282 individuals without mechanical complications (control). Pairing was performed for sex, age (range = 3 years), and follow-up months (range = 11 months). The primary outcome measure was implant survival, while the secondary outcome measures were marginal bone loss and biological complication parameters (peri-implant pathology, soft tissue inflammation, fistula formation, and abscess formation).
Statistical Analysis
Cumulative implant survival was estimated by using life tables. Descriptive statistics with 95% confidence intervals (CI) and inferential statistics (Chi-square test) were performed to evaluate differences between cases and controls. The significance level was set at 5%.
Results
The average follow-up duration was 8.5 years. Mechanical complications included prosthetic fracture (
n
= 159), abutment loosening (
n
= 89), prosthetic screw loosening (
n
= 20), milled abutment (
n
= 12), milled prosthetic screw (
n
= 1), and decemented crown (
n
= 1). Implant failure occurred in one patient from the control group, with survival rates of 100 and 99.6% for cases and controls, respectively (
p
= 0.317). The average marginal bone loss was 1.72 (95% confidence interval [CI]: 1.60–1.84) for cases and 1.55 (95% CI: 1.45–1.65) for controls (
p
= 0.068). Biological complications were observed in 90 patients, with significant differences between cases (
n
= 54) and controls (
n
= 36;
p
= 0.038).
Conclusion
Mechanical complications did not significantly influence survival or marginal bone loss; nevertheless, there is a need for studies with longer follow-up duration. Mechanical complications also significantly influence the incidence of biological complications.
Collapse
Affiliation(s)
- Patrícia W Ferreira
- Unidade de Epidemiologia, Instituto de Medicina Preventiva e Saúde Pública, Faculdade de Medicina, Universidade de Lisboa, Avenida Professor Egas Moniz, Lisboa, Portugal
| | - Paulo J Nogueira
- Unidade de Epidemiologia, Instituto de Medicina Preventiva e Saúde Pública, Faculdade de Medicina, Universidade de Lisboa, Avenida Professor Egas Moniz, Lisboa, Portugal
| | - Miguel A de Araújo Nobre
- Unidade de Epidemiologia, Instituto de Medicina Preventiva e Saúde Pública, Faculdade de Medicina, Universidade de Lisboa, Avenida Professor Egas Moniz, Lisboa, Portugal.,Research, Development and Education Department, Maló Clinic, Avenida dos Combatentes, Lisboa, Portugal.,Clínica Universitária de Estomatologia, Faculdade de Medicina, Universidade de Lisboa, Avenida Professor Egas Moniz, Lisboa, Portugal
| | - Carlos Moura Guedes
- Prosthodontics Department, Maló Clinic, Avenida dos Combatentes, Lisboa, Portugal
| | - Francisco Salvado
- Clínica Universitária de Estomatologia, Faculdade de Medicina, Universidade de Lisboa, Avenida Professor Egas Moniz, Lisboa, Portugal.,Centro de Investigação Integrada Egas Moniz, Campus Universitário, Quinta da Granja, Caparica
| |
Collapse
|
6
|
Ângelo DF, Wang Y, Morouço P, Monje F, Mónico L, González-Garcia R, Moura C, Alves N, Sanz D, Gao J, Sousa R, Neto L, Faísca P, Salvado F, López Peña M, Permuy M, Munñoz F. A randomized controlled preclinical trial on 3 interposal temporomandibular joint disc implants: TEMPOJIMS-Phase 2. J Tissue Eng Regen Med 2021; 15:852-868. [PMID: 34323386 DOI: 10.1002/term.3230] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Revised: 05/31/2021] [Accepted: 07/22/2021] [Indexed: 01/03/2023]
Abstract
The effort to develop an effective and safe temporomandibular joint (TMJ) disc substitute has been one of the mainstreams of tissue engineering. Biodegradable customized scaffolds could approach safety and effectiveness to regenerate a new autologous disc, rather than using non-biodegradable materials. However, it is still technically challenging to mimic the biomechanical properties of the native disc with biodegradable polymers. In this study, new 3D tailored TMJ disc implants were developed: (1) Poly(glycerol sebacate) (PGS) scaffold reinforced with electrospun Poly(εcaprolactone) (PCL) fibers on the outer surface (PGS+PCL); (2) PCL and polyethylene glycol diacrylate (PEGDA) (PCL+PEGDA); and (3) PCL. The TMJ implants were tested in a randomized preclinical trial, conducted in 24 black Merino sheep TMJ, perfoming bilateral interventions. Histologic, imaging, and kinematics analysis was performed. No statistical changes were observed between the PGS+PCL disc and the control group. The PCL+PEGDA and PCL groups were associated with statistical changes in histology (p = 0.004 for articular cartilage mid-layer; p = 0.019 for structure changes and p = 0.017 for cell shape changes), imaging (p = 0.027 for global appreciation) and dangerous material fragmentation was observed. No biomaterial particles were observed in the multi-organ analysis in the different groups. The sheep confirmed to be a relevant animal model for TMJ disc surgery and regenerative approaches. The PCL and PCL+PEGDA discs presented a higher risk to increase degenerative changes, due to material fragmentation. None of the tested discs regenerate a new autologous disc, however, PGS+PCL was safe, demonstrated rapid resorption, and was capable to prevent condyle degenerative changes.
Collapse
Affiliation(s)
- David Faustino Ângelo
- Instituto Português da Face, Lisboa, Portugal.,Faculdade de Medicina da Universidade de Lisboa, Lisboa, Portugal.,Centre for Rapid and Sustainable Product Development, Polytechnic Institute of Leiria, Leiria, Portugal
| | | | | | - Florencio Monje
- Complejo Hospitalario Universitario de Badajoz, Badajoz, Spain
| | | | | | - Carla Moura
- Centre for Rapid and Sustainable Product Development, Polytechnic Institute of Leiria, Leiria, Portugal
| | - Nuno Alves
- Centre for Rapid and Sustainable Product Development, Polytechnic Institute of Leiria, Leiria, Portugal
| | - David Sanz
- Instituto Português da Face, Lisboa, Portugal
| | - Jin Gao
- Department of Bioengineering, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Rita Sousa
- Faculdade de Medicina da Universidade de Lisboa, Lisboa, Portugal
| | - Lia Neto
- Faculdade de Medicina da Universidade de Lisboa, Lisboa, Portugal
| | - Pedro Faísca
- Gulbenkian Institute of Science, Oeiras, Portugal
| | | | | | - Maria Permuy
- University of Santiago de Compostela-Lugo Campus, Lugo, Spain
| | - Fernando Munñoz
- University of Santiago de Compostela-Lugo Campus, Lugo, Spain
| |
Collapse
|
7
|
Coutinho JC, Coutinho GC, Mota B, Cruz L, Caldas C, Palmela P, Simão R, Nunes M, Salvado F. P-258 Oral leukoplakia: risk factors associated with malignancy. Oral Oncol 2021. [DOI: 10.1016/s1368-8375(21)00541-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
|
8
|
Cruz L, Coutinho J, Coutinho G, Mota B, Coelho T, Contente F, Andrade C, Palmela P, Caldas C, Simão R, Salvado F. P-110 Variability in Minor Salivary Gland Tumors of Oral Cavity. Oral Oncol 2021. [DOI: 10.1016/s1368-8375(21)00397-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
9
|
Mota B, Andrade C, Cruz L, Coelho A, Coutinho J, Coutinho G, Contente F, Nunes M, Fontes S, Salvado F. P-111 Necrotizing Sialometaplasia: Differential diagnosis and treatment of a malignant masquerade. Oral Oncol 2021. [DOI: 10.1016/s1368-8375(21)00398-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
10
|
Coutinho JC, Contente F, Coutinho GC, Mota B, Cruz L, Coelho T, Andrade C, Caldas C, Aguiar A, Palmela P, Salvado F. P-259 Immunodeficiency and Oral Squamous Cell Carcinoma: Our Experience. Oral Oncol 2021. [DOI: 10.1016/s1368-8375(21)00542-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
|
11
|
Augusto D, Pereira CP, Rodrigues A, Cameriere R, Salvado F, Santos R. Dental Age Assessment by I 2M and I 3M: Portuguese Legal Age Thresholds of 12 and 14 Year Olds. Acta Stomatol Croat 2021; 55:45-55. [PMID: 33867537 PMCID: PMC8033628 DOI: 10.15644/asc55/1/6] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
Objective Better understanding of dental age assessment may help in cases of age estimation in Forensic Clinics. The first aim was to provide essential information on method reliability for upcoming studies using dental age assessment by second molar index (I2M), and third molar index (I3M) for age estimation on legal ages of 12 - 14 years. The second aim was to document forensic method outcomes of the Demirjian method which has already been used in forensic clinic. Material and Methods Two samples were used for this purpose: for I2M, 633 orthopantomographs (270 females / 363 males), the age range from 7 to 17 years and for I3M, 471 orthopantomographs (253 females / 218 males), the age range from 10 to 23 years, from the database population of Lisbon North University Hospital Center, approved by the Ethic Committee. Results The I3M cut-off point (1.133) for 12- year- olds obtained better results than the cut-off point stated by the I2M (0.135). Besides, I2M cut-off point (0.001) for 14- year- olds showed better results when compared with the cut-off point (0.705) established by the I3M. Both methods are reliable for the legal age thresholds of 12 and 14 years. However, using I2M and I3M allows us to vary the cut-off value to privilege sensitivities or specificity, depending on which is more appropriate to the intended application. Conclusions The accuracy (88.94%) of I3M obtained better results for the 12- year- old cut-off point (1.133) and the accuracy (90.21%) of the I2M performed better for the 14- year- old cut-off point (0.001).
Collapse
Affiliation(s)
- Diana Augusto
- - Faculty of Dental Medicine, University of Lisbon, Portugal. Orcid Number: 0000-0003-2698-6210, Student of master's in dental medicine
| | | | - Ana Rodrigues
- - Faculty of Dental Medicine, University of Lisbon, Portugal, and Junior Researcher of the CEAUL Forensic Analysis Group. Orcid Number: 0000-0003-3081-0875, Student of master's in dental medicine
| | - Roberto Cameriere
- - Department of Forensic Medicine, University of Sechenov, Moscow, Russia & Age Estimation Project, FOR.MED.LAB, University of Macerata, Macerata, Italy. Orcid Number 0000-0002-3775-2244
| | - Francisco Salvado
- - Faculty of Medicine, University of Lisbon, collaborator researcher at the Centre of Statistics and Applications of University of Lisbon (CEAUL), Portugal, Head of Stomatology Department (Santa Maria Hospital - Lisbon). Orchid Number 0000-0002-1095-8090
| | - Rui Santos
- - Department of Mathematics, School of Technology and Management, Polytechnic of Leiria, Portugal, integrated researcher at the Centre of Statistics and Applications, University of Lisbon (CEAUL), Portugal. Orcid Number 0000 0002 7371 363 X
| |
Collapse
|
12
|
Palmela Pereira C, Rodrigues A, Santos A, Salvado F, Santos R, Cameriere R. Cut-off for the legal ages in the Portuguese Population by Third Maturity Index: Measures of Accuracy. Arch Oral Biol 2021; 125:105089. [PMID: 33640556 DOI: 10.1016/j.archoralbio.2021.105089] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2020] [Revised: 02/13/2021] [Accepted: 02/18/2021] [Indexed: 11/24/2022]
Abstract
OBJECTIVES The aim of this study is to estimate the cut-off points for the Portuguese legal ages through the I3M, and to compare them with the methods of Demirjian, Nolla and Moorrees. DESIGN The lower third molars were analyzed on 348 orthopantomography's aged between 12 and 23 years in a Portuguese Population. The images were analyzed by ImageJ and the cut-off points were calculated for the respective legal ages of 14, 16, 18 and 21 years old. RESULTS The correlation between age and the I3M was 0.862, whereas with Demirjian's stadiums, Nolla's stages, and Moorrees' stages the correlation coefficients were 0.863, 0.842 and 0.844, respectively. For the cut-off point of 0.08 for the age of 18, a sensitivity of 78.99 %, specificity of 93.48 %, an accuracy of 88.54 %, a positive predictive value of 86.24 % and a posteriori Bayes probability of 92.82 %. The cut-off points established for the ages of 14, 16, 18 and 21 years for the Portuguese population achieved an accuracy of 83.67 %, 85.67 %, 88.54 % and 87.11 %, respectively. CONCLUSION Demirjian's method and Cameriere's method attain quite similar results. In certain ages, the methods of Nolla and Moorrees show higher sensitivity or higher specificity when compared to Cameriere's method, however this last method is more stable in terms of reliability and more suitable to use in the Portuguese population.
Collapse
Affiliation(s)
- Cristiana Palmela Pereira
- Faculty of Dental Medicine, FORENSEMED from UICOB, University of Lisbon, Portugal; Centre of Statistics and Applications of University of Lisbon (CEAUL), Forensic Analysis Group, Portugal.
| | - Ana Rodrigues
- Faculty of Dental Medicine, FORENSEMED from UICOB, University of Lisbon, Portugal; Centre of Statistics and Applications of University of Lisbon (CEAUL), Forensic Analysis Group, Portugal.
| | - Adriana Santos
- Faculty of Dental Medicine, FORENSEMED from UICOB, University of Lisbon, Portugal; Centre of Statistics and Applications of University of Lisbon (CEAUL), Forensic Analysis Group, Portugal.
| | - Francisco Salvado
- Centre of Statistics and Applications of University of Lisbon (CEAUL), Forensic Analysis Group, Portugal; Faculty of Medicine, University of Lisbon, Portugal; Stomatology Department (Santa Maria Hospital - Lisbon), Portugal.
| | - Rui Santos
- Centre of Statistics and Applications of University of Lisbon (CEAUL), Forensic Analysis Group, Portugal; Department of Mathematics, School of Technology and Management, Polytechnic of Leiria, Portugal.
| | - Roberto Cameriere
- Department of Forensic Medicine, University of Sechenov, Moscow, Russia; AgEstimation Project, FOR.MED.LAB, University of Macerata, Macerata, Italy.
| |
Collapse
|
13
|
Coutinho J, Coutinho G, Caldas C, Salvado F. Oral hybrid verrucous carcinoma: A challenging entity to clinicians. Eur J Surg Oncol 2021. [DOI: 10.1016/j.ejso.2020.11.292] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
|
14
|
Nobre MDA, Salvado F, Nogueira P, Rocha E, Ilg P, Maló P. A Prognostic Model for the Outcome of Nobel Biocare Dental Implants with Peri-Implant Disease after One Year. J Clin Med 2019; 8:jcm8091352. [PMID: 31480537 PMCID: PMC6780417 DOI: 10.3390/jcm8091352] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2019] [Revised: 08/26/2019] [Accepted: 08/29/2019] [Indexed: 01/07/2023] Open
Abstract
Background: This investigation, based on a 1-year retrospective cohort study, aimed to estimate and validate a prognostic model for ailing and failing implants due to peri-implant disease. Methods: A total of 240 patients (male: 97; female: 143; average age of 57.3 years) with at least one ailing or failing implant were included: 120 patients for model derivation and 120 patients for model validation. The primary outcome measure was the implant status: success, defined as the arrest of the disease, or failure defined as implant extraction, prevalence or re-incidence of peri-implant disease). Potential prognostic risk indicators were collected at the baseline evaluation. The relative risk (RR) was estimated for the predictors through logistic regression and the c-statistic (95% confidence interval) was calculated for both derivation and validation sets. The significance level was set at 5%. Results: The risk model retrieved the prognostic factors age (RR = 1.04), history of Periodontitis (RR = 3.13), severe peri-implant disease status (RR = 3.26), implant length (RR = 3.52), early disease development (RR = 3.99), with good discrimination in both the derivation set (0.763 [0.679; 0.847]) and validation set (0.709 [0.616; 0.803]). Conclusions: A prognostic risk model for estimating the outcome of implants with peri-implant disease is available, with a good performance considering the c-statistic evaluation.
Collapse
Affiliation(s)
- Miguel de Araújo Nobre
- University Clinic of Stomatology, Faculty of Medicine, University of Lisbon, 1649-028 Lisbon, Portugal.
- Research and Development Department, Maló Clinic, 1600-042 Lisbon, Portugal.
| | - Francisco Salvado
- University Clinic of Stomatology, Faculty of Medicine, University of Lisbon, 1649-028 Lisbon, Portugal
| | - Paulo Nogueira
- Institute of Preventive Medicine, Faculty of Medicine, University of Lisbon, 1649-028 Lisbon, Portugal
| | - Evangelista Rocha
- Institute of Preventive Medicine, Faculty of Medicine, University of Lisbon, 1649-028 Lisbon, Portugal
| | - Peter Ilg
- Oromaxillofacial Surgery, University of Campinas, São Paulo 13083-970, Brazil
| | - Paulo Maló
- Implantology Department, Maló Clinic, 1600-042 Lisbon, Portugal
| |
Collapse
|
15
|
Botelho J, Machado V, Gomes JC, Borrecho G, Maia P, Mendes JJ, Salvado F. Multiple Complex Odontomas of the Mandible: A Rare Case Report and Literature Review. Contemp Clin Dent 2019; 10:161-165. [PMID: 32015661 PMCID: PMC6974989 DOI: 10.4103/ccd.ccd_463_18] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
A 53-year-old female appeared with pain in the right mandible ramus, for the past 9 months, after tooth extraction. Clinical and radiological examination using conventional and advanced computerized tomography diagnostic imaging led to a provisional diagnosis of multiple complex odontomas. Complete conservative excision of the lesion was performed. The clinical diagnosis was confirmed histopathologically. Postoperative period was uneventful with no evidence of recurrence. According to an extensive literature review, this report describes the oldest patient ever diagnosed with multiple odontomas in the literature.
Collapse
Affiliation(s)
- João Botelho
- Department of Periodontology, Clinical Research Unit, Centro de Investigação Interdisciplinar Egas Moniz, Instituto Universitário, Almada, Portugal
| | - Vanessa Machado
- Department of Periodontology, Clinical Research Unit, Centro de Investigação Interdisciplinar Egas Moniz, Instituto Universitário, Almada, Portugal
| | - João Carvalho Gomes
- Department of Periodontology, Clinical Research Unit, Centro de Investigação Interdisciplinar Egas Moniz, Instituto Universitário, Almada, Portugal
| | - Gonçalo Borrecho
- Department of Periodontology, Clinical Research Unit, Centro de Investigação Interdisciplinar Egas Moniz, Instituto Universitário, Almada, Portugal
| | - Paulo Maia
- Department of Oral Surgery, Clinical Research Unit, Centro de Investigação Interdisciplinar Egas Moniz, Instituto Universitário, Almada, Portugal
| | - José João Mendes
- Department of Periodontology, Clinical Research Unit, Centro de Investigação Interdisciplinar Egas Moniz, Instituto Universitário, Almada, Portugal
| | - Francisco Salvado
- Department of Periodontology, Clinical Research Unit, Centro de Investigação Interdisciplinar Egas Moniz, Instituto Universitário, Almada, Portugal
- Department of Oral and Maxillofacial Surgery, Faculty of Medicine, University of Lisbon, Lisbon, Portugal
| |
Collapse
|
16
|
Martinelli-Kläy CP, Lombardi T, Mendis B, Soares EG, Salvado F, Courvoisier DS, Mauricio P. Tissue eosinophilia in oral intraepithelial neoplasia as a probable indicator of invasion. Oral Dis 2018; 24:103-108. [PMID: 29480618 DOI: 10.1111/odi.12789] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2017] [Revised: 09/22/2017] [Accepted: 09/25/2017] [Indexed: 12/27/2022]
Abstract
OBJECTIVE To investigate the presence of eosinophils in oral intraepithelial neoplasia (OIN) and oral squamous cell carcinoma (OSCC) lesions and its relation to invasion. SUBJECTS AND METHODS Ninety-nine oral biopsies were selected and subdivided into the following: OIN-1(16 cases), OIN-2 (18 cases), OIN-3 (17 cases), microinvasive OSCC (10 cases), non-metastatic OSCC (22 cases) and metastatic OSCC (16 cases). The tissue eosinophilia was evaluated histologically in slices stained with haematoxylin and eosin. RESULTS Eosinophil distribution was associated with diagnosis severity (p < .01). A significant difference was found between OIN-3 or microinvasive OSCC and non-metastatic or metastatic OSCC. Stromal invasion threshold was 7 eos/10 high power field (hpf) (96.1% specificity and 62.5% sensitivity). Eosinophils were absent in OIN-1; in OIN-2, two cases were positive. In OIN-3, five cases showed tissue eosinophilia, four of which had ≥3 eos/hpf or ≥7 eos/10 hpf. Three cases were suspected of invasion; two had a previous history of OSCC with elevated eosinophil infiltrate. In microinvasive OSCC, the four positive cases presented ≥3 eos/hpf and ≥7 eos/10 hpf. Although not significantly different, non-metastatic invasive OSCC had a higher number of cases (68.2%) with ≥22 eos/10 hpf contrasting with 50% in metastatic OSCC. CONCLUSION Our results suggest that eosinophils can be considered an indicator of invasion in OIN, helping in cases of difficult diagnosis.
Collapse
Affiliation(s)
- C P Martinelli-Kläy
- Oral Medicine and Oral and Maxillofacial Pathology Unit, Laboratory of Oral & Maxillofacial Pathology, Division of Oral Maxillofacial Surgery, Department of Surgery, University Hospitals of Geneva, University of Geneva, Geneva, Switzerland
| | - T Lombardi
- Oral Medicine and Oral and Maxillofacial Pathology Unit, Laboratory of Oral & Maxillofacial Pathology, Division of Oral Maxillofacial Surgery, Department of Surgery, University Hospitals of Geneva, University of Geneva, Geneva, Switzerland
| | - Brrn Mendis
- Oral Medicine and Oral and Maxillofacial Pathology Unit, Laboratory of Oral & Maxillofacial Pathology, Division of Oral Maxillofacial Surgery, Department of Surgery, University Hospitals of Geneva, University of Geneva, Geneva, Switzerland
| | - E G Soares
- Department of Pathology, School of Medicine of Ribeirão Preto, University of São Paulo, Ribeirão Preto, SP, Brazil
| | - F Salvado
- Center for Interdisciplinary Research Egas Moniz (CiiEM), Health Sciences Institute, Monte da Caparica, Portugal
| | - D S Courvoisier
- Department of Rheumatology, University Hospitals of Geneva, University of Geneva, Geneva, Switzerland
| | - P Mauricio
- Center for Interdisciplinary Research Egas Moniz (CiiEM), Health Sciences Institute, Monte da Caparica, Portugal
| |
Collapse
|
17
|
Martins AS, Correia JA, Salvado F, Caldas C, Santos N, Capelo A, Palmela P. Relevant factors for treatment outcome and time to healing in medication-related osteonecrosis of the jaws - A retrospective cohort study. J Craniomaxillofac Surg 2017; 45:1736-1742. [PMID: 28838836 DOI: 10.1016/j.jcms.2017.07.014] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2017] [Revised: 06/28/2017] [Accepted: 07/20/2017] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND Risk factors for medication-related osteonecrosis of the jaw (MRONJ) are well known, although few studies evaluate the factors that influence treatment outcomes in MRONJ and whether discontinuing antiresorptive medication influences healing. PURPOSE (1) Describe the characteristics of a population of patients with MRONJ. (2) Identify the factors associated with favourable outcomes. (3) Identify a temporal correlation between discontinuation of antiresorptives and healing time. METHODS A retrospective longitudinal cohort study was carried out, including 77 patients with MRONJ treated between 2004 and 2016. Primary outcome was defined as healed/improved vs. worse/stable. Time to healing was set as the secondary outcome. Statistical significance was defined as p < 0.05. RESULTS Primary disease, route of administration, lesion location, and development of complications influenced the outcome of treatment. Significant differences in outcomes according to primary disease (p < 0.05) were found when staging, gender, and lesion location were held constant. Time to healing was longer for patients who discontinued medication more than 3 months after diagnosis than for those who discontinued at diagnosis or before - respectively, 36, 9, and 7 months (p = 0.01). CONCLUSIONS The outcome of MRONJ treatment may be influenced by primary disease and route of administration of antiresorptives. Antiresorptive medication discontinuation contributes to reduce healing time in MRONJ.
Collapse
Affiliation(s)
- Ana Silva Martins
- Stomatology and Oral Surgery Department, Centro Hospitalar Lisboa Norte - Hospital de Santa Maria, Lisbon, Portugal.
| | - João André Correia
- Stomatology and Oral Surgery Department, Centro Hospitalar Lisboa Norte - Hospital de Santa Maria, Lisbon, Portugal
| | - Francisco Salvado
- Stomatology and Oral Surgery Department, Centro Hospitalar Lisboa Norte - Hospital de Santa Maria, Lisbon, Portugal
| | - Cecília Caldas
- Stomatology and Oral Surgery Department, Centro Hospitalar Lisboa Norte - Hospital de Santa Maria, Lisbon, Portugal
| | - Nuno Santos
- Stomatology and Oral Surgery Department, Centro Hospitalar Lisboa Norte - Hospital de Santa Maria, Lisbon, Portugal
| | - António Capelo
- Stomatology and Oral Surgery Department, Centro Hospitalar Lisboa Norte - Hospital de Santa Maria, Lisbon, Portugal
| | - Paulo Palmela
- Stomatology and Oral Surgery Department, Centro Hospitalar Lisboa Norte - Hospital de Santa Maria, Lisbon, Portugal
| |
Collapse
|
18
|
Ângelo DF, Monje FG, González-García R, Little CB, Mónico L, Pinho M, Santos FA, Carrapiço B, Gonçalves SC, Morouço P, Alves N, Moura C, Wang Y, Jeffries E, Gao J, Sousa R, Neto LL, Caldeira D, Salvado F. Bioengineered Temporomandibular Joint Disk Implants: Study Protocol for a Two-Phase Exploratory Randomized Preclinical Pilot Trial in 18 Black Merino Sheep (TEMPOJIMS). JMIR Res Protoc 2017; 6:e37. [PMID: 28254733 PMCID: PMC5355627 DOI: 10.2196/resprot.6779] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2016] [Accepted: 12/16/2016] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Preclinical trials are essential to test efficacious options to substitute the temporomandibular joint (TMJ) disk. The contemporary absence of an ideal treatment for patients with severe TMJ disorders can be related to difficulties concerning the appropriate study design to conduct preclinical trials in the TMJ field. These difficulties can be associated with the use of heterogeneous animal models, the use of the contralateral TMJ as control, the absence of rigorous randomized controlled preclinical trials with blinded outcomes assessors, and difficulties involving multidisciplinary teams. OBJECTIVE This study aims to develop a new, reproducible, and effective study design for preclinical research in the TMJ domain, obtaining rigorous data related to (1) identify the impact of bilateral discectomy in black Merino sheep, (2) identify the impact of bilateral discopexy in black Merino sheep, and (3) identify the impact of three different bioengineering TMJ discs in black Merino sheep. METHODS A two-phase exploratory randomized controlled preclinical trial with blinded outcomes is proposed. In the first phase, nine sheep are randomized into three different surgical bilateral procedures: bilateral discectomy, bilateral discopexy, and sham surgery. In the second phase, nine sheep are randomized to bilaterally test three different TMJ bioengineering disk implants. The primary outcome is the histological gradation of TMJ. Secondary outcomes are imaging changes, absolute masticatory time, ruminant time per cycle, ruminant kinetics, ruminant area, and sheep weight. RESULTS Previous preclinical studies in this field have used the contralateral unoperated side as a control, different animal models ranging from mice to a canine model, with nonrandomized, nonblinded and uncontrolled study designs and limited outcomes measures. The main goal of this exploratory preclinical protocol is to set a new standard for future preclinical trials in oromaxillofacial surgery, particularly in the TMJ field, by proposing a rigorous design in black Merino sheep. The authors also intend to test the feasibility of pilot outcomes. The authors expect to increase the quality of further studies in this field and to progress in future treatment options for patients undergoing surgery for TMJ disk replacement. CONCLUSIONS The study has commenced, but it is too early to provide results or conclusions.
Collapse
Affiliation(s)
- David Faustino Ângelo
- Centro Hospitalar de Setúbal, EPE, Stomatology Department, Setúbal, Portugal
- Instituto Politécnico de Leiria, Centre for Rapid and Sustainable Product Development (CDRSP), Leiria, Portugal
- Faculdade de Medicina, Universidade de Lisboa, Lisboa, Portugal
| | - Florencio Gil Monje
- University Hospital Infanta Cristina, Badajoz, Spain, Department of Oral and Maxillofacial Surgery, Badajoz, Spain
| | - Raúl González-García
- University Hospital Infanta Cristina, Badajoz, Spain, Department of Oral and Maxillofacial Surgery, Badajoz, Spain
| | - Christopher B Little
- Kolling Institute, Institute of Bone and Joint Research, University of Sydney, Sydney, Australia
| | | | - Mário Pinho
- Faculdade de Medicina Veterinaria, Interdisciplinary Centre of Research in Animal Health (CIISA), Lisbon University, Lisboa, Portugal
| | - Fábio Abade Santos
- Faculdade de Medicina Veterinaria, Interdisciplinary Centre of Research in Animal Health (CIISA), Lisbon University, Lisboa, Portugal
| | - Belmira Carrapiço
- Faculdade de Medicina Veterinaria, Lisbon University, Lisboa, Portugal
| | | | - Pedro Morouço
- Instituto Politécnico de Leiria, Centre for Rapid and Sustainable Product Development (CDRSP), Leiria, Portugal
| | - Nuno Alves
- Instituto Politécnico de Leiria, Centre for Rapid and Sustainable Product Development (CDRSP), Leiria, Portugal
| | - Carla Moura
- Instituto Politécnico de Leiria, Centre for Rapid and Sustainable Product Development (CDRSP), Leiria, Portugal
| | - Yadong Wang
- University of Pittsburgh, Chemical Engineering and Surgery Pittsburgh, University of Pittsburgh, Pittsburgh, PA, United States
| | - Eric Jeffries
- University of Pittsburgh, Chemical Engineering and Surgery Pittsburgh, University of Pittsburgh, Pittsburgh, PA, United States
| | - Jin Gao
- University of Pittsburgh, Chemical Engineering and Surgery Pittsburgh, University of Pittsburgh, Pittsburgh, PA, United States
| | - Rita Sousa
- Faculdade de Medicina, Universidade de Lisboa, Lisboa, Portugal
| | - Lia Lucas Neto
- Faculdade de Medicina, Universidade de Lisboa, Lisboa, Portugal
| | - Daniel Caldeira
- Faculdade de Medicina, Universidade de Lisboa, Lisboa, Portugal
| | | |
Collapse
|
19
|
de Araújo Nobre M, Maló P, Gonçalves Y, Sabas A, Salvado F. Dental implants in diabetic patients: retrospective cohort study reporting on implant survival and risk indicators for excessive marginal bone loss at 5 years. J Oral Rehabil 2016; 43:863-870. [DOI: 10.1111/joor.12435] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/05/2016] [Indexed: 12/01/2022]
Affiliation(s)
- M. de Araújo Nobre
- Faculty of Medicine; University of Lisbon; Lisbon Portugal
- Malo Clinic; Lisbon Portugal
| | - P. Maló
- Malo Clinic; Lisbon Portugal
| | | | | | - F. Salvado
- Faculty of Medicine; University of Lisbon; Lisbon Portugal
| |
Collapse
|
20
|
Carvalho C, Manso AC, Escoval A, Salvado F, Nunes C. Self-perception of oral health in older adults from an urban population in Lisbon, Portugal. Rev Saude Publica 2016; 50:53. [PMID: 27556967 PMCID: PMC4988800 DOI: 10.1590/s1518-8787.2016050006311] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2015] [Accepted: 07/15/2015] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVE To analyze if the self-perception of oral health in the urban context is associated with sociodemographic factors that interfere in the life quality of oral health. METHODS Cross-sectional study with convenience sample of older individuals (65 years old or more) enrolled in the Agrupamento de Centros de Saúde de Lisboa Norte (ACES Lisboa Norte – Health Centers Groupings North Lisbon). The self-perception of oral health and associated life quality was evaluated by the Geriatric Oral Health Assessment Index and the individuals were classified according to sociodemographic characteristics. The internal consistency of the questionnaire was evaluated by Cronbach’s alpha (α). Later, we used binary logistic regression models to characterize the factors associated with the self-perception of oral health, considering the sociodemographic variables and the older adults’ clinical conditions of oral health and establishing the crude and adjusted (to age) odds ratios and their 90% confidence intervals. RESULTS A total of 369 older adults participated in this study, with an average age of 74.2 years (SD = 6.75); 62.9% were female. On average, the index was moderated, with tendency to be high: 32.9 (SD = 3.6; 12-36 interval). The Cronbach’s alpha was high: 0.805. Age, marital status, and the last dental appointment were the factors significantly associated with self-perception of oral health. CONCLUSIONS The study shows that these individuals have a moderate, with tendency to high, self-perception of oral health. The self-perception of oral health assessment allowed us to identify the main associated sociodemographic factors. This instrument can help guiding planning strategies and oral health promotion directed toward a better life quality for this population group.
Collapse
Affiliation(s)
- Catarina Carvalho
- Escola Nacional de Saúde Pública. Universidade Nova de Lisboa. Lisboa, Portugal
| | - Ana Cristina Manso
- Instituto Superior de Ciências da Saúde Egas Moniz. Centro de Investigação Interdisciplinar Egas Moniz. Caparica, Portugal
| | - Ana Escoval
- Escola Nacional de Saúde Pública. Universidade Nova de Lisboa. Lisboa, Portugal
| | - Francisco Salvado
- Instituto Superior de Ciências da Saúde Egas Moniz. Centro de Investigação Interdisciplinar Egas Moniz. Caparica, Portugal
| | - Carla Nunes
- Escola Nacional de Saúde Pública. Universidade Nova de Lisboa. Lisboa, Portugal
| |
Collapse
|
21
|
Angelo DF, Morouço P, Alves N, Viana T, Santos F, González R, Monje F, Macias D, Carrapiço B, Sousa R, Cavaco-Gonçalves S, Salvado F, Peleteiro C, Pinho M. Choosing sheep (Ovis aries) as animal model for temporomandibular joint research: Morphological, histological and biomechanical characterization of the joint disc. Morphologie 2016; 100:223-233. [PMID: 27450042 DOI: 10.1016/j.morpho.2016.06.002] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2015] [Revised: 04/07/2016] [Accepted: 06/15/2016] [Indexed: 12/24/2022]
Abstract
Preclinical trials are essential to the development of scientific technologies. Remarkable molecular and cellular research has been done using small animal models. However, significant differences exist regarding the articular behavior between these models and humans. Thus, large animal models may be more appropriate to perform trials involving the temporomandibular joint (TMJ). The aim of this work was to make a morphological (anatomic dissection and white light 3D scanning system), histological (TMJ in bloc was removed for histologic analysis) and biomechanical characterization (tension and compression tests) of sheep TMJ comparing the obtained results with human data. Results showed that sheep processus condylaris and fossa mandibularis are anatomically similar to the same human structures. TMJ disc has an elliptical perimeter, thinner in the center than in periphery. Peripheral area acts as a ring structure supporting the central zone. The disc cells display both fibroblast and chondrocyte-like morphology. Marginal area is formed by loose connective tissue, with some chondrocyte-like cells and collagen fibers in diverse orientations. Discs obtained a tensile modulus of 3.97±0.73MPa and 9.39±1.67MPa, for anteroposterior and mediolateral assessment. The TMJ discs presented a compressive modulus (E) of 446.41±5.16MPa and their maximum stress value (σmax) was 18.87±1.33MPa. Obtained results suggest that these animals should be considered as a prime model for TMJ research and procedural training. Further investigations in the field of oromaxillofacial surgery involving TMJ should consider sheep as a good animal model due to its resemblance of the same joint in humans.
Collapse
Affiliation(s)
- D F Angelo
- Hospital de Santa Maria, Faculty of Medicine, Lisbon, Portugal.
| | - P Morouço
- Centre for Rapid and Sustainable Product Development, Polytechnic Institute of Leiria, Leiria, Portugal
| | - N Alves
- Centre for Rapid and Sustainable Product Development, Polytechnic Institute of Leiria, Leiria, Portugal
| | - T Viana
- Centre for Rapid and Sustainable Product Development, Polytechnic Institute of Leiria, Leiria, Portugal
| | - F Santos
- CIISA, Interdisciplinary Centre of Research in Animal Health, Faculty of Veterinary Medicine, Lisbon, Portugal
| | - R González
- Infanta Cristina Hospital, Faculty of Medicina, University of Extremadura, Badajoz, Spain
| | - F Monje
- Infanta Cristina Hospital, Faculty of Medicina, University of Extremadura, Badajoz, Spain
| | - D Macias
- Department of Anatomy, Faculty of Medicina, University of Extremadura, Badajoz, Spain
| | - B Carrapiço
- CIISA, Interdisciplinary Centre of Research in Animal Health, Faculty of Veterinary Medicine, Lisbon, Portugal
| | - R Sousa
- Hospital de Santa Maria, Faculty of Medicina, Lisbon, Portugal
| | - S Cavaco-Gonçalves
- National Institute of Agrarian and Veterinary Research, Santarém, Portugal
| | - F Salvado
- Hospital de Santa Maria, Faculty of Medicina, Lisbon, Portugal
| | - C Peleteiro
- CIISA, Interdisciplinary Centre of Research in Animal Health, Faculty of Veterinary Medicine, Lisbon, Portugal
| | - M Pinho
- Interdisciplinary Centre of Research in Animal Health, Faculty of Veterinary Medicine, Lisbon, Portugal
| |
Collapse
|
22
|
de Araújo Nobre M, Mano Azul A, Rocha E, Maló P, Salvado F. Attributable fractions, modifiable risk factors and risk stratification using a risk score for peri-implant pathology. J Prosthodont Res 2016; 61:43-53. [PMID: 27032718 DOI: 10.1016/j.jpor.2016.03.004] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2015] [Revised: 03/10/2016] [Accepted: 03/16/2016] [Indexed: 10/22/2022]
Abstract
PURPOSE This study aimed to estimate the impact of risk factors for peri-implant pathology, to identify potentially modifiable factors, and to evaluate the accuracy of the risk algorithm, risk scores and risk stratification. METHODS This retrospective case-control study with 1275 patients (255 cases; 1020 controls) retrieved a model according to the predictors: history of Periodontitis, bacterial plaque, bleeding, bone level, lack of passive fit or non-optimal screw joint, metal-ceramic restoration, proximity to other implants/teeth, and smoking habits. Outcome measures were the attributable fraction; the positive and negative likelihood ratios at different disease cut-off points illustrated by the area under the curve statistic. RESULTS Six predictors may be modified or controlled directly by either the patient or the clinician, accounting for a reduction in up to 95% of the peri-implant pathology cases. The positive and negative likelihood ratios were 9.69 and 0.13, respectively; the area under the curve was 0.96; a risk score was developed, making the complex statistical model useful to clinicians. CONCLUSIONS Based on the results, six predictors for the incidence of peri-implant pathology can be modified to significantly improve the outcome. It was possible to stratify patients per risk category according to the risk score, providing a tool for clinicians to support their decision-making process.
Collapse
|
23
|
Nobre MDA, Maló P, Gonçalves Y, Sabas A, Salvado F. Outcome of dental implants in diabetic patients with and without cardiovascular disease: A 5-year post-loading retrospective study. Eur J Oral Implantol 2016; 9:87-95. [PMID: 27022640] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
PURPOSE To investigate the outcome of immediate function of dental implant rehabilitations in diabetic patients with and without coexisting cardiovascular diseases (CVD). MATERIALS AND METHODS This retrospective study included 70 diabetic patients (33 females and 37 males, average age: 59 years old), rehabilitated with 352 implants and divided into two groups (CVD: 38 patients; non-CVD: 32 patients). Diabetes mellitus was defined as fasting plasma glucose ≥ 7.0 mmol/l (126 mg/dl) or 2 h plasma glucose ≥ 11.1mmol/l (200 mg/dl). The data was retrieved from patient records. Primary outcome measures were prosthesis and implant survival; secondary outcome measures were marginal bone loss and complications (biological or mechanical). The follow-up was 5 years after loading for all patients. RESULTS Seven patients (10%) were lost to follow-up (one patient in the CVD group; and six patients in the non-CVD group). One prosthesis failed in the non-CVD group, rendering a 97.4% survival rate, compared to 100% in the CVD group (non-significant difference between groups; P = 0.359). Ten implants failed in 7 patients: CVD group with eight implant failures in 5 patients (86.7% cumulative survival rate) versus two implants in 2 patients in the non-CVD group (93.8% cumulative survival rate) with a non-significant difference between both groups (P = 0.365). The average (95% confidence interval) marginal bone loss at 1- and 5-years was 0.95 mm (0.66 mm; 1.23 mm) and 1.52 mm (1.20 mm; 1.88 mm), respectively in the CVD group; and 0.78 mm (0.40 mm; 1.16 mm) and 1.54 mm (0.86 mm; 2.31 mm), respectively for the non-CVD group; with no significant differences between groups at 1 year (P = 0.979) and 5 years (P = 0.300). Complications occurred in 38 patients (CVD group: 21 patients; non-CVD group: 16 patients); with a non-significant difference between both groups (P = 0.660). CONCLUSIONS Implant rehabilitations represent a valid treatment for diabetic patients with or without coexisting CVD, with a good risk/benefit ratio.
Collapse
|
24
|
Abstract
Temporomandibular joint (TMJ) lysis and lavage arthrocentesis with viscosupplementation are an effective treatment for acute disc displacement (DD) without reduction. Clinical success seems to be related to multiple factors despite the lack of understanding of its mechanisms. The authors present a case report of 17-year-old women with acute open mouth limitation (12 mm), right TMJ pain-8/10 visual analog scale, right deviation when opening her mouth. The clinical and magnetic resonance imaging (MRI) diagnosis was acute DD without reduction of right TMJ. Right TMJ arthrocentesis was purposed to the patient with lysis, lavage, and viscosupplementation of the upper joint space. After 5 days, a new MRI was performed to confirm upper joint space distension and disc position. Clinical improvement was obtained 5 days and 1 month after arthrocentesis. Upper joint space increased 6 mm and the disc remained displaced. We report the first early TMJ MRI image postoperative, with measurable upper joint space.
Collapse
Affiliation(s)
- David Faustino Ângelo
- Department of Stomatology, Santa Maria University Hospital - North Lisbon Hospital, Lisbon, Portugal
| | - Rita Sousa
- Department of Neuroradiology, Santa Maria University Hospital - North Lisbon Hospital, Lisbon, Portugal
| | - Isabel Pinto
- Department of Maxilofacial, Coimbra Hospital and University Centre, Coimbra, Portugal
| | - David Sanz
- Department of Maxilofacial, Coimbra Hospital and University Centre, Coimbra, Portugal
| | - F Monje Gil
- Department of Oromaxilofacial, Hospital Infanta Cristina, Badajoz, Spain
| | - Francisco Salvado
- Department of Stomatology, Santa Maria University Hospital - North Lisbon Hospital, Lisbon, Portugal
| |
Collapse
|
25
|
Santos A, Galrito M, Barona TM, Fonseca I, Papoila AL, Salvado F, Macor C. Oral Cancer’s Early Diagnosis: The Contribution of Contact Endoscopy. Otolaryngol Head Neck Surg 2014. [DOI: 10.1177/0194599814541627a101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Objectives: Oral cancer has high incidence and prevalence rates. Despite the fact that the oral cavity might be easily observed, the diagnosis of oral cancer is usually done later than expected. Early diagnosis is the main oral cancer challenge to decrease morbidity and mortality. Contact endoscopy allows the assessment in vivo and in situ of epithelial cells, glandular ostia, and microvascular network (60X, 150X). The authors describe the contribution of contact endoscopy in performing real time histological diagnosis and guide biopsies in an office setting. Methods: The authors carried out a prospective double blind study (July 2012 - February 2014) where diagnosis was made by contact endoscopy and histology (gold-standard) in a population of 122 patients with oral lesions persisting without involution for 3 weeks, considering a clinical classification: benign (n = 26), premalignant (n = 83), and malignant (n = 13). Sensitivity, specificity, negative and positive predictive values, and likelihood ratios were calculated. Results: Sensitivity and specificity were superior to 95%. By the identification of the cellular and vascular heterogeneous patterns characteristic of a malignant lesion, contact endoscopy allowed the definition of real cellular margins and the detection of suspicious areas without macroscopic disease. Conclusions: In our study, contact endoscopy allowed in an office setting a precise diagnosis with similar effectiveness of histology. This noninvasive technique was revealed to be an important guide for biopsies, an easy way to define real safety surgical margins, and a good way to improve follow-up efficiency. The authors concluded that contact endoscopy has good potential to improve oral cancer’s early diagnosis.
Collapse
|
26
|
Gaspar J, Borrecho G, Oliveira P, Salvado F, Martins dos Santos J. Osteotomy at low-speed drilling without irrigation versus high-speed drilling with irrigation: an experimental study. ACTA MEDICA PORT 2013; 26:231-236. [PMID: 23815837] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2012] [Accepted: 03/03/2013] [Indexed: 06/02/2023]
Abstract
INTRODUCTION Excessively traumatic surgery can adversely affect the maturation of bone tissue and consequently diminish the predictability of osseointegration so the mechanical and thermal damage should be minimized during surgical procedure. The purpose of this study is to evaluate immediate histological alterations in rabbit tibias, produced by low speed drilling (50 rpm) without irrigation and conventional drilling (800 rpm) under profuse irrigation. MATERIAL AND METHODS Thirty-six implant osteotomies were created in the tibias of 6 White female rabbits. Drilling began with a 1.5 mm round bur, followed by 2.0 mm, 2.5 mm and 3.5 mm helical drills. The posterior tibial cortex was evaluated as the positive control, and it was preserved during the surgical procedure. The receptor beds were collected for histological analysis. RESULTS All defects showed regular edges. Hematoxylin eosin (HE) sections showed that both techniques preserved the bone structure and the presence of living cells. No histological differences between the two surgical drilling techniques were found. CONCLUSIONS Based on our results, we can conclude that the effects of implant site preparation on bone by low speed drilling (50 rpm) without irrigation and conventional drilling (800 rpm) under abundant irrigation are similar. Both surgical drilling techniques preserve bone-cell viability and the clinician can decide which drilling technique to use, based on other criteria.
Collapse
Affiliation(s)
- João Gaspar
- Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Instituto Superior de Ciências da Saúde Egas Moniz, Monte de Caparica, Portugal
| | | | | | | | | |
Collapse
|
27
|
Salvado F, Furtado I. [A case of erythema multiforme with only oro-genital manifestations]. Rev Port Estomatol Cir Maxilofac 1988; 29:19-24. [PMID: 3267943] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
|