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- Amelogenin-based molecular methods for sexual dimorphism identification: protocol of a scoping reviewPublication . Lopes Cardoso, Inês; Moreira, Teresa; Dupuis, Clarisse; Correia de Castro, Filipe; Guimarães, Maria InêsForensic dentistry and sexual dimorphism are distinct concepts. Still, they are related due to the usefulness that the first may have in the second, and this review focuses on them. A scoping review will be performed according to the Joanna Briggs Institute’s methodology. Scientific databases and grey literature will be used, and the following keywords will be applied: amelogenin, analyses, sex determination, and human identification. This scoping review will include in vitro studies concerning the goal of this review. This scoping review will deepen our knowledge concerning using teeth and amelogenin genes in sex identification in a forensic context. According to the available data, it will help implement guidelines for human remains identification. This protocol was registered with the Open Science Framework.
- Degree of contamination of Gutta-Percha points by Staphylococcus aureus (MRSA/MSSA) strainsPublication . Moura Teles, Ana; Pina, Cristina; Lopes Cardoso, Inês; Tramontana, Antea; Cardoso, Miguel; Duarte, Ana Sofia; Bartolomeu, Maria; Noites, RitaMethicillin-resistant Staphylococcus aureus (MRSA) is considered one of the most harmful bacteria to human health. Dentistry, like all healthcare disciplines, places great emphasis on preventing scenarios that may result in cross-infection. Although various tested and already used materials are suitable for filling the root canal system, Gutta-Percha (GP) remains the preferred and widely accepted gold standard. Objective: We performed an in vitro analysis of the contamination of GP points, regarding the strains of Methicillin-resistant (MRSA) and Methicillin-sensitive (MSSA) Staphylococcus aureus, using classical microbiology methods and molecular biology techniques. Methods: Gutta-Percha points of two different brands from opened packages (already in use for 1 month) were collected for analysis. The assessment involved incubating the GP points in Brain Heart Infusion (BHI) medium to detect microbial growth. Growing microorganisms were plated on a selective and differential chromogenic medium for MRSA/MSSA strains, and the identification of isolates was confirmed by Polymerase Chain Reaction (PCR). In the case of microbial growth, the GP point was submitted to a disinfection protocol. Results: From the 315 collected GP points, only 6 (1.9%) resulted in being positive for microbial growth. After confirmation by PCR, only one sample of the six GP points was contaminated by MRSA, and the remaining five were MSSA-contaminated. The disinfection protocol was effective in all contaminated GP points. Conclusions: The Gutta-Percha points from opened pre-sterilized packages showed a very low degree of contamination by MRSA/MSSA. However, the detection of MSSA and MRSA strains raises concerns about potential contamination in dental clinic environments, and this risk cannot be considered negligible.
- Determination of sexual dimorphism through molecular methods: a scoping reviewPublication . Guimarães, Maria Inês; Moreira, Teresa; Dupuis, Clarisse; Lopes Cardoso, InêsBackground: Sexual dimorphism is crucial in forensic investigations. Molecular methods involving amelogenin, a protein in tooth enamel, are used to determine sexual dimorphism by extracting DNA from teeth, amplifying the gene coding for amelogenin through PCR, and analyzing PCR product sizes to identify X and/or Y chromosomes. Objective: This scoping review explored scientific studies using the amelogenin gene to determine sex in forensic dentistry. It addressed the research question: do molecular methods determine sexual dimorphism for forensic identification? Material and methods: A literature review (1996–2024) was conducted using PubMed, MEDLINE (via BVS), and CINAHL (via EBSCO host). Inclusion and exclusion criteria guided the selection process, summarized in a PRISMA flowchart. A PCC (Population-Concept-Context) strategy was applied to formulate the research question. Results: Thirteen of the 1091 articles initially considered met the inclusion and exclusion criteria. These studies examined forensic dentistry and sex determination through amelogenin identification. They were categorized into “with treatment” (7 studies) and “without treatment” (6 studies), and all involved in vitro research. Conclusion: Molecular methods targeting the amelogenin gene on the X and Y chromosomes offer an accurate and reliable approach to determining sex.
- Genetic involvement in dental treatment fearPublication . Khodabakhshi, Donja; Pina, Cristina; Moura Teles, Ana; Lopes Cardoso, InêsBeing a global health concern, dental fear and anxiety is estimated to affect at least one in ten individuals all around the globe. Ensuing the vicious circle of dental fear comes detrimental outcomes in quality of life. Despite the wide range of knowledge concerning the environmental factors that contribute to the acquisition of dental fear and anxiety, the prevalence has not decreased, giving researchers the possibility to highlight other concomitant etiological factors. The possible hereditary or genetic component is most recently being explored, although facing tremendous dynamical elements to substantially delineate its role. The purpose of this review was to explore, reflect and call attention to the current knowledge of the genetic involvement of dental treatment fear and anxiety. Although findings mostly stress the relation between dental fear to other phenotypes giving rise to individual vulnerability, there are studies disclosing suggestive heritability rates for dental fear and anxiety.
- Hypohidrotic ectodermal dysplasia and its manifestations in the oral cavityPublication . Cardoso, Jennifer; de Faria Carvalho, Célio Domingos; Carvalho Silva, Cátia; Moura Teles, Ana; C. Leal, M. Fernanda; Lopes Cardoso, InêsThe Ectodermal Dysplasias generally present orofacial manifestations, such as skeletal discrepancies and dental alterations. Therefore, the role of a paediatric dentist in the detection and recognition of these repercussions can be crucial in early diagnosis of the disease. The oral rehabilitation of paediatric patients with this condition is extremely important, ideally, at a very early stage, yet contributing for the re-establishment of normal chewing, swallowing and phonetics functions, and, naturally, aesthetics increase. The purpose of this narrative review aims to elucidate dentists about their role in the detection, diagnosis, treatment and monitoring of the Ectodermal Dysplasia’ oral manifestations in paediatric patients, through the presentation of general physical and specific craniofacial characteristics.
- Intracanal medication as antibiotic control in case of permanent mature teeth with necrotic pulp or apical periodontitisPublication . Moura Teles, Ana; Lassarat, Rebecca; Pina, Cristina; Lopes Cardoso, InêsNon-Surgical Endodontic Treatment consists in the removal of dental pulp and the elimination of microorganisms that cause infection of the pulp space. This treatment can be performed in a single or in multiple sessions and, sometimes, the use of Intracanal Medication may be necessary. The purpose of Intracanalar Medication is to reach bacteria present in places inaccessible to instrumentation or irrigants and, also, to inhibit the invasion of the root canal system by bacteria or its products by coronal, lateral or apical communications with the outside through dentinal tubules, apical foramen or accessories root canals. The present work is a narrative review of the Literature that aims to analyse the different opinions among authors, in the case of permanent mature teeth with diagnosis of necrosis with or without apical periodontitis associated, and to understand in which situations it is necessary to apply Intracanal Medication, which should be chosen and how it should be applied. In this way, it is also intended that this work can be a useful guide for clinicians.
- Mental health and alcohol consumption among university students in the post-pandemic context: an exploratory cross-sectional study in PortugalPublication . Moreira, Teresa; Guimarães, Maria Inês; Silveira, Augusta; Loibl, Beatriz; Guedes Lopes, Beatriz; Alves Ribeiro Ferraz, Hugo Filipe; Castro, Inês; Mira de Almeida, Sofia; Lopes Cardoso, Inês; Pereira Rodrigues, Sandra Beatriz; Lima, Andreia Maria NovoIntroduction: The COVID-19 pandemic had significant effects on mental health and lifestyle behaviours, especially among university students who experienced academic disruptions, social isolation, and fewer social interactions. Alcohol consumption has long been part of student culture. Still, the influence of post-pandemic academic reintegration on drinking patterns and psychological distress remains relatively unexplored, particularly in countries like Portugal, where student traditions heavily shape consumption habits. This study aimed to describe the prevalence of alcohol consumption, depression, anxiety, and stress in a sample of Portuguese university students during the post-pandemic academic period, and to explore associations with sociodemographic variables. Methods: A cross-sectional study was conducted in November 2021 with 90 students from a private higher education institution in northern Portugal. Data were collected via an online questionnaire including sociodemographic information, the Alcohol Use Disorders Identification Test (AUDIT), and the Depression, Anxiety and Stress Scale (DASS-21). Result: The majority of the participants were not at risk of alcohol addiction (95.3%). In total, 15.1% of students reported anxiety symptoms ranging from severe to extremely severe. A binomial logistic regression was performed to ascertain the effects of being away from home and psychological distress (DASS-42 score), on the likelihood that participants were at risk of alcohol addiction (Level 3 and 4 in the AUDIT scale). The logistic regression model was statistically significant, χ2(2) = 9.20, p = 0.010. Living away from home was associated with a substantially lower likelihood of high-risk status (B = −2.79, p = 0.034), corresponding to an odds ratio of 0.06, indicating a strong protective effect. DASS-42 total score was positively associated with high-risk status (B = 0.04, p = 0.039), such that higher psychological distress increased the odds of being classified as high risk. Conclusions: The findings reveal a low prevalence of alcohol risk but heightened symptoms of anxiety, depression, and stress. Psychological distress notably increases the likelihood of hazardous alcohol use, emphasising the importance of targeted mental health and alcohol-use interventions among university students.
- Perception of Portuguese and Brazilian dentists regarding the importance of teeth and dental materials after exposure to high temperatures: forensics perspectivePublication . Ramos, Beatriz; Abreu, Isabel; Moreira, Teresa; Silveira, Augusta; Lopes Cardoso, Inês; Guimarães, Maria Inês; Mele, Federica; Santoro, ValeriaBackground: The main objective of this study was to carry out an online questionnaire in order to assess dentists’ knowledge and perception of dental materials submitted to high temperatures, helping to clarify and raise awareness of possible gaps in the area of forensic dentistry, especially in human identification. Results: Out of a total of 272 respondents, there was a greater influx of responses from countries such as Portugal and Brazil, the majority being female (66.3%), with an average age of 39 years. Most dentists consider complete clinical records to be extremely important. In addition, professionals with less experience provide fewer models in releasing their clinical records. In the case of dental materials, dentists consider composite resin and glass ionomers to be more susceptible to changes in shape and colour, while amalgam is considered the most stable, followed by ceramic and metal-ceramic crowns. On the other hand, dentin is considered more susceptible to colour changes than enamel. Enamel is seen by most professionals as resistant, undergoing few changes in shape at high temperatures. Conclusions: The opinion of the surveyed dentists on this subject is broadly in line with the existing literature. The only observed differences were related to exposure time and enamel resistance, since they assume that enamel is more resistant, and dentin is more vulnerable.
- Porphyromonas gingivalis and fusobacterium nucleatum in oral oncogenesis and tumour progressionPublication . Seroto, Cristiana; Dias Sequeira, Maria Teresa; Guimarães, Maria Inês; Correia de Castro, Filipe; Lopes Cardoso, Inês; Silveira, AugustaOncological pathology of the oral cavity is a subject of study due to its significant impact on the quality of life of patients, caregivers and on public health. According to the National Institute of Statistics, oncological disease is the second leading cause of death in Portugal, with oral and pharyngeal cancer having an incidence rate of 16.7% and a 50% mortality rate. Periodontal disease is one of the most prevalent infectious conditions in the world, affecting 25-40% of the adult population. This pathology is often associated with the presence of Porphyromonas gingivalis and Fusobacterium nucleatum, being a consequence of the complex interactions between these microorganisms and their products, triggering a host inflammatory response that leads to tissue destruction, increasingly associated with oral oncogenesis and tumor progression. This work goal is to study the involvement of Porphyromonas gingivalis and Fusobacterium nucleatum in oral oncogenesis and tumor progression to understand how these bacteria influence the pathophysiology of oral cavity cancer. The conducted systematic review used Cochrane guidelines through the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) diagram and based on the Population, Intervention, Comparison, Outcome (PICO) criteria. Literature search covered four databases – B On, Science Direct, PubMed, Cochrane Library - and grey literature (master's theses, conference proceedings, world organizations). Publications between 2013 and 2023 were selected for full reading. Several mechanisms explain the association between Porphyromonas gingivalis and Fusobacterium nucleatum and oral oncogenesis and tumor progression. These bacteria can promote cell proliferation by modulating various signaling pathways, and facilitate cellular invasion, allowing the dissemination of cancer cells. Another important mechanism is the induction of chronic inflammation. Prolonged inflammatory response creates a favorable environment for tumor progression. Pro-inflammatory cytokines (interleukin-6 and interleukin-8) play key roles in the inflammatory process, promoting cell proliferation, invasion, and metastasis. Immune evasion is the mechanism by which cancer cells avoid detection and destruction by the immune system. These bacterial strains modulate host immune response, favoring survival and dissemination of cancer cells. This systematic review highlights the complex interaction between chronic inflammation induced by periodontal bacteria and oral oncogenesis. The results underline the need for future investigations to deepen the molecular mechanisms involved and to develop effective therapeutic approaches. Early identification and targeted treatment of chronic inflammation, as well as modulation of the oral microbiome, may be promising strategies to improve clinical outcomes for oral cancer patients, highlighting the importance of preventive measures in oral oncology.
- Postmortem pink teeth in forensic medicine: a scoping review of forensic significance and interpretive limitsPublication . Lopes Cardoso, Inês; Sá, Mariana; Moreira, Teresa; Guimarães, Maria Inês; Barone, Pier MatteoBackground/Objectives: The presence of postmortem pink teeth is a phenomenon occasionally observed during forensic autopsies. This phenomenon has been typically associated with deaths involving drowning, asphyxiation, trauma, or electrocution. However, the recent literature suggests that it is nonspecific. Despite being recognized in forensic literature for decades, its pathophysiology, prevalence, and forensic relevance remain controversial. The existing evidence is scattered and primarily based on case reports, narrative reviews, or isolated observations. This scoping review aims to systematically map the available scientific evidence on the phenomenon of postmortem pink teeth and its potential role in determining the cause of death within the context of forensic medicine. Methods: This review was conducted following the Joanna Briggs Institute (JBI) methodology for scoping reviews and reported according to the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) guidelines. Results: A comprehensive search was carried out across multiple databases to identify studies addressing the occurrence, mechanisms, and forensic interpretation of pink teeth in postmortem examinations. After application of the inclusion and exclusion criteria, the search allowed for the selection of 12 publications (case reports and observational studies). Conclusions: Collected data from the selected studies allowed us to conclude that PTP is a nonspecific taphonomic artifact, lacking diagnostic value in determining the cause of death. Mapping the current evidence on pink teeth contributed to a better understanding of this phenomenon and its lack of forensic significance, promoting more informed decision-making in postmortem assessments.