Henrique Luis

Objetivos: Avaliar a correlação e a confiabilidade clínica do método de Willis, analisando a relação entre a distância canto–comissura (DCC) e as dimensões verticais do terço inferior da face em repouso (DVR) e em oclusão (DVO), em indivíduos dentados. Métodos: Realizou-se um estudo transversal e observacional com estudantes de Medicina Dentária da Faculdade de Medicina Dentária da Universidade de Lisboa. Previamente, foi conduzido um estudo piloto para testar a metodologia, avaliar a calibração intra e interexaminador e calcular o tamanho da amostra. Os participantes que cumpriram os critérios de inclusão foram submetidos a medições de DCC, DVR e DVO. As medições foram realizadas com uma craveira digital por duas examinadoras independentes, sem acesso aos resultados uma da outra. A análise estatística incluiu os testes de Shapiro-Wilk e Levene, correlação de Pearson e teste t (α = 0,05). Resultados: A calibração intra e interexaminador revelou elevada concordância e os coeficientes de correlação intraclasse demonstraram fiabilidade boa a excelente. Foram avaliados 36 alunos, correspondendo ao tamanho amostral previamente calculado. A variável DVR apresentou a maior variabilidade (s = 7,29) e a DCC a menor (s = 4,86). Observou-se uma correlação forte e positiva entre a DCC e a DVR (r = 0,741; p<0,001) e entre o DCC e a DVO (r = 0,701; p<0,001). A análise comparativa revelou diferenças estatisticamente significativas entre DCC e DVO (p<0,001) e entre DCC e DVR (p<0,001). Conclusões: Verificou-se correlação entre as dimensões canto–comissura e inferior da face; contudo, os resultados sugerem que a DCC, isoladamente, não constitui um parâmetro suficientemente fiável para a determinação da DVO ou DVR. Assim, o método de Willis deve apenas ser utilizado como método complementar na determinação da dimensão vertical em reabilitação oral.

Objectives: To investigate the impact of chemotherapy on the oral health and quality of life of patients at the Oncology Department of Vila Franca de Xira Hospital. Methods: This cross-sectional observational study, with an analytical component, involved 76 patients aged between 18 and 65 in the hospital's Oncology Department. A questionnaire was administered to participants about changes in oral health and oral hygiene habits during chemotherapy, and to doctors to collect medical information related to chemotherapy. Data were analyzed using IBM SPSS Statistics V.27, using descriptive and inferential methods at a 5% significance level (p<0.05). Results: After the start of chemotherapy, 89.5% of respondents experienced at least one oral alteration; the most common conditions that negatively impacted quality of life were edema of the mouth (p=0.050), trismus (p=0.040), mucositis (p=0.008), ulcers (p=0.008), and oral pain (p=0.003). More than 50% of respondents had an unsatisfactory oral health-related quality of life. Only the monoclonal antibody protocol was significantly associated (p=0.035) with oral symptoms, while the anthracycline group protocol was associated with a higher frequency of oral manifestations. Conclusions: The participants in the study had a high prevalence of self-reported oral alterations resulting from chemotherapy, with an impact on quality of life related to oral health, and there were differences between protocols. Understanding the signs and symptoms can help improve quality of life, enabling preventive actions.

To evaluate the anticaries and antigingivitis properties of cannabinoid-containing oral health products. A systematic research strategy was employed. Specific search terms were used, including “Cannabinoids AND dental caries,” “Cannabinoids AND oral health,” “Cannabinoids AND dental plaque,” “Cannabinoids AND gingivitis AND periodontitis,” “Cannabinoids AND S. mutans,” “Cannabidiol AND oral health,” and “Cannabidiol AND oral biofilm.” The search was conducted in PubMed, Cochrane, and EBSCO Host databases. The search yielded a total of 73 articles, out of which 15 articles (20.5%) were relevant to the scope of this systematic review. Among the relevant articles, only eight (10.9%) directly addressed the research question. The findings from these articles suggest that cannabinoids have the potential to reduce the metabolism of cariogenic bacteria, specifically Streptococcus mutans , and decrease the number of bacterial colonies in dental plaque. In vitro studies also demonstrated a significant inhibitory effect of cannabinoids on oral biofilms and create a considerable inhibitory zone of growth when investigated on oral biofilms in vitro . Furthermore, CBD exhibited antibacterial properties against Porphyromonas gingivalis , a primary pathogen associated with periodontal disease. The current review shows insufficient data to conclude on the anticaries and antigingivitis effects of cannabinoids. Despite extensive research on their systemic therapeutic benefits, their oral health impact remains underexplored, lacking clinical trials and primary research.

Objectives: To analyze the patient profile and characterize the oral health status, oral habits, and daily oral hygiene difficulties of individuals with rare diseases. Methods: Data were collected from records of the clinic for people with disabilities at the Faculdade de Medicina Dentária da Universidade de Lisboa, using the Decayed, Missing, and Filled Teeth index, the simplified debris index, and the bleeding index. Results: The sample comprised 64 individuals with 33 different rare diseases, with a mean age of 31.5(±10.29) years, predominantly male (54.7%). Most could move without difficulty (51.6%), required assistance in activities of daily living (60.9%), and were cooperative in oral hygiene (54.7%). Also, 40.6% could not communicate. Half of the sample brushed their teeth twice a day, with 18.8% being independent in this activity, and the most common toothbrushing difficulty was not being able to rinse (53.1%). The Decayed, Missing, and Filled Teeth index was 8.81 (±7.54), with a higher number of filled teeth (4.47; ±5.35). The bleeding index had a mean of 1.23 (±0.56), and the simplified debris index had a mean value of 1.62 (±0.78). Conclusions: The population studied expresses care for oral health and treatment.

Objectives Mechanical debridement is the traditional method for the treatment of peri-implant mucositis (P-im) and its success depends on the patient's correct oral hygiene. It is believed that probiotics may help by their ability to modulate the oral biofilm, resulting in anti-inflammatory and antibacterial plaque action. The aim of this study was to evaluate the adjuvant effect of the probiotic Limosilactobacillus reuteri (LR) in the mechanical treatment of P-im. Materials and Methods This exploratory study included 29 subjects with implant-supported total rehabilitation and P-im, divided into test (TG) and control (CG) groups, equally subjected to professional mechanical debridement, with the administration of a daily GUM PerioBalance lozenge for 30 days added to the TG. The modified Plaque Index (mPlI) modified Sulcus Bleeding Index (mBI) and pocket depth (PD) were evaluated before the intervention (baseline) and 6 and 10 weeks later. Statistical Analysis Parametric and nonparametric tests with 5% significance level were used in the statistical analysis, using IBM SPSS Statistics 27.0 software. Results Both treatments resulted in reduced mPlI, mBI, and PD at 6 weeks; while from 6 to 10 weeks there was an increase in mPlI and mBI and maintenance of PD. Compared with baseline, differences were close to statistical significance in the reduction in PD at 10 weeks in the CG (p = 0.018), after Bonferroni correction, and statistically significant in the mPlI at 6 weeks in the CG (p = 0.004) and in the TG (p = 0.002) as well as at 10 weeks in the TG (p = 0.016). Comparing the groups in the postintervention assessments, no statistically significant differences were found. Conclusion LR adjuvant mechanical treatment of P-im does not show a clear benefit compared with mechanical treatment alone, with both interventions achieving similar clinical results. Further prospective and long-term studies are needed.

Cannabidiol presents several benefits, including but not limited to its analgesic, antioxidant, anti-inflammatory, antimicrobial, anti-pruritic, and anti-cancer properties. In this clinical trial, the antimicrobial impact of CBD-infused lozenges on Streptococcus mutans was examined using quantitative polymerized chain reaction (qPCR) bacterial analysis. This clinical trial involved 30 dental hygiene and nursing students who met the inclusion criteria participated in the study and were divided into two groups: experimental and control. The experimental group was given CBD-infused lozenges for 15 days, while the control group received sugar-free candy. Participants consumed one CBD-infused lozenge (300 mg) daily for 15 days, allowing it to dissolve slowly in the mouth for gradual absorption. The study focused on measuring changes in the salivary levels of Streptococcus mutans using quantitative polymerized chain reaction (qPCR) tests. Saliva samples were collected, and DNA extracted for qPCR analysis, assessing the bacterial load. The results, analyzed using a t-test, showed a significant decrease in Streptococcus mutans levels in the experimental group compared to the control group, with a statistically significant difference (p=0.0299).These findings suggest that cannabidiol may effectively reduce Streptococcus mutans in saliva, thus potentially helping to lower the risk of tooth decay as a multifactorial disease. This study underscores the potential of cannabidiol in enhancing oral health and calls for further research to explore its therapeutic applications in dental care.

The relationship between salivary proteome and dietary habits was studied in previous works, where a relationship between salivary proteins like cystatins and polyphenol/tannin levels in diet was observed. However, it remains to be elucidated if this association results from an effect of polyphenol-rich food ingestion on saliva composition. The aim of this work was to test the effects of apple intake on the saliva proteome, both in the short and medium term (after 4 days of continuous intake). By incubating saliva samples with apple phenolic-rich extract, protein bands containing α-amylase, S-type cystatins, and proline-rich proteins (PRPs) appeared in the fraction that precipitated, showing the potential of these (poly)phenols to precipitate salivary proteins. Among these, it was salivary cystatins that presented changes in their levels both in the saliva samples collected immediately after apple intake and in the ones collected after 4 days of intake of an extra amount of apple. These results support the thought that intake is reflected in the salivary proteome. The effect of a polyphenol-rich food, like the apple, on salivary cystatin levels is in line with results observed in animal models and, due to the involvement of these proteins in oral food perception, it would be interesting to explore in future studies the effect of these changes on sensory perception and acceptance of polyphenol-rich food.

The past few decades have witnessed remarkable progress in the application of artificial intelligence (AI) and machine learning (ML) in medicine, notably in medical imaging. The application of ML to dental and oral imaging has also been developed, powered by the availability of clinical dental images. The present work aims to investigate recent progress concerning the application of ML in the diagnosis of oral diseases using oral X-ray imaging, namely the quality and outcome of such methods. The specific research question was developed using the PICOT methodology. The review was conducted in the Web of Science, Science Direct, and IEEE Xplore databases, for articles reporting the use of ML and AI for diagnostic purposes in X-ray-based oral imaging. Imaging types included panoramic, periapical, bitewing X-ray images, and oral cone beam computed tomography (CBCT). The search was limited to papers published in the English language from 2018 to 2022. The initial search included 104 papers that were assessed for eligibility. Of these, 22 were included for a final appraisal. The full text of the articles was carefully analyzed and the relevant data such as the clinical application, the ML models, the metrics used to assess their performance, and the characteristics of the datasets, were registered for further analysis. The paper discusses the opportunities, challenges, and limitations found.

Objectives: To evaluate the relationship between depression, anxiety, and stress levels, headaches, and symptoms of temporomandibular joint disorders in healthcare pro...

The mental health of higher education students is a constant concern, and the pandemic situation caused by COVID-19 has intensified this concern. The social measures imposed to control and minimize the disease have led, among other things, to the reconfiguration of higher education students’ academic life habits, which has naturally altered their emotional balance, mental health, and substance abuse. This cross-sectional, descriptive, and correlational study assesses the influence of higher education students’ personal characteristics on their (self-reported) use of addictive substances (alcohol, tobacco, drugs, and pharmaceutical drugs) before and during their first compulsory confinement in Portugal, as well as its relationship with mental health. An online questionnaire was applied between 15 April and 20 May 2020, to students from various study cycles of higher education institutions in one region of Portugal (northern area of Alentejo), which included the Mental Health Inventory in its reduced version (MHI-5) and questions (constructed by the authors) on personal characterization and on the use of addictive substances before and during confinement. The convenience sample included 329 mostly female health care students between the ages of 18 and 24. In our results, we found a statistically significant decrease in tobacco, alcohol, and drug use; however, there was an increase in tobacco use among older students and an increase in anxiolytic use among students with higher academic achievement and among students who exhibited more active social behavior in the period prior to confinement. Students who took anxiolytics during confinement had higher MHI-5 scores and students who used the most addictive substances during confinement had lower MHI-5 scores than the other students.