Ana Cristina Braga

Clinical improvement following therapy for periodontitis: Association with a decrease in IL‑1 and IL‑6

Although a number of inflammatory cytokines have been shown to be associated with periodontal pathogenesis, it is important to investigate further whether these biomarkers are associated with the degree of success in nonsurgical treatment of chronic periodontitis. The aim of the present study was to quantify the total levels of interleukin (IL)-1α, -1β, -6, -10 and tumour necrosis factor (TNF)-α in gingival crevicular fluid (GCF) of chronic periodontitis patients prior to and following nonsurgical periodontal therapy. In total, 52 GCF samples from disease sites of patients with chronic periodontitis, prior to and following periodontal therapy, and ten non-disease sites from non-periodontitis subjects, were collected and cytokine concentrations were determined using a multiplex method. Periodontal parameters, including bleeding on probing, probing pocket depth and the clinical attachment level, in all the sites were recorded. Untreated disease sites exhibited higher cytokine levels in the GCF when compared with the non-disease sites. Nonsurgical periodontal therapy resulted in a statistically significant decrease in the total levels of IL-1α, -1β and -6 in the GCF, but not in IL-10 or TNF-α. The results support the hypothesis that proinflammatory cytokines, including IL-1α, IL-1β and IL-6, are likely to be involved in the pathogenesis of periodontitis and are good markers to evaluate the success of nonsurgical therapy in disease sites of patients with periodontitis.

IL1 gene polymorphisms and unsuccessful dental implants

OBJECTIVES This study aimed to analyse the association between polymorphisms in the IL1 gene cluster and failure of dental implants in a Portuguese population. MATERIAL AND METHODS A total of 155 Caucasian Portuguese subjects were divided into two groups: 100 with successful dental implants and 55 with unsuccessful dental implants. DNA was obtained through an oral mucosa scraping. PCR was used to identify the polymorphisms: single nucleotide changes in positions -889 of IL1A gene and +3953 of IL1B gene. RESULTS The prevalence of the polymorphisms -889IL1A gene and +3953IL1B gene, determined by the positive result of TGP (Genetic Test for Periodontitis; CGC, Genetics, Portugal), in the studied population rehabilitated with dental implants was of 33.50%. Allele 1 of the IL1B gene was the most prevalent (62.20%), followed by allele 1 of the IL1A gene (54.80%) and the least frequent was allele 2 of IL1B gene (37.40%). Success of dental implants was mainly associated with a negative TGP result, whereas no success was found to be related to a positive result. There were no statistically significant differences between the alleles 1 and 2 of the genes IL1A and IL1B and the tobacco and alcohol consumption for the success or no success of the dental implants. CONCLUSIONS The alleles 1 and 2 of IL1A gene and the alleles 1 and 2 of IL1B gene were statistically associated with the success or no success of the dental implants. Tobacco habit and alcohol consumption showed no statistically significant association with success or no success of the dental implants.

The prevalence of anterior open bite in Portuguese children during deciduous and mixed dentition – Correlations for a prevention strategy

INTRODUCTION Anterior open bite (AOB) is a vertical malocclusion that requires thorough diagnosis to ensure long-term stability. The aim of this study was to determine the prevalence of AOB in Portuguese children during deciduous and mixed dentition in order to assess the need for orthodontic treatment and to determine its relation to other associated features. MATERIAL AND METHODS A group of 1264 children aged between 3 and 12 from Porto in Portugal were observed. The statistical methodology included the independent Chi(2) test, Fishers exact test and binary logistic regression. RESULTS The prevalence of AOB was 16.9% with 95% CI (11.9%, 24.5%) for primary dentition and 11.3% with 95% CI (8.4%, 15.1%) for mixed dentition. Pacifier sucking, thumb sucking, tongue thrust and oral breathing are major risk factors for AOB in primary dentition, ranked in descending order. In mixed dentition, the factors are ranked as follows: pacifier sucking, lip sucking, tongue thrust and oral breathing. CONCLUSION Due to the close connection between the prevalence of AOB and dysfunctional problems, prevention strategies should be integrated into a national public health program. The habits mentioned above should be eliminated early by using the appropriate protocols in order to reduce the risk factors of malocclusion.

Periodontal inflammation in renal transplant recipients receiving Everolimus or Tacrolimus – preliminary results

OBJECTIVE To compare oral health status between renal transplant recipients (RTRs) receiving tacrolimus (Tac) or everolimus (ERL) as immunosuppressive therapy. DESIGN This study is a cross-sectional study. METHODS Thirty-six RTRs receiving Tac and 22 RTRs receiving ERL were included in the study. Age, gender, time since transplant and pharmacological data were recorded for both groups. Oral health status was assessed through the evaluation of teeth, periodontal parameters as well as saliva flow rate and pH. RESULTS RTRs receiving ERL were older than those receiving Tac. No differences were found between groups concerning oral hygiene habits, oral symptoms, smoking habits, unstimulated and stimulated saliva flow rate and pH, clinical attachment level or the number of decayed, missing and filled teeth. However, RTRs receiving ERL presented lower visible plaque index and lower values for bleeding on probing when compared to RTRs receiving Tac. In addition, RTRs receiving ERL presented a gingival index varying from normal to moderate inflammation whereas RTRs receiving Tac presented a gingival index varying from mild to severe inflammation. CONCLUSIONS RTRs receiving ERL have lower periodontal inflammation when compared to RTRs receiving Tac.

Diagnostic analysis based on ROC curves: theory and applications in medicine

Receiver operating characteristic (ROC) analysis is a powerful tool to measure and specify the problems with diagnostic performance in medicine. Describes this analysis and the importance of the index area under ROC curve, using some examples to demonstrate its application. The study was conducted on two sets of new‐borns with very low birth weight, coming from neonatal intensive care units from Portuguese hospitals. The first application uses correlated samples, and aims to define which of the five indices of clinical seriousness can be considered the best to evaluate the risk of death for babies with very low birth weight. In the second application, regarding independent samples, compares four Portuguese hospitals, the aim being to identify the neonatal intensive care unit which presents the best performance in terms of care to the new‐borns, i.e. evaluated through the comparison of the clinical severity indices.

Stakeholders satisfaction and sustainable success

The relationship between stakeholders satisfaction and organisational sustainable growth and success is investigated focusing on the importance of a firms relationships with critical stakeholders that may lead to better performance, as organisations while integrating business and societal considerations create value for their stakeholders. However, it is of most importance that top management actively leads this approach and that the governance bodies of the organisations support and check that this really happens. Framed on stakeholder theory and social responsibility theory an online survey was administered to managers of Portuguese organisations with certified management systems by a leading management systems certification Portuguese body. The findings suggest that competitive position is strongly correlated with shareholders, suppliers and partners, employees and customers satisfaction, legitimating Freemans stakeholder theory. In an overall final remark, the importance of shareholders, partners/suppliers, employees and customers satisfaction for organisational sustainable success is highlighted in this study results.

Different manifestations of class II division 2 incisor retroclination and their association with dental anomalies.

Objective To investigate whether there is an association between dental developmental anomalies (DDAs) and different manifestations of class II division 2 (CII/2) malocclusion incisor retroclination. Design Retrospective comparative study. Setting Private orthodontic practice in the regions of Lisbon and Porto, Portugal. Subjects and methods The sample comprised 115 CII/2 malocclusions distributed into two groups on the basis of incisor retroclination: Group I composed of 48 CII/2 with retroclination exclusively of both maxillary central incisors; Group II composed of 67 CII/2 with retroclination of all four maxillary incisors. Using the initial orthodontic records, it was determined for each patient the presence of the following DDAs: tooth impaction, tooth agenesis, maxillary lateral incisor microdontia, tooth transpositions and supernumerary teeth. Results Fifty-five per cent of patients were diagnosed with at least one of the DDAs studied. In the total sample the prevalence rates were: 20.0% of palatal maxillary canine impaction, 27.4% of third molar agenesis, and 15.7% of maxillary lateral incisor microdontia. No patient exhibited any transposition or supernumerary teeth. The distribution of the DDAs studied by groups revealed a strong association of palatal canine impaction, tooth agenesis and maxillary lateral incisor microdontia with Group II but not with Group I. Conclusion The association of DDAs with CII/2 malocclusion is not common to all types of maxillary incisor retroclination, suggesting different etiologic factors among the different manifestations of CII/2 incisor retroclination.

The Key Project Managers’ Competences for Different Types of Projects

This paper describes a quantitative research approach for identifying key project managers’ competences for different types of projects. By identifying the perceived most valuable project manager competences, as having the most potential for increased contribution to project management (PM) performance, practitioners and organizations can select their priorities when developing their PM practices. The 46 competences (technical, behavioural and contextual) provided by IPMA (International Project Management Association) were surveyed through an online questionnaire. Three dimensions to distinguish project types were used: application area, innovation and complexity. Completed questionnaires were received from 96 project managers from Portugal. The results showed that 13 key competences (20%) were common to the majority of the projects. Most of these are behavioural competences, such as: ethics, reliability, engagement, openness, and leadership. It was also observed a clear correlation between technical competences and project complexity.

The analysis of variability of pavement indicators: MPD, SMTD and IRI. A case study of Portugal roads

Macrotexture is one of the main pavement quality parameters considered in Portuguese Quality Control Plans which is not specifically approached in data variability analysis studies. In this study, the analysis of variance (ANOVA) – Full factorial method was used to analyse the variability of the mean profile depth, the sensor measured texture depth and also the international roughness index. The ANOVA is appropriated to assess some sources of variation such as repeatability and reproducibility, and it allows us to investigate the contribution of several factors and interaction between them on the variability of a performance parameter. In this study, data from five profilometers running on six long road sections were used. The investigated parameters were type of surface, operator and system and run repetition. Repeatability results were different for each parameter and the analysis of factors points to the necessity to further investigate the effect of the type of surface on data variability. The development of an operational plan to assure reproducibility is required.

An alternative method for global and partial comparison of two diagnostic systems based on ROC curves

In this paper, an alternative method for the comparison of two diagnostic systems based on receiver operating characteristic (ROC) curves is presented. ROC curve analysis is often used as a statistical tool for the evaluation of diagnostic systems. However, in general, the comparison of ROC curves is not straightforward, in particular, when they cross each other. A similar difficulty is also observed in the multi-objective optimization field where sets of solutions defining fronts must be compared with a multi-dimensional space. Thus, the proposed methodology is based on a procedure used to compare the performance of distinct multi-objective optimization algorithms. In general, methods based on the area under the ROC curves are not sensitive to the existence of crossing points between the curves. The new approach can deal with this situation and also allows the comparison of partial portions of ROC curves according to particular values of sensitivity and specificity of practical interest. Simulations results are presented. For illustration purposes, considering real data from newborns with very low birthweight, the new method was applied in order to discriminate the better index for evaluating the risk of death.