Browsing by Author "Lopes, Pedro"
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- Deep carious lesions management with stepwise, selective, or non-selective removal in permanent dentition: a systematic review of randomized clinical trialsPublication . Figundio, Nicola; Lopes, Pedro; Tedesco, Tamara Kerber; Fernandes, Juliana Campos Hasse; Fernandes, Gustavo Vicentis Oliveira; Mello-Moura, Anna Carolina VolpiObjective: The goal of this systematic study was to investigate the effectiveness of selective, stepwise, and non-selective removal techniques for caries removal in permanent teeth with deep carious lesions. The primary focus was the results found comparing techniques for caries removal to check whether there was pulp exposition; the secondary was the materials used for pulp protection and clinical findings reported within the included studies. Methods: The search was performed in two databases (PubMed/MEDLINE and Web Of Science). The studies included in this systematic review were selected based on eligibility criteria. The inclusion criteria were: (1) randomized controlled trials (RCTs), (2) that compared the total removal of carious tissue with selective removal in permanent teeth with deep carious lesions, (3) with a follow-up period of at least 6 months, and (4) publications in English. Regarding the exclusion criteria, the following were not considered: (1) articles published in other languages, (2) articles that did not compare the different types of total/selective decay removal, and (3) articles published before January 2008. The risk of bias and the quality of the included studies were independently assessed by two reviewers using the RoB 2 tool. Results: 5 out of 105 potentially eligible studies were included. Regarding the teeth included in the study, three articles performed management only on permanent molars, while other studies also performed management on incisors/canines/premolars/molars. Management protocols were divided into nonselective caries removal and partial caries removal (selective/stepwise). The theory of non-selective caries removal was considered an excessive, unnecessarily invasive option and a form of outdated management, and selective removal was preferred. Conclusion: The selective removal technique presented a higher success rate and fewer incidences of pulpal exposure than total removal, after up to 18 months of follow up. Moreover, only one session seemed to be a better management choice compared to two sessions because the cavity re-opening procedure is more prone to pulp exposure and highly depends on patient commitment. Otherwise, at 5 years of follow up, there was no difference between selective removal and total removal in management longevity. In addition, there were also no differences between the success of the materials used for definitive restorations in teeth subjected to any of the techniques evaluated.
- Dentisteria minimamente invasiva: encerramento de diastemas no sector anterior - um caso clínicoPublication . Pedro, Kaone; Martins, Ruben; Fidalgo-Pereira, Rita; Lopes, Pedro; Mello-Moura, A.; Pereira, Maria; Rio, Rute
- Evaluating glass ionomer cement longevity in the primary and permanent teeth - an umbrella reviewPublication . Panetta, Alessandro; Lopes, Pedro; Novaes, Tatiane Fernandes; Rio, Rute; Fernandes, Gustavo Vicentis Oliveira; Mello-Moura, Anna Carolina VolpiThe aim of this umbrella review was to evaluate the longevity of glass ionomer cement (GIC) as a restorative material for primary and permanent teeth. Research in the literature was conducted in three databases (MedLine/PubMed, Web of Science, and Scopus). The inclusion criteria were: (1) to be a systematic review of clinical trials that (2) evaluated the clinical longevity of GICs as a restorative material in primary and/or permanent teeth; the exclusion criteria were: (1) not being a systematic review of clinical trials; (2) not evaluating longevity/clinical performance of GICs as a restorative material; and (3) studies of dental restorative materials in teeth with enamel alterations, root caries, and non-carious cervical lesions. Twenty-four eligible articles were identified, and 13 were included. The follow-up periods ranged from 6 months to 6 years. Different types of GICs were evaluated in the included studies: resin-modified glass ionomer cement (RMGIC), compomers, and low- and high-viscosity glass ionomer cement. Some studies compared amalgam and composite resins to GICs regarding longevity/clinical performance. Analyzing the AMSTAR-2 results, none of the articles had positive criteria in all the evaluated requisites, and none of the articles had an a priori design. The criteria considered for the analysis of the risk of bias of the included studies were evaluated through the ROBIS tool, and the results of this analysis showed that seven studies had a low risk of bias; three studies had positive results in all criteria except for one criterion of unclear risk; and two studies showed a high risk of bias. GRADE tool was used to determine the quality of evidence; for the degree of recommendations, all studies were classified as Class II, meaning there was still conflicting evidence on the clinical performance/longevity of GICs and their recommendations compared to other materials. The level of evidence was classified as Level B, meaning that the data were obtained from less robust meta-analyses and single randomized clinical trials. To the best of our knowledge, this is the first umbrella review approaching GIC in permanent teeth. GICs are a good choice in both dentitions, but primary dentition presents more evidence, especially regarding the atraumatic restorative treatment (ART) technique. Within the limitation of this study, it is still questionable if GIC is a good restorative material in the medium/long term for permanent and primary dentition. Many of the included studies presented a high risk of bias and low quality. The techniques, type of GIC, type of cavity, and operator experience highly influence clinical performance. Thus, clinical decision-making should be based on the dental practitioner’s ability, each case analysis, and the patient’s wishes. More evidence is needed to determine which is the best material for definitive restorations in permanent and primary dentition.
- FMD-Caries Risk Assessment Index - a new caries risk assessment index including salivary and microbiological factorsPublication . Lopes, Pedro; Fonseca, André; Ribeiro, Vanessa; Mendes, Ana; Gomes, Ana; Pinto, Marla; Rio, Rute; Correia, Maria
- A importância da idade e do género no mimetismo dentárioPublication . Cunha, Joana; Lopes, Pedro; Rio, RuteIntrodução: Os médicos dentistas têm hoje, o poder de alterar rostos tornando-os mais ou menos aprazíveis através da modificação do sorriso. Apenas uma abordagem sistemática à análise dento-labial com a avaliação de parâmetros específicos garante uma avaliação exaustiva e um plano de tratamento que vise uma reabilitação correta. Objetivos: Análise de parâmetros estéticos do sorriso a fim de entender a sua prevalência face à idade e ao género. Materiais e Métodos: Fotografias extra e intra-orais de 114 indivíduos, divididos de acordo com a idade e género. Análise das variáveis: desvio da linha média, curvatura do lábio superior, linha do sorriso, arco do sorriso, largura do sorriso e forma dos incisivos centrais superiores. Resultados: A curvatura do lábio superior, linha do sorriso, arco do sorriso, largura do sorriso e forma dos incisivos centrais superiores encontram-se significativamente relacionadas com a idade. A curvatura do lábio superior, arco do sorriso e forma dos incisivos centrais superiores encontram-se significativamente relacionadas com o género. Discussão: A idade e o género mostram-se fulcrais aquando do planeamento de casos em que a estética é pretendida. Conclusões: O conhecimento das alterações dentofacais provocadas pelo envelhecimento bem como das diferenças entre géneros são imprescindíveis para obter resultados estéticos, duradouros e funcionais. Implicações clínicas: Uma avaliação cuidadosa dos referidos parâmetros permite ao clínico criar restaurações harmoniosamente enquadradas quer no sorriso, quer na face. Assim, seria vantajoso o desenvolvimento de guidelines com os padrões prevalentes nas diferentes faixas etárias e géneros.
- La alfabetización de la memoria: la ficción como espacio para recordar y olvidar diferentes comunidades étnicas, sociales y económicasPublication . Lopes, Pedro¿Cómo es que las series de ficción audiovisual contemporáneas pueden interpelar los mitos constitutivos sobre la nación, en particular en relación a sus comunidades étnicas y raciales discriminadas? ¿De qué manera estas producciones tensan la Historia, la(s) memoria(s) y la relación con y entre las comunidades? El creador de las se ries de ficción “Codex632” (Globoplay, 2023) y “Glória” (Netflix, 2021) explora los desafíos que representan para la producción audiovisual proponer nuevas formas no sólo de contar historias, sino de que éstas sean más complejas, apelen a diversos actores y “viajen” para encontrar nuevas audiencias. Este ensayo transita por el mito fundacional de Portugal como bom colonizador, la expansión/contracción de la diversidad sexogenérica en el audiovisual en una economía global de circulación de estas obras y las tentaciones de algunos actores por reescribir el pasado. Todo ello sobre la base de que la ficción audiovisual puede ser un agente de la Historia.
- Mechanisms of degradation of collagen or gelatin materials (hemostatic sponges) in oral surgery: a systematic reviewPublication . Catarino, Maria; Castro, Filipe; Macedo, José Paulo; Lopes, Otília; Pereira, Jorge; Lopes, Pedro; Fernandes, Gustavo Vicentis OliveiraObjective: The goal of this systematic review was to identify the mechanisms associated with the enzymatic degradation of collagen and gelatin biomaterials and the possible associated flaws. Methods: Four databases (PubMed, B-On, Cochrane Library, and ResearchGate) were used for the bibliographic search of articles. The research question was formulated using the PCC method, (P): collagen or gelatin sponges, hydrogels, and scaffolds; concept (C): enzymatic degradation of collagen or gelatin sponges, hydrogels, and scaffolds; and context (C): effect of enzymatic action on degradation time of collagen or gelatin sponges, hydrogels, and scaffolds. The search was contextualized according to PRISMA recommendations. The identification and exclusion of evidence followed the PRISMA criteria, with specific inclusion and exclusion factors being stipulated for the selection of articles. The risk of bias assessment was performed using the QUIN Scale. Results: The initial search was composed of 13,830 articles after removing duplicates; 56 articles followed for the full-text reading; 45 were excluded; then, 11 articles were obtained, constituting the results of this systematic review. All studies evaluated the materials using gravimetric analysis, and collagenases were the proteases used for the degradation solution. The materials tested were as follows: humanlike collagen (HLC) hydrogel with microbial transglutaminase (MTGase), gelatin sponges subjected to different types of crosslinking, and collagen scaffolds with different types of crosslinking. The period of analysis varied between 0.25 h and 35 days. It was possible to highlight the lack of uniformity in the protocols used, which varied largely, thus influencing the degradation times. The risk of bias was low in nine studies and medium in two studies. Conclusions: This systematic review identified a gap in the literature, highlighting the absence of in vitro studies using human saliva and a collagenase concentration close to the physiological levels to simulate oral dynamics. However, based on existing literature, the mechanisms associated with collagen enzymatic degradation in collagen and gelatin biomaterials were comprehensively understood, answering the first research question postulated. In response to the second research question, the main shortcomings identified in the laboratory evaluation of mechanisms associated with collagen enzymatic degradation in collagen and gelatin biomaterials included the lack of standardization in degradation test protocols; this limited inter-study comparisons, which increased heterogeneity. Additionally, variations in collagenase concentrations and types influenced collagen degradation rates, and inappropriate evaluation intervals hindered the identification of total degradation time.
- Methods of primary clinical prevention of dental caries in the adult patient: an integrative reviewPublication . Veiga, Nélio; Figueiredo, Ricardo; Correia, Patrícia; Lopes, Pedro; Couto, Patrícia; Fernandes, Gustavo VicentisAim: Preventive approaches to oral health diseases, mainly dental caries, require individual and collective policies. Thus, this review was conducted to identify the primary prevention methods of dental caries in adults to improve oral health at the clinical and community levels. Methods: This review followed the PICO strategy with the research question: “What are the methods of primary prevention of dental caries, in adults, for improving and maintaining oral health integrating clinical and community-based strategies?” Electronic screening was carried out by two independent reviewers in five databases (MedLine/PubMed, SciELO, Web of Science, Cochrane Library, and LILACS) to find relevant publications between 2015–2022. We applied eligibility criteria for selection of the articles. The following MeSH terms were used: “Primary Prevention”; “Adult”; “Oral Health”; “Dental Caries”; “Fluorides, Topical”; “Fluoride Varnishes”; “Pit and Fissure Sealants”; “Preventive Dentistry”. Although the term “Prevention strategy” is not a MeSH descriptor, several correlated terms appeared and were used in the search engines: “Preventative Care”, “Disease Prevention, Primary”, and “Prevention, Primary”. The tool provided by the JBI organization (Joanna Briggs Institute) was used to assess the quality of the included studies. Results: Nine studies were included. Overall, it was found that the main primary prevention methods applied in dentistry in adults are the application of pit and fissure sealants, topical application of fluoride performed in the dental clinic, use of fluoridated toothpaste, mouthwash with chlorhexidine at home, use of xylitol, the recommendation for regular appointments with the dentist, and the need to inform patients about the saliva buffer capacity and adoption of a non-cariogenic diet. For that purpose, preventive policies should be taken to prevent dental caries. These include three major challenges: providing the adult population with more knowledge regarding their oral health, empowering patients through adopting healthy lifestyles, and developing new preventive strategies and awareness campaigns aimed at the adult population to promote proper oral health habits. Conclusions: A small number of studies were found whose participants were adult patients. There was some consistency regarding primary prevention methods in our studies. However, good quality randomized control studies are still required to define the best intervention strategies for adult caries prevention.
- Oral health literacy and determinants among an elderly community in PortugalPublication . Costa, Helder; Lopes, Pedro; Correia, Maria José; Couto, Patrícia; Silva, Ana Margarida; López-Marcos, Joaquin Francisco; Veiga, NélioHigh average life expectancy has caused an increase in the elderly population and with it arises the need to characterize this population regarding their health and, in particular, their oral health. The purpose of this study was to assess and characterize oral health, oral rehabilitation, oral health literacy, oral health perception and quality of life in a sample of elderly participants of a physical activity program in Portugal. An observational cross-sectional study was designed with a group of 206 individuals. All the individuals were clinically assessed, DMFT, PSR and the plaque index were registered, and a questionnaire was applied in the form of a “face-to-face” interview with questions related to the quality of life related to oral health (GOHAI index and the REALD-30 scale). Of the 206 study participants, 90.3% admit brushing their teeth daily, 6.3% practice daily flossing, and 5.8% had a dental appointment in the last 12 months. Applying the REALD-30 scale, 22.7% have a low level (score 0–14), 43.7% a moderate level (score 15–22) and 33.6% a high level (score 23–29) of oral health literacy. The GOHAI scale reveals that 37.4% have a high self-perception of their oral health. A considerable proportion of the sample studied present a moderate level of oral health literacy. Therefore, educating each person about their oral health when participating in a specific health program and developing proposals for oral health promotion activities should be widely considered as a strategy towards primary prevention. Future oral health literacy sessions should be held in order to improve oral health and quality of life among the community.
- Portugal: diretiva europeia "Serviços de comunicação audiovisual a pedido": o princípio do fim da monocultura da telenovela (?)Publication . Burnay, Catarina Duff; Lopes, Pedro; Sousa, Marta Neves de; Félix, João; Carvalho, Ana Lúcia