Browsing by Author "Lopes, Pedro C."
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- Application of digital technologies in health literacy in situations of social isolation: a systematic reviewPublication . Veiga, Nélio; Lopes, Pedro C.; Pires, Benedito; Couto, Patrícia; Correia, Patrícia; Fernandes, Juliana Campos Hasse; Fernandes, Gustavo Vicentis OliveiraObjective: Health literacy relates to the ability of individuals to acquire, understand, and, consequently, act in accordance with information provided to them to make appropriate decisions regarding their health status. About half of the European population has a low level of health literacy. Additionally, given the worsening state of isolation experienced by the COVID-19 pandemic, the aim of this systematic review was to analyze the impact of digital technologies on health literacy in situations of social isolation. Methods: A systematic review was performed following the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) guidelines. The search strategies were based on the PICO question: “In contexts of social isolation (P), What is the impact (C) of digital technologies (I) on improving health literacy (O)?” An extensive electronic search was performed in three databases (PubMed/MedLine, Cochrane, and Web of Science (WoS)). Articles published in English, Portuguese, and Spanish languages from 2011 until 2021 were included; which approached social isolation, institutionalized or with pathologies that cause the need for dependence and care from others, studies that evaluate the impact of new technologies on improving health literacy, studies that compare aspects related to health literacy application strategies using new technologies, studies that demonstrated the impact of new technologies on improving the health literacy of populations in social isolation, and all types of studies, focusing essentially on observational studies, analytical studies, quasi-experimental and experimental studies. Results: Thirteen full-text articles were included in the study. Digital technologies were considered an intrinsic part of people's daily lives, having numerous advantages: allowing greater contact with family and friends, providing a moment of leisure and acquisition of knowledge, and contact with health professionals. In this way, new technologies have made it possible to increase users’ health literacy due to their easy access to information on various pathologies and health promotion measures. Conclusions: It is possible to conclude that the existence of individuals with access to digital media who are more able to acquire information about pathologies, their prevention, and treatment is related to better health conditions. Thus, health professionals' motivation for patients to use technological resources in the health component is essential. Moreover, the constant sharing of information on the internet, combined with the concept of telehealth and personalized monitoring by professionals in the field, has emphasized the importance of knowledge and health literacy.
- Do clear aligners release toxic chemicals? - a systematic reviewPublication . Ferreira, Mariana; Costa, Hélder; Veiga, Nélio; Correia, Maria J.; Gomes, Ana T. P. C.; Lopes, Pedro C.The use of advanced polymer materials in clear aligners, such as polyurethane and PET-G, has gained widespread acceptance due to their mechanical properties, biocompatibility and aesthetic appeal. However, concerns persist regarding their potential to release chemical compounds. Our goal is to understand the impact of the toxicity of clear aligners on oral cavity of orthodontic patients. An extensive systematic search was conducted in electronic databases PubMed, Scopus and Cochrane, to identify articles with relevant data. This systematic review will be conducted following the Preferred Reporting Items for Systematic reviews and Meta-analysis guidelines to answer a question formulated according to the Population, Intervention, Com-parison and Outcomes strategy. Four hundred and thirteen articles potentially relevant were identified and after applying PRISMA guidelines 7 articles were included in this review. Our results suggest that clear aligners are generally safe, concerns remain regarding the chemical leaching of thermoplastic materials, bacterial accumulation due to reduced saliva flow, and mild inflammatory responses. Our review empha-sizes that although most materials are biocompatible, some exhibit moderate cytotoxicity, underscoring the need for continued research and improvements in material composition.
- Do clear aligners release toxic chemicals? - a systematic reviewPublication . Ferreira, Mariana; Costa, Hélder; Veiga, Nélio; Correia, Maria J.; Gomes, Ana T. P. C.; Lopes, Pedro C.Clear aligners are a modern orthodontic solution designed to address dental malocclusions discreetly and effectively. In terms of clinical side effects, the most reported issues among aligner users are mild irritation of the oral mucosa, localized inflammation, and hypersensitivity. The use of advanced polymer materials in clear aligners, such as polyurethane and PET-G, has gained widespread acceptance due to their mechanical properties, biocompatibility, and aesthetic appeal. However, concerns persist regarding their potential to release chemical compounds. Our goal is to understand the impact of clear aligner toxicity on the oral cavity of orthodontic patients. An extensive systematic search was conducted in the electronic databases PubMed, Scopus, and Cochrane to identify articles with relevant data. This systematic review was conducted following the Preferred Reporting Items for Systematic reviews and Meta-analysis guidelines (PRISMA) to answer a question formulated according to the Population, Intervention, Comparison, and Outcomes. Four hundred and thirteen articles potentially relevant were identified and after applying PRISMA guidelines and inclusion/exclusion criteria, seven articles were included in this review. Our results suggest that clear aligners are generally safe, but concerns remain regarding the chemical leaching of thermoplastic materials, bacterial accumulation due to reduced saliva flow, and mild inflammatory responses. Our review emphasizes that although most materials are biocompatible, some exhibit moderate cytotoxicity, with the potential to impact these patients’ oral health, underscoring the need for continued research and improvements in material composition.
- Impact of digital innovations on health literacy applied to patients with special needs: a systematic reviewPublication . Cardoso, Lucilene Bustilho; Couto, Patrícia; Correia, Patrícia; Lopes, Pedro C.; Fernandes, Juliana Campos Hasse; Fernandes, Gustavo Vicentis Oliveira; Veiga, Nélio JorgeMHealth strategies have been used in various health areas, and mobile apps have been used in the context of health self-management. They can be considered an adjuvant intervention in oral health literacy, mainly for people with special health needs. Thus, the aim of this study was to identify the improvement of oral health literacy in patients with special needs when using digital platforms. A systematic literature review, based on the Joanna Briggs Institute (JBI) guidelines, was the main research method employed in this study. A search was undertaken in PubMed/MEDLINE and Cochrane Central Register of Controlled Trials (CENTRAL) databases, according to the relevant Mesh descriptors, their synonyms, and free terms (Entry Terms). Studies published between the years 2012 and 2023 were included. Two researchers independently assessed the quality of the included studies by completing the Newcastle–Ottawa Quality Assessment Scale questionnaire. The analysis corpus comprised 5 articles among the 402 articles selected after applying the inclusion/exclusion criteria (k = 0.97). The evidence from the considered articles is consensual regarding the effectiveness of using new technologies and innovations in promoting oral health literacy in patients with special health needs. The interventions were based on using the Illustration Reinforcement Communication System, inspired by the Picture Exchange Communication System, Nintendo® Wii™ TV, virtual reality, smartphones, with software applications to read messages sent, Audio Tactile Performance technique, and Art package. One study had a low-quality assessment, and four had a high quality. The evidence from the articles included in this systematic review is consistent regarding the effectiveness of using new technologies and innovations in promoting oral health literacy in patients with special health needs.
- Literacy in the scope of radiation protection for healthcare professionals exposed to ionizing radiation: a systematic reviewPublication . Rodrigues, Belinda V.; Lopes, Pedro C.; Mello-Moura, Anna C.; Flores-Fraile, Javier; Veiga, NelioBackground: The use of radiation is important in different medical procedures, and to ensure a high level of good medical practice, radiation protection (RP) should be seen as a very important subject. This review shows information about the knowledge in the scope of radiation protection among healthcare professionals exposed to ionizing radiation. There are not many studies that evaluate the radiation exposure of healthcare professionals. Methods: A systematic search was performed, using PRISMA guidelines, in Pubmed and Scopus databases and manually to identify relevant articles to answer the PICOS question, “Is there an adequate level of literacy in the scope of radiation protection among healthcare professionals exposed to ionizing radiation?”. This systematic review included cross-sectional studies with the following inclusion criteria: (i) in Portuguese, Spanish, or English; (ii) about literacy in the scope of radiation protection; (iii) published between 2017 and 2024; and (iv) participants must be dentists, radiographers, doctors, and nurses. The JBI critical assessment tool was used to assess the risk of bias. Results: The search identified 566 potentially relevant references, which, after applying inclusion/exclusion criteria, resulted in 12 articles. Studies found that the overall knowledge of these healthcare workers was unsatisfactory, and a lack of knowledge in radiation protection negatively affects health services’ quality. Training is essential and must emphasize how radiation exposure can be minimized, safeguarding health professionals’ trust and sense of security. Results showed that more years of experience make workers more attentive to protection measures, suggesting that training strategies focused on basic radiological risks and radiation safety are needed. Conclusions: Key findings recommend implementing a standardized national training program on the basic principles and safety of ionizing radiation for all healthcare professionals.
- Machine assisted instrumentation for preparation of primary teeth: an umbrella reviewPublication . Teles, Ana Moura; Lopes, Pedro C.; Veiga, Nélio; Andrea, Mariana D’; Correia, Patrícia; Mello-Moura, Anna C.Maintaining primary teeth in optimal anatomical and functional condition until physiological exfoliation is crucial for the healthy development of permanent dentition. Trauma and extensive carious lesions may result in pulp involvement, necessitating endodontic treatment. Various techniques for the instrumentation of root canals in primary teeth, including both manual and rotary instruments, are potential treatment options. This study aims to evaluate, through an umbrella review, the feasibility of rotary instrumentation of root canals in primary teeth for clinical practice. The work is grounded in Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines and seeks to address the following PICO question: In primary teeth undergoing endodontic treatment (P), is it feasible (O) to perform rotary instrumentation (I) compared to the conventional (manual) root canal preparation technique (C)? The data sources utilized were PubMed, Web of Science and Scopus, supplemented by manual search. The methodological quality of the included studies was assessed using the A Measurement Tool to Assess Systematic Reviews (AMSTAR-2) tool, while the risk of bias was evaluated with the Risk of bias (ROBIS) tool. Two reviewers independently conducted the quality assessment and risk of bias analyses. The search identified several potentially relevant references, resulting in a total of 39 publications. However, after applying the eligibility criteria, only three articles were ultimately included in the review. Regarding the principal findings, no systematic review provided a defiNi-Tive conclusion concerning the optimal method of root canal instrumentation in primary teeth. However, empirical data have shown that rotary canal preparation in rotary root canal preparation in primary teeth reduces clinical working time and, due to its various kinematics and instrument designs, facilitates the filling process. Nevertheless, we cannot defiNi-Tively assert that this method yields superior benefits for treatment outcomes.
- Oral health in inflammatory bowel disease: the overlooked impact and the potential role of salivary calprotectinPublication . Rodrigues, Cláudio; Gomes, Ana T. P. C.; Leal, Joana; Pereira, Pedro; Lopes, Pedro C.; Mendes, Karina; Correia, Maria J.; Veiga, Nélio; Rosa, Nuno; Soares, Caroline; Ministro, PaulaBackground: Inflammatory Bowel Disease (IBD), a chronic condition characterized by gastrointestinal inflammation, is influenced by genetic and environmental factors. Emerging evidence suggests a “mouth-gut axis,” with the oral cavity reflecting extra-intestinal manifestations of IBD. This study evaluated the oral health status of IBD patients and the potential of salivary calprotectin (SCP) as a biomarker for assessing IBD activity and oral health. Methods: Oral health was assessed in 100 IBD patients [60 with Crohn’s disease (CD) and 40 with ulcerative colitis (UC)] and 14 controls. Evaluations included the Decayed, Missing, and Filled Teeth (DMFT) Score, Periodontal Diagnosis and the need for dental or prosthetic treatment. Saliva and stool samples were collected to measure SCP and faecal calprotectin (FCP) levels using the Elia Calprotectin 2 Test. IBD activity was evaluated with FCP, the Harvey-Bradshaw Index for CD, and the Partial Mayo Score for UC. Results: The DMFT index mean was comparable between IBD patients (mean 7.99, SD 7.73) and controls (mean 10.00, SD 6.49). However, periodontal disease was significantly more prevalent in IBD patients (57% in CD, 70% in UC) than in controls (29%), with severe cases (stages III/IV) more frequent in IBD. Additionally, 89% of IBD patients required dental treatment, and 39% needed prosthetic rehabilitation. SCP levels showed no significant correlation with disease activity or oral health status, while FCP correlated with C-reactive protein and erythrocyte sedimentation rate. Conclusions: This study underscores the need for improved oral health management in IBD patients and suggests that SCP may not be a reliable biomarker for monitoring IBD or periodontal disease.
- The role of training and education for enhancing empathy among healthcare students: a systematic review of randomised controlled trialsPublication . Schwartzkopf, Caroline Teggi; Alves, Renata Tolêdo; Lopes, Pedro C.; Braux, Julien; Capucho, Filomena; Ribeiro, CéliaBackground: Empathy can lead to a better patient-professional relationship, and this skill that can be learned and trained, and the university is the ideal place to start this training. The aim of this systematic review is to assess whether training and education interventions have an impact on increasing empathy in health students. Methods: The acronym PICOS was used to formulate the research question. A high-sensitivity search was made combining indexed terms, entry terms, and Boolean OR/AND in 9 databases, including grey literature and manual search of retrieved articles. Two researchers selected the studies based on previously established eligibility criteria. The risk of bias was verified using the RoB2 tool and a meta-analysis was performed using RevMan 5.4. Results: The analysis included 30 studies in the qualitative synthesis and 20 studies that presented adequate data for the meta-analysis. An overall moderate effect on participants’ empathy was found after the intervention (standardized mean difference 0.45, 95% CI 0.25 to 0.65). However, heterogeneity was high (I2 = 79%). More than half of the studies were considered at high risk of bias. The results suggests that interventions can be effective in increasing empathy. Conclusion: This topic has been in the spotlight in the area of health education in recent years. And more quality studies will be needed, as well as long-term evaluation of interventions to ensure the durability of empathy enhancement. Clinical trial number: Not applicable.
- "Ser criança'' - an oral health literacy program for vulnerable children and familiesPublication . Veiga, Nélio; Dias, Beatriz; Oliveira, Mário; Correia, Patrícia; Couto, Patrícia; Lopes, Pedro C.; Correia, Maria José; Duarte, Ana Sofia; Mello-Moura, Anna C.Background: Oral health literacy and knowledge about primary prevention methods are essential to decrease possible effects of poor oral health on systemic health. This is more evident among the vunerable communities. The objectives of this work consists in the establishment of methods to promote oral health literacy applicable to the participants of the “Ser Criança” program, namely: development of a website—“Ser Criança— Aprender a Sorrir” (To be a Child—Learning to Smile) and creation of a protocol for remote dental appointment supported by information obtained by intraoral photos, using teledentistry. Methods: The work developed was focused on the development of a website for oral health literacy accessed by children of vulnerable communities and the creation of a pilot-protocol for remote dental appointment, by teledentistry, which can offer valuable diagnostic, therapeutic and preventive care online for the children and families involved which may not have easy access to oral health services. Results: The “Ser Criança” program is a initiative designed to empower communities with knowledge about oral health and to facilitate the detection and treatment of potential oral pathologies among children. The development of a digital platform for early education represents a strategic approach to improve oral health promotion and disease prevention, particularly among vulnerable communities. Conclusions: Promoting oral health literacy and understanding primary prevention methods are essential to reduce the negative impact of poor oral health on systemic conditions. The “Ser Criança” program represents a pioneering effort aimed at empowering communities with oral health knowledge and facilitating early detection and treatment of dental issues in children
- TAM pathway proteins as novel salivary biomarkers for periodontitisPublication . Mendes, Karina; Gomes, Ana T. P. C.; Tatakis, Dimitris N.; Marques, Tiago; Pinto, Marla; Lopes, Pedro C.; Correia, Maria J.; Rosa, NunoBackground The identification of molecular biomarkers that help clinicians in early diagnosis is a key focus of periodontal research. The major aim of this cross-sectional observational study was to assess whether salivary TAM pathway protein levels have the potential to discriminate between periodontally healthy or gingivitis controls and periodontitis patients, including those with mild (I/II) or severe (III/IV) disease. Methods Twenty-five periodontally healthy, 24 gingivitis, and 51 periodontitis patients further stratified into mild (stages I/II, n = 25) or severe (stages III/IV, n = 26) periodontitis were included. Salivary levels of tyrosine-protein kinase receptor UFO (AXL), TYRO3 protein tyrosine kinase (TYRO3), Proto-oncogene tyrosine-protein kinase MER (MERTK), and growth arrest-specific protein 6 (GAS6) were quantified using a multiplex immunoassay approach. Results Salivary AXL, TYRO3, MERTK, and GAS6 levels were significantly elevated in periodontitis compared to periodontally healthy and gingivitis patients. Similar results for each periodontitis severity subgroup compared to control groups (except for MERTK, which was significantly different only for stage III/IV) were obtained. Supporting these findings, AXL, TYRO3, and GAS6 were the most accurate in differentiating between periodontally healthy/gingivitis and periodontitis, including mild or severe periodontitis (area under the curve [AUC] ranging from 0.72 to 0.89). Overall, combining biomarkers enhanced the predictive value for identifying periodontitis, including mild and severe disease, compared to using individual biomarkers alone (AUC values between 0.81 and 0.91). Conclusion Salivary TAM pathway markers show promise as a potential noninvasive diagnostic screening tool to distinguish between controls (healthy/gingivitis) and periodontitis, including mild or severe periodontitis.