andre almeida
@egasmoniz.com.pt
Egas Moniz School of Health and Science
RESEARCH INTERESTS
Bruxism; Temporomandibular Disorders; TMJ; Orofacial Pain
Scopus Publications
Scopus Publications
Francisco Manuel Veigas Veladas, Giancarlo De la Torre Canales, Bryanne Brissian de Souza Nobre, Ana Escoval, Ana Rita Pedro, André Mariz de Almeida, Victor Abreu Assunção, and Ana Cristina Manso
Springer Science and Business Media LLC
Abstract Background Oral health literacy has gained importance in dental literature, and its relationship with oral health status and association with health status (HL) has been reported. Then, an association between the levels of HL and OHL could be expected. This study aimed to assess the levels of HL and OHL according to sociodemographic factors and to explore a possible association between HL and OHL. Methods The European Health Literacy Survey and Oral Health Literacy Adults Questionnaire were applied to a convenience sample from Portuguese individuals. Also, sociodemographic factors such as sex, age, schooling level of the participants and their parents, and if the participants were professionals or students of the health field were assessed. To analyze the data, the Kruskal–Wallis and Mann–Whitney U tests were used to compared sociodemographic variables and the levels of literacy in general and oral health. The Spearman correlation test assessed the correlation between the levels of HL and OHL. Results HL results showed that 45.1% of the volunteers were considered in a “problematic level” and 10.3% in “excellent level”. However, 75% presented an adequate level of OHL. Regarding the levels of HL in each sociodemographic variable, significant higher levels of “excellent level” were found in health professionals and students when compared with participants not related to health area (p < 0.001). Comparisons between the levels of OHL in each sociodemographic variable showed, significant differences regarding sex (p < 0.05), age (p < 0.001), levels of schooling of the participants and their parents (p < 0.009 and p < 0.001) and relationship with health field. (p < 0.001). A significant positive – weak correlation was found between HL and OHL (p < 0.001). Conclusions HL and OHL levels are associated and could be influenced by sociodemographic factors.
André Mariz de Almeida, João Botelho, Vanessa Machado, José João Mendes, Cristina Manso, and Santiago González-López
MDPI AG
The aim of this study was to compare the effectiveness of arthrocentesis followed by hyaluronic acid infiltration treatment (ASH) and mandibular exercise therapy (MET) in patients with symptomatic disc displacement without reduction (DDwoR) by examining pain intensity (VAS), mandibular range of motion (MO), and quality of life (QoL). Fifty-two patients were randomly allocated into two groups, MET (N = 26) and ASH (N = 26), and therapy was applied at the baseline and one month after. Patients were followed up at 1 and 12 months after the baseline assessment. Clinical and patient-reported outcomes were compared at the baseline, 1-month follow-up, and 12-month follow-up. The study found no significant differences in VAS and MO between the ASH and MET groups at the baseline. However, while not significant, it was noted that the ASH group showed higher values for MO. Regarding OHIP-14 at 1 month of follow-up, the ASH group showed significant improvements in physical pain (p > 0.01), physical and psychological disability (p = 0.043 and p = 0.029), and handicap (p = 0.033). At the 12-month follow-up, the ASH group showed significant improvements in functional limitation, psychological discomfort, psychological disability, and handicap (p = 0.008, p = 0.001, p = 0.001, p = 0.005, respectively). ASH treatment did not reduce pain or improve mandibular range of motion more than physical therapy in patients with symptomatic DDwoR. However, ASH could be preferable given its positive long-term effects on patients’ quality of life. The clinician’s main objective is to prioritize the treatment plan order with a focus on the patient’s quality of life. Accordingly, healthcare professionals should consider ASH as a treatment option for patients with symptomatic DDwoR who desire long-term improvement in their quality of life.
Alessandra Maria Santos Athadeu, Mariana Barbosa Câmara-Souza, Rodrigo Lorenzi Poluha, Vivian Werneck Heredia Alvim Soares, Bryanne Brissian de Souza Nobre, Cristina Manso, André Mariz de Almeida, and Giancarlo De la Torre Canales
Springer Science and Business Media LLC
Giancarlo De la Torre Canales, Rodrigo Lorenzi Poluha, Natalia Alvarez Pinzón, Bruno Rodrigues Da Silva, Andre Mariz Almeida, Malin Ernberg, Ana Cristina Manso, Leonardo Rigoldi Bonjardim, and Célia Marisa Rizzatti-Barbosa
Toxins MDPI AG
This study assessed the effects of botulinum toxin type A (BoNT-A) in mandibular range of motion and muscle tenderness to palpation in persistent myofascial pain (MFP) patients (ReBEC RBR-2d4vvv). Eighty consecutive female subjects with persistent MFP, were randomly divided into four groups (n = 20): three BoNT-A groups with different doses and a saline solution group (placebo control group). Treatments were injected bilaterally in the masseter and anterior temporalis muscle in a single session. Clinical measurements of mandibular movements included: pain-free opening, maximum unassisted and assisted opening, and right and left lateral excursions. Palpation tests were performed bilaterally in the masseter and temporalis muscle. Follow-up occurred 28 and 180 days after treatment. For the statistical analysis the Mann–Whitney U-test with Bonferroni correction was used for groups comparisons. Regardless of dose, all parameters of mandibular range of motion significantly improved after 180 days in all BoNT-A groups, compared with the control group. Palpation pain over the masseter and temporalis muscles were significantly reduced in all BoNT-A groups regardless of dose, compared with the control group, after 28 and 180 days of treatment. Independent of doses, BoNT-A improved mandibular range of motion and muscle tenderness to palpation in persistent MFP patients.
Laura Nykänen, Daniele Manfredini, Frank Lobbezoo, Antti Kämppi, Anna Colonna, Alessandra Zani, André Mariz Almeida, Alona Emodi-Perlman, Aslak Savolainen, Alessandro Bracci,et al.
MDPI AG
The prevalence of awake bruxism (AB) has been reported as being 30%, with sleep bruxism (SB) at 9–15%. Most studies have focused on SB, emphasizing the importance of AB research. For epidemiological evaluations of AB, a smartphone application based on ecological momentary assessment (EMA) was introduced. The aims of this multi-center study were: (1) to investigate how well lay subjects comprehend the AB terminology used in the smartphone application, and (2) to find out whether professional instruction improved their comprehension. The study population consisted of lay subjects from Italy, Portugal, and Finland comprising 307 individuals (156 men, 151 women; 18–86 years). Subjects first completed a five-item questionnaire about the meanings of the five AB terms used in the smartphone application. Each question offered four answer options, with one being correct. Immediately afterwards, the meanings of the terms were instructed. Lastly, the subjects were re-tested with the same questionnaire. In Finland and Italy, the re-tested correct answer scores for the single terms were at 89–97% per term. Improved comprehension was seen across sex, education, and age groups. In the Portuguese data, no improvement was found. Significant differences were found between countries in the improved scores for all terms that were correct following the instruction (Finland, 16.3% to 72.1%; Italy, 32.3% to 83.8%; Portugal, 23.1% to 33.7%) (p < 0.001). In conclusion, standardized instruction on AB terminology prior to EMA is recommended to improve the reliability of collected data.
Paula Manuela Mendes Moleirinho‐Alves, André Mariz Coelho Santos de Almeida, Fernado Gustavo Exposto, Raul Alexandre Nunes da Silva Oliveira, and Pedro Luís Camecelha de Pezarat‐Correia
Wiley
BACKGROUND
Pain and anxiety contribute to decreasing quality of life related to oral health in patients with temporomandibular disorders (TMD). Evidence-based practice has shown that therapeutic and aerobic exercise programs are adequate strategies for modifying these factors.
OBJECTIVE
Assess the effects of aerobic exercise on pain, anxiety and quality of life related to oral health in patients with TMD.
METHODS
Forty-five patients diagnosed with TMD were divided into three groups of 15 participants: a therapeutic exercise program (G1, mean 26.9±5.5 years), a therapeutic and aerobic exercise program (G2, mean 26±4.4 years) and an aerobic exercise program (G3, mean 24.9±3.4 years). Pain intensity was assessed using a numerical rating scale (NRS), anxiety level and quality of life related to oral health through GAD-7 and OHIP-14, respectively. These parameters were evaluated twice at baseline (T0a/T0b), ending 8-week intervention period (T1), and 8-12 weeks after ending intervention (T2).
RESULTS
NRS significantly decreased in G1 (mean difference T0a/T1=5.2, p˂0.001), G2 (mean difference T0a/T1=6.0, p˂0.001) and G3 (mean difference T0a/T1=2.2, p=0.001). OHIP-14 significantly decreased in G1 (mean difference T0a/T1=13.5, p˂0.001) and G2 (mean difference T0a/T1=15.8, p ˂ 0.001) but not in G3 (mean difference T0a/T1=1.2, p=0.55). There were no significant differences between groups regarding GAD-7. Between T1 and T2 there were no significant differences in variables.
CONCLUSION
Therapeutic exercises and therapeutic excercises combined with aerobic exercise groups had a significant decrease in pain and oral health related quality of life at 8 and 12 weeks. These decreases were not seen for the aerobic exercise group.
F. Santos, P. Cebola, S. Félix, C. Godinho, J. Rua, A. Dias, and A. Almeida
Informa UK Limited
Abstract Introduction There is growing research regarding the influence of intra oral devices over sportive performance [1,2]. There is however an unclear definition of the intermaxillary relation during athletes activity and its influence upon the performance. This theme is absent across the scientific research and should be the starting key point on this kind of study. Our goal is to create and assess an experimental setup to determine the intermaxillary relation in surfers during take off - getting up on the surfboard. Materials and methods Ten male adults free surfers were invited for this study. We applied a standard questionnaire about intermaxillary relation during sports. Two possible setups were tested in terms of distance to capture the masticatory muscles in video of 5 take offs; we used a Cannon®️ 77 D on a tripod first at a distance of 1 m from a white tape placed on the floor perpendicularly to the body of the surfer facing down, where both hands were placed while he was laying on the ground ready for take off. Then we gave them a signal to execute the takeoff and all was recorded on video for posterior slow motion analysis. The exact same procedure was done a second time for a distance of 2 metres. This case series study was approved by the Egas Moniz Ethical Committee and each patient signed previously an informed consent. All the assumptions of the Helsinki Declaration have been fulfilled. Results Comparing the 2 setups, it was unclear, in terms of image analysis, the setup with the 1 m distance, becoming clear, in terms of muscle contraction, the 2 metres distance. Even so, the comparison between the standard questionnaire about intermaxillary relation and the video captured is highly variable and somewhat confusing, presenting some analysis limitations, giving us a clear notion that we need another mean of instrumental analysis about the intermaxillary position of the surfers. Discussion and conclusions It is clear to us the high variability of the intermaxillary position of athletes during take off as the lack of self perception on their practice. It is mandatory to design a setup to have an instrumental analysis like electromyography to confirm masticatory muscle contraction and validate the possible influence or relation between intermaxillary relation and sportive performance.
Paula Manuela Mendes MOLEIRINHO-ALVES, André Mariz Coelho Santos de ALMEIDA, Pedro Miguel Teixeira Carvas CEBOLA, Raul Alexandre Nunes da Silva OLIVEIRA, and Pedro Luís Camecelha de PEZARAT-CORREIA
FapUNIFESP (SciELO)
Abstract Objective To assess the effects of three 8-week exercise programs on the frequency, intensity, and impact of headaches in patients with headache attributed to temporomandibular disorder (TMD). Methodology Thirty-six patients diagnosed with headache attributed to TMD participated in the study and were divided into three groups of 12 patients: a therapeutic exercise program (G1, mean age: 26.3±5.6 years), a therapeutic and aerobic exercise program (G2, mean age: 26.0±4.6 years), and an aerobic exercise program (G3, 25.8±2.94 years). Headache frequency and intensity were evaluated using a headache diary, and the adverse headache impact was evaluated using the Headache Impact Test (HIT-6). The intensity was reported using the numerical pain rating scale. These parameters were evaluated twice at baseline (A01/A02), at the end of the 8-week intervention period (A1), and 8–12 weeks after the end of the intervention (A2). Results At A1, none of the G2 patients reported having headaches, in G1, only two patients reported headaches, and in G3, ten patients reported headache. The headache intensity scores (0.3 [95% CI: -0.401, 1.068]), (0.0 [95% CI: -0.734, 0.734]) and HIT-6 (50.7 [95% CI: 38.008, 63.459]), (49.5 [95% CI: 36.808, 62.259]), significantly decreased in G1 and G2 at A1. At A2 headache intensity scores (0.5 [95% CI: -0.256, 1.256]), (0.0 [95% CI: -0.756, 0.756]) and HIT-6 (55.1 [95% CI: 42.998, 67.268]), (51.7 [95% CI: 39.532, 63.802]) in G1 and G2 haven’t change significantly. The effects obtained immediately after the completion of the intervention programs were maintained until the final follow-up in all groups. Conclusion The programs conducted by G1 (therapeutic exercises) and G2 (therapeutic and aerobic exercise) had significant results at A1 and A2.
Luca Guarda-Nardini, Andrè De Almeida, and Daniele Manfredini
Quintessence Publishing
AIMS
To review randomized clinical trials on arthrocentesis for managing temporomandibular disorders (TMD) and to discuss the clinical implications.
METHODS
On March 10, 2019, a systematic search of relevant articles published over the last 20 years was performed in PubMed, as well as in Scopus, the authors' personal libraries, and the reference lists of included articles. The focus question was: In patients with TMD (P), does TMJ arthrocentesis (I), compared to any control treatment (C), provide positive outcomes (O)?
RESULTS/CONCLUSION
Thirty papers were included comparing TMJ arthrocentesis to other treatment protocols in patients with disc displacement without reduction and/or closed lock (n = 11), TMJ arthralgia and/or unspecific internal derangements (n = 8), or TMJ osteoarthritis (n = 11). In general, the consistency of the findings was poor because of the heterogenous study designs, and so caution is required when interpreting the meta-analyses. In summary, it can be suggested that TMJ arthrocentesis improves jaw function and reduces pain levels, and the execution of multiple sessions (three to five) is superior to a single session (effect size = 1.82). Comparison studies offer inconsistent findings, with the possible exception of the finding that splints are superior in managing TMJ pain (effect size = 1.36) compared to arthrocentesis, although this conclusion is drawn from very heterogenous studies (I2 = 94%). The additional use of cortisone is not effective for improving outcomes, while hyaluronic acid or platelet-rich plasma positioning may have additional value according to some studies. The type of intervention, the baseline presence of MRI effusion, and the specific Axis I diagnosis do not seem to be important predictors of effectiveness, suggesting that, as in many pain medicine fields, efforts to identify predictors of treatment outcome should focus more on the patient (eg, age, psychosocial impairment) than the disease.